Building Healthy Communities : GP Network, Medicare Local and Primary Health Care in the Wheatbelt Region of Western Australia

• Government reports consistently recognise the importance of Primary Health Care to an efficient health system. Barriers identified in Australia’s Primary Health Care include workforce pressures, increase rate of chronic disease, and equitable access to Primary Health Care services. • General Practitioners (GPs) are the key to the successful delivery of Primary Health Care especially in rural and remote regions such as the Wheatbelt region in Western Australia (WA). • The Wheatbelt region of WA is vast: some 72,500 residents spread across 150,000km2 in 43 Local Government Authorities catchments. Majority of the Wheatbelt residents live in small towns. There is a higher reported rates of chronic disease, more at risk of chronic diseases and less utilisation of Primary Health Care services in this region. • General practice patients in the Wheatbelt are among those most in need of Primary Health Care services. • Wheatbelt GP Network (the “Network”) was established in 1998. It is a key health service delivery stakeholder in the Wheatbelt. • The Network has responded to the health needs of the community by creating a mobile Allied Health Team that works closely with GPs and is adaptive to ensure priority needs are met. • The Medicare Local model introduced by the Australian Government in 2011 aimed to improve the delivery of Primary Health Care services by improved health planning and coordinating service delivery. • Little if any recognition has been given to the outstanding work that many Divisions of General Practice have done in improving the delivery of Primary Health Care services such as the Network. • The Network has continued to support GPs and general practices and created a complementary system that integrated general practice with the work of an Allied Health Team. Its program mix is extensive. • The Network has consistently delivered on-required contract outputs and has a fifteen (15) years history of operating successfully in a large geographical area comprising in the main smaller communities that cannot support the traditional health services model. • The complexity of supporting International Medical Graduates in the region requires special attention. • The introduction of the Medicare Local in the South West of WA and their intention to take over the delivery of health services, thus effectively shutting the Network will have catastrophic consequences and cannot be supported economically. • The Network proposes to create a new model, built on its past work that increases the delivery of Primary Health Care services through its current Allied Health Team. • The proposal uses the Wheatbelt GP Super Clinic currently under construction in Northam, part of the Network and funded by the Australian Government is a key to the proposed new model. • Wheatbelt GP Super Clinic is different from existing models of GP Super Clinics around Australia which focus predominately on co-location of services. Wheatbelt GP Super Clinic utilises a hub and spoke model of service outreach to small rural towns to ensure equitable Primary Health Care coverage and continuum of care in a financially responsible and viable manner. In particular, the Wheatbelt GP Super Clinic recognises the importance of Allied Health Professionals and will involve them in a collaborative model with rural general practice. • The proposed model advocated by the Network aims to substitute the South West WA Medicare Local direct service delivery proposed for the Wheatbelt. The Network’s proposed model is to expand on the current hub and spoke model of Primary Health Care delivery to otherwise small unviable Wheatbelt towns. A flexible and adaptive skill mix of Allied Health Professionals, Nurse Practitioners and GPs ensure equitable access to service. Expanded scope of practices are utilised to reduce duplication of service and concentration of services in major towns. This involves a partnership approach. • If the proposed model not funded, the Network and the Wheatbelt region will stand to lose 16 Allied Health Professionals and defeats the purpose of Australian Government current funding for the construction of the Wheatbelt GP Super Clinic. • The Network has considered how its model can best be funded. It proposes a re-allocation of funds made available to the South West WA Medicare Local. • This submission argues that the proposal for the South West WA Medicare Local to take over the service delivery of Primary Health Care services in the Wheatbelt makes no economic sense when an existing agency (the Network) has the infrastructure in place, is experienced in working in this geographical area that has special needs and is capable to expand its programs to meet demand.

