P-OGC63 Care Close to Home in the Era of Centralisation

Background With increasingly centralised services for people diagnosed with OG Cancer we wanted to ensure our local service was maintained to provide the appropriate care and management by collaborating with the Specialist Sites and raising the profile of local services. Most patients remain local due to their disease stage, performance status or through choice. We wanted those patients who have tests and treatment on other sites to be able to have their care managed locally as much as possible and therefore only have to travel when absolutely necessary. We aim to facilitate and deliver a streamlined service. Methods Weekly Local MDT triages patients to Specialist MDT once appropriate information is available. Established local outreach clinic for specialist service. Ensures patients are known to specialist service from diagnosis. Patients will be diagnosed and managed locally unless input required elsewhere. Local CNS attends both Local/Specialist MDT as patient advocate and provides cross site communication and care planning. Local User Involvement- contributes to service development and feedback both locally and beyond. Local HNA at point of diagnosis to establish a bench mark. Ongoing emotional support is integral to the local service and continues wherever the patient is in their care pathway. Results Streamlined care with local and specialist team contacts. Improved communication between professionals. Identifiable contact for patients Rapid referral process - timely and appropriate discussions. Improved patient satisfaction. Direct access to specialist site from point of diagnosis. Improved patient advocacy across sites Effective use of clinic time. The right patient being seen at the right time in the right hospital with the right information. Local follow up enables integration of additional local services/teams into patient care More inclusion for local teams in wider service development. Local leadership within the network has ensured investment in local services and raised the profile. Conclusions Care is more streamlined Patients are assessed by the right person at the right time enabling more open communication Avoids unnecessary referrals Less travelling between sites Reduces patient anxiety Encourages user involvement- more personalised care. Promotes continuity of patient care Allows inclusion of local teams in decision making at specialist level Promotes collaboration and team working with flexible leadership amongst team members Improved job satisfaction by establishing a shared vision Upper GI Cancer delivery will continue to go through changes but with a motivated team who work together these changes can be implemented efficiently and effectively.

Policy Forum: Implementing the Chippewas of Georgina Island First Nation Property Tax System—Opportunities, Challenges, and Lessons Learned

In 2018, the Chippewas of Georgina Island First Nation (GIFN) implemented a First Nation property tax system under the First Nations Fiscal Management Act (FMA)—one of the earliest First Nations in Ontario to do so. Implementation of a property tax system gave GIFN an opportunity to improve funding for and expand local services, and provide a more equitable sharing of local service costs between cottagers leasing First Nation land and the First Nation. Key challenges encountered when implementing the property tax system were building consensus around the need for a tax system, building an appropriate administrative infrastructure, carrying out property assessments, and professionals lacking knowledge of First Nation property tax. These challenges, however, presented opportunities to create a knowledge base around property taxation within GIFN, among cottage leaseholders, and in the wider community. Key lessons learned were (1) start as soon as possible; (2) First Nations Tax Commission support and standards are important; (3) staff training is important; (4) communicate early and often; (5) hold open houses; (6) local services are more than garbage collection; (7) property taxes do not harm lease rates or cottage sales; (8) educate lawyers, real estate agents, and other professionals; (9) startup costs were significant; (10) coordinate laws and standards with provincial variations; (11) modernize systems; and (12) utilize other parts of the FMA.

US subnational cybersecurity risks are rising

Significance These problems also affect subnational governments, which have increasingly come under attack in recent years. They have suffered a string of outages and interruptions to crucial local services ranging from parking payment to real estate purchases. Impacts A private vendor providing security to multiple local government entities will become the single point of failure. Demand for cyber insurance at subnational level will rise, and ransom payments will continue if they are covered by insurers. The federal government will likely make cybersecurity aid to states contingent on tighter security standards.

Institutionalizing innovation in welfare local services through co-production: toward a Neo-Weberian State?

Innovative practices based on the involvement of citizens as co-producers of welfare local services have been increasingly adopted by the public sector to effectively tackle emerging social problems. Despite the development in the literature on this subject, recent studies still do not clearly indicate which are the challenges for the institutionalization of such practices. By applying a governance lens to the analysis of co-production of local public services, this article aims to contribute to bridging this gap through the empirical analysis of the childcare experience in four European cities. More in detail, it debates the concepts of co-production and innovation in public service delivery within the context of the different waves of public administration reforms; and it investigates how three different sets of conditions – namely, state support and capacity; organizational cultures which support innovation; and integration with facilitative technologies – integrate to facilitate or hinder the institutionalization of co-production initiatives. The findings show that the enabling role of the state actor is a sine qua non to guarantee an institutionalization of these practices, particularly concerning the promotion of trust-building processes. Doing so, the article contributes to the international debate about the possible co-existing of the paradigms of public administration that are arising in the last decades to remedy the problems with the New Public Management; and it provides professionals working in public management and administration with key policy recommendations for the elaboration of new governance systems for the provision of social and welfare services.

