Small towns big returns: economic and social impact of the Karen resettlement in Nhill

Increased resettlement of migrants and refugees in regional Australia has been an on-going focus of the policies of successive governments. One recent regional resettlement experience, initiated at the local level, has yielded significant outcomes for a small regional community and the refugees involved. This case study – Small towns, Big returns – provides new and important insights into the economic and social value that can accrue through these initiatives, and identifies factors that contribute to their success. These insights can both create the case for, and inform planning of, resettlement in other Australian communities. Since early 2010, approximately 160 Karen refugees have resettled in Nhill, in north western Victoria. Nhill is a small, relatively isolated agricultural town in the wheat-belt Wimmera region of Victoria. Like a number of small regional towns, Nhill has faced a declining working-age population, which has had flow-on implications for the economic and social prosperity of the town. The context of a declining population, combined with very low unemployment, was a key catalyst in this resettlement. In particular there was a need for labour to support expansion of Luv-a-Duck, the largest local commercial business, and driven by a combination of economic and humanitarian motivations, Luv-a-Duck management identified the Karen as potential employees. Through a staged recruitment and resettlement process, the Karen community now comprises approximately 10% of the Nhill population, including significant numbers of working age adults and families with young children. Furthermore, labour force participation linked to this population increase is high. Fifty-four Karen are directly employed in Luv-a-Duck, and seven are employed in businesses that supply Luv-a-Duck. Beyond this, the increased population has enabled the creation and filling of additional jobs across a number of broader community businesses and services. A total of 70.5 Full Time Equivalent (FTE) positions have been added to the regional economy over the five year period of analysis, representing approximately 3% of total employment across Hindmarsh. The economic impact of this increased labour supply, in terms of Gross Regional Product – as modelled by Deloitte Access Economics, is estimated to be $41.5 million in net present value terms. The wider social impacts of the resettlement of the Karen in Nhill provide the story behind the numbers. In short the Karen resettlement in Nhill has helped to: • redress population decline for the township • revitalise local services and attract increased government funding • increase social capital across both communitie

Retirement village physical activity and nutrition intervention process evaluation:Informing practice

© 2018 AJA Inc. Objective: This process evaluation aimed to determine participants’ perceptions of the strategies utilised in a six-month intervention that set out to improve physical activity and nutrition in retirement village (RV) residents. Methods: Qualitative and quantitative data were collected from intervention participants residing in 17 RVs located in Perth, Western Australia, via self-report questionnaires (n = 139) and semi-structured interviews (n = 16). Results: Intervention resources were moderately useful and suitable. Program ambassadors were encouraging (86%), but more frequent, and more direct, contact were preferred. The main reason for withdrawing from the program was health-related conditions (aches, pains, injuries). Conclusion: This study provides evidence that the intervention was reasonably appropriate for older adults residing in RVs. Program ambassadors were well accepted, a successful strategy that should be considered for future interventions in RVs. Increased face-to-face engagement was preferred, but such an approach will require greater investment. The findings contribute to a small research base concerned with health behaviour interventions in RVs

Estimating the returns to UK publicly funded cancer-related research in terms of the net value of improved health outcomes

© 2014 Glover et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background - Building on an approach developed to assess the economic returns to cardiovascular research, we estimated the economic returns from UK public and charitable funded cancer-related research that arise from the net value of the improved health outcomes. Methods - To assess these economic returns from cancer-related research in the UK we estimated: 1) public and charitable expenditure on cancer-related research in the UK from 1970 to 2009; 2) net monetary benefit (NMB), that is, the health benefit measured in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of GB£25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1991 to 2010; 3) the proportion of NMB attributable to UK research; 4) the elapsed time between research funding and health gain; and 5) the internal rate of return (IRR) from cancer-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using sensitivity analyses to illustrate the effect of some key parameters. Results - In 2011/12 prices, total expenditure on cancer-related research from 1970 to 2009 was £15 billion. The NMB of the 5.9 million QALYs gained from the prioritised interventions from 1991 to 2010 was £124 billion. Calculation of the IRR incorporated an estimated elapsed time of 15 years. We related 17% of the annual NMB estimated to be attributable to UK research (for each of the 20 years 1991 to 2010) to 20 years of research investment 15 years earlier (that is, for 1976 to 1995). This produced a best-estimate IRR of 10%, compared with 9% previously estimated for cardiovascular disease research. The sensitivity analysis demonstrated the importance of smoking reduction as a major source of improved cancer-related health outcomes. Conclusions - We have demonstrated a substantive IRR from net health gain to public and charitable funding of cancer-related research in the UK, and further validated the approach that we originally used in assessing the returns from cardiovascular research. In doing so, we have highlighted a number of weaknesses and key assumptions that need strengthening in further investigations. Nevertheless, these cautious estimates demonstrate that the returns from past cancer research have been substantial, and justify the investments made during the period 1976 to 1995.Wellcome Trust, Cancer Research UK, the National Institute of Health Research, and the Academy of Medical Sciences

The neglected social dimensions to a vehicle-to-grid (V2G) transition: a critical and systematic review

Vehicle-to-grid (V2G) refers to efforts to bi-directionally link the electric power system and the transportation system in ways that can improve the sustainability and security of both. A transition to V2G could enable vehicles to simultaneously improve the efficiency (and profitability) of electricity grids, reduce greenhouse gas emissions for transport, accommodate low-carbon sources of energy, and reap cost savings for owners, drivers, and other users. To understand the recent state of this field of research, here we conduct a systematic review of 197 peer-reviewed articles published on V2G from 2015 to early 2017. We find that the majority of V2G studies in that time period focus on technical aspects of V2G, notably renewable energy storage, batteries, or load balancing to minimize electricity costs, in some cases including environmental goals as constraints. A much lower proportion of studies focus on the importance of assessing environmental and climate attributes of a V2G transition, or on the role of consumer acceptance and knowledge of V2G systems. Further, there is need for exploratory work on natural resource use and externalities, discourses and narratives as well as social justice, gender, and urban resilience considerations. These research gaps need to be addressed if V2G is to achieve the societal transition its advocates seek

