Factors affecting retention of allied health professionals working with people with disability in rural New South Wales, Australia: discrete choice experiment questionnaire development

Objective: This paper describes the development of a discrete choice experiment (DCE) questionnaire to identify the factors (attributes) that allied health professionals (AHPs) working with people with disability identify as important to encouraging them to remain practising in rural areas. Methods: Focus groups and semi-structured interviews were conducted with 97 purposively selected service providers working with people with disability in rural New South Wales, Australia. Focus groups and interviews were digitally recorded, transcribed, and analysed using a modified grounded theory approach involving thematic analysis and constant comparison. Results: Six attributes that may influence AHPs working with people with disability in rural areas to continue to do so were inductively identified: travel arrangements, work flexibility, professional support, professional development, remuneration, and autonomy of practice. The qualitative research information was combined with a policy review to define these retention factors and ensure that they are amenable to policy changes. Conclusion: The use of various qualitative research methods allowed the development of a policy-relevant DCE questionnaire that was grounded in the experience of the target population (AHPs)

Carers\u27 preferences for the delivery of therapy services for people with disability in rural Australia: Evidence from a discrete choice experiment

Background: The implementation of the Australian National Disability Insurance Scheme (NDIS) is expected to generate a responsive, person-centred system that will empower people with disability to choose the services and support they receive. However little attention has been paid to examine how users of the NDIS will choose and spend their individual budgets. This study aimed to determine quantitatively the relative importance that carers of people with a disability living in rural Australia place on different therapy service delivery characteristics. Methods: A stated preference discrete choice experiment (DCE) was incorporated into a survey of carers of people with disability living in rural Australia. Carers chose between therapy delivery services differing in attributes such as travel time to receive therapy, sector providing the service (i.e. Government, not-for-profit, private), out-of-pocket costs, person who delivers the therapy (therapist or other staff) and waiting time. Results: A total of 133 carers completed the DCE. The majority of respondents cared for a child with a disability (84%), the average age of the person they cared for was 17 years (SD 14.25). Participants expressed strong preferences for a short waiting time (0-3 months) to receive therapy services; services delivered by a therapist, no out of pocket cost and travelling up to 4 hours to receive a therapy session (p Conclusion: Carers of people with a disability in rural Australia exhibited strongest preferences for short waiting times (0-3 months). Therapy services that are delivered by therapy assistants or support workers will require careful introduction to achieve uptake and acceptability

Should I stay or should I go? Exploring the job preferences of allied health professionals working with people with disability in rural Australia

Introduction: The uneven distribution of allied health professionals (AHPs) in rural and remote Australia and other countries is well documented. In Australia, like elsewhere, service delivery to rural and remote communities is complicated because relatively small numbers of clients are dispersed over large geographic areas. This uneven distribution of AHPs impacts significantly on the provision of services particularly in areas of special need such as mental health, aged care and disability services. Objective: This study aimed to determine the relative importance that AHPs (physiotherapists, occupational therapists, speech pathologists and psychologists – “therapists”) living in a rural area of Australia and working with people with disability, place on different job characteristics and how these may affect their retention. Methods: A cross-sectional survey was conducted using an online questionnaire distributed to AHPs working with people with disability in a rural area of Australia over a 3-month period. Information was sought about various aspects of the AHPs’ current job, and their workforce preferences were explored using a best–worst scaling discrete choice experiment (BWSDCE). Conditional logistic and latent class regression models were used to determine AHPs’ relative preferences for six different job attributes. Results: One hundred ninety-nine AHPs completed the survey; response rate was 51 %. Of those, 165 completed the BWSDCE task. For this group of AHPs, “high autonomy of practice” is the most valued attribute level, followed by “travel BWSDCE arrangements: one or less nights away per month”, “travel arrangements: two or three nights away per month” and “adequate access to professional development”. On the other hand, the least valued attribute levels were “travel arrangements: four or more nights per month”, “limited autonomy of practice” and “minimal access to professional development”. Except for “some job flexibility”, all other attributes had a statistical influence on AHPs’ job preference. Preferences differed according to age, marital status and having dependent children. Conclusions: This study allowed the identification of factors that contribute to AHPs’ employment decisions about staying and working in a rural area. This information can improve job designs in rural areas to increase retention

An Experimental Investigation of the Scaling of Columnar Joints

Columnar jointing is a fracture pattern common in igneous rocks in which cracks self-organize into a roughly hexagonal arrangement, leaving behind an ordered colonnade. We report observations of columnar jointing in a laboratory analog system, desiccated corn starch slurries. Using measurements of moisture density, evaporation rates, and fracture advance rates as evidence, we suggest an advective-diffusive system is responsible for the rough scaling behavior of columnar joints. This theory explains the order of magnitude difference in scales between jointing in lavas and in starches. We investigated the scaling of average columnar cross-sectional areas due to the evaporation rate, the analog of the cooling rate of igneous columnar joints. We measured column areas in experiments where the evaporation rate depended on lamp height and time, in experiments where the evaporation rate was fixed using feedback methods, and in experiments where gelatin was added to vary the rheology of the starch. Our results suggest that the column area at a particular depth is related to both the current conditions, and hysteretically to the geometry of the pattern at previous depths. We argue that there exists a range of stable column scales allowed for any particular evaporation rate.Comment: 12 pages, 11 figures, for supporting online movies, go to http://www.physics.utoronto.ca/nonlinear/movies/starch_movies.htm

