Feasibility and design of a tertiary education entitlement in Australia

Overview: This report to the Mitchell Institute presents the outcomes of modelling the potential costs of an income contingent loan (ICL) that would form a core element of a tertiary education entitlement, as proposed in the February 2015 Mitchell Institute paper Financing tertiary education in Australia – the reform imperative and rethinking student entitlements by Mitchell Professorial Fellow Peter Noonan and Mitchell Policy Analyst Sarah Pilcher. This report, Feasibility and design of a tertiary education entitlement in Australia: Modelling and costing a universal income contingent loan, models the costs of a single income contingent loans scheme for higher education and vocational education and training (VET) students. It seeks to quantify the largely hidden subsidies involved in income contingent loans through unpaid debt and the difference between the rate at which debt is indexed and the costs to government of borrowing to finance student debt.  Feasibility and design of a tertiary education entitlement in Australia: Modelling and costing a universal income contingent loan has been prepared by Dr Timothy Higgins and Professor Bruce Chapman, two of Australia’s leading experts on the design of income contingent loans. Background Feasibility and design of a tertiary education entitlement in Australia presents the outcomes of various financial modelling of the potential costs of applying an income contingent loan scheme to include all tertiary education students in Australia. The modelling maps students’ projected incomes by qualification level, finding significant variation in lifetime incomes across VET and higher education qualifications. At present, there are a range of different income contingent loan schemes operating in Australia’s higher education and VET sectors. Under such schemes, students are not required to pay the upfront cost of their course. Instead, they are able to take out a loan with the government and repay the loan through the taxation system once they enter the workforce and their incomes reach a certain threshold. But these loans are not available to all students. In the VET system, those studying for Certificate III and most Certificate IV VET courses, for example, early childhood education, aged care, and hospitality, do not have access to an income contingent loan. These students must pay the cost of their course upfront – a potential barrier as fees for many of these courses are increasing.   The Mitchell Institute will draw on the Higgins and Chapman report to finalise its proposal for an integrated tertiary education funding system in Australia

Income Contingent Loans for Paid Parental Leave

In early 2008 the federal government instructed the Productivity Commission (PC) to enquire into the social and economic policy issue of paid parental leave (PPL). In their draft report, the PC (2008) has called for a taxpayer funded scheme of 18 weeks duration, despite Australian governments having so far resisted the introduction of a broad grants-based system. A case for government subsidy of PPL can be made on the basis that the social benefits exceed the advantages accruing directly to families. However, as there are also indisputable private benefits accruing to the parents taking leave, there is a case for private contributions. We identify a market failure in that commercial banks will not provide funds in the absence of collateral due to repayment uncertainty during parental leave, a situation quite similar to the market failure inherent with respect to the financing of tuition for higher education (Gans, 2008). To address this financing impasse, we consider how an income contingent loan (ICL) could be used as an optional supplement to a taxpayer funded PPL scheme. Moral hazard and adverse selection are critical policy issues and these are addressed in the scheme design by: restricting loan duration and size; restricting eligibility to parents with workforce attachment; reducing minimum repayment thresholds to below those of HECS; imposing a loan surcharge, and; making the debt an obligation of both parents. We explain and present simulations of debt, repayment and subsidies for different households. The results show that an optional top-up ICL would not require major contributions from taxpayers, yet would introduce flexibility and choice, and provide consumption-smoothing and lifetime income distribution advantages over possible alternatives.paid parental leave; income contingent loans; public policy; industrial relations

