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Objective: This study aimed to describe the development and implementation of a co-designed value-based healthcare (VBHC) framework within the public dental sector in Victoria. Methods: A mixed-method study was employed. Explorative qualitative design was used to examine patient, workforce and stakeholder perspectives of implementing VBHC. Participatory action research was used to bring together qualitative narrative-based research and service design methods. An experience-based co-design approach was used to enable staff and patients to co-design services. Quantitative data was sourced from Titanium (online patient management system). Results: Building a case for VBHC implementation required intensive work. It included co-designing, collaborating, planning and designing services based on patient needs. Evidence reviews, value-stream mapping and development of patient reported outcomes (PROMs) and patient reported experience measures (PREMs) were fundamental to VBHC implementation. Following VBHC implementation, a 44% lower failure to attend rate and 60% increase in preventive interventions was reported. A higher proportion of clinicians worked across their top scope of practice within a multi-disciplinary team. Approximately 80% of services previously provided by dentists were shifted to oral health therapists and dental assistants, thereby releasing the capacity of dentists to undertake complex treatments. Patients completed baseline International Consortium for Health Outcomes Measurement PROMs (n = 44,408), which have been used for social/clinical triaging, determining urgency of care based on risk, segmentation and tracking health outcomes. Following their care, patients completed a PREMs questionnaire (n = 15,402). Patients agreed or strongly agreed that: the care they received met their needs (87%); they received clear answers to their questions (93%); they left their visit knowing what is next (91%); they felt taken care of during their visit (94%); and they felt involved in their treatment and care (94%). Conclusion: The potential for health system transformation through implementation of VBHC is significant, however, its implementation needs to extend beyond organisational approaches and focus on sustaining the principles of VBHC across healthcare systems, policy and practice. What is known about the topic? Value-based healthcare (VBHC) has gained significant momentum within the healthcare sector and is seen as a driver for improving patient outcomes and equitable use of resources. What does this paper add? The paper describes firsthand experience and lessons learnt from implementing VBHC within a Victorian public healthcare system; the learnings are applicable to other organisations wanting to implement VBHC. What are the implications for practitioners? In implementing a co-designed VBHC framework, we ensured that its principles are applicable at both patient and population levels, centres on equity of access to care, achieves the best possible health outcomes and sustainable use of resources. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Growing dissatisfaction with representative democracy and concomitantly, the increasing expectation that citizens assert more influence over public policy have seen the emergence of more participatory and deliberative forms of governance in public management practice. This article explores the attempt of the state government of Victoria, Australia to legislate for mandatory deliberative engagement as part of its local government strategic planning instruments. The ambition of the reform was significant; however, it was almost unanimously rejected by the local government sector. Based on analysis of the key themes that emerged from the submissions made during the 3‐year Victorian Local Government Act Review process, we explore the limitations and barriers to implementing deliberative engagement practice at a local government level. We demonstrate that whilst the promise of participatory democracy might have been compelling, in the case of Victoria there were a series of contextual and capacity considerations that needed to be taken into account before the implementation of such reforms were pursued. This article explores the process of legislating for deliberative engagement as a strategic planning instrument during the Victorian Local Government Act Review process. We demonstrate that whilst the promise of participatory democracy might have been compelling, there were limitations to implementing this practice which needed to be considered in the reform. [ABSTRACT FROM AUTHOR]

Dental caries, a non-communicable disease, is one of the most prevalent diseases globally and share common modifiable risk factors with obesity such as excess sugar intake. However, prioritization by governments to improve population oral health has been limited and is typically excluded from the discourse of public health policy development. Therefore, interventions that target dental caries can have other co-benefits including obesity prevention. In Victoria, Australia, local government authorities have a regulatory requirement to develop their Municipal Health and Wellbeing Plans. The aim of this paper is to identify whether prioritization for oral health by local government authorities in Victoria has changed through the subsequent renewal of the Victorian Public Health and Wellbeing Plans 2011–2015 and 2019–2023. Three desktop audits for all publicly available Municipal Health and Wellbeing Plans by local government authorities in Victoria were conducted between 2014 and 2022. Key terms related to oral health was searched within these policy documents and categorized into six indicators: (i) included oral health as a priority, (ii) linked healthy eating and oral health, (iii) supported the Achievement Program, (iv) included the Smiles 4 Miles program, (v) advocated for fluoridated drinking water, and (vi) included other strategies related to oral health. Overall, there was statistically significant reduction in five of the six indicators, with the exception for prioritization of other strategies related to oral health such as targeting excess sugar intake and smoking. A multi-sectoral approach, that includes oral health would be advantageous to address the growing burden of non-communicable diseases. [ABSTRACT FROM AUTHOR]

In Australia, like many high-income countries, food insecurity is associated with increased risks of chronic diseases, sub-optimal development outcomes in children, and mental health conditions including depression and anxiety. Food insecure households employ a range of strategies, including the use of food charity, to help alleviate hunger and meet cost of living pressures. The aim of this paper is to investigate the lived experience of food insecurity for welfare-dependent households, and to examine these experiences within a structural violence framework. Structural violence investigations seek to understand the distal causal factors that can help explain poor health patterns and inequities. Semi-structured interviews were conducted with customers (n = 78) of food pantries, soup kitchens, and community development programs (June 2018 to January 2019) in the state of Victoria, Australia. Thematic analysis established evidence of controlling, demeaning and depriving practices in the interactions between the participants and the services and staff at national welfare providers and food charities. The same providers and charities nominally set up to address the exact situations in which participants found themselves. The findings of this study suggest that food and social services are an on-the-ground setting through which structural violence is enacted and experienced. [ABSTRACT FROM AUTHOR]

