Academic literature on the topic 'Public welfare Australia History'

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Journal articles on the topic "Public welfare Australia History"

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McKay, Jennifer. "Water institutional reforms in Australia." Water Policy 7, no. 1 (February 1, 2005): 35–52. http://dx.doi.org/10.2166/wp.2005.0003.

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With a brief description of the physical setting and institutional history of the Australian water sector, this paper reviews the water institutional reforms in Australia focusing especially on the nature and extent of reforms initiated since 1995 and provides a few case studies to highlight the issues and challenges in effecting changes in some key reform components. The reforms initiated in 1995 are notable for their comprehensiveness, fiscal incentives and clear and time-bound targets to be achieved. Although water institutions in Australia have undergone remarkable changes, thanks to the reforms, there are still issues and challenges inherent in reforming maturing water institutions. Regional diversity in legal systems and quality standards as well as conflicts between private interest and public welfare are still serious to constraining market-based water allocation and management. While Australia still needs further reforms, its recent reform experience provides considerable insights into the understanding of both the theory and the practice of water institutional reforms.
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Watts, Rob. "Family allowances in Canada and Australia 1940–1945: A comparative critical case study." Journal of Social Policy 16, no. 1 (January 1987): 19–48. http://dx.doi.org/10.1017/s0047279400015713.

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ABSTRACTWhilst quantitive and ‘positivist’ modes of comparative social policy can reveal significant structural factors involved in the making of welfare states, they too often ignore the role of human agency, intention and political processes. A critical-historical comparative case study of the introduction of ‘child endowment’ and of ‘family allowances’ respectively in Australia (1941) and in Canada (1944) reminds us of the interplay between structural constraints and human agency in the history of welfare states. Detailed analysis suggests that institutionalised arrangements in Australia after 1905 to resolve capital-labour conflict via arbitral and wage fixation mechanisms put the question of the adequacy of wages in meeting family needs and with it proposals for child endowment onto the public agenda as early as 1920. In Canada the absence of such mechanisms, and alternative welfare arrangements to deal with family welfare, combined to keep such proposals off the public agenda. After 1939 the development of ‘war economies’ in Australia and Canada created common contradictions for governments, trying to maintain both industrial peace and anti-inflation policies, which the introduction of family allowances in both countries were attempts to resolve. Consideration is also given to a range of political problems and contexts in both countries which this particular policy measure attempted to deal with.
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Wilson, Jacqueline Z. "Beyond the Walls: Sites of Trauma and Suffering, Forgotten Australians and Institutionalisation via Punitive ‘Welfare’." Public History Review 20 (January 4, 2014): 80–93. http://dx.doi.org/10.5130/phrj.v20i0.3748.

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Women’s and children’s welfare and institutionalisation are a neglected area of Australian public history, and the historic sites which operated as carceral venues within that field today stand largely forgotten, in many cases derelict. The prime example of such sites is the Parramatta Female Factory Precinct (PFFP). In practice, Australian women’s and children’s welfare was strongly focused on a punitive approach, resulting in many thousands of vulnerable people suffering significant harm at the hands of their ‘carers’. These victims comprise the group known as the ‘Forgotten Australians’. The article discusses the nature of the relationship between the historic sites and the narratives of individuals who were victims of the system, whether actually incarcerated or merely threatened with such. As a form of case study, the author’s own story of State wardship and her encounters with the welfare system is employed to illustrate the connections between the ‘generic’ stories embodied in the sites, the policies underlying the system, and the nature of institutionalisation. It is argued that immersion in the system can induce a form of institutionalisation in individuals even when they are not actually incarcerated. The effective omission of women’s and children’s welfare and the Forgotten Australians from the forthcoming national Australian Curriculum in History is discussed, with a focus on the potential of the PFFP to be developed as a public history venue emphasizing its educational possibilities as an excursion destination, and a source of public information on the field from convict settlement to the present day.
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Curran, Georgia. "Amanda Harris. Representing Australian Aboriginal Music and Dance, 1930–1970." Context, no. 47 (January 31, 2022): 85–87. http://dx.doi.org/10.46580/cx80760.

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In Representing Australian Aboriginal Music and Dance 1930–1970, Amanda Harris sets out a history of Aboriginal music and dance performances in south-east Australia during the four-decade-long period defined as the Australian assimilation era. During this era, and pushing its boundaries, harsh government policies under the guise of ‘protection’ and ‘welfare’ were designed forcibly to assimilate Aboriginal people into the mainstream population. It is striking while reading this book how few of these stories are widely known, particularly given the heavy influence that Harris uncovers it having on the Australian art music scene of today. As such, the book makes an important contribution to the ‘truth telling’ of Australian history while also showing that—despite the severe policies during this era, including the banning of speaking in Indigenous languages and restricting the performance of ceremony—Aboriginal people have remained active agents in driving their own engagements and asserting their own culturally distinct modes of music and dance performance. This resilience against significant odds has been aptly described by one of the book’s contributors, Yorta Yorta and Dja Dja Warrung cultural leader, visual and performance artist, curator and opera singer Tiriki Onus, as ‘hiding in plain sight,’ referring to the ways in which Aboriginal people ensured the continued practice and performance of their culture by doing so in public, the only place they were allowed to…
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Nevile, John. "Learning from full employment history: The 1945 Australian White Paper in practice." Economic and Labour Relations Review 29, no. 4 (November 19, 2018): 446–58. http://dx.doi.org/10.1177/1035304618810973.

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The part played by unemployment in the rise to power of Hitler weighed on the minds of leaders in Western democracies. There was a determination to create a world in which large-scale unemployment was abnormal and at worst only a temporary phenomenon. The war had shown that this was possible in a community united to pursue a common goal and the aim was to create such a community in a world free from the horrors of war, by creating communities in which the welfare of every person was important. Australia was remarkably successful in achieving this for 30 years. Its success depended on governments responding to any sustained increase in unemployment by undertaking large increases in public sector expenditure supported by accommodating monetary policy and tax cuts if desirable. In bad times as well as good, there was a determination to ensure that both the incomes and prices paid for necessities by the less well-off did not force anyone to live in poverty. The biggest obstacle to achieving this today is the growth of neoliberalism with its emphasis on ‘freedom’ or giving individuals the ability to act as they please with minimal constraints and an ideological commitment to small government. JEL Codes: E02, E61, N1, N4
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Bell, Alan W. "Animal science Down Under: a history of research, development and extension in support of Australia’s livestock industries." Animal Production Science 60, no. 2 (2020): 193. http://dx.doi.org/10.1071/an19161.

