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The production of sociological knowledge in Australian universities is explored through an empirical study of research papers published in a selection of academic outlets between 1960 and 2011. Drawing on theories concerning scholarly practices, institutional formation and the sociology of knowledge, questions are posed about the factors that shape and structure the production of sociological knowledge about health and medicine. The concept of intellectual schools is examined, with evidence sought for the presence of these 'knowledge networks' in the Australian context. The study suggests the formation and maintenance of schools are subject to structural factors within the university sector, specifically the relative wealth and prestige of the university and the dictates of the higher education market. [ABSTRACT FROM AUTHOR]

Objectives: The study is an exploratory study of a media event in Australia based on the publication of two separate systematic analyses of complementary medicine (CM) therapies. The objective of the study was to measure the scientific quality of Australian newspaper media reports about two international peer-reviewed research papers reporting results on complementary medicines published in biomedical journals during Feb/March 2007. For purposes of clarity, we refer to the papers as the ‘Antioxidant Study’ (Bjelakovic et al 2007) and the ‘Prenatal Multivitamin Study’ (Goh et al 2007). Methods: We sourced articles that were published about the two research papers in mainstream metropolitan and national Australian newspapers during February and March 2007. We then applied a model of analysis called the Index of Scientific Quality (ISQ) to measure the scientific quality of the news reports. Results: We identified 14 newspaper articles and one newswire article about the Antioxidant Study and two newspaper articles about the Prenatal Multivitamin Study. Of the seven ISQ criteria, ‘validity’ and ‘precision’ were rated the least adequate, ‘important consequences’ of the research were reported partially in the Antioxidant Study and wholly in the Prenatal Multivitamin Study, and ‘opinion from fact’ was adequate in the majority of articles. Conclusion: This exploratory study conveyed an overall inadequacy in the scientific quality of the newspaper reporting about the two CM studies in major metropolitan and national Australian newspapers. Whilst we found that journalists were careful to attribute opinions to their sources, their reports conveyed a very limited understanding of biomedical research methodologies and a subsequent incapacity to scrutinise these methodologies with rigour. [ABSTRACT FROM AUTHOR]

The large number of international medical graduates (IMGs) working in Australia, and many other countries around the world, has received significant attention from the media, governments and academia. These institutions utilise a number of classificatory schemes in order to categorise IMGs. Such classification is often stigmatising, yet goes largely unquestioned. In this paper I show that the 'official naming' of IMGs in Australia, as well as the naming of IMGs by staff in hospitals, is historically, politically and socially produced. Following Bourdieu's call to also study how the classified classify, the paper goes on to examine ways in which IMGs name and categorise each other, drawing on ethnographic research. I argue that IMGs use classification themselves, strategically, in order to modify their marginalised position within the 'social space' of the hospital. The article questions taken-for-granted assumptions about classified groups such as IMGs and leaves an opening for change. [ABSTRACT FROM AUTHOR]

This paper draws upon literature from economics, and the human capital and equity fields in order to present a theoretical framework for a new multidimensional measure of poverty for Australia. Poverty is about having low living standards; but its measurement has traditionally focused only on an individual's income or on other dimensions of living standards that are not appropriate for contemporary Australian society, such as calorie intake. There are two additional capabilities individuals require for adequate living standards: health and education. Each of these is required for basic functioning within modern society, but have traditionally been ignored by measures of poverty. This paper argues that health is a basic capability people need for a fulfilling life, allowing individuals to participate in activities essential in modern society, and that education can also be seen in this light. As such it is vital that health and education be included in measures of poverty. In order to move Australian poverty measurement forward and build upon the work of the past, poverty measurement must move its focus away from only looking at low income, and take a holistic focus on the living standards of individuals by incorporating assessments of health and education. [ABSTRACT FROM AUTHOR]

This paper explores a number of the ways in which globalization can accentuate the uncertainties and risks borne by Australians with retirement savings in superannuation funds or who are receiving superannuation benefits. It begins by addressing the impact of globalization on job prospects as a result of off-shoring. It then turns its attention to the impact of globalization on domestic inflation. The third area addressed by this paper is the vulnerability of superannuation funds to the ‘regular’ financial crises of the world financial system. Here, particular attention is given to the way international hedge funds operate in bear markets. Finally, the paper describes the increasing prominence of sovereign wealth funds and explores the implications of their growing role for future superannuation fund earnings. A major conclusion of the paper is that the certainty of the financial uncertainties and risks associated with the occupational superannuation pillar means that Australia's retirement income system needs to be modified in order to limit the exposure of workers' retirement savings and benefits in payment to some of the consequences of a globalized financial system. [ABSTRACT FROM AUTHOR]

This paper explores the experiences of twenty Australian women living with the chronic and incurable gynaecological condition endometriosis. It examines how women become experts in their own care and the ramifications of these processes for women. Women experience patient expertise as a form of work, described here as a ‘third shift’ performed in addition to women's paid and unpaid work. It argues that both benefits and problems flow from such work, which involves the acquisition of expertise about a chronic illness and associated processes of self-management. The central argument of this paper is that the responsibilities associated with becoming an expert endometriosis patient can both reduce and compound existing stresses for women living with this chronic illness. It concludes with some suggestions about improvements to support women living with this chronic condition. [ABSTRACT FROM AUTHOR]

