South Australian Government Research Articles

New norms new policies: Did the Adelaide Thinkers in Residence scheme encourage new thinking about promoting well-being and Health in All Policies?

Health systems have long been criticised for focussing on curing rather than preventing disease. This paper examines to what extent the Adelaide Thinkers in Residence (ATiR) scheme contributed to the change in norms whereby promoting well-being and a strategy to achieve this - Health in All Policies (HiAP) - was adopted by the South Australian (SA) State Government from 2007. The data presented in this paper are drawn from a five year (2012–2016) detailed mixed methods case study of the SA HiAP initiative which involved document analysis, interviews and workshops with public servants and political actors. We adapt the framework used by Finnemore and Sikkink (1998) which explains how norm changes can lead to political changes in international affairs. We also use Kingdon's concept of policy entrepreneurs to determine whether these ideas moved to an implementable initiative with the help of both a specific ATiR program on HiAP and the broader TiR scheme which promoted a series of innovations relevant to health. The process involved the ATiR reinforcing the work of local norm entrepreneurs with that of powerful external policy entrepreneurs, adapting the discourse about the value of prevention and promoting well-being so that it fitted with the dominant economic one. The powerful organisational platform of the ATiR, which was under the Department of the Premier and Cabinet and linked to the South Australian Strategic Plan (SASP) was used to advance these ideas. The case study offers important lessons for other jurisdictions on how to shift policy to encourage intersectoral approaches to health.

Nuclear Subsidies and Proliferation: Clarifying the Link

ABSTRACTIn March 2015, the South Australian state government established a royal commission to investigate the financial, social, technical, diplomatic, and nonproliferation benefits and risks of expanding its nuclear industry, including activities related to uranium mining; enriching, reprocessing, and fabricating nuclear fuels for both domestic use and export; producing nuclear power; and storing radiological waste, including foreign spent reactor fuel. Given its enormous uranium reserves and current mining activities, some Australians have argued that Australia could benefit financially by expanding the mining sector and by adding value to its uranium exports by enriching the material and fabricating it into reactor fuel assemblies. Others have maintained that Australia can realize significant economic benefits by recycling and storing foreign spent fuel and producing carbon-free nuclear power. In the end, the commission recommended that Australia consider opening up a high-level waste repository to take in foreign spent fuel. It did not recommend any other nuclear activities at this time. The following viewpoint is based on testimony I delivered to the commission on the nuclear weapon proliferation implications of the proposed activities. If Australia wants to avoid the temptation of selling nuclear goods to states that might use these goods to make bombs, it should only consider new nuclear activities that can be entirely financed by the private sector and turn a profit without having to resort to foreign sales. This policy would also enable Australia to set an important, new international nonproliferation standard.

Social inclusion under Labor in South Australia

Social inclusion policies were championed by the former Rann Labor government in South Australia from 2002 to 2011. In 2011 the Social Inclusion Unit was dissolved by the South Australian government. It is argued that the relatively narrow focus of the former SIU on ‘problem’ communities limited its capacity to provide more than residual solutions. The diminishing political returns on social inclusion also encouraged the South Australian government to abandon this initiative. In 2014 this government has had to grapple with the end of car making in Australia and a declining manufacturing labour force, traditionally a ‘mainstream’ constituency of the Labor Party. The return to ‘mainstreaming’ social policy in South Australia might offer limited space for realignment of social policy with the concept of social citizenship. It might also represent a move away from the functionalist morality of social inclusion. Social inclusion as practiced in South Australia has limited capacity to address generalised social disadvantage. The latter is likely to concern a re‐elected Labor minority government grappling with significant job losses and a declining local economy.