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This account of the development and achievements of the animal sciences in Australia is prefaced by a brief history of the livestock industries from 1788 to the present. During the 19th century, progress in industry development was due more to the experience and ingenuity of producers than to the application of scientific principles; the end of the century also saw the establishment of departments of agriculture and agricultural colleges in all Australian colonies (later states). Between the two world wars, the Council for Scientific and Industrial Research was established, including well supported Divisions of Animal Nutrition and Animal Health, and there was significant growth in research and extension capability in the state departments. However, the research capacity of the recently established university Faculties of Agriculture and Veterinary Science was limited by lack of funding and opportunity to offer postgraduate research training. The three decades after 1945 were marked by strong political support for agricultural research, development and extension, visionary scientific leadership, and major growth in research institutions and achievements, partly driven by increased university funding and enrolment of postgraduate students. State-supported extension services for livestock producers peaked during the 1970s. The final decades of the 20th century featured uncertain commodity markets and changing public attitudes to livestock production. There were also important Federal Government initiatives to stabilise industry and government funding of agricultural research, development and extension via the Research and Development Corporations, and to promote efficient use of these resources through creation of the Cooperative Research Centres program. These initiatives led to some outstanding research outcomes for most of the livestock sectors, which continued during the early decades of the 21st century, including the advent of genomic selection for genetic improvement of production and health traits, and greatly increased attention to public interest issues, particularly animal welfare and environmental protection. The new century has also seen development and application of the ‘One Health’ concept to protect livestock, humans and the environment from exotic infectious diseases, and an accelerating trend towards privatisation of extension services. Finally, industry challenges and opportunities are briefly discussed, emphasising those amenable to research, development and extension solutions.
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Clark, Dave, Bill Malcolm, and Joe Jacobs. "Dairying in the Antipodes: recent past, near prospects." Animal Production Science 53, no. 9 (2013): 882. http://dx.doi.org/10.1071/an12281.

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The majority of dairy farmers and processors in Australia and New Zealand are considered world class due to their ability to produce dairy products at a cost that is competitive on the world market without requirement for subsidy. International and domestic forces beyond the farm influence the international competitiveness of Antipodean dairy systems, as much or more than, the within-farm characteristics of the systems. Critical external forces include: world population growth, protein demand from increasingly wealthy developing countries, dairy supply from domestic and international producers, international dairy prices and exchange rate volatility. Within farm, the keys to persistent profitability, business survival, and growth will continue to be management ability and labour skill as well as the relationship between milksolids (milk fat + milk protein) produced per system and total production costs. Domestic forces will include competition for resources such as land, water, quality labour and capital, and public expectation that farms will meet the costs of community environmental and welfare objectives. Public and industry investment in research, development and extension in innovations that increase productivity is essential if dairying is to remain competitive. The operation of the comparative advantage principle determines which industries thrive, or decline, in an economy. New Zealand dairying has a strong comparative advantage over alternative pastoral industries which will continue. In Australia, the comparative advantage of dairy farming over alternative activities is less clear-cut. History shows that the best farmers and processors handle risks such as market and climate volatility and other challenges better than others, and their prospects are positive. However, world class performers in the future dairy industry will certainly not be all, or even the majority, of the current population of dairy farmers.
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Pollard, Irina. "Bioscience-bioethics and life factors affecting reproduction with special reference to the Indigenous Australian population." Reproduction 129, no. 4 (April 2005): 391–402. http://dx.doi.org/10.1530/rep.1.00268.

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The demand for equality of recognition or respect is the dominant passion of modernity. The 20th century experienced a giant leap in technological inventiveness and ruthless use of technological power. In the 21st century, human welfare and environmental wellbeing demand fundamental political appraisal. We have the means, if we choose, to eradicate poverty and to responsibly protect the global environment. However, economic, political and cultural systems act to differentially allocate the benefits and risks for growth between socioeconomic groups. For example, it is a matter of pride that the neonatal mortality rate in affluent societies has dropped substantially since the late 1970s. However, the level of infant mortality (three times the national average) and low birthweight (13%) among the Indigenous Australian population is the highest in the country. With hindsight we now know that is the inevitable legacy of Australia’s colonial history. Chronic physical and psychological stress is recognized as an important etiological factor in many lifestyle diseases of the cardiovascular, immune and reproductive systems. Diseases of adaptation are further advanced by non-adaptive lifestyle choices, depression, alcoholism and other drug dependencies. This review describes the principles of bioscience ethics and targets equity issues as they affect human reproduction across generations with particular reference to the Indigenous population of Australia. The review also considers ways we may advance global and cultural maturity from the Indigenous Australian perspective and proposes an ecologically based model of preventative care. If we are to embrace fundamental social change and protect future children without threatening parents’ basic freedoms, then new beliefs and priorities – based on a compassionate understanding of biological systems – must evolve from the general public. Belief in human rights arising from a sense of human dignity is a collective outcome originating from individual commitment. The golden rule; that is, Nature’s principle of reciprocity, is fundamental in bridging the gap between knowledge and effective action.
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Bessant, Judith. "Professional credibility and public trust in those working with young people." Children Australia 29, no. 2 (2004): 5–13. http://dx.doi.org/10.1017/s1035077200005952.

