Where have all the Linkages Gone? Staples in the Ghanaian Economy

SUMMARY There has been renewed interest in the relevance of the growth of a staple export trade to development. The staple is supposed to stimulate growth through technical, market and fiscal linkages. Some of this theoretical literature is reviewed in the light of a recent article by A. O. Hirschman. Ghana contains both ‘peasant’ and ‘enclave’ type export industries and their linkage effects are compared and contrasted. RESUME Où sont passèes toutes les liaisons? Matières premières dans I'economie ghaneenne II y a un relent d'intérêt pour le développement des exportations de matières premières en tant que facteur de développement. Les matières premières sont supposées stimuler le développement en créant des liaisons techniques, commerciales et fiscales. Certains de ces concepts théoriques sont revus à la lumière d'un récent article par A. O. Hirschman. Le Ghana a des industries d'exportation de type “paysan” et de type “enclave” et l'auteur compare leurs effets de liaison. RESUMEN Donde han ido a parar todos los enlaces? Productos basicos en la economí de Ghana Ha habido un interés renovado en la importancia del crecimiento de un comercio básico de exportación en función al desarrollo. Se supone que esta base estimule el crecimiento a través de enlaces técnicos, comerciales y fiscales. Se vuelve a examinar parte de esta literatura teórica en vista de un artículo publicado recientemente por A. O. Hirschman. Ghana tiene industrias de exportación tanto tradicionales como modernas, y se compara y contrasta sus efectos de enlace

Housing Affordability in Australia: The National Rental Affordability Scheme v. Public Housing and Welfare Programs

ABSTRACT The National Rental Affordability Scheme (NRAS) was introduced by the Federal Government of Australia, on the 1 st July 2008. Whilst the primary aim of the scheme is to provide new dwellings for low to middle income Australian families, there is also the added bonus of a tax incentive program for property investors. In contrast, whilst public housing and welfare programs are not accompanied by tax incentives for property investors, these are also generally considered as suitable options for providing affordable rental housing. The purpose of this research paper is to undertake a comparison of NRAS against other welfare programs, such as public housing and to evaluate the long term viability of these programs and schemes. It is argued, that in the long term, schemes such as NRAS, which are accompanied by tax incentives for property investors, are able to provide a more permanent solution to the housing rental affordability issues within Australia

Past, present and future challenges in health care priority setting:findings from an international expert survey

Purpose Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a “magic bullet” is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues. Design/methodology/approach An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015. Findings “Decision-making frameworks” and “Engagement” were the two most frequently mentioned notable achievements. “Priority setting in practice” and “Awareness and education” were the two most frequently mentioned policy and practical challenges. “Priority setting in practice” and “Engagement” were the two most frequently mentioned areas in need of future research. Research limitations/implications Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly. Practical implications Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area. Originality/value Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges. </jats:sec

Outcome Measurement in Economic Evaluations of Public Health Interventions: a Role for the Capability Approach?

Public health interventions have received increased attention from policy makers, and there has been a corresponding increase in the number of economic evaluations within the domain of public health. However, methods to evaluate public health interventions are less well established than those for medical interventions. Focusing on health as an outcome measure is likely to underestimate the impact of many public health interventions. This paper provides a review of outcome measures in public health; and describes the benefits of using the capability approach as a means to developing an all encompassing outcome measure

Measuring Health Spillovers for Economic Evaluation:A Case Study in Meningitis

The health of carers and others close to the patient will often be relevant to economic evaluation, but it is very rarely considered in practice. This may reflect a lack of understanding of how the spillover effect of illness can be appropriately quantified. In this study we used three different approaches to quantify health spillovers resulting from meningitis. We conducted a survey of 1218 family networks affected by meningitis and used regression modelling to estimate spillover effects. The findings show that meningitis had long-term effects on family members' health, particularly affecting the likelihood of family members reporting anxiety and depression. These effects extended beyond a single close family member. These findings suggest that vaccinating against meningitis will bring significant health benefits not just to those that might have contracted the illness but also to their family networks. In methodological terms, different approaches for quantifying health spillovers provided broadly consistent results. The choice of method will be influenced by the ease of collecting primary data from family members in intervention contexts

Can improving working memory prevent academic difficulties? A school based randomised controlled trial.