A social licence to operate: Corporate social responsibility, local communities and the constitution of global production networks

This article contributes to the theorization of the role of informal regulation (undertaken by leading firms) in the ongoing organization of global production networks. It does so through a qualitative case study of BHP Billiton's Ravensthorpe Nickel Operation (RNO) in the rural Shire of Ravensthorpe in Western Australia. This less tangible, and to date under-researched, dimension of global production networks is foregrounded through a focus on the corporate social responsibility strategy implemented by RNO in the service of achieving and/or demonstrating a broader ‘social licence to operate’. This ‘licence’ functions – beyond the corporation – as a legitimated and legitimating multi-scalar mechanism through which to gain and maintain access to mineral resources and thus to establish viable and ongoing global production networks. Further, this informal regulation is shown to shape social relations and qualities of place conducive to competitive global mineral extraction and to facilitate the positioning of local communities and places in mineral global production networks.

Optimisation Problems in Wireless Sensor Networks : Local Algorithms and Local Graphs

This thesis studies optimisation problems related to modern large-scale distributed systems, such as wireless sensor networks and wireless ad-hoc networks. The concrete tasks that we use as motivating examples are the following: (i) maximising the lifetime of a battery-powered wireless sensor network, (ii) maximising the capacity of a wireless communication network, and (iii) minimising the number of sensors in a surveillance application. A sensor node consumes energy both when it is transmitting or forwarding data, and when it is performing measurements. Hence task (i), lifetime maximisation, can be approached from two different perspectives. First, we can seek for optimal data flows that make the most out of the energy resources available in the network; such optimisation problems are examples of so-called max-min linear programs. Second, we can conserve energy by putting redundant sensors into sleep mode; we arrive at the sleep scheduling problem, in which the objective is to find an optimal schedule that determines when each sensor node is asleep and when it is awake. In a wireless network simultaneous radio transmissions may interfere with each other. Task (ii), capacity maximisation, therefore gives rise to another scheduling problem, the activity scheduling problem, in which the objective is to find a minimum-length conflict-free schedule that satisfies the data transmission requirements of all wireless communication links. Task (iii), minimising the number of sensors, is related to the classical graph problem of finding a minimum dominating set. However, if we are not only interested in detecting an intruder but also locating the intruder, it is not sufficient to solve the dominating set problem; formulations such as minimum-size identifying codes and locating dominating codes are more appropriate. This thesis presents approximation algorithms for each of these optimisation problems, i.e., for max-min linear programs, sleep scheduling, activity scheduling, identifying codes, and locating dominating codes. Two complementary approaches are taken. The main focus is on local algorithms, which are constant-time distributed algorithms. The contributions include local approximation algorithms for max-min linear programs, sleep scheduling, and activity scheduling. In the case of max-min linear programs, tight upper and lower bounds are proved for the best possible approximation ratio that can be achieved by any local algorithm. The second approach is the study of centralised polynomial-time algorithms in local graphs these are geometric graphs whose structure exhibits spatial locality. Among other contributions, it is shown that while identifying codes and locating dominating codes are hard to approximate in general graphs, they admit a polynomial-time approximation scheme in local graphs.

Energy efficient area monitoring using information coverage in wireless sensor networks

In this paper, we are concerned with energy efficient area monitoring using information coverage in wireless sensor networks, where collaboration among multiple sensors can enable accurate sensing of a point in a given area-to-monitor even if that point falls outside the physical coverage of all the sensors. We refer to any set of sensors that can collectively sense all points in the entire area-to-monitor as a full area information cover. We first propose a low-complexity heuristic algorithm to obtain full area information covers. Using these covers, we then obtain the optimum schedule for activating the sensing activity of various sensors that maximizes the sensing lifetime. The scheduling of sensor activity using the optimum schedules obtained using the proposed algorithm is shown to achieve significantly longer sensing lifetimes compared to those achieved using physical coverage. Relaxing the full area coverage requirement to a partial area coverage (e.g., 95% of area coverage as adequate instead of 100% area coverage) further enhances the lifetime.

