Enabling prosperity: success factors in Indigenous economic development

Public discussion about ‘closing the gap’ between Indigenous and non-Indigenous Australians tends to focus on measures such as life expectancy, child mortality, early childhood education, literacy and numeracy, and employment.  These are, rightly, essential markers of health and well-being for all people, and for decades they have provided evidence that Australia’s health and social systems have not met the needs of Indigenous Australians. However, there is another story, one that focuses on the measures of success, as evident in the many thriving Indigenous businesses and corporations around the country.  Across Australia, there is a growing story of economic security and success, in which Indigenous Australians are creating enterprises combining sound business principles with strong cultural and social foundations for the benefit of individuals, families and communities. Urbis was commissioned by Westpac to undertake research into Indigenous business development, to provide an evidence base to support the work of the Empowered Communities group. The report, Enabling Prosperity: Success Factors in Indigenous Economic Development, suggests that these factors are much the same as for any other businesses: human capital, access to capital and markets, infrastructure, location and an authorising environment created through government policy and regulation. In practice, businesses succeed because of more than one factor, and multiple factors can strengthen the capacity of a business to grow and develop.  For instance, access to capital often relies on the development of successful partnerships, while ownership of land and resources requires human capital to realise its potential. Indigenous culture can be both a support and a resource. Individual attitude and vision are also essential ingredients in business success, while government plays an important role in ensuring the regulatory environment enables rather than hinders business efforts. Much can be learned by examining successful Indigenous businesses both in Australia and internationally. Businesses are the key driver for wealth creation, helping to provide job opportunities and improve social and economic conditions. Fostering business success, therefore, has the potential to increase employment, improve living standards, and contribute to stable and nurturing communities. Current government policy frameworks, such as the Indigenous Economic Development Strategy, are largely focused on increasing education and training and generating opportunities for private sector employment and enterprise.  This is important. Just as important is the contribution that successful community or non-profit enterprises can make in providing employment, generating business investment for growth, building partnerships and demonstrating positive role models. The Empowered Communities group is such a national initiative. Formed in 2013, the group brings together Indigenous leaders from eight communities across Australia and seeks to strengthen Indigenous individuals and communities through a range of activities (see https://empoweredcomms.wordpress.com for more information). Strategies that strengthen both individual and community business initiatives will help to ensure that more Indigenous Australians have the opportunity to live successful and productive lives.  Everyone has a contribution to make in this regard. Governments can create an enabling regulatory environment. Banks can enable access to capital. Local chambers of commerce can foster business development through support and networks for new entrepreneurs. Communities and individuals can purchase goods and services from Indigenous businesses. Building a strong and vibrant Indigenous business and social enterprise sector can then contribute to improving many of the health and social indicators, such as improving nutrition and healthy lifestyle choices, and increasing employment and education.  Efforts to improve Indigenous outcomes really are everyone’s business

Strategies for Enhancing Communication Between Students, Academics and Researchers Participating in Large-Scale Undergraduate Research Projects

Spreading the word about science and inspiring people to connect with the processes and outcomes of science, whether as researchers, educators, students, industry professionals or consumers, is essential in forging stronger links among scientists and with the communities that stand to benefit from their work. How do we nurture inspirational scientific communication in the context of university undergraduate science education, particularly in large cohort settings that are often more mind-numbing than soul-stirring? Communicating your own discoveries effectively is the zenith of scientific endeavour. We have developed a large-scale original research experience for second or third year undergraduate biomedical science students. The students undertake ‘mini’ projects and present their research outcomes verbally, visually and in a written format suitable for journal publication. This helps students understand how science works and develops their ability to explain scientific concepts to their peers and others. To promote ‘original research’ to students in ways that inspire and motivate participation, we have also evolved strategies to help instructors and researchers communicate successfully with large student cohorts, including a wiki for secure data storage, FAQ sheets and databases of bioinformatics tools. Introduction of the research experience has improved survey scores overall and on items relating to communication. These strategies are applicable to any course seeking to introduce students to the practice of research and communication of research outcomes. Our experience suggests optimal multidimensional communication may be best achieved through instructors, researchers and students working together to develop effective stratagems for surviving and thriving in the information-dense, digital world

