Small-scale Program Research Articles

Transformative issues in privatizing public sector undertakings: a case study of Ethiopia

This article examines the transformative issues involved in privatizing public sector undertakings in Ethiopia. The transformative issues comprise of pre-privatization issues, that is, business environment and legal framework for the country in general and for the privatization agency in particular, and implementation issues, that is, identification and sequencing, restructuring and valuation, bidding and tendering, and buyer's response and modalities. The study covers a period of 10 years, ranging between 1990/91 and 2003/04, and analyses the data with simple statistical tools. It reveals that the privatization programme was a small-scale programme with lots of ups and downs, and there were multiple flaws in the transformative procedures. The dominant modality in privatizing was the direct asset sale since the choice of public offerings of shares cannot be exercised in the context of having a weak capital and zero stock market. The mixed result shown by the analysis of performance of the privatized enterprises was not much in favour of such enterprises, putting under the scanner the effectiveness of the transformative mechanisms and processes involved in the privatization. It is suggested that the government should ensure a competitive market and business environment, soothing tax system, appropriate and obstacles-free legal framework, an independent agency for implementing privatization, and systematic and transparent procedures, particularly for the valuation and accurate modalities so as to maximize the advantages of privatization.

Treating Schizophrenia with DOTS in Developing Countries: Author's Reply

I am grateful to Souza et al. [1] for taking interest in our article [2] and pointing out some very relevant points. I agree with the authors that despite the fact that the World Health Organization and many other agencies have advocated that mental health care in developing countries be integrated into primary care, there has been no real progress. We need to think about the real causes for this failure. Lack of commitment by governments is only a partial explanation. We, the mental health professionals practicing in developing countries, must also accept responsibility. One of the major reasons is that we have not been able to formulate simple interventions that can be implemented at the primary care level as a public health measure. The approach based on DOTS for treating schizophrenia is one such intervention. Most of the issues raised by Souza et al. are the problems that we are likely to face in applying an approach developed basically for an infectious disease to a chronic noncommunicable disease. I would like to stress that, as mentioned in the article, the approach is based on the principles of DOTS, not on applying DOTS exactly as practiced in tuberculosis control to the treatment of schizophrenia. I agree with the authors that it will need considerable modifications before it can be applied to a chronic disorder like schizophrenia. They have pointed out several issues and I would like to address these. 1. Health workers would definitely need to be better trained under the supervision of mental health professionals to apply this approach in primary care. 2. I very much appreciate the work of the authors and agree that passive case finding is not an option. This will result in the plight of patients mentioned in their letter. One of the benefits of the approach suggested in our article is that as a result of an intervention available at the public health level there will be greater awareness of severe mental illness. Consequently there will be earlier recognition of these cases in the community. As mentioned in the article, this should also result in reduced stigma for the disorder. 3. It should be possible to provide a standard regimen for treatment of schizophrenia based on the essential psychotropic drugs. We were able to develop this for our pilot project and are also using the same approach in our randomized controlled trial [3]. 4. One of the major reasons for advocating this approach is that it could ensure free supplies of the drugs as a part of a DOTS program. One of five essential components of the DOTS strategy is government commitment to providing drugs free of cost. This is the cornerstone of the strategy suggested in our article. 5. Monitoring and tracking of patients is important but need not stretch primary care workers beyond capacity, as schizophrenia is a low prevalence disorder. As explained in the article, the implementation of DOTS would be for a two-year period. The community can only be involved if we can offer effective interventions for those suffering from this chronic and disabling disorder. The approach suggested in our article represents an attempt to bring mental health into the public health arena. Schizophrenia is a low prevalence disorder, for which effective interventions are available and can be implemented at the community level. It therefore represents an ideal disorder for intervention based on DOTS. Applying an approach developed essentially for a disorder which has a time-limited course and is high on the public health agenda to a disorder which is noncommunicable and runs a much protracted course demands a paradigm shift. There are examples of similar approaches in other noncommunicable diseases. Insulin Demonstration projects, which have been initiated to improve access to insulin by the International Diabetes Foundation Task Force, can provide good models [4]. Small scale programs based on the model suggested in our article should be developed locally in developing countries before we can expect governments to support them. Organizations such Medecins Sans Frontieres are ideally suited to develop programs like these. One size may not fit all but we can make a suitable size for a great majority.

