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Reducing the risks associated with drinking is an ongoing public health goal. Approximately two-fifths of Australian adults consume alcohol within low-risk guidelines, yet little is known about their drinking patterns or practices. In this paper, we use social practice theory to consider low-risk drinking at home as a routinised social practice with material, meaning and competence dimensions. We analysed open-text survey responses from 252 Australian adults (30–65, 89% female) who were considered low-risk drinkers. A low-risk drinking occasion was typically closely linked to other practices such as eating dinner or connecting with family or friends. Drinking alcohol, even in small amounts, was associated with enjoyment. Being attuned to bodily sensations and applying some self-imposed rules were competencies that allowed low-risk drinkers to avoid intoxication. Low-risk drinking practices entail some elements that can inform health promotion, including encouraging efforts to limit drinking to times of the day (e.g. during meals) and to attend to bodily feelings of sufficiency. The study also shows how low-risk drinking is entangled with gendered and age-related norms about drinking, and facilitated by rarely being in 'intoxigenic' environments. These factors are imbricated with individual decisions in our respondents' capacity to consume alcohol moderately. [ABSTRACT FROM AUTHOR]

Disproportionately high numbers of Aboriginal young people access residential alcohol and other drug programs in Australia. While demand is high, these programs often have low numbers of Aboriginal staff. Residential programs, however, generally offer supports that reflect features of Aboriginal health care – holistic, group-based, connected to local communities, and addressing determinants of health. The qualitative research outlined in this paper was a collaboration between a mainstream residential therapeutic community program and two Aboriginal community-controlled organisations, and Aboriginal young people and researchers, with Aboriginal research leadership. It used an Aboriginal healing framework to understand the experiences of 12 young Aboriginal people in the program, triangulated with 19 key informant interviews. This provided an opportunity to understand how Indigenous knowledge about healing related to mainstream programs and the experiences of Aboriginal young people. This moves beyond individualist and deficit-focused conceptions of youth alcohol and drug use and centres Aboriginal cultures as healing. Findings point to the need for critically self-reflective mainstream organisations, a larger Aboriginal workforce with leadership roles, partnerships with Aboriginal Elders and organisations, and an investment in Aboriginal community-controlled alcohol and other drug services. [ABSTRACT FROM AUTHOR]

In this paper we examine how popular media reporting positions dating and hookup app use as a 'social problem' that impacts on health and wellbeing. The paper adopts a mixed-methods media studies approach to create and analyse a dataset of over 6,000 international news articles published within a 12-month period, drawing on thematic content analysis and inductive and deductive techniques. These analyses are framed in relation to online consultations with Australian sexual health professionals and app users. Applying Briggs and Hallin's theory of biocommunicability (2007) – which proposes that contemporary health professionals' scientific framing of public health problems are, in part, shaped by popular media discourses – we identify a significant category of supportive discussions of safer app use within social news and lifestyle reporting. This discursive space features what we have termed 'vernacular pedagogies' of app use, revealing app users' safety strategies, and their experiences of pleasure and playfulness. We argue that an analysis of popular media can provide valuable insights into how everyday experiences of safety, risk and wellbeing are being shaped and contested with dating and hookup app use, and that these insights can be used to develop meaningful health promotion strategies. [ABSTRACT FROM AUTHOR]

Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals – as holders of organisational power – and how they construct 'truths' or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users; (2) participants implied cultural superiority in their conceptualisation of 'other' cultures; and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) degrees in Australian and British universities have come under attack from sceptics who argue that such courses teach only 'pseudoscience'. Moreover, CAM academics have themselves been publicly labelled 'quacks'. Comparatively little is known about this group of health professionals who span the two worlds of CAM practice and academia. How do they navigate between these domains, and how are their collective and individual professional identities constructed? Drawing on 47 semi-structured interviews, this paper explores the professional identities of academics working in three university-based CAM disciplines in Australia and the UK: osteopathy, chiropractic and Chinese medicine. By analysing these individuals' accounts, and building on prior research on health professions in the academy, the paper contributes to understanding how contests about professionalism and professional knowledge take place against the academic-practice divide. By focussing on a domain where knowledge claims are conspicuously contested, it highlights the salience of navigating 'epistemic stress' for both group and individual professional identity. [ABSTRACT FROM AUTHOR]

