Lifetime Subsidies in Australian Private Health Insurance Markets with Community Rating

This paper considers the problem of inducing low-risk individuals of all ages to buy private health insurance in Australia. Our proposed subsidy scheme improves upon the age-based penalty scheme under the current "Australian Lifetime Cover" (LTC) scheme. We generate an alternative subsidy profile that obviates adverse selection in private health insurance markets with mandated, age-based, community rating. Our proposal is novel in that we generate subsidies that are both risk- and age-specific, based upon actual risk probabilities. The approach we take may prove useful in other jurisdictions where the extant law mandates community rating in private health insurance markets. Furthermore, our approach is useful in jurisdictions that seek to maintain private insurance to complement existing universal public systems.

Business and social entrepreneurs in the UK:gender, context and commitment

Purpose – The purpose of this paper is to investigate what sort of people become social entrepreneurs, and in what way they differ from business entrepreneurs. More importantly, to investigate in what socio-economic context entrepreneurial individuals are more likely to become social than business entrepreneurs. These questions are important for policy because there has been a shift from direct to indirect delivery of many public services in the UK, requiring a professional approach to social enterprise. Design/methodology/approach – Evidence is presented from the Global Entrepreneurship Monitor (GEM) UK survey based upon a representative sample of around 21,000 adults aged between 16 and 64 years interviewed in 2009. The authors use logistic multivariate regression techniques to identify differences between business and social entrepreneurs in demographic characteristics, effort, aspiration, use of resources, industry choice, deprivation, and organisational structure. Findings – The results show that the odds of an early-stage entrepreneur being a social rather than a business entrepreneur are reduced if they are from an ethnic minority, if they work ten hours or more per week on the venture, and if they have a family business background; while they are increased if they have higher levels of education and if they are a settled in-migrant to their area. While women social entrepreneurs are more likely than business entrepreneurs to be women, this is due to gender-based differences in time commitment to the venture. In addition, the more deprived the community they live in, the more likely women entrepreneurs are to be social than business entrepreneurs. However, this does not hold in the most deprived areas where we argue civic society is weakest and therefore not conducive to support any form of entrepreneurial endeavour based on community engagement. Originality/value – The paper's findings suggest that women may be motivated to become social entrepreneurs by a desire to improve the socio-economic environment of the community in which they live and see social enterprise creation as an appropriate vehicle with which to address local problems.

Knowledge Construction Technology through Hypermedia-Based Intelligent Conversational Channel

There have been multifarious approaches in building expert knowledge in medical or engineering field through expert system, case-based reasoning, model-based reasoning and also a large-scale knowledge-based system. The intriguing factors with these approaches are mainly the choices of reasoning mechanism, ontology, knowledge representation, elicitation and modeling. In our study, we argue that the knowledge construction through hypermedia-based community channel is an effective approach in constructing expert’s knowledge. We define that the knowledge can be represented as in the simplest form such as stories to the most complex ones such as on-the-job type of experiences. The current approaches of encoding experiences require expert’s knowledge to be acquired and represented in rules, cases or causal model. We differentiate the two types of knowledge which are the content knowledge and socially-derivable knowledge. The latter is described as knowledge that is earned through social interaction. Intelligent Conversational Channel is the system that supports the building and sharing on this type of knowledge.

The contribution of community enterprise to British urban regeneration in a period of state retrenchment

This chapter discusses the growth and nature of community enterprise and in particular the sub-set of asset-based community development trusts and reviews their contribution to urban regeneration in Britain. Three models are presented and illustrated with case studies.

Sound Art and Public Engagement in the Built Environment: Reflections from an Architecture Center

This article explores the deployment of sound in architectural-curatorial and community engagement contexts through the work of PLACE, a multidisciplinary not-for-profit architecture center in Belfast, Northern Ireland. The author, who worked with PLACE and contributed to the projects discussed here, contextualizes architecture centers and their relationship with sound before examining the specific case of sound and sound art in Northern Ireland and case studies of projects delivered by PLACE. Specifically, the article evaluates two sound installation artworks and three community engagement projects for young audiences. As a means of curating urbanism and architecture, sound-art-as-public-art affords useful strategies to examine, describe or critique the environment as alternatives to traditional architecture exhibition formats. Sound’s temporality and materiality allow sound art works to exist as temporary sculptural interventions in the urban sphere, with attendant implications for public art procurement and urban acoustics. Rich territories of engagement are opened when using sound in a community participatory context.