This paper explores the potential of community development interventions to contribute to improvements in Aboriginal health, the theory underpinning community development interventions, and the methods used to evaluate such interventions. This paper is based on a review of health literature to identify Australian and international examples of interventions utilising a community development approach with a view to directly addressing a health issue and contributing to the empowerment of Aboriginal people. Seventeen articles published over a ten year period from 1994 were identified which met the criteria for community development with a specific empowerment objective. Aboriginal communities are undoubtedly engaged in community development with the aim of improving health outcomes for their own communities. We argue that interventions promoting empowerment and control should be included as part of an overall strategy to reduce health inequalities in Aboriginal settings. There is an urgent need for further research in this area, particularly research which can engage with unpublished examples of community development in Aboriginal health contexts. [ABSTRACT FROM AUTHOR]

As Leader of the Opposition in 1987, the current Prime Minister of Australia John Howard, stated unequivocally that he would dismantle Medicare at his first opportunity. By April 2000, the Health Minister in a Howard-led government proudly proclaimed to the Australian Parliament the Coalition was 'the best friend Medicare ever had'. Such a shift in ideology and policy position appears remarkable, overturning more than 60 years of conservative opposition to a universal, publicly funded, health care system. This paper traces the shift from the lead-up to the 1996 election until 2000, interrogating official policy texts to map how the Coalition reconfigured its own policy narrative about the Australian health care system. This paper argues that in order to understand contemporary reforms to the health care system, we must consider the way in which those reforms provide solutions to discursively, rather than objectively constructed, policy problems. [ABSTRACT FROM AUTHOR]

This paper sets out some of the parameters of social intervention in the family in Australia around the turn of the 20th century in ways which permit interventions in Aboriginal and non-Aboriginal populations to be broadly compared and contrasted. It focuses on forms of intervention underpinned by the kind of liberal political reasoning that allowed administrators to intervene on the basis of assessments of the capacity of families to govern themselves (Hindess 2000, 2001). The paper draws on archival material in Victoria, and the evidence of interventions in Aboriginal populations focuses on the removal of Aboriginal children from their communities in various parts of the state during this period. 'Race' comes to be constructed in terms that allow legislators and administrators to make discriminations within Aboriginal populations in order to manage them. [ABSTRACT FROM AUTHOR]

In the past decades, public health has increasingly addressed what has been called the children's obesity 'epidemic', most notably through large-scale initiatives promoting physical activity. Through a discourse analysis the current paper critically examines such efforts in Canadian and Australian public health. Public health websites in Canada and Australia were examined for information concerning children's health, physical activity and obesity and explored for how these issues were represented in the discourse. Bacchi's (2009) 'What's the problem represented to be?' approach to discourse analysis guided our interrogation of the taken-for-granted assumptions underlying Canadian and Australian public health discourse, the ideological and political influences involved in its construction, and the knowledge base upon which it rests. The article calls for critical reflection on how children's physical and leisure activities are being advanced. [ABSTRACT FROM AUTHOR]

This paper offers a study of the specialist field of the sociology of health and medicine, and examines its institutional development in Australia. A thesis is developed about the relationship between the field and the parent discipline of sociology. The formation of the discipline and the specialist field are proposed to have occurred in stages: the formative years, a period of inter-disciplinarity and collaboration, a stage of intensification and organisation, the years of institutional growth and specialisation, the decade of consolidation and fragmentation, and, its most recent phase, a time of 'new' internationalisation. Moreover, the institutionalisation of the sociology of health and medicine has closely followed the developmental trajectory of its parent discipline, even though its disciplinary boundaries have been, and continue to be, less rigid. [ABSTRACT FROM AUTHOR]

Nurse practitioners were introduced into Australia in 1990 to improve access to health care in isolated communities where medical doctors are scarce. The slow uptake of nurse practitioners in these areas has largely been the result of legislation not affording them access to provider numbers through the Medicare Australia Act 1973. This has denied nurse practitioners the opportunity to become primary care providers because they cannot prescribe medications and order diagnostic tests at rebated costs. Recently this Act changed, making provision for nurse practitioners. Ironically the enactment of the new legislation still prevents nurse practitioners from practicing effectively. This paper describes the discursive practices in legislation, driven by traditional power brokers, which perpetuate the traditional role of nurses as care givers and fails to support the evolution of nurse practitioners as care providers. These continued practices effectively prevent nurse practitioners from working to their potential, despite government reassurance under recent health care reform in Australia. [ABSTRACT FROM AUTHOR]

Despite heightened concerns about levels of obesity and overweight in Western societies, there is a relative absence of sociological research into the subjective experience of dieting, especially for men. This paper focuses on findings related to the male participants from a qualitative study of fourteen volunteers (six female and eight male) drawn from a larger clinical trial comparing two diet conditions. Semi-structured interviews were conducted in two stages to gain an in-depth understanding of the experience of dieting, and found that these men understood and practiced their dieting in different ways from the women, but also from each other, depending on their notions of masculinity. Some were eager to reframe their dieting in 'more manly' terms. The social support or sabotage received from friends and family is significant to these experiences of dieting. This paper discusses how men understand and practice dieting within the framework of gendered discourses and gendered relations that can make healthy eating hard to sustain. [ABSTRACT FROM AUTHOR]

Since 2003, avian influenza has recently spread around the world sparking fears of a potential pandemic. As a result of this, a range of explanations and expectations surrounding the phenomenon were generated. Such social representations of disease depict the issue under discussion and frame reactions to the event. This paper explores the social representations surrounding avian influenza in Australia. Methodologically, a textual analysis of media and government documents was conducted in order to uncover the social representations implicit in these accounts. This demonstrated a symbolic framing of avian influenza with reference to the Spanish Influenza pandemic (1918). Analytically, the study draws upon the concepts of social representations from Durkheim and of risk and symbolic risk in the work of Beck. Overall, it is argued that the framing of avian influenza as a risk, mediated through the collective memory of Spanish Influenza, characterised the nature of the social representations surrounding the phenomenon. This resulted in the production of symbolic solutions to the threat. [ABSTRACT FROM AUTHOR]

