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Assessment is said to drive student learning, though the value of a 'grade' within work-integrated learning (WIL) is still not clear and most field placement students do not want their learning to be assessed beyond a pass/fail grade. Is then, the 'learning' in WIL as important as 'learning' in non-WIL courses? The focus of this paper is on the 'value' stakeholders place on the academic standards and grading practices in WIL. Data from a small qualitative constructivists grounded theory study undertaken in the Human Services sector will be used and how to grade 'reflection' will link learning, assessment and grading practices, identifying the difficulties and challenges to mainstreaming WIL. The importance of employability from a WIL experience will be the focus of a future paper.

Neighbourhood Houses in Australia are community place-based organisations that provide education, support services, and develop responses to local issues with local communities. The practices within Neighbourhood Houses are informed by community development. Yet knowledge, understanding and practices of community development vary across the workforce. In 2019, Neighbourhood Houses Victoria commenced a programme of professional learning for the workforce. This paper draws on data from an impact evaluation and examines the benefits and barriers to embedding a professional learning programme in community development within its workforce. Using practice theory to examine the tensions and contradictions inherent in delivering professional learning in neoliberal times of managerialism and accountability in not-for-profit organisations. The contradictions of practice will resonate with organisations seeking to implement a professional learning across a broad range of human service organisations such as settlement houses, human services and community education settings. We claim most not-for-profit workforces are impacted by the discursive practices of neoliberalism such as contractual arrangements and the adoption of business practices to comply with funding requirements. These compliance requirements contrast with the philosophy and practices of community development and have the potential to impact on professional learning and the practices within these workplaces.

This paper explores the contribution of a physical learning space to student engagement in social work education. Drawing on a constructivist methodology, this paper examines the findings of a survey conducted with students and staff in a social work and human service programme about their experiences of a Social Work Studio learning space. The analysis identified that students and staff who used the Studio reported that students were emotionally, cognitively and behaviourally engaged in the space, which enriched their development as social work and human service practitioners. The researchers concluded that the Social Work Studio is a useful tool for enhancing social work student engagement and increasing their confidence to address the "real-life" challenges they may face as social work practitioners.

Relationship‐based practice refers to approaches within human services which centralise inter‐personal relationships—either those between clients and workers or between clients and their own network—as a way to achieve positive service outcomes. Relationship‐based practice is increasingly recognised as a critical component in many areas of human services, particularly youth services. Despite increasing policy intentions for programs to adopt a relationship‐based approach, it is not always clear how services can implement this in practice. While relationship‐based skill training can be offered to individual workers, a question remains as to what can be done at an organisational and policy level to cultivate relationship‐based practice. Within this context, this paper explores how programs can be designed to foster relationship‐based practice. The paper draws on the evaluation of an intensive and tailored service for addressing long‐term youth unemployment in Australia: the your job your way pilot program run by yourtown. A key success of the program was strong relationship‐based practice, and this paper explores five features of the program's design that enabled this: (1) small caseloads, (2) intensive support, (3) staff with complementary skills and a professional and 'youth friendly' demeanour, (4) staff discretion about some aspects of program implementation, and (5) support delivered through social and group activities. The paper draws implications for how service provider organisations and governments can cultivate relationship‐based practice in human services. [ABSTRACT FROM AUTHOR]

Nearly a decade ago, the Australian Federal Government introduced a Digital Service Standard (DSS) for new and redesigned government services. This was an opportunity to encourage digital services and disruptive innovations to help the government improve citizens outcomes, and indeed there was a significant uptake in the digital services assessments offered by the program with key government agencies across health, human services, taxation, and education on board. However, by the 2020s the number of publicly visible assessments had significantly reduced. The initial broad adoption and recent reduction in numbers present an opportunity to explore the effectiveness of this government innovation management program that was ahead of its time. This paper reviews the impact of the DSS in fostering public service innovation and presents lessons learnt from the program. To perform this analysis, this research evaluates to what extent the DSS applied common private sector innovation management approaches of Innovation Process Management and Innovation Portfolio Management in the public sector. It also looks at the impact of these programs in encouraging specific types of modern digital innovations. The analysis draws on DSS assessments from 2015 to 2021 and considers how the program demonstrated public sector innovation leadership. This paper proposes a framework to improve the DSS by tailoring its approach for new and existing services, adopting specific standards to encourage incremental and disruptive innovations, and promoting more transparent reporting and funding of innovation management programs. This evaluation found that the DSS exemplifies Innovation Process Management in its use of stages and gates, and Innovation Portfolio Management in its use of targeted assessment criteria across innovation portfolios of various government agencies. The analysis also identified design limitations in the DSS as a whole of government innovation management approach due to its limited uptake in multiple large agencies and lack of specific standards to encourage different types of innovation. The impact of this research is to increase the adoption of the DSS and increase the innovation outcomes delivered by this government program. We conclude by reflecting some of the unique considerations in applying private sector innovation management practices in the public sector. Points for practitioners: Innovation management techniques are emerging but remain immature in the public sector.Australia has shown leadership in Government Innovation Process and Portfolio Management.Government must remain committed to innovation management programs and sharing the outputs of these programs.Government Innovation Management Programs should build in flexibility to encourage different types of innovation. [ABSTRACT FROM AUTHOR]

