Coordination of palliative cancer care in the community: "unfinished business"

Goal: This study assessed the degree to which services in south-central Ontario, Canada, were coordinated to meet the supportive care needs of palliative cancer patients and their families. Participants and method: Programs within the region that were identified as providing supportive care to palliative cancer patients and their families were eligible to participate in the study. Program administrators participated in a semi-structured interview and direct-care providers completed a survey instrument. Main results: Administrators from 37 (97%) of 38 eligible programs and 109 direct-care providers representing 26 (70%) programs participated in the study. Most administrator and direct-care respondents felt that existing services in the community were responsive to palliative care patients' individual needs. However, at a system level, most respondents in both groups felt that required services were not available and that resources were inadequate. The most frequently reported unmet supportive care need identified by both respondent groups was psychological/social support. Most administrator (69%) and direct-care (64%) respondents felt that palliative care services were not available when needed. The majority of administrator and direct-care respondents were satisfied with the exchange of patient information within and between programs, although direct-care staff identified a deficit in information transferred on palliative care patients' social/psychological status. Conclusions: The study demonstrated the value of a theory-based approach to evaluate the coordination of palliative cancer care services. The findings revealed that service programs faced significant challenges in their efforts to provide coordinated care. © 2009 Springer-Verlag.

Helping the most vulnerable out of the poverty trap and reducing inequality: Policies, strategies, and services for individuals with Autism Spectrum Disorder, including intellectual and neurodevelopmental disabilities: BASE Project Report (Volume 2) NILT Survey Autism Module

The primary purpose of the BASE Project was to establish how to help individuals with Autism Spectrum Disorder out of poverty by promoting social inclusion. In order to achieve this, a range of methodologies were utilised that aimed to provide a baseline against which the effect of the Autism Act (NI) 2011 and the associated Autism Strategy (2013-2020) and Action Plans can be measured. The BASE Project is reported in 5 volumes. Volume 2 reports on the analysis of the autism module of the Northern Ireland Life and Times (NILT) Survey that assessed public awareness, attitudes, knowledge, and projected behaviours with regard to individuals with ASD (all primary data and technical reports are available at www.ark.ac.uk/nilt/).

The NILT (2012) survey first ever autism module (n=1204) offered a baseline against which the impact of new autism legislation, policies, and strategies can be measured. Key findings:

• 82% awareness: Most people in Northern Ireland are aware of autism (n=989).
• 50% of all participants knew someone with autism personally (n=606).

Of those who were aware of autism:
• 19% had a close family member with autism (n=186), and/or a friends/acquaintance (n=296), and/or a work colleague (n=79) with autism.
• Autism awareness was particularly low for those from ethnic minorities and those with no internet access.
• Awareness of autism specific legislation was low (20%).
• Good levels of knowledge about autism strengths and challenges, slight tendency to overestimate the occurrence of special talents.
• Prevalence of autism was underestimated (62% thought autism was much less prevalent than official figures or did not know).
• Fairly accurate perception about causes of autism, i.e., not caused by poor parenting (84%).
• Strong support for evidence-based behavioural interventions (77%), but confusion about interventions that are not evidence-based (64%).
• Strong positive attitudes towards children and adults in social, educational and employment settings.
• Autism not viewed as necessarily ‘lifelong’ (58%); support for independent living (78%), e.g., driving a car (83%).
• More business for employers who employ people with autism (12%).
• Strong support for families caring rather than residential care (64%).
• Confusion about service responsibility: education (26%) health (33%) or both (28%).

Given increasing prevalence rates of ASD it is important that the general population is aware of autism and able to respond responsibly to the associated strengths and challenges. The results of the NILT (2012) first ever autism module show that the general public was well aware of autism, had positive attitudes, and was relatively knowledgeable about the issues faced by individuals and families affected directly. However, there was a lack of clarity about responsibility for effective service delivery. The NILT results show that a shift in focus is necessary from ‘awareness raising campaigns’ to an approach that delivers clarity with regard to intervention and accountability.

