Suchergebnisse

On health grounds, immigration detention should be used in very limited ways Like all rich nations, Australia has experienced an increase in people crossing its national borders without the documents authorising them to do so. Since 1992, Australia has had a policy of mandatory detention for these people. About a third of the people in immigration detention are asylum seekers who are requesting sanctuary under the 1951 United Nations Convention Relating to the Status of Refugees, to which Australia was an early signatory. Although some form of immigration detention exists in most developed countries, asylum seekers are generally released into the community after a period of time in detention, while their claims are being processed. Australia pioneered the notion that detention for asylum seekers was a kind of endgame, in which people arriving without authority stayed in detention until they obtained a visa or were deported. Among the Convention signatories, no other nation has followed suit.

AbstractWomen Entrepreneurs in the Gambia: Challenges and Opportunities. M. Della‐Giusta, C. Phillips. Journal of International Development (18)8: 1051–1064.The authors should appear in the following order: 'C. Phillips and M. Della‐Giusta' and not 'M. Della‐Giusta and C. Phillips' as published.

AbstractThis paper is the result of the analysis of 200 interviews with Zambian enterprise owners during the summer of 2006. It examines the reasons for the lack of growth of micro and small firms and the resulting 'missing middle' in Zambia. The study finds that most enterprise owners are risk takers, have bounded rationality in terms of their understanding of market structure, conduct and performance and rely on inappropriate channels for their information. A second group of enterprise owners who are less risk preferring, and do not have aspirations in terms of firm growth is also identified. Most enterprises in these two groups do not operate on a growth trajectory. Finally there is a very small group of enterprise owners who are truly entrepreneurial. Policy recommendations address issues concerning the need for differentiated targeting to support firm sustainability and growth. Copyright © 2007 John Wiley & Sons, Ltd.

AbstractThis article reviews the literature on women entrepreneurs in developing countries and presents evidence from a case study undertaken during 2001 and 2002 in Gambia examining the challenges facing women entrepreneurs in the small enterprise sector. The article attempt to discuss the gendered nature of the barriers to survival and growth, particularly the low productivity of sectors in which women entrepreneurs operate, the difficulty in accessing capital for expansion and the need to reconcile business with domestic activities and the propensity to view business as part of an overall livelihood diversification strategy. The article argues that further to addressing specific gender needs of women entrepreneurs, policy and support mechanisms must be sensitive to and geared towards both enterprises with potential and aspirations for growth and diversification and those whose primary objective is that of sustaining livelihoods. Copyright © 2006 John Wiley & Sons, Ltd.

Background: In rural settings, relationships between place and self are often stronger than for urban residents, so one may expect that rural people would view dying at home as a major feature of the 'good death'. Aim: To explore the concept of the 'good death' articulated by rural patients with life-limiting illnesses, and their family caregivers. Design: Ethnography, utilising open-ended interviews, observations and field-notes. Participants: In total, 12 rural (town and farm) patients with life-limiting illnesses, 18 family caregivers and 6 clinicians, in the Snowy Monaro region of New South Wales, Australia, participated in this study over the course of the deaths of the patients. Interviews were transcribed and analysed with observational data using an emergent thematic process. Results: A 'safe death' was central to a 'good death' and was described as a death in which one could maintain (1) a connection with one's previous identity; (2) autonomy and control over decisions regarding management of end-of-life care and (3) not being overwhelmed by the physical management of the dying process. For all participants, the preferred place of death was the 'safe place', regardless of its physical location. Conclusion: Safety, in this study, is related to a familiar place for death. A home death is not essential for and does not ensure a 'good death'. We all have a responsibility to ensure all places for dying can deliver the 'safe death'. Future research could explore the inter-relationships between safety and preference for home or home-like places of death. ; This research was supported by an Australian Government Research Training Programme (RTP) Scholarship