Contemporary manifestations of race are dynamic and elusive in the forms and shapes they take. "Colourblind" racism is effective at drawing on seemingly objective and race‐neutral discourses to obfuscate racialized forms of structural exclusion. Framed by Critical Race Theory and Critical Narrative Analysis this paper presents an example from the Australian context that examines the relationships between a grassroots initiative developed by creatives from the African diaspora and two not‐for‐profit human services organizations, to illustrate how ideologies of race are enacted and obscured by managerialist ideologies and discourses of risk. Specifically, it shows how harmful dominant cultural narratives of deficit and danger transforms racialized Africans in Australia into "risky subjects." In a managerialist organization, risk must be controlled, and thus risk becomes the rationality for the control of racialized and risky subjects. Resistance to control by those subjects produces forms of organizational defensiveness that are mobilized through managerialist discourses and practices that work to structurally exclude. These findings illustrate the ways ideologies of race work alongside and through other ideological discourses and practices which render racialized dynamics of oppression race‐neutral. Highlights: Contemporary and color‐blind manifestations of racism are evasive.Ideologies of race are obscured by discourses of risk.Risk discourses contribute to racialized forms of control and structural exclusion. [ABSTRACT FROM AUTHOR]

Purpose: Trauma-informed care and practice (TICP) has gained international attention since the mid-1990s, but its recent adoption in Australia has been met with various barriers, including a lack of training and education opportunities to enhance professional knowledge and practice. This paper aims to identify and further understand what is occurring in TICP training and education for health and human service professionals in Australia; specifically, what is known about TICP content and training strategies being used. Design/methodology/approach: A scoping methodology was used to undertake a systematic search of the literature to identify and map the scope and nature of research activity on TICP training and education for professionals in Australia. Based on the predetermined inclusion and exclusion criteria, removal of duplications, abstract review and full-text screening, six studies met the inclusion criteria for content analysis in this review. Findings: The studies showed that TICP training and education was occurring predominantly in the Australian health sector for nursing professionals and improved knowledge, confidence to respond to disclosures of trauma and approaches to care. Training was commonly delivered through one-day workshops and brief Web-based approaches. The findings suggested that there is a need for consensus on TICP content to ensure that fidelity to the principles of TICP is promoted in unique workplace settings and for ongoing commitment by relevant stakeholders and funding bodies. Originality/value: To the best of the authors' knowledge, this is the first review exploring what is happening across disciplines and sectors for trauma-informed education. The findings have implications for clinicians, professionals, educators and researchers. [ABSTRACT FROM AUTHOR]

Neighbourhood Houses in Australia are community place-based organisations that provide education, support services, and develop responses to local issues with local communities. The practices within Neighbourhood Houses are informed by community development. Yet knowledge, understanding and practices of community development vary across the workforce. In 2019, Neighbourhood Houses Victoria commenced a programme of professional learning for the workforce. This paper draws on data from an impact evaluation and examines the benefits and barriers to embedding a professional learning programme in community development within its workforce. Using practice theory to examine the tensions and contradictions inherent in delivering professional learning in neoliberal times of managerialism and accountability in not-for-profit organisations. The contradictions of practice will resonate with organisations seeking to implement a professional learning across a broad range of human service organisations such as settlement houses, human services and community education settings. We claim most not-for-profit workforces are impacted by the discursive practices of neoliberalism such as contractual arrangements and the adoption of business practices to comply with funding requirements. These compliance requirements contrast with the philosophy and practices of community development and have the potential to impact on professional learning and the practices within these workplaces. [ABSTRACT FROM AUTHOR]

Disability support is often provided at the interface with other human services such as health, education, and employment agencies. This can present many organisational problems for people receiving support and the organisations that provide it. Individualised funding is one attempt to ease problems of fragmentation and unmet needs, but perversely, it introduces further interface complexities as organisations consider how to manage their service provision and financial structures. Drawing on interviews with 28 managers, the focus in this paper is on organisational and interface changes and challenges following the introduction of the National Disability Insurance Scheme (NDIS) in Australia, and the adaptive strategies of organisations to provide individualised and coordinated supports. The three themes derived from the thematic analysis, adopting a commercial mindset, finding a business niche, and working across complex interfaces, epitomise the benefits, constraints, and consequences of new market mechanisms for the delivery of supports, and how organisations are adjusting to a more commercial‐orientated sector while also creatively negotiating multiple funding and governance systems. The findings contribute to understandings of how individualisation is creating new dynamics of local disability support governance and collaboration in service provision. Whereas much of the literature on individualised funding has focused on the fragmentation of services, this study of organisation managers contributes to understandings of how individualisation also generates new dynamics of collaboration and tension in local disability support governance and service provision. [ABSTRACT FROM AUTHOR]