Denmotoxin, a Three-finger Toxin from the Colubrid Snake Boiga dendrophila (Mangrove Catsnake) with Bird-specific Activity

Boiga dendrophila (mangrove catsnake) is a colubrid snake that lives in Southeast Asian lowland rainforests and mangrove swamps and that preys primarily on birds. We have isolated, purified, and sequenced a novel toxin from its venom, which we named denmotoxin. It is a monomeric polypeptide of 77 amino acid residues with five disulfide bridges. In organ bath experiments, it displayed potent postsynaptic neuromuscular activity and irreversibly inhibited indirectly stimulated twitches in chick biventer cervicis nerve-muscle preparations. In contrast, it induced much smaller and readily reversible inhibition of electrically induced twitches in mouse hemidiaphragm nerve-muscle preparations. More precisely, the chick muscle alpha(1)betagammadelta-nicotinic acetylcholine receptor was 100-fold more susceptible compared with the mouse receptor. These data indicate that denmotoxin has a bird-specific postsynaptic activity. We chemically synthesized denmotoxin, crystallized it, and solved its crystal structure at 1.9 A by the molecular replacement method. The toxin structure adopts a non-conventional three-finger fold with an additional (fifth) disulfide bond in the first loop and seven additional residues at its N terminus, which is blocked by a pyroglutamic acid residue. This is the first crystal structure of a three-finger toxin from colubrid snake venom and the first fully characterized bird-specific toxin. Denmotoxin illustrates the relationship between toxin specificity and the primary prey type that constitutes the snake's diet.

Leading a change process to improve health service delivery

In the fields of health and development, donors channel multiple resources into the design of new practices and technologies, as well as small-scale programmes to test them. But successful practices are rarely scaled up to the level where they beneficially impact large, impoverished populations. An effective process for change is to use the experiences of new practices gained at the programme level for full-scale implementation. To make an impact, new practices need to be applied, and supported by management systems, at many organizational levels. At every level, potential implementers and likely beneficiaries must first recognize some characteristics that would benefit them in the new practices. An effective change process, led by a dedicated internal change agent, comprises several well-defined phases that successively broaden and institutionalize the use of new practices.

Patchwork Quilt or Seamless Day? Parent, Teacher and Child Care Staff Views on Early Childhood Education Programs for Kindergarten-Age Children in Canada

In Canada, child care for kindergartners typically combines part-day school and child care. Exploratory research examined parents', teachers', and child care staff views on coordination between these programs. Community-based research surveyed these three groups. There was general agreement, and some key differences, among the groups in priorities for programs for kindergarten-age children. Social and language skills were generally considered most important; reading and writing least. Parents were particularly enthusiastic about a coordinated, school-based program. Teachers and child care staff were somewhat less enthusiastic about the model, with teachers' reactions the least positive. Teachers' views on the advisability of an integrated program were varied—some thought it would be of benefit to children, others disagreed. All three groups felt that a coordinated program would benefit by being school-based. Direct experience with integrated programs seemed to produce strong opinions about the value of program integration, with those teachers who had on-site child care programs giving the integrated programs the highest and the lowest ratings. Arguments are made for small-scale demonstration programs to expand provision of child care services using kindergarten as a foundation—and for rigorous evaluation of program impacts and outcomes.

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.

Using Portfolios in Program Evaluation: An Investigation of Interrater Reliability

Portfolios and other open-ended assessments are increasingly incorporated into evaluations and testing programs. However, questions about the reliability of such assessments continue to be raised. After reviewing forces that may be leading to increased interest in and use of portfolio assessment, we investigate the interrater reliability of a portfolio assessment used in a small-scale program evaluation. Three types of portfolio scores were investigated—analytic, combined analytic (formed by summing across analytic scores), and holistic. The interrater reliability coefficient was highest for summed analytic scores ( r 5 .86). Results indicate that at least three raters are required to obtain acceptable levels of reliability for holistic and individual analytic scores.