In recent months in Australia there has been extended debate about whether the age pension, particularly with regard to single pensioners, is sufficiently high to allow older Australians to attain an acceptable standard of living. This is an important policy consideration given Australia’s rapidly ageing population. By using microdata and microsimulation models, this paper examines the national and spatial impacts on the distribution of poverty among older single people of an increase in the single age-pension rate. This paper shows that the cost of increasing the single age-pension to 66 per cent of the couple-age pension rate would be about $A1.3 billion and would benefit about 824,000 single age-pensioners. Further, it is estimated that such an increase would reduce poverty rates for lone older persons from 46.5 per cent to 36.5 per cent, a 10-percentage point reduction. Looking at the spatial distribution of such benefits, the effect of the policy change seems to be generally stronger in capital cities, and in bands of rural areas in New South Wales and Victoria. [ABSTRACT FROM AUTHOR]

WorkSafe Victoria and the Transport Accident Commission are two Victorian government agencies that determine the policies that guide decisions to fund treatments and services provided to Victorians injured in transport or workplace accidents. These agencies identified that an internal system was required to manage requests for funding of new or emerging treatments. In particular, the agencies recognised a system that supported consistency in decision making in the context of therapeutic uncertainty and ensured the safety of injured Victorians was needed. The New, Emerging or Non-Established Treatments (NENETs) policy was launched in its current form by the agencies in 2013. The NENETs system includes a record of contemporary evidence for emerging treatments and an evidence-informed decision-making system to ensure consistency and information sharing. A system of recording decisions on emerging treatments was also implemented to ensure that funding decisions could later be reversed if necessary. The NENETs system has proved to be a robust and sustainable method of managing uncertainty for WorkSafe Victoria and the Transport Accident Commission and could be transferable to other funding bodies. What is known about the topic?: An algorithm to guide clinicians when prescribing off-label medications was developed in 2006, although it has not been used widely in everyday practice. In 2019 the Medical Board of Australia launched a discussion paper on 'complementary and unconventional medicine and emerging treatments' because no system for managing such treatments exists. Third-party payers have a responsibility to make objective and reliable decisions about new, emerging or non-established treatments to ensure high value care is offered to health consumers. What does this paper add?: This paper provides an overview of the policy and decision-making system implemented by WorkSafe Victoria and the Transport Accident Commission to managing requests for new, emerging or non-established treatments. The system is adaptable to other third-party payers, health service funders and regulators in Australia and internationally. What are the implications for practitioners?: It is important that practitioners caring for injured Victorians are aware of the systems used to inform decision making around requests for funding new, emerging or non-established treatments. Knowledge of the principles underlying this system may assist other funding bodies and the Medical Board of Australia to develop systems in other jurisdictions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Both public health, and the health of the natural environment, are affected by policy decisions made across portfolios as diverse as finance, planning, transport, housing, education, and agriculture. A response to the interdependent character of public health has been the "health in all policies" (HiAP) approach. OBJECTIVES: With reference to parallels between health and environment, this paper argues that lessons from HiAP are useful for creating a new integrated environmental management approach termed "environment in all polices" (EiAP). DISCUSSION: This paper covers the theoretical foundations of HiAP, which is based on an understanding that health is strongly socially determined. The paper then highlights how lessons learned from HiAP's implementation in Finland, California, and South Australia might be applied to EiAP. It is too early to learn from evaluations of HiAP, but it is apparent that there is no single tool kit for its application. The properties that are likely to be necessary for an effective EiAP approach include a jurisdiction-specific approach, ongoing and strong leadership from a central agency, independent analysis, and a champion. We then apply these properties to Victoria (Australia) to demonstrate how EiAP might work. CONCLUSIONS: We encourage further exploration of the feasibility of EiAP as an approach that could make explicit the sometimes surprising environmental implications of a whole range of strategic policies. CITATION: Browne GR, Rutherfurd ID. 2017. The case for "environment in all policies": lessons from the "health in all policies" approach in public health. Environ Health Perspect 125:149-154; http://dx.doi.org/10.1289/EHP294 [ABSTRACT FROM AUTHOR]

In Victoria, Australia, considerations of live music have become central to debates on how to best regulate the late-night economy. This paper examines the origins of this consideration and the reasons it has become a key matter in policy discussion about late-night licensing regulation. Using a media analysis of 110 Victorian newspaper articles (2003–2016), this paper demonstrates how the newspaper media has exerted significant power in producing a live music discourse. The live music discourse was firmly established by 2010, driven by the Tote Hotel's closure (referenced in 52 articles). The number of live music stakeholders engaged in the debate (80 quoted) far outweighed those from the government (26 quoted), impacting the overall presentation of the regulations along with the value of live music to the state. Gaps in media coverage, and the political context in which these matters were being debated aided advocates in facilitating subsequent regulatory change in favour of live-music venues. Consequently, it is argued that the media reporting contributed to a policy environment where perceptions of a threat to live music venues have become a barrier to restricting hours of sale in the future. [ABSTRACT FROM AUTHOR]

This paper reviews rail station access outcomes and potentials across the Melbourne metropolitan area. Assumptions and discussions around rail transit access tend to emphasise the issue of park and ride (P&R) to a degree that is not borne-out by the reality of access to stations in usage statistics. Equally, a great deal of energy is invested in discussion of sustainable planning and ‘integration’, without making the vital connection between mass transit and new investments in walking and in cycling infrastructure for access to transit. In this paper, we critically review the level of performance in station access mode shares across Melbourne – using techniques such as cluster analysis, in combination with mapping and cross-references to broader demographic and land-use trends. We find that P&R in Melbourne are sometimes a ‘poor fit’ by being heavily utilised in some middle-suburban locations. Melbourne's bus–rail connectivity is patchy – with some locations delivering high levels of bus-based access to rail and other locations under-playing this important option. Trams are found to be a surprisingly important and high-impact mode of access to heavy rail, and implications from this finding are put forward. Melbourne demonstrates poor outcomes in generating trips to the station by bicycle – and the paper delivers discussion and suggestions around a potential new direction for cycling policy and infrastructure in Melbourne. [ABSTRACT FROM AUTHOR]