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As the embarrassment and shame around the ‘resignation’ of our last Governor-General indicates, the abuse of children and young people has become a major public issue. An increasing body of Australian research reveals a history of violence against young people while media reports reveal a history of serious physical and sexual abuse and exploitation of young people by professionals responsible for their care and protection.Moreover much of this systemic abuse took place in educational and welfare sectors that were and are relatively unregulated in respect to the professionalisation of workers. While there are now formal professional registration processes affecting teachers and psychologists, there is no equivalent for youth workers, social workers or community development workers.The disclosures of abuse and neglect revealed the suffering and harm experienced by young people, and in turn seriously damaged the professional standing of those working with young people, as well as the public trust traditionally conferred on professions and institutions.I argue that restoring public trust in the institutions and services where abuse took place, and indeed may still be happening, is an issue of considerable importance.I critically review the conditions necessary for restoring public trust. Those conditions include improved governance and systematic improvements in the intellectual and professional education of youth workers to ensure that they have the requisite capabilities such as critical insight, advocacy skills and political resolve. The value of establishing a code of professional practice ethics is also considered.Finally it is argued that advocating for young people's rights is another means of securing their well-being and workers' professional standing. I point out, however, that the rights option is somewhat limited because, although it obligates, it does not specify who owes the obligation, and for this reason rights talk too often remains ineffectual because it's abstracted. I suggest that the identification of obligations is also necessary for securing public trust and young people's well-being because, unlike rights, they specify who is bound and to whom the obligation is owed.
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Fidelis, Małgorzata. "Odzyskać liberalizm. Recenzja książki Andrzeja Walickiego "Od projektu komunistycznego do neoliberalnej utopii", Warszawa: Universitas 2013." Studia Litteraria et Historica, no. 3–4 (January 31, 2016): 297–304. http://dx.doi.org/10.11649/slh.2015.016.

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To Recover Liberalism. Review of a book by Andrzej Walicki Od projektu komunistycznego do neoliberalnej utopii (From the Communist Project to the Neoliberal Utopia), Warszawa: Universitas 2013This review discusses a recent book by Andrzej Walicki, Od projektu komunistycznego do neoliberalnej utopii (From the Communist Project to the Neoliberal Utopia) (Warszawa: Universitas 2013). The book features a collection of essays, interviews, and scholarly articles published by Walicki in academic and popular journals between 2001 and 2012. Topics include a history of the communist project in a broader European perspective; the significance and legacy of de-Stalinization in Poland, with a particular emphasis on what the author calls "the Polish road away from communism" after 1956; right-wing conservative politics in Poland after 1989, the politicization of the memory of communism; and possible directions for the development of the Polish Left as a necessary component of a healthy democratic system. The compelling scholarly discussion is often combined with autobiographical sketches of an intellectual who has been deeply engaged in intellectual and social life in postwar Poland. Walicki, a prominent intellectual and specialist on intellectual history, studied and worked in Warsaw until he emigrated to Australia and then the United States (The University of Notre Dame) in the 1980s. In that sense, Walicki provides a unique perspective on Polish history and culture, influenced by both Polish and American academic worlds and intellectual traditions. The strength of the book is its focus on the role of language and the manipulation of terms such as "communism" or "liberalism" by contemporary political leaders in Poland to achieve specific emotional reactions from the public. One of the central claims of the book is that Polish political elites have "distorted" the meaning of liberalism by connecting it solely to the free market rather than to the original idea of individual freedoms. In this way, the dominant conservative elites in Poland are able to depict human rights and the welfare state as alien to the “Polish” tradition, supposedly exclusively Catholic and socially conservative. Walicki points to the need to recover the rich history of the Polish Left as well as to restore the original meaning and value of liberalism in shaping Polish democracy. Odzyskać liberalizm. Recenzja książki Andrzeja Walickiego Od projektu komunistycznego do neoliberalnej utopii, Warszawa: Universitas 2013Recenzja omawia najnowszą książkę Andrzeja Walickiego Od projektu komunistycznego do neoliberalnej utopii (Warszawa: Universitas 2013). Książka to zbiór esejów, wywiadów oraz artykułów naukowych publikowanych przez A. Walickiego zarówno w czasopismach naukowych, jak i popularnych w latach 2001-2012. Tematyka prac dotyczy: historii projektu komunistycznego w szerszej, europejskiej perspektywie; znaczenia i spuścizny destalinizacji w Polsce ze szczególnym naciskiem na to, co sam autor nazywa „polską drogą od komunizmu” po 1956 roku; prawicowej, konserwatywnej polityki w Polsce po roku 1989; polityzacji pamięci komunizmu oraz możliwych dróg rozwoju polskiej lewicy jako niezbędnego elementu zdrowego systemu demokratycznego.Interesująca dyskusja naukowa jest często połączona z autobiograficznymi szkicami autora, który angażował się w życie intelektualne i społeczne powojennej Polski. Andrzej Walicki, prominentny intelektualista i historyk idei, studiował i pracował naukowo na Uniwersytecie Warszawskim do lat osiemdziesiątych, kiedy wyemigrował do Australii, a następnie do USA na Uniwersytet Notre Dame. Z tego punktu widzenia Walicki dostarcza nam wyjątkowego spojrzenia na Polską historię i kulturę, ukształtowanego zarówno przez polską, jak i amerykańską tradycję intelektualną i oba akademickie światy. Siłą książki jest koncentracja autora na roli języka i manipulowaniu terminami takimi, jak „komunizm” czy „liberalizm”, przez współczesnych politycznych liderów w Polsce po to, aby osiągnąć określoną reakcję emocjonalną odbiorców. Jedno z kluczowych twierdzeń książki dotyczy zniekształcenia znaczenia pojęcia „liberalizm” przez polskie elity intelektualne i polityczne poprzez połączenie go wyłącznie z wolnym rynkiem zamiast z oryginalną ideą wolności jednostki. W ten sposób dominujące konserwatywne elity w Polsce są w stanie przedstawić prawa człowieka oraz państwo opiekuńcze jako obce „polskiej” tradycji, z założenia wyłącznie katolickiej i społecznie konserwatywnej. Walicki wskazuje na potrzebę ponownego odkrycia bogatej historii polskiej lewicy, przywrócenia pierwotnych wartości liberalizmowi i odrestaurowania jego znaczenia w kształtowaniu polskiej demokracji.
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Dissertations / Theses on the topic "Public welfare Australia History"

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Ilbiz, Ethem. "The impact of the European Union on Turkish counter-terrorism policy towards the Kurdistan Workers Party." Thesis, University of Nottingham, 2014. http://eprints.nottingham.ac.uk/14280/.