In Australia we have become preoccupied with the potential adverse impact of our ageing population on our health and social systems. The projected cost of having increasing proportions of our population in the over 70s, retired, chronically ill category of the demographic profile is emerging as a major challenge for governments and private insurers: so much so in fact that the government is now urging older people to stay at work longer. In America, new approaches to the management and self-management of chronic diseases have been invoked to encourage and support older people to improve their quality of life and reduce their recourse to and dependence upon health care technologies, clinical interventions and health care management systems. Unless this is achieved, it is argued, the cost of looking after this emerging ‘bubble’ of elderly people will become increasingly unsustainable as fewer and fewer (proportionately) younger people work to pay the taxes that support ageing, retired, sick and dependent populations. This paper argues that we are at real risk of having our economic wealth and productivity impeded and truncated by the financial burden of looking after high demand and high cost dependants at the aged end of the social demographic. This paper offers an alternative view of our ageing population, as well as highlighting some of the assets we have in our elderly populations, and providing suggestions as to an alternative view of the phenomenon of ageing that incorporates elements such as flexible working arrangements and the application of new, enabling technologies. This approach to our ageing population dilemma is predicated on a concept of lifelong learning and social participation along with better preventive and early intervention systems of health care. [ABSTRACT FROM AUTHOR]

There is growing recognition that investment by governments on children in their early years is an important part of social policy. However there is currently little information either about how much governments invest on children of different ages, or about what the optimum investment in the early years would look like. Using currently available Australian datasets, this article explores two approaches to estimate the adequacy of investment in early childhood; comparing government expenditure between countries, and analysing one country (in this case Australia) in terms of expenditure over time on children of different ages. We find that, overall, Australia spends more than the average of OECD countries on the early years, but that a much higher proportion of this expenditure is spent on cash transfers to parents rather than on early care and education. Furthermore, spending on the early years has grown proportionately to spending on older children over the past several years. The paper ends with a number of suggestions for further research which will refine the analysis of investment in the early years. [ABSTRACT FROM AUTHOR]

This paper examines the way some public health campaigns in Australia have been caught within a paradigm shift in the management of 'risk society'. It details this paradigm shift in terms of an intensification of political technologies of 'pre-emption' in response to incalculable threats to physical security. The challenge this presents to public health programs, particularly those dealing with 'life style' health problems such as obesity, depression, and drugs (illegal and legal), is that, in pursuing admirable aims of the prevention of ill-health in the population, such campaigns need to avoid reproducing (and indeed should counter) the harmful effects of the pre-emptive approach to security. Using the example of 'quit smoking' campaigns of 2006-7, key features of the preemption paradigm are outlined, particularly the conservative comportment toward the future that it fosters. With reference to Foucault's concept of 'political technologies of bodies' and Merleau-Ponty's ideas about the temporality and intercorporeality of bodies, the paper also explores deleterious effects of this approach to risk and health on human agency, well-being, and social relations in general. The negative impact of the pre-emption approach is outlined in terms of the way it tends to dampen the openness (or 'potentiality') of bodies toward the future, the world, and other people. However, the temporality and intercorporeality of bodies also explains the operation of resistance by human agents to both the paradigm of pre-emption and the health prevention strategies that employ its way of thinking. This provides the basis for a gesture toward a more 'democratic', respectful, and effective approach to the promotion of health and well-being. [ABSTRACT FROM AUTHOR]

In 2004 and 2005 the West Australian Labor Government significantly amended the Workers Compensation and Injury Management Act 1981 (WA) (the Act). These amendments followed over a decade of shifting power plays and uncertainty for the many stakeholders in the system. The significance of these state-based reforms cannot be underestimated, providing a localised example of a broader contestation between the interests of private business and the shifting terrain of industrial citizenship. This article documents the last decade of workers compensation reforms within Western Australia and a summary of changes which ultimately took effect in November 2005. In keeping with the post-modern emphasis on context, this paper locates the Western Australian changes within a broader discussion of the shifting landscape of rights and entitlements engendered through neo-liberal discourse. In particular, as this paper explores, the changes to Western Australian workers compensation policy can be read as a reflection on the way employers, government and the insurance industry interpret and engage with the continuing realignment of worker entitlements. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between the prominent aetiological frameworks for mental illness in Australian psychiatry, and ideas and strategies for preventing mental illness. Data is drawn from the Australian and New Zealand Journal of Psychiatry for the period 1967-2005, and textbooks used to teach the psychiatric component of the medical degree at six Australian universities since 1950. Content analysis of the journal demonstrates that social aetiological models dominated Australian psychiatry until 1985 and the rise of biological models. This represented a shift in the focus of mental health prevention from the social environment to the individual, and the re-location of psychopathology from social relationships to social and biological risk factors. A consequence of this new focus has been the re-targeting of mental health strategies toward individuals and their exposure to social and biological risk factors. [ABSTRACT FROM AUTHOR]