This paper explores community-level action in relation to socially based climate change adaptations for vulnerable citizens—older people in particular. While awareness of risk and adaptation has increased in various institutions across Australia, the translation of awareness into action is limited, particularly in the area of socially based adaptive measures for the most vulnerable. Through content analysis of local government documents in two major Australian cities, this paper assesses the extent of action and identifies trends and strategies in relation to social adaptation. Findings indicate varying levels of action and some examples of "best practice," but overall, evidence indicates more effort is needed at the community level. The role of the social work profession in challenging and broadening discourse is also explored especially in terms of highlighting the social impacts of climate change in future policy development, community action, and initiatives. [ABSTRACT FROM AUTHOR]

Governments across Australia are struggling to address escalating child protection notifications, a marked increase in the number of children in State care, a decrease in the number of foster carers and chronic workforce shortages in child welfare services. This paper explores the reform process that culminated in the proclamation of the Victorian Children, Youth and Families Act, 2005 and represents an aspect of the response in Victoria to these wider issues. It explores the history of the reform from the perspective of key actors from government, non-government sectors and academics who participated in the process. The paper explores the “ingredients of social policy reform” and how the change process was managed in Victoria. It does not seek to evaluate the reform but rather to understand the complex processes through which a propitious moment for reform was both seized and constructed. [ABSTRACT FROM AUTHOR]

Abstract Recent coastal legislative and policy reform in Australia reflects the changing focus of coastal management studies in the international scientific literature indicating a move towards systems perspectives, cross-boundary management strategies and an integration of marine and terrestrial environments. Significant global and national reports on integrated coastal management and climate change set the stage for a 21st Century wave of coastal reform in Australia. Given the absence of Australian national coastal legislation or coastal policy the reforms were initiated by a number of state governments such as in New South Wales and Victoria where new pieces of state-based coastal legislation came into law in 2018. This paper examines new coastal legislation, policies, manuals, and government documents and the rationale and triggers behind these reforms. These are discussed in the context of Australian governance structures and the international coastal management literature. The paper concludes that the latest wave of coastal reform in Australia represents a non-uniform stateled push for a more integrated approach to coastal management including, adaptation to climate change, sustainable development, a systems-based approach to coastal processes and inclusion of both marine and terrestrial environments. [ABSTRACT FROM AUTHOR]

Background: Rural Australian populations experience an increased burden of ischaemic heart disease (IHD) compared to their metropolitan counterparts, similar to other developed countries, globally. Policy and other efforts need to address and acknowledge these differences in order to reduce inequalities in health burden. This paper examines rural health policy makers’ perceptions and use of evidence in efforts to reduce the burden of IHD in rural areas. Methods: Policy makers and government advisors (n = 21) who worked with, or advised on, rural health policy at local, state and federal government levels, with specific focus on the state of Victoria (n = 9) were identified from publicly available documents and subsequent snowball sample. Semi-structured qualitative interviews were conducted in regards to the use of evidence in policy to prevent IHD and thematic analysis undertaken applying two theoretical perspectives: context-based evidence-based policy making and the conceptual framework for understanding rural and remote health. Results: The rural context, particularly low resourcing, was seen as limiting potential for evidence based policy at local government (LG) level. Lower levels of political pressure and education were seen as constraints to evidence-based policy in rural communities. Participants described the potential for policy to have a greater impact on reducing heart disease in rural areas though they felt under-resourced and out of touch with the scientific evidence. Scientific studies were less valued than local anecdote to prioritise specific policy. At all levels (local, state and federal) low self-efficacy in interpreting evidence and perceived lack of relevance inhibited development of evidence informed policy. Conclusion: The rural context constrains the use of scientific evidence in policy making for the prevention of heart disease in rural areas in Australia with multiple factors influencing the capacity for evidenced based health policy. This is similar to findings at the international scale and is for consideration across other developed countries that experience inequalities in IHD disease burden between rural and urban populations. [ABSTRACT FROM AUTHOR]

The widely held view is that effective action on climate change requires commitment by national governments to international agreements. Developed nations like Canada and Australia continue to fall short in their commitments to emissions reduction targets established under the 1997 Kyoto Protocol. Australia refused to ratify its Kyoto commitments until 2008 and Canada withdrew its commitment in 2011. Subnational governments in both countries have been active in developing policy responses to climate change yet remain largely excluded as serious policy partners in national mitigation and adaptation initiatives. This paper utilizes Kingdon’s Multiple Streams Framework to consider why subnational governments address climate change and the main factors shaping their policy choices. The experiences of the Australian state of Victoria and the Canadian province of Ontario provide examples through which to explore the factors contributing to climate policy opportunities and constraints faced by subnational governments in these countries. [ABSTRACT FROM AUTHOR]

The metropolitan planning strategy 'Melbourne 2030' was released by the Victorian state government in 2002 as a major step towards a low-carbon city and a counter to urban sprawl; it provides for intensification of land-use within an urban growth boundary focused on activity centres and transit-oriented development. It is now widely acknowledged that this policy has not been implemented, while the growth boundary has been expanded substantially. A primary reason for this failure is the government's fear of negative electoral reaction if Melbourne's much-loved urban 'character' is transformed. There has been a lack of both capacity modelling to show where and how the existing fabric can be densified, and of realistic urban design visions that might stimulate the electorate's imagination. This paper has two aims: first, to quantify the capacities for compact growth and, secondly, to use these measures as frameworks for understanding the urban design opportunities embodied in them. Using a combination of GIS mapping and digital modelling tools, scenarios based on transit-related planning principles and urban design criteria are explored as a basis for understanding resident responses. A key finding of this study is that Melbourne does not need a particularly radical change to its built form to achieve substantial increases in gross density. Modest height limits in activity centres and of 4-5 storeys along transit lines are easily enough to accommodate the projected population growth within the existing built-up area. We suggest that if height controls can be properly enforced then this can be achieved democratically and without significant electoral backlash. [ABSTRACT FROM AUTHOR]