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This study seeks to examine the impact of the EU on Turkish counter-terrorism policies towards the Kurdistan Workers Party (PKK). It analyses what impact it has had within three distinct periods: the pre-Helsinki European Council (1984-1999) period, the post-Helsinki European Council (1999-2004) period, and the post-Brussels European Council (2004-2013) period. It conceptualizes and empirically investigates the EU’s norm diffusion role by relying on the concept of “Rule Adoption”, and by utilising two norm diffusion mechanisms: the “Conditionality” and the “Socialization” mechanism, and their domestic and EU-level determinants. The thesis argues that when the EU has promoted democratisation in Turkey, it has also implicitly impacted on Turkey’s counter-terrorism policies. It argues for this thesis by generalizing from the following empirical findings: When the EU has provided a credible membership prospect to Turkey, and when the PKK attacks have been at a low-level, then the EU conditionality mechanism has been influential on Turkey’s adoption of EU promoted norms. However, when there has been no membership prospect and high levels of PKK violence, it has been the openness of Turkish political actors that has resulted in rule adoption, in which the social learning of the Turkish political actors has led to the adoption of EU promoted norms as an appropriate way to solve existing terrorism problems.
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Gleeson, Damian John School of History UNSW. "The professionalisation of Australian catholic social welfare, 1920-1985." Awarded by:University of New South Wales. School of History, 2006. http://handle.unsw.edu.au/1959.4/26952.

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This thesis explores the neglected history of Australian Catholic social welfare, focusing on the period, 1920-85. Central to this study is a comparative analysis of diocesan welfare bureaux (Centacare), especially the Sydney, Melbourne and Adelaide agencies. Starting with the origins of professional welfare at local levels, this thesis shows the growth in Catholic welfare services across Australia. The significant transition from voluntary to professional Catholic welfare in Australia is a key theme. Lay trained women inspired the transformation in the church???s welfare services. Prepared predominantly by their American training, these women devoted their lives to fostering social work in the Church and within the broader community. The women demonstrated vision and tenacity in introducing new policies and practices across the disparate and unco-ordinated Australian Catholic welfare sector. Their determination challenged the status quo, especially the church???s preference for institutionalisation of children, though they packaged their reforms with compassion and pragmatism. Trained social workers offered specialised guidance though such efforts were often not appreciated before the 1960s. New approaches to welfare and the co-ordination of services attracted varying degrees of resistance and opposition from traditional Catholic charity providers: religious orders and the voluntary-based St Vincent de Paul Society (SVdP). For much of the period under review diocesan bureaux experienced close scrutiny from their ordinaries (bishops), regular financial difficulties, and competition from other church-based charities for status and funding. Following the lead of lay women, clerics such as Bishop Algy Thomas, Monsignor Frank McCosker and Fr Peter Phibbs (Sydney); Bishop Eric Perkins (Melbourne), Frs Terry Holland and Luke Roberts (Adelaide), consolidated Catholic social welfare. For four decades an unprecedented Sydney-Melbourne partnership between McCosker and Perkins had a major impact on Catholic social policy, through peak bodies such as the National Catholic Welfare Committee and its successor the Australian Catholic Social Welfare Commission. The intersection between church and state is examined in terms of welfare policies and state aid for service delivery. Peak bodies secured state aid for the church???s welfare agencies, which, given insufficient church funding proved crucial by the mid 1980s.
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O'Donnell, David O'Donnell, and n/a. "Re-staging history : historiographic drama from New Zealand and Australia." University of Otago. Department of English, 1999. http://adt.otago.ac.nz./public/adt-NZDU20070523.151011.

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Since the 1980s, there has been an increasing emphasis on drama, in live theatre and on film, which re-addresses the ways in which the post-colonial histories of Australia and New Zealand have been written. Why is there such a focus on �historical� drama in these countries at the end of the twentieth century and what does this drama contribute to wider debates about post-colonial history? This thesis aims both to explore the connections between drama and history, and to analyse the interface between live and recorded drama. In order to discuss these issues, I have used the work of theatre and film critics and historians, supplemented by reference to writers working in the field of post-colonial and performance theory. In particular, I have utilised the methods of Helen Gilbert and Joanne Tompkins in Post-Colonial Drama: Theory, Practice, Politics, beginning with their claim that in the post-colonial situation history has been seen to determine reality itself. I have also drawn on theorists such as Michel Foucault, Linda Hutcheon and Guy Debord who question the �truth� value of official history-writing and emphasize the role of representation in determining popular perceptions of the past. This discussion is developed through reference to contemporary performance theory, particularly the work of Richard Schechner and Marvin Carlson, in order to suggest that there is no clear separation between performance and reality, and that access to history is only possible through re-enactments of it, whether in written or performative forms. Chapter One is a survey of the development of �historical� drama in theatre and film from New Zealand and Australia. This includes discussion of the diverse cultural and performative traditions which influence this drama, and establishment of the critical methodologies to be used in the thesis. Chapter Two examines four plays which are intercultural re-writings of canonical texts from the European dramatic tradition. In this chapter I analyse the formal and thematic strategies in each of these plays in relation to the source texts, and ask to what extent they function as canonical counter-discourse by offering a critique of the assumptions of the earlier play from a post-colonial perspective. The potential of dramatic representation in forming perceptions of reality has made it an attractive forum for Maori and Aboriginal artists, who are creating theatre which has both a political and a pedagogical function. This discussion demonstrates that much of the impetus towards historiographic drama in both countries has come from Maori and Aboriginal writers and directors working in collaboration with white practitioners. Such collaborations not only advance the project of historiographic drama, but also may form the basis of future theatre practice which departs from the Western tradition and is unique to each of New Zealand and Australia. In Chapter Three I explore the interface between live and recorded performance by comparing plays and films which dramatise similar historical material. I consider the relative effectiveness of theatre and film as media for historiographic critique. I suggest that although film often has a greater cultural impact than theatre, to date live theatre has been a more accessible form of expression for Maori and Aboriginal writers and directors. Furthermore, following theorists such as Brecht and Brook, I argue that such aspects as the presence of the live performer and the design of the physical space shared by actors and audience give theatre considerable potential for creating an immediate engagement with historiographic themes. In Chapter Four, I discuss two contrasting examples of recorded drama in order to highlight the potential of film and television as media for historiographic critique. I question the divisions between the documentary and dramatic genres, and use Derrida�s notion of play to suggest that there is a constant slippage between the dramatic and the real, between the past and the present. In Chapter Five, I summarize the arguments advanced in previous chapters, using the example of the national museum of New Zealand, Te Papa Tongarewa, to illustrate that the �performance� of history has become part of popular culture. Like the interactive displays at Te Papa, the texts studied in this thesis demonstrate that dramatic representation has the potential to re-define perceptions of historical �reality�. With its superior capacity for creating illusion, film is a dynamic medium for exploring the imaginative process of history is that in the live performance the spectator symbolically comes into the presence of the past.
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McGuire, Linda. "Counting quality or qualities that count? : an inquiry into performance reporting for professional public services in Australia." Monash University, Dept. of Management, 2004. http://arrow.monash.edu.au/hdl/1959.1/5247.