Late Night Lockout Laws

In October 2013, the South Australian government introduced the Late Night Trading Code of Practice ('the Code') as a means of reducing incidences of alcohol-related violence and antisocial behaviour in and around late night licensed venues in South Australia. Adelaide's notorious West End club district was especially targeted following a spate of brutal attacks including cowardly 'king hits'. In support of the move, then Minister for Business Services and Consumers, John Rau, issued a media release citing statistics which indicated there were 12 500 hospital admissions and 600 deaths attributable to alcohol in the state annually. Mr Rau also noted South Australia Police data demonstrating that the demand for police and health resources responding to alcoholrelated issues was at its greatest in the early hours of Saturday and Sunday mornings. Alcohol, and the trading hours of the late night venues which served it, were said to be the problem.

Water consumption characteristics at a sustainable residential development with rainwater-sourced hot water supply

The use of water-efficient appliances and inclusion of alternative water sources in urban residential developments is becoming increasingly necessary to meet the growing demands on conventional urban water supplies. As an initiative commissioned by the South Australian State Government in 2009, Lochiel Park is a recent model designed to embrace sustainable planning principles and technologies in a domestic context. An extensive post-occupancy monitoring program of actual residential water and energy usage was conducted. The study aimed at analysing and quantifying the water consumption at 59 houses through real-time monitored data collected over 3 years between 2010 and 2013, incorporating the monitored usage of mains water, collected rainwater and hot water usage. The analysis shows that the annual average total water consumption per household at Lochiel Park is significantly lower than both the Adelaide and national averages by about 24% and 16% respectively, while average mains water consumption is lower by 36% and 29% respectively. Rainwater contributes 6–10% of the total water use in summer and up to 26% in winter, with an average annual contribution of around 14%. A significant part of the saving is attributed to the increased minimum rainwater tank capacity from the 1 kL specified in the Building Code of Australia to 1.5 kL, and feeding rainwater into the hot water supply in a climate where rainfall occurs in winter. Although a reduced hot water demand is also prompted by having efficient fixtures and rainwater supply depends on climate, rainwater fed into hot water supply saves 40% of hot water consumption annually. Greater rainwater utilization in hot water is possible if rainwater tank sizing and a greater roof catchment area can match household winter hot water demand, rather than having a single minimum requirement across all households as in the current regulation. The study provides an understanding of the performance of alternative urban water systems. The outcomes verify the effectiveness of the Water Sensitive Urban Design (WSUD) features implemented and will be useful for future strategic planning and design initiatives for implementation of similar developments on a larger scale.

Telephone-based low intensity therapy after crisis presentations to the emergency department is associated with improved outcomes

Introduction In Australia there is an overwhelming need to provide effective treatment to patients presenting to the Emergency Department (ED) in mental health crisis. We adapted Improving Access to Psychological Therapies service model (IAPT) from the National Health Service (NHS) method for the large scale delivery of psychological therapies throughout the United Kingdom to an Australian ED setting. This telephone-based low intensity therapy was provided to people presenting in crisis to the EDs with combinations of anxiety, depression, substance use, and suicidal thinking. Methods This uncontrolled study utilised session-by-session, before-and-after measures of anxiety and depression via Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7). Results Of 347 eligible post-crisis ED referred patients, 291 (83.9%) engaged with the IAPT team. Most patients (65%) had attended the ED previously on an average of 3.9 (SD = 6.0) occasions. Two hundred and forty one patients received an average of 4.1 (SD = 2.3) contacts of low-intensity psychological therapies including 1.2 (SD = 1.7) community outreach visits between 20th Oct 2011 and 31st Dec 2012. Treated patients reported clinically significant improvements in anxiety, depression and suicidal ideation. Uncontrolled effect sizes were moderate for anxiety (0.6) and depression (0.6). Discussion The Australian ED IAPT program demonstrated that the UK IAPT program could be adapted for emergency mental health patients and be associated with similar clinical benefits as the original program. Funding The Flinders Medical Centre IAPT program received Emergency Department project funding from the Australian Commonwealth Government through the Council of Australian Governments (COAG) and the South Australian Government initiative, Every Patient Every Service (EPES).

Not addressing the root cause: An analysis of submissions made to the South Australian Government on a Proposal to Protect Midwifery Practice.

