(Re)form with Substance? Restructuring and governance in the Australian health system 2004/05

The Australian health system has been the subject of multiple reviews and reorganisations over the last twenty years or more. The year 2004–2005 was no different. This paper reviews the reforms, (re)structures and governance arrangements in place at both the national and state/territory levels in the last year. At the national level some progress has been made in 2004/05 through the Australian Health Ministers' Council and there is now a national health reform agenda, albeit not a comprehensive one, endorsed by the Council of Australian Governments (COAG) in June 2005. Quality and safety was an increasing focus in 2004–2005 at both the national and jurisdictional levels, as was the need for workforce reform. Although renewed policy attention was given to the need to better integrate and coordinate health care, there is little evidence of any real progress this last year. More progress was made on a national approach to workforce reform. At the jurisdictional level, the usual rounds of reviews and restructuring occurred in several jurisdictions and, in 2005, they are organisationally very different from each other. The structure and effectiveness of jurisdictional health authorities are now more important. All health authorities are being expected to drive an ambitious set of national and local reforms. At the same time, most have now blurred the boundary between policy and service delivery and are devoting significant resources to centrally 'crisis managing' their service systems. These same reasons led to decentralisation in previous restructuring cycles. While there were many changes in 2004–2005, and a new national report to COAG on health reform is expected at the end of 2005, based on current evidence there is little room for optimism about the prospects for real progress

Making foreign aid policy in Japan

This thesis examines the hypothesis that Japan's aid policy was subject to serious organisational constraints, which prevented a positive response in the 1970s to criticism of her programs. It is a study of the Japanese bureaucratic process, for policy-making was dominated by procedures and, at the same time, it assesses ideas about policy-making in Japan. In analysing foreign aid, it adopts a "policy area" approach to test how a policy is defined within government. Chapters 1 to 3 examine ideologies and organisational change, and include a study of the creation of the Japan International Cooperation Agency, an aid implementing organisation. They reveal a link between perceptions of aid in Japan and the development of the aid machinery. Chapters 4 and 5 deal, respectively, with the fact that the relationship between aid policy and structures of government was irregular, and with the complex formal and informal procedures for aid policy formulation and management. Chapter 6 details to what extent aid policy is determined by budgeting, while Chapters 7 and 8 fill out the analysis of non-bureaucratic influences on policy introduced earlier in the thesis. Politics is shown to have affected policy, by promoting certain "special" bilateral relationships. The concept of the "aid cycle" (the steady accumulation of aid flows to selected recipients, as implementation narrowed future policy options), demonstrates that bureaucracy was dependent on private enterprise (especially consulting engineers) to induce policy innovation. The original hypothesis is found to be valid. Internal policy change was inhibited because power was balanced between ministries, political will was erratic, and the affiliation of officials was to the immediate task of the primary work group. Coordination was therefore unavoidably weak and the only adaptive element reinforced predominant policy "biases" in favour of bilateral capital project aid. These conclusions challenge some widely held beliefs about Japanese policy-making, and Japanese aid in particular. Finally, the usefulness of the "policy area" approach is confirmed by the fact that foreign aid, as it related to other government concerns, was being continually redefined by policy-makers, and policy represented attempts by participants to adjust contents to changing perceptions of policy limits. This suggests that "policy" should be conceived of as a fluid set of ideas and interpretations, and government as a "map" of interdependent and similarly shifting policy areas

Knowing what you need to know about needs assessment

This paper reviews the scientific literature on needs assessment of individuals living in the community. Providing an overview of the field with a focus on capturing useful information for planning health interventions in the community, this paper will highlight: The current policy context that underpins the importance of needs assessment in health care; Key papers and basic theoretical concepts that can guide a coherent approach to community care needs assessment, including Bradshaw, 1972 and Stevens & Gabbay, 1991; The development of semi-structured interviews in mental health as a focus for designing new tools - with the Camberwell Assessment of Need (CAN) being the most well known; How to deal with the organisational issues involved with the assessment of unmet need in the community; The current evidence base for developing a national approach to needs assessment; And a brief look at the latest self-reported needs assessment instruments

WFI J2026-4536 and WFI J2033-4723: Two New Quadruple Gravitational Lenses

We report the discovery of two new gravitationally lensed quasars, WFI J2026-4536 and WFI J2033-4723, at respective source redshifts of z=2.23 and z=1.66. Both systems are quadruply imaged and have similar PG1115-like image configurations. WFI J2026-4536 has a maximum image separation of 1.4", a total brightness of g = 16.5, and a relatively simple lensing environment, while WFI J2033-4723 has a maximum image separation of 2.5", an estimated total brightness of g = 17.9, and a more complicated environment of at least six galaxies within 20". The primary lensing galaxies are detected for both systems after PSF subtraction. Several of the broadband flux ratios for the two lenses show a strong (0.1-0.4 mags) trend with wavelength, suggesting either microlensing or differential extinction through the lensing galaxy. For WFI J2026-4536, the total quasar flux has dimmed by 0.1 mag in the blue but only half as much in the red over three months, suggestive of microlensing-induced variations. For WFI J2033-4723, resolved spectra of some of the quasar components reveal emission line flux ratios that agree better with the macromodel predictions than either the broadband or continuum ratios, also indicative of microlensing. The predicted differential time delays for WFI J2026-4536 are short, ranging from 1-2 weeks for the long delay, but are longer for WFI J2033-4723, ranging from 1-2 months. Both systems hold promise for future monitoring campaigns aimed at microlensing or time delay studies.Comment: 34 pages, including 9 postscript figures. Submitted to A

