Thesis (Ph. D.)--University of Sydney, 1984. / Title from title screen (viewed 25 March 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of History. Degree awarded 1984; thesis submitted 1982. Includes bibliographical references. Also available in print form.

Thesis (Ph. D.)--University of Sydney, 2007. / Title from title screen (viewed 26 March 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Sociology and Social Policy, Faculty of Arts. Includes bibliographical references. Also available in print form.

Thesis (M.A.)--University of Sydney, 1971. / Title from title screen (viewed December 9, 2009) Submitted in partial fulfilment of the requirements for the degree of Master of Arts to the Faculty of Arts, University of Sydney. Degree awarded 1971; thesis submitted 1970. Consists of 2 vols. Includes bibliographical references. Also available in print form.

No description available.

How health care is best provided remains topical, contentious, and political. Debates continue over funding allocation and the weighting placed on preventive, curative, institutional and community services. Such debates were evident in 1973 when a new Federal Labor Government began to reform Australia's health system by implementing a national Community Health Program policy. Implementation led to the establishment of community health centres and multi-disciplinary teams. Studies have generally concluded that community health centre teams have ???failed??? to achieve the goals of this policy. This study sought to answer one broad question. How was the community health program policy implemented, in what context did this event occur, what processes were used and why, and how did generalist community nurses participate? This case study of the Hunter Region, New South Wales, between 1974 and 1989, was based on data collected from four sources: over five hundred documents and archives, including relevant literature, epidemiological studies, centre records, official government and newspaper reports; 69 in-depth interviews with practitioners and administrators; and participant observation. The findings revealed that implementation was hindered by political, administrative and professional impediments. However, practitioners established and provided a broad range of relevant new services by changing the way they practised. Generalist community nurses worked with non-government, private and public organisations offering health, educational and social services. As boundary riders they filled structural holes and created social capital. Conclusions drawn were first, that context strongly influenced how public health policies were implemented and the services offered by different discipline groups. Second, teamwork would have been improved had pre-service health professional education fostered a common understanding of the aim of health care and the broader determinants of health. Third, a preventive orientation needed reinforcing via an organisational context, administrative processes, ongoing learning opportunities and leadership. Fourth, generalist community nurses??? commitment to a preventive approach was embedded in a growing understanding of people's circumstances and health problems. Finally, while policy implementation was constrained in the Hunter Region during the study period it achieved what its architects intended, that is, a broader mix of accessible services, and collaboration between organisations and groups as the boundaries that maintained their separation were bridged.

Sustainable development is a multi-faceted and complex proposition, investigating such a goal required a grounded study capable of analysing real world issues. Managing such a highly diverse region as Western Sydney with its multiple demands is complicated by the plethora of government administration agencies. Contemporary land use planning policies and decisions appear frequently at odds with community values and aspirations for the region. Evidence presented in this research suggests a declining natural resource base that manifests itself in an insidious cost impost to the public sector while the benefits accrue to the private sector.Eventual developments in the resolution and maintenance of the functional integrity of the natural systems in Western Sydney may demand a major paradigm shift in economic and social policy. This research suggests that a precautionary based approach to thresholds of harm in the Western Sydney region is long overdue. Tools developed in this study appear capable of clarifying the evident land use planning paradoxes and may assist in negotiating sustainable outcomes by fostering a collaborative learning process between decision makers, experts and the community. / Doctor of Philosophy (PhD)

This thesis examines community structure of cliff-top coastal heathlands in Botany Bay National Park, Sydney. Community properties of floristic composition, structure and species richness are investigated. This investigation is made in order to assess the justification for contemporary pre-emphasis in local studies on individual community properties. It is also made in order to assess the relative and independent contributions of individual properties to variance in overall community structure. It is also made in order to assess the relative utility of multi-property classifications in summarising community structure of cliff-top coastal heathlands. First, the presence of determinable structure in each property is assessed through multivariate classification of respective data sets. Secondly, a new model of community structure is developed in which the hypothesis that community structure is a function of common (shared) and independent (unique) variance in each of the three properties is assessed. This is achieved through application of variance partitioning using correspondence analysis techniques. Thirdly, a matrix combining variance in all three properties is classified. This classification is compared with those of individual properties in order to assess the hypothesis that more ecologically cohesive classifications than those of single properties are obtainable. The ecological significance (environmental relativity) of all classifications and variance components is assessed through examination of relationships with variance in 20 environmental factors which encompass variation in maritime factors, soil physical factors, soil nutrition factors and effects of time since fire. Classifications of individual properties showed the presence of determinable structure in each. Eleven floristic complexes, nine structural complexes and eighteen species richness complexes were recognised. Nineteen community complexes were recognised from the classification of the combined property matrix. All complexes were shown to differ significantly with respect to multiple environmental factors. Variance partitioning showed the presence of both independent and common variance components with respect to properties compared pairwise. These were all shown to differ in magnitude. Examination of environmental correlates showed ecological differentiation of all properties and most variance components. Maritime and fire factors provide a major axis of environmental differentiation for most properties and variance components. A second major axis was resolved with respect to physical soil factors. With the exception of variance in species richness, major soil nutrients were generally of secondary importance to community structure. Low soil nutrients may demarcate heathlands from other vegetation types. However, this study shows elevated importance of other major areas of environment for community structure within cliff-top coastal heathlands. Comparisons of environmental homogeneity characteristics between all classification systems showed the classification of the combined property matrix to be more ecologically robust than those of structure or species richness. Homogeneity characteristics of the combined classification remained statistically inseparable from that of floristic composition. However, studies provided some evidence suggesting greater robustness of the combined classification with regard to fine-scale variance in community structure. This thesis shows that variance in all major community properties of the studied vegetation to be of ecological significance. It also shows that this significance is differential with respect to properties and their variance components. Pre-emphasis on individual properties in syntheses of local systems thus involves the loss of ecological information. I thus conclude that if adequate ecological syntheses of cliff-top coastal heathlands are to be obtained which are appropriate to their scale of distribution and functioning in the Sydney area then inclusion of attributes of multiple properties is required. Equally, multiple sources of environmental variation need to be examined.

