NGOs, enterprise and rural development

Non-Government Welfare Organisations (NGOs) in rural areas have traditionally relied upon the state for a large part of their revenue which in turn provides the state with the capacity to impose strict monitoring and evaluation. However the tightening of state funding has either forced NGOs to stretch their own resource to the limit or to become more enterprising and innovative in their desire to provide people with access to an ever increasing range of community-based services and opportunities for connection with their local communities. The term that is often used for these new approaches is ‘social enterprise’ that has been defined as a business with primarily social objectives whose surpluses are principally reinvested for that purpose in the business or the community, rather than being driven by the need to maximise profit for shareholders and owners’ . It is most often seen as an interface between public and private sector, being part of neither but engaging closely with both through partnerships, stakeholding and joint ventures as well as through complex trading and contracting relationships.

Such broad definitions however do not give much guidance to how particular NGOs can shift to a social enterprise model and still remain within their chosen missions. It is the very processes of re-imagining and reforming their enterprise that is a vital element in moving to a successful social enterprise practice. Accordingly this project focuses on two NGOs in different parts of the world (Brophy Family and Youth Services in Warrnambool. Australia and Aberdeen Foyer in Aberdeen, Scotland) that have developed (and are developing) new ways of approaching their roles as service providers and early intervention agents for youth in their local areas. Since both organisations have faced (and are facing) issues associated with depleting state allocated resources they are attempting to break new ground in the ways in which they redevelop their work with youth. Both agencies are leading the way in developing a broader approach that draws together disparate element of a social enterprise model. The project analyses the processes used by these two agencies to develop as social enterprises and how likeminded agencies can use the model for capability enhancement.

Gender differences in the prevalence of impaired fasting glycaemia and impaired glucose tolerance in Mauritius. Does sex matter?

Objective: To examine gender differences in the characteristics and prevalence of various categories of glucose tolerance in a population study in Mauritius.

Research design and methods: In 1998, a community-based cross-sectional survey was conducted in Mauritius. Categories of glucose metabolism were determined in 5388 adults, with an oral glucose tolerance test given to those who did not have previously diagnosed diabetes (n = 4036). Other cardiovascular risk factors were assessed among those without known diabetes.

Results: For men and women the prevalence of diabetes (22.0 vs. 21.8%, respectively) and the prevalence of coexisting impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) (3.2 vs. 2.9%) were similar. However, men were twice as likely as women to have isolated IFG [5.1% (4.2–6.0) vs. 2.9% (2.3–3.5)], despite being younger, thinner and with lower plasma insulin but higher lipids. Conversely, the prevalence of isolated IGT was lower in men [9.0% (7.9–10.2) vs. 13.9% (12.6–15.1)]. Among non-diabetic individuals, fasting glucose was higher in men than women, whereas 2-h glucose was higher in women. In people without diabetes, women had significantly higher body mass index, beta cell function (HOMA-B), fasting and 2-h insulin than men and significantly lower waist-hip ratios, waist circumference, insulin sensitivity (HOMA-S) and triglycerides.

Conclusion: In Mauritius, the distribution of impaired glucose metabolism differs by sex. The observation that IFG is more prevalent in men and IGT more prevalent in women raises important questions about their underlying aetiology and the ability of the current glucose thresholds to equally identify men and women at high-risk of developing diabetes. IFG should be seen as a complimentary category of abnormal glucose tolerance, rather than a replacement for IGT.