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McCarthy, Dayton. "The once and future army an organizational, political, and social history of the Citizen Military Forces, 1947-1974/." Connect to this title online, 1997. http://www.library.unsw.edu.au/~thesis/adt-ADFA/public/adt-ADFA20020722.120746/.

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Alsabah, Mohammad. "Welfare Economics and Public Policy in Early 20th Century Great Britain." Scholarship @ Claremont, 2017. http://scholarship.claremont.edu/cmc_theses/1723.

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The Liberal welfare reforms were a series of bills passed in the British Parliament in the early twentieth-century. Initiated in response to a number of pressing economic and social issues, the Liberal welfare reforms were legislated with the purpose of combating poverty and improving the livelihood of the British working-class citizen. This thesis in economics outlines and examines critically the economic design behind the Liberal welfare reforms between 1906 and 1914.
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Featherstone, Lisa. "Breeding and feeding: a social history of mothers and medicine in Australia, 1880-1925." Australia : Macquarie University, 2003. http://hdl.handle.net/1959.14/38533.

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Thesis (PhD)--Macquarie University, Division of Humanities, Department of Modern History, 2003.
Bibliography: p. 417-478.
Introduction: breeding and feeding -- The medical man: sex, science and society -- Confined: women and obstetrics 1880-1899 -- The kindest cut? The caesarean section as turning point -- Reproduction in decline -- Resisting reproduction: women, doctors and abortion -- From obstetrics to paediatrics: the rise of the child -- The breast was best: medicine and maternal breastfeeding -- The deadly bottle and the dangers of the wet nurse: the "artificial" feeding of infants -- Surveillance and the mother -- Mothers and medicine: paradigms of continuity and change.
The late nineteenth and early twentieth centuries saw profound changes in Australian attitudes towards maternity. Imbibed with discourses of pronatalism and eugenics, the production of infants became increasingly important to society and the state. Discourses proliferated on "breeding", and while it appeared maternity was exulted, the child, not the mother, was of ultimate interest. -- This thesis will examine the ways wider discourses of population impacted on childbearing, and very specifically the ways discussions of the nation impacted on medicine. Despite its apparent objectivity, medical science both absorbed and created pronatalism. Within medical ideology, where once the mother had been the point of interest, the primary focus of medical care, increasingly medical science focussed on the life of the infant, who was now all the more precious in the role of new life for the nation. -- While all childbirth and child-rearing advice was formed and mediated by such rhetoric, this thesis will examine certain key issues, including the rise of the caesarean section, the development of paediatrics and the turn to antenatal care. These turning points can be read as signifiers of attitudes towards women and the maternal body, and provide critical material for a reading of the complexities of representations of mothers in medical discourse.
Mode of access: World Wide Web.
478 p
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Sendziuk, Paul 1974. "Learning to trust : a history of Australian responses to AIDS." Monash University, School of Historical Studies, 2001. http://arrow.monash.edu.au/hdl/1959.1/9264.

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Shafer, Linda K. "Rethinking the history of social welfare policy : poverty, citizenship and ideology in antebellum debates /." view abstract or download file of text, 2000. http://wwwlib.umi.com/cr/uoregon/fullcit?p9986758.

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Thesis (Ph. D.)--University of Oregon, 2000.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 253-266). Also available for download via the World Wide Web; free to University of Oregon users.
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Radbone, Ian. "A history of land transport regulation in South Australia : the relevance of public choice theory." Title page, contents and summary only, 1989. http://web4.library.adelaide.edu.au/theses/09PH/09phr124.pdf.

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Books on the topic "Public welfare Australia History"

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1937-, Martin Elaine, and Oxenberry Rod 1943-, eds. Rations, residence, resources: A history of social welfare in South Australia since 1836. Netley, S. Aust: Wakefield Press, 1986.

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A decent provision: Australia welfare policy, 1870 to 1949. Burlington, VT: Ashgate, 2011.

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The working class and welfare: Reflections on the political development of the welfare state in Australia and New Zealand, 1890-1980. Wellington: Allen & Unwin, 1985.

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Ternowetsky, Gordon W. Labour market restructuring and the public safety net: Current trends in the Australian and Canadian welfare state. Regina: Social Administration Research Unit, Faculty of Social Work, University of Regina, 1993.

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Out of luck: Poor Australians and social welfare, 1788-1988. Sydney: Allen & Unwin, 1990.

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author, Gillespie James, ed. Making Medicare: The politics of universal health care in Australia. Sydney, N.S.W: NewSouth Publishing, 2013.