Hepatitis C has long been a public health problem in Australia. 'Revolutionary' new drugs with the potential to cure hepatitis C have now emerged. The Australian government has invested heavily in them, and has an ambitious goal to eliminate hepatitis C by 2030. Numerous shifts in policy and practice are required if the elimination agenda is to be realised. This paper explores the significance of these shifts. We ask: what is the race to elimination doing with the subject? We argue that the race to elimination can be understood, simultaneously, as a product of posthuman forces, capable of being analysed using the theoretical tools made available via the posthuman turn; producing an intervention in what it means to be human; and generating a dilemma for people who use (or used) drugs, people with hepatitis C, and posthuman scholarship. In drawing out these issues, we aim to: trace the significant developments underway in hepatitis C medicine and raise awareness of them; encourage reflection on the consequences of these developments; and invite reflections on what might be lost when the human is remade by hepatitis C medicine. [ABSTRACT FROM AUTHOR]

Despite the frequent occurrence of unwanted disclosure of HIV status in Australia, there is little understanding of its determinants and consequences. This paper offers an analysis of lived experiences of unwanted disclosure amongst 28 people with HIV in urban settings in Australia. Of the 28 individuals interviewed, 17 men and 8 women had experienced unwanted disclosure of their HIV status by other people in work, health, social and other settings. Through the lenses provided by the concepts of habitus and agentic practice, this paper focuses on unintentional and deliberate practices of unwanted disclosure, and the consequences that may arise from this. Findings reveal how unwanted disclosure may lead to reflexive and agentic action among people with HIV as they struggle to reclaim control over their lives and how they are perceived. Despite what is sometimes assumed, the negative social responses the HIV epidemic has given rise to persist in Australia. Some 30 years into the epidemic, findings highlight the need to establish a social climate that is intolerant of unwanted disclosure, and which recognises the damage it may cause. [ABSTRACT FROM AUTHOR]

Although abortion rates appear to be declining in high-income nations, there is still a need for accessible, safe abortion services. However, limited attention has been paid to understanding the social contexts which shape access to abortion information and services for communities who are less engaged with sexual and reproductive health care more generally. This paper explores the views and experiences of 27 migrant and refugee young people (16–24 years old) living in Sydney, Australia, regarding unintended pregnancy and abortion. Pregnancy outside marriage was described by all participants as a shameful prospect as it revealed pre-marital sexual activity. Even when abortion was described as culturally and/or religiously unacceptable, it was believed many families would find an abortion preferable to continuing an unintended pregnancy outside marriage. However, a pervasive culture of silence regarding sexual and reproductive health may limit access to quality information and support in this area. To better meet the needs of these young people, greater attention must be paid to strengthening youth and community awareness of the availability of contraception including emergency contraception, pregnancy options, and access to abortion information and services. [ABSTRACT FROM AUTHOR]

Diabetes presents a challenge to healthcare services worldwide. Diabetes educators work with individuals and communities to reduce the impact of diabetes. In Australia, diabetes educators derive from one of several primary qualifications including nursing, medicine or a specified allied health background, and have an accredited postgraduate qualification in diabetes education. The peak professional body, the Australian Diabetes Educators Association (ADEA), promotes equivalence of all diabetes educators in terms of their scope of practice. However, in practice, there is evidence of inequities, particularly between those from nursing and allied health backgrounds. This paper uses a neo-Weberian lens to explore the interprofessional role dynamics of a 'postprofessional' group of practitioners, who adopt a common role and title to create a professional identity at post-qualifying level. Data were collected via individual interviews with 19 stakeholders and analysed using an abductive template approach. Differential role boundaries between nurse and allied health diabetes educators were established and reinforced in several ways. Diabetes education is considered a sub-specialty of nursing only; access to education and credentialing has been restricted for allied health; reinforcement of professional stereotypes and perceived professional values; and perceived legislative differences in access to medication management for nurse and allied health diabetes educators. [ABSTRACT FROM AUTHOR]

Despite the increased diversification of Australian families, the nuclear family formed through reproductive heterosex continues to be treated as the norm. This paper argues that this norm impacts negatively upon families formed in other ways, by exposing them to increased scrutiny. Drawing on interviews with 60 participants from four cohorts (families formed through reproductive heterosex, intercountry adoption, long-term foster care, or surrogacy), a comparative thematic analysis is presented in which two key themes are elaborated: (1) the impact of government policies and practices, and (2) the degree to which families are treated as public property. Findings suggest that families formed through reproductive heterosex were the least regulated and scrutinised; families formed through either adoption or surrogacy received a considerable degree of regulation and scrutiny; and foster families were the most scrutinised and negatively impacted by government policies. The paper concludes by considering what is required to engender more inclusive and supportive responses to all families. [ABSTRACT FROM AUTHOR]

