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The book "Women and Whitlam: Revisiting the Revolution" edited by Michelle Arrow is a collection of essays that explores the agenda for women during the Whitlam government in Australia. The book is divided into five sections, each focusing on different aspects such as political influence, the law, health and social policy, media, arts, and education, and the legacies of the era. The essays provide historical knowledge, personal stories, and inspiration for readers. The collection aims to shape the future by examining the past and highlighting what was achieved and what still needs to be done for women's equality and justice. The book also emphasizes the importance of diverse perspectives and voices, including Indigenous contributors, in the fight for lasting and meaningful change. [Extracted from the article]

This paper sets out the Collaborative Service Design Playbook, to guide planning, design, and implementation of co-created health services. Successful health service development and implementation is best guided by theoretically informed approaches; however, organisations often lack design and implementation know-how and have difficulty applying it. This study seeks to improve health service design and potential for scale-up by proposing a tool to guide an end-to-end process, drawing together service design, co-design, and implementation science; and exploring the tool's feasibility to establish a sustainable service solution developed with participants and experts that is scalable and sustainable. The Collaborative Service Design Playbook phases include, (1) Define the opportunity and initiatives, (2) Design the concept and prototype, (3) Deliver to scale and evaluate; and (4) Optimise to transform and sustain. This paper has implications for health marketing through providing an end-to-end approach with phased guidance for health service development, implementation, and scale up. [ABSTRACT FROM AUTHOR]

This article describes the development and dissemination of an evidence-based Policy Statement and Background Papers by the Australian Rehabilitation and Assistive Technology Association (ARATA). An experienced project team was engaged to conduct literature reviews and member consultations, develop resources and implement a targeted advocacy strategy that included a policy launch and meetings with government officials. The Policy Statement and Background Papers have enabled ARATA to represent the views of Assistive Technology (AT) Practitioners in consultations around the National Disability Insurance Scheme and other AT-related inquiries. In ARATA's experience, developing a policy statement and disseminating it through a targeted advocacy strategy is an effective way for a not-for-profit professional organisation to influence government policy. [ABSTRACT FROM AUTHOR]

Intergenerational care is a program where both the younger and older generations are receiving programmed care in an environment where activities and resources are shared between them. Anecdotally, an intergenerational care program takes on many forms. This paper presents a systematic literature review of intergenerational care models. Our findings are relevant to policy makers as the paper highlights the opportunities to create an age-friendly environment by introducing intergenerational models in Australia, where intergenerational care development is in its infancy. Future research will help articulate the personal, social, and economic value of intergenerational care. [ABSTRACT FROM AUTHOR]

Violence and abuse against people with intellectual disabilities are internationally recognised as a pervasive social problem. Recent years have seen the development and implementation of preventative strategies, yet only few of them have been rigorously evaluated. The present paper aims to identify preventative abuse strategies for people with intellectual disabilities and explore the evidence about their quality and effectiveness. A scoping review method was implemented, and a comprehensive search of 14 online databases identified six peer-reviewed articles, published between January 2007 and June 2019, that reported on evaluation of violence prevention strategies designed for adults with intellectual disabilities. Each program and its evaluation were critically and systematically reviewed. Overall, the analysis reveals the strategies' core elements, and highlights strengths and gaps in delivery and evaluation. More rigorous evaluation is required to establish the effectiveness of violence prevention strategies and to advance evidence-based practice in this field. IMPLICATIONS The social work profession has a critical role in the development, implementation, and evaluation of violence prevention strategies for adults with intellectual disabilities. Design of violence prevention strategies needs to be multifaceted, and embedded within the social and cultural environments of people with intellectual disabilities. Violence prevention strategies need to evolve from focusing solely on risk reduction to a broader approach encompassing the safety of adults with intellectual disabilities as part of their human rights. [ABSTRACT FROM AUTHOR]

Purpose: Substantial evidence supports assistive technology and environmental adaptations as key enablers to participation. In order to realise the potential of these interventions, they need to be both recognised in policy, and resourced in practice. This paper uses political theory to understand the complexities of assistive technology (AT) policy reform in Australia. AT research will not be influential in improving AT policy without consideration of political drivers. Method: Theories of policy formation are considered, with Kingdon's (2003) theory of multiple streams identified as a useful lens through which to understand government actions. This theory is applied to the case of current AT policy reformulation in Australia. Results: The convergence model of problem identification, policy formulation and political will is found to be an applicable construct with which to evaluate contemporary policy changes. This paper illustrates the cogency of this theory for the field of AT, in the case of Australia's recent disability and aged care reforms. Conclusions: Political theory provides a way of conceptualising the difficulties of consumers and AT practitioners experience in getting therapeutically valid solutions into public policy, and then getting policies prioritised and funded. It is suggested that AT practitioners must comprehend and consider political factors in working towards effective policies to support their practice. [ABSTRACT FROM AUTHOR]

Globally, population ageing is one of the most pressing social and policy issues faced today. Over the next two decades, Australian society will face dramatic increases in the proportion of the population aged 65 years and over, as the baby boomers move into older age and fertility levels remain low. Yet population ageing is not a surprising or new trend—demographic changes in the age profile of a population tend to occur incrementally rather than suddenly. As a demographer and geographer, Graeme Hugo drew attention to this trend in Australia’s population more than three decades ago. Throughout Graeme Hugo’s vast breadth of work over the past 40 years, there has been a consistent thread of demographic analysis and academic thought associated with the ageing of Australia’s population. This paper focuses on Hugo’s contributions to academic thought and policy on Australia’s ageing population and the challenges associated with this for both service delivery and health policy as Australian society moves into an unprecedented era of population ageing. [ABSTRACT FROM PUBLISHER]