Caribbean Quarterly Bulletin: Volume 10: Issue 2, August 2021

For more than a year, the Caribbean economics team at the Inter-American Development Bank (IDB) has focused on the potential implications of the COVID-19 pandemic for lives and livelihoods across the region. The pandemic is still with us, but there is hope that the cycles of lockdowns and containment measures will eventually come to an end as vaccination programs progress, even if unevenly, across the region. However, the availability of vaccine supply remains a concern, and the pandemic continues to pose a constraint for the recovery of key sectors such as tourism and local services sectors. This edition of the Caribbean Quarterly Bulletin focuses on two topics: (1) forecasts of key macroeconomic variables, based on the April 2021 WEO, and (2) financial sector risks. In general, regional economies are embarking on a fragile path to recovery. Continued progress with vaccination programs, credible medium-term fiscal programs, and continued attention to financial vulnerabilities will be needed to push that path to recovery forward.

Linking Geoheritage and Traditional Architecture for Mitigating Depopulation in Rural Areas: the Palaeozoic Villages Route (Courel Mountains UNESCO Global Geopark, Spain)

The use of stone in traditional architecture represents one of the most relevant links between geological and cultural heritage. As a topic of general interest and easily understandable to all public, this link is a guiding thread for touristic routes mitigating the depopulation trend that affects large inland rural areas, including many areas in UNESCO Global Geoparks (UGGp). In the northwest of Spain, the Courel Mountains UGGp created the Palaeozoic Villages Route for touristic purposes in 2018, highlighting the relevance of local stones in traditional architecture as a key feature for sustainable development. For the design and creation of this route, seven villages were selected along six criteria: (1) the representativeness of the building stone with the bedrock of the UGGp, (2) the preserved traditional architecture, (3) their link with geoheritage, (4) the scenic beauty of their surroundings, (5) the potential combination with other touristic activities, and (6) the presence of local services. The Palaeozoic Villages Route exhibits four rock types/sections/structures spanning four Palaeozoic periods, as well as different uses for walling and roofing depending on the rock feature. Since 2018, the route experienced an increased revenue of 19% in the touristic sector to the traditional villages, while visitors used up to 61% of the local services of the UGGp for one or more days. In addition, the route reinforces the awareness of depopulation and abandonment of rural villages, fostering the purchase and/or restoration of dwellings as second regular residences in tranquil and scenic environments. In the short to medium term, these actions are expected to reverse or, at least, minimise the loss of population in the UGGp.

MODELING THE IMPACTS OF E-GOVERNMENT SERVICES ON CORRUPTION REDUCTION IN RWANDA: A CASE EVIDENCE FROM NYAMASHEKE DISTRICT, RWANDA

The study entitled modeling the impacts of e-government services on corruption reduction in Rwanda: Case evidence from Nyamasheke District, Rwanda was about assessing the contribution of e-government services use on reducing corruption in the area under study. The study was guided with the objective of exploring the utilization of multinomial logistic regression (MLR) in modeling the impact of e-government services on reduction status of corruption. In this regard, the MLR model was performed using a maximum likelihood estimation method on the data set collected to find the parameter estimates of the model describing the relationship between the explanatory and the outcome variables and determine the significance of the explanatory variables that contribute significantly to the reduction status of corruption in the area under study. The study adopted both qualitative and quantitative approaches to collect data from 381 respondents from the target population of 8041 using Solvin’s formula for sample size calculation. Data were collected using questionnaire and interview schedule techniques and analyzed using SPSS-23. In this analysis, the results show that on the total of eleven independent variables, the explanatory variables such as age, income, ownership of the devices used in applying for the local government services and the advice types were dropped from the training set of explanatory variables that contribute significantly to the reduction of corruption in the area under study. In model selection that overall fits well the data, the obtained variables that contributed significantly to the outcome variable were education, e-government services’ use status, cost of accessing e-government services and the e-government services types delivery. The parameters estimate of the selected model revealed that the variables that best predicted the probability of reducing corruption once the e-government services are delivered online were education, status of using e-government services, types of e-government services delivery online while the cost of accessing the e-government services decreased the logit (the probability) of reducing corruption. The main challenges faced by users of e-government services were the cost given while applying to these e-government services is high and lack of enough skills to cope with technological usage. Finally the study recommended that local leaders in the area under study should strengthen the online system in delivering local services to people, educate people to be aware about the use of e-government services since the more a person is educated the more is attempting to use e-government services and then reduce the cost of using e-government services while applying to the local services since this has been the only explanatory variable that decreased the logit of reducing corruption in the study area. <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0790/a.php" alt="Hit counter" /></p>

Does Disassociation with a Majority Religion Influence Community Desirability? Evidence from Rural Utah

This study examines how disassociation with a majority religion influences subjective perception of community desirability in rural communities. Current community literature shows that religious affiliation identification can influence community sentiment, while other studies suggest the possibility of either mixed or inconclusive results. To further clarify the relationship between religious affiliation and community desirability, we draw upon data from the 2017 Rural Utah Community Study. We find that even when accounting for the length of residence, age, and perception of local services, a resident’s religious affiliation continues to be associated with community desirability. These findings have potential implications for understanding other communities with a large, singular religious presence.