Social work field education is under pressure across the globe, including in Australia. Current application of neoliberal principles to education and human services policy and service delivery impact on social work practice, social work education and the availability and delivery of practice placements. Social work educators are concerned about delivering quality social work education so that students can engage in supervised service delivery in preparation for professional social work practice. Field education staff in universities across the country experience significant challenges in ensuring and organising increasing numbers of quality student placements. The formation of a national leadership group was triggered by a collective realisation that all university field education programs were facing similar challenges. The purpose of a national group was to better respond to the identified challenges and identify directions for research. Collaboration has been effectively used across university-based field education programs as a leadership approach, in the development of the Australian National Field Educators Network (NFEN). This paper reports on the formation of the NFEN and the resulting identification of six themes affecting provision of social work field education as an example of collaborative leadership. The paper concludes with an appraisal of the opportunities and challenges of taking a collaborative approach in developing a national response and working as a unified national organisation. [ABSTRACT FROM AUTHOR]

This article explores the findings of a qualitative study comparing social work and human service practice with people who have sought asylum in Germany and Australia. Globally social workers are concerned with the record high of people forcibly displaced worldwide and the Global North host-nations' increasingly hostile, discriminatory and restrictive policies towards people seeking asylum. This policy context is antithetical to the professional values of social workers and human services practitioners. The findings of this study reveal how the policy directly impacts social work and human service practice, creates unique ethical challenges and dilemmas and, subsequently, diverse practice responses. The paper also suggests that the country of practice influences how practitioners perceive and respond to ethical challenges and dilemmas. Through doing so, the findings challenge traditional understandings of critical practice theories that suggest that practice focused solely on the individual level is inadequate for work with people seeking asylum. Due to the diversity of contexts and their influences, we encourage social work and human services to view practice on a personal-political continuum when working with people seeking asylum. [ABSTRACT FROM AUTHOR]

Over two-thirds of Australians are owner-occupiers and a majority of the population holds most of their wealth in housing. Australian taxation privileges homeowners and retirement income policy is built around the assumption that state pensions can be kept low because an overwhelming majority of older Australians are outright homeowners and therefore have a considerable asset base and low housing costs post-retirement, a situation often referred to as ‘wealthfare’. However, ageing of the population and falling housing affordability mean that the number of asset-poor older Australians unable to rely on ‘wealthfare’ – lifetime renters or those who drop out of homeownership – is likely to grow in the future. In this paper we look at housing career pathways into precarious housing in older age, its impact on older Australians’ ontological security and coping strategies as they grapple with the housing circumstances that typically accompany asset poverty. Based on 30 interviews conducted with older Australians, the paper reports qualitative findings from a mixed methods research project conducted in Melbourne in 2009–2010. [ABSTRACT FROM PUBLISHER]

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To date, people with intersex variations have been mainly studied via small-scale clinical research, with only a small amount of reflective commentary contributed by sociocultural scholars. This paper reports on findings from a 2015 online Australian survey of 272 people with intersex variations, which aimed to redress the gap in research on this groups’ experiences and perspectives concerning education. Participants ranged in age from 16 to 87 years, and represented all Australian states and territories. Most had experienced two medical treatment interventions related to their intersex variation: commonly reported interventions included hormonal treatment and genital surgery delivered to participants when they were aged under 18 years of age. Participants reported various physical and psychological impacts from these treatments. Well-being risks were high; most of the group had engaged in suicidal ideation, particularly when individuals first found out about their variation. This impacted on their schooling – almost one-fifth of survey respondents had received no high school certification due to their early dropout and the overwhelming majority did not attend schools with inclusive puberty/sex education provision or counselling. Most survey participants had not disclosed their intersex variation to staff, although more than half had done so to their classmates. Many had experienced bullying. Only one-quarter of participants rated their overall education experiences positively. Participants suggested improvements to schools’ information provision and support features. [ABSTRACT FROM PUBLISHER]