Use of electronic communication to develop Mentor-Protégé relationships between adolescent and adult AAC users: Pilot study

Times of transition are often difficult for individuals with communication disabilities who rely on augmentative and alternative communication (AAC) systems. Mentoring by more experienced partners has been embraced by both business and education as an effective means of easing transitions. Mentoring by experienced adults who use AAC seems to offer many potential benefits for adolescents and young adults who require AAC. The purpose of this exploratory study was to develop, implement, and conduct a preliminary evaluation of a small-scale mentor program for adolescents and young adults who use AAC in order to identify issues for further consideration and research. In this study, four successful adult augmentative communicators were recruited to serve as mentors for four individuals using AAC. All of the interactions that took place between the mentors and protégés occurred using electronic mail (e-mail). The e-mail messages for each dyad were analyzed to investigate the frequency and length of messages, the goals set and attained by protégés, and the topics discussed. Consumer satisfaction data and suggestions for future mentoring programs were collected at the end of the program. The results of this preliminary study suggest that mentoring by successful users of AAC may be effective in easing the transition of younger users of AAC. The results also suggest that training of mentors and carefully matching protégés and mentors may be important steps in developing effective mentoring programs. E-mail may serve as an effective medium for establishing a mentoring program for individuals who use AAC, provided that the participants have guidelines for expectations of frequency of message exchanges, reliable Internet service, and opportunities for additional methods of contact.

Using portfolios in program evaluation: an investigation of interrater reliability

Portfolios and other open-ended assessments are increasingly incorporated into evaluations and testing programs. However, questions about the reliability of such assessments continue to be raised. After reviewing forces that may be leading to increased interest in and use of portfolio assessment, we investigate the interrater reliability of a portfolio assessment used in a small-scale program evaluation. Three types of portfolio scores were investigated—analytic, combined analytic (formed by summing across analytic scores), and holistic. The interrater reliability coefficient was highest for summed analytic scores ( r = .86). Results indicate that at least three raters are required to obtain acceptable levels of reliability for holistic and individual analytic scores.

97/04265 Fuels program for the Nucla AFBC plant

The Nucla Station originally consisted of three 1959 vintage, 36 (3 x 12) MWe, stoker-fired boilers. The plant was built under the Rural Electrification Administration program to service the scenic, western slope of Colorado. In 1988, the stokers were replaced by a new, dual combustor, 110 MWe AFBC boiler in EPRI`s fluidized bed demonstration program. A new 74 MWe topping steam turbine/generator, with extraction to the existing turbines, was installed at that time. The Nucla Plant was a key project in EPRI`s program to demonstrate the commercialization of AFBC technology. This program has been the subject of numerous reports and papers on fluidized bed combustion. The fuel used by the Nucla Station was a relatively good quality, bituminous coal. Nucla`s coal was trucked more than 100 miles to the plant from a mine in Colorado. In addition, some high sulfur coal was test burned in the plant. This coal was trucked to the plant from a mine located near Kayenta, Arizona. The primary purpose of the demonstration program was to scale-up the size of the combustor and examine parameters that affect fluidization, heat transfer, erosion, and other boiler related issues. Sulfur capture and the ability to utilize lower grade fuelsmore » was previously demonstrated in other, smaller scale programs. To utilize project funds efficiently, the 1988 AFBC retrofit was dedicated to adding the 110 MWe combustor and related equipment. The plant was revamped specifically for test purposes. To conserve funds, silo storage of coal for the AFBC unit was limited to an 8-hour supply. Existing plant auxiliaries, that could adequately perform during the demonstration, were not upgraded. These included the coal handling system.« less

Mission-period settlement structure: A test of the model at san martín de Timucua

Beginning in 1968, the Florida Division of Historical Resources sponsored several small-scale testing programs of Spanish mission sites in northern Florida. A formal model of Mission-period settlement structure emerged from those excavations. However, more recent excavations involving large block exposures at a few mission compounds have shown settlement structure to be more complex, and less regular, than modeled. Such is the case at San Martin de Timucua. Recent excavations there have demonstrated that the imposition of the preexisting model on results from previous limited excavations has resulted in misinterpretations of structure architecture and function as well as site layout. These results demonstrate that long-term commitments to extensive excavations will be necessary to understand intrasite settlement patterns in Florida missions.