Community policing in Northern Ireland: a resistance narrative

Policing in stable democratic societies is predominantly concerned with the implementation and practice of the globally accepted philosophy of community policing. However, the subtle complexities of Northern Ireland's transitional landscape present acute problems for the community policing concept, both as a vehicle for police reform and as a tool for increasing the co-production of security through improved community interaction with the police. This article will examine the current position of the Police Service of Northern Ireland (PSNI) and their Policing with the Community policy. Providing an overview of contextual and contemporary developments, it will assess the efficacy with which the PSNI have realised community policing, as espoused in Patten Recommendation 44. It concludes by determining the role and extent of community engagement with policing in Northern Ireland and the resistances and contestations to the implementation of the community policing in a post-conflict society.

Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam

BACKGROUND: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. OBJECTIVE: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. DESIGNS: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). RESULTS: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. CONCLUSIONS: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

Objectives for management of socio-ecological systems in the Great Barrier Reef region, Australia

A wide range of goals and objectives have to be taken into account in natural resources management. Defining these objectives in operational terms, including dimensions such as sustainability, productivity, and equity, is by no means easy, especially if they must capture the diversity of community and stakeholder values. This is especially true in the coastal zone where land activities affect regional marine ecosystems. In this study, the aim was firstly to identify and hierarchically organise the goals and objectives for coastal systems, as defined by local stakeholders. Two case study areas are used within the Great Barrier Reef region being Mackay and Bowen–Burdekin. Secondly, the aim was to identify similarities between the case study results and thus develop a generic set of goals to be used as a starting point in other coastal communities. Results show that overarching high-level goals have nested sub-goals that contain a set of more detailed regional objectives. The similarities in high-level environmental, governance, and socio-economic goals suggest that regionally specific objectives can be developed based on a generic set of goals. The prominence of governance objectives reflects local stakeholder perceptions that current coastal zone management is not achieving the outcomes they feel important and that there is a need for increased community engagement and co-management. More importantly, it raises the question of how to make issues relevant for the local community and entice participation in the local management of public resources to achieve sustainable environmental, social, and economic management outcomes. © 2015 Springer-Verlag Berlin Heidelberg

Giving Voice to Voiceless: Engaging Urban Youth for Possibilities

This symposium will discuss the expansion of The Education Effect – Booker T. Washington, as a university community school partnership designed to engage urban youth for college and career readiness. The partnership is focused on developing collective impact and capacity for academic achievement, social success and college completion. The partnership aligns university expertise, resources and evidenced based strategies to address educational needs through the improvement of teaching and learning; increase graduation rate and parental involvement.

Economic Instruments and Regulatory Approaches in Implementing Riparian Revegetation Options: Observations of the Queensland System

Riparian vegetation can be an effective measure for preventing degradation of streambanks and riparian areas. However, riparian revegetation imposes large costs on landholders associated with tree establishment and removal of land from cropping, while providing benefits to downstream landholders, fishers, the local community and environmentalists. Appropriate policy instruments are required to promote sustainable and balanced use of riparian zones. This article analyses the capacity of existing legislation and other instruments to promote restoration of degraded riparian zones on private land. The role of legislation. economic instruments, community engagement and extension programs, in persuading landholders to revegetate riparian areas and improve riparian vegetation cover; is examined in the context ofa small degraded catchment in an intensive farming area in tropical north Queensland. It is found that while legislation and regulations can control undesirable modification of riparian areas, in general they are unable to make a useful contribution to restoration of these areas; incentives and assistance measures appear to offer greater potential.

Virtual Communities of Practice: Design and Development of Support Platforms and Participation Fostering

Mestrado em Engenharia Informática - Área de Especialização em Sistemas Gráficos e Multimédia

Barriers preventing the successful integration of mental health services into Primary Health Care in Nigeria : a mixed methods approach

