Journal articles on the topic 'Zimbabwe. Public Service Review Commission'

Historically, health care in Zimbabwe was provided primarily to cater to colonial administrators and the expatriate, with separate care or second-provision made for Africans. There was no need for legislation to guarantee its provision to the settler community. To address the inequities in health that had existed prior to 1980, at independence, Zimbabwe adopted the concept of Equity in Health and Primary Health Care. Initially, this resulted in the narrowing of the gap between health provision in rural areas and urban areas. Over the years, however, there have been clear indications of growing inequities in health provision and health care as a result of mainly Economic Structural Adjustment Policies (ESAP), 1991–1995, and health policy changes. Infant and child mortality have been worsened by the impact of HIV/AIDS and reduced access to affordable essential health care. For example, life expectancy at birth was 56 in the 1980s, increased to 60 in 1990 and is now about 43. Morbidity (diseases) and mortality (death rates) trends in Zimbabwe show that the population is still affected by the traditional preventable diseases and conditions that include nutritional deficiencies, communicable diseases, pregnancy and childbirth conditions and the conditions of the new born. The deterioration of the Zimbabwean health services sector has also partially been due to increasing shortages of qualified personnel. The public sector has been operating with only 19 per cent staff since 2000. Many qualified and competent health workers left the country because of the unfavourable political environment. The health system in Zimbabwe has been operating under a legal and policy framework that in essence does not recognize the right to health. Neither the pre-independence constitution nor the Lancaster House constitution, which is the current Constitution of Zimbabwe, made specific provisions for the right to health. Progress made in the 1980s characterized by adequate financing of the health system and decentralized health management and equity of health services between urban and rural areas, which saw dramatic increases in child survival rates and life expectancy, was, unfortunately, not consolidated. As of 2000 per capita health financing stood at USD 8.55 as compared to USD 23.6, which had been recommended by the Commission of Review into the Health Sector in 1997. At the beginning of 2008 it had been dramatically further eroded and stood at only USD 0.19 leading to the collapse of the health system. Similarly, education in Zimbabwe, in addition to the changes it has undergone during the different periods since attainment of independence, also went through many phases during the colonial period. From 1962 up until 1980, the Rhodesia Front government catered more for the European child. Luckily, some mission schools that had been established earlier kept on expanding taking in African children who could proceed with secondary education (high school education). Inequity in education existed when the ZANU-PF government came into power in 1980. It took aggressive and positive steps to redress the inequalities that existed in the past. Unfortunately, the government did not come up with an education policy or philosophy in spite of massive expansion and investment. The government had cut its expenditure on education because of economic and political instability. This has happened particularly in rural areas, where teachers have left the teaching profession.

In Zimbabwe reports of abuse of public office have manifested in various forms resulting in public outcry; poor service delivery, and government losing millions of dollars. This study aims to undertake a reflective inquiry on the ethical conduct in the Zimbabwean public sector through content and process analysis in order to provide intervention mechanisms to the problem. Statistical analysis of corruption level is made to benefit the study. Results indicated some legislative gaps and an incapacitated Anti-Corruption Commission which has been unable to execute its mandate fully. Most senior public officials and politicians appear to have too much power and authority with no checks and balances in place. Practical implications of the widespread unethical practices call for the government to plug the glaring legislative gaps; take stern measures against offenders; empowering the Anti-Corruption Commission; term limits for senior public officials as well as for political appointments; and motivating political will to uphold ethical leadership. The recommendations will open a window for the Zimbabwean government and administrators to view how some advanced economies have propped up ethical behaviour in the public sector. It is the way to go for ailing economies like Zimbabwe. The paper demonstrated the importance of ethical awareness in another political and economic setting-Zimbabwe.

Abstract This paper provides a conceptual analysis of government debt servicing in Zimbabwe from 1980 to 2015. The mounting debt burden arising largely from nonconcessionary foreign loans since the 1980s, and the economic hardships that characterise the country beginning the late 1990s, caused dreadful public debt servicing challenges. Thus, the paper discusses the public debt service reforms and policies; trends; and problems in Zimbabwe over the review period. In the paper, it was identified that between 1983 and 1997, the government’s debt servicing costs were growing exponentially, resulting in liquidity challenges. However, between 1998 and 2015, the country had plunged into public debt service overhang, with public debt servicing liabilities exceeding the country’s foreign exchange earnings. Notwithstanding the various public debt servicing reforms to boost domestic revenues, Zimbabwe, as many other developing countries, still faces a number of debt servicing problems. Among others, these include: high government debt, low industrial and export competitiveness, narrow revenue base and subdued investor confidence. The paper recommends the government of Zimbabwe to undertake the following measures, among others, aimed at either boosting or expanding the revenue base: (i) improving tax enforcements; (ii) mobilising the informal sector; and (iii) expanding the productive capacity of public entities.

This article highlights that Bangladesh has not been able to achieve desired success in implementing Public Administration Reform Commission’s (PARC) new public management (NPM)-driven reform recommendations as there are major challenges such as lack of political commitment, bureaucratic unwillingness to bring about change, lack of advocacy for NPM reform among the people and inefficient public service management. To face the challenges of NPM reform implementation, it is needed to ensure political commitment, bureaucratic support, awareness among the people through government, non-government and social organisations.

Purpose The purpose of this paper is to evaluate accuracy of macro fiscal forecasts done by Government of Zimbabwe and the spillover effects of forecasting errors over the period 2010-2015. Design/methodology/approach In line with the study objectives, the study employed the root mean square error methodology to measure the accuracy of macro fiscal forecasts, borrowing from the work of Calitz et al. (2013). The spillover effects were assessed through running simple regression in Eviews programme. The data used in the analysis are based on annual national budget forecasts presented to the Parliament by the Minister of Finance. Actual data come from the Ministry of Finance budget outturns and Zimbabwe Statistical Agency published national accounts. Findings The results of the root mean square error revealed relatively high levels of macro-fiscal forecasting errors, with revenue recording the highest. The forecasting errors display a tendency of under predicting the strength of economic recovery during boom and over predicting its strength during periods of weakness. The study although found significant evidence of GDP forecasting errors translating into revenue forecasting inaccuracies, the GDP forecasting errors fail to fully account for the revenue errors. Revenue errors were, however, found to be positive and significant in explaining the budget balance errors. Originality/value In other jurisdictions, particularly developed countries, they undertake regular evaluation of their forecasts in order to improve their forecasting procedures, which translate into quality public service delivery. The situation is lagging in Zimbabwe. Given the poor performance in public service delivery in Zimbabwe, this study contributes in dissecting the sources of the challenge by providing a comprehensive review of macro fiscal forecasts.

Dollarisation in emerging economies of Southern Africa like Zambia and Zimbabwe, led High-Income Earning Individuals (HIEI) to invest offshore as an investment diversification strategy. The turbulent past experiences influenced African HIEI behavior in relation to their wealth management approaches. HIEI started looking for ways to protect its financial assets against future political and economic volatilities. The purpose of this study was to equip academics and the wider commercial fraternity with practical and strategic knowledge of the emerging markets’ offshore wealth management services industry. This would assist emerging markets to regulate HIEI markets, boost capital flow, fight tax evasion to allow banks to assist, help governments protect pensions, promote transparency in investments and avoid negative effects of dollarisation. Data were collected from 81 participants including HIEIs with offshore investments, those individuals without, financial advisors, and the Securities Exchange Commission (the industry regulator). The study used a qualitative approach in its methodology using questionnaires, interviews, and a computer-aided system for data analysis. We found that HIEI feels their wealth is under attack and looks towards offshore investing as a refuge. We identified the desperate urge of African HIEIs to secure their wealth as the main influence driving the offshore investing phenomenon

The Industry Commission review of service provision in school education aims to define performance benchmarks for Australia's eight government education systems, by providing comparative measures of efficiency in education provision. Such benchmarks are likely to lead to a reduction in the level of public resources for government schools unless it is possible to demonstrate the link between expenditure on schooling and school effectiveness. If efficiency audits like the Industry Commission review are to deal with issues of school effectiveness adequately, they should avoid the tendency of previous public sector audits to focus on financial data on schools expenditure to the exclusion of data on student achievement. This paper suggests an approach to measuring system performance which would establish benchmarks that reflected both the efficiency and effectiveness of Australian school systems, and warns against the misuse of performance indicators as an instrument in the determination of funding levels for schools.

Alongside the process of legislative review and enactment, questions of administrative structure and implementation received lively consideration. At stake were such issues as whether to treat the new scheme as a matter of law reform or an aspect of social security. ACC's eventual status as an independent commission posed challenges to public officials from several departments, while preserving certain tensions that would emerge later in the 1970s. This paper credits the New Zealand public service for its creative response to implementing ACC, which required it to bridge the structural divides and alternative conceptions of how the new scheme might work. The paper describes the pivotal decisions and persons that guided ACC into its initial decade.

Summary The Civil Service Act, passed in 1918, had never been substantially modified for the 43 years following its adoption. In 1957 however the Government asked the Civil Service Commission to review personnel procedure in the Government Service and to prepare a report. The report produced was entitled Personnal Administration in the Public Service. The following article is an analysis of Bill C-71, which resulted from the Commission's report and from the work of a Special Committee of the House established in 1961.

If you are working in mental health, you get used to being inspected and commented upon – the Mental Health Act Commission, Audit Commission, Social Services Inspectorate, Health Advisory Service (HAS, as was) and public inquiries into patient homicides. Working in multidisciplinary teams has made us used to operating with a variety of perspectives and for most of us this is a necessary and welcome part of the job. Few psychiatrists, however, are so sanguine about the former HAS or about homicide inquiries. The repeated complaint has been their inconsistency. Their quality and tone (potentially as damaging as their findings) have varied to quite an indefensible degree.

This paper analyzes the implications of HIV and AIDS prevention, treatment, and care programmes on the health system in Zimbabwe. The programmes have been spearheaded by various stakeholders that include the public and private sectors, nongovernmental organizations, formal and informal institutions, and intergovernmental organizations. There has been a tremendous increase of the programmes as they adapt to local contexts, accommodate new funders, and changes in population attitudes, and expectations in the country. Through a comprehensive literature review, this paper focuses on Behaviour Change, the Antiretroviral Therapy, Home-Based Care, Prevention to Mother To Child Transmission and Voluntary Counselling and Testing programmes and services in relation to the components of the health system that include health service delivery, human resources, finance, leadership and governance, and the medical products and technologies. Thus far, the implications are uneven throughout the health system and there is need to integrate the HIV and AIDS programmes within the health system in order to achieve positive heath outcomes.