Fuzzy programming for large-scale multiobjective linear programming problems with block angular structure

Since Dantzig and Wolfe proposed the decomposition principle for the large-scale linear programming problem with the block angular structure in the early 1960's, there have been made a large number of intensive studies for the large-scale mathematical programming problems with special structures. Considering the fuzziness of the human decision, however, it seems more adequate to assume that the decisionmaker has the fuzzy goals or fuzzy constraints for the objective functions and for the coupled constraints in the problem formulated as the large-scale linear programming problem with the block angular structure. From such a viewpoint, this paper focuses on the large-scale multiobjective linear programming problem and proposes a new method to derive easily the satisficing solution for the decisionmaker considering his/her fuzzy goal. In the proposed method, the fuzzy goal of the decisionmaker for each objective function is specified by the linear membership function through the interaction with the decisionmaker. Fuzzy decision is applied to integrate the fuzzy goals. Then the original problem is decomposed into a master problem and several independent small-scale linear programming subproblems. The Dantzig-Wolfe decomposition principle is applied, where the optimal solution as a whole is obtained through iterations, by updating the goal function of each subproblem according to the solution of the master problem. Thus, it is shown that the satisficing solution is obtained relatively easily considering the fuzzy goals of the decisionmaker.

The Internship Experience and Clarification of Career Choice

The use of internships in educating sociology majors has increased in recent years so that currently most departments offer some type of internship opportunity. Most programs are on a small scale, offering three or four hours of course credit. Although a major justification of internship programs is that they help students in career choice clarification, there has been little hard evidence that small-scale programs achieve this end. Using qualitative and quantitative data to evaluate a small-scale internship program, this research found that it helped students significantly in clarifying career choices, by providing information on occupations, reducing indecisiveness and anxiety regarding choice, and increasing confidence in the ability to choose.

Evaluating Minimal Intervention Health Promotion in a Clinical Context

This article has two objectives. The first objective is to summarize the evaluation of a minimal intervention cardiovascular health promotion program offered to a sample of forty-seven persons having percutaneous transluminal coronary angioplasty procedures. The second objective is to highlight several issues concerning the utility of small-scale program evaluation in a clinical context, as exemplified by this study. Results of a four month follow-up evaluation of the intervention showed significant findings in the areas of knowledge gain and lifestyle behavior change; these findings are illustrated through binomial effect size displays. The study failed to demonstrate statistically significant results on several measures of physiological and self-reported risk factors. Difficulties in interpreting results due to methodological limitations raise issues concerning the utility of conducting program evaluation efforts with limited resources. Dilemmas often confronted in small-scale evaluation projects and the importance of considering their relative, practical utility are discussed.

Training engineering supervisors for small-scale irrigation development in Nigeria

Peoples' programme A very significant feature of the small-scale irrigation programme is that with a bit of ingenuity and tact it can be made a 'peoples' programme', and the community's active participation can be secured in its implementation. This will not only cut the costs of such schemes substantially, but will also encourage the people to think of these schemes as their own, which is very important to the success of any programme undertaken in the public sector. Obviously such a personal attachment is missing in any largescale project. Separate small-scale irrigation departments need to be set up in both the federal and state governments to encourage development. The benefits of small-scale irrigation should not be overlooked, and the The ultimate aim is the optimum use of the soil and water resources, and the adoption of appropriate technology within the framework of the particular socio-economic structure. Only the careful use of both surface and groundwater together will have a dramatic effect on increased food production. Small-scale schemes are attractive because the initial outlay involved is small, they can be executed quickly and yield quick results, they normally require no special expertise or equipment, and local expertise and resources (including human resources) can be easily mobilized for their execution. The disadvantages, however, are their cost of maintenance, their relatively short life, and the limited protection they afford. Because of the current funding constraints; the urgent need to curb food imports; the lack of well-trained, technical personnel and sophisticated construction equipment; and the need to make full use of our human and material resources; these smallscale schemes are often very appropriate. where large projects are suitable, and there are others where only small schemes are possible. Still others may offer a chance to blend the two. In the northern part of the country a large number of seasonal streams could be tapped by constructing small storage tanks made of earthen dams and their canal systems, while in the south numerous perennial streams could be harnessed by constructing masonry THE CONFLICTING roles of the large-scale and small-scale irrigation schemes in the green revolution programme, and the economics of such schemes, are often questioned. There should in fact be no conflict between these two types of schemes, because they are complementary to and not competitive with each other. In a large, geographically varied country like Nigeria, there should be ample scope for both. There are parts of the country