It is well recognised that bereavement deals a significant impact on all individuals and societies, and yearning to be with a recent decedent is a common and almost universal grief response. How we strive to mitigate our loss by maintaining a sense of being in the presence of our loved one is not so well appreciated, yet this elicits perhaps the most evident and popular practical response among the recently bereaved. Although over thirty-three million visits are made to Australian cemeteries each year, understanding this behaviour and meeting the real needs of these visitors have attracted little consideration, even among those responsible for managing and providing such facilities. This paper draws on the author's twenty-four years' experience in the operation of small and large, provincial and urban cemeteries, and national sociological field research into personal and social values of the cemetery or memorial park. Quantitative studies involving over 3,000 cemetery visitors throughout Australia furnished vital generalisations, and complementary in-depth qualitative investigation of over two dozen cases identified personal values of visitation to mourners within different social and cultural contexts. This paper presents a summary of key findings. To literally millions of recently bereaved Australians the cemetery provides a vital focal point for remembrance of the deceased, with the grave or memorial site becoming a crucial locus for working through personal grief. [ABSTRACT FROM AUTHOR]

Social capital is attracting increasing attention, particularly as a means of improving health status. However, much of the work on social capital employs Putnam's (1995) formulation of the concept. This view suggests social capital produces generalised benefits, thus presenting an anomaly between the higher stocks of social capital in Australian rural communities relative to urban areas, and their poorer health status. This paper presents data on the experience of same-sex attracted (SSA) women living in rural communities in South Australia. It suggests Bourdieu's account of social capital is more theoretically and empirically compelling than that of Putnam's, because of its capacity to explain the harmful psycho-social consequences of exclusion for those who are samesex attracted. Moreover, the different experiences of younger and older samesex attracted people in rural Australia indicates the need to take seriously the claim that social capital is unequally distributed and experienced in different ways. A conclusion of this paper is that blanket claims to increase and enhance social capital should be treated cautiously because of the adverse consequences for some groups. [ABSTRACT FROM AUTHOR]

This is an account of various unsuccessful efforts to combat petrol-sniffing in River Town, a remote Aboriginal settlement in north Australia. The paper provides insights into the dynamics of remote Aboriginal settlements, highlighting the dissonance between non-Aboriginal service providers and the Aboriginal residents. Attention is drawn to the need for more involvement of Aboriginal people in policy making and program implementation. The paper suggests also that there is a need for adequate resources to resolve the problems experienced in settlements such as River Town. [ABSTRACT FROM AUTHOR]

This paper sets out to explore the Australian instance of a significant international problem: Intergenerational solidarity and the willingness of younger generations to support the future care of older people. It draws on Bengston's intergenerational solidarity theory, in particular his conception of normative solidarity relative to filial obligations, to analyse data from the Australian Survey of Social Attitudes. This data demonstrates evidence of intergenerational solidarity at the policy level and a need for a continued role for government in the provision of residential care, insurance schemes, and the payment of income to full time and occasional carers. At the family level there is less support for the role of adult children in the payment of formal care or the provision of informal care. There is also a significant difference between men and women concerning the direct provision of informal care to ageing parents. Suggestions for future research are highlighted. [ABSTRACT FROM AUTHOR]

With the commodification of healthcare in general and of private health in particular, it is difficult not to acknowledge the growing influence of competition and 'the market' in shaping the way that nurses' work is managed by private hospitals and by nurses themselves. This paper explores the discourses shaping nurses' work in private healthcare, drawing upon data from an ethnographic study conducted in one Australian acute care private hospital. The framework for analysis relies on an exploration of the mentalities and governance of nurses' work in such a setting. The study shows how marketing and performance measures are believed to ensure the viability of the enterprise while simultaneously commodifying nurses' caring work. It is this work that remains invisible to the healthcare system and the hospitals where they work. [ABSTRACT FROM AUTHOR]

Contemporary Western societies focus considerable policy and media attention on the 'epidemic of childhood obesity'. In this paper we examine the mobilisation of notions of responsibility and consumption in these discussions, and consider the implications they have for women as mothers. In particular, we are interested to explore the potential conflicts mothers face as care providers and nurturers when responsible care is framed as withholding or managing the food consumption of children. We argue that the competing discursive frameworks around mothers' food provision invite further theorisation that explicitly addresses nourishment and consumption as elements of maternal practice and care. We draw on the work of Neysmith and Reitsma-Street (2005) regarding 'provisioning' to undertake a critical examination of the discourses in the 'childhood obesity' epidemic, with particular attention to Australian media and policy discussions. According to Neysmith and Reitsma-Street, mothers are central to social 'provisioning', that is, the labour that secures the necessities of life. This provisioning framework captures paid market work and unpaid caring labour, policy settings and social locations, allowing for a rich conceptualisation of the conditions mothers negotiate as they provide for their children. Taking up the possibilities of this framework, we argue that, insofar as health risks and responsibilities are largely individualised, mothering is framed as primarily about giving, and childhood obesity is considered a disease of affluence and over-consumption, imperatives for maternal provisioning and nurture are potentially in conflict with critiques of consumption and excess. [ABSTRACT FROM AUTHOR]