It is well established that social determinants are crucial to health outcomes. However, the link between how social determinants contribute to health inequalities for people with disability has often failed to be acknowledged. For example, Australian disability policy has paid little attention to social determinants of health, despite people with disability faring particularly badly on a range of outcomes. This paper identifies barriers to policy action on the social determinants of health for people with disability in Australia. Data obtained from interviews with key disability policy stakeholders are analysed using a micro, meso, macro level policy analysis framework. Our analysis identifies a "services drift" acting as an important barrier to policy action, where attention is focused on health service access rather than broader social determinants such as housing, employment and education. We also identify issues in how disability policy is made that hinders action on social determinants of health. The environments people live, work and interact in like their housing, employment and education, have been shown to be more important for good health than having access to health services, yet these areas are often neglected in policy for people with disability. Using interviewees with people involved in disability policy in Australia this article aims to explore why these areas are neglected in policy relative to the focus on access to health services. Reasons for focusing more on health services compared to other policy areas include people's attitudes towards disability such as thinking about it as a medical problem rather than a social problem. There are also issues with how disability policy is being made, such as a lack of consultation with people with disability, and a lack of co-ordination between government levels and departments. Identifying these policy barriers is an important step in finding ways to get more policy action on improving the environments people with disability live in. [ABSTRACT FROM AUTHOR]

Young people transitioning from out-of-home care, commonly called care leavers, are known to be a vulnerable group. Many experience poor outcomes leading them to become homeless or involved in the criminal justice system. Yet compared to most other Anglophone democracies, Australia lacks mandatory assistance for care leavers beyond 18 years of age. There are also major legislative, policy, and program differences between care leaver entitlements in the individual states and territories. This paper argues that the Commonwealth Government should introduce a nationally consistent extended care system that would require all jurisdictions to provide a minimum standard of support until at least 21 years of age. A uniform set of extended care standards is even more vital in the context of COVID-19. IMPLICATIONS Many Australian care leavers have poor life chances despite recent advances in the support programs provided by the states and territories. A nationally consistent extended care program is likely to progress improved opportunities and outcomes for care leavers. [ABSTRACT FROM AUTHOR]

As the speech-language pathology (SLP) profession matures and evolves, there will continue to be an ongoing need for practice change. Practice change has many drivers: consumer need; an advancing evidence base; clinical innovations; financial efficiency; local service needs; population change; government policy etc. If we are to continue to have a profession with a strong identity and the capacity to make meaningful contributions to the modern education and healthcare landscape, then practice change is a necessity. To achieve practice change we must step away from long-held traditional paradigms and service delivery models. We need a workforce that is ready, committed and willing to accept change. We need organisations that are willing and open to adopt new service models, and we must have the evidence base to support these new roles and responsibilities. Making change to ensure clinicians are working to full scope or considering extended scope models (when appropriate) is actively encouraged to help achieve a more client-centred, cost-effective health service. In this discussion paper, the benefits, issues and impacts of expanding scope of practice are discussed, and ways that individual clinicians, services, training institutions, and researchers can help support the future growth of our profession are highlighted. [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]

This two-year (2016–2018) study aimed to identify what a good life is for Aboriginal people with disability in remote Central Australia and how service providers can support them to achieve a good life. This paper presents the findings that relate to barriers to delivering services for Aboriginal people with disability. In-depth interviews and focus groups were held with Aboriginal people with disability and their carers aged at least 18 years from the Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Lands and community organisations providing services there. The data were analysed using thematic analysis. There were 109 participants, of whom 47 were workers in service provider organisations and 62 were Aboriginal people. From the data, barriers to delivering services to support Aboriginal people to live a good life and solutions to overcome the barriers, were identified and described under the headings of environmental barriers and systemic issues. We discuss the policy implications of these findings with regard to addressing Indigenous disadvantage and how governments, service providers, communities, and Aboriginal people with disability and their families can work in partnership to address these barriers. Indigenous people with disability living in remote and very remote communities experience significant access and equity barriers to culturally responsive services that enable them to live a socially and culturally engaged life. Localised government and service provider disability policy approaches in Indigenous communities need to focus on both environmental and systemic issues. Greater investment in local remote communities is required to build the capacity of Indigenous families to support Aboriginal people with a disability to live a culturally and socially included life. [ABSTRACT FROM AUTHOR]

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The abuse of older people, often perpetrated by family and friends, is a complex multidimensional social problem. In most Australian jurisdictions, responses are currently limited to either primary-level (information, education and referral) or tertiary-level statutory responses. Outside of Australia, Family Group Conferencing has partially addressed this secondary-level service gap by inviting the older person and their wider family system to identify and establish a family-led plan to address potential or actual risk of abuse. This paper presents the core processes of Family Group Conferencing, including the quality of the established evidence base for its use with older people. The limitations and caveats associated with this approach are explored, and a way forward is proposed to explore the utility and suitability of Family Group Conferencing for adults in Australia in response to some types and severities of abuse and mistreatment. The abuse of older people is complex and under-reported, and many older people choose to take no action as a large proportion of perpetrators are family members. Limited Australian responses focus on either primary prevention or tertiary-level statutory responses. Family Group Conferencing may enhance secondary-level service responses to abuse, mobilising the older person's protective networks, and reducing the risk of abuse. [ABSTRACT FROM AUTHOR]