Measuring the extent of gerontological home care staff participation in agency policy making and planning.

A survey study of the work experience and views of administrative and direct service program staff (N = 91) in both small scale and large scale Older Americans Act-funded home care programs in New York City sheds light on the extent to which various categories of personnel in the field of community home care have opportunities to participate in a range of agency policy making and planning functions. Findings reveal that home care staff in small scale programs were more directly involved in both client-centered and program-centered policy/making activities. In particular, these workers felt they were significantly more active in: changing service plans; discussing changes that need to be made in how the agency operates; planning new services and programs at the agency; and helping to train or orient new workers in the program. A strong negative correlation between level of organizational complexity and worker participation rates was discovered. Additional data suggest that all staff, regardless of their status or work responsibility, would like to be granted more of a voice in planning decision. Those who participate least in such activities were most adamant over being given a greater role in this aspect of program life. Heightened levels of job satisfaction were also associated with greater measures of worker involvement in organizational decision-making. Study findings are seen to have implications for the design of more equitable decision-making mechanisms in gerontological home care specifically and human service programs generally.

Design and Evaluation of A Migration Experiment in Thailand

In many less developed countries, planners are concerned about the concentration of population in one or two major cities. The authors implemented a small-scale experimental program in Northeast Thailand designed to alter patterns of outinigration from a rural area, specifically to redirect migration to urban centers within the same region rather than toward Bangkok. Using data from a baseline survey and a follow-up survey 12 months later, strong effects on mobility behavior, modest effects on information, and little or no effect on community evaluations and mobility plans are discerned. Implications for the attitude-behavior literature are discussed.

Current research in developing countries: Teacher credentialling and distance education

Current research is reviewed on two aspects of educational efficiency in ‘developing’ countries: the effect of teacher credentials on student achievement and the cost-effectiveness of distance education. Major research findings on each topic are reviewed, followed by selected abstracts of current research publications and a brief annotated reference list. Complex debate over teacher credentials now concurs that investment in teacher credentialing is frequently productive but that the efficiency of particular investment strategies is often unknown. The potential cost-savings in distance teacher education are often not realized because of the small scale programs.

Down under Amnesties: Background, Programs and Comparative Insights

Australia, proportionately, accepts more immigrants than the United States and, consequently, immigrants and immigration policy carry a greater impact there, than in the United States. Although Australia's location limits its experience with undocumented migrants, there have been enough of them to cause Australia to conduct three alien legalization programs in 1973, 1976 and 1980. Australia's small-scale programs, by U.S. standards, provide some useful lessons to the U.S.

Macro-Intervention to Support Health Behavior: Some Theoretical Perspectives and Practical Reflections

Large-scale, integrated programs--as distinct from multiple and widespread replications of small-scale programs--require for their planning, implementation and evaluation a qualitatively different set of concepts, methods, and procedures. They are not merely the sum of the parts making up numerous applications of the same health education messages and objectives in various organizations or communities. This review of theory, research and the experience of national and community-based studies in mass media and community development for health, family planning and cardiovascular risk reduction identifies some distinctions between micro- and macrointerventions, as well as between the uses of mass media in commercial marketing and those in health promotion.