Purpose This paper is concerned with the current decision of the European Commission regarding Google’s comparison shopping service (Google Shopping). In 2017, the Commission has fined Google €2.42 billion for abusing its dominant position as a search engine by giving illegal advantage to Google Shopping. Consequently, Google has to stop its illegal conduct. In particular, the decision requires Google to treat rival comparison shopping services and its own service equally. The purpose of this paper is to analyse the decision from a perspective of two-sided markets. Google Shopping is an integrated service of Google Search and acts as an intermediary between companies, offerings products in the internet and people searching for products in the internet. This complies with the typical conditions of a two-sided market. From the perspective of sellers of goods and services in Europe, Google may be seen as a gatekeeper to the potential customers and thus as an essential facility. In the light of the current decision, this paper provides a possible regulation alternative. It is shown that Google Shopping represents a typical club good, so that welfare-optimising rules must be adhered to. In this context, it should be noted that in the current Google Shopping search results, artificial rivalry is created among sellers so as to ensure maximum willingness to pay for a top listing. The solution proposed in this paper entails a summary score list of all sellers of a particular product, for which a turnover-dependent contribution should be required, instead of a reduced score list, where positions are sold by auctions. Design/methodology/approach This paper uses methods of two-sided markets and public good theory. Findings It is shown that Google Shopping represents a typical club good, so that welfare-optimising rules must be adhered to. In this context, it should be noted that in the current Google Shopping search results, artificial rivalry is created among sellers so as to ensure maximum willingness to pay for a top listing. The solution proposed in this paper entails a summary score list of all sellers of a particular product, for which a turnover-dependent contribution should be required, instead of a reduced score list, where positions are sold by auctions. Originality/value To the best of the author’s knowledge, it is the very first paper about the decision of the European Union (06/2017) concerning Google Shopping.

Backdating of stock option grants is receiving substantial investigative attention by the Securities and Exchange Commission, the Department of Justice, the Public Company Accounting Oversight Board, and the Internal Revenue Service. The redating of stock options has significant potential economic and legal implications to executives, employees, and shareholders of the granting firms. Accordingly, this topic is of considerable current interest in both the academic and popular press. In this paper, we discuss the tax implications of manipulating stock option grant and exercise dates, review the tax treatment of stock option and stock purchase plans including I.R.C. §162(m) and I.R.C. §409A implications, and present a real world example illustrating the potential economic magnitude of this problem to both the option grantees and the option granting firms.

O presente artigo objetiva analisar os efeitos desinentes às irregularidades nos provimentos dos cargos de livre nomeação, isto é, cargos em comissão e funções de confiança, bem como o papel do Ministério Público como agente fiscalizador da Administração Pública, mormente, em relação à regularização destas ocupações. Tais cargos em fidúcia representam uma excepcionalidade no quadro do funcionalismo estatal brasileiro ao dispensarem prévia aprovação em concurso público: trata-se, logo, de ocupações desprovidas de estabilidade, sustentadas pela confiança depositada pelo agente público. No entanto, a miríade de provimentos irregulares e os ruidosos desvios de finalidade nas repartições públicas do país têm comprometido a qualidade dos serviços públicos, bem como a gestão pública, mormente em relação ao Poder Executivo. O presente estudo desenvolveu-se mediante pesquisa bibliográfica e revisão de literatura embasadas em fontes de pesquisa tais quais jurisprudências, doutrinas, artigos científicos, notícias, leis e textos em geral, correspondendo, assim, a pesquisa documental com método indutivo. Concluiu-se, destarte, que o controle externo exercido pelo órgão ministerial configura fator essencial à fiscalização, correção e conscientização quanto aos vícios culturais e políticos inseridos nos provimentos dos cargos em fidúcia – máxime em razão de sua autonomia funcional e comprometimento com a defesa dos interesses coletivos –, desse modo, restabelecendo a qualidade almejada pela população em relação aos serviços públicos e reafirmando os princípios constitucionais basilares da Administração Pública. PUBLIC PROSECUTION CONTROL OVER CIVIL SERVICE MANAGEMENT: A REVIEW OF COMMISSION POSTS AND POSITIONS OF TRUST ABSTRACT The present paper aims to review the effects resulting from irregularities in the provision of free nomination posts, that is to say, commission posts and positions of trust, as well as the Public Ministry role as a supervisory agent for Public Administration, mostly regarding the regulation of those posts. Such fiduciary duty posts represent an exception for the Brazilian State Functionalism scenario when dismissing previous approval in public tendering: it is, therefore, an unstable position, maintained on behalf of the trust in the federal agent. However, a myriad of irregular provisions and misuse at government offices around the country has affected the quality of public services, as well as public management, mostly regarding Executive Power. The present study carried out a bibliographic and literature review based on research sources such as jurisprudence, doctrines, academic papers, news, laws, and texts in general, thereby corresponding to a documental research with the inductive method. Therefore, it was concluded that the ministerial body external control constitutes an essential factor for supervision, correction, and awareness concerning cultural and political behavior embedded with the provision of public posts in fiduciary duty- absolute in functional autonomy and commitment with defending collective interest. Hence, reestablishing the population’s desired quality regarding public service and reaffirming the Public Administration basic constitutional principles. Keywords: Public Administration. Free Nomination Posts. Public Ministry. External Control. Public Management.

THIS ISSUE OF Australian Health Review started as part of a Festschrift to celebrate the work and leadership of Professor Mike Ward, currently Commissioner of the Health Quality and Complaints Commission in Queensland but previously inaugural Senior Director of the Clinical Practice Improvement Centre in Queensland Health and a Professor of Medicine at the University of Queensland, as well as Commissioner of the Australian Commission on Safety and Quality in Health Care. During his time at Queensland Health and in clinical practice, Mike made an outstanding contribution to health care in Queensland, recognised by the award of the Public Service Medal. Initially trained as a gastroenterologist, Professor Ward?s interest broadened to include organisational issues such as communication among teams, and how to measure and improve quality of care. He was particularly interested in methods of displaying data to highlight the underlying patterns in the information presented. Mike, not surprisingly for someone who occupied a professorial role, was also interested in the development of health professionals and played a key role in the creation and shaping of Queensland Health?s world renowned Skills Development Centre.

Over the past 40 years, a complex review and oversight system has grown within the United States and internationally to regulate the conduct of human subjects research. This system developed in response to revelations of abuses of human subjects in experiments such as those conducted in the Nazi concentration camps, the Tuskegee Study of Untreated Syphilis in the Negro Male, the Willowbrook Hepatitis Studies, and the studies described by Beecher in his 1966 article in the New England Journal of Medicine. The oversight system is based on a foundation, first implemented by the U.S. Public Health Service (PHS) in 1966 and by the U.S. Food and Drug Administration in 1971, of prior review and approval of a written experimental protocol by an independent committee. The World Medical Association articulated the ethical centrality of independent review in its 1975 revision of the Declaration of Helsinki, and the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research endorsed the requirement in its flagship Belmont Report.

This article addresses the current “state of the art” in Portuguese media diversity policy, focusing on the social inclusiveness domain within public service media. The indicators assess regulatory and policy safeguards for community media, access to media by minorities, local and regional communities, women and people with disabilities, as well as the country’s media literacy environment. Although the majority of these in dicators have legal safeguards or benefit from specific policies, we concluded there is still considerable work to be done, particularly in the realms of media literacy and the representation of minority groups and women in the media. This article results from an on-going research, gathering data and literature review from the following projects: Media Pluralism Monitor (MPM) project, implemented by the Centre for Media Pluralism and Media Freedom (CMPF) at the European University Institute and funded by the European Commission; and DIVinTV - Public Television and Cultural Diversity in Portugal, funded by FCT.

IntroductionSuicide remains a major public health issue around the world. People bereaved by suicide are a vulnerable group who are at considerable risk of developing mental and physical health problems, such as complicated grief, post-traumatic stress disorder or cardiovascular disease. Many unanswered questions remain, in particular, in terms of their use of healthcare services. This protocol describes how we aim to systematically scope the existing literature on the professional follow-up and health service use by families bereaved by suicide. The scoping review will help to identify research gaps in the literature and aid in the planning and commission of future research. We will provide a summary of research findings.Methods and analysisWe will use the scoping review framework provided by the Joanna Briggs Institute. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews will be used as a guide for reporting our results. We plan to conduct an extensive literature search using relevant health-related databases (MEDLINE, Embase, PsycINFO and CINAHL) and Web of Science. Two independent reviewers will screen the articles in a two-stage process: (1) titles and abstracts and (2) full-text documents.Ethics and disseminationThis scoping review will identify and consider only previously published research. Hence, no ethical approval is considered necessary. We will disseminate the results in a scientific journal and at conferences, as well as through user organisations for people bereaved by suicide and social media.

The ‘reclaiming’ by Paris of its water back into public hands is a paradox in the homeland of transnational water companies and at a time when the European Commission rather favours the liberalisation of public services ‘of general economic interest’. Yet what has happened is more complex. A quick historical review of management formulas in Europe reveals both the specific model of delegation to private companies made in France, and also the maintained direct labour management formula (with direct public procurement by municipalities) used in several French cities to be presented. Paris has a long history of public procurement of water, whilst using a private company for metering and billing customers. Mayor Chirac changed to a semi-public company with public production and private distribution contracted out to two private companies (with responsibility for the right and left banks). Mayor Delanoë managed to reclaim the distribution in a commercial but public institution called an Établissement Public à caractère Industriel et Commercial (EPIC); this had unsuspected impacts on water supply issue in the suburbs. While Paris can obviously run its services directly, the emerging issue appears to be multi-level governance at the metropolitan level, rather than just a public–private debate. This paper also discusses in detail the arguments put forward by Anne le Strat, Deputy Mayor for Water, in favour of returning to public control, and presents the difficulties of assessing the performance of a service operator, under both delegation and direct management.

International migration has led to increasingly diverse populations in many high-income countries. With approximately 250,000 newcomers each year, it should be no surprise that developing services that meet the needs of immigrants, refugees, ethnocultural, and racialized populations (IRER) is a major priority in the Mental Health Strategy for Canada. The published Canadian literature on the mental health of diverse populations concludes that differences in the exposure to social risk factors lead to differences in rates of illness for some groups. Whether rates of illness are high or low in a particular group, however, problems in accessing services are ubiquitous. Improving the service response will require political will, leadership, strategic planning, and data, and must include people with lived experience and the populations at highest risk. This paper outlines the “Issues and Options” paper commissioned by the Mental Health Commission of Canada, which used a thorough literature review and a national consultation to develop a model for service development. A health equity approach that utilizes local-population-based planning and the evidence-based interventions that are available for diverse groups could improve services for IRER groups in Canada.

The Information and Documentation Management Officer (PPID) at State University of Medan was formed to answer the Minister of Research and Technology Regulation No. 75 of 2016 concerning Public Information Services in the Ministry of Research, Technology and Higher Education. In carrying out its duties as a provider, store, document, and safeguard public information, PPID synergizes with the Cooperation and Public Relations Subdivision which routinely publishes all information through the State University of Medan official website and social media immediately. This research was conducted with the aim of analyzing the role of PPID in carrying out the task of implementing policies, services, and public information publications at Medan State University, as well as analyzing the obstacles encountered and providing solutions to efforts to overcome these obstacles. The method used in this research is descriptive research method. The results showed that based on observations made, it was obtained that more than 70 percent of respondents concluded that they were very satisfied with the public information services provided so far. 2. There are three main substances of the KIP laws and regulations that are used as the main reference for determining the assessment parameters that will be used as an assessment instrument. First, fulfillment of the obligation on information that must be provided and announced periodically in accordance with Article 9 of the FOI Law, which is more detailed in Article 11 of the Information Commission Regulation Number 1 of 2010 concerning Public Information Service Standards (SLIP). The review of information that must be made available and announced periodically is done by means of publication in the form of the main website of the Public Agency with instruments to fulfill the points as stipulated in the KIP laws and regulations. 3. The efforts made by PPID State University of Medan are in overcoming the obstacles faced are: a) Provision of information, b) Information services that are fast, accurate, and simple, in accordance with applicable regulations, c) Determination of operational procedures for disseminating public information, d) Testing of consequences, d) Classification of information, e) Determination of excluded information that has expired, f) Determination of consideration for each policy taken to fulfill the right of everyone to public information.