This paper examines the experiences of a small group of socio-economically disadvantaged people and their attempts to access disability welfare under Australia's National Disability Insurance Scheme (NDIS). We interviewed 32 individuals with some form of disability who were potentially eligible to apply for the NDIS. Our research revealed that only a small proportion of a sample successfully applied to the NDIS, with our interviewees characterised as 'hard-to-reach' because of their socio-economic disadvantage, social isolation, and lack of adequate support. Reflecting on the many and varied experiences of this group, we consider our interviewees to be at risk of further marginalisation in the absence of effective measures to engage and support them. We recommend ways to bring the hard-to-reach group within the ambit of the NDIS, as well as possibilities for future research. This article reports on the experiences of people who have attempted to engage with Australia's national disability support scheme. Only a few people within our sample had successfully applied for support under the national scheme, with others either unaware of it or unsuccessful in their applications Many in our sample were effectively excluded from the scheme due to the complexities of disability, social exclusion, and financial hardship. Further research in this area is critical so that the problems faced by people in the hard-to-reach group, with respect to accessing the national disability support scheme, can be addressed. [ABSTRACT FROM AUTHOR]

Purpose:In 2013, the Australian Government Senate formed a committee for inquiry and report into the prevalence of speech, language, and communication disorders and speech pathology services in Australia. Submissions were sought from individuals and organisations. In this paper, submissions made by individuals with a history of childhood communication disorder were examined to explore their life experiences and the impact on their lives when the right to communicate could not be enacted. Method:There were 305 submissions to the Australian Government Senate Committee Inquiry, of which 288 were publically accessible. In this study, the submissions (n = 17) from children or adults with a history of communication disorder (including speech, language and stuttering), who provided personal accounts of their experiences, were analysed using an interpretative phenomenological approach. Result:Four themes emerged relating to: personal identity, life with communication disorder, the importance of help, and how life would be different without a communication disorder. Conclusions:This paper gives voice to children and adults with communication disorder. In listening to these voices, the impact of communication disorder on the right to communicate and on other human rights can be heard, and the need for a response is clear. However, the challenge is to determine how the voices of these individuals, and others like them, can be enabled to exert real influence on practice and policy so communication disorder will no longer be a barrier to attainment of their human rights. [ABSTRACT FROM PUBLISHER]

Objective: The following mixed methods study aimed to decipher the factors influencing the psychological wellbeing of language brokers. Specifically, ethnic identity, attitudes towards brokering, family connectedness, and high intensity brokering situations were examined. Method: One hundred and twenty four individuals completed surveys in either paper pencil format or online. Six survey participants also volunteered to participate in semi‐structured interviews. Results: The quantitative results revealed ethnic identity and attitudes towards brokering positively correlated with psychological wellbeing, no support was found for family connectedness or for brokering in high intensity contexts. The moderating effects of ethnic identity, attitudes, and family connectedness on the relationship between high intensity brokering and wellbeing were not supported by the quantitative analysis. Emerging themes from the six interviews provided insight into familial relationships, community connection, and multicultural Australia with the sub‐themes of acceptance and non‐acceptance of diversity. Conclusion: These results support the current policies requiring health services and legal aid to provide free interpreters for individuals not fluent in English. Additionally, these results my assist in government bodies and policy makers providing additional support and resources to language brokers in the home setting and the community. [ABSTRACT FROM AUTHOR]

The main goal of palliative care is to relieve suffering. Opioids are an essential part of the pharmacological options required to address suffering by helping to relieve the pain and chronic breathlessness that may be experienced by someone with a life-limiting illness. This paper considers the recent history and current issues of the 'opioid crisis' providing recommendations to which regulatory and peak bodies can work with the Australian government, ensuring consistent adherence to WHO guidelines maintaining access to evidence based opioid management for palliative care patients whilst actively avoiding unintended suffering restricted access can cause. The recommendations are as follows: Review of the Palliative Care schedule of the Pharmaceutical Benefit Scheme Support of prescribers with current evidence, clinical practice guidelines and regulatory frameworks National opioid prescribing policies promoting linkages between palliative care and pain and addiction specialists. National real time monitoring of all opioid prescriptions Palliative care involvement in all opioids stewardship programs in acute services. Reform Medical Benefits Schedule to improve access for primary and other speciality practitioners to provide palliative care services. Compulsory palliative care education in undergraduate medical, nursing and allied health tertiary courses. Adequate, consistent stock of evidence based opioids for palliative care in community pharmacies and residential aged care facilities. These recommendations provide the regulatory guidance required to ensure persons with life limiting illness have continued access to safe and effective medication that can relieve suffering. [ABSTRACT FROM AUTHOR]

Trade agreements influence the distribution of money, goods, services and daily living conditions – the social determinants of health and health equity, which ultimately impacts differentially on health within and between countries. In order to advance health equity as a trade policy goal, greater understanding is needed of how different actors frame their interests in order to shape government priorities, thus helping to identify competing agendas across policy communities. This paper reports on a study of how policy actors framed their interests for the Trans Pacific Partnership agreement. We analysed 88 submissions made by industry actors, not for profit organisations, unions, researchers and individual citizens to the Australian government during treaty negotiations. We show that policy actors' ideas of the purpose of trade agreements are shaped by competing underlying assumptions of the role of the state, market and society. We identify three primary framings: a dominant neoliberal market frame, and counter frames for the public interest and state sovereignty. Our analysis highlights the potential enabling and constraining impact of policy frames for health equity. In particular, the current dominant market framing largely excludes the social determinants of health and health equity. We argue that advocacy needs to tackle head on the underlying assumptions of market framings in order to open up space for the social. We identify successful examples of health framing for equity as well as opportunities for engagement with 'non-traditional' allies on shared issues of concern. [ABSTRACT FROM AUTHOR]