Through interviews with users and providers of anti-ageing medicine in Australia as well as the analysis of various internet sites, anti-ageing clinics, journals and magazines dealing with anti-ageing medicine, this paper will argue that the anti-ageing industry in Australia is an example of how ‘mediascapes’ operate, seeking in this case to replicate the American model while developing a more localized practice meeting local needs, cultural orientations and regulatory frameworks. The products being studied here include some which have been on the market for many years in the Complementary and Alternative Medicine (CAM) industry, but have only recently been rebranded as ‘anti-ageing’. These include vitamins, anti-oxidants, supplements such as beta-carotene, selenium and coenzyme Q10, homeopathic products, exercise and diet programs. Other products that have been recently labelled as ‘anti-ageing’ and are included in this study are hormone therapies, testosterone, melatonin, Human Growth Hormone (HGH), and Dehydroepiandrosterone (DHEA). These products have been previously trialled and used in the treatment of medical problems such as heart disease, sexual dysfunction, cognitive and memory loss problems, and hormonal deficiency. Current medical research on stem cells, particularly embryonic stem cells, has also fallen within the realm of anti-ageing treatments developed from this research area and available primarily in countries with limited regulation and control over the use and availability of embryonic stem cells in the context of the private anti-ageing clinic. The differences and similarities between the practice of anti-ageing medicine in Australia and in America highlight current tensions and correspondences in the manner in which ageing is being constructed, managed and experienced. They are indicative of the impact that social policy directions, regulatory frameworks and economic policies have on the way in which ageing individuals and society at large approach the experience of old age. [ABSTRACT FROM AUTHOR]

In Australia, fluoridation was first endorsed as an effective, safe and equitable means of improving population oral health over fifty years ago. However, recent opposition to attempts to introduce the measure in several regional Victorian towns has demonstrated that it remains a highly controversial health policy. This paper investigates the history of the Victorian fluoridation debate within a national and international context. It finds that although the evidence concerning fluoridation has advanced considerably, the essential arguments put forward by proponents and opponents have remained largely unchanged over that time. Protagonists incorporate the same scientific evidence yet come to polarised and unshakeable conclusions. I argue that the concept of deep structure ideation is a useful means to understand how this occurs. Furthermore, analysis of the ideas and social processes that determine a partisan position in the fluoridation debate makes this an important case study for approaching other durable scientific controversies. [ABSTRACT FROM AUTHOR]

This paper contributes to debate in Australia about sexuality-based restrictions on access to Assisted Reproduction Services, particularly sperm donation by gay and bi-sexual men. It utilises content analysis of print-media and reveals that the public image of sperm donation is saturated with concern about risk, particularly risk to heterosexual donors and their property, from claims made by recipient women and their children. In contrast, a detailed analysis of the profiles of men who register to donate sperm through the Australian Sperm Donor Registry reveals that most donors are open to identity disclosure. However a marked difference is evident between heterosexual and gay/bisexual donors with the latter being significantly more likely to desire contact with children born of their donations. It appears sperm donation offers gay and bi/sexual men an opportunity for family formation and parenting which is denied by Australian laws and clinical practices that exclude them from Assisted Reproduction Services and adoption. [ABSTRACT FROM AUTHOR]

This paper develops discourse analysis of Australian press representations of dying during the operation of the Northern Territory of Australia's Rights of the Terminally Ill Act 1995 (McInerney 2006). Operating in tandem, the discourses of aesthetics and embodiment constructed contemporary dying as an intolerable corporeal state. The body in disarray is attractive to media imperatives of drama and crisis, and dominated press reports during the analysed period. Such images functioned as absolute justification for a medicallyinduced requested death. Modern equating of physical integrity and personal dignity supports such responses to dying. The requested death interventions of euthanasia and physician-assisted suicide were depicted as halting the physical deteriorations associated with terminal illness and thereby redeeming the dying person, by providing them with the opportunity to reclaim the social status lost via their progressive corporeal decline. [ABSTRACT FROM AUTHOR]

With rapid developments in life-prolonging technologies and increases in average life expectancy, euthanasia has become an increasingly topical issue. This paper contributes to the euthanasia debate an analysis of Australian attitudes to assisted suicide, active non-voluntary as well as passive non-voluntary euthanasia. Between 1993 and 2002, Australians supported access to voluntary euthanasia of the terminally ill, but had reservations when death was not imminent. The age of patients was relatively unimportant in these considerations. Non-voluntary euthanasia of babies and adults received widespread approval only when particular situations could be defined as 'letting die' rather than 'killing'. [ABSTRACT FROM AUTHOR]

Until recently, permanent residents in caravan parks were often absent from discussions about homelessness and housing in the Australian context. When permanent residency was recognised and legislated for in the 1980s, efforts were made to ensure scope for standard community infrastructure such as roads, sewerage and community gathering places. Although the number of long term caravan parks in Australia has recently decreased, on the edge of Melbourne some parks are expanding to cater for a growing clientele reflecting a new and partly de-institutionalised society. This society is characterised by mobile, temporary and casualised work and changing, volatile family relationships; each trend creating a need for different forms of housing. In this paper, preliminary interviews with ten caravan park managers from the outskirts of Melbourne reveal their role in the complex relationship between space, community formation and social solidarity: a relationship which directly impacts on the health and well-being of caravan park residents. [ABSTRACT FROM AUTHOR]

There are numerous ways that researchers can creatively approach social research and translation. This article discusses elements from the first stages of a novel project that centres social research translation in the form of a public exhibition. 'Creative Approaches to Health Information Ecologies' is a project by a multidisciplinary research team in collaboration with an Australian health consumer organisation. The project uses creative workshop methods to explore how people learn, think, and feel about their bodies and health states, and brings attention to the significance of communities, places, spaces, objects, and other living things – the 'ecologies' of health information. It then builds on these insights to create an interactive exhibition of materials designed for public engagement. This reflexive article unpacks how this creative translation-centred collaboration contributed to the make-up of the project team, the project's research methods, and the process of making exhibition materials. We discuss what the research team learned from the process about creative collaboration, research-creation, and research translation. [ABSTRACT FROM AUTHOR]