The politicization of the bureaucracy cannot be separated from its mutualism character. Regional heads need electoral nutrition from ASN to win their political machine, while ASN needs political networks and closeness to power to build a career in the bureaucracy. This phenomenon will only destroy impartiality, thicken discrimination and KKN-ism in public services, shackle politics in a political remuneration cage and, no less important, reduce the value of democracy. This study method uses a qualitative method, where data is obtained using a literature review. The literature exploration in this study uses data and information sources related to the neutrality of ASN in the context of local elections in various regions and its implications for bureaucracy and democracy. Then the data is classified and analyzed.The results of the study concluded that the principle of ASN neutrality must be a fixed price, especially in the 2020 Regional Election. The ASN Commission as a partner of Bawaslu and the institution was given the authority to supervise ASN neutrality must be proactive, objectively following up on findings of violations in the field. Therefore, there is no reason for the Civil Service Officer (PPK) (regent/mayor/governor) not to impose strict sanctions on a number of ASN Commission recommendations regarding violations of ASN neutrality. The firmness of PPK in imposing sanctions will greatly help minimize “naughty” ASN.

The question of electronic solutions in public health care has become a contemporary issue at the European Union level since the action plan of the Commission on the e-health developments of the period between 2012 and 2020 has been published. In Hungary this issue has been placed into the centre of attention after a draft on modifications of regulations in health-care has been released for public discourse, which – if accepted – would lay down the basics of an electronic heath-service system. The aim of this paper is to review the basic features of e-health solutions in Hungary and the European Union with the help of the most important pieces of legislation, documents of the European Union institutions and sources from secondary literature. When examining the definition of the basic goals and instruments of the development, differences between the European Union and national approaches can be detected. Examination of recent developmental programs and existing models seem to reveal difficulties in creating interoperability and financing such projects. Finally, the review is completed by the aspects of jurisdiction and fundamental rights. It is concluded that these issues are mandatory to delineate the legislative, economic and technological framework for the development of the e-health systems. Orv. Hetil., 2014, 155(21), 822–827.

Objective Capital is an essential enabler of contemporary public hospital services funding hospital buildings, medical equipment, information technology and communications. Capital investment is best understood within the context of the services it is designed and funded to facilitate. The aim of the present study was to explore the information on capital investment in Australian public hospitals and the relationship between investment and acute care service delivery in the context of efficient pricing for hospital services. Methods This paper examines the investment in Australian public hospitals relative to the growth in recurrent hospital costs since 2000–01 drawing from the available data, the grey literature and the reports of six major reviews of hospital services in Australia since 2004. Results Although the average annual capital investment over the decade from 2000–01 represents 7.1% of recurrent expenditure on hospitals, the most recent estimate of the cost of capital consumed delivering services is 9% per annum. Five of six major inquiries into health care delivery required increased capital funding to bring clinical service delivery to an acceptable standard. The sixth inquiry lamented the quality of information on capital for public hospitals. In 2012–13, capital investment was equivalent to 6.2% of recurrent expenditure, 31% lower than the cost of capital consumed in that year. Conclusions Capital is a vital enabler of hospital service delivery and innovation, but there is a poor alignment between the available information on the capital investment in public hospitals and contemporary clinical requirements. The policy to have capital included in activity-based payments for hospital services necessitates an accurate value for capital at the diagnosis-related group (DRG) level relevant to contemporary clinical care, rather than the replacement value of the asset stock. What is known about the topic? Deeble’s comprehensive hospital-based review of capital investment and costs, published in 2002, found that investment averages of between 7.1% and 7.9% of recurrent costs primarily replaced existing assets. In 2009, the Productivity Commission and the National Health and Hospitals Reform Commission (NHHRC) recommended capital, for the replacement of buildings and medical equipment, be included in activity-based funding. However, there have been persistent concerns about the reliability and quality of the information on the value of hospital capital assets. What does this paper add? This is the first paper for over a decade to look at hospital capital costs and investment in terms of the services they support. Although health services seek to reap dividends from technology in health care, this study demonstrates that investment relative to services costs has been below sustainable levels for most of the past 10 years. The study questions the helpfulness of the highly aggregated information on capital for public hospital managers striving to improve on the efficient price for services. What are the implications for practitioners? Using specific and accurate information on capital allocations at the DRG level assists health services managers advance their production functions for the efficient delivery of services.

Background: Though substantial progress has been made to curb the HIV epidemic, high rates of new HIV infections persist among adolescent girls and young women (AGYW) in sub-Saharan Africa, reflecting critical gaps in reaching them with integrated HIV prevention and sexual and reproductive health (SRH) services. With the scale-up of oral pre-exposure prophylaxis (PrEP) and multiple novel HIV prevention products on the horizon, countries have a unique opportunity to expand innovative approaches to deliver comprehensive, integrated HIV/SRH services. Methods: This article is a comparative analysis of findings from rapid landscaping analyses in Kenya, Malawi and Zimbabwe to highlight cross-country trends and context-specific realities around HIV/SRH integration. The analyses in Kenya and Zimbabwe were completed by Ministries of Health (MOH) and the HIV Prevention Market Manager project and include 20 health facility assessments, 73 key informant interviews and six community dialogues. In Malawi, the analysis was completed by the MOH and Georgetown University Center for Innovation in Global Health and includes 70 key informant interviews and a review of national policies and program implementation in Blantyre. Findings were validated through a review of literature and policies in each country. Results: The policy environment in all three countries is conducive to HIV/SRH integration, though operationalization continues to present challenges, with most policies preceding and not accounting for oral PrEP rollout. National coordination mechanisms, youth-friendly health services and prevention of mother-to-child transmission programs are promising practices, while siloed and resource-constrained health systems, limited provider capacity, lack of support for demand generation and structural factors exacerbate barriers to achieving integration. Conclusions: As new HIV prevention products are introduced, demand for integrated HIV/SRH services is likely to grow. Investing in HIV/SRH integration can help to ensure sustainable, government-led responses to the HIV epidemic, streamline service delivery and improve the health outcomes and lives of AGYW.

Purpose The purpose of this paper is to investigate and clarify “irrationality” problem through the maritime industry practices and leading incentives behind common investors. Design/methodology/approach This paper includes a review of broader business and economics literature; review of shipping business practices and detection of institutional pathways and misleading mechanisms behind the irrational preferences; investigation of data (for some arguments); and introduction of a theoretical approach. Findings There are several industry practices and norms well established and followed by decision makers, which may cause and initiate illogical and irrational (long-run) preferences. Short-termism is an erroneous habit of common shipping investors, which is embedded and forced through traditional financial math (i.e. discounted cash flow), financial system (e.g. initial public offerings with high-frequency transactions, interest rate governance and asset valuation mechanism) or flawed contracting tradition (i.e. commission bias). Practical implications Both shipping business and financial institutions need to redesign their working mechanisms, evaluation systems, risk detection and assessment procedures. As discussed in Section 4.7, commission-based (float) services must be converted to regular flat rate payments with long-term contracts to protect investors from rational choices of intermediaries in the short-run which encourages investor’s irrationality. Having a long-term service contract will also improve sustainability of intermediaries and lower their business risk (win-win). Originality/value The impact of this paper is two-fold. First, it raises critical questions about professional decay and drawbacks of some traditional instruments in the shipping business. For the first time, this paper emphasises on various challenges which deteriorate credibility of the industry and causes ill-defined investments. Some arguments have extreme priority for strengthening the foundations of the industry. Second, this paper establishes a new stream of scholarly research highlighting weaknesses of conventional economic approach and demand for outsourcing other schools of economics (e.g. institutional and behavioural) into the shipping business.

ABSTRACTImproving access to culturally-appropriate services and enhancing responses to the needs of older people from black and minority ethnic backgrounds were among the aims of theNational Service Framework for Older People(NSFOP) that was introduced in England in 2001. Progress in meeting the aims of the NSFOP was evaluated by a mid-term independent review led by the Healthcare Commission, the body responsible for regulating health-care services in England. This paper reports the consultation with older people that underpinned the evaluation. It focuses on the views and experiences of older people from black and minority ethnic (BME) groups and of the staff that work in BME voluntary organisations. A rapid appraisal approach was used in 10 purposively selected local councils, and plural methods were used, including public listening events, nominal groups and individual interviews. In total 1,839 older people participated in the consultations and 1,280 (70%) completed a monitoring form. Some 30 per cent defined themselves as of a minority ethnic background. The concerns were more about the low recognition of culturally-specific and language needs than for the development of services exclusively for BME older people.

BackgroundMarginalised communities such as homeless people, people who use drugs (PWUD), lesbian, gay, bisexual, transgender and intersex people (LGBTI), prisoners, sex workers and undocumented migrants are at high risk of poor health and yet face substantial barriers in accessing health and support services. The Nobody Left Outside (NLO) Service Design Checklist aims to promote a collaborative, evidence-based approach to service design and monitoring based on equity, non-discrimination and community engagement.MethodsThe Checklist was a collaborative project involving nine community advocacy organisations, with a focus on homeless people, PWUD, LGBTI people, prisoners, sex workers, and undocumented migrants. The Checklist was devised via a literature review; two NLO platform meetings; a multistakeholder policy workshop and an associated published concept paper; two conference presentations; and stakeholder consultation via a European Commission-led Thematic Network (including webinar).ResultsThe NLO Checklist has six sections in line with the WHO Health Systems Framework. These are: (1) service delivery, comprising design stage (6 items), services provided (2 items), accessibility and adaptation (16 items), peer support (2 items); (2) health workforce (12 items); (3) health information systems (7 items); (4) medical products and technologies (1 item); (5) financing (3 items); and (6) leadership and governance (7 items). It promotes the implementation of integrated (colocated or linked) healthcare services that are community based and people centred. These should provide a continuum of needs-based health promotion, disease prevention, diagnosis, treatment and management, together with housing, legal and social support services, in alignment with the goals of universal health coverage and the WHO frameworks on integrated, people-centred healthcare.ConclusionsThe Checklist is offered as a practical tool to help overcome inequalities in access to health and support services. Policymakers, public health bodies, healthcare authorities, practitioner bodies, peer support workers and non-governmental organisations can use it when developing, updating or monitoring services for target groups. It may also assist civil society in wider advocacy efforts to improve access for underserved communities.