Objectives: To review the literature on different models of clinical governance and to explore their relevance to Australian primary health care, and their potential contributions on quality and safety. Data sources: 25 electronic databases, scanning reference lists of articles and consultation with experts in the field. We searched publications in English after 1999, but a search of the German language literature for a specific model type was also undertaken. The grey literature was explored through a hand search of the medical trade press and websites of relevant national and international clearing houses and professional or industry bodies. 11 software packages commonly used in Australian general practice were reviewed for any potential contribution to clinical governance. Study selection: 19 high-quality studies that assessed outcomes were included. Data extraction: All abstracts were screened by one researcher, and 10% were screened by a second researcher to crosscheck screening quality. Studies were reviewed and coded by four reviewers, with all studies being rated using standard critical appraisal tools such as the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Two researchers reviewed the Australian general practice software. Interviews were conducted with 16 informants representing service, regional primary health care, national and international perspectives. Data synthesis: Most evidence supports governance models which use targeted, peer-led feedback on the clinician's own practice. Strategies most used in clinical governance models were audit, performance against indicators, and peer-led reflection on evidence or performance. Conclusions: The evidence base for clinical governance is fragmented, and focuses mainly on process rather than outcomes. Few publications address models that enhance safety, efficiency, sustainability and the economics of primary health care. Locally relevant clinical indicators, the use of computerised medical record systems, regional primary health care organisations that have the capacity to support the uptake of clinical governance at the practice level, and learning from the Aboriginal community-controlled sector will help integrate clinical governance into primary care.

BACKGROUND: Multiple sclerosis (MS) is a chronic serious condition of uncertain course and outcome. There is relatively little literature on the experiences of people who live with a person with MS. They inhabit a locus of care that spans caring for (a relational act) and caring about (a moral stance, addressing fairness, compassion and justice) the person with MS. METHODS: Using the theoretical lens of personhood, we undertook a scoping review and meta‐synthesis of the qualitative literature on the experiences of people who live with a person with MS, focusing on the nature of, and constraints upon, caring. RESULTS: Of 330 articles, 49 were included in the review. We identified five themes. One of these—seeking information and support—reflects the political economy of care. Two are concerned with the moral domain of care: caring as labour and living with uncertainty. The final two themes—changing identities and adapting to life with a person with MS—point to the negotiation and reconstitution of personhood for both the person with MS and the people they live with. CONCLUSION: People with MS are embedded in relational social networks of partners, family and friends, which are fundamental in the support of their personhood; the people who live with them are 'co‐constituents of the patient's identity' assisting them to make sense of their world and self in times of disruption due to illness. Support services and health care professionals caring for people with MS are currently very much patient‐centred; young people in particular report that their roles are elided in the health system's interaction with a parent with MS. There is a need to look beyond the person with MS and recognize the relational network of people who surround them and broaden their focus to encompass this network. PATIENT AND PUBLIC INVOLVEMENT: Our research team includes four members with MS and two members with lived experience of living or working with people with MS. A third person (not a team member) who lives with a partner with MS ...

• To minimise the health impact of pandemic influenza, general practice will need to provide influenza-related and non-influenza primary health care, as well as contribute to the public health goal of disease control. • Through interviews and workshop

• To minimise the health impact of pandemic influenza, general practice will need to provide influenza-related and non-influenza primary health care, as well as contribute to the public health goal of disease control. • Through interviews and workshop

Introduction: Enhancing quality and safety in primary health systems is of central importance to fianders, practitioners, policy makers and consumers. In this paper we explore the roles of general practice nurses in relation to quality and safety. Method: Cross-sectional multimethod study of 25 Australian general practices. Using rapid appraisal we collected data for each practice from interviews with practice nurses, general practitioners and practice managers; photographs of nurse-identified 'key work-spaces'; structured observation of nurses for two one-hour sessions; and floor plans. Results: Quality was articulated in two domains, reflecting both external and intrinsic determinants. External determinants included a large number of essentially structural, procedural or regulatory processes, the most marked of these being practice accreditation and occupational health and safety; these corresponded to the Habermasian idea of system. Intrinsic determinants related mostly to nurse perception of their own quality behaviour, and consisted of ways and means to improve or optimise patient care; these correspond to Habermas' notion of the lifeworld. Discussion: Nurses describe a productive tension between the regulatory roles that they play in general practices, and patient-focused care, contrary to Habermas' suggestion that system subsumes life-world. Current funding systems often fail to recognise the importance of the particular elements of nurse contributions to quality and safety in primary care.