Small-scale Initiatives Research Articles

Integrating Health Care for the Most Vulnerable: Bridging the Differences in Organizational Cultures Between US Hospitals and Community Health Centers.

Policymakers have increasingly promoted health services integration to improve quality and efficiency. The US health care safety net, which comprises providers of health care to uninsured, Medicaid, and other vulnerable patients, remains a largely fragmented collection of providers. We interviewed leadership from safety net hospitals and community health centers in 5 US cities (Boston, MA; Denver, CO; Los Angeles, CA; Minneapolis, MN; and San Francisco, CA) throughout 2013 on their experiences with service integration. We identify conflicts in organizational mission, identity, and consumer orientation that have fostered reluctance to enter into collaborative arrangements. We describe how smaller scale initiatives, such as capitated model for targeted populations, health information exchange, and quality improvements led by health plans, can help bridge cultural differences to lay the groundwork for developing integrated care programs.

Medical Brigades and Global Health

Recently, recommendations have been made that global health initiatives change their focus from disease specific intervention to bolstering health systems and general health care. The aim of this is to ultimately increase access to primary care, clean water, education, hygiene, and prevent malnutrition, among other goals. While many major global health initiatives have followed this trend, so have many smaller scale programs including short term medical brigades. Despite a trending increase in the number of privately run short term medical brigades, until recently, little research has been done on the potential positive and negative effects that can arise from such programs. Now, guidelines have been initiated to create well-structured programs. When followed, these smaller scale initiatives can be successful in helping increase access to healthcare, sustainably strengthening communities in terms of general health. While recent legislation in the United States has addressed domestic policy in the Patient Protection Affordable Care Act of 2010 (ACA), the ACA should also consider some of the basic “sustainable” policies being implemented by international health care providers.

Social capital in large-scale environmental collaboration: the case of the Platte River Recovery Implementation Program

Environmental collaborative governance arrangements have the potential to build social capital, leading to long-term cooperation among parties with a history of conflict over water use, in particular in irrigation, hydropower production and riverine wildlife habitat. Previous research on social capital in the context of collaborative governance has emphasized small-scale grassroots initiatives where actors hold common membership in civic associations. This study explores a large-scale policy level collaborative arrangement as a case of collective action facilitated by elements of social capital, with a special emphasis on the concept of the institution as social capital. The Platte River Recovery Implementation Program is the basis for initial findings that social capital formation and cooperative implementation of innovative approaches to water policy can occur at both the local action and large-scale policy levels of collaboration.

Large-scale teacher professional development endeavor: the Lincoln Tri-State Institute

This article explores a two-year professional development initiative with four state geographic alliances. Professional development planners, whether planning for a large- or small-scale initiative or one with unlimited or limited funding, will benefit from learning about this successful professional development activity and how the impact in the lives of teachers and students was measured. The actual process of this professional development and the assessment methods that were used throughout the entire two years are both noteworthy and could serve as a model for others.

Seed processing and oil quality of Jatropha curcas L. on farm scale: A comparison with other energy crops

There are many examples of small-scale initiatives, based on exploitation of the jatropha-crude oil chain, to provide energy at local level, especially in the rural areas of a developing country, where mechanical pressing is currently the most widely used process to extract oil from seed. This study is a comparative analysis of the extraction performance parameters and the quality of the cold pressed oil obtained utilizing a commercial single screw extruder at the farm level for the extraction of Jatropha curcas, sunflower and rapeseed oil. In the case of J. curcas, the best operating results were obtained at a seed feed rate of 25.7kg/h yielding about 8kg/h of oil. This result, although satisfactory, was much lower than that of the rape and sunflower seeds. The levels of the main mineral contents (phosphorus, calcium and magnesium) in the jatropha oil, are significantly higher than those specified in the DIN V 51605 standard. Moreover jatropha oil showed high K and Na content (>2ppm), the elements that promote deposit formations in engines, while these were not detectable in rapeseed and sunflower oil. Preventive measures (optimizing harvest and storage condition) and avoiding an excessive rise in oil temperature (<50°C) during the extraction process are necessary to improve the quality of the jatropha crude oil. In order to meet the quality standards of the new DIN 51506, in order to reduce the mineral elements content in the jatropha oil (especially P, Ca+Mg) inert additives may be mixed with the oil during the seed processing, but these additives can lower the oxidation stability of the oil, so a stabilizer also needs to be added. Moreover these steps complicate the technological process and lower the commercial value of the oil, clearly demonstrating the advantage of producing oil with low concentration of P, Ca+Mg and K+Na in the first place.