Kelp Bed Expansion at Edmonds Underwater Park

Edmonds Underwater Park in Puget Sound just north of the Edmonds Ferry Terminal contains extensive bull kelp (Nereocystist sp.) bed in the north east corner. Kelp grows on a natural gravelly substrate but most of the Park has a sand bottom. Kelp also grows on some of the artificial structures placed in the Park but not in a dense pattern like in the northeast corner. Beginning in 1999 we began a series of efforts to encourage the kelp to grow farther south in the Park. We have employed two basic techniques: an Oasis approach and a Linear approach. We started with the Oasis approach creating rock/concrete mounds, cairns, to scope out suitable sites. Once we had a positive response from the Oasis effort we could ramp things up. We then tried our hand at Linear structures following depth contours from rock / concrete rubble to extend the kelp pattern. Our success has been using native rocks as well as recycled ones from prior features and infrastructure to support our continued progress. Diver surveys of the existing kelp bed and the areas deeper and in each direction along shore were made to explore what options might be available. We began with three Oasis features: The Zig-Zag, a 70 foot long split rail fence shaped structure (1999); The Erratics, 15 cairns in a 20 foot grid pattern (2003-5); Matt’s Place which is a series of cairns placed on foundation pieces to help reduce material subsidence (2009-12). These were followed up with a low New England styled rock wall which stretches 500 feet following the – 12 foot (MLLW) contour (still in progress). We have started efforts to connect the rock wall with the Erratics with additional cairns. To support this effort we have placed two diver trails along the bottom; Glacier Way which is about 1,000 feet and Rocky Road which is about 750 feet long to assist with construction and follow-on assessment. The trails were located to avoid running through eel grass beds closer to shore. The proof has been in the kelp’s favorable response to the rock wall and Matt’s Place. We had a scattered response to the Oasis approach at the other sites with kelp growth but not annually. The rockfish seem to be enjoying the cairns and the lingcod have used them as nesting sites over the years. The red algae (for example Chondracanthus sp. Turkish Towel and Cryptopleura sp. Hidden Rib) enjoy the block and rope trails masking it from sight with lush growth late in the season. The only down side to the success is the continued presence of the warty kelp condition (a Streblonema-like endophyte) seems to persist consistently in the Park. This effort has been supported seasonally by the Edmonds Underwater Park Volunteers with cooperation from the City of Edmonds

The Discourse of Management and the Management of Discourse

Discourse is a pervasive tool of management; one might even say that discourse is what managers do. A widespread assumption among managers is that discourse is not only a pervasive tool, but an effective one for precise communication of information, for making decisions, and for enlisting action, essentially a transmission tool. This paper maintains that the transmission view is a limited conception of language use, one which leads to a faulty conception of what managers do. It ignores the need for an ethics of communication and misjudges the creative aspects of language use. Management discourse is a far more complex and fluid phenomenon, one requiring not just effective use, but management itself. In other words consideration of the discourse of management leads us to the need for the management of discourse.

Introduction and Summary

This chapter is an introduction to and summary of "Income Contingent Loans: Theory, Practice and Prospects." An International Economics Association workshop on the broad topic of ICL (income congruent loan) was held at Dhurakij Pundit University in Bangkok in April 2013 with Professors Joseph E. Stiglitz and Bruce Chapman. This workshop covered: the conceptual and theoretical underpinnings of ICL; the costs and benefits of different types of higher education student loans; and potential contingent loan policy applications beyond higher education. A number of participants presented commentary during and after the workshop, summarising their thoughts on the discussion, and examining, among other things, advantages and disadvantages of particular features of different ICL programs, lessons learned, unresolved questions, and future prospects and challenges. This volume contains revised versions of the presentations and commentaries presented at the workshop

A comparison of vertical drift‐envelopes to conventional drift‐bottles

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109919/1/lno19752010141.pd

The development and optimisation of a primary care-based whole system complex intervention (CARE Plus) for patients with multimorbidity living in areas of high socioeconomic deprivation

<B>OBJECTIVES</B> To develop and optimise a primary care-based complex intervention (CARE Plus) to enhance the quality of life of patients with multimorbidity in the deprived areas. <B>METHODS</B> Six co-design discussion groups involving 32 participants were held separately with multimorbid patients from the deprived areas, voluntary organisations, general practitioners and practice nurses working in the deprived areas. This was followed by piloting in two practices and further optimisation based on interviews with 11 general practitioners, 2 practice nurses and 6 participating multimorbid patients. <B>RESULTS</B> Participants endorsed the need for longer consultations, relational continuity and a holistic approach. All felt that training and support of the health care staff was important. Most participants welcomed the idea of additional self-management support, though some practitioners were dubious about whether patients would use it. The pilot study led to changes including a revised care plan, the inclusion of mindfulness-based stress reduction techniques in the support of practitioners and patients, and the stream-lining of the written self-management support material for patients. <B>DISCUSSION</B> We have co-designed and optimised an augmented primary care intervention involving a whole-system approach to enhance quality of life in multimorbid patients living in the deprived areas. CARE Plus will next be tested in a phase 2 cluster randomised controlled trial

Dementia assessment and management in primary care settings: a survey of current provider practices in the United States.