This thesis has three main research aims. First the development of a questionnaire to measure HRQOL of ICU patients. Second, to examine a model of HRQOL proposed to assist with the development of the questionnaire. Third, to examine the HRQOL outcomes of patient after hospital discharge. The proposed model is based on a review of conceptual issues related to Quality of Life (QOL), Health Status and HRQOL. After a content analysis of a broad range of definitions of QOL, Health Status and HRQOL, QOL was defined as a dynamic attitude, continually being modified by experience. It is a function of the cognitive and affective appraisals of the discrepancies between domain specific perceptions and expectations. HRQOL was defined as an individuals cognitive and affective response to, or the QOL associated with, their health status. Health status was seen to consist of two health dimensions, physical and psychological health, with each dimension being composed of a number of component measures assessed subjectively. The developed questionnaire, the Sydney Quality of Life (SQOL) had good construct validity, based on substantial correspondence between qualitative and quantitative data, and internal consistency data (factor analysis and Cronbach's alpha). It had good concurrent validity in relation to the Sickness Impact Profile. The second order factor analysis of the SQOL suggested that health status may consist of three dimensions, physical health, positive mental health and negative mental health. The HRQOL model when formally examined, using Structural Equation Modelling (using LISREL), was not supported. However, exploratory modelling supported the separation of mental health into positive and negative components. The structure of HRQOL was different for patients than for the community from which they came. Patients QOL was determined largely by positive mental and physical health, whereas community members QOL was largely determined by negative mental health. Sixty three percent of patients at 12 months after discharge had significantly worse physical and functional health, lower satisfaction with their lives, lower positive affect and poorer QOL. Overall, mental health adapts rapidly to the impact of serious physical ill health and hospitalisation. Implications for clinical practice are examined.

How health care is best provided remains topical, contentious, and political. Debates continue over funding allocation and the weighting placed on preventive, curative, institutional and community services. Such debates were evident in 1973 when a new Federal Labor Government began to reform Australia's health system by implementing a national Community Health Program policy. Implementation led to the establishment of community health centres and multi-disciplinary teams. Studies have generally concluded that community health centre teams have ???failed??? to achieve the goals of this policy. This study sought to answer one broad question. How was the community health program policy implemented, in what context did this event occur, what processes were used and why, and how did generalist community nurses participate? This case study of the Hunter Region, New South Wales, between 1974 and 1989, was based on data collected from four sources: over five hundred documents and archives, including relevant literature, epidemiological studies, centre records, official government and newspaper reports; 69 in-depth interviews with practitioners and administrators; and participant observation. The findings revealed that implementation was hindered by political, administrative and professional impediments. However, practitioners established and provided a broad range of relevant new services by changing the way they practised. Generalist community nurses worked with non-government, private and public organisations offering health, educational and social services. As boundary riders they filled structural holes and created social capital. Conclusions drawn were first, that context strongly influenced how public health policies were implemented and the services offered by different discipline groups. Second, teamwork would have been improved had pre-service health professional education fostered a common understanding of the aim of health care and the broader determinants of health. Third, a preventive orientation needed reinforcing via an organisational context, administrative processes, ongoing learning opportunities and leadership. Fourth, generalist community nurses??? commitment to a preventive approach was embedded in a growing understanding of people's circumstances and health problems. Finally, while policy implementation was constrained in the Hunter Region during the study period it achieved what its architects intended, that is, a broader mix of accessible services, and collaboration between organisations and groups as the boundaries that maintained their separation were bridged.

How health care is best provided remains topical, contentious, and political. Debates continue over funding allocation and the weighting placed on preventive, curative, institutional and community services. Such debates were evident in 1973 when a new Federal Labor Government began to reform Australia's health system by implementing a national Community Health Program policy. Implementation led to the establishment of community health centres and multi-disciplinary teams. Studies have generally concluded that community health centre teams have ???failed??? to achieve the goals of this policy. This study sought to answer one broad question. How was the community health program policy implemented, in what context did this event occur, what processes were used and why, and how did generalist community nurses participate? This case study of the Hunter Region, New South Wales, between 1974 and 1989, was based on data collected from four sources: over five hundred documents and archives, including relevant literature, epidemiological studies, centre records, official government and newspaper reports; 69 in-depth interviews with practitioners and administrators; and participant observation. The findings revealed that implementation was hindered by political, administrative and professional impediments. However, practitioners established and provided a broad range of relevant new services by changing the way they practised. Generalist community nurses worked with non-government, private and public organisations offering health, educational and social services. As boundary riders they filled structural holes and created social capital. Conclusions drawn were first, that context strongly influenced how public health policies were implemented and the services offered by different discipline groups. Second, teamwork would have been improved had pre-service health professional education fostered a common understanding of the aim of health care and the broader determinants of health. Third, a preventive orientation needed reinforcing via an organisational context, administrative processes, ongoing learning opportunities and leadership. Fourth, generalist community nurses??? commitment to a preventive approach was embedded in a growing understanding of people's circumstances and health problems. Finally, while policy implementation was constrained in the Hunter Region during the study period it achieved what its architects intended, that is, a broader mix of accessible services, and collaboration between organisations and groups as the boundaries that maintained their separation were bridged.