From student to therapist : follow up of a first cohort of Bachelor of occupational therapy students

Aim: This study aimed to investigate the perception of graduate students on their preparation for practice, at 7 months post graduation.
Method: Using an anonymous postal questionnaire, 18 respondents (58% response rate) provided data on the nature of current employment, the experience as a graduate therapist, and perceptions of their undergraduate experience in preparing them for practice.
Results: Fifty percent of the respondents were practising in a rural environment. There was a significant positive relationship between respondents perception of their curriculum and fieldwork experiences and their preparation for practice (rho = 0.52, p < 0.05, and rho = 0.55, p < 0.05, respectively). Of the fieldwork experiences, respondents rated block placements as more beneficial to practice than non-traditional placements. However, a correlational analysis showed the non-traditional placement was significantly related to preparation for practice (rho = 0.54, p < 0.05). On a sevenpoint Likert scale, respondents rated themselves from 5.2 to 5.7 for perceived self-competence as a newly graduated practitioner with community-based graduates having the higher rating. Confidence in clinical decision-making was rated 5.0 to 5.6 with community-based graduates having higher rating. Respondents reported a positive perception that the undergraduate program prepared them to enter the workforce and practise as an occupational therapist (mean ratings 5.5 to 6.2).
Conclusion: Respondents felt adequately prepared to enter the occupational therapy profession and workforce. Strengths and weaknesses in their preparation are discussed as well as the need for further research.

Relationship between hypoactive sexual desire disorder and aging

Objective: Explore the association between Hypoactive Sexual Desire Disorder (HSDD) and aging. The American Foundation of Urologic Disease and the American Psychiatric Association stipulate that HSDD is only diagnosed when both low sexual desire and sexually related personal distress are present.
Design : Community-based, cross-sectional study.
Setting : Europe (UK, Germany, France, Italy) and the USA.
Patient(s) Women aged 20-70 in sexual relationships participating in the Women’s International Study of Health and Sexuality (n=1998 Europe, n=1591 USA).
Intervention(s) : No interventions were administered.
Main Outcome Measures : Self-administered questionnaire that included two validated instruments: Profile of Female Sexual Function© measured sexual desire; Personal Distress Scale© measured sexual distress. Women with low desire and distress were considered to have HSDD.
Results : The proportion of European women with low desire increased from 11% amongst women aged 20-29 years to 53% amongst women aged 60-70 years. The proportion of American women with low desire displayed a trend towards an increase with age. In the 20-29 year age group 65% of European women and 67% of American women with low sexual desire were distressed by it. This decreased to 22% and 37%, respectively, in the 60-70 year age group. In Europe and the USA the prevalence of HSDD in the population did not change significantly with age (6-13% in Europe, 12-19% in the USA).
Conclusions: The proportion of women with low desire increased with age while the proportion of women distressed about their low desire decreased with age. Consequently, the prevalence of HSDD remained essentially constant with age. This may explain why no association between HSDD and age is often reported in the literature.

Measuring the economic impact of falls prevention interventions

The objective of this paper is to assess the appropriateness of available health economic models and concepts in the development of a best practice model to assess community based multifactorial falls prevention programs. To this end, a critical review and synthesis of contemporary published and unpublished  methodological approaches to economic evaluation of health initiatives in general and falls prevention initiatives in particular, has been carried out. The review  indicates that costs, time and utility all need to be taken into consideration when economically evaluating a falls prevention program.

A recommended approach that takes into account a full consideration of relevant costs and benefits associated with falls prevention programs is outlined. This approach can help demonstrate the true relative efficacy of preventing falls over the treatment of their consequences.

Birds and beaches, dogs and leashes : dog owners' sense of obligation to leash dogs on beaches in Victoria, Australia

Domesticated dogs threaten the conservation of beach-nesting birds in Australia through disturbance, and destruction of eggs and chicks. Leashing of dogs can improve conservation outcomes, but few dogs are leashed on beaches. We surveyed dog owners to explore their sense of obligation to leash dogs on beaches. Dog owners were more likely to feel obliged to leash their dog when they believed other people expected dogs to be leashed, and when they believed their dog was a threat to wildlife or people. Dog owners were less likely to feel obliged to leash their dog if they considered unleashed dog recreation to be important. Improved compliance may be achieved through community-based approaches to foster social norms for dog control, tailoring information products to emphasize the risk that all unleashed dogs may pose to beach-nesting birds and raising awareness of designated off-leash exercise dog recreation areas.