BACKGROUND:Primary care providers (PCPs) are typically the first to screen and evaluate patients for neurocognitive disorders (NCDs), including mild cognitive impairment and dementia. However, data on PCP attitudes and evaluation and management practices are sparse. Our objective was to quantify perspectives and behaviors of PCPs and neurologists with respect to NCD evaluation and management. METHODS:A cross-sectional survey with 150 PCPs and 50 neurologists in the United States who evaluated more than 10 patients over age 55 per month. The 51-item survey assessed clinical practice characteristics, and confidence, perceived barriers, and typical practices when diagnosing and managing patients with NCDs. RESULTS:PCPs and neurologists reported similar confidence and approaches to general medical care and laboratory testing. Though over half of PCPs performed cognitive screening or referred patients for cognitive testing in over 50% of their patients, only 20% reported high confidence in interpreting results of cognitive tests. PCPs were more likely to order CT scans than MRIs, and only 14% of PCPs reported high confidence interpreting brain imaging findings, compared to 70% of specialists. Only 21% of PCPs were highly confident that they correctly recognized when a patient had an NCD, and only 13% were highly confident in making a specific NCD diagnosis (compared to 72 and 44% for neurologists, both p < 0.001). A quarter of all providers identified lack of familiarity with diagnostic criteria for NCD syndromes as a barrier to clinical practice. CONCLUSIONS:This study demonstrates how PCPs approach diagnosis and management of patients with NCDs, and identified areas for improvement in regards to cognitive testing and neuroimaging. This study also identified all providers' lack of familiarity with published diagnostic criteria for NCD syndromes. These findings may inform the development of new policies and interventions to help providers improve the efficacy of their decision processes and deliver better quality care to patients with NCDs

Combination formoterol and inhaled steroid versus beta(2)-agonist as relief medication for chronic asthma in adults and children (Review)

Background Formoterol has a fast onset of action and can therefore be used to relieve symptoms of asthma. A combination inhaler can deliver formoterol with different doses of inhaled corticosteroid; when used as a reliever both drugs will be delivered more frequently when asthma symptoms increase. This has the potential to treat both bronchoconstriction and inflammation in the early stages of exacerbations. Objectives To assess the efficacy and safety of combined inhalers containing both formoterol and an inhaled corticosteroid when used for reliever therapy in adults and children with chronic asthma. Search methods We last searched the Cochrane Airways Group trials register in April 2009, and no new studies were found for inclusion in the review. Selection criteria Randomised trials in adults and children with chronic asthma, where a combination inhaler containing formoterol and inhaled corticosteroid is compared with fast-acting beta2-agonist alone for the relief of asthma symptoms. This should be the only planned difference between the trial arms. Data collection and analysis Two review authors independently extracted the characteristics and results of each study. Authors or manufacturers were asked to supply unpublished data in relation to primary outcomes. Main results Three trials involving 5905 participants were included. In patients with mild asthma who do not need maintenance treatment, no clinically important advantages of budesonide/formoterol as reliever were found in comparison to formoterol as reliever. Two studies enrolled patients with more severe asthma who were not controlled on high doses of inhaled corticosteroids (around 700 mcg/day in adults), and had suffered a clinically important asthma exacerbation in the past year. Hospitalisations related to asthma in the two studies comparing budesonide/formoterol for maintenance and relief with the same dose of budesonide/formoterol for maintenance with terbutaline for relief yielded an odds ratio of 0.68 (95% CI 0.40 to 1.16), which was not a statistically significant reduction. In adults there was a reduction in exacerbations requiring oral corticosteroids compared to terbutaline, odds ratio 0.54 (95% CI 0.44 to 0.65), which translates into a number needed to treat over 12 months of 15 (95% CI 13 to 21). The study in children found less serious adverse events with budesonide/formoterol used for maintenance and relief. There was no significant difference in annual growth in children using budesonide/formoterol reliever in comparison to terbutaline. Authors’ conclusions In mild asthma it is not yet known whether patients who use a budesonide/formoterol inhaler for relief of asthma symptoms derive any clinically important benefits. In more severe asthma, two studies enrolled patients who were not controlled on inhaled corticosteroids, and had suffered an exacerbation in the previous year, and then had their maintenance inhaled corticosteroids reduced in both arms of the study. Under these conditions the studies demonstrated a reduction in the risk of exacerbations that require oral corticosteroids with budesonide/formoterol for maintenance and relief in comparison with budesonide/formoterol for maintenance and terbutaline or formoterol for relief. The incidence of serious adverse events in children was also less using budesonide/formoterol for maintenance and relief in one study, which similarly enrolled children who were not controlled on inhaled corticosteroids, and who had their maintenance inhaled corticosteroids reduced at the start of the study. This study also compared an explorative maintenance dose of budesonide/formoterol that is not approved for treatment