A Deep Photometric Look at Two of Andromeda's Dwarf Spheroidals: X and XVII

We use deep wide-field photometry from the Large Binocular Camera to study the stellar and structural properties of the recently discovered Andromeda X and Andromeda XVII (And X and And XVII) dwarf galaxies. Using the mean apparent magnitude of the horizontal branch (HB), we derive distances of 621 +- 20 kpc to And X and 734+- 23 kpc to And XVII, closer by >60 kpc than the previous estimates which were based on red giant branch (RGB) observations. Thus our results warrant against the use of the RGB tip method for determining distances to systems with sparsely populated RGBs, and show how crucial HB observations are in obtaining accurate distances in systems such as these. We find that And X is a relatively faint (MV = -7.36), highly elongated (e = 0.48) system at a distance of 174 +- 62 kpc from Andromeda. And XVII is brighter (MV = -8.61) with an M31-centric distance of 73 kpc which makes it one of the closest satellites to Andromeda. Both galaxies are metal-poor: we derive =-2.2 for And X, while And XVII shows = -2.0, consistent with the relation of higher luminosity dwarfs being more metal- rich. Additionally, both galaxies show considerable intrinsic spreads in metallicity (0.2 and 0.3 dex for And X and And XVII respectively), consistent with multiple stellar populations.Comment: 8 pages, 6 figure

Ultradeep Near-Infrared ISAAC Observations of the HDF-S: Observations, Reduction, Multicolor Catalog, and Photometric Redshifts

We present deep near-infrared (NIR) Js, H, and Ks-band ISAAC imaging of the WFPC2 field of the HDF-S. The 2.5'x 2.5' high Galactic latitude field was observed with the VLT under the best seeing conditions with integration times amounting to 33.6 hours in Js, 32.3 hours in H, and 35.6 hours in Ks. We reach total AB magnitudes for point sources of 26.8, 26.2, and 26.2 respectively (3 sigma), which make it the deepest ground-based NIR observations to date, and the deepest Ks-band data in any field. The effective seeing of the coadded images is ~0.45" in Js, ~0.48" in H, and ~0.46" in Ks. Using published WFPC2 optical data, we constructed a Ks-limited multicolor catalog containing 833 sources down to Ks,tot ~< 26 (AB), of which 624 have seven-band optical-to-NIR photometry. These data allow us to select normal galaxies from their rest-frame optical properties to high redshift (z ~< 4). The observations, data reduction and properties of the final images are discussed, and we address the detection and photometry procedures that were used in making the catalog. In addition, we present deep number counts, color distributions and photometric redshifts of the HDF-S galaxies. We find that our faint Ks-band number counts are flatter than published counts in other deep fields, which might reflect cosmic variations or different analysis techniques. Compared to the HDF-N, we find many galaxies with very red V-H colors at photometric redshifts 1.95 < z < 3.5. These galaxies are bright in Ks with infrared colors redder than Js-Ks > 2.3 (in Johnson magnitudes). Because they are extremely faint in the observed optical, they would be missed by ultraviolet-optical selection techniques, such as the U-dropout method.Comment: LaTeX, 24 pages, 15 figures, 3 tables. Accepted for publication in the Astronomical Journal. The paper with full resolution images and figures is available at http://www.strw.leidenuniv.nl/~fires/papers/2002Labbe.ps.gz . The reduced data and catalogs can be found at http://www.strw.leidenuniv.nl/~fires/data/hdfs

The Rest-Frame Optical Luminosity Density, Color, and Stellar Mass Density of the Universe from z=0 to z=3