BACKGROUND: Low academic achievement is common and is associated with adverse outcomes such as grade repetition, behavioural disorders and unemployment. The ability to accurately identify these children and intervene before they experience academic failure would be a major advance over the current 'wait to fail' model. Recent research suggests that a possible modifiable factor for low academic achievement is working memory, the ability to temporarily store and manipulate information in a 'mental workspace'. Children with working memory difficulties are at high risk of academic failure. It has recently been demonstrated that working memory can be improved with adaptive training tasks that encourage improvements in working memory capacity. Our trial will determine whether the intervention is efficacious as a selective prevention strategy for young children at risk of academic difficulties and is cost-effective. METHODS/DESIGN: This randomised controlled trial aims to recruit 440 children with low working memory after a school-based screening of 2880 children in Grade one. We will approach caregivers of all children from 48 participating primary schools in metropolitan Melbourne for consent. Children with low working memory will be randomised to usual care or the intervention. The intervention will consist of 25 computerised working memory training sessions, which take approximately 35 minutes each to complete. Follow-up of children will be conducted at 6, 12 and 24 months post-randomisation through child face-to-face assessment, parent and teacher surveys and data from government authorities. The primary outcome is academic achievement at 12 and 24 months, and other outcomes include child behaviour, attention, health-related quality of life, working memory, and health and educational service utilisation. DISCUSSION: A successful start to formal learning in school sets the stage for future academic, psychological and economic well-being. If this preventive intervention can be shown to be efficacious, then we will have the potential to prevent academic underachievement in large numbers of at-risk children, to offer a ready-to-use intervention to the Australian school system and to build international research partnerships along the health-education interface, in order to carry our further studies of effectiveness and generalisability.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

On the study of the effects of sea views, greenery views and personal characteristics on noise annoyance perception at homes

Noise annoyance has caused significant adverse impacts on human beings and numerous efforts have been spent on mitigating annoyance problems. Natural greenery has been shown to be able to moderate annoyance problems at home but this conclusion was drawn without properly controlling the potential confounding factors. Furthermore, few have explored the moderation effect of a sea view. Accordingly, this study formulated a multivariate model to examine the impacts of natural views as well as personal characteristics on annoyance perception. A housing estate was selected in Hong Kong as the survey site for which some of the residents were exposed to greenery views, sea views, or both from their homes. Eight hundred and sixty-one responses were collected via questionnaire surveys and analyzed using an ordered logit model. The results suggest that both a greenery view and a sea view can moderate annoyance responses. Several individual’s personal characteristics are found to affect individuals’ annoyance perception. The duration of time spent daily at home is shown to have an influence on the moderation impact exerted by a greenery view, while the age of an individual is shown to have an influence on noise moderation effect exerted by a sea view.Department of Building Services Engineerin

Preventing mental health problems in children : the families in mind population-based cluster randomised controlled trial.

BackgroundExternalising and internalising problems affect one in seven school-aged children and are the single strongest predictor of mental health problems into early adolescence. As the burden of mental health problems persists globally, childhood prevention of mental health problems is paramount. Prevention can be offered to all children (universal) or to children at risk of developing mental health problems (targeted). The relative effectiveness and costs of a targeted only versus combined universal and targeted approach are unknown. This study aims to the effectiveness, costs and uptake of two approaches to early childhood prevention of mental health problems ie: a Combined universal-targeted approach, versus a Targeted only approach, in comparison to current primary care services (Usual care).DesignThree armed, population-level cluster randomised trial (2010-2014) within the universal, well child Maternal Child Health system, attended by more than 80% of families in Victoria, Australia at infant age eight months. Participants: Families of eight month old children from nine participating local government areas. Randomised to one of three groups: Combined, Targeted or Usual care. Intervention: (a) the Combined universal and targeted program where all families are offered the universal Toddlers Without Tears group parenting program followed by the targeted Family Check-Up one-on-one program or (b) the Targeted Family Check-Up program. The Family Check-Up program is only offered to children at risk of behavioural problems. Analysis: Participants will be analysed according to the trial arm to which they were randomised, using logistic and linear regression models to compare primary and secondary outcomes. An economic evaluation (cost consequences analysis) will compare incremental costs to all incremental outcomes from a societal perspective.DiscussionThis trial will inform public health policy by making recommendations about the effectiveness and cost-effectiveness of these early prevention programs. If effective prevention programs can be implemented at the population level, the growing burden of mental health problems could be curbed.<br /

An observational cohort study to produce and evaluate an improved tool to screen older women with back pain for osteoporotic vertebral fractures (Vfrac): study protocol.

The aim of this study is to produce an easy to use checklist for general practitioners to complete whenever a woman aged over 65 years with back pain seeks healthcare. This checklist will produce a binary output to determine if the patient should have a radiograph to diagnose vertebral fracture. PURPOSE: People with osteoporotic vertebral fractures are important to be identified as they are at relatively high risk of further fractures. Despite this, less than a third of people with osteoporotic vertebral fractures come to clinical attention due to various reasons including lack of clear triggers to identify who should have diagnostic spinal radiographs. This study aims to produce and evaluate a novel screening tool (Vfrac) for use in older women presenting with back pain in primary care based on clinical triggers and predictors identified previously. This tool will generate a binary output to determine if a radiograph is required. METHODS: The Vfrac study is a two-site, pragmatic, observational cohort study recruiting 1633 women aged over 65 years with self-reported back pain. Participants will be recruited from primary care in two sites. The Vfrac study will use data from two self-completed questionnaires, a simple physical examination, a lateral thoracic and lateral lumbar radiograph and information contained in medical records. RESULTS: The primary objective is to develop an easy-to-use clinical screening tool for identifying older women who are likely to have vertebral fractures. CONCLUSIONS: This article describes the protocol of the Vfrac study; ISRCTN16550671