Health risk assessment for the general population and industrial workers is most commonly based on analysis related to the determination of harmful chemicals in environmental objects (air, water, soil, food). An increasing number of experts have recently been inclined to believe an approach to give no an idea of the total amount of chemical pollutants actually entering the human body, and another approach based on the biomonitoring procedure has been suggested. The aim of the work was to systematize current concepts about the classification of biomarkers, their toxicological and hygienic characteristics and the prospects for the practical use of laboratory research results in prevention of chemical etiology of diseases. Analytical review of national and foreign literature information concerning current terminology and classification of biological markers used in biomonitoring process to assess human body exposure degree to harmful environmental chemicals is submitted. The development and improvement of biomonitoring strategies, the range of studied specific biomarkers were revealed to be being widened, enhance the objectivity of risk assessment of the development of chemical etiology diseases caused by environmental pollution. At the present stage, the classification of biomarkers is represented by four types: exposure, effect, sensitivity, and “omics” for scientific research. According to chemical structure exposure biomarkers are divided into two groups: organic compounds and metals. It is suggested to use in Russia foreign experience in developing a biomonitoring system by the example of European Union countries and the United States, where there are national biomonitoring programs in which each country determines its priorities for choosing biomarkers based on assessment of public health risks, exposure levels in a particular region, toxicological characteristics, interpretability of findings, analytical feasibility, possibility of reducing exposure. Each biomarker is ranked according to its total weight score. Biological exposure limits developed by the Human Biomonitoring Commission of German Environment Agency are most often used in literature for assessment of biomonitoring findings. Taking into account foreign experience, introduction of biomonitoring strategies in Russia appears to be most reasonable as based on current social and hygienic monitoring system in Rospotrebnadzor (Federal Service for Surveillance over Consumers’ Rights Protection) institutions in cooperation with health care institutions of RF Health Ministry).

Objective – Libraries have had to temporarily shut their doors because of the COVID-19 pandemic, resulting in the provision of online and remote services. This review analyzed services offered by libraries, the technological tools used, and the challenges facing libraries during the pandemic. Methods – This study employed a systematic literature review, following the PRISMA checklist (Moher at al., 2009). The Building Blocks search strategy was employed to search for keywords of concepts in Library and Information Science Abstract (LISA), Library and Information Science Technology Abstract (LISTA), Library Science Database, Web of Science (WoS) core collections, and Google Scholar. A set of inclusion and exclusion criteria was pre-determined by the authors prior to database searching. Quality assessment of included studies was performed using the Mixed Methods Appraisal Tool (Hong et al., 2018). A tabular approach was used to provide a summary of each article allowing the synthesis of results, which led to the identification of eight broad categories of services provided by libraries in included studies. Results – The first set of searches from the 5 databases produced 3,499 results. After we removed duplicates and applied the inclusion and exclusion criteria based on titles and abstracts, 37 potentially relevant articles were identified. Further screening of the full-text led to the final inclusion of 23 articles used for the qualitative synthesis. The majority of the studies were conducted in the United States of America (n= 6, 26.1%), followed by India (n=4, 17%), and China (n=2, 8.7%). The remaining studies were carried out in United Kingdom, Ireland, Canada, Mexico, Romania, Czech Republic, Indonesia, Pakistan, Nigeria, Lesotho, and Zimbabwe. The most common method used in selected studies was the case study (n= 11, 48%), followed by survey (n=7, 30.4%), content analysis (n=4, 17.4%), and mixed methods (n=1, 4.3%). The majority of the studies were carried out in academic libraries (74%), while the rest were based on medical, public, and special libraries. Findings show that the majority of academic libraries in the included studies are providing and expanding access to electronic resources (n=16, 69.6%) and increasing open access resources and services (n=11, 47.8%). More so, most academic libraries are assisting in virtual education and teaching endeavors of faculty and students (n=13, 56.5%). In addition, some medical and public libraries are bolstering public health safety through health literacy (n=12, 52.2%), supporting research efforts, and engaging in virtual reference services, among others. In order to carry out these services, libraries are harnessing several educational, social networking, communication, and makerspaces technologies. Most of the libraries in the included studies reported budgetary challenges, and the need for new ICT infrastructure and Internet service as they move their services online. Conclusion – This review found that libraries are adapting in a number of ways to continue their roles in meeting patrons’ needs in spite of the growing challenges posed by COVID-19 restrictions and lockdown. For libraries to thrive in these trying times, there must be a well-structured approach to ensuring continuity of services. Libraries should prioritize the acquisition of electronic resources as well as increase their efforts to digitize resources that are only available in printed copies. As library services have predominantly shifted online, there should be concerted effort and support from government and funding agencies to equip libraries with the technological facilities needed to provide cutting-edge services. The quality assessment of the included studies shows that there is need for rigor and transparency in the methodological description of studies investigating library services provision in a pandemic. This review provides an overview of the ways libraries have responded to the challenges posed by a global pandemic, and hence will be of use and interest to all librarians especially those in health and academic sectors.

The purpose of the article is to study the order and progress of the mobilization of the European Union and its bureaucratic structures to counter the "Russian information threat" after the Ukrainian crisis (2015-2016), the role of individual states and EU bodies in the process of getting involved in the fight against "Russian disinformation" and especially doctrinal consolidation and institutional organization of this opposition in the activities of the European Union. The study showed that of all the communitarian bodies of the European Union, the most active role in promoting the discourse on the "Russian information threat" after the Ukrainian crisis was played by the European Parliament, which was the main platform for bringing this topic to the level of the European public space and the EU political agenda. The most significant practical effect in terms of doctrinal and institutional consolidation of this discourse at the EU level was made by the European External Action Service, within which in mid-2015 the East Stratcom Task Force was formed. The East Stratcom Operational Working Group, responsible for monitoring and timely refutation of "Russian fakes and disinformation", voiced radical assessments in relation to certain (pro) Russian information materials. The European Commission has shown the least activity in strengthening the confrontation with Russia in the information sphere. In doctrinal terms, in 2015–2016 the European Union has made significant progress towards recognizing the relevance of information and so-called “hybrid” threats, however, at the level of the basic position documents adopted during the period under review (primarily the EU Global Strategy 2016), the direct linkage of these threats to Russia was not clearly articulated.

Objective This study asks ‘Is capital investment in Australian public hospitals effectively funding patient access to efficient hospital care?’ Methods The study drew information from semistructured interviews with senior health infrastructure officials, literature reviews and World Health Organization (WHO) reports. To identify which systems most effectively fund patient access to efficient hospitals, capital allocation systems for 17 Organisation for Economic Cooperation and Development (OECD) countries were assessed. Results Australian government objectives (equitable access to clinically appropriate, efficient, sustainable, innovative, patient-based) for acute health services are not directly addressed within Australian capital allocation systems for hospitals. Instead, Australia retains a prioritised hospital investment system for institutionally based asset replacement and capital planning, aligned with budgetary and political priorities. Australian systems of capital allocation for public hospitals were found not to match health system objectives for allocative, productive and dynamic efficiency. Australia scored below average in funding patient access to efficient hospitals. The OECD countries most effectively funding patient access to efficient hospital care have transitioned to diagnosis-related group (DRG) aligned capital funding. Measures of effective capital allocation for hospitals, patient access and efficiency found mixed government–private–public partnerships performed poorly with inferior access to capital than DRG-aligned systems, with the worst performing systems based on private finance. Conclusion Australian capital allocation systems for hospitals do not meet Australian government standards for the health system. Transition to a diagnosis-based system of capital allocation would align capital allocation with government standards and has been found to improve patient access to efficient hospital care. What is known about the topic? Very little is known about the effectiveness of Australian capital allocation for public hospitals. In Australia, capital is rarely discussed in the context of efficiency, although poor built capital and inappropriate technologies are acknowledged as limitations to improving efficiency. Capital allocated for public hospitals by state and territory is no longer reported by Australian Institute of Health and Welfare due to problems with data reliability. International comparative reviews of capital funding for hospitals have not included Australia. Most comparative efficiency reviews for health avoid considering capital allocation. The national review of hospitals found capital allocation information makes it difficult to determine ’if we have it right’ in terms of investment for health services. Problems with capital allocation systems for public hospitals have been identified within state-based reviews of health service delivery. The Productivity Commission was unable to identify the cost of capital used in treating patients in Australian public hospitals. Instead, building and equipment depreciation plus the user cost of capital (or the cost of using the money invested in the asset) are used to estimate the cost of capital required for patient care, despite concerns about accuracy and comparability. What does this paper add? This is the first study to review capital allocation systems for Australian public hospitals, to evaluate those systems against the contemporary objectives of the health systems and to assess whether prevailing Australian allocation systems deliver funds to facilitate patient access to efficient hospital care. This is the first study to evaluate Australian hospital capital allocation and efficiency. It compares the objectives of the Australian public hospitals system (for universal access to patient-centred, efficient and effective health care) against a range of capital funding mechanisms used in comparable health systems. It is also the first comparative review of international capital funding systems to include Australia. What are the implications for practitioners? Clinical quality and operational efficiency in hospitals require access for all patients to technologically appropriate hospitals. Funding for appropriate public hospital facilities, medical equipment and information and communications technology is not connected to activity-based funding in Australia. This study examines how capital can most effectively be allocated to provide patient access to efficient hospital care for Australian public hospitals. Capital investment for hospitals that is patient based, rather than institutionally focused, aligns with higher efficiency.

Purpose The purpose of this paper was to uncover morality and dynamics of community of incentivized reviewers who primarily review products on Amazon.com. and, as of late, on various social media platforms. This study is important because it uncovers unknown dynamics that shapes consumer morality and drives reviewer’s ethics. Given the fact that consumers heavily rely on reviews, findings of this paper are of great values to practitioners, consumers and policymakers and highlight potential area of research particularly related to morality. Design/methodology/approach This study, conducted over a period of 1.5 years, relying on a netnography to collect data and thematic analysis to make sense of data, uncovered behaviors that contribute to the J-shape distribution of reviews on Amazon.com and questionable reviewer ethics. Findings Findings of this study suggest suppressed consumer morality driven by desire to gain benefits in form of free products and manipulation of the review system in an attempt to boost sales and the prevalence of biased reviews. The findings shed light on overconsumption driven by an opportunity to receive free products, introduction of review bias into the public domain and attempts to manipulate Amazon’s algorithms. Research limitations/implications Findings of this study carry tremendous implications for average consumer who relies on consumer-generated reviews without realizing the presence of bias. Furthermore, the findings shed light of unfair business practices of sellers who demand high ratings. Finally, the findings suggest that there is opportunity for policymakers to address a loophole because incentivized reviewers, regardless of Federal Trade Commission regulations, may be operating in gray area, much less controlled than advertising. Originality/value This study is unique because while other studies may conduct similar netnographies of reviewing communities, this community was examined during a span that covered the incentivized reviewing boom, Amazon’s ban on incentivized reviewing, and the revival of reviewing activity post ban. Given recent changes to Amazon’s Terms of Service, the researcher documented changes that future studies will not be able to examine unless data have already been collected. However, post ban activity continues and is likely affecting purchasing decisions of unsuspecting consumers all around.