Background: While there is a growing interest in the field of research translation, there are few published examples of public health interventions that have been effectively scaled up and implemented in the community. This paper provides a case study of the community-wide implementation of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT), an obesity prevention program for parents with infants aged 3-18 months. The study explored key factors influencing the translation of the Program into routine practice and the respective role of policy makers, researchers and implementers.Methods: Case studies were conducted of five of the eight prevention areas in Victoria, Australia who implemented the Program. Cases were selected on the basis of having implemented the Program for 6 months or more. Data were collected from January to June 2015 and included 18 individual interviews, one focus group and observation of two meetings. A total of 28 individuals, including research staff (n = 4), policy makers (n = 2) and implementers (n = 22), contributed to the data collected. Thematic analysis was conducted using cross case comparisons and key themes were verified through member checking.Results: Key facilitators of implementation included availability of a pre-packaged evidence based program addressing a community need, along with support and training provided by research staff to local implementers. Partnerships between researchers and policy makers facilitated initial program adoption, while local partnerships supported community implementation. Community partnerships were facilitated by local coordinators through alignment of program goals with existing policies and services. Workforce capacity for program delivery and administration was a challenge, largely overcome by embedding the Program into existing roles. Adapting the Program to fit local circumstance was critical for feasible and sustainable delivery, however balancing this with program fidelity was a critical issue. The lack of ongoing funding to support translation activities was a barrier for researchers continued involvement in community implementation.Conclusion: Policy makers, researchers and practitioners have important and complementary roles to play in supporting the translation of effective research interventions into practice. New avenues need to be explored to strengthen partnerships between researchers and end users to support the integration of effective public health research interventions into practice. [ABSTRACT FROM AUTHOR]

Background: Older people living in Residential Aged Care Facilities (RACF) are a vulnerable, frail and complex population. They are more likely than people who reside in the community to become acutely unwell, present to the Emergency Department (ED) and require admission to hospital. For many, hospitalisation carries with it risks. Importantly, evidence suggests that some admissions are avoidable. A new collaborative model of care, the Aged Care Emergency Service (ACE), was developed to provide clinical support to nurses in the RACFs, allowing residents to be managed in place and avoid transfer to the ED. This paper examines the effects of the ACE service on RACF residents' transfer to hospital using a controlled pre-post design.Methods: Four intervention RACFs were matched with eight control RACFs based on number of total beds, dementia specific beds, and ratio of high to low care beds in Newcastle, Australia, between March and November 2011. The intervention consisted of a clinical care manual to support care along with a nurse led telephone triage line, education, establishing goals of care prior to ED transfer, case management when in the ED, along with the development of collaborative relationships between stakeholders. Outcomes included ED presentations, length of stay, hospital admission and 28-day readmission pre- and post-intervention. Generalised estimating equations were used to estimate mean differences in outcomes between intervention and controls RACFs, pre- and post-intervention means, and their interaction, accounting for repeated measures and adjusting for matching factors.Results: Residents had a mean age of 86 years. ED presentations ranged between 16 and 211 visits/100 RACF beds/year across all RACFs. There was no overall reduction in ED presentations (OR = 1.17, p = 0.56) with the ACE intervention. However, when compared to the controls, the intervention group reduced their ED length of stay by 45 min (p = 0.0575), and was 40 % less likely to be admitted to hospital, . The latter was highly significant (p = 0.0012).Conclusions: Transfers to ED and admission to hospital are common for residents of RACFs. This study has demonstrated that a complex multi-strategy intervention led by nursing staff can successfully reduce hospital admissions for older people living in Residential Aged Care Facilities. By defining goals of care prior to transfer to the ED, clinicians have the opportunity to better deliver care that patients require. Integrated care requires accountability from multiple stakeholders.Trial Registration: The Australian New Zealand Clinical Trials Registration number is ACTRN12616000588493 It was registered on 6(th) May 2016. [ABSTRACT FROM AUTHOR]

The question of culturally respectful and competent practice is important for human services, particularly in Australia, which is characterised by a highly culturally diverse population as a result of migration. On arrival in Australia, migrants start using local services which they anticipate to be appropriate to their culture, situations and aspirations. This study explored what culturally respectful and competent practice looks like for organisations working with migrant youth in the Illawarra region of the state of New South Wales using in-depth interviews and focus groups. Although our focus was youth, responses were more broad to reflect the day-to-day roles of participants. From the responses, themes that came out included awareness of own culture as a practitioner and understanding the cultures of service users; paying attention to service user views of the dominant culture; employing staff from refugee and migrant communities; interpreter services; supporting practitioners in addressing agency limitations; and use of a strengths-based approach. What is central to these themes is capacitating human resources with cultural knowledge and a tendency towards prioritising service users' interpretation of their culture and addressing the disadvantage and injustice that arise from cultural differences. For the organisations, a key barrier to achieving this is inadequate financial resources. In view of these findings, we conclude that, in relation to the topic and organisations we investigated, culturally respectful and competent practice means embedding service user cultural interpretations and priorities in organisational employment practices, staff skilling and service delivery in order to achieve the best and sustainable cultural, social and economic settlement outcomes. [ABSTRACT FROM AUTHOR]