Recently, the Australian Government has provided significant support for the expansion of Nurse Practitioner services in the community. As a result, the emerging role and ongoing retention of these professionals is an area for policy investigation. However, there is also a broader significance in the Nurse Practitioner role for which sociological perspectives can provide insight. Sociologists identify two key characteristics of late-modernism as the rise in service work and the emphasis on service worker knowledge as a commodity. This paper argues that the Nurse Practitioner role is an embodiment of these trends. Specifically, the paper considers the expanding Nurse Practitioner role as an example of the shifting boundaries between human care professionals. The paper argues that these changes point to a need for renewed consideration of identity, interaction, negotiation and emotion in relation to professional human care work. It concludes by considering conceptual resources that could support new sociological understandings of the Nurse Practitioner role in the future. [ABSTRACT FROM AUTHOR]

This paper concerns itself with some of the consequences of legislatively supported public health interventions into smoking. These have emerged from the legislative environment of 'smokefree' in Australia, and centrally concern the constitution of public space under its operation; the conceptualisation of risk which circulates within it; and the way in which agency may be imagined in public health framings of smoking. I make a critical anthropological analysis of the ways in which risk, agency and a certain kind of public are imagined and brought to bear on smokers in particular ways. The paper is equally an invitation into the social practice of smoking, as it is undertaken by smokers and as I have ethnographically encountered smoking practice since I began work in the area in 2005. Both the critical analysis and the invitation are difficult to make in a context where research on smoking is increasingly expected to contribute to a public health cessation agenda. [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]

Drawing on Foucault's conceptualisation of power, this paper examines public health as a distinctly modern regime of governance. An account of the historical regulation of drug use is traced in order to examine socio-historical shifts and lines of continuity in contemporary technologies of harm reduction. Using qualitative interview data, we examined practices of power in the context of contemporary drug use, including self-governance using techniques of monitoring, self-management and self-tracking. Participants' accounts revealed that they were encouraged to self-govern their drug use through a variety of reformist technologies that are embedded in harm-reduction programs. It is argued that participants' subjectivity is formed at the intersection of authoritative governance and self-governance, through ethical practices of the self which have emerged from disciplinary health practices, and incorporate the body as the site of power. We illustrate this by drawing a distinction between hygienist and sanitationist practices of public health. These governmental practices, which are embedded in public health programs, encourage people who use drugs to transform themselves into moral citizens, aligning their ethical practices with governing interests. [ABSTRACT FROM AUTHOR]

In this paper we report on the findings from six focus groups conducted with Australian medical students. The focus groups discussed students' perceptions of conflicts of interest and the influence of commercial values in health care and medical education. Our research revealed that students were aware of a number of structural influences that affected the medical education they received and that had the potential to shape their attitudes and practices as they progressed in becoming a doctor. We found that the pressures of educational workload and anticipated career trajectories tended to have an individualising effect that limited the perceived possibility of collective action and response to structural influences. We interpreted these findings through the lens of neoliberal governmentality to articulate the way commercial interests are negotiated and normalised by medical students. Based on these findings, we suggest that medical education should not only explicitly alert students to effects of political and commercial influences on the healthcare system, but also encourage the collective agency of students and strategies that do not place unrealistic expectations on individuals to effect structural 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]

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]

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]

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]

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 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]

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 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]

This paper starts from the premise that embodied knowledge is critical to understanding health policy implementation. We explore this notion through a qualitative investigation of the way that knowledge has functioned in the implementation of an Australian mental health policy, Partners in Recovery (PIR). Analysis uses the theoretical lens of interpretive policy analysis and the 'embodied, inscribed, enacted' knowledge schema developed by Freeman and Sturdy [(2014a). Introduction: Knowledge in policy – embodied, inscribed, enacted. In R. Freeman & S. Sturdy (Eds.), Knowledge in policy: Embodied, inscribed, enacted (pp. 1–19). Bristol: Policy Press]. Our analysis reveals a policy problem centred around difficulties of coordination where the inscribed solution lies in individuals who must implement the PIR program in local areas. Our interviews with PIR consortium members and stakeholders show that this implementation happens through the enactment of embodied knowledge. However this implementation is not straightforward and we point to difficulties arising from the centrality of embodied processes in implementation, related to the localisation of systems knowledge in individuals and structural devaluation of certain types of knowledge over others. [ABSTRACT FROM AUTHOR]