The Big Question: Upwardly Mobile: What role should technology play in Africa’s development?

The Big Question: Upwardly Mobile: What role should technology play in Africa’s development?

'Complaining time is over'

This article traces the history of the New York Musicians Organization (NYMO), an artist-run collective that rose to brief prominence at the dawn of the loft jazz era. Founded in 1972, NYMO attracted a broad membership and considerable press attention for two heavily-publicized summer festivals. In stressing themes of self-reliance, avant garde performance practice and African American agency, the group’s organizers drew extensively from earlier Midwestern collectives like the AACM. Yet unlike those groups, NYMO failed to establish a strong central governing body, instead acting as a consortium of smaller, independently-managed ventures. This approach laid the groundwork for the proliferation of small-scale initiatives that characterized the loft period, and several former NYMO members went on to establish important loft venues. While the group’s prominence was short-lived, it played a crucial bridge role between the collectivized strategies of the 1960s and the loosely-connected musical networks of the loft era.

Hollow Words: Foreign Aid and Peacebuilding in Peripheral Conflicts

Many foreign aid agencies promote peacebuilding as a global policy objective. This paper considers how they have fared in practice in subnational, “peripheral” conflicts in Asia that have relatively low international profiles, using case material from Aceh in Indonesia, the Far South of Thailand, and Sri Lanka. Foreign aid has supported long-term economic growth in these countries but typically failed to address peacebuilding concerns or associated inequalities between ethnic groups. Many barriers limit the scope to promote peacebuilding, stemming from recipient governments’ reluctance to accept external involvement and from aid agencies’ own limitations. Those agencies that do address conflict concerns tend not to use technical peacebuilding tools or methodologies. Instead, they prioritize the root causes of conflicts, recognizing human rights protection and equality of opportunity as policy aims. They also devise responses locally, build good relationships with governments, and work incrementally from a strong knowledge base. Wider adoption of similar policy objectives and practice would enable further small-scale peacebuilding initiatives.

Molecular management: Protocols in the maker culture

ABSTRACTEarly industrialism was influenced by the organization of cottage industries, and in a similar vein, many of today's creative industries emerge largely from networked small-scale initiatives or cultural scenes. Collaborations and interactions are the backbone of the contemporary Do-It-Yourself (DIY) or ‘maker culture’, a distributed milieu of open software programmers and hardware hackers, but also crafters, backyard tinkerers, hobbyists and homesteaders. The scene is held together by micro-management tactics, or ‘molecular’ management, using protocols to guide collaborative innovation and shared craft practices, forming an emergent and innovative creative cottage industry. The maker culture is thus less of a DIY and more a do-it-together culture, merging collaborative play and interactions, often for the sake of shared curiosity. The mindset of the participants is that of the explorative craftsman; using a practical attitude of sharing ideas, methods and skills among practitioners, and the interactions are managed in a flat and meshworked manner through the use of protocols. The text specifically examines the protocols of the maker movement, finding an immediate connection between hardware protocols, like the ‘makers bill of rights’ guiding the principles of open source hardware, and the principles reflected in the social protocols of two hacker spaces. The maker culture is not only a loose network of dispersed tinkerers, it is also a close-knit molecular assemblage of materials, tools, skills and makers.