This multiple‐case study examines the adoption of a case management system (CMS) across two community organisations in Australia using organizational routines as a theoretical lens. Both the adopters and the vendor were interviewed to explore how the CMS was instituted in the adopting organisations. Many of the concerns or problems associated with a CMS as reported in the literature were not supported in this study. Although the two cases differed significantly in terms of size and resources, the findings show that the adoption of CMS led to new ostensive and performative routines around data collection and service delivery in both organisations. This had implications for accountability and organisational learning. In particular, better access to data improved visibility and reporting on the provision of services and subsequently supported fundraising. This study also highlights some of the situational factors that facilitate or impede the transition to a CMS such as the critical role of the CMS administrator and the way the change is managed in adopting organisations. Overall, this study contributes to the discourse on CMS by providing some evidence to support a more nuanced view of CMS including as 'systems of accountability' or even a 'necessity' of the digital age rather than merely as 'instruments of neoliberal policy' and enablers of bureaucratisation of social work. [ABSTRACT FROM AUTHOR]

Little is known about why people with disability choose to take part in disability research and what their experience is like. Knowledge of this may help researchers and research ethics committees improve the empowered and ethical participation of people with disability in disability, healthcare, and human service focussed research. This cross-sectional mixed-methods study explored the perspectives and experiences of a group of Australian adults with disability regarding their involvement in research. Online surveys (N = 29) and follow-up interviews (N = 15) were conducted. The study found the decision to participate was a complex appraisal of benefit to self and others, research relevance, value, comfort, convenience, safety and risk. The attitudes and behaviours of researchers in cultivating trust by adopting an empathic approach to the conduct of disability research appear to be an important aspect of participant experience. Research ethics committees may benefit from knowledge of the 'microethical' moments that occur in such research. [ABSTRACT FROM AUTHOR]

We show how policy discourses construct consumer choice, performance measurement and quality standards as key technologies in the marketisation of disability services and aged care in Australia. The emergence of performance outcome measurement and increased consumer access to these through diverse consumer facing and interactive platforms enables the state to "govern at a distance" through the management and shaping of outcome indicators rather than delivery of services. The state does this by creating market competition and establishing outcomes which reflect the construction people using services as informed and rational consumers rather than citizens. This construction and operationalisation frame marketisation as a rational solution to broken systems, assume choice is unproblematic and ignore diverse capacities to access and use information, resource differentials and contextual variables such as market maturity and service availability. The benign marketisation of human services thus discriminates against those who are already marginalised and disadvantaged unless equity strategies are clearly in place. [ABSTRACT FROM AUTHOR]

Human Centred Design (HCD) is emerging in Australia as a participatory approach to service design in social work and human services organisations. In this article, we reflect upon our incorporation of HCD into a core unit offered to final-year students in a Bachelor of Social Work (Honours) degree, as part of a collaboration between design and social work academics. We highlight successes and challenges, and identify adaptations that can provide HCD with a stronger strength-based, critical approach that better aligns with critical social work education. We provide suggestions for social work practitioners and educators around implementing HCD, in ways that inspire critical and reflexive thinking, promote social justice and focus on designing for progressive, structural and social change. [ABSTRACT FROM AUTHOR]

Dowry-related abuse and intimate-partner violence among Indian immigrants in Australia have received considerable attention in the national media in recent years. Media reportage and commentary on these issues have highlighted the testimonies and experiences of migrants who have faced dowry-related abuse and intimate-partner violence, untangling the complex context-specific issues (around culture and matrimony, and migration pathways, among others) that such testimonies raise. Demands for state intervention in response to emerging concerns about dowry-related abuse among Indian migrants in Australia have dominated public discourse on the issue. This article comments on the emergence of discourses prioritizing state intervention in this domain, highlighting the views of community and government representatives, and discussing the authors' perspectives on the implications of these emergent discussions for practitioners in health and human services. [ABSTRACT FROM AUTHOR]

We use survey and archival data from 271 fee‐generating not‐for‐profit human service organisations in Australia to examine how the use of performance measurement systems affects those organisations' client performance. Using Simons' levers of control, we find that interactive and diagnostic uses of performance measurement systems are positively related to client performance. We also find beliefs control to positively moderate the relation between diagnostic use of performance measurement systems and client performance, and boundary control to negatively moderate the relation between interactive use of performance measurement systems and client performance. The findings have implications for research and practice. [ABSTRACT FROM AUTHOR]

This article explores theoretical responses to the living structures of dominance and subordination within modern postcolonial societies, highlighting racialised international students' experiences within Australian universities. Drawing on coloniality of power and border thinking, it seeks to address ethical responsibilities for social work and human service educators from the author's positioning as a non-Western immigrant 'Other', and experience of belonging as an educator of future social work and human service practitioners in Australia. Utilising autoethnographic and qualitative study, the article offers great insight into the systemic nature of discrimination in Australian tertiary education institutions. It suggests a need for critical, self-reflexive awareness about the legacies of colonialism and hegemonic whiteness to permeate social work and human service profession and education. This article, thus, enables decolonising minds, securing informed understanding, and initiating a shift in the way non-white (and non-Western) racialised international social work students are seen, constructed, and understood in contemporary Australian (Western) societies. [ABSTRACT FROM AUTHOR]