Background: Consumer and carer participation in mental health service development and evaluation has widespread nominal support. However, genuine and consistent participation remains elusive due to systemic barriers. Aims: This paper explores barriers to reform for mental health services from the perspectives of consumers and carers actively engaged in advocating for improvements in the mental health system. Method: Qualitative research with two mental health systemic advocacy organisations analysed 17 strategic communication documents and nine interviews to examine barriers to reform and participation identified by consumer and carer advocates and staff. Results: A number of individual-level barriers were described, however advocates gave more focus to systemic barriers, for which five themes emerged. These reflected lack of awareness, limited participation opportunities, slow progress for change, policy issues and mental health culture including stigma. Conclusions: Findings highlight systemic barriers to participation for consumer and carer advocates as a whole and the influence of these barriers on the individual experiences of those engaged in advocacy and representation work. Participants also emphasised the need for leadership to overcome some of these obstacles and move towards genuine consumer and carer participation and reform. Findings are discussed in the context of power within mental health systems. [ABSTRACT FROM AUTHOR]

Young adults, aged 18-30 years, are disproportionally mentioned in sexually transmissible infection surveillance data both in Australia and internationally. This contributes to categorising young adults as an ‘at risk’ group in health policy. How young adults are framed in policy, and what informs this, have direct implications for policy priorities and responses, including the development of health promotion programmes. In this paper, we provide a case study of Australia’s National Strategies for Blood Borne Viruses and Sexually Transmissible Infections from 2005 to 2017. We identify how ‘young adults’ as a population are masked by, and subsumed within, the broader category of ‘young people’ within these strategies. As a result, young adults become framed by default as a ‘risk category’ that requires education to correct its deficits, regardless of personal experience. For health promotion to advocate, mediate and enable better sexual health outcomes, a policy environment is needed that reflects the changing social and cultural contexts and sexual independence that young adults experience. Sexual health policies should reflect the complexity and opportunities of young adulthood if we are to offer an enabling policy environment for innovative and nuanced health promotion strategies, including adult appropriate health education. [ABSTRACT FROM AUTHOR]

Public health efforts to lift childhood vaccination rates can be supported or undermined by media representations of parents. Polarising representations neglect the large range of ‘middle-ground’ positions people occupy, potentially alienating parents. In recent years, Australian public health actors have tried to better engage journalists to avoid this. As these efforts have unfolded, the main national immunisation policy lever has become more punitive. This paper examines whether Australian newspaper representations of parents have changed, by comparing 153 newspaper articles from two periods: 1997-1998 (prior to the development of a public health lobby targeting the media; when the first national childhood immunisation policy was introduced) and; 2015-2016 (5 years after advocacy groups began working with the media; and when the national policy took a punitive turn). We analyse patterns and shifts (between 1997-1998 and 2015-2016) in the portrayal of parents as complacent, alternative, hesitant and as choosing. Australian newspaper portrayals of parents are broadly aligned with the policy targets of the day. In 2015-2016, there was less negative representation of parents who occupy the ‘middle-ground’ between vaccine acceptance and rejection. However, coverage of alternative parents (vaccine objectors) intensified in quantity and negativity. Concurrently, there were new (minority) portrayals of vaccine objectors as invisible, and as victims being denied choice. This signals that reporting may simultaneously align with national policy targets and destabilise public health efforts to avoid polarising misrepresentations of parents, characterisations likely to undermine trust in public health. Rather than ‘blame the media’, this analysis illuminates conflicts within public health. [ABSTRACT FROM AUTHOR]

In most developed countries, competent patients have the legal right to refuse any medical treatment; Advance Care Planning mechanisms extend this right to non-competent patients. However, some groups, including lesbian, gay, bisexual, transgender and intersex (LGBTI) people, risk their wishes not being respected if they lose capacity, more than others. Little is known about medical practitioners' knowledge of, or attitudes to, the law in this area, especially in relation to LGBTI people, or how the law influences their decision-making. An Australian postal survey explored knowledge and attitudes of medical specialists to legal issues relating to withdrawing/ withholding life-sustaining treatment from adults without capacity. One scenario (the focus of this paper) asked which of four plausible substitute decision-makers, including a same-sex partner, had the legal authority to make such decisions. The overall response rate was 32% (867/2702). Less than one-third of respondents correctly identified the same-sex partner as the legally authorised decision-maker. LGBTI people face multiple obstacles to having their end-of-life wishes respected. Where healthcare providers are also ignorant of the partner's legal right to make such decisions, the problem is compounded. Improved legal education for clinicians and promotion of educational resources for members of the LGBTI community is needed. [ABSTRACT FROM AUTHOR]

Objective: Integrated care has been identified as means of managing the demands on the healthcare budget while improving access to and quality of services. It is particularly pertinent to rural health services, which face limited access to specialist and support services. This paper explores the capacity of three rural communities in South Australia to deliver integrated mental health support for older people. Methods: Thirty-one interviews were conducted with local health and social service providers from mental health, community health, general practice, residential aged care, private practice, NGOs and local government as part of a larger action research project on service integration. Results: Participants highlighted differences in service delivery between the communities related to size of the community and access to services. Three structural barriers to delivery of integrated care were identified. These are as follows: fragmentation of governmental responsibility, the current funding climate, and centralisation and standardisation of service delivery. Conclusion: We conclude that despite a focus upon integrated care in mental health policy, many features of current service delivery undermine the flexibility and informal relationships that typically underpin integration in rural communities. [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 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]