Aromatic, microporous polymer networks with high surface area generated in Friedel-Crafts-type polycondensations

A series of novel, microporous polymer networks (MPNs) have been generated in a simple, acid catalysed Friedel-Crafts-type self-condensation of A(2)B(2)- and A(2)B(4)-type fluorenone monomers. Two A2B4-type monomers with 2,7-bis(N, N-diphenylamino) A or 2,7-bis [4-(N, N-diphenylamino) phenyl] D substitution of the fluorenone cores lead to MPNs with high S(BET) surface areas of up to 1400 m(2) g(-1). Two MPNs made of binary monomer mixtures showed the highest Brunauer-Emmett-Teller (BET) surface areas S(BET) of our series (SBET of up to 1800 m(2) g(-1)) after washing the powdery samples with supercritical carbon dioxide. Total pore volumes of up to 1.6 cm(3) g(-1) have been detected. It is observed that the substitution pattern of the monomers is strongly influencing the resulting physicochemical properties of the microporous polymer networks (MPNs).

Governing the local networks in Indian agrarian societies-an MAS perspective

In a networked society, governing advocacy groups and networks through decentralized systems of policy implementation has been the interest of governance network literature. This paper addresses the topic of governing networks in the context of Indian agrarian societies by taking the case example of a welfare scheme for the Indian rural poor. We explore context-specific regulatory dynamics through the situated agent based architectural framework. The effects of various regulatory strategies that can be adopted by governing node are tested under various action arenas through experimental design. Results show the impact of regulatory strategies on the resource dependencies and asymmetries in the network relationships. This indicates that the optimal feasible regulatory strategy in networked society is institutionally rational and is context dependent. Further, we show that situated MAS architecture is a natural fit for institutional understanding of the dynamics (Ostrom et al. in Rules, games, and common-pool resources, 1994).

Caribbean connectivity: implications for Marine Protected Area Management. Proceedings of a Special Symposium, 9-11 November 2006, 59th Annual Meeting of the Gulf and Caribbean Fisheries Institute, Belize City, Belize

Executive Summary: Tropical marine ecosystems in the Caribbean region are inextricably linked through the movement of pollutants, nutrients, diseases, and other stressors, which threaten to further degrade coral reef communities. The magnitude of change that is occurring within the region is considerable, and solutions will require investigating pros and cons of networks of marine protected areas (MPAs), cooperation of neighboring countries, improved understanding of how external stressors degrade local marine resources, and ameliorating those stressors. Connectivity can be broadly defined as the exchange of materials (e.g., nutrients and pollutants), organisms, and genes and can be divided into: 1) genetic or evolutionary connectivity that concerns the exchange of organisms and genes, 2) demographic connectivity, which is the exchange of individuals among local groups, and 3) oceanographic connectivity, which includes flow of materials and circulation patterns and variability that underpin much of all these exchanges. Presently, we understand little about connectivity at specific locations beyond model outputs, and yet we must manage MPAs with connectivity in mind. A key to successful MPA management is how to most effectively work with scientists to acquire the information managers need. Oceanography connectivity is poorly understood, and even less is known about the shape of the dispersal curve for most species. Dispersal kernels differ for various systems, species, and life histories and are likely highly variable in space and time. Furthermore, the implications of different dispersal kernels on population dynamics and management of species is unknown. However, small dispersal kernels are the norm - not the exception. Linking patterns of dispersal to management options is difficult given the present state of knowledge. The behavioral component of larval dispersal has a major impact on where larvae settle. Individual larval behavior and life history details are required to produce meaningful simulations of population connectivity. Biological inputs are critical determinants of dispersal outcomes beyond what can be gleaned from models of passive dispersal. There is considerable temporal and spatial variation to connectivity patterns. New models are increasingly being developed, but these must be validated to understand upstream-downstream neighborhoods, dispersal corridors, stepping stones, and source/sink dynamics. At present, models are mainly useful for providing generalities and generating hypotheses. Low-technology approaches such as drifter vials and oceanographic drogues are useful, affordable options for understanding local connectivity. The “silver bullet” approach to MPA design may not be possible for several reasons. Genetic connectivity studies reveal divergent population genetic structures despite similar larval life histories. Historical stochasticity in reproduction and/or recruitment likely has important, longlasting consequences on present day genetic structure. (PDF has 200 pages.)