Objective. Recent health system enquiries and commissions, including the National Health and Hospital Reform Commission, have promoted clinical engagement as necessary for improving the Australian healthcare system. In fact, the Rudd Government identified clinician engagement as important for the success of the planned health system reform. Yet there is uncertainty about how clinical engagement is understood in health policy and management. This paper aims to clarify how clinical engagement is defined, measured and how it might be achieved in policy and management in Australia. Methods. We review the literature and consider clinical engagement in relation to employee engagement, a defined construct within the management literature. We consider the structure and employment relationships of the public health sector in assessing the relevance of this literature. Conclusions. Based on the evidence, we argue that clinical engagement is similar to employee engagement, but that engagement of clinicians who are employees requires a different construct to engagement of clinicians who are independent practitioners. The development of this second construct is illustrated using the case of Visiting Medical Officers in Victoria. Implications. Antecedent organisational and system conditions to clinical engagement appear to be lacking in the Australian public health system, suggesting meaningful engagement will be difficult to achieve in the short-term. This has the potential to threaten proposed reforms of the Australian healthcare system. What is known about the topic? Engagement of clinicians has been identified as essential for improving quality and safety, as well as successful health system reform, but there is little understanding of how to define and measure this engagement. What does this paper add? Clinical engagement is defined as the cognitive, emotional and physical contribution of health professionals to their jobs, and to improving their organisation and their health system within their working roles in their employing health service. While this construct applies to employees, engagement of independent practitioners is a different construct that needs to recognise out-of-role requirements for clinicians to become engaged in organisational and system reform. What are the implications for practitioners? This paper advances our understanding of clinical engagement, and suggests that based on research on high performance work systems, the Australian health system has a way to go before the antecedents of engagement are in place.

The advancement of digital technology forces humans to make adjustments in all aspects of life, likewise, with the local elections' holding (Pilkada). However, the conditions for each region in the Indonesian archipelago have different problems. Availability of telecommunication facilities, local elections (Pilkada) organizers, level of difficulty in Frontier, Outermost, and Disadvantaged Region (3T), community digital literacy level, and accuracy of results. Have the local elections (Pilkada) been digitalized? How far has it been achieved? What challenges are faced, and what are the solutions? Several studies on e-voting, even the local elections (Pilkada) digitization, have been carried out. This study is novel because it looks at the 2020 local elections (Pilkada) implementation from digitalization that was carried out in line with the COVID-19 pandemic. Due to data limitations and availability, this study only focuses on implementing local elections (Pilkada) in nine provinces. This study uses a qualitative method based on a literature review with a systematic review method. The study aims to reveal the achievements and challenges of digitalization in the implementation of local elections (Pilkada) along with policy solutions so that digitalization is more completed. Through analysis, it was found that the organizers of the local elections (Pilkada) have made efforts to realize digitalization. Various Subscriber Identity Modules (SIM) and applications have been created by the General Election Commission (KPU), the General Election Supervisory Board (Bawaslu), and the General Election Organizer Honorary Council (DKPP). It is hoped that digitalization will further increase the effectiveness, efficiency, and quality of service. Besides, the data shows that there are obstacles in the field, especially the availability of telecommunication infrastructure, which is very diverse in the nine provinces. Fundamentally, it is necessary to formulate regulations/policies that synergize the implementation of local elections (Pilkada) through the adoption of digital technology based on the internet of things (IoT), big data analysis, and artificial intelligence (AI). The local elections (Pilkada) digitization brings several benefits - more transparent, accountable, credible, practical, and economical. On the other hand, the community feels more of its services because the digital local elections (Pilkada) procession educates the public to elect local leaders with integrity.

Background Local authorities in England commission the NHS Health Check programme to invite everyone aged 40–74 years without pre-existing conditions for risk assessment and eventual intervention, if needed. However, the programme’s effectiveness, cost-effectiveness and equity impact remain uncertain. Aim To develop a validated open-access flexible web-based model that enables local commissioners to quantify the cost-effectiveness and potential for equitable population health gain of the NHS Health Check programme. Objectives The objectives were as follows: (1) co-produce with stakeholders the desirable features of the user-friendly model; (2) update the evidence base to support model and scenario development; (3) further develop our computational model to allow for developments and changes to the NHS Health Check programme and the diseases it addresses; (4) assess the effectiveness, cost-effectiveness and equity of alternative strategies for implementation to illustrate the use of the tool; and (5) propose a sustainability and implementation plan to deploy our user-friendly computational model at the local level. Design Co-production workshops surveying the best-performing local authorities and a systematic literature review of strategies to increase uptake of screening programmes informed model use and development. We then co-produced the workHORSE (working Health Outcomes Research Simulation Environment) model to estimate the health, economic and equity impact of different NHS Health Check programme implementations, using illustrative-use cases. Setting Local authorities in England. Participants Stakeholders from local authorities, Public Health England, the NHS, the British Heart Foundation, academia and other organisations participated in the workshops. For the local authorities survey, we invited 16 of the best-performing local authorities in England. Interventions The user interface allows users to vary key parameters that represent programme activities (i.e. invitation, uptake, prescriptions and referrals). Scenarios can be compared with each other. Main outcome measures Disease cases and case-years prevented or postponed, incremental cost-effectiveness ratios, net monetary benefit and change in slope index of inequality. Results The survey of best-performing local authorities revealed a diversity of effective approaches to maximise the coverage and uptake of NHS Health Check programme, with no distinct ‘best buy’. The umbrella literature review identified a range of effective single interventions. However, these generally need to be combined to maximally improve uptake and health gains. A validated dynamic, stochastic microsimulation model, built on robust epidemiology, enabled service options analysis. Analyses of three contrasting illustrative cases estimated the health, economic and equity impact of optimising the Health Checks, and the added value of obtaining detailed local data. Optimising the programme in Liverpool can become cost-effective and equitable, but simply changing the invitation method will require other programme changes to improve its performance. Detailed data inputs can benefit local analysis. Limitations Although the approach is extremely flexible, it is complex and requires substantial amounts of data, alongside expertise to both maintain and run. Conclusions Our project showed that the workHORSE model could be used to estimate the health, economic and equity impact comprehensively at local authority level. It has the potential for further development as a commissioning tool and to stimulate broader discussions on the role of these tools in real-world decision-making. Future work Future work should focus on improving user interactions with the model, modelling simulation standards, and adapting workHORSE for evaluation, design and implementation support. Study registration This study is registered as PROSPERO CRD42019132087. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 35. See the NIHR Journals Library website for further project information.

BackgroundExposure to domestic violence and abuse (DVA) during childhood and adolescence increases the risk of negative outcomes across the lifespan.ObjectivesTo synthesise evidence on the clinical effectiveness, cost-effectiveness and acceptability of interventions for children exposed to DVA, with the aim of making recommendations for further research.Design(1) A systematic review of controlled trials of interventions; (2) a systematic review of qualitative studies of participant and professional experience of interventions; (3) a network meta-analysis (NMA) of controlled trials and cost-effectiveness analysis; (4) an overview of current UK provision of interventions; and (5) consultations with young people, parents, service providers and commissioners.SettingsNorth America (11), the Netherlands (1) and Israel (1) for the systematic review of controlled trials of interventions; the USA (4) and the UK (1) for the systematic review of qualitative studies of participant and professional experience of interventions; and the UK for the overview of current UK provision of interventions and consultations with young people, parents, service providers and commissioners.ParticipantsA total of 1345 children for the systematic review of controlled trials of interventions; 100 children, 202 parents and 39 professionals for the systematic review of qualitative studies of participant and professional experience of interventions; and 16 young people, six parents and 20 service providers and commissioners for the consultation with young people, parents, service providers and commissioners.InterventionsPsychotherapeutic, advocacy, parenting skills and advocacy, psychoeducation, psychoeducation and advocacy, guided self-help.Main outcome measuresInternalising symptoms and externalising behaviour, mood, depression symptoms and diagnosis, post-traumatic stress disorder symptoms and self-esteem for the systematic review of controlled trials of interventions and NMA; views about and experience of interventions for the systematic review of qualitative studies of participant and professional experience of interventions and consultations.Data sourcesMEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, EMBASE, Cochrane Central Register of Controlled Trials, Science Citation Index, Applied Social Sciences Index and Abstracts, International Bibliography of the Social Sciences, Social Services Abstracts, Social Care Online, Sociological Abstracts, Social Science Citation Index, World Health Organization trials portal and clinicaltrials.gov.Review methodsA narrative review; a NMA and incremental cost-effectiveness analysis; and a qualitative synthesis.ResultsThe evidence base on targeted interventions was small, with limited settings and types of interventions; children were mostly < 14 years of age, and there was an absence of comparative studies. The interventions evaluated in trials were mostly psychotherapeutic and psychoeducational interventions delivered to the non-abusive parent and child, usually based on the child’s exposure to DVA (not specific clinical or broader social needs). Qualitative studies largely focused on psychoeducational interventions, some of which included the abusive parent. The evidence for clinical effectiveness was as follows: 11 trials reported improvements in behavioural or mental health outcomes, with modest effect sizes but significant heterogeneity and high or unclear risk of bias. Psychoeducational group-based interventions delivered to the child were found to be more effective for improving mental health outcomes than other types of intervention. Interventions delivered to (non-abusive) parents and to children were most likely to be effective for improving behavioural outcomes. However, there is a large degree of uncertainty around comparisons, particularly with regard to mental health outcomes. In terms of evidence of cost-effectiveness, there were no economic studies of interventions. Cost-effectiveness was modelled on the basis of the NMA, estimating differences between types of interventions. The outcomes measured in trials were largely confined to children’s mental health and behavioural symptoms and disorders, although stakeholders’ concepts of success were broader, suggesting that a broader range of outcomes should be measured in trials. Group-based psychoeducational interventions delivered to children and non-abusive parents in parallel were largely acceptable to all stakeholders. There is limited evidence for the acceptability of other types of intervention. In terms of the UK evidence base and service delivery landscape, there were no UK-based trials, few qualitative studies and little widespread service evaluation. Most programmes are group-based psychoeducational interventions. However, the funding crisis in the DVA sector is significantly undermining programme delivery.ConclusionsThe evidence base regarding the acceptability, clinical effectiveness and cost-effectiveness of interventions to improve outcomes for children exposed to DVA is underdeveloped. There is an urgent need for more high-quality studies, particularly trials, that are designed to produce actionable, generalisable findings that can be implemented in real-world settings and that can inform decisions about which interventions to commission and scale. We suggest that there is a need to pause the development of new interventions and to focus on the systematic evaluation of existing programmes. With regard to the UK, we have identified three types of programme that could be justifiably prioritised for further study: psycho-education delivered to mothers and children, or children alone; parent skills training in combination with advocacy: and interventions involving the abusive parent/caregiver. We also suggest that there is need for key stakeholders to come together to explicitly identify and address the structural, practical and cultural barriers that may have hampered the development of the UK evidence base to date.Future work recommendationsThere is a need for well-designed, well-conducted and well-reported UK-based randomised controlled trials with cost-effectiveness analyses and nested qualitative studies. Development of consensus in the field about core outcome data sets is required. There is a need for further exploration of the acceptability and effectiveness of interventions for specific groups of children and young people (i.e. based on ethnicity, age, trauma exposure and clinical profile). There is also a need for an investigation of the context in which interventions are delivered, including organisational setting and the broader community context, and the evaluation of qualities, qualifications and disciplines of personnel delivering interventions. We recommend prioritisation of psychoeducational interventions and parent skills training delivered in combination with advocacy in the next phase of trials, and exploratory trials of interventions that engage both the abusive and the non-abusive parent.Study registrationThis study is registered as PROSPERO CRD42013004348 and PROSPERO CRD420130043489.FundingThe National Institute for Health Research Public Health Research programme.