Increasing public participation has the potential to inform better alcohol policy. One method for increasing participation is the citizens' jury – a strategy that has been both touted as a panacea for issues of democratic representation and dismissed as ineffective in impacting policy. Seeking to look past both hype and cynicism, we reflect on two Australian juries with an aim to identify both the potentials and pitfalls of the use of citizens' juries in alcohol policy. Using public documentation, we analyse two alcohol-related citizens' jury processes – one in Adelaide, SA, and one in Sydney, NSW – with respect to their implications for alcohol policy development. We reflect on matters of participation, deliberation, authority, remit, and impact of recommendations. The case studies indicate the importance of clear aims; whether these are instrumental and focussed on developing specific alcohol policy recommendations or focussed on broader epistemic democratic effects. Jury composition, the notion of vested interests, and the extent of juries' authorising power are key considerations for juries deliberating on alcohol policy. Due to the nature of policy-making, no single strategy can be a democratic panacea. However, we find that carefully considered and situationally aware elements of citizens' juries may be useful in alcohol policy development. [ABSTRACT FROM AUTHOR]

Walking along side those responding to climate-related threats as co-researchers is surfacing new understanding of the potential for community action in complex and chaotic situations. Action research enables academia, government, non-government organizations and community members to learn collaboratively, building knowledge that is nuanced and contextualized. Whilst this approach aims to disrupt traditional power in relation to knowledge production, it continues to struggle for legitimacy and, hence, policy and practice traction, sitting uncomfortably in a field dominated by positivist empirical strategies a "single truth." This article draws on two action research case studies – the first a multi-partner place-based engagement and the second a learning partnership with a philanthropic organization operating across two Australian States – to illustrate how we might navigate the contours of power that shape our efforts to build knowledge collaboratively. Drawing on these experiences we identify two key challenges to successful industry/academic action research partnerships: shifting power and translating knowledge to broader audiences. We conclude with ideas to improve future action research practice. [ABSTRACT FROM AUTHOR]

Improved job quality will make longer working lives in the aged care sector more sustainable. We interviewed 20 older aged care workers to identify which job characteristics are significant for health and to identify policy remedies. Workers take pleasure and pride in responding autonomously to a care recipient's situation, developing understanding, maintaining morale and performing intimate bodily care with dignity. However, a shortage of staff time requires workers to take a task-oriented approach. This causes worker stress and diminishes their desire and capacity to delay retirement. In the Australian context, regulating minimum staffing is the most suitable policy response. [ABSTRACT FROM AUTHOR]

Research on the mental health of people who identify as lesbian, gay, bisexual or transgender (LGBT) often emphasises individual vulnerability to mental health issues. However, attitudes towards LGBT individuals may also contribute to their experiences of minority stress. In the present study, the relationship between mental health literacy (MHL) and attitudes towards LGBT individuals in Australia and India was investigated. Seven-hundred and eleven participants (355 male) from Australia (n = 303) and India (n = 408) completed an online survey which included questionnaires indexing the participants' MHL and their attitudes towards LGBT individuals. MHL was associated with attitude scores, such that participants with higher levels of MHL tended to report more positive attitudes towards LGBT individuals. These relationships were stronger for Australian participants compared to Indian participants. These findings suggest that minority stress may be intensified for LGBT individuals when the MHL of the people they interact with is low. Alternatively, MHL may signal how willing an individual is to offer mental health support to a LGBT person. The present results also highlight the influence of cultural context on MHL and the need to consider this when examining attitudes towards LGBT individuals. [ABSTRACT FROM AUTHOR]

To evaluate a dog-walking program (called "Dog Buddies") designed to address the need for evidence-based programs that create opportunities for people with cognitive disabilities to be more socially included in mainstream society. The research question was: Does community dog walking foster social interaction for people with cognitive disabilities? Single-case experimental design was used with four individuals (three with intellectual disability; one with Acquired Brain Injury (ABI)) recruited via two disability service providers in Victoria. Target behaviours included frequency and nature of encounters between the person with disability and community members. Change was measured from baseline (five community meetings with a handler but no dog) to intervention period (five meetings minimum, with a handler and a dog). Semi-structured interviews, audio-recorded and transcribed verbatim, provided three participants' subjective experiences of the program. Dog Buddies increased the frequency of encounters for all participants. The presence of the dog helped to foster convivial encounters, community members were found to be more welcoming, and some participants were recognised or acknowledged by name over time in the intervention phase. The dog-walking program offered a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities. The co-presence of people with disabilities in the community with the general population does not ensure social interaction occurs. Both disability policy, and the programs or support that is provided to people with disabilities, needs to have a strong commitment to the inclusion of people with disabilities in mainstream communities. Dog Buddies is a promising example of a program where the presence of a pet dog has been demonstrated to support convivial, bi-directional encounters of people with cognitive disabilities and other community members. Dog-walking offers a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities. [ABSTRACT FROM AUTHOR]

A key goal of the NDIS, the federally funding individualised funding scheme for people with a disability in Australia, is to facilitate an ordinary life for them in their communities. This study examined family perceptions of the contribution NDIS made to create an ordinary life for their adult member with intellectual disability. Semi-structured interviews were conducted with 20 families. The families found this to be a complex process in that while the move to the new funding system supported some elements of a life more aligned to that of similar aged peers, there were also a number of missed opportunities. The opportunities that were available to the adult with intellectual disability were affected by stakeholders' differing views of disability. NDIS presents an opportunity to continue to build towards enabling people with a disability to make their own choices and, with support when needed, build a life similar to their peers. The National Disability Insurance Scheme (NDIS) is the new federal individualised funding scheme for people with a disability in Australia. The National Disability Insurance Scheme gives people with a disability their own funding. This helps them to be able to make their own choices about what they want to do and what support they need. The National Disability Insurance Scheme hopes to support an ordinary life for people with a disability in their communities. This study investigated how it is working for adults with intellectual disability. It showed that it is a complicated process. Some aspects of the National Disability Insurance Scheme are working well but there are missed opportunities. There is a need to keep talking about how people think about disability so we can understand the impact different views have on the National Disability Insurance Scheme planning and outcomes for adults with intellectual disability. [ABSTRACT FROM AUTHOR]

