Community participation agreements: a model for welfare reform from community-based research

Summary In its June 2001 budget, the Federal Government announced a new framework for welfare reform, Australians Working Together. One component of the framework is the proposed development of Community Participation Agreements in remote Indigenous communities, to deal with welfare income payments, mutual obligation and related service delivery. This paper presents the results of community consideration and the author’s field research between March and August 2001 at Mutitjulu, Central Australia, regarding what such an Agreement might look like on the ground. Mutitjulu presents a microcosm of many of the issues currently affecting remote Indigenous communities. As Mutitjulu residents struggle daily to come to terms with substantial economic and social difficulties, they find their culturally-based forms of social and cultural capital are being undermined by external factors seemingly beyond their immediate control. These include: the continuing failure of governments to develop a comprehensive approach to planning and service delivery, reflected in a band-aid approach to addressing welfare dependence; the debilitating impacts of inter-generational dependence on welfare income; and the multiplicity of local corporate structures and institutions with ill-defined roles and poor accountability to the Mutitjulu community. The failure to adequately address welfare dependence and major community problems of substance abuse, family breakdown, domestic violence, and low levels of education is viewed by Anangu (local Aboriginal people) as directly contributing to a noticeable deterioration in the wellbeing of individuals, their families and the community at large. There is growing frustration over the failure, at all levels, to deal effectively with these matters. The Mutitjulu Community Council has formally decided to proceed with the development of a Community Participation and Partnership Agreement (the ‘Mutitjulu Agreement’), in partnership with government and other stakeholders, as one means to begin addressing these matters. The development of practical partnerships with key government departments and local agencies will be a critical factor in the overall success of the proposed Mutitjulu Agreement. It is for this reason that the name of the proposed Agreement has been expanded to include the strategy of ‘partnership’ and well as ‘participation’. The paper begins with an overview of the background to the community-based research, terms of reference and research methodology. The proposed Mutitjulu Agreement is then placed in its national policy context to identify the factors that have generated this particular initiative. The paper goes on to describe the community context for the Agreement, including the nature of the local welfare economy, and Anangu views about the impacts of the welfare system. Consideration is given to the nature of contemporary Anangu social and economic relations, and how the term ‘participation’ might be most relevantly defined for the purposes of a community agreement about participation

Health Care Disparities for Persons with Limited English Proficiency: Relationships from the 2006 Medical Expenditure Panel Survey (MEPS)

Inadequate communication between patients with limited English proficiency (LEP) and providers can be associated with lower access to health care. The purpose of this research was to determine if there is a significant difference among those persons whose primary language is English and those with LEP in ability to access care and preventative screenings and perception of interaction with their physician. Chi square analysis was performed to determine if there was a significant relationship between primary language spoken and access to health care and patient-provider interaction. Data were obtained from the 2006 Medical Expenditure Panel Study. Results show that there is a significant difference in ability to access health care and screenings for persons with LEP. Those persons with LEP also perceived poorer patient-physician interaction compared to those persons who primarily speak English. Strategies such as interpretative services, translation of health care materials and provider education and training in communication with persons who are LEP and cultural competency should be established to improve access and communication between patient and provider

Uniform bounds on multigraded regularity

We give an effective uniform bound on the multigraded regularity of a subscheme of a smooth projective toric variety X with a given multigraded Hilbert polynomial. To establish this bound, we introduce a new combinatorial tool, called a Stanley filtration, for studying monomial ideals in the homogeneous coordinate ring of X. As a special case, we obtain a new proof of Gotzmann's regularity theorem. We also discuss applications of this bound to the construction of multigraded Hilbert schemes.Comment: 23 pages, 2 figure