Jatropha curcas: Sowing local seeds of success in Malawi? : In response to Achten et al. (2010)

Achten et al. (2010) note that small-scale, local shifts towards growing the inedible, biodiesel crop Jatropha curcas ( Jatropha) may overcome some of the negative points inherent in popular biofuel-focused debates, including those on food insecurity and environmental degradation concerns. In this short response, we assess the views expressed by Achten et al. (2010) in light of recent case study-based research in Malawi that identifies and analyses the current context and potential for rural development of both local-level community-led and larger-scale private sector Jatropha projects in Malawi. Although large-scale cultivation of Jatropha is at risk of economic loss resultant from knowledge gaps and unpredictable yields, our research shows that small-scale initiatives do have the potential to contribute positively to rural livelihoods. Sales of seeds or production of Jatropha oil for stoves, engines, soap and paraffin can result in reduced household expenditure or increased incomes. In order for these benefits to be realised and up-scaled, further institutional support in terms of knowledge and technical provision is vital, and must be communicated through established and context-specific, locally-appropriate channels. While the biofuel debate remains global, we assert that actions should be focused at the local level in order to realise developmental, sustainability and climate change mitigation benefits across a range of scales.

Building systems of innovation in less developed countries: the role of intermediate organizations supporting interactions in Tanzania and El Salvador

The aim of this article is to discuss the role of intermediate organizations in supporting different forms of interactive learning and capability building in small-scale business initiatives in emerging innovation systems in developing countries, using data from Tanzania and El Salvador. It is argued that different types of intermediate organizations have played key roles in linking marginalized economic actors to sources of knowledge and other resources that are essential for capability upgrading and innovation in both traditional and more differentiated economic activities. They thus play an important role in linking innovative activity, to maintaining and upgrading the quality of existing jobs in crisis, generating new ones where opportunities arise, and providing income crucial for family well-being in countries characterized by low levels of human development and high levels of inequality.

Bending bamboo: Restructuring rural electrification in Sarawak, Malaysia

This article examines the strategy of electrification for Sarawak which centers on large-scale hydroelectric projects. Drawing from extensive in-field interviews of stakeholders in Sarawak who are affected by the soon-to-be-completed 2400 megawatt (MW) Bakun Hydroelectric Project, this article presents documentary evidence that these “hard path” mega energy projects are economically, socially and ecologically sub-optimal. The study suggests that more rigorous development of “soft path” small-scale, decentralized renewable energy systems more effectively support development and electrification aspirations for the region. The paper concludes with an analysis which invalidates the rationale for supporting mega projects yet recognizes that powerful advocates pose significant threats to a transition from hard to soft energy paths. It puts forth a concluding recommendation that pressure to scale down these mega projects and bolster decentralized, small-scale initiatives represents the most feasible approach to optimizing rural electrification in Sarawak. Overall, this case study provides both a detailed analysis of the inadequacies of mega energy projects in supporting economic development in less affluent regions and insight into how to strategically facilitate ideological change from hard (mega projects) to soft (decentralized energy systems) energy paths.

Hybrid and ‘Everyday’ Political Ordering: Constructing and Contesting Legitimacy in Somaliland