To investigate factors influencing provision of care and support to older adults with traumatic injury in Australia, from a health service and policy perspective. Semi-structured interviews were undertaken with 16 clinicians, support providers, researchers, policy makers, and representatives from peak bodies in Australia, who had experience across injury, ageing, and disability sectors. A thematic analysis was performed using a framework approach. Themes identified included prolonged injury recovery in older adults, limited accommodation options, restricted access to preventive care, escalating care needs over time, issues with siloed funding schemes and funding availability, and the need for advocacy to coordinate care across different schemes. Certain themes were specific to people who were older when injured. Others related to people who had acquired an injury at a younger age and were ageing with injury. However, most themes had relevance for both groups. For older adults, this research has highlighted a range of cross-sector problems which impact upon the potential to recover from injury and to age well with injury. To improve the lives of older adults with injuries, Australia needs better coordinated system interfaces, shared funding models or packages of care across sectors, and improved advocacy and case management. To address the lack of long-term, multi-disciplinary preventive care for age-related conditions and secondary complications in people with injuries, older adults may need more prolonged, or individualised, care following injury, episodic health checks, and a greater focus on long-term health care. Accessible and well-coordinated specialist housing and support responses, that offer timely access to health care professionals and carers trained in both ageing and disability, and enable greater support for "ageing in place", are required to manage changing care needs of people ageing with injury. There needs to be greater involvement of geriatricians, nurses, and allied health care professionals within the aged care sector in order to care for people with complex needs, including older adults with injury-related disability. To reduce gaps in care and support for injured older adults, Australia needs better coordinated system interfaces, shared funding models or packages of care across sectors. [ABSTRACT FROM AUTHOR]

Assumptions about time, value, labour, and health coalesce in the policy decision to extend the pension eligibility age in Australia from 65 to 67 years. Acknowledging the multiple, often incompatible ways in which time is conceptualised and experienced, we question the expectation of extending Australians' working lives. Drawing on semi-structured interviews with 19 male and female bus drivers over the age of 55 in Australia, we illustrate that older blue collar workers may accumulate chronic health conditions that not only limit their ability to maintain the strict time-discipline required to remain in the workforce, but also introduce demands on their time beyond paid employment (including those required for the management of chronic health conditions). Poor health, and the multiple ways in which it constrains labour participation and time, fosters diverse, unequal, and uneven experiences of the final years of work for these blue collar workers, which may not allow them to meet the policy expectation to work until the age of 67. We argue that by failing to acknowledge the long-term health effects of blue collar work and its work-limiting bodily effects, raising the pension age devalues industrial work histories and manual labour. Finally, acknowledging the social milestone of retirement, we question the moral dimensions of extending the pension eligibility age. [ABSTRACT FROM AUTHOR]

Public health agencies tasked with improving the health of communities are poorly supported by many 'business-as-usual' funding practices. It is commonplace to call for more funding for health promotion, but additional funding could do more harm than good if, at the same time, we do not critically examine the micro-processes that lead to health enablement – micro-processes that are instigated or amplified by funding. We are currently engaged in a university-and-policy research partnership to identify how funding mechanisms may better serve the practice of community-based health promotion. We propose three primary considerations to inform the way funds are used to enable community-based health promotion. The first is a broader understanding and legitimising of the 'soft infrastructure' or resources required to enhance a community's capacity for change. The second is recognition of social relationships as key to increasing the availability and management of resources within communities. The third consideration understands communities to be complex systems and argues that funding models are needed to support the dynamic evolution of these systems. By neglecting these considerations, current funding practices may inadvertently privilege communities with pre-existing capacity for change, potentially perpetuating inequalities in health. To begin to address these issues, aspects of funding processes (e.g., stability, guidance, evaluation, and feedback requirements) could be designed to better support the flourishing of community practice. Above all, funders must recognise that they are actors in the health system and they, like other actors, should be reflexive and accountable for their actions. [ABSTRACT FROM AUTHOR]

For patient communities, digital media have dramatically transformed the options for action. This includes working collectively to change policies in ways that would have been difficult, if at all possible, before the internet. Yet, to date, the impacts of patients' growing use of digital media on their sense of collective agency have been little explored. Drawing on the findings from an Australian study on patients' use of digital media to access treatments (involving 50 interviews with participants from HIV/AIDS, breast cancer and neurodegenerative communities) and using a governmentality lens, this article sheds light on the changing character of patients' sense of agency in an age of digital media. We identify a shift in patients' conceptions of their agentic selves associated with the growing use of these media – from 'activists' to 'advocates' – and consider the implications for critical public health. As we argue, this 'digital self-advocacy' is manifest in patients' accounts of how they use digital media to achieve their goals and reflects the responsibilisation that is a hallmark of neoliberal governance. We suggest that digital self-advocacy offers a restricted vision of patient agency that limits rather than facilitates actions needed to respond to crises and to advance health justice. In our conclusion we consider whether the context and the nature of a condition or disease may also have a bearing on patients' sense of agency in an age of digital media, making reference to patient responses to a new illness phenomenon dubbed 'long COVID-19ʹ. [ABSTRACT FROM AUTHOR]

Reducing the gap between the need for and access to effective and best practice care at the end-of-life is a goal of the Australian palliative care sector. Largely absent from the suite of plans, strategies and frameworks that map Australia's path to quality end-of-life care for all patients isPalliatiev CAre Australia the role of ambulance services. Instead, patients' need for these services tends to be characterized as an undesirable consequence of an under-resourced palliative care sector and no longer necessary when the sector is fully resourced. We hypothesize that one reason for this characterization is that the ambulance and palliative care sectors have fundamentally different perspectives of end-of-life care. We conclude that further if the palliative care sector were to partner with ambulance services, the gap between the need for and access to end-of-life care would be reduced more rapidly and cost effectively. [ABSTRACT FROM AUTHOR]