RESUMO: A Nigéria tem uma população estimada em cerca de 170 milhões de pessoas. O número de profissionais de saúde mental é muito diminuto, contando apenas com 150 psiquiatras o que perfaz aproximadamente um rácio de psiquiatra: população de mais de 1:1 milhão de pessoas. O Plano Nacional de Saúde Mental de 1991 reconheceu esta insuficiência e recomendou a integração dos serviços de saúde mental nos cuidados de saúde primários (CSP). Depois de mais de duas décadas, essa política não foi ainda implementada. Este estudo teve como objetivos mapear a estrutura organizacional dos serviços de saúde mental da Nigéria, e explorar os desafios e barreiras que impedem a integração bem-sucedida dos serviços de saúde mental nos cuidados de saúde primários, isto segundo a perspectiva dos profissionais dos cuidados de saúde primários. Com este objetivo, desenvolveu-se um estudo exploratório sequencial e utilizou-se um modelo misto para a recolha de dados. A aplicação em simultâneo de abordagens qualitativas e quantitativas permitiram compreender os problemas relacionados com a integração dos serviços de saúde mental nos CSP na Nigéria. No estudo qualitativo inicial, foram realizadas entrevistas com listagens abertas a 30 profissionais dos CSP, seguidas de dois grupos focais com profissionais dos CSP de duas zonas governamentais do estado de Oyo de forma a obter uma visão global das perspectivas destes profissionais locais sobre os desafios e barreiras que impedem uma integração bem-sucedida dos serviços de saúde mental nos CSP. Subsequentemente, foram realizadas entrevistas com quatro pessoas-chave, especificamente coordenadores e especialistas em saúde mental. Os resultados do estudo qualitativo foram utilizados para desenvolver um questionário para análise quantitativa das opiniões de uma amostra maior e mais representativa dos profissionais dos CSP do Estado de Oyo, bem como de duas zonas governamentais locais do Estado de Osun. As barreiras mais comummente identificadas a partir deste estudo incluem o estigma e os preconceitos sobre a doença mental, a formação inadequada dos profissionais dos CPS sobre saúde mental, a perceção pela equipa dos CSP de baixa prioridade de ação do Governo, o medo da agressão e violência pela equipa dos CSP, bem como a falta de disponibilidade de fármacos. As recomendações para superar estes desafios incluem a melhoria sustentada dos esforços da advocacia à saúde mental que vise uma maior valorização e apoio governamental, a formação e treino organizados dos profissionais dos cuidados primários, a criação de redes de referência e de apoio com instituições terciárias adjacentes, e o engajamento da comunidade para melhorar o acesso aos serviços e à reabilitação, pelas pessoas com doença mental. Estes resultados fornecem indicações úteis sobre a perceção das barreiras para a integração bem sucedida dos serviços de saúde mental nos CSP, enquanto se recomenda uma abordagem holística e abrangente. Esta informação pode orientar as futuras tentativas de implementação da integração dos serviços de saúde mental nos cuidados primários na Nigéria.------------ABSTRACT: Nigeria has an estimated population of about 170 million people but the number of mental health professionals is very small, with about 150 psychiatrists. This roughly translates to a psychiatrist:population ratio of more than 1:1 million people. The National Mental Health Policy of 1991 recognized this deficiency and recommended the integration of mental health into primary health care (PHC) delivery system. After more than two decades, this policy has yet to be implemented. This study aimed to map out the organizational structure of the mental health systems in Nigeria, and to explore the challenges and barriers preventing the successful integration of mental health into primary health care, from the perspective of the primary health care workers. A mixed methods exploratory sequential study design was employed, which entails the use of sequential timing in the combined methods of data collection. A combination of qualitative and uantitative approaches in sequence, were utilized to understand the problems of mental health services integration into PHC in Nigeria. The initial qualitative phase utilized free listing interviews with 30 PHC workers, followed by two focus group discussions with primary care workers from two Local Government Areas (LGA) of Oyo State to gain useful insight into the local perspectives of PHC workers about the challenges and barriers preventing successful integration of mental health care services into PHC. Subsequently, 4 key informant interviews with PHC co-ordinators and mental health experts were carried out. The findings from the qualitative study were utilized to develop a quantitative study questionnaire to understand the opinions of a larger and more representative sample of PHC staff in two more LGAs of Oyo State, as well as 2 LGAs from Osun State. The common barriers identified from this study include stigma and misconceptions about mental illness, inadequate training of PHC staff about mental health, low government priority, fear of aggression and violence by the PHC staff, as well as non-availability of medications. Recommendations for overcoming these challenges include improved and sustained efforts at mental health advocacy to gain governmental attention and support, organized training and retraining for primary care staff, establishment of referral and supportive networks with neighbouring tertiary facilities and community engagement to improve service utilization and rehabilitation of mentally ill persons. These findings provide useful insight into the barriers to the successful integration of mental health into PHC, while recommending a holistic and comprehensive approach. This information can guide future attempts to implement the integration of mental health into primary care in Nigeria.