This paper draws upon critical discourse analysis, cultural studies and communication theory, studies on media and educational reform, and the work of Bernstein, Bourdieu and Luhmann in particular, to explore how the print and media 'mediated' a period of educational change marked by moves to self-management in schools in Victoria, Australia. It considers how the media was mobilized by various education stakeholders, and in turn informed relations between schools and government, through policy discourses and texts. It considers why and how particular themes became media 'issues', how schools and teachers responded to these issues, and how the media was used by various stakeholders in education to shape policy debates. It is based on a year-long qualitative study that explored critical incidents and representations about education in the print media over a year in the daily press. It illustrates the ways in which a neo-liberal Victorian government mobilized the media to gain strategic advantage to promote radical education reform policies, considers the media effects of this media/tion process on schools and teachers, and conceptualizes how school and system performance is fed from and into media representations, public perceptions and community understandings of schools and teachers' work. [ABSTRACT FROM AUTHOR]

Parental incarceration has wide-ranging impacts on families. One key effect may be disruption to the care and legal custody of children, yet few studies have examined processes and outcomes relating to care planning for children of prisoners. This paper presents findings of interviews with 151 primary carer prisoners in two Australian states which aimed to address this research gap. The study examined care planning for children upon parental arrest, sentencing and imprisonment, stability of care arrangements and primary carer prisoners' involvement and satisfaction with care planning. Around one third of prisoners had discussions regarding children's care arrangements at arrest and imprisonment, although the issue was more commonly raised at sentencing. While there was much variation in the stability of care arrangements, children placed in out-of-home care experienced the most instability. A minority of prisoners reported being involved in care planning and decision-making for children upon imprisonment, and around one third rated care planning process poorly. Prisoners were more satisfied with care planning when there were fewer movements of children, where prisoners felt involved with decision-making, and when police officers, lawyers and corrections staff inquired about the welfare of their children. Implications for policy and future research are discussed. [ABSTRACT FROM AUTHOR]

Over the past decade, major landscape wildfires (or ‘bushfires’ in Australia) in fire-prone countries have illustrated the seriousness of this global environmental problem. This natural hazard presents a complex mesh of dynamic factors for those seeking to reduce or manage its costs, as ignitions, hazard behaviour, and the reactions of different human and ecological communities during and after hazard events are all extremely uncertain. But while those at risk of wildfire have been subject to significant research, the social dimensions of its management, including the role of science, have received little attention. This paper reports on a case study of the Barwon-Otway area of Victoria in Australia, a high wildfire risk area that has recently been a pilot site for a new risk mitigation strategy utilising the wildfire simulation model PHOENIX RapidFire. Against simple equations between ‘more science’ and ‘less uncertainty,’ this paper presents results from interviews and a workshop with practitioners to investigate how scientific research interacts with and informs both wildfire policy and practice. We suggest that attending to cultural and social specificities of the application of any technical innovation—such as next generation modelling—raises questions for future research about the roles of narrative, performance, and other knowledges in the sedimentation of science. [ABSTRACT FROM AUTHOR]

Aim Recent National Aged Care Policy Reforms are directed at streamlining entry into aged care services, building on the challenges associated with developing integrated assessment processes. Such reform is core to achieving a comprehensive, efficient process. Methods Here, we report the first stage of a collaborative project with three regional aged care assessment services to explore how services can better work together and improve the assessment process. Specifically, this paper reports the collection of local demographic and assessment data to describe and compare assessment tools and processes across services. Results Findings demonstrate the high level of need of those entering the community aged care system; the diversity of tools and processes utilised by the three services; and the high level of duplication and commonality across assessment categories. Conclusions Findings suggest the need for improved service integration to clarify the assessment process for older people and conserve regional aged care workforce. [ABSTRACT FROM AUTHOR]

Framework climate legislation has been introduced in many jurisdictions around the world, at the national and subnational scales, to govern climate change mitigation and adaptation activities by governments. The Climate Change Act 2017 (Vic) is an example which embodies many of the typical features of framework climate laws: emissions reduction targets, mitigation strategies and adaptation plans. Yet the Victorian legislation also includes explicit provision for climate mainstreaming: a general legal duty to take account of climate change, where relevant, in government decisions, policies, programs and processes, and a more specific duty to have regard to climate change considerations in prescribed decisions. These mainstreaming provisions reflect a legislative intent to promote an integrated, whole-ofgovernment approach to climate change. This recognises that a broad range of policy areas both contribute to climate change and are affected by climate change, and that effectively integrating climate change across government functions is critical to achieve mitigation and adaptation objectives. This article reports on an empirical study exploring the effect of the mainstreaming provisions on government practices in Victoria. Interviews with Victorian public servants from a wide range of policy and operational areas provide insights into the value, role and function of legislation in supporting climate mainstreaming, as well as lessons from practice in how to effectively operationalise legal mainstreaming duties. [ABSTRACT FROM AUTHOR]

Recognition of human rights on the basis of sexual orientation, gender identity and intersex status by the United Nations has led to the development of new policies concerning homophobia and transphobia in educational contexts. This paper examines new Australian education policies impacting gay, lesbian, bisexual, transgender, intersex and queer (GLBTIQ) teachers. A policy review uncovered a range of protections for GLBTIQ teachers in contexts such as the State of Victoria, alongside restrictions. Experiences of policy discussed in pilot study data from surveys of 63 Victorian GLBTIQ teachers, and in-depth interviews with nine Victorian GLBTIQ teachers, revealed that GLBTIQ teachers were relatively unaware of the protections available to them, compared to their awareness of protections for students. Many teachers were out as lesbian or gay to some staff members but fewer had come out to students. Teachers in religious schools had more difficulties, causing some to leave the sector. Further promotion of protections and more research are recommended. [ABSTRACT FROM AUTHOR]