A range of barriers that impede collaborations between consumer researchers and other researchers have been identified, despite clear acknowledgement of the benefits of this approach in the literature. Recent research has questioned whether the costs of collaborative research outweigh the benefits. The overarching aim of the current study is to better understand non-consumer researchers' attitudes to, and issues concerning, engagement with consumer researchers. Non-consumer researchers from mental health disciplines were invited to participate in the cross-sectional Consumers as Researchers in Mental Health survey, and to respond to open-ended questions about their experiences of collaborative research with consumer researchers. The findings demonstrate a range of benefits associated with collaborations with consumer researchers – including increased relevance and credibility of research, and greater translation of research findings into changes in health policy, service, research and education. Collaborations were found to be varied and not limited by research design, decision-making styles, or research topic. Understanding these benefits within the context of identified barriers can make an important contribution to the proliferation of mental health consumer researcher roles. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic shows variable dynamics in WHO Regions, with lowest disease burden in the Western-Pacific Region. While China has been able to rapidly eliminate transmission of SARS-CoV-2, Germany – as well as most of Europe and the Americas – is struggling with high numbers of cases and deaths. Objective: We analyse COVID-19 epidemiology and control strategies in China and in Germany, two countries which have chosen profoundly different approaches to deal with the epidemic. Methods: In this narrative review, we searched the literature from 1 December 2019, to 4 December 2020. Results: China and several neighbours (e.g. Australia, Japan, South Korea, New Zealand, Thailand) have achieved COVID-19 elimination or sustained low case numbers. This can be attributed to: (1) experience with previous coronavirus outbreaks; (2) classification of SARS-CoV-2 in the highest risk category and consequent early employment of aggressive control measures; (3) mandatory isolation of cases and contacts in institutions; (4) broad employment of modern contact tracking technology; (5) travel restrictions to prevent SARS-CoV-2 re-importation; (6) cohesive communities with varying levels of social control. Conclusions: Early implementation of intense and sustained control measures is key to achieving a near normal social and economic life. [ABSTRACT FROM AUTHOR]

Background: Dedifferentiated policy treats adults with intellectual disabilities as part of the larger group of people with disabilities. The implications of the dedifferentiated National Disability Insurance Scheme (NDIS) for adults with intellectual disabilities are explored. Methods: Analysis of peer reviewed and grey literature between 2014 and 2020 about design of the NDIS and outcomes. Results: Many participants experienced problems with NDIS implementation. Outcomes for adults with intellectual disabilities compared poorly to other groups. They were disadvantaged by standardised planning processes relying on self-expressed needs and omission of supported decision making. As the NDIS matures, it is becoming more differentiated but issues relevant to adults with intellectual disability remain largely invisible. Conclusions: Further shifts towards standardised planning and functional assessment may be disadvantageous for adults with intellectual disabilities for whom support needs are dependent on social and contextual factors, and exercise of choice on support for decision making. [ABSTRACT FROM AUTHOR]

Objectives: Despite being considered a low-intensity exercise, concerns have been raised about the risk of injuries associated with yoga. This study aimed to analyze the characteristics and trend of yoga-related emergency department (ED) presentations from July 2009 to June 2016 in Victoria, Australia. Methods: The Victorian Emergency Minimum Dataset (VEMD) was used to collect the de-identified data. The data were first analyzed using descriptive statistics and Spearman's correlation. Further injury trend was analyzed by calculating the percentage change of the number of yoga-related injuries during the 7-year study period. Results: There were 118 yoga-related injury cases that significantly (p <.05) increased by 357% from July 2009 to June 2016. Most of the cases were female (n = 96; 81.4%) and between 20 and 39 years old (n = 68, 57.6%). Most common injuries comprised dislocations/sprains/strains (n = 60, 51.7%) followed by fractures (n = 17, 14.4%), and injury to muscle/tendon (n = 15, 12.7%). Conclusion: The findings warrant future nationwide research as well as an investigation into the risk management strategies of yoga service providers to minimize the risk of injury. [ABSTRACT FROM AUTHOR]

Media and politicians both influence public opinion and policy responses to illicit drug issues. This study examines the contribution each may have made in Australia in 2015 to the problem and politics streams of the policy process, as outlined in Kingdon's 'multiple streams' heuristic, when a National Ice Taskforce responded to increased public, political and media concern about methamphetamine use. A retrospective content analysis compared the frequency and content of articles about methamphetamine in print media (N = 639) and federal parliament speeches (N = 158) in 2015. Peaks in the number of media articles and debates in parliament followed the establishment and interim findings of the Ice Taskforce. The findings showed that politicians more frequently framed methamphetamine use as a crisis or epidemic than the media. Both frequently portrayed cost to society as the consequence of methamphetamine use and often cited law enforcement sources. The media most frequently positioned methamphetamine users as criminal or deviant compared to politicians who did not position the user or positioned them as an addict or victim. This analysis highlights the convergence of the problem and politics streams and suggests they are not independent as first posited by Kingdon. [ABSTRACT FROM AUTHOR]