Resilience is a desirable attribute for social work and human services (SWHS) graduates. A history of childhood adversity may have led students to develop resilience, which is transferable to SWHS practice. Limited research has been conducted with students as to how resilience is formed and conceptualised. This survey of 265 SWHS students is the first Australian research to survey students about their conceptualisation of resilience and childhood adversity. Within the study, students resoundingly viewed resilience as a process that occurred often due to childhood adversity but also from the protective factors of family. Students' experience of childhood adversity allowed them to develop independence and determination, which led to the development of resilience giving them greater ability to cope with the stresses of SWHS courses. Exploration of students' conceptualisation of resilience and its formation provides an insider voice as to how we can assist emerging practitioners in their development of resilience for future practice. The development of resilience is important for social work practice and is a protective factor that can assist social work students to manage stress and promote wellbeing. Resilience developed from childhood adversity can be an important, sometimes overlooked, factor in the professional formation of SWHS practitioners. [ABSTRACT FROM AUTHOR]

Much of the discourse regarding social care practice focuses on the differences between the various professions, practice fields, geographical, and organizational contexts involved in the provision of social care. This study surveyed Australian social care practitioners' (N = 438) perceptions of influence on their practice and what similarities and differences existed in these perceptions. Eighteen influential factors were identified with minimal differences across the participants' profession, practice field, organizational sector, or geographical context. These findings suggest that a common ground of experience exists that can be used as a basis for critical discussions and interdisciplinary practice and, thereby, provide a foundation for more consistent and integrated service delivery and outcomes. [ABSTRACT FROM AUTHOR]

The shift by government to contracting of social welfare and human services in Australia in the 1990s raised questions about the possible impacts of not-for-profit agencies becoming financially dependent on government. It was suggested that this move would result in institutional secularisation evidenced in detachment by church-related agencies from their founding bodies and distinctive accounts of mission. This article reports on research that maps the extent of financial dependence of church-related welfare agencies on government and the degree of their (dis)connection to the churches and the Christian tradition after nearly two decades of contracting. The evidence suggests that there is not a necessary and automatic connection between high financial dependence on government and secularisation of church-related agencies. Denominational governance, agency size, along with choices by agency leadership, appear to buffer to varying degrees these impacts of contracting. [ABSTRACT FROM AUTHOR]

In Australia, e-government is continuously re-defining service boundaries. While this may be good in the case of transactional interactions, for example the online submission of tax returns, it is less clear that interpersonal services, such as working closely with the long-term unemployed, are best delivered digitally. We consider the impact of social services digitisation on vulnerable communities drawing on an analysis of remote Aboriginal communities. Digital uptake affords great opportunities, but it also carries risks. Some communities have no digital infrastructure and in certain cases traditional face-to-face services have been curtailed, leaving those not online with reduced assistance. We find that concerns about the ‘digital divide’ are well founded. Problems generated by e-government flow across boundaries and appear left to the third sector to resolve with the state playing an even more diminished role in the lives of disadvantaged citizens. [ABSTRACT FROM AUTHOR]

The Royal Commission into Institutional Responses to Child Sexual Abuse has provided a depth of knowledge about sexual assault within institutions, highlighting the multiple ways that adults failed to protect victims. This article will show that this elision of responsibility towards children also occurred outside of institutions. It argues that many key players - including doctors and other professionals - did not step up to protect victims, and that the Australian community continued to ignore, overlook or discount evidence of abuse. Outside of institutions, it was easier to look away than to deal with the horrors of sexual violence against children. [ABSTRACT FROM AUTHOR]

Aim: To determine whether participation in the continuous quality improvement (CQI) Audit and Best Practice for Chronic Disease programme improved care and outcomes for Indigenous children.Methods: Data were collected from 59 Australian primary health-care centres providing services to Indigenous people and participating in the programme (February 2008 and December 2013). Indigenous children aged less than 2 years and centres that completed three or more consecutive annual audits within the 6-year study period were included. Crude and adjusted logistic generalised estimating equation models were used to examine the effect of year of audit on the delivery of care. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Outcomes were related to age-relevant health issues, including prevention and early intervention. These included administrative, health check, anticipatory guidance and specific health issues.Results: During the audit period, there were 2360 files from 59 centres. Those that had a recall recorded, improved from 84 to 95% (OR 2.44, 95% CI 1.44-4.11). Hearing assessments improved from 52 to 89% (OR 1.37, 95% CI 1.22-1.54). Improvement in anticipatory guidance, treatment and follow-up of medical conditions was almost universal.Conclusion: We documented significant improvements in quality of care of Indigenous children. Outcomes and their corresponding treatment and follow-ups improved over time. This appears to be related to services participating in annual CQI activities. However, these services may be more committed to CQI than others and therefore possibly better performing. [ABSTRACT FROM AUTHOR]