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Welfare, Australian Institute of Health and. Welfare expenditure Australia 2002-03. Canberra, ACT: Australian Institute of Health and Welfare, 2005.

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The politics of Australian child care: From philanthropy to feminism. Cambridge: Cambridge University Press, 1994.

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The politics of Australian child care: Philanthropy to feminism and beyond. Cambridge: Cambridge University Press, 1998.

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Peter, Saunders. Welfare and inequality: National and international perspectives on the Australian welfare state. Cambridge, UK: Cambridge University Press, 1994.

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Book chapters on the topic "Public welfare Australia History"

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Lynch, Gordon. "‘A Serious Injustice to the Individual’: British Child Migration to Australia as Policy Failure." In UK Child Migration to Australia, 1945-1970, 1–22. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-69728-0_1.

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AbstractThe Introduction sets this book in the wider context of recent studies and public interest in historic child abuse. Noting other international cases of child abuse in the context of public programmes and other institutional contexts, it is argued that children’s suffering usually arose not from an absence of policy and legal protections but a failure to implement these effectively. The assisted migration of unaccompanied children from the United Kingdom to Australia is presented, particularly in the post-war period, as another such example of systemic failures to maintain known standards of child welfare. The focus of the book on policy decisions and administrative systems within the UK Government is explained and the relevance of this study to the historiography of child migration and post-war child welfare is also set out.
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Lynch, Gordon. "‘Avoiding Fruitless Controversy’: UK Child Migration and the Anatomy of Policy Failure." In UK Child Migration to Australia, 1945-1970, 299–317. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-69728-0_8.

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AbstractThis concluding chapter explores why it was that post-war child migration to Australia was allowed to resume and continue by the UK Government despite known failings in these schemes. It is argued that one factor was the sheer administrative complexity of a multi-agency programme operating over different national jurisdictions and large distances which made control and oversight of conditions for British child migrants harder to achieve. Despite concerns that the post-war welfare state would be a powerful, centralised mechanism, the history of these programmes demonstrates British policy-makers’ sense of the limits of their powers—limits arising from lack of resource, the perceived need to avoid unproductive conflict with powerful stakeholders, the wish to respect boundaries of departmental policy remits and assumptions about the value of following policy precedents. The chapter concludes by considering how fine-grained analyses of such policy failures can contribute to public debates about suitable redress.
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Searle, Robert J. "Fiscal Federalism in Australia." In The Welfare State, Public Investment, and Growth, 295–324. Tokyo: Springer Japan, 1998. http://dx.doi.org/10.1007/978-4-431-67939-4_15.

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White, Steven. "Animal Protection Law in Australia: Bound by History." In Animal Law and Welfare - International Perspectives, 109–29. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-26818-7_6.

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Struyven, Ludo. "Varieties of Market Competition in Public Employment Services - A Comparison of the Emergence and Evolution of the New System in Australia, the Netherlands and Belgium." In Contracting-out Welfare Services, 33–53. Chichester, UK: John Wiley & Sons, Ltd, 2015. http://dx.doi.org/10.1002/9781119016458.ch2.

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Villalta Puig, Gonzalo. "The Judicial History of the Federal Market of Australia: Free Trade Versus Free Enterprise." In World Trade and Local Public Interest, 155–72. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41920-2_9.

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Thomson, Sue. "Australia: PISA Australia—Excellence and Equity?" In Improving a Country’s Education, 25–47. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-59031-4_2.

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AbstractAustralia’s education system reflects its history of federalism. State and territory governments are responsible for administering education within their jurisdiction and across the sector comprising government (public), Catholic systemic and other independent schooling systems. They collaborate on education policy with the federal government. Over the past two decades the federal government has taken a greater role in funding across the education sector, and as a result of this involvement and the priorities of federal governments of the day, Australia now has one of the highest rates of non-government schooling in the OECD. Funding equity across the sectors has become a prominent issue. Concerns have been compounded by evidence of declining student performance since Australia’s initial participation in PISA in 2000, and the increasing gap between our high achievers and low achievers. This chapter explores Australia’s PISA 2018 results and what they reveal about the impact of socioeconomic level on student achievement. It also considers the role of school funding and the need to direct support to those schools that are attempting to educate the greater proportion of an increasingly diverse student population including students facing multiple layers of disadvantage.
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Dellios, Alexandra. "Personal, Public Pasts: Negotiating Migrant Heritage—Heritage Practice and Migration History in Australia." In Remembering Migration, 219–36. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-17751-5_15.

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Kirchhelle, Claas. "Ruth the Ruthless: Activism, Welfare, and Generational Change." In Palgrave Studies in the History of Social Movements, 149–74. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-62792-8_9.

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AbstractThis chapter studies the polarisation of 1970s’ British farm animal welfare politics and Ruth Harrison’s career as a full-time public campaigner on the RSPCA Council and as head of her own welfare Trust. Polarised conflicts triggered a professionalisation of RSPCA campaigning. The Society adopted new public pressure tactics, established expert committees, and started commissioning behavioural research. Internal tensions over elite “field sports” also led to the formation of the RSPCA Reform Group. Reform Group members oversaw a streamlining of RSPCA management and leadership. They also popularised animal rights thinking. Ruth Harrison supported opposition to “field sports” and helped trigger the internal crisis that led to the Reform Group’s formation. However, tensions over her role on FAWAC and her focus on gradualist reforms isolated Harrison. Forced to declare bankruptcy after a libel suit against another Council member, Harrison focused on developing her own Farm Animal Care Trust (FACT).
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Kirchhelle, Claas. "From Protest to ‘Holy Writ’: The Mainstreaming of Welfare Politics." In Palgrave Studies in the History of Social Movements, 205–22. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-62792-8_11.