Purpose: High demand for speech-language pathology services is reflected in long waiting lists. Waiting can be active or passive and has implications for stakeholders, including consumers, professionals, and organisations. The present study explored experiences and perspectives regarding waiting for speech-language pathology services through analysis of stakeholders' written submissions to an Australian Government Senate Inquiry. Method: Written submissions (n = 337) were screened for terms related to waiting. Included submissions (n = 133) were written by organisations (36.8%), speech-language pathologists (29.3%), parents (27.8%), individuals with communication and/or swallowing difficulties (5.3%), and others. Result: Inductive thematic analysis identified three themes. (1) Duration. Consistently described as long. (2) Consequences. Consumers' consequences included: burden on physical health, finances, time, emotional wellbeing, and relationships, reduced continuity of care, and increased intervention needs. Professional consequences included: stress and burnout impacting job satisfaction, and reduced effectiveness. Societal consequences included: social and ethical burden, and a drain on health and legal systems. (3) Actions. Consumers advocated and sought alternatives (e.g. threats to harm their child, relocation to a capital city), professionals implemented service delivery and policy actions, and organisations lacked effective system-wide strategies. Conclusion: Existing services did not appear to meet stakeholders' needs. Action is needed to improve speech-language pathology waiting lists and access to services, and minimise possible consequences for stakeholders. [ABSTRACT FROM AUTHOR]

Copyright of Australian Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research aimed to develop and prioritize recommendations for prevention of suicide among nursing home residents. The study employed a nominal group technique, comprising three rounds, including two forums and a follow-up survey to prioritize recommendations for prevention. Participants included experts and stakeholders in aged care, geriatric psychiatry, suicide prevention, and public policy. The study was conducted and described in accordance with the consolidated criteria for reporting qualitative studies (COREQ). Nine participants (n = 6 males, 66%) developed eleven recommendations for prevention. The top three prioritized recommendations included expanding state and national suicide prevention frameworks, aligning nursing home life with community living, and improving residents' access to mental health services. The recommendations provide a foundation for suicide prevention strategies in Australian nursing homes and contribute to the limited international knowledge base on prevention of suicide among nursing home residents. [ABSTRACT FROM AUTHOR]

Rebranding men's dietary choices in the mind of the mainstream Australians to include more plant-based options, is a difficult task. Eating meat is a way to satisfy nutritional requirements but also has an embedded symbolism of power to which Australian men are accustomed. Vegetarian men are seen by the majority of the male population and the social discourse surrounding gendered food as betraying the social expectations about masculine behavior despite research showing the need for higher intake of fiber to reduce non-communicable diseases and improve planetary health. Those who have adopted vegetarian diets are exposed to ridicule and may face social isolation because of their unorthodox food choices. In order to reshape the meat consumption of men in Australia, we must recognize the gendered dynamics of dietary choices that associate meat consumption with masculinity. This research examines the power of the current food discourse and social constrains imposed on vegetarian men based on a 2019 survey in Sydney, Australia with 1053 male participants who have different frequencies of meat consumption. The participants were asked to express their opinion about vegetarian dietary choices, and the dominant view is that they provoke non-acceptance and various degrees of aversion. Instead of practicing overt dietary choices, those who embrace vegetarianism prefer to be unidentifiable as such to avoid social prejudice. While individual dislike may change over time, the current mass perception of vegetarianism is of unmanly behavior. A new role for institutions and policies related to public health, environmental wellbeing and use of resources in motivating a greater uptake of plant-based food choices, is also needed. [ABSTRACT FROM AUTHOR]

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Health services internationally are reconsidering whether current service delivery models are inclusive and responsive to lesbian, gay, bisexual, trans* and gender diverse, intersex, and/or queer (LGBTIQ+) identifying individuals. A survey was conducted to establish a baseline needs analysis, as part of an LGBTIQ+ workforce development program, on perceived staff knowledge and confidence in a multi-site public mental health service in Melbourne, Australia. The survey comprising multiple choice, 5-point Likert scale ratings, and short answer sections was administered to mental health staff attending training at their place of work. Workplaces included: community clinics, residential services, acute inpatient services, service development, and research departments. Perceptions of self-confidence and knowledge, and further support needs expressed, were examined through analyzing quantitative and qualitative responses in feedback following the education sessions. The sample comprised 85 respondents; the majority female (66%), with a good representation of staff across age brackets. While the majority of staff identified as heterosexual (68%), LGBTIQ+ individuals were represented. Though 64% of staff surveyed noted that opportunities exist in the workplace to discuss LGBTIQ+ issues, a desire to increase knowledge was expressed by 94% of staff. Staff attitudes, knowledge, confidence, and support needs should be carefully considered at organizational and leadership levels, to ensure health services foster LGBTIQ+ responsive service delivery models and practices. [ABSTRACT FROM AUTHOR]

Critics of government intervention for the prevention of lifestyle-related chronic disease often conceptualise such efforts as 'nanny state', reflecting a neoliberal perspective and derailing wider debate. However, it is unknown how the community perceives such interventions. Given the importance of public opinion to government willingness to implement population-level system change, we aimed to better understand Australian community attitudes towards government-led prevention, in particular whether nanny state conceptualisations reflect community attitudes. We used an iterative mixed methods approach to data collection and analysis based on focus groups (n = 49) and a national survey (n = 2052). Despite strong endorsement (91%) of personal responsibility for health, 46% of survey respondents thought government plays a large role in prevention. The nanny state conceptualisation was not dominant in either the survey or focus group data. Qualitative data analysis highlighted alternative conceptualisations, namely government as a: canny investor; leader on positive health behaviour; partner or facilitator for health. Respondents' level of support for specific interventions overlaid these general conceptualisations with considerations of the target population and risk factor, intervention mechanism and government motives. Community perceptions regarding prevention therefore reflect more thoughtful and complex interpretations of preventive actions and policies than suggested by nanny state conceptualisations. We argue that advocates and legislators should not allow debate around preventive measures to be restricted to the nanny state-libertarian continuum, but engage the community in more collectivist considerations of future health costs, beneficiaries, equity and likely outcomes of both action and inaction in order to garner community support and identify information gaps. [ABSTRACT FROM AUTHOR]