A number of recent post-colonial liberal peace critiques have moved beyond the counter-positioning of ‘liberal/Western’ versus ‘communal/non-Western’ peace and political order. Instead, they draw attention to the interstices – the processes of contestation, repulsion and accommodation – between these approaches. Some argue that the most promising, if contentious, forms of political ordering and peace building take place exactly in a hybrid of state-based and liberal practices, and local customs and ‘everyday’ life in post-conflict settings.Through a case-study of Somaliland, this article examines the potentials and limits of such a hybrid approach to advancing peace and political order. The analysis in particular engages with the largely uncharted issue of how political legitimacy is constructed or undermined, in the context of post-conflict hybrid political orders. Somaliland’s reconstruction process was characterised by very low international intervention when compared to other so-called ‘fragile states’ and post-conflict settings. The article looks at how political institutions and structures of governance were constituted from within Somaliland through local agencies and formation of alliances, which cut across the dichotomies of ‘state/non-state’ and ‘liberal/traditional’ forms of governance and legitimacy. It illustrates the advantages, as well as some of the challenges, of this process of political ordering and hybridization, where the domestic sphere was allowed to be constitutive for the creation of legitimacy.Examining a small-scale international-local initiative of peace dialogues and community policing in Somaliland, the article also discusses how international support may engage with ‘everyday’ strategies of self-securing, and deliberately ‘facilitate’ hybridity in the context of conflict management and justice.The analysis offers an empirical anchoring of the concepts of ‘hybridity’ and the ‘everyday’, but also demonstrates how the case of Somaliland speaks more broadly to post-colonial liberal peace critiques and the call for new approaches to peace and political order.

Structuring properties of irrigation systems: understanding relations between humans and hydraulics through modeling

Irrigation systems were clearly important in ancient times in supplying crops with water. This requires physical distribution facilities and socio-political arrangements to coordinate between actors. Resulting systems are highly diverse, and are being studied extensively within archeology and history. Whether initiated by a central authority or emerging from small-scale initiatives, irrigation systems are shaped through activities of individuals, households, and small groups into patterns and landscapes. This article discusses how hydraulic modeling techniques are powerful methodologies to study such irrigation development. Modeling daily interactions by agents and water fluxes will build better understanding of irrigation systems as anthropogenic landscapes. Three case studies will be used to illustrate this argument. A current irrigation system in Arequipa, Peru, shows that one can relate irrigation infrastructure and social action. A second case from Peru on a pre-Colombian irrigation system suggests that one can link irrigation system, water flows, and settlement. In the third case in the Jordan Valley, this possible link between irrigation and settlement is further studied.

Grizzly Bear conservation in the Foothills Model Forest: appraisal of a collaborative ecosystem management effort

In west-central Alberta, Canada, an ambitious collaborative conservation program for grizzly bears began in 1999, after extensive controversy over the Cheviot coal mine project and successful negotiation of a unique federal–provincial strategic framework for grizzly bear conservation. Unfortunately that program was effectively terminated without any substantive implementation of its research findings. The regional ecosystem approach for conserving grizzlies in the Foothills Model Forest originated in federal and provincial legislative processes but proved vulnerable to shifting goals and containment by a single powerful participant. This case study’s results demonstrate vulnerabilities of the ecosystem management approach to conserving large carnivores. To enable other such conservation efforts to achieve their goals, we recommend supporting emergent small-scale initiatives and designing collaborative institutions that limit the potential for containment of decision processes.

The 'Small-scale Initiative'; the Rhetoric and the Reality of Community Policing in Australia

Australian police jurisdictions engage in several forms of community policing. Numerous initiatives in all states and territories are delivered through a range of programs. Common to these programs is a commitment to community engagement and participation. This article briefly examines community policing practice in Australia and considers the challenges of developing a comprehensive community policing model. It suggests that community policing in Australia is not a fully developed concept and its approach is essentially ‘small scale’, ie. a local approach intended to bring police into non-confrontational contact with the community. The article considers the organisational and managerial constraints that hinder the development of strong community policing models in Australia. It argues that conflicting governing structures, the absence of legislative and policy support, an emphasis on performance management in a highly politicised environment and the expectations of a community whose support is imperative to police legitimacy are the primary constraining factors.