Background: The transmission of pathogenic organisms in healthcare settings is a major cause of healthcare-associated infections (HAIs). In recent years, infections with carbapenem-resistant Enterobacteriaceae (CRE) have become a significant public health threat, in part because many patients are arriving at the hospital already colonized, and colonization is a major risk factor for infection. Reducing transmission requires understanding how patient movement drives the spread of CRE; however, analysis of this issue has mostly been modeled at a hospital-level without much consideration for the population dynamics that occur outside of the hospital setting and how patients move between healthcare settings. Patients move between hospitals, other healthcare settings, such as long-term care facilities (LTCFs), and the community, all of which pose different colonization risks. Thus, studying each environment in isolation fails to realistically address the consequences of large-scale policy interventions. One such intervention is a statewide electronic registry to track patients who are known to be colonized or have had a CRE infection. Understanding the potential for reducing CRE morbidity and mortality requires consideration of small- and large-scale effects on patients’ movement and transmission. Methods: We developed a multiscale, metapopulation model for hospitals, communities, and LTCFs in the state of Maryland. In our computational simulation, we included a regional- as well as a local-scale model that were informed by the patient-mix data from the Maryland Health Service Cost Review Commission. We examined the impact of implementing a registry compared to less coordinated scenarios. Results: The most effective policy was the implementation of an electronic registry which resulted in 9.6% median reduction in CRE HAIs in Maryland for simulated outcomes (Fig. 1). Other interventions included colonization screening at various or all hospitals and using a predictive algorithm to determine at-risk patients that need to be screened. These interventions only resulted in ~1%–3% reductions in HAIs. We also observed that coupling other interventions with an electronic registry does not aid in reducing more HAIs.Funding: NoneDisclosures: NoneBoxplot of simulated outcomes of all scenarios compared to the baseline scenario. The scenarios include (1) complete screening with no electronic registry, (2) selective screening with no electronic registry, (3) predictive screening with no electronic registry, (4) baseline with an electronic registry, (5) complete screening with an electronic registry, (6) selective screening with an electronic registry, and (7) predictive screening with an electronic registry. Scenarios 5-7 include the same interventions as 1–3 coupled with an electronic registry.

The policy of Ukraine for the establishment and development of relations with the European Union began in 1993, was carried out all the years of Ukraine’s existence, and received intensive deepening with the beginning of the formation of an international treaty – the Association Agreement, which includes a list of legal, social, economic, and technical regulations, and Deep and Comprehensive Free Trade Area (DCFTA), in 2014 and its final signing in 2017. Political and economic objectives of the Agreement are of fundamental importance to the future of both Ukraine and the whole European region. The political goal is to implement European standards on the territory of Ukraine. This implies the introduction of fundamental European values, namely democracy, rule of law, respect for human rights and the standards of the European security system. The Agreement does not foresee membership in the European Union, however, does not exclude such an opportunity in the future. The economic goal is to help to modernize the Ukrainian economy by expanding trade volumes with the EU and other countries, as well as reforming economic regulation mechanisms in line with the best European practices. Subject to the improvement of the business climate, Ukraine will become attractive for foreign and domestic investment for further production for export to the EU and other markets of the world. Harmonization of standards and European regulations has become a much more important process than the fulfilment of strictly technical requirements and underlies the introduction of effective governance without corruption. In the process of harmonization of interaction, an adaptive institutional mechanism was formed (the highest level – annual Summits; the key coordinator is the Association Council, consisting of members of the Council of the European Union and members of the European Commission, and members of the Cabinet of Ministers of Ukraine; the level of operational coordination – the Association Parliamentary Committee, which includes members of the European Parliament, representatives of the Verkhovna Rada of Ukraine, and the Civil Society Platform; in order to coordinate processes on the territory of Ukraine, the Ukrainian government has introduced a few supervisory committees and commissions). The harmonization of the economic aspect of the mechanism has been determined in solving issues of openness of markets for duty-free import from Ukraine in April 2014, obtaining a visa-free regime with the EU, abolishing export-import tariffs, implementing European technical standards for food safety, phytosanitary norms, competition policy, service provision, and public procurement policy. The issues of further deepening of relations include a review of the terms for the introduction of regulations and legislative provisions before their actual implementation, stabilization of financial and economic processes in the country, and further development of democratic values and social institutions.

Acute physicians are confronted daily by the relentless increase in clinical demand, inadequate continuity of care, breakdown in out of hours care and a looming crisis in the medical workforce. The scale and gravity of these factors, together with changes to patient’s needs relating to the ageing demography, were detailed in the RCP report published in September 2012 ‘Hospitals on the edge’. The top concern of RCP members and fellows was the lack of continuity of care, ahead of financial pressures and clinical staff shortages. Worryingly one in ten physicians stated they would not recommend their hospital to a family member, and a further 25% were ambivalent on this question. Concern about the provision of acute medical care is not confined to consultants and specialist registrars. Another RCP report, ‘Hospital workforce, fit for the future?’ (2013) highlighted that 37% of FT2s and CMTs considered the workload of the medical registrar on call ‘unmanageable’. The outcome of the Mid Staffs independent inquiry in February 2013 provided critical context for the launch of the Future Hospital Commission (FHC) report, which was launched seven months later in September. The report was met with an extremely positive response from patients, carers, NHS staff, healthcare leaders and politicians. Lancet Editor Richard Horton said that the Commission had ‘produced the most important statement about the future of British medicine for a generation.’ Secretary of State for Health Jeremy Hunt praised the report and its ‘buck stops here’ approach. The Daily Mirror even noted that the report was one of the few areas on which the government and the opposition could agree! ‘Future Hospital: caring for medical patients’ places the patient at the centre of healthcare. Organising healthcare delivery around the needs of the patient is at its heart and features extensively in the core principles and 50 recommendations. A series of unequivocal commitments were made to patients, on issues generating considerable patient concern: moving beds in hospital, quality of communication and arrangements to leave hospital. Patients and carers were represented in each of the Commission’s five work streams, led on the recommendations relating to building a culture of compassion and respect, and participated in launch of the report to the media. The primary focus of the FHC report is on the acute care of medical patients and the views of acute physicians were key to articulating these recommendations. However the report is clear that the solution to current acute pressures on hospitals and specifically in-patient pathways, lie across the whole health and social care system. Care must be delivered in the setting in which the patient’s clinical, care and support needs can best be met and not merely delegated to the acute hospital site. This inevitably means 7 day services in the community as well as in hospital and a consistent new level of “joined up care” with integration, collaboration and information sharing across hospital and all healthcare settings. In keeping with this the report highlights the urgent need to establish alternatives to hospital admission including the extensive use of ambulatory emergency care (AEC), the provision of secondary care services in the community and an expansion of intermediate care rehabilitation services. Many of the report’s recommendations arose from clinical staff devising innovative solutions to improve the quality of care and ameliorate clinical demand. The report showcased a range of case studies describing service developments and new patterns of care, innovations that would not have been possible without the leadership and sheer determination of physicians and their teams. Dr Jack Hawkins, Acute Physician in Nottingham Queen’s Medical Centre, described how analysis of performance data showing that 50% of acute medical patients were discharged within 15 hours, led to the starting vision for their new AEC service as “everyone is ambulatory until proven otherwise”. The case studies highlight the resources needed to implement service change and the supportive staff relationships and changes to working practices that underpin their success. The report describes the “acute care hub” as the focus of acute medical services, comprising colocation of the AMU, short stay wards, enhanced care beds and the AEC. Much of this echoes the front door configuration described by the acute medicine task force report in 2007 ‘Acute medical care: The right person, in the right setting, first time’. What the FHC adds are recommendations to co-locate AEC and a clinical co-ordination centre to provide clinicians with real time data on capacity in community-based services (rehabilitation and social services), and link to rapid access specialist clinics or community services to support pathways out of AEC and AMU. Recommendations to structure acute services to maximise continuity of care is a major theme. There should be sufficient capacity in the acute care hub to accommodate admitted patients who do not require a specialist care pathway and are likely to be discharged within 48 hours. This is supported by recommended changes to working practices of consultant led teams where they commit to two or more successive days working in the hub. This allows the consultant led team who first assess the patient in AMU to continue to manage them on the short stay ward through to their discharge – an approach familiar to acute physicians but which may be novel to GIM physicians assigned a single on call day. Striving to deliver continuity by a stable clinical team should also simplify handover, improve training, feedback and the quality and safety of the care delivered. The commission recommends designating enhanced care (level 1) and high dependency (level 2) beds in the acute care hub to improve the care of acutely ill patients requiring an increased intensity of monitoring and treatment. The RCP acute medicine taskforce made the same recommendation in 2007 but acute trusts have been slow to embed level 2 beds in particular, on AMUs. In the future hospital every effort should be made to enhance rapid access to specialist pathways that benefit patients, including entry to pathways for acute coronary disease or stroke or the frail elderly direct from the community or emergency department. Here the report is clear that the responsibility for continuity of care rests with the specialty consultant, who should review the patient on the day of admission. Patient experience should be valued as much as clinical effectiveness. Patients want “joined up care” that is tailored to their acute illness, comorbidities and requirements for social support. From a patient’s perspective, failures of information sharing between primary and secondary care, or specialist services within the same or neighbouring Trusts, are incomprehensible. The report highlights that this informatics disconnect undermines accurate clinical assessment at the time of presentation with an acute illness, when patients are most vulnerable, and this deficit will impact on patient experience, timely access to specialist staff, patient outcome and resource use. Robert Francis, in commenting on the report of the Mid Staffordshire public enquiry highlighted that the subject was ‘too important to suffer the same fate as other previous enquiries .. where after initial courtesy of welcome, implementation was slow or non existent’. The RCP shares this urgency and having accepted the recommendations of the FHC as a comprehensive ‘treatment’ for the care of patients in the future hospital, is determined that the FHC report itself will not sit on a shelf, gathering dust. The RCP is now embarking on a future hospital implementation programme. This programme gathers momentum this month with the appointment of future hospital officers and staff and the immediate priority is to identify partners to set up national development sites. The RCP is seeking enthusiastic clinical teams to investigate changes to a range of hospital and community based medical services in line with the FHC principles and to evaluate the impact on patient care. Over the next 3 years it is envisaged that the programme will also include research and new approaches to commissioning, workforce deployment, healthcare facility design and integrated working across the health economy. The evaluation of these projects, in relation to the quality and safety of patient care and patient experience, will be crucial and will be shared through the RCP and its partners. In addition, from April the RCP will publish a Future Hospital journal to help share the learning from the implementation programme and welcomes submissions of innovative best practice in acute care. The challenge now is to convert the goodwill generated by publication of the FHC principles, into an implementation programme nationally, that helps build an effective evidence base to support new ways of providing high quality, safe, patient care. Acute physicians are crucial partners in meeting this challenge.

