Linking Community Initiatives to National Institutions: Ghana

The ILO has developed an innovative concept of global solidarity for social security — the Global Social Trust — which supports the development of national social protection systems through international financing. The concept is ready to be tested nationally and the present paper proposes a pilot project for Ghana. The paper considers the virtues and weaknesses of developing-country social security healthcare systems and community-based voluntary insurance schemes, their lack of informal sector coverage on the one hand and their financial disequilibria on the other. It outlines the socio-economic and macro-policy context of Ghana and the current health policy environment. It argues for a fusion of the social health insurance and mutual health organization concepts in Ghana, thus linking community initiatives to national institutions, enhancing coverage and the quality of services for all. The paper outlines a basic model that could apply to Ghana, its organizational structure, practical functioning, financing arrangements and expected outputs. In particular it seeks to develop a model for the cross-subsidization of insurance premiums for the poor. It describes a concept that would combine local ownership initiatives with national responsibility and financing, arguing for a truly interrelated network of social protection. The authors welcome feedback and comments from the wider social security audience.     

Learning Experiences of Older Volunteers in a Community-based Social Program for People with Dementia

Abstract

This qualitative study aimed to explore older adults’ perspectives on volunteering in an activity-based social program for community-dwelling people with dementia called Stepping Stones. Semi-structured interviews were individually conducted with eight older adults who had volunteered in Stepping Stones. Interpretative phenomenological analysis was used to analyze interview data. Four themes related to learning experiences of older volunteers in Stepping Stones emerged. These themes include (a) self-growth and confidence in working with people with dementia; (b) understanding dementia, people with dementia, and needed support for people with dementia and their families; (c) desire not to develop dementia, while recognizing that anything can happen in old age; and (d) exercising person-centered approaches and taking on advocacy roles. Findings suggest that older volunteers gain feelings of personal growth and confidence in working with people with dementia, better understanding, and enhanced attitudes toward people with dementia through volunteering in an activity-based social program for people with dementia. Older adults will be able to fill the needs of community programs for people with dementia, while experiencing benefits from volunteering and learning in later life. Further research is needed to examine to what extent having previous dementia experiences make their experiences and learning different.     

Spatial Dispersion as a Dynamic Coordination Problem

Following Schelling (1960), coordination problems have mainly been considered in a context where agents can achieve a common goal (e.g., rendezvous) only by taking common actions. Dynamic versions of this problem have been studied by Crawford and Haller (1990), Ponssard (1994), and Kramarz (1996). This paper considers an alternative dynamic formulation in which the common goal (dispersion) can only be achieved by agents taking distinct actions. The goal of spatial dispersion has been studied in static models of habitat selection, location or congestion games, and network analysis. Our results show how this goal can be achieved gradually, by indistinguishable non-communicating agents, in a dynamic setting.     

The Relationship Between Maternal Education and Children's Academic Outcomes: A Theoretical Framework

The importance of maternal education for children's academic outcomes is widely recognized, and yet the multiple potential mechanisms that explain this relationship are underexplored. The authors integrate theories of human, cultural, and social capital with 2 developmental psychology theories—bioecological theory and developmental niche theory—to draw attention to how maternal education may influence children's academic outcomes through a range of parenting mechanisms, some of which have been largely neglected in research. This framework provides a more complete picture of how maternal education shapes proximal and distal influences on children's academic outcomes and the ways in which these mechanisms interact and reinforce one another across time and context. The implications of this framework for future family research are then discussed.     

Hidden champions: Exploring supportive family relationships of youth experiencing homelessness

The relationships that youth experiencing homelessness (YEH) have with supportive family members (i.e. those who provide them with social support) may be protective against risk behaviours and buffer adverse health outcomes. However, little is known about the nature of YEH's supportive family relationships and the type of social support that these family relationships offer them. Thus, we conducted in-depth interviews with 30 YEH to examine the type of social support received from family relationships and to explore the social dynamics of these relationships. We found that many YEH not only continued to maintain relationships with family members after becoming homeless but also received emotional and/or instrumental support from these family members. Beyond providing this type of social support, family members served as a source of motivation for these youth. Additionally, YEH contributed to their family relationships and gained a sense of connectedness in return. Lastly, we found that YEH's family support was influenced by their family circumstances and their need for autonomy. Collectively, our findings suggest there may be a need for interventions designed to strengthen relationships with supportive family members among YEH, who may derive multiple positive benefits from relating with the ‘hidden champions’ in their lives.     

Additional results for 'Sequential design approaches for bioequivalence studies with crossover designs'

In 2008, this group published a paper on approaches for two‐stage crossover bioequivalence (BE) studies that allowed for the reestimation of the second‐stage sample size based on the variance estimated from the first‐stage results. The sequential methods considered used an assumed GMR of 0.95 as part of the method for determining power and sample size. This note adds results for an assumed GMR = 0.90. Two of the methods recommended for GMR = 0.95 in the earlier paper have some unacceptable increases in Type I error rate when the GMR is changed to 0.90. If a sponsor wants to assume 0.90 for the GMR, Method D is recommended. Copyright © 2011 John Wiley & Sons, Ltd.     

Analysis and Management of Periodic Review,Order‐Up‐To Level Inventory Systems with Order Crossover

In this article, we investigate the (R, S) periodic review, order‐up‐to level inventory control system with stochastic demand and variable leadtimes. Variable leadtimes can lead to order crossover, in which some orders arrive out of sequence. Most theoretical studies of order‐up‐to inventory systems under variable leadtimes assume that crossovers do not occur and, in so doing, overestimate the standard deviation of the realized leadtime distribution and prescribe policies that can inflate inventory costs. We develop a new analytic model of the expected costs associated with this system, making use of a novel approximation of the realized (reduced) leadtime standard deviation resulting from order crossovers. Extensive experimentation through simulation shows that our model closely approximates the true expected cost and can be used to find values of R and S that provide an expected cost close to the minimum cost. Taking account of, as opposed to ignoring, crossovers leads, on average, to substantial improvements in accuracy and significant cost reductions. Our results are particularly useful for managers seeking to reduce inventory costs in supply chains with variable leadtimes.