The NHS plan: an economic perspective

The NHS Plan, published in July 2000, presented an ambitious blueprint for the transformation of the way the NHS delivers health care. The backdrop to the Plan is the substantial increase in resources for the NHS promised for the next 5 years. At the heart of the Plan is the aim of ensuring these resources are used effectively to provide a health service “designed around the patient”. After reviewing the perceived flaws in the current system and dismissing the notion of alternative systems of health care funding, the main part of the Plan outlines the strategy for tackling the shortcomings. The discussion is wide-ranging and includes not only those areas we would expect to see covered, such as the interface between health and social care and the performance management system, but also issues such as investment in infrastructure, the relationships between the NHS and the private sector and key personnel issues such as the supply of health care professionals and their contractual arrangements. This discussion paper summarises the main elements of the Plan before focusing more closely on seven key themes on which economic analysis has a distinctive insight to offer – investment, information, labour markets, the independent sector, waiting times, performance management, and patient and carer responses. Some of the preconditions for success of the Plan are outlined and gaps in the available evidence to support various aspects of the Plan are highlighted. Our conclusions suggest that there is reason to be optimistic that the Plan will deliver many of its lofty aspirations if two key conditions are met. First, that front-line staff are on board and have the resources and the will to help implement the Plan; and second, that political expediency and the desire to achieve short-term goals does not drive out the commitment to the long-term aims for the NHS.The NHS Plan

Synthetic and Endogenous Cannabinoids Inhibit Breast Cancer Cell Growth and Metastasis

With one million cases diagnosed yearly worldwide, breast cancer is the second most common cancer in women. Metastasis to the brain is the leading cause of death in breast cancer patients due to the inability of drug treatments to cross the blood brain barrier, limiting the efficacy of some forms of chemotherapy. The most common chemokine receptor expressed by breast cancer cells is CXCR4, a protein involved in cell migration. CXCR4’s ligand Stromal Derived Factor 1 (SDF1-a or CXCL12) is expressed by the tissues to which breast cancer migrates, suggesting that the CXCR4/CXCL12 axis plays a role in metastasis of breast cancer cells to the brain. Endogenously produced endocannabinoids 2- arachidonoylglycerol (2-AG) and anandamide (AEA), and synthetic cannabinoids JWH- 015 and Met-F-AEA bind to cannabinoid receptors CB1 and CB2. Cannabinoid receptor inhibition by synthetic cannabinoids has been shown to block CXCR4/CXCL12-mediated in vitro migration of immune cells. Due to the high expression of CB1 receptor in the brain, cannabinoids have the ability to cross the blood brain barrier, implicating their capacity to inhibit breast cancer cell metastasis to the brain. Therefore, we explored the ability of endogenous and synthetic cannabinoids to inhibit CXCR4/CXCL12-induced in vitro metastatic assays using various breast cancer cell lines such as MDA-MB-231/BR3 (that specifically metastasizes to the brain), NT2.5 (highly metastatic mouse breast cancer cell line), MCF7-CXCR4 (highly expresses CXCR4), and SCP2 (highly metastatic human cell line). These cell lines were used to perform various CXCL12-induced invasive assays such as wound healing, chemotaxis, and chemoinvasion in the presence of endogenous and synthetic cannabinoids. These cannabinoids significantly reduced breast cancer cell chemoinvasion, migration and wound healing. Furthermore, delineation of signaling mechanisms revealed that cannabinoids may inhibit chemoinvasive properties of breast cancer cells by inhibiting CXCL12-induced ERK activity and focal adhesion kinase complex formation. These studies suggest that cannabinoids have the potential to inhibit metastasis of breast cancer cells to various organs including the brain. With future in vivo studies using various animal models, including knock-out mouse models which address dosage/targeting issues, endogenous and synthetic cannabinoids could be used to develop new therapies for breast cancer growth and metastasis.Research funded by Undergraduate Research Office, College of Pharmacy Department of Pathology, and College of Arts and SciencesNo embarg

Farm fresh food boxes: Increasing food access in rural communities and urban food deserts through new markets for farmers and retailers