Caracterização da seleção de medicamentos para a atenção primária no Brasil

Objetivo: caracterizar o processo de seleção de medicamentos na atenção primária à saúde, nas regiões brasileiras. Métodos: artigo integrante da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços 2015, um estudo transversal que envolveu o levantamento de informações numa amostra de municípios das cinco regiões do Brasil. Os dados utilizados foram coletados por meio de entrevistas com os responsáveis pela assistência farmacêutica (n = 506), profissionais que realizam a dispensação de medicamentos (n = 1.139) e médicos (n = 1.558). Para avaliar a diferença entre as proporções foi adotado o teste do qui-quadrado para amostras complexas. As diferenças entre as médias foram analisadas em modelos lineares generalizados, com teste F com correção de Bonferroni para comparações múltiplas. Foram significativas as análises com valores de p ≤ 0,05. Resultados: os responsáveis da assistência farmacêutica relataram não haver Comissão de Farmácia e Terapêutica formalmente constituída (12,5%). Eles afirmaram possuir uma Lista de Medicamentos Essenciais (85,3%) atualizada (80,4%), e serem participantes deste processo (88,2%). Contudo, na percepção dos entrevistados a Lista atende apenas parcialmente (70,1%) as demandas de saúde. Dos profissionais que realizam a dispensação de medicamentos entrevistados, apenas 16,6% eram farmacêuticos, mesmo assim, 47,8% referiram conhecer os procedimentos para mudança da lista. Na perspectiva da maior parte desses profissionais (70,9%), a lista atende as demandas de saúde do município. Dentre os médicos apenas 27,2% declararam ter conhecimento dos procedimentos para mudança da lista, mas 76,5% teriam alguma reivindicação de alteração. A maior parte reporta que baseia suas reivindicações em experiências clínicas (80,0%); para 13,0% deles, a lista atende às demandas de saúde. Conclusões: por tratar-se da primeira pesquisa nacional de caracterização do processo de seleção de medicamentos no âmbito da atenção primária à saúde, traz dados inéditos para a avaliação das políticas relacionadas com medicamentos no Brasil.Objetive: to characterize the process of selection of medicines for primary health care in the Brazilian regions. Methods: this article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional study that consisted of an information gathering in a sample of cities in the five regions of Brazil. The data used were collected by interviews with those responsible for pharmaceutical services (PS) (n = 506), professionals responsible for the dispensing of medicines (n = 1,139), and physicians (n = 1,558). To evaluate the difference between ratios, we adopted the Chi-square test for complex samples. The differences between the averages were analyzed in generalized linear models with F-test with Bonferroni correction for multiple comparisons. The analyses considered significant had p≤0.05. Results: the professionals responsible for pharmaceutical services reported non-existence of a formally constituted Pharmacy and Therapeutics Committee (PTC) (12.5%). They claimed to have an updated (80.4%) list of Essential Medicines (85.3%) and being active participants of this process (88.2%). However, in the perception of respondents, the list only partially (70.1%) meets the health demands. Of the interviewed professionals responsible for the dispensing of medicines, only 16.6% were pharmacists; even so, 47.8% reported to know the procedures to change the list. From the perspective of most of these professionals (70.9%), the list meets the health demands of the city. Among physicians, only 27.2% reported to know the procedures to change the list, but 76.5% would have some claim to change it. Most of them reported to base their claims in clinical experiences (80.0%). For 13.0% of them, the list meets the health demands. Conclusions: as this is the first national survey of characterization of the process of selection of medicines within primary health care, it brings unpublished data for the assessment of policies related to medicines in Brazil

Investigation of the human disease osteogenesis imperfecta: a research-based introduction to concepts and skills in biomolecular analysis

A blended approach encompassing problem-based learning (PBL) and structured inquiry was used in this laboratory exercise based on the congenital disease Osteogenesis imperfecta (OI), to introduce commonly used techniques in biomolecular analysis within a clinical context. During a series of PBL sessions students were presented with several scenarios involving a 2 year old child, who had experienced numerous fractures. Key learning goals related to both the theory and practical aspects of the course, covering biomolecular analysis and functional genomics, were identified in successive PBL sessions. The laboratory exercises were conducted in 3 hour blocks over six weeks, focused firstly on protein analysis, followed by nucleic acids. Students isolated collagen from normal and OI affected fibroblast cultures. Analysis by SDS-PAGE demonstrated α1 and α2 of collagen Type I chains at approximately 95 kDa and 92 kDa, respectively. Subtle differences in protein mobility between the control and OI samples were observed by some students, but most considered it inconclusive as a diagnostic tool. The nucleic acid module involved isolation of RNA from OI affected fibroblasts. The RNA was reverse transcribed and used as template to amplify a 354 bp COL1A1 fragment. Students were provided with the sequence of the OI affected COL1A1 PCR product aligned with the normal COL1A1 sequence, allowing identification of the mutation, as the substitution of Arg for Gly⁹⁷⁶ of the triple helical region. Our experience with student cohorts over several years is that presentation of this laboratory exercise within a relevant clinical context, and the opportunity for active engagement with the experimental procedures via PBL sessions, supported the learning of basic theory and practical techniques of biomolecular analysis

Characterization of the selection of medicines for the Brazilian primary health care

ABSTRACT OBJECTIVE To characterize the process of selection of medicines for primary health care in the Brazilian regions. METHODS This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional study that consisted of an information gathering in a sample of cities in the five regions of Brazil. The data used were collected by interviews with those responsible for pharmaceutical services (PS) (n = 506), professionals responsible for the dispensing of medicines (n = 1,139), and physicians (n = 1,558). To evaluate the difference between ratios, we adopted the Chi-square test for complex samples. The differences between the averages were analyzed in generalized linear models with F-test with Bonferroni correction for multiple comparisons. The analyses considered significant had p≤0.05. RESULTS The professionals responsible for pharmaceutical services reported non-existence of a formally constituted Pharmacy and Therapeutics Committee (PTC) (12.5%). They claimed to have an updated (80.4%) list of Essential Medicines (85.3%) and being active participants of this process (88.2%). However, in the perception of respondents, the list only partially (70.1%) meets the health demands. Of the interviewed professionals responsible for the dispensing of medicines, only 16.6% were pharmacists; even so, 47.8% reported to know the procedures to change the list. From the perspective of most of these professionals (70.9%), the list meets the health demands of the city. Among physicians, only 27.2% reported to know the procedures to change the list, but 76.5% would have some claim to change it. Most of them reported to base their claims in clinical experiences (80.0%). For 13.0% of them, the list meets the health demands. CONCLUSIONS As this is the first national survey of characterization of the process of selection of medicines within primary health care, it brings unpublished data for the assessment of policies related to medicines in Brazil

Systems Ideologies and Street-Level Bureaucrats: Policy Change and Perceptions of Quality In a Behavioral Health Care System

This article examines the stability of street-level bureaucrats\u27 negative perceptions regarding a newly implemented managed care system on quality of care and service delivery in a publicly funded behavioral health care system. Overall findings indicate that the generally negative perception of managed care did not differ between staff in the two programs, indicating a weak effect on attitudes of frontline workers. More proximal variables to the caregiver, such as service type and job title, show more influence on attitudes. The conclusion discusses the implications of these findings for practicing administrators and academic researchers