Inter-operator and inter-device agreement and reliability of the SEM Scanner

AbstractObjectiveThe SEM Scanner is a medical device designed for use by healthcare providers as part of pressure ulcer prevention programs. The objective of this study was to evaluate the inter-rater and inter-device agreement and reliability of the SEM Scanner.MethodsThirty-one (31) volunteers free of pressure ulcers or broken skin at the sternum, sacrum, and heels were assessed with the SEM Scanner. Each of three operators utilized each of three devices to collect readings from four anatomical sites (sternum, sacrum, left and right heels) on each subject for a total of 108 readings per subject collected over approximately 30 min. For each combination of operator-device-anatomical site, three SEM readings were collected. Inter-operator and inter-device agreement and reliability were estimated.ResultsOver the course of this study, more than 3000 SEM Scanner readings were collected. Agreement between operators was good with mean differences ranging from −0.01 to 0.11. Inter-operator and inter-device reliability exceeded 0.80 at all anatomical sites assessed.ConclusionThe results of this study demonstrate the high reliability and good agreement of the SEM Scanner across different operators and different devices. Given the limitations of current methods to prevent and detect pressure ulcers, the SEM Scanner shows promise as an objective, reliable tool for assessing the presence or absence of pressure-induced tissue damage such as pressure ulcers

How do pharmacists in English general practices identify their impact? An exploratory qualitative study of measurement problems

Background: In England, there is an ongoing national pilot to expand pharmacists’ presence in general practice. Evaluation of the pilot includes numerical and survey-based Key Performance Indicators (KPIs) and requires pharmacists to electronically record their activities, possibly by using activity codes. At the time of the study (2016), no national evaluation of pharmacists’ impact in this environment had been formally announced. The aim of this qualitative study was to identify problems that English pharmacists face when measuring and recording their impact in general practice. Methods: All pharmacists, general practitioners (GPs) and practice managers working across two West London pilot sites were invited, via e-mail, to participate in a focus group study. Appropriately trained facilitators conducted two audio-recorded, semi-structured focus groups, each lasting approximately one hour, to explore experiences and perceptions associated with the KPIs. Audio-recordings were transcribed verbatim and the data analysed thematically. Results: In total, 13 pharmacists, one GP and one practice manager took part in the study. Four major themes were discerned: inappropriateness of the numerical national KPIs (“whether or not we actually have positive impact on KPIs is beyond our control”); depth and breadth of pharmacists’ activity (“we see a huge plethora of different patients and go through this holistic approach - everything is looked at”); awareness of practice based pharmacists’ roles (“I think the really important [thing] is that everyone knows what pharmacists in general practice are doing”); and central evaluation versus local initiatives (“the KPIs will be measured by National Health Service England regardless of what we think” versus “what I think is more pertinent, are there some local things we’re going to measure?”). Conclusions: Measures that will effectively capture pharmacists’ impact in general practice should be developed, along with a set of codes reflecting the whole spectrum of pharmacists’ activities. Our study also points out the significance of a transparent, robust national evaluation, including exploring the needs/expectations of practice staff and patients regarding pharmacists’ presence in general practice

Age-related macular degeneration in a randomized controlled trial of low-dose aspirin: Rationale and study design of the ASPREE-AMD study

Purpose: Although aspirin therapy is used widely in older adults for prevention of cardiovascular disease, its impact on the incidence, progression and severity of age-related macular degeneration (AMD) is uncertain. The effect of low-dose aspirin on the course of AMD will be evaluated in this clinical trial. Design: A sub-study of the ‘ASPirin in Reducing Events in the Elderly’ (ASPREE) trial, ASPREE-AMD is a 5-year follow-up double-blind, placebo-controlled, randomized trial of the effect of 100 mg daily aspirin on the course of AMD in 5000 subjects aged 70 years or older, with normal cognitive function and without cardiovascular disease at baseline. Non-mydriatic fundus photography will be performed at baseline, 3-year and 5-year follow-up to determine AMD status. Primary outcome measures: The incidence and progression of AMD. Exploratory analyses will determine whether aspirin affects the risk of retinal hemorrhage in late AMD, and whether other factors, such as genotype, systemic disease, inflammatory biomarkers, influence the effect of aspirin on AMD. Conclusion: The study findings will be of significant clinical and public interest due to a potential to identify a possible low cost therapy for preventing AMD worldwide and to determine risk/benefit balance of the aspirin usage by the AMD-affected elderly. The ASPREE-AMD study provides a unique opportunity to determine the effect of aspirin on AMD incidence and progression, by adding retinal imaging to an ongoing, large-scale primary prevention randomized clinical trial

Public–Private Partnership in Tunisia: Enfidha Airport Assessment of an Infrastructure Achievement

One of the largest recent private-sector investments and the first airport private-sector concession in the Maghreb is Enfidha Airport, a key factor in the success of the Tunisian Government’s public– private partnership (PPP) strategy. However, since Tunisia’s Jasmine Revolution, political and social turmoil is sweeping the country and worsening the economic indicators. This article aims to assess this PPP infrastructure, allowing us to determine if it is profitable in the long term and contributes therefore to the economic growth. The case study reveals the key role of the economic, social, and political environment in Tunisia, the dawn of the Arab Spring