We present the evolution of the rest-frame optical luminosity density, of the integrated rest-frame optical color, and of the stellar mass density for a sample of Ks-band selected galaxies in the HDF-S. We derived the luminosity density in the rest-frame U, B, and V-bands and found that the luminosity density increases by a factor of 1.9+-0.4, 2.9+-0.6, and 4.9+-1.0 in the V, B, and U rest-frame bands respectively between a redshift of 0.1 and 3.2. We derived the luminosity weighted mean cosmic (U-B)_rest and (B-V)_rest colors as a function of redshift. The colors bluen almost monotonically with increasing redshift; at z=0.1, the (U-B)_rest and (B-V)_rest colors are 0.16 and 0.75 respectively, while at z=2.8 they are -0.39 and 0.29 respectively. We derived the luminosity weighted mean M/LV using the correlation between (U-V)_rest and log_{10} M/LV which exists for a range in smooth SFHs and moderate extinctions. We have shown that the mean of individual M/LV estimates can overpredict the true value by ~70% while our method overpredicts the true values by only ~35%. We find that the universe at z~3 had ~10 times lower stellar mass density than it does today in galaxies with LV>1.4 \times 10^{10} h_{70}^-2 Lsol. 50% of the stellar mass of the universe was formed by $z~1-1.5. The rate of increase in the stellar mass density with decreasing redshift is similar to but above that for independent estimates from the HDF-N, but is slightly less than that predicted by the integral of the SFR(z) curve.Comment: 19 pages, 12 figures, Accepted for Publication in the Dec. 20, 2003 edition of the Astrophysical Journal. Minor changes made to match the accepted version including short discussions on the effects of clustering and on possible systematic effects resulting from photometric redshift error

The Color Magnitude Distribution of Field Galaxies to z~3: the evolution and modeling of the blue sequence

Using deep NIR VLT/ISAAC and optical HST/WFPC2 imaging in the fields of the HDFS and MS1054-03, we study the rest-frame UV-to-optical colors and magnitudes of galaxies to z~3. While there is no evidence for a red sequence at z~3, there does appear to be a well-defined color-magnitude relation (CMR) for blue galaxies at all redshifts, with more luminous galaxies having redder U-V colors. The slope of the blue CMR is independent of redshift d(U-V)/dMV = -0.09 (0.01) and can be explained by a correlation of dust-reddening with luminosity. The average color at fixed luminosity reddens strongly \Delta(U-V) = 0.75 from z~3 to z=0, much of which can be attributed to aging of the stars. The color scatter of the blue sequence is relatively small sigma(U-V) = 0.25 (0.03) and constant to z~3, but notably asymmetrical with a sharp blue ridge and a wing towards redder colors. We explore sets of star formation histories to study the constraints placed by the shape of the scatter at z=2-3. One particular set of models, episodic star formation, reproduces the detailed properties very well. For a two-state model with high and low star formation, the duty cycle is constrained to be > 40% and the contrast between the states must be a factor > 5 (or a scatter in log(SFR) of > 0.35 dex around the mean). However, episodic models do not explain the observed tail of very red galaxies, primarily Distant Red Galaxies (DRGs), which may have ceased star formation altogether or are more heavily obscured. Finally, the relative number density of red, luminous MV < -20.5 galaxies increases by a factor of ~ 6 from z = 2.7 to z = 0.5, as does their contribution to the total rest-frame V-band luminosity density. We are likely viewing the progressive formation of red, passively evolving galaxies.Comment: 29 pages, 24 figures, in emulateapj style. Abstract is abridged. Some postscript figures are compressed. accepted for publication in ApJ (scheduled for August 20, 2007, v665n 2 issue

Measuring the Average Evolution of Luminous Galaxies at z<3: The Rest-frame Optical Luminosity Density, Spectral Energy Distribution, and Stellar Mass Density

(Abridged) We present the evolution of the volume averaged properties of the rest-frame optically luminous galaxy population to z~3, determined from four disjoint deep fields with optical to near-infrared wavelength coverage. We select galaxies above a rest-frame V-band luminosity of 3x10^10 Lsol and characterize their rest-frame UV through optical properties via the mean spectral energy distribution (SED). To measure evolution we apply the same selection criteria to a sample of galaxies from the Sloan Digital Sky Survey and COMBO-17. The mean rest-frame 2200Ang through V-band SED becomes steadily bluer with increasing redshift but at z<3 the mean SED falls within the range defined by ``normal'' galaxies in the nearby Universe. We measure stellar mass-to-light ratios (Mstar/L) by fitting models to the rest-frame UV-optical SEDs and derive the stellar mass density. The stellar mass density in luminous galaxies has increased by a factor of 3.5-7.9 from z=3 to z=0.1, including field-to-field variance uncertainties. After correcting to total, the measured mass densities at z<2 lie below the integral of the star formation rate (SFR) density as a function of redshift as derived from UV selected samples. This may indicate a systematic error in the mass densities or SFR(z) estimates. We find large discrepancies between recent model predictions for the evolution of the mass density and our results, even when our observational selection is applied to the models. Finally we determine that Distant Red Galaxies (selected to have J_s - K_s>2.3) in our LV selected samples contribute 30% and 64% of the stellar mass budget at z~2 and z~ 2.8 respectively. These galaxies are largely absent from UV surveys and this result highlights the need for mass selection of high redshift galaxies.Comment: Accepted for publication in the Astrophysical Journal, 24 pages, 16 figure