Reports of unregulated birth workers attending birth at home, with no registered midwife in attendance (freebirth), have become more frequent in Australia in recent years. A Coronial Inquiry (2012) into the deaths of three babies born at home in South Australia resulted in a call for legislation to restrict the practice of midwifery to registered midwives. A Proposal to Protect Midwifery Practice in South Australia was issued as a consultation paper in January 2013. To report the views of those making a submission to the Proposal to Protect Midwifery Practice in South Australia. Thirty submissions to the South Australian Government were downloaded, read and thematically analysed. Twenty-five (81%) submissions supported the legislation, 5 (16%) opposed it and 2 (6%) were neither for nor against. Support for the proposed legislation was strong, however the underlying root causes that have led to the rise of UBWs attending homebirth in Australia were not addressed. Recommendations called for all stakeholders to work with women to develop a better framework of care that respected and met their needs and choices whilst safeguarding maternal and neonatal health. The Proposal to Protect Midwifery Practice may promote greater protection of midwifery practice however, Private Indemnity Insurance (PII), collaborative agreements and power struggles associated with the medical domination of childbirth continue to marginalise homebirth and prevent women from accessing the care they want and need. These unresolved issues represent the root causes for UBWs attending homebirth; hence the proposal is only a partial solution.

Citizen science for policy development: The case of koala management in South Australia

Abstract Citizen science involves the engagement of non-scientists in scientific research. Citizen science projects have been reported to be useful in policy development but there is little detail of how projects have contributed. The citizen science project, the Great Koala Count (GKC) collected ecological data about koalas and social data that have been used in the initial stages of the development of a South Australian Government koala management and conservation policy. After the GKC, we conducted an online survey of people who participated in the project and a control group. The survey focussed on opinions towards possible management options for koalas in South Australia. GKC participants were also asked about project-related changes in knowledge and opinions. We received 970 valid surveys and found some differences in opinions between GKC participants and the control group. Therefore, the GKC did not provide a representative sample of the entire South Australian population. However, we contend that the data from the citizen scientists are still valuable for policy development as it has been provided by people who are highly engaged in the topic (koala management in this case). It can be difficult to engage the public in the policy development process, and the citizen science project enabled the collection of a wide range of opinions, helping to discover and define relevant issues. Additionally, many people learnt about koalas and koala-related management issues, and some changed their opinions regarding koala management, also useful outcomes from the project in the policy development context. Our findings suggest that citizen science is useful for policy makers because projects provide the opportunity for dialogue with the people most interested in the topic of the project.

Deterrence, and the Slow Death of the Shop Theft Act in South Australia

The Shop Theft (Alternative Enforcement) Act 2000 (SA) ('the Act') came into effect on 11 November 2001. Its provenance can be found in the work of the Retail Industry Crime Prevention Advisory Committee, which was set up by the South Australian government in 1995 to reduce crime against the retail industry. The committee identified minor shop theft as a key concern, and put forward a proposal for a formal police cautioning procedure.

What Next in Transportation? [Transportation Systems

On 21 October 2013, the South Australian government announced an integrated transport and land use plan for the Adelaide region that includes a major expansion of its existing tram service. The expansion would be accomplished by including the existing tram line between downtown Adelaide and Glenelg (see ?Figure 1) in a new AdeLINK tram network that would consist of the following six lines:

Impacts of groundwater extraction on salinization risk in a semi-arid floodplain

Abstract. In the lower River Murray in Australia, a combination of a reduction in the frequency, duration and magnitude of natural floods, rising saline water tables in floodplains, and excessive evapotranspiration have led to an irrigation-induced groundwater mound forcing the naturally saline groundwater onto the floodplain. It is during the attenuation phase of floods that these large salt accumulations are likely to be mobilised and discharged into the river. This has been highlighted as the most significant risk in the Murray–Darling Basin and the South Australian Government and catchment management authorities have subsequently developed salt interception schemes (SIS). The aim of these schemes is to reduce the hydraulic gradient that drives the regional saline groundwater towards the River Murray. This paper investigates the interactions between a river (River Murray in South Australia) and a saline semi-arid floodplain (Clark's floodplain) that is significantly influenced by groundwater lowering due to a particular SIS. The results confirm that groundwater extraction maintains a lower water table and a higher amount of fresh river water flux to the saline floodplain aquifer. In terms of salinity, this may lead to less solute stored in the floodplain aquifer. This occurs through three mechanisms, namely extraction of the solute mass from the system, reducing the saline groundwater flux from the highland to the floodplain and changing the floodplain groundwater regime from a losing to a gaining one. It is shown that groundwater extraction is able to remove some of the solute stored in the unsaturated zone and this can mitigate the floodplain salinity risk. A conceptual model of the impact of groundwater extraction on floodplain salinization has been developed.

