The Cooperative federal-state-local health statistics system.

"May 1973"--P. [2] of cover.

Development of test items for the entry-level social worker class in selected State and local jurisdictions /

Photocopy. Springfield, Va. : U.S. Dept. of Commerce, National Technical Information Service, 1977. -- v, 74 leaves ; 28 cm.

Caring for the past : grants-in-aid : tribal programs : Certified Local Governments : historic preservation planning.

Mode of access: Internet.

Wiring the country: Local telecommunications and Australian rural communities

In rural Australia in the early twenty-first century, telecommunications reform has seen the rise of local telecommunications as a new way to wire the country, delivering new technologies and meeting community needs and aspirations. 1his paper discusses the prospects for local telecommunications in light of a research project on online rural communities commissioned by the Telstra Consumer Consultative Council. Based on interviews conducted in three small towns in rural eastern Australia, the paper examines the role of community networking as a new force in telecommunications service delivery, posing questions for local and regional communications policy development.

Evaluating a GP consultative psychiatric service in an Australian metropolitan hospital district

Objective: The aim was to develop a psychiatric assessment and advisory service for local general practitioners (GPs). Method: In July 2001, five full-time psychiatrists at Royal Brisbane ­Hospital each dedicated a 1-h appointment per week in their hospital private practice clinic to assess patients referred by local GPs. The 'Psych Opinion' clinic was advertised through the Division of General Practice Newsletter. After 12 months, the referrals to the clinic had been disappointing so two surveys were carried out: one to the GPs who had used the service and the other to those who had not referred. Results: Feedback from the GPs who had used the service showed a high level of satisfaction with the service. The second survey of the GPs who had not referred showed a strong endorsement of the concept but there was poor awareness of the service's existence. Conclusions: This model offers a way for public sector psychiatrists to provide timely assessments to local GPs without additional funding. There is strong support and willingness from the GPs to refer. However, the need to actively market the service both initially and on an ongoing basis is ­highlighted.

Evaluation of a pilot second-opinion child telepsychiatry service

A second-opinion child psychiatry service was piloted for six months in the northern-most two-thirds of Queensland. It provided specialist expertise by telehealth to local multidisciplinary teams of mental health staff. During the study period, 28 videoconferences were performed by the service: nine for administrative purposes, two for educational purposes, and 17 for direct and indirect clinical applications. The mean time between a referral being made and a consultation being performed was 4.7 days (range 1-13), A survey administered to referring and non-referring mental health workers showed that the major barriers to service implementation included the limited allied health applications that were offered, a perceived lack of communication during the implementation phase of the service, and the creation of a new referral network that did not conform to traditional referral patterns in the north of Queensland.

Assessing the effectiveness of a mammography screening service

Background: Trials have shown that mammography screening reduces mortality and probably decreases morbidity related to breast cancer. Methods: We assessed whether the major mammography service in Western Australia (BreastScreen WA) is likely to reduce mortality by comparing prognostic variables between screen-detected and other cases of breast cancer diagnosed in 1999. We assessed likely reductions in morbidity by comparing treatments received by these two groups. To confirm mortality and morbidity reduction, we also compared prognostic variables and treatments with targets. Information on demographic variables, tumour characteristics at presentation and treatments were collected from medical records for all incident cases of breast cancer in Western Australia in 1999. We matched cases with the Western Australian Cancer Registry records to determine which cases had been detected by BreastScreen WA. Results: BreastScreen WA achieved the targets for mortality reduction. Tumours detected by BreastScreen WA were smaller in size, less likely to have vascular invasion, of lower histological grade and were more likely to be ductal carcinoma in situ alone without invasive carcinoma. Oestrogen receptor status was more likely to be positive, the difference in progesterone status was not significant, and lymph node involvement tended to be lower. BreastScreen WA patients were treated more often with local therapy and less often with systemic therapy, and the proportion of patients treated with breast-conserving surgery was close to the target for minimizing morbidity in breast cancer. Conclusion: Mammographic detection of breast cancer by BreastScreen WA is associated with reduced breast cancer morbidity and a more favourable prognosis.

Effects of tourism development on the local poor people - Case study in Taibai Region China

In China, protected areas are one of the main destinations attracting tourists and homeland for many poor people living in and around them. Based on a case study, the paper focuses on correlation between tourism and poverty alleviation by tracing the cash flows to the local poor. It also reviews the social and environmental effects of tourism on local area. The case study is conducted in a group of protected areas in Qinling Mountain Region in Shaanxi, a western province in China. Qinling Mountain is one of the most important distribution zones for Giant Panda and some other endangered wildlife such as Golden Takin and Golden Monkey. The tourism development in the region is happening. Research indicates that there is 29.33%, of tourist expenditure is going to local households, directly or indirectly. Tourist spends US$7.11 (13.67%) in food and beverage, and US$6.39 (12.23%) in accommodation service, which are the greatest contributors to local households in terms of tourism benefits. Local households can get US$8.15 from food/beverage and accommodation sectors, taking 56.64% of total income from tourism. Generally, tourism development benefits all stakeholders. However, poor people get less benefit. The paper analyses the barriers for the poor to be involved in tourism development, and discusses the government roles, major issues in implementation of Sustainable Tourism-Eliminating Poverty (ST-EP) model. [ABSTRACT FROM AUTHOR]

