https://hdl.handle.net/2123/11610 2026-06-07T03:22:36Z https://hdl.handle.net/2123/31940 Bundled payments – what makes them work? + MOU Signing Neville, Sarah The University of Sydney is entering into an exciting period of partnership with the Independent Health and Aged Care Pricing Authority (IHACPA). To celebrate this partnership, Dr Sarah Neville, Director, Analytics at the Independent Health and Aged Care Pricing Authority, delivered a seminar looking at the design, implementation, monitoring and evaluation of bundled payment models in the US, to understand the factors that determine the success of these models. 2023-01-01T00:00:00Z https://hdl.handle.net/2123/13611 NGOs and illicit drug policy change in the Russian Federation Zheluk, Andrey Antonovich In the decade to 2010, international initiatives directed at changing Russian illicit drug policy gained considerable momentum. However from 2010 official Russian government ambivalence evolved into open hostility directed against foreign ideas and against donor funded NGOs. By 2013, large scale donor-funded programs directed at reducing the social and individual harms associated with illicit drug use became effectively unimplementable in Russia. The main objective of this thesis is to establish if any non-government initiatives directed at illicit drug policy change were politically feasible in Russia between 2010 and 2013. In order to address this overarching objective, I sought to answer the following research questions: 1. What framed the possibilities and limits of political feasibility of drug policy initiatives that relied on international funding sources? 2. What political and other structures framed the feasibility of domestically funded non-government drug policy initiatives? 3. Contemporary Russia has presented unique barriers to the application of conventional methods of researching illicit drug policy. What novel data sources and methods might frame these limits? This thesis examines Russian drug policy from a pragmatic perspective. It examines both internationally and domestically funded civil society actors to identify what worked to influence Russian drug policy in the recent past. This thesis consists of a series of mixed methods exploratory case studies that offer a rich "bottom up" description of the contemporary Russian context. It also describes novel "big data" quantitative Internet search methods as a valid research method to study of complex environments. Against the backdrop of increasing security tensions between Russia and NATO, it proposes mechanisms that may allow future collaboration between donors, researchers, and Russian civil society organisations in a new, largely unknown policy space. 2014-10-29T00:00:00Z https://hdl.handle.net/2123/11647 HIV among older adults in sub-Saharan Africa : a neglected epidemic Negin, Joel As the HIV epidemic enters into its fourth decade, the epidemiology continues to change and the response continues to adapt. One of the most significant trends in HIV in developed countries has been the ageing of the cohort as HIV-positive individuals infected while young survive longer with anti-retroviral treatment and due to ongoing sexual transmission among those aged 50 years and older. In the United States for example, recent estimates have noted that around 50% of people living with HIV will be older than 50 by 2015. Despite these clear trends and their significant implications for prevention, care and treatment – specifically with regard to co-morbidity with various chronic diseases – very little analysis has been conducted on the HIV and ageing phenomenon in developing countries. This thesis aims to address the shortage of evidence in this emerging area by focusing on HIV infection among older adults in sub-Saharan Africa – the region where the HIV burden is greatest – from a number of different quantitative angles. This thesis contains five published works. The University of Sydney’s Academic Board approved submission of published work as a thesis on 14 August 2002. The thesis adheres to the University of Sydney thesis by publication format. Chapter One highlights the high rates of AIDS-related mortality among older adults in a rural community in high prevalence western Kenya. This mortality underscores the need to better understand the issue of HIV among older adults in Africa. Chapter Two estimates the number of people aged 50 years and older living with HIV in sub-Saharan Africa using United Nations data. Chapter Three examines HIVrelated awareness, knowledge and testing behaviour among those aged 50 years and older in nine rural sites in seven African countries. Chapter Four examines HIV infection and treatment outcomes among older adults in Zomba District in Malawi. Chapter Five uses a large population-based survey among older adults in South Africa to develop a picture of HIV infection along with an examination of rates of diabetes, stroke, arthritis, depression and other conditions. Together, these papers and chapters explore the multi-faceted aspects of HIV among older adults in Africa. Mortality, epidemiology, awareness, treatment outcomes and co-morbidities are all addressed to develop a fuller quantitatively-driven picture of the issues and challenges facing older adults and the responses needed for this important emerging trend. Ethical Clearance Malawi’s National Health Sciences Research Committee provided ethical approval for Chapter Four. The research conducted for Chapters One and Three was approved by the ethical review committee at Columbia University, New York, USA, and by all governments of host countries – in the case of Chapter One specifically, the Kenya Medical Research Institute ethics board. Ethical review and clearance for Chapter Five was obtained through the World Health Organization and South Africa’s Human Sciences Research Council Research Ethics Committee. Ethical approval was not required for Chapter Two. Prior to receipt and analysis for this thesis, all data sets were anonymised. 2012-01-01T00:00:00Z https://hdl.handle.net/2123/10475 Fixing our fractured food system: the path towards practical solutions Downs, Shauna Celebrating the career of Emeritus Professor Stephen Leeder 2014-05-07T00:00:00Z https://hdl.handle.net/2123/10059 Starting from scratch: patient-reported outcome questionnaires & their role in an integrative medicine primary care minimum-dataset Hunter, Jennifer Ann Aim This research explored the use of patient questionnaires for evaluating integrative medicine (IM) clinics in the primary care setting. Background Integrative medicine (IM) combines traditional, complementary, and alternative medicine with conventional biomedicine. With more clinics in Australia offering IM, it is important to evaluate outcomes. Methods Mixed methods were used. This included a case study of an IM clinic in Sydney, Australia; interviews with 20 patients and 13 staff at the clinic; and a systematic literature review of patient questionnaires. Results Challenges for meausring IM outcomes limitations with routine clinical data collection, selecting appropriate questionnaires able to measure the wide range of IM outcomes whilst minimizing responder burden, patient recruitment and practitioner support. Electronic questionnaires have many advantages. Alternative formats such as paper are still needed. Not all interviewees were interested in cohort results or research and instead wanted to access their individual patient results. Discussion The results from the studies were synthesised and a set of recommendations are offered. Conclusions Patient questionnaires could be used to establish a minimum dataset for use in research, health service development, and informing and improving individual patient care. A bottom-up approach that adresses stakeholders’ needs for a dataset is essential. 2013-09-11T00:00:00Z