The role of airborne geophysics in facilitating long-term outback water solutions to support mining in South Australia

Mining and energy development in South Australia's far north is set to have significant consequences for the water resources of the region. These sectors generate significant economic value to the State and their support remains a priority for the government. The scale of the planned developments and the potential from current exploration programs facilitated by the South Australian Government through PACE Program will result in a substantial increase in infrastructure requirements, including access to water resources and Aboriginal lands for potential mine developments. Increased demand for water and in particular groundwater is compromised by the limited knowledge we have about these resources. This includes information about their character, variability, sustainability and their relationship to environmental and cultural assets, which is most notable in the priority areas for development. There is a recognised need to develop this knowledge so that water is not a limiting factor to development. In this paper results from the Goyder Institute's Long-Term Outback Water Solutions (G-FLOWS) Project are presented. Particular reference is made to work completed in the Musgrave Province. It illustrates the role of local scale AEM, acquired for exploration, and regional scale airborne magnetics in helping develop a hydrogeological conceptual model for the Province. The AEM data reveal a complex, extensive inset palaeovalley system which contains groundwater of variable quality (2000 - 4500 mg/L TDS). Examination of their location against the regional magnetics indicates a strong lithostructural control on their orientation and distribution. If mineral resources were to be developed in the area, these groundwater systems would represent the best option for water supply. A regional scale water resource map, based on information gleaned from the geophysics, existing hydrogeological and digital elevation data, is presented that provides a framework for groundwater resource determination when/if mineral deposits were to be mined in the region.

Pregnancy loss managed by cervical dilatation and curettage increases the risk of spontaneous preterm birth

Do women with a previous miscarriage or termination of pregnancy have an increased risk of spontaneous preterm birth and is this related to previous cervical dilatation and curettage? A single previous pregnancy loss (termination or miscarriage) managed by cervical dilatation and curettage is associated with a greater risk of SpPTB. Miscarriage affects ∼20% of pregnancies and as many as a further 20% of pregnancies undergo termination. We utilized data from 5575 healthy nulliparous women with singleton pregnancies recruited to the Screening for Pregnancy Endpoints (SCOPE) study, a prospective cohort study performed between November 2004 and January 2011. The primary outcome was spontaneous preterm birth (defined as spontaneous preterm labour or preterm premature rupture of membranes (PPROM) resulting in preterm birth <37 weeks' gestation). Secondary outcomes included PPROM, small for gestational age, birthweight, pre-eclampsia and placental abruption. Women with previous pregnancy loss (miscarriage or termination) were compared with those with no previous pregnancy loss. There were 4331 (78%) women who had no previous pregnancy loss, 974 (17.5%) who had one early previous pregnancy loss, 249 (4.5%) who had two and 21 (0.5%) who had three or four losses. Women with two to four previous losses, but not those with a single loss, had an increased risk of spontaneous preterm birth (adjusted OR 2.12; 95% CI 1.55, 2.90) and/or placental abruption (adjusted OR 2.30; 95% CI 1.36, 3.89) compared with those with no previous pregnancy. A single previous miscarriage or termination of pregnancy where the management involved cervical dilatation and curettage was associated with an increased risk of spontaneous preterm birth (adjusted OR 1.64; 95% CI 1.08, 2.50; 6% absolute risk and adjusted OR 1.83; 95% CI 1.35, 2.48; 7% absolute risk, respectively) compared with those with no previous pregnancy losses. This is in contrast with women with a single previous miscarriage or termination managed non-surgically who showed no increase risk (adjusted OR 0.86; 95% CI 0.38, 1.94; 3.4% absolute risk and adjusted OR 0.87; 95% CI 0.69, 1.12; 3.8% absolute risk, respectively). Although every effort was made to record accurate previous pregnancy data, it was not feasible to confirm the history and management of previous pregnancy loss by hospital records. This may have introduced recall bias. This large prospective cohort study of healthy nulliparous women has demonstrated that women with either a previous miscarriage or termination of pregnancy were at increased risk of spontaneous preterm birth if they were managed by procedures involving cervical dilatation and curettage. However, overall, women with a single pregnancy loss did not have an increased risk of having any other of the adverse pregnancy outcomes examined. In contrast, two to four previous pregnancy losses were associated with an increased risk of having a pregnancy complicated by spontaneous preterm birth and/or placental abruption. Research is required to determine whether non-surgical management of miscarriage or termination of pregnancy should be advocated over surgical treatment. New Zealand: New Enterprise Research Fund, Foundation for Research Science and Technology; Health Research Council; Evelyn Bond Fund, Auckland District Health Board Charitable Trust. Australia: Premier's Science and Research Fund, South Australian Government. Ireland: Health Research Board. Leeds: Cerebra Charity, Carmarthen. Manchester: National Health Service NEAT Grant; Manchester Biotechnology and Biological Sciences Research Council; University of Manchester Proof of Concept Funding. King's College London: Guy's and St Thomas' Charity. King's College London and Manchester: Tommy's-The Baby Charity. N/A.