Decarbonisation at home: The contingent politics of experimental domestic energy technologies

This is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this recordPolicy efforts to reduce the carbon intensity of domestic energy consumption have, over the last three decades, been dominated by an almost dichotomous reading of the relationship between technology and social change. On the one hand, there is a conception of personal responsibility that constructs domestic energy users as key actors in the adoption and (appropriate) use of low carbon energy technologies; from this perspective, environmental change becomes a matter of mobilising personal capacities such that individuals make better choices. On the other hand, decarbonising homes is conceived to be an outcome of top-down infrastructural interventions, with householders (or end users) positioned as relatively passive agents who will respond to engineered efficiency in linear and predictable ways. In practice, both positions have been found wanting in terms of accounting for how (and why) change happens and in turn delivering on ambitious policy goals. The argument we develop in this article goes beyond critiquing these problematic framings of technology and the locus of agency. Drawing on three contrasting low carbon energy technology projects in the UK, we present an alternative perspective which foregrounds a more experimental, ad hoc and ultimately provisional mode of governing with domestic energy technologies. We reflect on the meaning and political implications of this experimental turn in transforming (and decarbonising) domestic energy practices.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research on which this paper is based was funded by a grant from EON/EPSRC (EP/G000395/1)

ASD intervention research in real world contexts: Refining single case designs

Abstract: There is a pressing need for intervention research that reflects real world practice to support evidence based decision making for families, professionals and administrators who support children with ASD. Some of the challenges confronting intervention research are explored, with solutions offered based on single case design methodology. Challenges with single case designs are also outlined and contemporary solutions that are applicable in real world contexts are illustrated in a study by the authors. Research utilizing these strategies may assist with facilitating practitioners to engage in practice-based research to bridge the research to practice gap in intervention with young children with ASD

Beyond the public and private divide: Remapping transnational climate governance in de 21th century

This article provides a first step towards a better theoretical and empirical knowledge of the emerging arena of transnational climate governance. The need for such a re-conceptualization emerges from the increasing relevance of non-state and transnational approaches towards climate change mitigation at a time when the intergovernmental negotiation process has to overcome substantial stalemate and the international arena becomes increasingly fragmented. Based on a brief discussion of the increasing trend towards transnationalization and functional segmentation of the global climate governance arena, we argue that a remapping of climate governance is necessary and needs to take into account different spheres of authority beyond the public and international. Hence, we provide a brief analysis of how the public/private divide has been conceptualized in Political Science and International Relations. Subsequently, we analyse the emerging transnational climate governance arena. Analytically, we distinguish between different manifestations of transnational climate governance on a continuum ranging from delegated and shared public-private authority to fully non-state and private responses to the climate problem. We suggest that our remapping exercise presented in this article can be a useful starting point for future research on the role and relevance of transnational approaches to the global climate crisis

Planning for Sustainability in Small Municipalities: The Influence of Interest Groups, Growth Patterns, and Institutional Characteristics

How and why small municipalities promote sustainability through planning efforts is poorly understood. We analyzed ordinances in 451 Maine municipalities and tested theories of policy adoption using regression analysis.We found that smaller communities do adopt programs that contribute to sustainability relevant to their scale and context. In line with the political market theory, we found that municipalities with strong environmental interests, higher growth, and more formal governments were more likely to adopt these policies. Consideration of context and capacity in planning for sustainability will help planners better identify and benefit from collaboration, training, and outreach opportunities

Subnational climate entrepreneurship: innovative climate action in California and São Paulo

The distinct role of subnational governments such as states and provinces in addressing climate change has been increasingly acknowledged. But while most studies investigate the causes and consequences of particular governments’ actions and networking activities, this article argues that subnational governments can develop climate action as a collective entrepreneurial activity. Addressing many elements explored in this special issue, it focuses on the second question and identifies climate entrepreneurship in two subnational governments—the states of California (USA) and São Paulo (Brazil). Examining internal action, as well as interaction with local authorities, national governments and the international regime, entrepreneurial activities are identified in the invention, diffusion and evaluation of subnational climate policy in each case. The article draws from the recent scholarship on policy innovation, entrepreneurship and climate governance. It contributes to the literature by exploring entrepreneurial subnational government activity in addressing climate change and expanding the understanding of the effects of policy innovation at the subnational level