This article gives voice to trans experiences of disasters, investigating their specific vulnerabilities and resilient capacities. We draw on findings from a project on lesbian, gay, bisexual and trans (LGBT) experiences of recent Australian and New Zealand disasters. We present and analyse trans voices from a survey conducted across multiple case study sites and insights from interview data with a trans person who experienced the 2011 Brisbane floods. Conceptually, to provide a robust understanding of trans experiences of disasters, we bring socially sensitive disaster studies into conversation with trans geographies. Disaster studies have begun to examine LGBT experiences, with some suggestion that trans people are most vulnerable. We advance this work by focusing on trans lives. Trans geographies, in turn, underline the importance of space, place and the body in understanding trans lives, and the need to examine the lived reality of trans people’s everyday geographies rather than embodiment as an abstract concept. Applying these insights to the trans voices in our project, we examine four themes that highlight impediments to and possibilities for trans-inclusive disaster planning: apprehension with emergency services and support; concerns about home and displacement; anxiety about compromising the trans body; and the potential of trans and queer interpersonal networks for capacity building. We offer suggestions for trans-inclusive disaster planning and preparedness, and indicate how the insights from trans experience can enrich disaster planning and preparedness for wider social groups. [ABSTRACT FROM AUTHOR]

The transportation of convicts to the British penal colony at New South Wales in the late 18th and early 19th centuries was largely undertaken by private merchants under contract to government. In the early years, the outcomes of this system, as measured by mortality rates, were mixed, but by the turn of the century, public officials had refined its operation, resulting in a significant decline in convict deaths. Close study of the evolution of this system reveals that government officials were grappling with many of the same issues encountered by public service commissioners today - trade-offs between price and quality, the use of transactional versus relational contracting forms, and heavy reliance on financial incentives as opposed to intrinsic motivation. Government's success in reducing mortality on the convict ships highlights the importance of system design, effective monitoring and management when public services are delivered under contract. [ABSTRACT FROM AUTHOR]

Background: A wide range of health care options are utilised by pregnant women in Australia. The out-of-pocket costs of maternity care in Australia vary depending on many factors including model of care utilised, health insurance coverage, and women's decision to access health services outside of conventional maternity care provision.Methods: Women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) who identified as pregnant or as recently having given birth in 2009 were invited to complete a sub-study questionnaire investigating health service utilisation during their most recent pregnancy.Results: A total of 1,835 women agreed to participate in the sub-study. The majority of women (99.8%) consulted with a conventional health care practitioner during pregnancy, 49.4% consulted with a complementary and alternative medicine practitioner at least once during pregnancy and 89.6% of the women used a complementary and alternative medicine product. Women reported an average of AUD$781.10 in out-of-pocket expenses for consultations with conventional health care practitioners, AUD$185.40 in out-of-pocket expenses for consultations with complementary and alternative medicine practitioners and AUD$179.60 in out-of-pocket expenses for complementary and alternative medicine products. From the study data we estimate Australian pregnant women spend over AUD$337 M on out-of-pocket health services.Conclusion: While the majority of pregnant women in Australia may obtain health services via the publically-funded health care system and/or private health insurance coverage, our analysis identifies substantial out-of-pocket expenditure for health care by pregnant women - a trend in public spending for maternity care of importance to policy makers, health administrators, and health professionals. [ABSTRACT FROM AUTHOR]

Background: Aboriginal Community Controlled Organisations (ACCOs) provide community-focussed and culturally safe services for First Peoples in Australia, including crisis intervention and health promotion activities, in a holistic manner. The ecological model of health promotion goes some way towards describing the complexity of such health programs. The aims of this project were to: 1) identify the aims and purpose of existing health promotion programs conducted by an alliance of ACCOs in northern Victoria, Australia; and 2) evaluate the extent to which these programs are consistent with an ecological model of health promotion, addressing both individual and environmental determinants of health. Methods: The project arose from a long history of collaborative research. Three ACCOs and a university formed the Health Promotion Alliance to evaluate their health promotion programs. Local community members were trained in, and contributed to developing culturally sensitive methods for, data collection. Information on the aims and design of 88 health promotion activities making up 12 different programs across the ACCOs was systematically and prospectively collected. Results: There was a wide range of activities addressing environmental and social determinants of health, as well as physical activity, nutrition and weight loss. The design of the great majority of activities had a minimal Western influence and were designed within a local Aboriginal cultural framework. The most common focus of the activities was social connectedness (76 %). Physical activity was represented in two thirds of the activities, and nutrition, weight loss and culture were each a focus of about half of the activities. A modified coding procedure designed to assess the ecological nature of these programs showed that they recruited from multiple settings; targeted a range of individual, social and environmental determinants; and used numerous and innovative strategies to achieve change. Conclusion: First Peoples' health promotion in the Goulburn-Murray Rivers region encompasses a broad range of social, cultural, lifestyle and community development activities, including reclaiming and strengthening cultural identity and social connectedness as a response to colonisation. [ABSTRACT FROM AUTHOR]