Agent based modeling of energy networks

Attempts to model any present or future power grid face a huge challenge because a power grid is a complex system, with feedback and multi-agent behaviors, integrated by generation, distribution, storage and consumption systems, using various control and automation computing systems to manage electricity flows. Our approach to modeling is to build upon an established model of the low voltage electricity network which is tested and proven, by extending it to a generalized energy model. But, in order to address the crucial issues of energy efficiency, additional processes like energy conversion and storage, and further energy carriers, such as gas, heat, etc., besides the traditional electrical one, must be considered. Therefore a more powerful model, provided with enhanced nodes or conversion points, able to deal with multidimensional flows, is being required. This article addresses the issue of modeling a local multi-carrier energy network. This problem can be considered as an extension of modeling a low voltage distribution network located at some urban or rural geographic area. But instead of using an external power flow analysis package to do the power flow calculations, as used in electric networks, in this work we integrate a multiagent algorithm to perform the task, in a concurrent way to the other simulation tasks, and not only for the electric fluid but also for a number of additional energy carriers. As the model is mainly focused in system operation, generation and load models are not developed.

An investigation of the organization of canoe fisheries in Nigeria: A case study of Ilaje/Esedo local government area of Ondo State

The effects of some socio-economic variables on the performance of artisanal fishermen were investigated. The variables include the age-structure of the fishermen, level of investment, educational background, membership of co-operative societies and marketing arrangements. All these variables were found to be crucial to productivity in the artisanal fishing sector

Distributed optimization in power networks and general multi-agent systems

The dissertation studies the general area of complex networked systems that consist of interconnected and active heterogeneous components and usually operate in uncertain environments and with incomplete information. Problems associated with those systems are typically large-scale and computationally intractable, yet they are also very well-structured and have features that can be exploited by appropriate modeling and computational methods. The goal of this thesis is to develop foundational theories and tools to exploit those structures that can lead to computationally-efficient and distributed solutions, and apply them to improve systems operations and architecture.

Specifically, the thesis focuses on two concrete areas. The first one is to design distributed rules to manage distributed energy resources in the power network. The power network is undergoing a fundamental transformation. The future smart grid, especially on the distribution system, will be a large-scale network of distributed energy resources (DERs), each introducing random and rapid fluctuations in power supply, demand, voltage and frequency. These DERs provide a tremendous opportunity for sustainability, efficiency, and power reliability. However, there are daunting technical challenges in managing these DERs and optimizing their operation. The focus of this dissertation is to develop scalable, distributed, and real-time control and optimization to achieve system-wide efficiency, reliability, and robustness for the future power grid. In particular, we will present how to explore the power network structure to design efficient and distributed market and algorithms for the energy management. We will also show how to connect the algorithms with physical dynamics and existing control mechanisms for real-time control in power networks.

The second focus is to develop distributed optimization rules for general multi-agent engineering systems. A central goal in multiagent systems is to design local control laws for the individual agents to ensure that the emergent global behavior is desirable with respect to the given system level objective. Ideally, a system designer seeks to satisfy this goal while conditioning each agent’s control on the least amount of information possible. Our work focused on achieving this goal using the framework of game theory. In particular, we derived a systematic methodology for designing local agent objective functions that guarantees (i) an equivalence between the resulting game-theoretic equilibria and the system level design objective and (ii) that the resulting game possesses an inherent structure that can be exploited for distributed learning, e.g., potential games. The control design can then be completed by applying any distributed learning algorithm that guarantees convergence to the game-theoretic equilibrium. One main advantage of this game theoretic approach is that it provides a hierarchical decomposition between the decomposition of the systemic objective (game design) and the specific local decision rules (distributed learning algorithms). This decomposition provides the system designer with tremendous flexibility to meet the design objectives and constraints inherent in a broad class of multiagent systems. Furthermore, in many settings the resulting controllers will be inherently robust to a host of uncertainties including asynchronous clock rates, delays in information, and component failures.

