Understanding the Bare Breech Phenotype

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How are population-based funding formulae for healthcare composed?

Population-based funding formulae act as an important means of promoting equitable health funding structures. To evaluate how policy makers in different jurisdictions construct health funding formulae and build an understanding of contextual influences underpinning formula construction we carried out a comparative analysis of key components of funding formulae across seven high-income and predominantly publically financed health systems: New Zealand, England, Scotland, the Netherlands, the state of New South Wales in Australia, the Canadian province of Ontario, and the city of Stockholm, Sweden.Methods Core components from each formula were summarised and key similarities and differences evaluated from a compositional perspective. We categorised approaches to constructing funding formulae under three main themes: identifying factors which predict differential need amongst populations; adjusting for cost factors outside of needs factors; and engaging in normative correction of allocations for ‘unmet’ need. Results We found significant congruence in the factors used to guide need and cost adjustments. However, there is considerable variation in interpretation and implementation of these factors. Conclusion Despite broadly similar frameworks, there are distinct differences in the composition of the formulae across the seven health systems. Ultimately, the development of funding formulae is a dynamic process, subject to availability of data reflecting health needs, the influence of wider socio-political objectives and health system determinants

An Investigation of the Perceptions of Clergy and Laity on Race-Based Organizational Segregation in the Southern Union Conference of Seventh-day Adventists

Problem The Seventh-day Adventist Church in the United States maintains a racially segregated organization in a society that has intentionally dismantled segregation in most of its organizations. The church needs to evaluate its current conference organization in light of this reality. The purpose of this study was to describe the perceptions of Seventh-day Adventist clergy and members in two conferences in the Southern Union concerning race-based organizational segregation in the church. Method This study used a mixed method and was descriptive in design. Four focus groups were conducted to explore the dimensions of the research problem. This step was followed by the development of a quantitative survey, which was administered to clergy and members of a White (“state”) conference and the other a Black (“regional”) Conference of the Southern Union Conference of Seventh-day Adventists. Conclusions The study found that members of various ethnic backgrounds and ages in the church are open to the idea of changing the race-based organizational structure in the Adventist Church. Whether they are employed by the church or not, respondents are not comfortable with the current system. They strongly see God calling the church to integration, and they believe that the success of the church’s outreach to the culture demands such a change. They are concerned about how leadership positions would be equitably distributed in an integrated church, but those surveyed see the benefits outweighing these concerns. Respondents indicated minimal support for the idea that separate conferences are necessary for the effective prosecution of the church’s mission. They also seemed to feel that segregation does affect the church’s witness but are unsure of the level of strength of that influence. The respondents indicated that leadership issues rather than worship style may be the primary cause of Caucasians leaving churches where they have become the minority. Respondents perceived a real economic benefit in merging state and regional conferences, though they were uncertain about the impact a merger of conferences would have on job opportunities for clergy. There was no indication that respondents felt a need to hold strongly to the current system. Demographics had less of an impact on responses than was expected. In particular, age was expected to have far more influence than it did. It was expected that the responses of younger members would vary significantly from those of older members, but generally this was not the case. On the other hand, non-employees consistently responded more favorably toward integration than did conference employees. Ethnic groups, particularly African-Americans and Caucasians, were much more in harmony than was expected. Though there were small degrees of difference, there was no sharp disagreement as might be expected for such a sensitive subject

Book review: The Divided Mind of the Black Church: Theology, Piety, and Public Witness

Raphael G. Warnock, senior pastor of the Ebenezer Baptist Church in Atlanta, Georgia, United States of America, describes a division in the Black church in the United States that centers on its true mission and purpose. On one side are Black pastors, and on the other are Black theologians. Pastors in the Black church tend to focus on piety and personal salvation (much like evangelicals), whereas Black theologians see the focal point of mission as a liberationist movement to save the culture from racism. Warnock argues for a coming together of the two sides, in order to “more fully integrate [the Black church’s] pietistic and protest dimensions into a more holistic understanding of what it means to truly be a prophetic church and a liberationist community” (188, 189)