Australian Football League (AFL) player Ben Cousins is one of the most highly acclaimed and recognised athletes in Australia. Followed closely in the media, his off-field activities are subject to as much attention and speculation as those on the field. In 2007, Cousins and his family confirmed long-standing rumours that he was an illicit (non-performance enhancing) drug user. Following a series of incidents, his football contract was terminated and Cousins publicly entered drug rehabilitation. In this article we explore the multiple extant accounts of Cousins' drug use. We examine media representations of his drug use, including accounts from a range of key stakeholders, and we also look at Cousins' public accounts of his own drug use. What emerges is paradoxical picture both of Cousins himself and of drug users more broadly. Cousins is simultaneously positioned as in control and out of control, as manipulative and as subject to the manipulations of his ‘addiction’, as criminal and victim, as culpable and innocent. In the process, he acts as a figure through which contemporary understandings of the nature and implications of addiction are produced and reproduced. What is addiction? If, as many now take for granted, it is a disease requiring a medical response, what can be said about the agency and responsibility of the ‘addict’ in the context of elite sport? How do mainstream understandings of elite sportsmen as intrinsically masterful, commanding and physically exemplary mesh with assumptions about drug addicts as passive and physically compromised? In considering this intersection of discourses of elite sports and of addiction, we also explore some of the unique dimensions of the Cousins case including the challenge his embodied athleticism poses to understandings of his drug use, and the significance attributed to his rehabilitation and ‘comeback’ in 2009. We conclude with some reflections on the ways in which Cousins' case troubles certainties about drug use, and on the strategic efficacy of disease models of addiction in Australia. [ABSTRACT FROM AUTHOR]

Many doctors migrate to find work opportunities elsewhere. Before being allowed to practice, these doctors, commonly referred to as International Medical Graduates (IMGs), must gain local registration, which can take considerable time. During this process many IMGs linger on the margins of hospitals, without medical employment. We follow this understudied group of IMGs in Melbourne, Australia, to understand their life on the margins of medicine. This takes us into hospital places on the fringes of clinical activity: a cafeteria, tutorial room and hospital library. We argue that these places are important for the doctors in retaining and strengthening their sense of professional identity in precarious circumstances. The IMGs find creative ways to inhabit familiar settings, creating their own pathways, to find their way into the local medical system. This analysis is in contrast to more common Foucauldian interpretations of hospitals that present the institution as having a structured, disciplining effect on its inhabitants. [ABSTRACT FROM AUTHOR]

The care of a person living at home near the end of their life is predominantly provided by family carers with the support of health services such as palliative care. In addition, informal caring networks also contribute at times to the support provided to the dying person and their carer. In this way, these networks can promote social capital in the communities from which they are drawn. This social approach to end of life care enhances community capacity to provide support to those dying at home and their carers. This article examines relevant published literature to explore the conceptual foundations of informal caring networks, examining the place of social capital and community development in the provision of end of life care at home, particularly in the Australian context. [ABSTRACT FROM AUTHOR]

Choice and control for birthing women have recently come under the global spotlight as a human rights issue, and are likely to remain so while midwives are being targetted for providing home birth care. While focussing on these issues appears to further widen the dichotomy between medicine and midwifery, understanding how this divide is maintained is necessary if we are to move beyond it. This article, utilising Foucault's theory of genealogy, recapitulates how midwifery knowledge came to be subjugated by a dominant medical discourse, particularly through the process of hospitalising birth. The submission of the Australian Medical Association to a government enquiry into maternity services is then examined to illustrate how discourse is perpetuated, and how medicine still configures itself as the dominant birth discourse in Australia. The importance of focussing on midwifery specific knowledge, using the notion of embodiment, is put forward. [ABSTRACT FROM AUTHOR]

Australia leads the world in the mass adoption of Human Papillomavirus (HPV) vaccines, a new frontier in mass vaccination programmes. This article reports on participatory workshops with the first generation of young Australian women to participate in the HPV mass vaccination programme. In particular, it addresses the themes of trust and confidence. A substantial literature highlights the growing realm of active trust at the expense of habitual confidence in 'risk society'. Another line of inquiry highlights the preference of governments for policies designed to enhance confidence rather than trust. This study finds that participants were guided by confidence in their adoption of the HPV vaccine, at the expense of trust. Participants readily transferred their confidence in the existing vaccination regime to the HPV mass vaccination programme, notwithstanding its novel features. Yet participants expressed growing misgivings about their informed consent and the 'marketing' of the vaccine in the course of workshops, reflecting failure to achieve their active trust. [ABSTRACT FROM AUTHOR]

Newspapers are a highly influential media that reflect and powerfully influence the views and cultural practices of individuals and societies. Study of phenomena using the media as a lens can provide new insights and understandings into how a phenomenon is culturally constructed and understood. This current study sought to explore media coverage of maternal grief following child death and loss. Articles published in major Australian newspapers over three months were gathered and analysed using a thematic approach. Findings showed that the tragic mother, a noble victim of suffering, is a powerful maternal image in the media. There were two key ways women as mothers were represented in their grief: as tragic heroes, and; as moral guides and activists. Using an interdisciplinary approach that references classical and modern interpretations of tragedy, this study interrogates how our culture imbues child death with dignity because of the quality of maternal grief. [ABSTRACT FROM AUTHOR]