Aim This paper describes current practices and gaps identified by Aged Care Assessment Service ( ACAS) clinicians in the assessment of cognition of clients of culturally and linguistically diverse ( CALD) background in Victoria. Method A web-based survey, exploring practices and challenges faced by clinicians in assessing CALD clients and their families, was sent to all Victorian ACAS managers to distribute to their teams. Three focus groups were also conducted with ACAS clinicians to further explore these issues. Results Seventy-nine web-based surveys were returned and 21 ACAS clinicians attended a focus group. Challenges reported included the availability and quality of interpreters, and variability in training received and confidence in assessing cognitive impairment in CALD clients. Conclusion ACAS clinicians reported that assessment of cognition for those of CALD background was challenging. Based on this feedback, practice tip sheets were developed as educational aids to assist ACAS staff. [ABSTRACT FROM AUTHOR]

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Education is state-run in Australia, and within each of the eight states and territories there are both government and independent schooling systems. This paper details the position of gay, lesbian, bisexual, transgender, intersex and queer (GLBTIQ) students within Australian education policy documents nationally, focusing on the three largest states and educational sectors in Australia. Survey data are used to report on the schooling experiences of over 3000 Australian GLBTIQ young people aged 14–21 years. Data from interviews with key policy informants identify both the obstacles to implementing policies, and how such obstacles have been overcome. Much official policy sees sexuality education as promoting inclusive, protective and affirming messages around GLBTIQ students. There exist significant correlations between policy and a variety of well-being and psycho-social outcomes for GLBTIQ students, including lowered incidence of homophobic abuse and suicide, and the creation of supportive school environments. Ideal policy visions are outlined, along with practical recommendations of relevance to a variety of stakeholders. [ABSTRACT FROM PUBLISHER]

Uncertainty around long-term droughts and water scarcity has been increasing as the impacts of El Nino cycles are felt globally. Understanding how the effects of these events are manifested on the ground in communities is particularly important if governments and associated agencies are to respond appropriately. Using a qualitative approach, this paper examines the impacts of drought on two rural towns in Victoria, Australia, and explores what lessons can be drawn from local experiences. The research suggests that previous responses to drought by governments have been largely ineffectual and as such, we question whether there is a need to reshape institutional understandings of what adapting to drought might mean. This research, therefore, seeks to further the discussion surrounding drought impacts and the myriad of challenges associated with it by drawing on locally situated knowledge to inform future decision-making in this evolving field of study. [ABSTRACT FROM AUTHOR]

Dominant discourses regarding concerns with anti-social behaviour in England and Victoria, Australia, reveal counterposed perspectives; the former positioning anti-social behaviour as an issue of law and order and an extension of concerns with crime and victimization, and the latter emphasizing concerns with the vulnerability of the perpetrator. These opposing perspectives inevitably give rise to markedly different policies and interventions. In England, an emphasis on the needs of the victim prioritizes the prevention of particular behaviours, whilst interventions in Victoria seek to address the needs of the perpetrator that are seen to contribute to or result from anti-social behaviour. To illustrate this contrast, the paper highlights the particular effects of these contradictory discourses on young people, and in doing so suggests a need to be wary of the impact of resultant approaches on those who may be most susceptible to committing anti-social behaviour, or to having their behaviour labelled as such. [ABSTRACT FROM PUBLISHER]

Since the United Nations Conference on Environment and Development (1992), the Integrated Coastal Zone Management (ICZM) concept has been adopted by Australian states, including the state of Victoria, as the framework vehicle to guide coastal management. Conceptually vital to the ICZM process is that appropriate environmental, social, demographic, and economic information should be available to all stakeholder groups, such that informed decision making can be supported across the entire catchment-marine-coastal continuum. It has been noted, both internationally and in Australia, that spatial information and related enabling technologies (e.g., geographical information systems -) have much potential to enhance the level of decision support for ICZM practitioners. However, despite much policy innovation regarding ICZM and spatial information infrastructure in Victoria since the early 1990s, stakeholders within the Victorian ICZM program are not yet served by any form of coordinated spatial information provision framework or any capacity-building initiatives vis-a` -vis the application of spatial enabling technologies for ICZM. In this paper, we report the findings of an anonymous online survey (responses n 5 342) administered to all Victorian ICZM stakeholder groups, which aimed to obtain baseline data regarding spatial information and enabling technology use. Survey results show that despite policy development and innovation at state government level, the current deployment of spatial information and its associated stakeholder-focussed decision-support technology does not meet its potential for decision support in bringing ICZM policy to practice. Results indicate that the initiation of targeted capacity-building programs, aimed specifically at increasing the capability of ICZM practitioners regarding the application of spatial information and enabling technologies, should be considered by lead agencies in order to provide an enhanced level of decision support within the Victorian ICZM program. [ABSTRACT FROM AUTHOR]

Despite the controversial nature of illicit drug treatment, there is a relative lack of research on policy formation in this area. This paper draws on qualitative interviews with service providers and analysis of policy documents, conducted for an Australian National Health and Medical Research Council funded project entitled 'Comparing the role of takeaways in methadone maintenance treatment in New South Wales and Victoria', to examine the formation and implementation of drug treatment policy. In particular, it considers two forces widely acknowledged to be important to drug treatment, and often argued to be antithetical to each other: community values and scientific evidence. Separation of the 'social' and the 'scientific' in treatment is a much-used but conceptually limited distinction. Two alternatives to evidence-based policy are proposed. The first, values-based policy, is increasingly important to critical discussions of social policy and could potentially add much to debates around drug treatment policy. The second alternative is suggested by social studies of science (STS), in particular feminist STS. [ABSTRACT FROM AUTHOR]