An n-of-1 trial service in clinical practice: Testing the effectiveness of stimulants for attention-deficit/hyperactivity disorder

OBJECTIVE. We sought to describe the clinical use of n-of-1 trials for attention-deficit/hyperactivity disorder in publicly and privately funded family and specialized pediatric practice in Australia. METHODS. We used a within-patient randomized, double-blind, crossover comparison of stimulant (dexamphetamine or methylphenidate) versus placebo or alternative stimulant using 3 pairs of treatment periods. Trials were conducted from a central location using mail and telephone communication, with local supervision by the patients' clinicians. PATIENTS. Our study population included children with clinically diagnosed attention-deficit/ hyperactivity disorder who were aged 5 to 16 years and previously stabilized on an optimal dose of stimulant. They were selected because treatment effectiveness was uncertain. MAIN OUTCOME MEASURES. Our measures included number of patients recruited, number of doctors who used the service, geographic spread, completion rates, response rate, and post-n-of-1 trial decisions. RESULTS. Forty-five doctors across Australia requested 108 n-of-1 trials, of which 86 were completed. In 69 drug-versus-placebo comparisons, 29 children responded better to stimulant than placebo. Immediately posttrial, 19 of 25 drug-versus-placebo responders stayed on the same stimulant, and 13 of 24 nonresponders ceased or switched stimulants. In 40 of 63 for which data were available, posttrial management was consistent with the trial results. For all types of n-of-1 trials, management changed for 28 of 64 children for whom information was available. DISCUSSION. Attention-deficit/hyperactivity disorder n-of-1 trials can be implemented successfully by mail and telephone communication. This type of trial can be valuable in clarifying treatment effect when it is uncertain, and in this series, they had a noticeable impact on short-term management.

Models of psychological service provision under Australia's better outcomes in mental health care program

The Access to Allied Psychological Services component of Australia's Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based mental health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular models were associated with differential levels of access to services. We found: 76% of projects were retaining their allied health professionals under contract, 28% via direct employment, and 7% some other way; Allied health professionals were providing services from GPs' rooms in 63% of projects, from their own rooms in 63%, from a third location in 42%; and The referral mechanism of choice was direct referral in 51% of projects, a voucher system in 27%, a brokerage system in 24%, and a register system in 25%. Many of these models were being used in combination. No model was predictive of differential levels of access, suggesting that the approach of adapting models to the local context is proving successful.

Searching the world wide web for local services and facilities: A review on the patterns of location-based queries

Many queries sent to search engines refer to specific locations in the world. Location-based queries try to find local services and facilities around the user’s environment or in a particular area. This paper reviews the specifications of geospatial queries and discusses the similarities and differences between location-based queries and other queries. We introduce nine patterns for location-based queries containing either a service name alone or a service name accompanied by a location name. Our survey indicates that at least 22% of the Web queries have a geospatial dimension and most of these can be considered as location-based queries. We propose that location-based queries should be treated different from general queries to produce more relevant results.

Superstring: A scalable service discovery protocol for the wide-area pervasive environment

Arguably, the world has become one large pervasive computing environment. Our planet is growing a digital skin of a wide array of sensors, hand-held computers, mobile phones, laptops, web services and publicly accessible web-cams. Often, these devices and services are deployed in groups, forming small communities of interacting devices. Service discovery protocols allow processes executing on each device to discover services offered by other devices within the community. These communities can be linked together to form a wide-area pervasive environment, allowing processes in one p u p tu interact with services in another. However, the costs of communication and the protocols by which this communication is mediated in the wide-area differ from those of intra-group, or local-area, communication. Communication is an expensive operation for small, battery powered devices, but it is less expensive for servem and workstations, which have a constant power supply and 81'e connected to high bandwidth networks. This paper introduces Superstring, a peer to-peer service discovery protocol optimised fur use in the wide-area. Its goals are to minimise computation and memory overhead in the face of large numbers of resources. It achieves this memory and computation scalability by distributing the storage cost of service descriptions and the computation cost of queries over multiple resolvers.

The digital divide and ICT learning in rural communities:examples of good practice service delivery

This article aims to gain a greater understanding of relevant and successful methods of stimulating an ICT culture and skills development in rural areas. The paper distils good practice activities, utilizing criteria derived from a review of the rural dimensions of ICT learning, from a range of relevant initiatives and programmes. These good practice activities cover: community resource centres providing opportunities for ‘tasting’ ICTs; video games and Internet Cafe´s as tools removing ‘entry barriers’; emphasis on ‘user management’ as a means of creating ownership; service delivery beyond fixed locations; use of ICT capacities in the delivery of general services; and selected use of financial support.