Explaining the trajectory of Australian health policies over the last century requires an analysis of different political regimes and their dreams of order for managing risk. Crook reverses the Beckian axiom that risk is the unintended outcome of the failure of industrial societies, arguing for an understanding of risk within a Foucauldian and Actor Network Theory of governmentality. Risk becomes a mechanism for the realisation of different dreams of order. The welfare state was the risk management mechanism of organised capitalism. Individual aspirations of reflexive individuals form the risk management mechanism of neo-liberal regimes. As competing risk discourses destabilise the field of maternity care, key actors (including doctors, midwives, women and policymakers) form themselves into neo-traditional communities in ongoing struggles to have their risk claims institutionalised within policies and protocols that further legitimise their interests. These struggles around risk and power are evident in recent debates over maternity policy in the context of the 2009 Maternity Services Review and the policy aftermath. [ABSTRACT FROM AUTHOR]

Signifi cant transformations of the health care services sector over the past three decades have seen an increasing reliance on the private provision of health care services mediated through private health insurance. In countries such as Australia and the UK, private health insurance is promoted as providing a greater choice for individuals and easing the burden on the public system. While these claims, the policy contexts and the decision-making processes of individual consumers have attracted some sociological attention, little has been said about the role of private insurers. In this article we present a comparative analysis of the websites of private health insurers in Australia and the UK. Our analysis highlights adoption by private health insurers of neoliberal discourses of choice and individual responsibility, partnership and healthy lifestyles. In these respects, similarities between the discourses over-ride national differences which might otherwise be expected given their contrasting health care traditions and contexts. [ABSTRACT FROM AUTHOR]

Indigenous cultural training for health workers is an increasingly popular intervention designed to improve the health services provided to Indigenous peoples in Australia. The provision of this training is based on the recognition that the measured discrepancy between Indigenous and non-Indigenous health outcomes is in part influenced by cultural difference and a history of racism in Australian society. Indigenous cultural training in Australia predominantly draws on a 'cultural awareness' framework which seeks to educate health workers about 'Indigenous culture'. To date, evaluations of Indigenous cultural training programs have found them to have questionable efficacy, although most of these evaluations have been methodologically inadequate. This article draws on postcolonial theory to explore the limitations of Indigenous cultural training as it is commonly conceptualised. Issues of essentialising 'Indigenous culture', 'otherness' and the absence of systemic responsibility for culturally appropriate health service provision are discussed. Finally, we consider future directions for Indigenous cultural training that are useful to both Indigenous service users and the health workers charged with 'closing the gap' between Indigenous and non-Indigenous health outcomes. [ABSTRACT FROM AUTHOR]

The cultural and historical background of the substantial deregulation of alcohol sales in Australia in the last quarter century is described and discussed. Drinking and intoxication was contested ground in Australian history, stereotypically split between the heavy-drinking male world of primary industries and the more feminine world of the suburb. In the temperance era of the late 19th and early 20th century, restrictions on alcohol sales gained ground, epitomised by six o'clock closing adopted during World War I. Alcohol's cultural position shifted after World War II: alcohol problems were redefined in terms of alcoholism, a personal failing, and a cultural–political movement led by the Sydney Bulletin led a successful cultural–political movement to caricature and derogate ‘wowsers’. Meanwhile, the alcohol industry moved to identify itself with high-valued features of Australian life. By the 1960s, a dynamic of relaxation of alcohol controls had started, starting with repeal of six o'clock closing and continuing to the present day. [ABSTRACT FROM AUTHOR]

The high incidence of sexual abuse of Indigenous children in remote Australia prompted the Australian Government to implement an emergency response of health and welfare measures (the Intervention) in 2007 to protect children and communities from harm. In this article we seek to assess the measures employed in the Intervention against the body of evidence of strategies likely to be effective in reducing Indigenous health disadvantage. Our view is that the emergency response may not have long-term benefit because of the dearth of basic primary health services in remote Aboriginal communities to continue the effort that the Intervention has begun. We conclude that Intervention measures are not sufficiently well aligned with evidence-based health improvement strategies to bring about long-term health gain in Indigenous communities. Governments must reassess the benefit of externally-imposed approaches to reducing health disparity and move to actively build capacity in Aboriginal communities to deliver culturally-relevant health and social services that meet community need. [ABSTRACT FROM AUTHOR]

This study aimed to address significant gaps in our understanding of how teenagers live their lives within the spatial and temporal limitations imposed by an 'adult' world, and in the context of changing work and household patterns in Australia. By keeping home, community, school and parental work in equal focus it acknowledges that each of these spheres has the potential to provide resources and exert demands which will influence the opportunities available to teenagers as they transition through adolescence into adulthood. Methods: One hundred and seventy four boys and girls aged between 11 and 18 years took part in twenty two focus groups concerned with how characteristics of home, local community and parental work impact on various aspects of their lives. Teenagers were recruited from both state and private schools servicing three master planned communities and three traditional lower socioeconomic status suburbs in South Australia, Victoria and Queensland. Findings: there is a clear indication that teenagers' lives are contingent upon adult space and time. What teenagers do, how they do it, when they do it and with whom they do it sits within and sometimes buts up against, the spatial and temporal realities of their parents and other adults in their communities. While this is the case for all teenagers the outcomes vary for teenagers of different socioeconomic backgrounds and for teenagers in different age groups. These findings demonstrate that the ability of teenagers to access opportunities for social interaction, work experience, education, physical activity and independent agency depend on the amenity, mobility and adult availability characteristics of the contexts within which they live. Conclusion: How teenagers are accommodated by home, local community, school and parental work affects not only their well-being but the well-being of their family and the wider community. [ABSTRACT FROM AUTHOR]