Aim: To examine how Australia, Singapore and the United States of America (USA) match to the World Stroke Organization Global Stroke Services health system monitoring indicators (HSI). Design: Descriptive comparative study Participants: The health systems of Australia, Singapore, the USA. Outcome measures: Published data available from each country were mapped to the 10 health system monitoring indicators proposed by the World Stroke Organization. Results: Most health system monitoring indicators were at least partially met in each country. Thrombolytic agents were available for use in acute stroke. Stroke guidelines and stroke registry data were available in all three countries. Stroke incidence, prevalence, and mortality rates were available but at non-uniform times post-stroke. The International Classification of Disease 9 or 10 coding systems are used in all three countries. Standardized clinical audits are routine in Australia and the USA, but not in Singapore. The use of the modified Rankin Scale is collected sub-acutely but not at one year post-stroke in all three countries. Conclusions: The three developed countries are performing well against the World Stroke Organization health system monitoring indicators for acute and sub-acute stroke care. However, improvements in stroke risk assessment and at oneyear post-stroke outcome measurement are needed. [ABSTRACT FROM AUTHOR]

Aim Although opioid substitution therapy (OST) immediately after prison release reduces mortality, the cost-effectiveness of treatment has not been examined. Therefore, we undertook a cost-effectiveness analysis of OST treatment upon prison release and the prevention of death in the first 6 months post-release. Design Population-based, retrospective data linkage study using records of OST entrants (1985-2010), charges and court appearances (1993-2011), prison episodes (2000-11) and death notifications (1985-2011). Setting New South Wales, Australia. Participants A cohort of 16 073 people with a history of opioid dependence released from prison for the first time between 1 January 2000 and 30 June 2011. Intervention OST treatment compared to no OST treatment at prison release. Measurements Mortality and costs (treatment, criminal justice system-court, penalties, prison-and the social costs of crime) were evaluated at 6 months post-release. Analyses included propensity score matching, bootstrapping and regression. Findings A total of 13 468 individuals were matched (6734 in each group). Twenty (0.3%) people released onto OST died, compared with 46 people (0.7%) not released onto OST. The final average costs were lower for the group that received OST post-release ($7206 versus $14 356). The incremental cost-effectiveness ratio showed that OST post-release was dominant, incurring lower costs and saving more lives. The probability that OST post-release is cost-effective per life-year saved is 96.7% at a willingness to pay of $500. Conclusion Opioid substitution treatment (compared with no such treatment), given on release from prison to people with a history of opioid dependence, is cost-effective in reducing mortality in the first 6 months of release. [ABSTRACT FROM AUTHOR]

This article examines a component of job quality which is particularly important for human service workers: the level of control they have over their work. Having control over work goals and tasks enables frontline workers to respond appropriately to the needs of the people they serve, so contributes to service quality and client outcomes, as well as employee wellbeing. However, much research has contended that job control is under threat in human service contexts, largely as a result of new public management. We examine these claims and contribute new data showing that levels of job control in the human service workforce have indeed been under pressure in recent years. From 2003 to 2012, Australia’s human service workforce did not experience the increase in job control experienced by other workers. In the education industry, levels of job control fell significantly. We discuss these trends in the context of debates about the impact of new public management on frontline human service work and challenges of securing the future provision of good quality services. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this research was to examine the use of quit smoking services and support options in Australia with national survey data to determine whether use of quit smoking services and pharmacotherapy contributes to socioeconomic status (SES) differences in smoking. Methods: Analyses were performed with data from 4 waves of the Australian National Drug Strategy Household Survey between 2001 and 2010. The primary outcomes were the use of quit smoking services or pharmacotherapy. The main predictor variables used were measures of SES including the Socio-Economic Indexes for Areas, income, and education. Other sociodemographic variables were also examined. Results: There was no systematic SES difference in the use of services or support options, with some used more by high SES and some used more by low SES. Those with university education (odds ratio [OR] = 0.72; 95% CI = 0.56–0.93) were less likely to use prescription medication. Conversely, those with higher incomes were more likely to use patches, gum, or an inhaler (OR = 1.13; 95% CI = 1.01–1.27). Prescription medication was significantly associated with increased odds for recent cessation, although only among those with lower levels of education (OR = 2.50; 95% CI = 1.94–3.23). Those with higher SES had the greatest odds for recent cessation. Conclusions: The evidence suggests that low-SES smokers use quit services and support options equally compared with high-SES smokers; thus, access does not drive the SES differential in smoking. However, the findings are positive, suggesting that increasing the uptake of prescription medication may help increase cessation rates among low-SES smokers. [ABSTRACT FROM PUBLISHER]

The author reflects on the article "Estimating Met Demand for Alcohol and Other Drug Treatment in Australia" by J. Chalmers, A. Ritter, and L. Berends which appears in the same issue of the journal. The challenges associated with estimating the number of people who receive alcohol and other drug (AOD) treatment in Australia are examined, along with the identification of potential data sources and primary research evidence. Health service system monitoring is assessed.