Farm Fresh Food Boxes (F3B) is a multi-state integrated research and extension project that represents an innovative approach to addressing access to healthy, affordable food in food deserts by connecting farmers, retailers, and consumers. The extension team was responsible for recruiting farms and associated retail sites in three participating states: Vermont, Washington, and California, and promoting this innovative program to consumers in communities with limited access to fresh, local produce. The research team conducted mixed-methods research on the experience of participating F3B farmers, retailers, and consumers. Farms offered weekly boxes of fresh produce at retail sites that provide convenient access to consumers. Retail sites advertised with flyers detailing the weekly content and cost of F3B from participating area farms. Customers’ pre-purchased boxes at the retail site or online on a week-to-week basis for later pick-up. Box contents and flyers change throughout the season to reflect seasonal availability and to move produce that is most abundant. Findings from mixed methods data collection include an assessment of market potential, revenue from box sales, measures of acceptability, and benefits and barriers to farmers, retailers, and consumers. F3B provides a low-risk strategy to address the complex supply, demand, and distribution challenges faced by producers and retailers of fresh local foods, while overcoming barriers that consumers face in accessing affordable, healthy food

Researching Australian Indigenous governance: a methodological and conceptual framework

This paper sets out the methodological and conceptual framework for the Indigenous Community Governance (ICG) Project on Understanding, Building and Sustaining Effective Governance in Rural, Remote and Urban Indigenous Communities. The paper describes the Project’s research aims, questions, and techniques; explores key concepts; and discusses the ethnographic case-study and comparative approaches which form the core components of the methodological framework. As an applied research project, the paper also considers the methodological issues inherent in participatory research, and for the dissemination and application of research fi ndings within Indigenous and policy arenas. The framework draws on the multi-disciplinary expertise of the project team in areas such as anthropology, political science, demography, policy and legal studies, linguistics, and community development

Jurisdictional devolution: Towards an effective model for Indigenous community self-determination

Over a decade ago the House of Representatives Standing Committee on Aboriginal Affairs and the Royal Commission into Aboriginal Deaths in Custody concluded that the essence of self-determination is the devolution of political and economic power to Indigenous communities. Self-determination was defined to mean Indigenous people having control over the ultimate decisions about a wide range of matters including political status, and economic, social and cultural development, and having the resources and capacity to control the future of their own communities within the legal structure common to all Australians. This paper proposes that the concept of jurisdictional devolution could provide a key framework for the practical implementation of self-determination at the community level for Indigenous Australians, and proceeds to examine the nature of the concept, its application, and the challenges and opportunities it presents. It argues that the concept of jurisdictional devolution can be used as an organising perspective or frame of reference. This enables us to develop a policy-relevant language with which to discuss the implementation of local-level self-determination, and connects theoretical propositions about inherent rights to self-determination, and the practice of achieving it in a workable form. The paper begins by developing an operational definition for the term 'jurisdictional devolution'. It then considers the question: why devolve? What are the imperatives for jurisdictional devolution, the likely advantages and benefits? The discussion focuses on practical design and implementation by examining the lessons that can be drawn from two case studies of devolution in the arena of welfare. The first is from the United States of America, where a process of welfare devolution to Native American Indian Tribes is in the early stages of implementation. The object of this case study is to extrapolate lessons and insights that can be applied to the design and implementation of a relevant Australian model.The second case study presents a preliminary proposal, developed by a central Australian community, for the future devolution of particular components of welfare jurisdiction. Against the backdrop of that broad comparative perspective, the paper proceeds to consider the factors that will be relevant in Australia for constructing a framework for jurisdictional devolution. A key issue is what might constitute the most effective and relevant Indigenous boundaries and units for devolution. To whom or what would jurisdiction be devolved? In other words, who constitutes the 'self' in self-determination? A 'geography of devolution' is proposed in the form of a flexible aggregation model-regionally dispersed, layered community governance-which has both community and regional elements. The paper concludes by drawing together these lessons, limitations and practical options in order to highlight the operating principles and types of strategic action that would need to inform the design and implementation of a workable framework for jurisdictional devolution in Australia