Resilience, Agency and Resistance in the Storytelling Practice of Aunty Hilda Wilson (1911-2007), Ngarrindjeri Aboriginal Elder

Resilience, Agency and Resistance in the Storytelling Practice of Aunty Hilda Wilson (1911-2007), Ngarrindjeri Aboriginal Elder

The impact of niche green developments in transforming the building sector: The case study of Lochiel Park

Energy use in residential buildings is a significant contributor to global carbon emissions. The South Australian Government responded to concern for anthropogenic greenhouse gas emissions by creating a model development of near zero energy homes in a near zero carbon impact estate. The creation of the Lochiel Park Green Village challenged a collective of industry experts and policy makers to set objectives, performance targets and regulatory guidelines outside existing institutional and professional norms. Literature suggests that the creation of niche events can help the transition away from dominant technologies, practices and beliefs, and lead to organisations embracing new tools, construction practices, technologies, standards and policies. By applying a multi-level socio-technical framework, and utilising evidence collected from a series of interviews with key government and industry leaders, this paper examines how, under the influence of landscape pressures, structural change at the regime level can come from the incubation of ideas and experiences at the niche level. The available evidence finds that the creation of the Lochiel Park Green Village has allowed many individuals and organisations to gain a more detailed and practical understanding of sustainable housing, and has given organisations the confidence to change industry practices, government policies, and regulatory standards.

A Comparative Study of Governmental One-Stop Portals for Public Service Delivery

The continuing need for governments to radically improve the delivery of public services has led to a new, holistic government reform strategy labeled “Transformational Government” that strongly emphasizes customer-centricity. Attention has turned to online portals as a cost effective front-end to deliver services and engage customers as well as to the corresponding organizational approaches for the back-end to decouple the service interface from the departmental structures. The research presented in this paper makes three contributions: Firstly, a systematic literature review of approaches to the evaluation of online portal models in the public sector is presented. Secondly, the findings of a usability study comparing the online presences of the Queensland Government, the UK Government and the South Australian Government are reported and the relative strengths and weaknesses of the different approaches are discussed. And thirdly, the limitations of the usability study in the context of a broader “Transformational Government” approach are identified and service bundling is suggested as an innovative solution to further improve online service delivery.