The Impact of Extension and Ecosystem Services on Smallholders’ Credit Constraint.

On formal credit markets, access to formal credit and reasonable credit terms of smallholder farmers
in rural sub-Saharan Africa is limited due to adverse selection. Financial institutions operating in
rural areas often cannot distinguish between borrowers (farmers) that are creditworthy and those that
are not, thus, allocate limited resource to agriculture to reduce credit risk. In the presence of limited business quality signaling by smallholder farmers, financial institutions shall demand for collateral and/or offer unfavorable contract terms. Moreover, agricultural productivity of rural sub-Saharan
Africa, dominated by subsistence or small-scale farmers, is also negatively impacted by the adverse
effect of climate change. A strategy that may make the farming practices of smallholder farmer’s
climate resilient and profitable may also improve smallholder farmer's access to formal credit. This
study investigates to what extent participating in ecosystem and extension services (EES) programs
signals business quality of smallholders, thus granting them credit accessibility. We collected data
on 210 smallholder farmers in 2013, comprising farmers that receive payments for ecosystem
services (PES) and farm management training from the International Small Group Tree Planting
Program (TIST) Kenya to test the aforementioned theory empirically. We use game theory,
particularly a screening and sorting model, to illustrate the prospects for farmers with EES to access
formal credit and to improve their credit terms given that they receive PES and banking services
training. Furthermore, the PES’ long term duration (10 – 30 years) generates stable cash-flow which
may be perceived as collateral substitute. Results suggest that smallholder farmers in the TIST
program were less likely to be credit constraint compared to non-TIST farmers. Distance to market,
education, livestock and farm income are factors that determine access to credit from microfinance
institutions in rural Kenya. Amongst farmers that have obtained loans, those keeping business records
enjoy more favorable formal credit conditions. These farmers were observed to pay ca. 5 percent less
interest rate in microfinance charges. For TIST farmers, this type of farm management practices may
be attributed to the banking services and other training they receive within the program. While the
availability of classical collateral (farmlands) and PES may reduce interest rate, the latter was found
to be statistically insignificant. This research underlines the importance of an effective extension
services in rural areas of developing countries and the need to improve gains from conservation
agriculture and ensuing PES. The benefits associated with EES and PES may encompass agricultural
financing.

The economic consequences of Portuguese State’s movement towards business sector

Over the last 36 years, the relationship with the Portuguese state-owned enterprises registered several dynamics: nationalizations, privatizations and corporatization of public services. However, until now the State Business Sector from a national accounts perspective was never analyzed. Based on data collected and compiled for the first time at Statistics Portugal, this PhD thesis aims to test, analyzing in eight dimensions, whether the weight of the State Business Sector increased and if it contributed positively to the Portuguese economy, from 2006 to 2010. In addition to this analysis, an overview of the economic theory of state intervention in the economy, the paradigm changes of public policy in the international context, the evolution of the Portuguese State Business Sector since 1974, accompanied with a business and national accounting perspective between 2006 and 2010, are also presented. The results allow us to conclude that, in general, the weight of the State Business Sector in the Portuguese economy increased and had a tendency of a positive contribution to its economic growth. The State Business Sector also contributed positively to the nominal labour productivity (although with a decreasing trend of contribution to growth over the period under review) and the profitability of the non-financial corporations sector (although impairing the overall ratio of this sector). Nonetheless, the State Business Sector contributed negatively to the fairness in compensation of employees (although with an improvement trend) and to the competitiveness of labour cost, investment and sectorial sustainability of the Portuguese economy (reinforced by a falling trend). The results also suggest that the State Business Sector had an economic behaviour closer to a welfare maximizing model than to a profit maximizing model. This distinct performance with respect to the institutional sector in which is included, highlights the need to study and reassess the relationship of the state with public corporations, in light of agency theory using micro-data. Lastly, contributions to improve the economic performance of the State Business Sector and future prospects of evolution are presented.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.

South Carolina business opportunities

This is a listing, published twice per week, of proposed procurements in construction, information technology, supplies & services as well as other information of interest to the business community.