The paper presents an historical critical policy analysis of deinstitutionalisation and the introduction of neoliberal forms of governance in mental health policy. It focuses particularly on a major period of policy reform in the 1980s and 1990s in Victoria, Australia. Many of the particularities of the Victorian experience can be generally observed with deinstitutionalisation throughout the world. In particular, the policy discourse of rights and entitlements, consumer choice and empowerment, at times stood in tension with the service void created by the transition from large, stand-alone psychiatric institutions, to dispersed forms of service provision outside the hospital. Further, certain policy features could be seen to perpetuate patterns of coercion, abuse and neglect. This article offers a number of potential lessons for mental health law, policy and practice today, which is poised for further advances of neoliberal governance, including through the policy of personalised services, individualised disability funding and human rights-based reform. [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]

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]

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]

Our paper analyses and explains the migration decision and labour market experience of migrant elites, by drawing on the case of South African-trained doctors in Australia. In doing so, we expand on the limited conceptualisation of skilled migration to which we offer a different interpretation by drawing on a multi-scale and integrated model of analysis tracing the experience of this group over a 60-year period. The research is informed by a sample of almost 500 culturally diverse South African-trained male and female medical practitioners migrating to and working in Australia from the 1950s through to 2009. Through an iterative process of analysing empirical findings and simultaneously examining the policy and scholarship on medical migration, we refine the concept of migrant elite as a category of skilled migration and respond to an absence we have identified in the scholarship and policy terrain. [ABSTRACT FROM AUTHOR]

This paper explores which measures of health accurately reflect the functional capabilities of individuals -- that is, in what measures of health do those classified as having poorer health actually have poorer functional outcomes. Using the 2003 Survey of Disability, Ageing and Carers, cross-tabulations, chi-squared analysis, and logistic regression models were used to identify the relationship between functional outcomes (core activity limitations and employment and education participation) and various measures of health and disability (composite disability measure, health utility scores and general health assessment). Both the composite disability measure and the health utility score accurately capture individual functional capacity -- with both measures being related to employment participation, employment and education restrictions, and core activity imitations. The health utility scores can also be divided into a categorical measure and still reflect this functional capacity. The general health assessment measure is also related to functional capacity and can potentially be used in the place of both the composite disability measure and the health utility score. [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]

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]

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]

Over the past decade, consumers in Australia and elsewhere have increasingly been confronted with a fast growing number of health food products. This profusion of health foods is accompanied by a proliferation in popular culture of professional nutritional advice on 'what is good to eat'. The genre of lifestyle magazines is one popular medium via which healthy eating practices and health foods are frequently reported. In this paper we use a visual discourse analysis of food-related editorial and advertorial content sourced from the long running and popular The Australian Women's Weekly to investigate how lifestyle magazines have been one important locus for constituting health conscious consumers. Taking up a Foucauldian governmentality perspective we trace how this active, responsible conceptualisation of the consumer, which we refer to as 'healthy food consumer', has increased in prevalence in the pages of The Australian Women's Weekly over time. Based on our analysis we suggest that the editorial and advertorial content offers models of conduct to individuals about what possible preventative activities in which to engage, and plays an important role in shaping how we think about taking care of our health through eating. [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]

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]

There is evidence to suggest that illicit drug use is increasingly a ‘normal’ part of the lives of many young people in Australia. The normalisation framework has been applied in limited contexts in Australia, and has not been assessed using longitudinal data. This paper uses cross-sectional periodic data collected at the Sydney Big Day Out music festival between 2006 and 2009 to examine several aspects of normalisation among festival patrons. Over the 4-year period high proportions of respondents reported that cannabis and ecstasy were ‘very easy’ or ‘fairly easy’ to obtain. In most years, over half the respondents reported ‘any illicit drug use’ in the past 12 months. A statistically significant relationship was found between recent illicit drug use and degree of contact with other people who use drugs (χ2 = 64.391, df = 4, p = 0.001). Such results suggest that certain aspects of drug use are normalised among festival patrons and that these are particularly concentrated among certain groups of young people. These groups could to be targeted when delivering drug education and prevention activities. [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]

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 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 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]

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]