Investigating psychological factors of behavioural intention of urban residents in South Australia to use treated stormwater for non-potable purposes

This paper reports on the intentions of urban residents in two South Australian Local Government Areas (LGAs) (council areas) to use stormwater treated through a managed aquifer recharge process for various potential non-potable uses. Data were collected through an online survey of the residents in these LGAs. The key finding is that, in common with recycled sewage water, the intention to use treated stormwater was lower for uses having closer contact with people. A hypothesized model consisting of possible factors influencing the intention to use treated stormwater was developed based on the contemporary literature relating to usage of treated sewage water. Greater trust in the local water authority was shown to be associated directly and closely with a lower perceived health risk. A positive attitude by respondents to the use of treated stormwater (as an aspect of a sustainable future) was found to be more likely to result in an intention to use the treated stormwater for non-potable purposes. Respondents' perceived health risk, emotions and environmental concerns all had significant associations with their attitudes to using stormwater but were not associated with their intention to use it.

Factors affecting rural landholders’ adaptation to climate change: Insights from formal institutions and communities of practice

This study explores the factors affecting rural landholders’ adaptation to climate change from the perspectives of formal institutions and communities of practice. Semi-structured interviews were conducted with formal institutions (e.g. South Australian government agencies) and communities of practice (e.g. farm systems groups) within two natural resource management regions in South Australia. Both groups noted that rural landholders autonomously adapt to a variety of risks, including those induced by climate variability; however, the types and levels of adaptation varied among individuals as a result of variety of barriers to adaptation. The lack of communication and engagement processes established between formal institutions and communities of practice was one major barrier. The paper presents and discusses a model for transferring knowledge and information on climate change among formal institutions, communities of practice, trusted individual advisors and rural landholders, and for supporting the co-management of climate change across multiple groups in rural agricultural areas in Australia and elsewhere.

Facilitating Long-Term Outback Water Solutions – Combining some of the old with some of the new

Mining and energy development in South Australia?s far north is set to have significant consequences for the water resources of the region. These sectors generate significant economic value to the State and their support remains a priority for the government. The scale of the planned developments and the potential from current exploration programs facilitated by the South Australian Government through the Plan for Accelerated Exploration (PACE) Program will result in a substantial increase in infrastructure requirements, including access to water resources and Aboriginal lands for exploration and potential mine developments. Presently, knowledge about the character and variability of groundwater resources, the sustainability of this resource, and its relationship to environmental and cultural assets remains very limited, particularly in the priority areas for development The FLOWS project is aiming to address some of these limitations by collating information on the location and characteristics of aquifers, their capacity, and the quality and variability of the contained groundwater resources initially for some priority areas. Key to this is the access and interpretation of historical geophysical data, particularly AEM data, acquired by exploration companies and government in priority areas identified by the State, including the Musgrave Block and the north and western parts of the Gawler Craton. This paper examines the approach being taken and challenges of adding complementary value to historical geophysical data sets.

Reduced corticomotor excitability and motor skills development in children born preterm

The mechanisms underlying the altered neurodevelopment commonly experienced by children born preterm, but without brain lesions, remain unknown. While individuals born the earliest are at most risk, late preterm children also experience significant motor, cognitive and behavioural dysfunction from school age, and reduced income and educational attainment in adulthood. We used transcranial magnetic stimulation and functional assessments to examine corticomotor development in 151 children without cerebral palsy, aged 10-13 years and born after gestations of 25-41 completed weeks. We hypothesized that motor cortex and corticospinal development are altered in preterm children, which underpins at least some of their motor dysfunction. We report for the first time that every week of reduced gestation is associated with a reduction in corticomotor excitability that remains evident in late childhood. This reduced excitability was associated with poorer motor skill development, particularly manual dexterity. However, child adiposity, sex and socio-economic factors regarding the child's home environment soon after birth were also powerful influences on development of motor skills. Preterm birth was also associated with reduced left hemisphere lateralization, but without increasing the likelihood of being left handed per se. These corticomotor findings have implications for normal motor development, but also raise questions regarding possible longer term consequences of preterm birth on motor function.