Poverty alleviation among fishermen within the floodplains of Kaduna River: implication for introducing commercial fish farming at village level in Doko local government area of Niger State, Nigeria

A diagnostic survey was conducted among the fishermen in six selected villages in Doko Local Government Area of Niger State. One hundred and fifty fishermen were randomly selected and interviewed to find out whether or not they had interest in commercial fish farming aimed at improving their livelihood. The dwindling fish catches in the natural flood plain ponds and Ex-bow Lakes continue to have a serious negative effect on the socio-economic well being of the village communities in question. A break on natural regular annual flooding of the plains had resulted into very low natural fish recruitment. Data analysis using simple descriptive statistics revealed that land tenure system, educational status, inadequate infrastructural facilities, religious taboos, existing fish species among others were found to be favourable indices for commercial fish farming. However, serious conflicts among the fishermen concerning the ownership status of these natural fish ponds are found to be major obstacles to commercial fish farming despite that the traditional ownership of the ponds were vested in the lands of individuals and village communities. Extensive fish farming and small-scale fish farming in the ponds and Ex-bow Lake with improved management practices are considered to be profitable venture. Despite the fact that fish seeds supply and extension effort are still inadequate, the fish farmers have indicated willingness to adopt commercial fish farming in the Ex-bow Lakes and flood plains in order to restore abundant fish production thereby providing for their food security and also increasing the daily income

Impact assessment of Niger State fisheries legislation on fisheries conservation in Edozhigi local government area (L.G.A.) of Niger State

A preliminary survey was conducted among the fishermen in five selected villages in Edozhigi L.G.A. of Niger State. One hundred and fifty fishermen were randomly selected and interviewed to find out the impact of Niger State fisheries legislation on fisheries conservation resources in the area. The analysis of data collected using descriptive statistics indicated that undersized mesh of gill nets, beach seines and traps are being used unabated. Also, fenced barriers across the entrance of flood plain ponds and Ex-bow lakes from the main stream are in the area. The fisheries rules and regulations implementers are rarely seen or not seen at all in the area. The decreasing nature of fish catches was detected. It is observed that government policy on fish conversation is neglected due to inadequate or lack of funding for meaningful extension and implementation of the fisheries rules and regulations

Technical efficiency in artisanal fisheries (AF) in Badagry local government area of Lagos State, Nigeria

This study examined the technical efficiency in artisanal fisheries in Lagos State of Nigeria. The study employed a two stage random sampling procedure for the selection of 120 respondents. The analytical techniques involved descriptive statistics and estimation of technical efficiency following maximum likelihood estimation (MLE) procedure available in FRONTIER 4.1. The MLE result of the stochastic frontier production function showed that hired labour, cost of repair and capital items are critical factors that influences productivity of artisanal fishermen with the coefficient of hired labour being highly elastic. This implies that employing more labour will significantly increase the catch in the study area. The predicted farm efficiency with an average value of 0.92 showed that there is a marginal potential of about 8 percent to increase the catch, hence the income of the fishermen. The study further examined the factors that influence productivity of fishermen in the study area. Year of education, mode of operation and frequency of fishing have important implication on the technical efficiency of fishermen in the study area.

Persistent Nodes for Reliable Memory in Geographically Local Networks

A Persistent Node is a redundant distributed mechanism for storing a key/value pair reliably in a geographically local network. In this paper, I develop a method of establishing Persistent Nodes in an amorphous matrix. I address issues of construction, usage, atomicity guarantees and reliability in the face of stopping failures. Applications include routing, congestion control, and data storage in gigascale networks.