The missing ingredient:inter-municipal cooperation and central-local relations in the UK

The thrust of the argument presented in this chapter is that inter-municipal cooperation (IMC) in the United Kingdom reflects local government's constitutional position and its exposure to the exigencies of Westminster (elected central government) and Whitehall (centre of the professional civil service that services central government). For the most part councils are without general powers of competence and are restricted in what they can do by Parliament. This suggests that the capacity for locally driven IMC is restricted and operates principally within a framework constructed by central government's policy objectives and legislation and the political expediencies of the governing political party. In practice, however, recent examples of IMC demonstrate that the practices are more complex than this initial analysis suggests. Central government may exert top-down pressures and impose hierarchical directives, but there are important countervailing forces. Constitutional changes in Scotland and Wales have shifted the locus of central- local relations away from Westminster and Whitehall. In England, the seeding of English government regional offices in 1994 has evolved into an important structural arrangement that encourages councils to work together. Within the local government community there is now widespread acknowledgement that to achieve the ambitious targets set by central government, councils are, by necessity, bound to cooperate and work with other agencies. In recent years, the fragmentation of public service delivery has affected the scope of IMC. Elected local government in the UK is now only one piece of a complex jigsaw of agencies that provides services to the public; whether it is with non-elected bodies, such as health authorities, public protection authorities (police and fire), voluntary nonprofit organisations or for-profit bodies, councils are expected to cooperate widely with agencies in their localities. Indeed, for projects such as regeneration and community renewal, councils may act as the coordinating agency but the success of such projects is measured by collaboration and partnership working (Davies 2002). To place these developments in context, IMC is an example of how, in spite of the fragmentation of traditional forms of government, councils work with other public service agencies and other councils through the medium of interagency partnerships, collaboration between organisations and a mixed economy of service providers. Such an analysis suggests that, following changes to the system of local government, contemporary forms of IMC are less dependent on vertical arrangements (top-down direction from central government) as they are replaced by horizontal modes (expansion of networks and partnership arrangements). Evidence suggests, however that central government continues to steer local authorities through the agency of inspectorates and regulatory bodies, and through policy initiatives, such as local strategic partnerships and local area agreements (Kelly 2006), thus questioning whether, in the case of UK local government, the shift from hierarchy to network and market solutions is less differentiated and transformation less complete than some literature suggests. Vertical or horizontal pressures may promote IMC, yet similar drivers may deter collaboration between local authorities. An example of negative vertical pressure was central government's change of the systems of local taxation during the 1980s. The new taxation regime replaced a tax on property with a tax on individual residency. Although the community charge lasted only a few years, it was a highpoint of the then Conservative government policy that encouraged councils to compete with each other on the basis of the level of local taxation. In practice, however, the complexity of local government funding in the UK rendered worthless any meaningful ambition of councils competing with each other, especially as central government granting to local authorities is predicated (however imperfectly) on at least notional equalisation between those areas with lower tax yields and the more prosperous locations. Horizontal pressures comprise factors such as planning decisions. Over the last quarter century, councils have competed on the granting of permission to out-of-town retail and leisure complexes, now recognised as detrimental to neighbouring authorities because economic forces prevail and local, independent shops are unable to compete with multiple companies. These examples illustrate tensions at the core of the UK polity of whether IMC is feasible when competition between local authorities heightened by local differences reduces opportunities for collaboration. An alternative perspective on IMC is to explore whether specific purposes or functions promote or restrict it. Whether in the principle areas of local government responsibilities relating to social welfare, development and maintenance of the local infrastructure or environmental matters, there are examples of IMC. But opportunities have diminished considerably as councils lost responsibility for services provision as a result of privatisation and transfer of powers to new government agencies or to central government. Over the last twenty years councils have lost their role in the provision of further-or higher-education, public transport and water/sewage. Councils have commissioning power but only a limited presence in providing housing needs, social care and waste management. In other words, as a result of central government policy, there are, in practice, currently far fewer opportunities for councils to cooperate. Since 1997, the New Labour government has promoted IMC through vertical drivers and the development; the operation of these policy initiatives is discussed following the framework of the editors. Current examples of IMC are notable for being driven by higher tiers of government, working with subordinate authorities in principal-agent relations. Collaboration between local authorities and intra-interand cross-sectoral partnerships are initiated by central government. In other words, IMC is shaped by hierarchical drivers from higher levels of government but, in practice, is locally varied and determined less by formula than by necessity and function. © 2007 Springer.

The Audit Commission:guiding, steering and regulating local government

How does the non-executant state ensure that its agents are fulfilling their obligations to deliver nationally determined policies? In the case of elected local government in England and Wales, this function is carried out by the Audit Commission (AC) for Local Authorities and the Health Service for England and Wales. Since being established in 1983, it is the means by which local authorities are held to account by central government, both for its own purposes and on behalf of other interested stakeholders. Although the primary function of the AC is to ensure that local authorities are fulfilling their obligations, it does so by using different methods. By acting as a regulator, an independent expert, an opinion former and a mediator, the AC steers local authorities to ensure that they are compliant with the regulatory regime and are implementing legislation properly.