Although 'child safety' is now a national policy priority in Australia, there is little research exploring the practices in schools that contribute to children and young people's felt sense of safety and wellbeing. Drawing on a mixed-method Australian Research Council (ARC) Discovery project, this article presents findings from interviews with school staff (N = 10), leaders (N = 5) and nine focus groups with students (N = 58), in primary and secondary schools in three Australian states (New South Wales, Victoria and South Australia). We employ relational ethics, recognition theory and the theory of practice architectures to explore practices at school that support student wellbeing and safety. The findings contribute significantly to understanding the 'bundled' nature of current practices and the conditions that enable and constrain these. Close attention to these findings is critical as schools seek to operationalise the National Child Safe Principles and refine ongoing safeguarding procedures. The findings have informed the development of an online survey that is currently testing, on a much larger scale, which elements of ethical practice are most positively associated with students' safety, wellbeing and recognition at school. [ABSTRACT FROM AUTHOR]

Background: Local government authorities are well-placed to invest in evidence-based food policies that promote a population-wide shift to healthy and sustainable diets. This study describes the contextual factors that facilitated or impeded policy-making related to healthy and sustainable diets within a 'best-performing' local government in Victoria, Australia. Methods: Guided by the Consolidated Framework for Implementation Research (CFIR), data from semi-structured interviews with individuals involved in developing the City of Greater Bendigo's Food System Strategy were analysed using the seven-stage Framework Method. Results: Semi-structured interviews (n = 24) were conducted with City of Greater Bendigo employees (n = 15) and key stakeholders working for local organisations (n = 6) or at a state or national level (n = 3). Interviewees mostly held positions of leadership (n = 20) and represented diverse areas of focus from health (n = 7), food systems (n = 4) and planning and public policy (n = 3). Data analysis revealed 12 cross-cutting themes; eight facilitating factors and four impeding factors. Facilitating factors included perseverance, community engagement, supportive state policy, effective leadership, a global platform and networks, partnerships, workforce capacity and passion, and the use of scientific evidence. Impeding factors included access to secure, ongoing financial resources, prohibitive state and federal policy, COVID-related disruptions to community engagement and competing stakeholder interests. Overall, this study suggests that the City of Greater Bendigo's success in developing an evidence-based local food system policy is built upon (i) a holistic worldview that embraces systems-thinking and credible frameworks, (ii) a sustained commitment and investment throughout the inner-setting over time, and (iii) the ability to establish and nurture meaningful partnerships with community groups, neighbouring local government areas and state-level stakeholders, built upon values of reciprocity and respect. Conclusions: Despite insufficient resourcing and prohibitive policy at higher levels of government, this 'best performing' local government in Victoria, Australia developed an evidence-based food system policy by employing highly skilled and passionate employees, embracing a holistic worldview towards planetary health and harnessing global networks. Local government authorities aspiring to develop integrated food policy should nurture a workforce culture of taking bold evidence-informed policy action, invest in mechanisms to enable long-standing partnerships with community stakeholders and be prepared to endure a 'slow-burn' approach. [ABSTRACT FROM AUTHOR]

Background: Victoria was the first Australian state to legalize voluntary assisted dying (elsewhere known as physician-assisted suicide and euthanasia). Some institutions indicated they would not participate in voluntary assisted dying. The Victorian government issued policy approaches for institutions to consider Objective: To describe and analyse publicly available policy documents articulating an institutional objection to voluntary assisted dying in Victoria. Methods: Policies were identified using a range of strategies, and those disclosing and discussing the nature of an institutional objection were thematically analysed using the framework method. Results: The study identified fifteen policies from nine policymakers and developed four themes: (1) extent of refusal to participate in VAD, (2) justification for refusal to provide VAD, (3) responding to requests for VAD, and (4) appeals to state-sanctioned regulatory mechanisms. While institutional objections were stated clearly, there was very little practical detail in most documents to enable patients to effectively navigate objections in practice. Conclusion: This study demonstrates that despite having clear governance pathways developed by centralized bodies (namely, the Victorian government and Catholic Health Australia), many institutions' public-facing policies do not reflect this guidance. Since VAD is contentious, laws governing institutional objection could provide greater clarity and regulatory force than policies alone to better balance the interests of patients and non-participating institutions. [ABSTRACT FROM AUTHOR]

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A voluminous empirical literature has focused on organizational characteristics and their relationship to organizational performance in the public sector, including municipal efficiency. However, as yet no effort has been made to examine the impact of administrative intensity on the effectiveness of local authorities, as measured by local resident satisfaction surveys. To address this gap in the literature, this article investigates the effect of administrative intensity on local resident satisfaction in the local government system of the Australian state of Victoria over the period 2014/2015 to 2018/2019. Using regression analysis, we find that there is a significant association between administrative intensity and the effectiveness of municipalities. However, the impact of administrative intensity on municipal effectiveness differs between urban local authorities and rural local authorities. This has significant public policy implications given that a uniform policy prescription may not achieve its intended aims due to the differential effects of the determinants of municipal effectiveness. [ABSTRACT FROM AUTHOR]