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AbstractThis chapter examines the evolution of British farm animal welfare politics during the last two decades of Harrison’s campaigning. In 1979, the RSPCA boycotted the Thatcher government’s new Farm Animal Welfare Council (FAWC). The short-lived protest triggered a membership revolt and moderation of RSPCA policies. It also coincided with a weakening of agricultural corporatism in Westminster. FAWC was granted relative independence from the Ministry of Agriculture, Fisheries, and Food and explicitly acknowledged an updated version of the five freedoms. Ensuing British welfare reforms were also driven by the increasing involvement of European bodies in animal welfare. Now in her 60s, Ruth Harrison joined FAWC as a welfare member. Her increasing public recognition as a senior welfare campaigner enabled her to proactively push for reforms, expand her fundraising activities, and sponsor additional welfare research. By the late 1990s, most of her welfare positions had become part of mainstream politics.
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Conference papers on the topic "Public welfare Australia History"

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Dmitriyev, Alexey. "The Welfare of Each and Everyone in Russian Legal Theory." In The Public/Private in Modern Civilization, the 22nd Russian Scientific-Practical Conference (with international participation) (Yekaterinburg, April 16-17, 2020). Liberal Arts University – University for Humanities, Yekaterinburg, 2020. http://dx.doi.org/10.35853/ufh-public/private-2020-24.

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The prerequisite for the study was the spread of views in the academic literature that the category of public welfare, without accounting for concretising factors, was a void abstraction, and that in Russia, public welfare was seen as the dominant principle over the individual. The main purpose of the study is to analyse the content of the term ‘the welfare of each and everyone’ in Russian legal theory. The author uses the methods of conceptual history and intellectual history to analyse the concept of ‘the welfare of each and everyone’ in the works of pre-revolutionary authors and the relationship between the concepts of ‘the welfare of each and everyone’ and ‘the common good’. The author determined that: ‘public welfare’ can be classified as fiction, purpose, method, interest and balance, depending on the context of use and semantic scope. The term ‘the welfare of each and every one’ became theoretically meaningful (as an objective, method, and interest), and was enshrined in law in Russian Empire in the XVIII -early XX centuries. The term was understood as achieving the common good, preserving the good of everyone and the reduction of public harm. Twentyfirst century Russian legal theory uses the related notion of ‘public welfare’, understood as a fiction, a goal, a method, an interest, a balance. The main findings of the study suggest that today the ‘public welfare’ is reduced to bringing benefits to anyone and everyone (D. I. Dedov), which is close to the historical understanding of ‘the welfare of each and every one’. The public welfare theory incorporates progressive elements such as the veil of ignorance, the win-win principle, and shapes institutions, resources, practices and formulates the issue of the emergence of a new generation of human rights.
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Stevens, Quentin. "A Brief History of the Short-Term Parklet in Australia." In The 38th Annual Conference of the Society of Architectural Historians Australia and New Zealand. online: SAHANZ, 2022. http://dx.doi.org/10.55939/a4018pognw.

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This paper examines the history within Australia of the ‘parklet’, a small architecturally-framed open space installed temporarily on an on-street car-parking space. The paper traces parklets’ varied and evolving forms, materials, production processes and functions. It examines how parklets have adapted to rapidly-changing social needs and priorities for economic activity, health, safety, socialising and on-street parking, and changes in street function. The contemporary parklet began in 2005 as a localised, grassroots activity to temporarily reclaim street space for public leisure, as part of the wider movement of ‘tactical urbanism’. Parklets rapidly became a worldwide phenomenon. Starting in 2008, parklets were absorbed into institutional urban planning practice, as a strategic tool to enhance community engagement, test possibilities, and win support for longer-term spatial transformations. From 2012, commercial parklet programs were developed in Australian cities to encourage local businesses to expand into street parking spaces, to calm traffic and enhance pedestrian amenity. A new generation of commercial ‘café parklets’ has emerged during the COVID-19 pandemic, facilitated by local governments, to support the heavily-impacted hospitality industry. Their design and construction show ongoing innovation, increasing scale and professionalism, but also standardisation. This paper draws on diverse Australian parklet examples to chart the emergence of varying approaches to their design and construction, which draw upon different materials, skills, local government strategies and international precedents. The findings also illustrate several convergences in the evolution of parklet design across different Australian cities, due to strong similarities in the spatial contexts, needs, risk factors, and technologies that have defined this practice.
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Sitorukmi, Galuh, Bhisma Murti, and Yulia Lanti Retno Dewi. "Effect of Family History with Diabetes Mellitus on the Risk of Gestational Diabetes Mellitus: A Meta-Analysis." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.05.55.

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Background: Gestational diabetes mellitus (GDM) is a serious pregnancy complication, in which women without previously diagnosed diabetes develop chronic hyperglycemia during gestation. Studies have revealed that the family history of diabetes is an important risk factor for the gestational diabetes mellitus. The purpose of this study was to investigate effect of family history with diabetes mellitus on the risk of gestational diabetes mellitus. Subjects and Method: This was meta-analysis and systematic review. The study was conducted by collecting published articles from Pubmed, Google Scholar, Scopus, Science Direct, and Springer Link electronic databases, from year 2010 to 2020. Keywords used risk factor, gestational diabetes mellitus, family history, and cross-sectional. The inclusion criteria were full text, using English language, using cross-sectional study design, and reporting adjusted odds ratio. The study population was pregnant women. Intervention was family history of diabetes mellitus with comparison no family history of diabetes mellitus. The study outcome was gestational diabetes mellitus. The collected articles were selected by PRISMA flow chart. The quantitative data were analyzed by random effect model using Revman 5.3. Results: 7 studies from Ethiopia, Malaysia, Philippines, Peru, Australia, and Tanzania were selected for this study. This study reported that family history of diabetes mellitus increased the risk of gestational diabetes mellitus 2.91 times than without family history (aOR= 2.91; 95% CI= 2.08 to 4.08; p<0.001). Conclusion: Family history of diabetes mellitus increases the risk of gestational diabetes mellitus. Keywords: gestational diabetes mellitus, diabetes mellitus, family history Correspondence: Galuh Sitorukmi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: galuh.sitorukmi1210@gmail.com. Mobile: 085799333013. DOI: https://doi.org/10.26911/the7thicph.05.55
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Wardani, Arista Kusuma. "Interprofessional Collaboration on Mental Health: A Scoping Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.26.