The rush to accelerate: Early stages of nuclear physics research in Australia

ABSTRACT From the mid-1930s, Australian physicists, though few in number, sought to join the exciting new field of research then opening up in experimental nuclear physics. Such research was already, however, largely based on the use of particle accelerators, and to acquire one demanded money and resources on a scale unprecedented in Australian scientific experience. Australian attempts during the period 1935–1960 to build accelerators or to acquire them by other means are described. The difficulties that Australian physicists faced in this connection and the strategies by which they sought to overcome them are considered. Three stages of development are identified: an initial period of small-scale initiatives in the 1930s, a postwar period of “do-it-yourself” accelerator building, and finally a growing practice of buying machines “off the shelf” from commercial suppliers.

Utilizing Collaboration Theory to Evaluate Strategic Alliances

Increasingly, collaboration between business, non-profit, health and educational agencies is being championed as a powerful strategy to achieve a vision otherwise not possible when independent entities work alone. But the definition of collaboration is elusive and it is often difficult for organizations to put collaboration into practice and assess it with certainty. Program evaluators can assist practitioners concerned with the development of a strategic alliance predicated on collaboration by understanding and utilizing principles of collaboration theory. The Strategic Alliance Formative Assessment Rubric (SAFAR) is an assessment tool that captures central principles of collaboration and has been used as part of a four-step evaluation process to help alliance leaders, managers, and members in Safe School/Healthy Student Initiatives to quantitatively and qualitatively gauge, celebrate, and communicate the relative strength of their collaborative endeavor over time. The collaboration principles and corresponding assessment processes described in this article can be used by evaluators of large- or small-scale initiatives that seek to capitalize on the synergistic power of the “collaborative effort.”

Utilizing Collaboration Theory to Evaluate Strategic Alliances

Increasingly, collaboration between business, non-profit, health and educational agencies is being championed as a powerful strategy to achieve a vision otherwise not possible when independent entities work alone. But the definition of collaboration is elusive and it is often difficult for organizations to put collaboration into practice and assess it with certainty. Program evaluators can assist practitioners concerned with the development of a strategic alliance predicated on collaboration by understanding and utilizing principles of collaboration theory. The Strategic Alliance Formative Assessment Rubric (SAFAR) is an assessment tool that captures central principles of collaboration and has been used as part of a four-step evaluation process to help alliance leaders, managers, and members in Safe School/Healthy Student Initiatives to quantitatively and qualitatively gauge, celebrate, and communicate the relative strength of their collaborative endeavor over time. The collaboration principles and corresponding assessment processes described in this article can be used by evaluators of large- or small-scale initiatives that seek to capitalize on the synergistic power of the “collaborative effort.”

Small-scale rural pilot programs in chronic illness management - what next?

In recent years, rural SA has been the recipient of significant funding to support a range of new primary health care initiatives. Much of this funding, additional to normal recurrent budgets in our health system, has facilitated effective change and development through demonstration and research projects across the state. The resultant work involves programs such as: ? coordinated care trials (COAG) ? more allied health services (MAHS) ? Commonwealth regional health service initiatives (CRHS) ? quality use of medicines (QUM) ? community packages for aged care services ? Indigenous chronic disease self-management pilot programs (CDSM) ? chronic disease self-management (CDSM) programs - Sharing Health Care SA ? chronic disease self-management (CDSM) programs in Indigenous communities. In addition to the resources listed above, funding was also provided by the Commonwealth to establish the South Australian Centre for Rural and Remote Health (SACRRH) and develop the University Department of Rural Health in Whyalla. While this new funding has led to substantial developmental work in chronic illness management in particular, one needs to ask whether the time might not be right now for these hitherto small-scale change initiatives to be transformed into ongoing mainstream programs, informed and guided by research outcomes to date. Is it time to move beyond tentative chronic illness programs and into mainstream reform? We have shown that there is much to be gained, both for patients and for the system, from improved coordination of primary care services and initiatives such as self-management programs for patients with chronic conditions. Better management leads to improved patient health outcomes and can reduce demand for unplanned hospital and emergency services. Many admissions to rural hospitals requiring expensive services, in terms of infrastructure and staffing, could be either prevented, or patients could be managed more effectively in the community as part of a wider primary health care program.