Twenty years before the ill-effects of exposure to asbestos dust became an issue of public concern in Victoria, medical knowledge about this occupational hazard and its management were readily available in the Industrial Hygiene Division of the Victorian Department of Health. The failure of the State Electricity Commission to incorporate this body of knowledge into the management of its power stations cannot be attributed to a callous disregard for workers’ health. It was rather that the organisational structure and ethos of this semi-autonomous government agency, dominated by engineering expertise, fostered an intolerance of the expertise of other professionals—in this case, that of medical practitioners specialising in industrial hygiene. The events recounted in this paper illustrate the extent to which the perception of an occupational hazard in ‘ordinary conditions’ of work can be obstructed by the everyday circumstances of an organisation’s operation [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this paper is to document and explain differences in cycling between Australia’s two largest cities. Our comparative case study analysis is based on a wide range of statistical datasets, secondary reports, and interviews with a panel of 22 bicycling policy and planning experts. The main finding is that cycling levels in Melbourne are roughly twice as high as in Sydney and have been growing three times as fast in recent years. The difference is due to Melbourne’s more favorable topography, climate, and road network as well as more supportive public policies. In particular, Melbourne has more and better integrated cycling infrastructure as well as more extensive cycling programs, advocacy, and promotional events. Melbourne also benefits from safer cycling than Sydney, which suffers from a lack of traffic-protected cycling facilities and aggressive motorist behavior toward cyclists on the road. While cycling has been increasing in Australia, it remains at very low levels relative to northern Europe, where both land use and transport policies are far more supportive of bicycling while discouraging car use through numerous restrictions and financial disincentives. [Copyright &y& Elsevier]

Victoria EPA is to introduce a Protocol for Environmental Management (PEM) for risk assessment as foreshadowed in the State Environment Protection Policy-Air Quality Management. This PEM will provide guidelines to evaluate the risk that beneficial uses of the environment will not be protected in the event that a design criterion for a given emission is not met in a proposed development. If the risk is determined as low, then the development will be permitted, while if the risk is medium then additional mitigation measures will be required. If the risk is determined as high, and mitigation measures cannot reduce risk to low, then the site is considered unsuitable for the development. It is anticipated that those indicators (nuisance dust, odour) that affect only amenity (rather than health), will have separate ERA (Environmental Risk Assessment) guidelines, to distinguish from emissions that impact on human health, for which a traditional Health Risk Assessment (HRA) would be appropriate. This paper considers the relevant factors to consider in an ERA for the case of odour emissions and presents a simple methodology for an ERA based on the AS/NZS 4360 - 2004 Risk Management standard. Outstanding issues are discussed and some case studies where this methodology has been used are presented. [ABSTRACT FROM AUTHOR]

Recent measures introduced by Australian governments to improve the visual-quality of the built environment have been criticised as being too prescriptive. Two opposing models of people’s aesthetic response to buildings have been proposed in the research literature. The preference-for-difference model has gained more support than the preference-for-prototype model but is at odds with current government policies. Both models are based on studies using photographs of buildings in laboratory settings, but have not been replicated through people’s actual experience of buildings in the real-world. This paper reports on a field study conducted to examine whether the preference-for-difference model could explain the public’s perception and aesthetic response to a building controversial for its contemporary architecture. Fifty people were interviewed in and immediately around Federation Square, Melbourne and asked to make aesthetic judgements of the Square. The public collectively found the building to be interesting, moderately unusual, and pleasing. The results supported the preference-for-difference model of aesthetic response. It is suggested that more field studies examining aesthetic response to buildings should be conducted. More importantly, and perhaps surprisingly, these findings suggest that to meet public aesthetic views, government policy should encourage diversity and innovation in design and aesthetics. [ABSTRACT FROM AUTHOR]

The emergence of ‘social cohesion’ as a policy concept in various Western states has been widely understood as part of a backlash against multiculturalism. This article applies an anthropological lens to the implementation of an Australian project to engage young people in order to ‘strengthen social cohesion’ in outer metropolitan Melbourne. Ethnographic analysis of the project lends empirical support to key critiques of the social cohesion paradigm, including the deployment of ‘community’ as a technology of cultural governance, the obscuring of socio-economic conditions and issues of social justice, and the foreclosing of any understanding of conflict as a potential social good. Some of the tensions evident in the project, however, are reflective not of recent shifts but rather of long-running dynamics in the governance of cultural difference. Thus, the article argues, narratives of a ‘multiculturalism backlash’ capture significant changes but also risk obscuring critical continuities in the exercise of governmentality. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to estimate the likely reduction in road trauma associated with the implementation of effective interventions to reduce road trauma among young Australians. Methods: A desktop evaluation was conducted to model the likely reduction in road trauma (deaths and serious injuries resulting in hospitalization) among young people aged 17–24 years residing in Queensland, New South Wales, and Victoria. Potential interventions were identified using a rapid literature review and assigned a score based on evidence of effectiveness and implementation feasibility with the 3 highest scoring interventions included in the modeling. Likely reduction in road trauma was estimated by applying the average risk reduction effect sizes for each intervention to baseline risk (passenger or driver death or serious injury per 100,000 population) of road trauma for young Australians. Point estimates were calculated for the potential number of deaths and serious injuries averted in each state and per 100,000 population, with a one-way sensitivity analysis conducted using uncertainty ranges identified. Results: Peer passenger and night driving restrictions as well as improved vehicle safety measures had the greatest potential to reduce road trauma. Peer passenger restrictions could avert 14 (range: 5–24) and 24 (range: 8–41) hospitalizations per year in Queensland and New South Wales, respectively, and night driving restrictions could avert 17 (range: 7–26), 28 (range: 12–45), and 13 (range: 6–21) hospitalizations annually in Queensland, New South Wales, and Victoria. These interventions reduced fatalities by less than 1 death annually in each state. Improved vehicle safety measures could avert 0–3, 0–4, and 0–3 deaths and 3–91, 4–156, and 2–75 hospitalizations in Queensland, New South Wales, and Victoria. Conclusions: Key elements of graduated licensing (peer passenger and night driving restrictions) along with vehicle safety interventions offer modest but practically significant reductions in road trauma for young Australians. State governments need to revise current legislation to ensure that these reductions in road trauma can be realized. [ABSTRACT FROM PUBLISHER]