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ABSTRACT Background: The increasing prevalence rate of mental illness due to demographic changes became the burden of disease in primary health care. Effective interprofessional collaboration strategies are required to improve professional welfare and quality of care. Interdisciplinary teamwork plays an important role in the treatment of chronic care, including mental illness. This scoping review aimed to investigate the benefit and barrier of interprofessional collaboration approach to mental health care. Subjects and Method: A scoping review method was conducted in eight stages including (1) Identification of study problems; (2) Determining priority problem and study question; (3) Determining framework; (4) Literature searching; (5) Article selection; (6) Critical appraisal; (7) Data extraction; and (8) Mapping. The search included PubMed, Science­Direct, and Willey Online library databases. The inclusion criteria were English-language, full-text, and free access articles published between 2010 and 2020. The data were reported by the PRISMA flow chart. Results: A total of 316 articles obtained from the search databases, in which 263 articles unmet the inclusion criteria and 53 duplicates were excluded. Based on the selected seven articles, one article from a developed country (Malaysia), and six articles from developing countries (Australia, Canada, Belgium, Norway) with quantitative (cross-sectional, surveil­lance) and qualitative study designs. The reviewed findings were benefit and barrier of interprofessional collaboration on mental health. Benefits included improve quality of care, increase job satisfaction, improve patient health status, increase staff satisfaction, increase performance motivation among employees, as well as shorter duration of treat­ment and lower cost. Barriers included hierarchy culture, lack of resources, lack of time, poor communication, and inadequate training. Conclusion: Interprofessional teamwork and collaboration have been considered an essential solution for effective mental health care. Keywords: interprofessional collaboration, benefit, barrier, mental health Correspondence: Arista Kusuma Wardani. Universitas ‘Aisyiyah Yogyakarta. Jl. Siliwangi (Ring Road Barat) No. 63 Mlangi, Nogotirto, Gamping, Sleman, Yogyakarta, 55292. Email: wardanikusuma­1313@gmail.com. Mobile: +6281805204773 DOI: https://doi.org/10.26911/the7thicph.04.26
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Hogben, Paul. "The Making of a Newcastle Modernist: The Early House Designs of Sydney C. Morton." In The 38th Annual Conference of the Society of Architectural Historians Australia and New Zealand. online: SAHANZ, 2022. http://dx.doi.org/10.55939/a3982p26oy.

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In his article series “Modern Homes of Newcastle”, published in the Newcastle Morning Herald between 1961 and 1964, journalist Alan Farrelly wrote about the contemporary domestic architecture of Newcastle and its surrounds and in doing so brought public attention to the work of a generation of the city’s younger architects. Prominent amongst these was Sydney Charles Morton who had four houses of his own design featured in the series. These houses stand out for their bold modernist appearance involving stark rectilinear forms, light-weight construction, flat roofs and large amounts of glazing. For readers of the newspaper, they were an illustration of how far residential design in their region had come. This paper looks at the pre-history of these houses in the early domestic work of Morton which included the design of ‘Orana’, or what locally became known as “the chicken coop”. In the context of early 1950s Newcastle, where pitched roof, brick and tile homes were standard, ‘Orana’ certainly represented a radical departure and rethinking of the modern house. Like that of many of his generation, Morton’s work, and in particular his breakthrough project in ‘Orana’, occupies a position of ‘ultra’ defiance against convention. The aim of this paper is to understand how this position developed and grew in strength within his time as a student at Sydney Technical College and within his early practice.
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Mazur-Kumrić, Nives, and Ivan Zeko-Pivač. "TRIGGERING EMERGENCY PROCEDURES: A CRITICAL OVERVIEW OF THE EU’S AND UN'S RESPONSE TO THE COVID-19 PANDEMIC AND BEYOND." In EU 2021 – The future of the EU in and after the pandemic. Faculty of Law, Josip Juraj Strossmayer University of Osijek, 2021. http://dx.doi.org/10.25234/eclic/18300.

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The large-scale COVID-19 pandemic is a severe public health emergency which poses distressing social and economic challenges to the international community as a whole. In order to provide immediate and effective support to affected welfare and healthcare systems as well as to build their lasting, inclusive and sustainable recovery, both the European Union and the United Nations have introduced a number of urgent measures aiming to help and protect citizens and economies. This paper looks into the specificities of urgent procedures launched and carried out by the two most influential international organisations with a view to rapidly respond to the unprecedented COVID-19 crisis. More specifically, it focuses on the involved institutions and steps of urgent procedures as well as on their most remarkable outcomes. In the case of the European Union, the emphasis is put primarily on two Coronavirus Response Investment Initiatives (CRIIs), adopted during the Croatian Presidency of the Council in one of the fastest legal procedures in the history of the European Union, and the Recovery Assistance for Cohesion and the Territories of Europe (REACT-EU) as an extension of the CRIIs’ crisis repair measures. The overarching United Nations’ response is assessed through an analysis of its urgent policy agenda developed on the premise that the COVID-19 pandemic is not only a health and socio-economic emergency but also a global humanitarian, security and human rights crisis. This particularly includes procedures foreseen by the Global Humanitarian Response Plan (GHRP) and the Strategic Preparedness and Response Plan (SPRP). In addition, the aim of the paper is to provide a critical overview of the subject by highlighting three pivotal elements. First, the paper sheds light on the financial aspects of the urgent fight against the COVID-19 pandemic, necessary for turning words into action. Notably, this refers to funds secured by the Multiannual Financial Frameworks 2014-2020 and 2021-2027, and the Next Generation EU recovery instrument, on the one hand, and the UN COVID-19 Response and Recovery Fund, the UN Central Emergency Response Fund and the Solidarity Response Fund, on the other hand. Second, it offers a comparative evaluation of the end results of the European and global emergency procedures in mitigating the impacts of the COVID-19 pandemic. Finally, it summarises the underlying elements of measures governing the aftermath of the ongoing crisis, i.e. those promoting a human-centred, green, sustainable, inclusive and digital approach to future life.
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Reports on the topic "Public welfare Australia History"

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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.

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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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