In an online survey of transgender people conducted in Australia and New Zealand, half the respondents (50.6%) reported having made attempts to amend formal documentation to reflect their current gender identity, and that this was crucial to their sense of personal and identity recognition, as well as an affirmation of citizenship. Experiences and outcomes varied, even within the same organisation, leading to different degrees of difficulty and frustration. For gender to be changed on some documentation, the individual is required to show evidence of having had a related surgical procedure. Almost 90% of participants who had undergone surgery had also made attempts to change documentation, and a quarter of participants who had not undergone any surgical procedures had made similar attempts. Participants who had been able to successfully change their documentation experienced this as affirming of their gender, and as recognition of civil belonging. [ABSTRACT FROM AUTHOR]

Many countries, including Australia, are currently experiencing severe shortages of professional, para-professional, and semi-professional workers in their health care systems. This is generally conceived as a problem stemming from rising demand in health care services or the production of inadequate numbers of health related graduates. A qualitative study of health care workers in the Australian context challenges the adequacy of this supply-demand approach to the health care system; and demonstrates that solutions lie in the conceptualisation of the health sector as a socio-cultural system. Findings indicate the extent to which policies independently formulated for the health, education, finance, and industry sectors have, in combination, inadvertently impacted on the functioning of the health care system, and some policy mechanisms, such as privatisation and marketisation, have fundamentally eroded its structural framework. Conclusions can therefore be drawn about the relationship between workforce shortages and the neo-liberal orientation of recent governments. [ABSTRACT FROM AUTHOR]

This exploratory study compares the financial performance of all companies listed on the Australian Stock Exchange pursuing vertical or virtual integration, horizontal integration or diversification in the pathology, diagnostic imaging and general practice sub-sectors over 2001-2005. Financial ratio analysis indicates vertical integration is the most profitable strategy. Accounting measures of performance also show horizontal integration is profitable; however, recent market developments raise questions about the viability over the long-term of horizontal integration of diagnostic imaging practices as a core business in the context of public corporations. With one exception, the study also found medical centres yield modest to poor financial performance, suggesting the revenue generated directly by general practice is unlikely to provide sufficient returns for GPs and investors, and is probably a result of cross-subsidies from diagnostic services owned or provided by the corporation. As all firms that provide general practice also provide diagnostic services, collectively, results provide tentative empirical support for the proposition that the value of general practice, at least to some listed corporations, is not in general practice per se, but its ability to generate referrals. The findings have significant implications for the public financing of health care services. These include: the potential for increased expenditure on healthcare from co-locating general practice with diagnostic services; the extent to which the provision of medical services by listed corporations represents the best use of limited public funds; and the efficacy of the use of Medicare to finance offshore expansion by public Australian companies. [ABSTRACT FROM AUTHOR]

Maternity services in Australia are becoming rationalised with contemporary, authoritative knowledge driving the provision of services under the premise that birth in larger regional and tertiary settings is the safest option. There is increasing evidence that families who live in rural and remote areas are not satisfied with having to travel long distances and be absent from their homes for weeks at a time for childbirth. This is particularly problematic for remote dwelling Aboriginal women, with evidence suggesting current maternity services and relocation for birth are culturally, socially and emotionally unsatisfactory and unsafe. The Indigenous knowledge around birthing that still exists in remote communities today, is not being acknowledged or incorporated into health service provision with the current 'risk equation' excluding the social, emotional and cultural risks that have been identified by the women themselves. Unlike the Inuit situation in Canada, which could provide leadership and advice for Australia, there has not been sufficient dialogue in Australia around the construction of risk and its importance in the birthing environment, particularly for Aboriginal women. [ABSTRACT FROM AUTHOR]

A case study of twenty-nine midwives and nine obstetricians working in a regional, public sector Australian hospital demonstrates the plasticity of professional boundaries within a post-welfare state. Driven by new discourses of globalisation, marketisation, managerialism and consumerism, professional boundaries in health care are being blurred, reordered and reconstituted. Government policies that call for a new interdisciplinarity between maternity professionals may be seen as responses to the above pressures. However, there remain considerable barriers to achieving collaborative models including conflicting interpretations of risk, of women's bodies and of childbirth; the veto power of decision-making retained by obstetricians; questions of professional accountability; and diversity over appropriate styles of micro-interaction. Collaboration demands a new egalitarianism to eclipse the old vertical system of obstetric dominance and this means that midwives need to create a distinctive professional specialty, or new object of knowledge. Midwives' skill in 'emotion management' could provide this speciality in addition to their rational-technical knowledge and thus elevate midwifery to an equivalent professional status with obstetrics but as yet neither obstetrics nor midwifery have realised its professionalising potential. [ABSTRACT FROM AUTHOR]

In a generation, Australia has changed from a country where most boys are circumcised in infancy to one where circumcision is the minority experience. Proponents argue that routine circumcision is desirable because it protects against a number of conditions. Yet circumcision can be seen rather as a sociocultural intervention with post hoc medical justification. As a form of body modification, it serves to exaggerate the visual difference between male and female. Reducing the ambiguity and untidiness of the penis turns it into a neat phallus more specifically fitted for what is seen as its purpose in a gendered sexual culture focused on coitus. Does circumcision reduce penile sensitivity? Applying the methods of evidence-based medicine to this question has problems, centrally that of how 'sensitivity' is to be measured. The nature of the loss is in a sense 'unspeakable' and for many people unimaginable, because the reception of delicate sensation is not part of their notion of masculine sexuality. [ABSTRACT FROM AUTHOR]