This article is about a case of policy failure and negative lesson drawing, namely the implementation of a mandatory smart metering programme – the Advanced Metering Infrastructure Program – in the State of Victoria, Australia, in the period 2009–2013. The article explores the framing of policy failure, and the ways in which failed polices might be mobile. The Advanced Metering Infrastructure Program provides an important empirical counterbalance to existing scholarship on policy learning, transfer and mobility, which is for the most part about positive best practice case studies, emulation and the travelling of ‘fast’ and (by implication) successful policy. There is evidence that the Victorian Advanced Metering Infrastructure Program circulated domestically within Australia and was influential in policy decision making, but that its international mobility was limited. The case is used to explore what gets left behind – or is immobile – in the telling of policy stories about failure. Science and Technology Studies scholarship on the inherent fragility of sociotechnical networks is drawn upon to consider how the concept of assemblage – a popular conceptual lens within policy mobility scholarship – might be applied to better understand instances of policy failure. [ABSTRACT FROM AUTHOR]

This article considers the implementation of police hate crime policy. Victoria, a state in Australia, provides a case study of a jurisdiction where police have introduced a Prejudice Motivated Crime Strategy without an animating hate crime offence. The article identifies the organisational, relational and operational challenges and opportunities that arise in the implementation of this strategy. The literature reveals that successfully policing hate crime is impeded where the approach to defining and categorising hate crime is over- or under-inclusive. Over-inclusive approaches focus on community expectations while under-inclusive approaches are oriented towards prosecution. The absence of a legally bounded definition of hate crime in Victoria provides an opportunity to develop an approach that meets public expectations and operational needs of police, thus avoiding the pitfalls of over- or under-inclusive approaches. To realise this opportunity, the article draws upon the results of a research partnership between Victoria Police and a consortium of Australian universities. Synthesising legal standards with community interests, a set of five markers are advanced for frontline officers to negotiate, rather than assume, a common understanding of hate crime and to build police/community trust. The article makes an important contribution to the field by demonstrating that it is possible to advance the implementation of hate crime policy through strategies that are responsive to both legal standards and community expectations. [ABSTRACT FROM AUTHOR]

The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the educational level of PCNs, PCN role expansion and the extent of interprofessional collaboration that is evident from research undertaken to date. Nurses with postgraduate education have the potential to increase their scope of practice, take on a greater teaching role and provide more preventive and chronic disease services in primary care. Policies aimed at increasing access to education for nurses working in primary care would strengthen the primary care nursing profession, and enhance the delivery of primary health care services in Australia. [ABSTRACT FROM AUTHOR]

The article examines the representation of housing risk in contemporary Australian policy discourse through a critical analysis of two policy texts from the recent Victorian Coalition government (2010-2014). Drawing on governmentality theory and contemporary debates on neoliberalism, it examines how these policy texts perpetuate a discourse in which 'housing risk' is primarily understood as an issue for individuals to manage, rather than as an issue with predominantly structural roots. It then explores how this particular neoliberal representation of 'housing risk' supports policy solutions that ultimately responsibilise individuals through a narrow focus on education and employment as the pathways to independence in the private housing market. The article argues that this situation is problematic in a context of increasing rates of homelessness and diminished access to affordable housing across Australia. [ABSTRACT FROM AUTHOR]

This article discusses the policies of the Australian government during the period from July to December 2014. The author comments on the leadership style of Prime Minister Tony Abbott and describes the negative public opinion surrounding his administration. The current political and economic conditions of several Australian regions, including New South Wales, Victoria, and Queensland, are also examined.

As in many other societies, Australian states have alcohol licensing laws, which specify who can sell alcoholic beverages and under what conditions. Police commonly have the authority to enforce licensing provisions, but are often distracted from this task by more pressing responsibilities. The state of Victoria, Australia, moved in July 2009 to establish a Compliance Directorate (the Directorate), comprising 40 civilian inspectors, to assist and support the work of the Victoria Police in enforcing requirements pertaining to liquor licensees. This article explores early indicators of the impact of this body on licensee compliance in Victoria. The Directorate was presented by the government as a part of an effort to influence cultures that promote harmful consumption of alcohol. Analysis of data and interviews with policy and enforcement staff and licensees indicate that the Directorate has substantially improved enforcement of administrative provisions of licence conditions. In a climate where previously very little liquor licence enforcement existed, the Directorate has been required to negotiate conflicting views on appropriate approaches to regulation, potentially undermining its capacity to pose a real threat of enforcement action for licensees who are in breach of their obligations. Although civilian inspectors promote a better regulated alcohol industry, evidence indicates that provisions prohibiting sales to minors and the intoxicated (with greatest potential to impact on alcohol-associated harm) remain insufficiently enforced. [ABSTRACT FROM AUTHOR]

• Summary: This article reports on a study funded by the Criminology Research Council, Australia, investigating the intersection between the child protection and criminal justice systems and the extent to which children before the Melbourne Children’s Court on child protection matters, during the study period June to December 2006, had a parent currently in prison, awaiting sentencing or previously in prison. This article focuses on what associations there might be between parental imprisonment and its impact on family life and the care of children.• Findings: Magistrates identified 156 children as meeting these criteria during the study period for whom there were concerns about physical and emotional harm, child development, or the parent’s incapacity to provide care for the child; concerns about parental substance abuse, mental health, family violence and transience. The instability in these children’s lives was linked to the parents’ offending and was reflected in the reasons why the children came to the attention of the court, and the child protection concerns expressed about them. Yet, there was no co-ordinated response by the child protection and justice systems to managing these children’s situations.• Application: Early intervention for children affected by parental offending, and the development of child protection service protocols with the corrections system about children when their parents enter prison is essential, to better address the instability and disruption in care these children experience, their vulnerability as adults to mental health and relationship problems, and their reduced education and employment outcomes. [ABSTRACT FROM PUBLISHER]