e4139111This article features schools and school districts with successful induction programs, all easily replicable. Increasingly, research confirms that teacher and teaching quality are the most powerful predictors of student success. In short, principals ensure higher student achievement by assuring better teaching. To do this, effective administrators have a new teacher induction program available for all newly hired teachers, which then seamlessly becomes part of the lifelong, sustained professional development program for the district or school. What keeps a good teacher are structured, sustained, intensive professional development programs that allow new teachers to observe others, to be observed by others, and to be part of networks or study groups where all teachers share together, grow together, and learn to respect each other’s work.ResumoEste artigo apresenta escolas e distritos escolares com programas bem sucedidos de indução, todos facilmente replicáveis. Cada vez mais, a pesquisa confirma que o professor e a qualidade do ensino são os mais poderosos preditores do sucesso do aluno. Em suma, os diretores garantem maior desempenho dos alunos, garantindo melhor ensino. Para fazer isso, os administradores eficazes têm um novo programa de indução de professores disponível para todos os professores recém-contratados, que então se torna parte do programa de desenvolvimento profissional sustentado ao longo da vida para o distrito ou escola. O que mantém um bom professor são programas estruturados, constantes e intensivos de desenvolvimento profissional que permitem que os novos professores observem outros, sejam observados por outros e façam parte de redes ou grupos de estudo onde todos os professores compartilham juntos, crescem juntos e aprendem a respeitar o trabalho um do outro.Tradução do original WONG, Harry K. “Induction Programs That Keep New Teachers Teaching and Improving”. NASSP Bulletin – Vol. 88 No 638 March 2004. © Harry K. Wong Publications, Inc. por Adriana Teixeira Reis.Palavras-chave: Programas de indução, Professor iniciante, Desenvolvimento profissional docente.Keywords: Induction programs, Beginner teacher, Teacher professional development.ReferencesALLINGTON, R. (2003). The six ts of effective elementary literacy instruction. Retrieved from www.readingrockets.org / article.php?ID=413.BREAUX, A., & WONG, H. (2003). New teacher induction: How to train, support, and retain new teachers. Mountain View, CA: Harry K. Wong Publications.BRITTON, E., PAINE, L., PIMM, D., & RAIZEN, S. (Eds.). (2003). Comprehensive teacher induction: Systems for early career learning. State: Kluwer Academic Publishers and WestEd.CROSS, C. T., & RIGDEN, D. W. (2002, April). Improving teacher quality [Electronic version]. American School Board Journal, 189(4), 24–27.DARLING-HAMMOND, L., & SYKES, G. (2003). Wanted: A national teacher sup- ply policy for education: The right way to meet the “highly qualified teacher” challenge. Education Policy Analysis Archives, 11(33). Retrieved from http: // epaa.asu.edu / epaa / v11n33 /DARLING-HAMMOND, L., & YOUNGS, P. (2002). Defining “highly qualified teachers”: What does scientifically-based research actually tell us? Educational Researcher, 31(9), 13–25.DEPAUL, A. (2000). Survival guide for new teachers: How new teachers can work effec- tively with veteran teachers, parents, principals, and teacher educators. Jessup, MD: U.S. Department of Education, Office of Educational Research and Improvement.DRUMMOND, S. (2002, April 18). What will it take to hold onto the next gen- eration of teachers? Harvard Graduate School of Education News. Retrieved from www.gse.harvard.edu / news / features / ngt04182002.htmlELMORE, R. (2002, January/ February). The limits of “change.” Harvard Education Letter. Retrieved from www.edletter.org / past / issues / 2002-jf / limitsofchange.shtmlFEIMAN-NEMSER, S. (1996). Teacher mentoring: A critical review. Washington, DC: ERIC Clearinghouse on Teaching and Teacher Education. (ERIC Document Reproduction Service No. ED397060)FULLAN, M. (2001). The new meaning of educational change (3rd ed.). New York: Teachers College Press.FULLAN, M. (2003). Change forces with a vengeance. London: Routledge Falmer.GARET, M., Porter, A., DESMOINE, L., BIRMAn, B., & KWANG, S. K. (2001). What makes professional development effective? American Educational Research Journal, 38(4), 915–946.GREENWALD, R., HEDGES, L., & LAINE, R. (1996). The effect of school resources on student achievement. Review of Educational Research, 66(3), 361–396.HANUSHEK, E. A., KAIN, J. F., & RIVKIN, S. G. (2001). Why public schools lose teachers (NBER Working Paper No. 8599). Cambridge, MA: National Bureau of Economic Research.HARE, D., & HEAP, J. (2001). Effective teacher recruitment and retention strategies in the Midwest. Naperville, IL: North Central Regional Laboratory. Re- trieved June 26, 2002, from www.ncrel.org / policy/ pubs / html / strategy/ index.htmlHASSEL, E. (1999). Professional development: Learning from the best. Naperville, IL: North Central Regional Educational Laboratory.HIEBERT, H., GALLIMORE, R., & STIGLER, J. (2002). A knowledge base for the teaching profession: What would it look like and how can we get one? Educational Researcher, 31(5), 3–15.JOHNSON, S., & BIRKELAND, S. (2003). Pursuing a sense of success: New teach- ers explain their career decisions. American Educational Research Journal, 40(3), 581–617.JOHNSON, S. M., & KARDOS, S. M. (2002). Keeping new teachers in mind. Educational Leadership, 59(6), 13–16.KARDOS, S. (2003, April). Integrated professional culture: Exploring new teachers’ experiences in 4 states. Paper presented at the annual meeting of the American Educational Research Association, Chicago, IL.LEHMAN, P. (2003, November 26). Ten steps to school reform at bargain prices. Education Week, 23(13), 36, 28.LIU, E. (2003, April). New teachers’ experiences of hiring: Preliminary findings from a 4-state study. Paper presented at the annual meeting of the American Educational Research Association, Chicago, IL.MARTIN, S. (2003, March). From the ground up: Building your own university. Paper presented at the annual meeting of the Association of Supervision and Curriculum Development, San Francisco, CA.NORTH CAROLINA TEACHING FELLOWS COMMISSION. (1995). Keeping talented teach- ers. Raleigh, NC: Public School Forum of North Carolina.PALOMBO, M. (2003). A network that puts the net to work. Journal of Staff Development, 24(1), 24–28.ROTHMAN, R. (2002 / 2003). Transforming high schools into small learning communities. Challenge Journal, 6(2), 1–8.SANDERS, W. (1996). Cumulative and residual effects of teachers on future student academic achievement. Knoxville, TN: University of Tennessee Value-Added Research & Assessment Center.SAPHIER, J., FREEDMAN, S., & ASCHHEIM, B. (2001). Beyond mentoring: How to nurture, support, and retain new teachers. Newton, MA: Teachers21.SCHLAGER, M., FUSCO, J., KOCH, M., CRAWFORD, V., & PHILLIPS, M. (2003, July). Designing equity and diversity into online strategies to support new teachers. Paper presented at the National Educational Computing Conference (NECC), Seattle, WA.SERPELL, Z., & BOZEMAN, L. (1999). Beginning teacher induction: A report of beginning teacher effectiveness and retention. Washington, DC: National Partnership for Excellence and Accountability in Teaching.WONG, H. (2001, August 8). Mentoring can’t do it all. Education Week, 20(43), pp. 46, 50.WONG, H. (2002a). Induction: The best form of professional development. Educational Leadership, 59(6), 52–55.WONG, H. (2002b). Play for keeps. Principal Leadership, 3(1), 55–58.WONG, H. (2003a). Collaborating with colleagues to improve student learn- ing. ENC Focus, 11(6), 9.WONG, H. (2003b, October). Induction: How to train, support, and retain new teachers. Paper presented at the conference of the National Staff Development Council.WONG, H. (2003c). Induction programs that keep working. In M. Scherer (Ed.), Keeping good teachers ( pp. 42–49). Alexandria, VA: Association of Supervision and Curriculum Development.WONG, H., & ASQUITH, C. (2002). Supporting new teachers. American School Board Journal, 189(12), p. 22.YOUNGS, P. (2003). State and district policies related to mentoring and new teacher induction in Connecticut. New York: National Commission on Teaching and America’s Future.

