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The number, range and foci of voluntary initiatives have been growing rapidly over the last decade, but there is still debate as to whether they work 'on the ground'. The paper begins by defining voluntary initiatives and considers their relative strengths and weaknesses. The main factors contributing to their effectiveness-monitoring, transparency, enforcement, content and compulsoriness-are discussed and are then reviewed in light of an Australian case study of a mining industry initiative. Interviews with mining industry executives and other stakeholders are used to offer insights into the ways in which the efficacy of voluntary initiatives might be improved. It is here that a paradox emerges: the voluntary initiatives with the most potential for success appear to be those that are, effectively, compulsory. The paper concludes by discussing the key ways in which 'compulsory' voluntary initiatives might differ from command-and-control regulation and the broader implications of this apparent movement towards the privatisation of regulation. [ABSTRACT FROM AUTHOR]

Objective:To compare clinical outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia.Methods:A retrospective review was conducted of patients who underwent injection laryngoplasty performed by a single laryngologist in a tertiary Australian laryngology centre, between February 2013 and December 2014. Patient demographics, anaesthetic modality and complications were recorded. Voice Handicap Index 10 and the Grade, Breathiness, Roughness, Asthenia, Strain scale were evaluated.Results:Thirty-four laryngoplasties were performed under general anaesthesia and 41 under local anaesthesia, with mean patient ages of 59.5 and 68.8 years, respectively. Voice Handicap Index 10 scores were significantly improved post-injection (p < 0.001), with no significant difference between general anaesthesia and local anaesthesia (p > 0.05). All aspects of the Grade, Breathiness, Roughness, Asthenia, Strain scale showed significant improvement post-injection, except asthenia. There were seven (9.3 per cent) minor complications (five in the general anaesthesia group, two in the local anaesthesia group), all managed conservatively.Conclusion:Injection laryngoplasties performed under general anaesthesia and local anaesthesia offer similar voice outcomes, with comparable complication rates. Hence, development of a management algorithm for injection laryngoplasties performed under local anaesthesia is recommended. [ABSTRACT FROM PUBLISHER]