STEAM-based learning is a global issue in early-childhood education practice. STEAM content becomes an integrative thematic approach as the main pillar of learning in kindergarten. This study aims to develop a conceptual and practical approach in the implementation of children's education by applying a modification from STEAM Learning to R-SLAMET. The research used a qualitative case study method with data collection through focus group discussions (FGD), involving early-childhood educator's research participants (n = 35), interviews, observation, document analysis such as videos, photos and portfolios. The study found several ideal categories through the use of narrative data analysis techniques. The findings show that educators gain an understanding of the change in learning orientation from competency indicators to play-based learning. Developing thematic play activities into continuum playing scenarios. STEAM learning content modification (Science, Technology, Engineering, Art and Math) to R-SLAMETS content (Religion, Science, Literacy, Art, Math, Engineering, Technology and Social study) in daily class activity. Children activities with R-SLAMETS content can be developed based on an integrative learning flow that empowers loose part media with local materials learning resources. Keyword: STEAM to R-SLAMETS, Early Childhood Education, Integrative Thematic Learning References Ali, E., Kaitlyn M, C., Hussain, A., & Akhtar, Z. (2018). the Effects of Play-Based Learning on Early Childhood Education and Development. Journal of Evolution of Medical and Dental Sciences, 7(43), 4682–4685. https://doi.org/10.14260/jemds/2018/1044 Ata Aktürk, A., & Demircan, O. (2017). A Review of Studies on STEM and STEAM Education in Early Childhood. Journal of Kırşehir Education Faculty, 18(2), 757–776. Azizah, W. A., Sarwi, S., & Ellianawati, E. (2020). Implementation of Project -Based Learning Model (PjBL) Using STREAM-Based Approach in Elementary Schools. Journal of Primary Education, 9(3), 238–247. https://doi.org/10.15294/jpe.v9i3.39950 Badmus, O. (2018). Evolution of STEM, STEAM and STREAM Education in Africa: The Implication of the Knowledge Gap. In Contemporary Issues in Science, Technology, Engineering, Arts and Mathematics Teacher Education in Nigeria. Björklund, C., & Ahlskog-Björkman, E. (2017). Approaches to teaching in thematic work: early childhood teachers’ integration of mathematics and art. International Journal of Early Years Education, 25(2), 98–111. https://doi.org/10.1080/09669760.2017.1287061 Broadhead, P. (2003). Early Years Play and Learning. In Early Years Play and Learning. https://doi.org/10.4324/9780203465257 Canning, N. (2010). The influence of the outdoor environment: Den-making in three different contexts. European Early Childhood Education Research Journal, 18(4), 555–566. https://doi.org/10.1080/1350293X.2010.525961 Clapp, E. P., Solis, S. L., Ho, C. K. N., & Sachdeva, A. R. (2019). Complicating STEAM: A Critical Look at the Arts in the STEAM Agenda. Encyclopedia of Educational Innovation, 1–4. https://doi.org/10.1007/978-981-13-2262-4_54-1 Colucci, L., Burnard, P., Cooke, C., Davies, R., Gray, D., & Trowsdale, J. (2017). Reviewing the potential and challenges of developing STEAM education through creative pedagogies for 21st learning: how can school curricula be broadened towards a more responsive, dynamic, and inclusive form of education? BERA Research Commission, August, 1–105. https://doi.org/10.13140/RG.2.2.22452.76161 Conradty, C., & Bogner, F. X. (2018). From STEM to STEAM: How to Monitor Creativity. Creativity Research Journal, 30(3), 233–240. https://doi.org/10.1080/10400419.2018.1488195 Conradty, C., & Bogner, F. X. (2019). From STEM to STEAM: Cracking the Code? How Creativity & Motivation Interacts with Inquiry-based Learning. Creativity Research Journal, 31(3), 284–295. https://doi.org/10.1080/10400419.2019.1641678 Cook, K. L., & Bush, S. B. (2018). Design thinking in integrated STEAM learning: Surveying the landscape and exploring exemplars in elementary grades. School Science and Mathematics, 118(3–4), 93–103. https://doi.org/10.1111/ssm.12268 Costantino, T. (2018). STEAM by another name: Transdisciplinary practice in art and design education. Arts Education Policy Review, 119(2), 100–106. https://doi.org/10.1080/10632913.2017.1292973 Danniels, E., & Pyle, A. (2018). Defining Play-based Learning. In Encyclopedia on Early Childhood Development (Play-Based, Issue February, pp. 1–5). OISE University of Toronto. DeJarnette, N. K. (2018). Implementing STEAM in the Early Childhood Classroom. European Journal of STEM Education, 3(3), 1–9. https://doi.org/10.20897/ejsteme/3878 Dell’Erba, M. (2019). Policy Considerations for STEAM Education. Policy Brief, 1–10. Doyle, K. (2019). The languages and literacies of the STEAM content areas. Literacy Learning: The Middle Years, 27(1), 38–50. http://proxy.libraries.smu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=eue&AN=133954204&site=ehost-live&scope=site Edwards, S. (2017). Play-based learning and intentional teaching: Forever different? Australasian Journal of Early Childhood, 42(2), 4–11. https://doi.org/10.23965/ajec.42.2.01 Faas, S., Wu, S.-C., & Geiger, S. (2017). The Importance of Play in Early Childhood Education: A Critical Perspective on Current Policies and Practices in Germany and Hong Kong. Global Education Review, 4(2), 75–91. Fesseha, E., & Pyle, A. (2016). Conceptualising play-based learning from kindergarten teachers’ perspectives. International Journal of Early Years Education, 24(3), 361–377. https://doi.org/10.1080/09669760.2016.1174105 Finch, C. R., Frantz, N. R., Mooney, M., & Aneke, N. O. (1997). Designing the Thematic Curriculum: An All Aspects Approach MDS-956. 97. Gess, A. H. (2019). STEAM Education. STEAM Education, November, 2011–2014. https://doi.org/10.1007/978-3-030-04003-1 Gronlund, G. (n.d.). “ Addressing Standards through Play-Based Learning in Preschool and Kindergarten .” Gronlund, G. (2015). Planning for Play-Based Curriculum Based on Individualized Goals to Help Each Child Thrive in Preschool and Kindergarten Gaye Gronlund. Gull, C., Bogunovich, J., Goldstein, S. L., & Rosengarten, T. (2019). Definitions of Loose Parts in Early Childhood Outdoor Classrooms: A Scoping Review. The International Journal of Early Childhood Education, 6(3), 37–52. Hapidin, Pujianti, Y., Hartati, S., Nurani, Y., & Dhieni, N. (2020). The continuous professional development for early childhood teachers through lesson study in implementing play based curriculum (case study in Jakarta, Indonesia). International Journal of Innovation, Creativity and Change, 12(10), 17–25. Hennessey, P. (2016). Full – Day Kindergarten Play-Based Learning : Promoting a Common Understanding. Education and Early Childhood Development, April, 1–76. gov.nl.ca/edu Henriksen, D. (2017). Creating STEAM with Design Thinking: Beyond STEM and Arts Integration. Steam, 3(1), 1–11. https://doi.org/10.5642/steam.20170301.11 Inglese, P., Barbera, G., La Mantia, T., On, P., Presentation, T., Reid, R., Vasa, S. F., Maag, J. W., Wright, G., Irsyadi, F. Y. Al, Nugroho, Y. S., Cutter-Mackenzie, A., Edwards, S., Moore, D., Boyd, W., Miller, E., Almon, J., Cramer, S. C., Wilkes-Gillan, S., … Halperin, J. M. (2014). Young Children’s Play and Environmental Education in Early Childhood Education. PLoS ONE, 2(3), 9–25. https://doi.org/10.1586/ern.12.106 Jacman, H. (2012). Early Education Curriculum. Pedagogical Development Unit, FEBRUARY 2011, 163. https://www.eursc.eu/Syllabuses/2011-01-D-15-en-4.pdf Jay, J. A., & Knaus, M. (2018). Embedding play-based learning into junior primary (Year 1 and 2) Curriculum in WA. Australian Journal of Teacher Education, 43(1), 112–126. https://doi.org/10.14221/ajte.2018v43n1.7 Kennedy, A., & Barblett, L. (2010). Supporting the Early Years Learning Framework. Research in Practise Series, 17(3), 1–12. Keung, C. P. C., & Cheung, A. C. K. (2019). Towards Holistic Supporting of Play-Based Learning Implementation in Kindergartens: A Mixed Method Study. Early Childhood Education Journal, 47(5), 627–640. https://doi.org/10.1007/s10643-019-00956-2 Keung, C. P. C., & Fung, C. K. H. (2020). Exploring kindergarten teachers’ pedagogical content knowledge in the development of play-based learning. Journal of Education for Teaching, 46(2), 244–247. https://doi.org/10.1080/02607476.2020.1724656 Krogh, S., & Morehouse, P. (2014). The Early Childhood Curriculum : Inquiry Learning Through Integration. Liao, C. (2016). From Interdisciplinary to Transdisciplinary: An Arts-Integrated Approach to STEAM Education. Art Education, 69(6), 44–49. https://doi.org/10.1080/00043125.2016.1224873 Lillard, A. S., Lerner, M. D., Hopkins, E. J., Dore, R. A., Smith, E. D., & Palmquist, C. M. (2013). The impact of pretend play on children’s development: A review of the evidence. Psychological Bulletin, 139(1), 1–34. https://doi.org/10.1037/a0029321 Maxwell, L. E., Mitchell, M. R., & Evans, G. W. (2008). Effects of Play Equipment and Loose Parts on Preschool Children’s Outdoor Play Behavior: An Observational Study and Design Intervention. Children, Youth and Environments, 18(2), 37–63. McLaughlin, T., & Cherrington, S. (2018). Creating a rich curriculum through intentional teaching. Early Childhood Folio, 22(1), 33. https://doi.org/10.18296/ecf.0050 Mengmeng, Z., Xiantong, Y., & Xinghua, W. (2019). Construction of STEAM Curriculum Model and Case Design in Kindergarten. American Journal of Educational Research, 7(7), 485–490. https://doi.org/10.12691/education-7-7-8 Milara, I. S., Pitkänen, K., Laru, J., Iwata, M., Orduña, M. C., & Riekki, J. (2020). STEAM in Oulu: Scaffolding the development of a Community of Practice for local educators around STEAM and digital fabrication. International Journal of Child-Computer Interaction, 26, 100197. https://doi.org/10.1016/j.ijcci.2020.100197 Moomaw, S. (2012). STEM Begins in the Early Years. School Science and Mathematics, 112(2), 57–58. https://doi.org/10.1111/j.1949-8594.2011.00119.x Peng, Q. (2017). Study on Three Positions Framing Kindergarten Play-Based Curriculum in China: Through Analyses of the Attitudes of Teachers to Early Linguistic Education. Studies in English Language Teaching, 5(3), 543. https://doi.org/10.22158/selt.v5n3p543 Pyle, A., & Bigelow, A. (2015). Play in Kindergarten: An Interview and Observational Study in Three Canadian Classrooms. Early Childhood Education Journal, 43(5), 385–393. https://doi.org/10.1007/s10643-014-0666-1 Pyle, A., & Danniels, E. (2017). A Continuum of Play-Based Learning: The Role of the Teacher in Play-Based Pedagogy and the Fear of Hijacking Play. Early Education and Development, 28(3), 274–289. https://doi.org/10.1080/10409289.2016.1220771 Quigley, C. F., Herro, D., & Jamil, F. M. (2017). Developing a Conceptual Model of STEAM Teaching Practices. School Science and Mathematics, 117(1–2), 1–12. https://doi.org/10.1111/ssm.12201 Ridgers, N. D., Knowles, Z. R., & Sayers, J. (2012). Encouraging play in the natural environment: A child-focused case study of Forest School. Children’s Geographies, 10(1), 49–65. https://doi.org/10.1080/14733285.2011.638176 Ridwan, A., Rahmawati, Y., & Hadinugrahaningsih, T. (2017). Steam Integration in Chemistry Learning for Developing 21st Century Skills. MIER Journail of Educational Studies, Trends & Practices, 7(2), 184–194. Rolling, J. H. (2016). Reinventing the STEAM Engine for Art + Design Education. Art Education, 69(4), 4–7. https://doi.org/10.1080/00043125.2016.1176848 Sancar-Tokmak, H. (2015). The effect of curriculum-generated play instruction on the mathematics teaching efficacies of early childhood education pre-service teachers. European Early Childhood Education Research Journal, 23(1), 5–20. https://doi.org/10.1080/1350293X.2013.788315 Sawangmek, S. (2019). Trends and Issues on STEM and STEAM Education in Early Childhood. Képzés És Gyakorlat, 17(2019/3-4), 97–106. https://doi.org/10.17165/tp.2019.3-4.8 Science, A. I. (n.d.). STEM Project-Based Learning. Spencer, R., Joshi, N., Branje, K., Lee McIsaac, J., Cawley, J., Rehman, L., FL Kirk, S., & Stone, M. (2019). Educator perceptions on the benefits and challenges of loose parts play in the outdoor environments of childcare centres. AIMS Public Health, 6(4), 461–476. https://doi.org/10.3934/publichealth.2019.4.461 Taylor, J., Bond, E., & Woods, M. (2018). A Multidisciplinary and Holistic Introduction. Varun A. (2014). Thematic Approach for Effective Communication in Early Childhood Education Thematic Approach for effective communication in ECCE. International Journal of Education and Psychological Research (IJEPR), 3(3), 49–51. https://www.researchgate.net/publication/289868193 Wang, X., Xu, W., & Guo, L. (2018). The status quo and ways of STEAM education promoting China’s future social sustainable development. Sustainability (Switzerland), 10(12). https://doi.org/10.3390/su10124417 Whitebread, D. D. (2012). The Importance of Play. Toy Industries of Europe, April, 1–55. https://doi.org/10.5455/msm.2015.27.438-441 Wong, S. M., Wang, Z., & Cheng, D. (2011). A play-based curriculum: Hong Kong children’s perception of play and non-play. International Journal of Learning, 17(10), 165–180. https://doi.org/10.18848/1447-9494/cgp/v17i10/47298 Zosh, J. M., Hopkins, E. J., Jensen, H., Liu, C., Neale, D., Hirsh-Pasek, K., Whitebread, Solis, S. L., & David. (2017). Learning through play : a review of the evidence (Issue November). The LEGO Foundation.

Public participation in Western Australian (WA) government policy development and strategy setting is not governed by a particular best practice model. The WA Service Priority Review Working Together One Public Sector Delivering for WA, released 2017, identified the need to build a public sector focussed on community needs and to develop a whole of government citizen engagement strategy for WA, including co-designing. The Road Safety Commission (Commission) employs a diverse range of public participation and engagement initiatives. An initial step in preparing for development and introduction of a whole of government strategy review of the nature of public participation initiatives of the Commission. The review method was an analysis of five initiatives that provide reasonable representation of the Commission’s public participation and engagement activities. For the purposes of this review, the International Association for Public Participation spectrum of public participation has been used to classify the activities. This paper presents a summation of the review to date, communicating the current status and potential future direction of the Commission. Further work is required by the Commission.