Academic literature on the topic 'Capital Territory Health Commission'

Objective: The objective of this study is to determine the 1998 rates, types, regional variation and Medicare expenditure of private psychiatry services for older people in Australia, as compared with younger adults and with 1985–1986 data. Method: Medicare Benefits Schedule Item Statistics for the psychiatric item numbers 300–352 and item 14224 were obtained from the Health Insurance Commission for each State and Territory. The items were examined in the age groups 15–64 years, 65 years and over and 75 years and over. Main outcome measures were per capita service provision by age group, State and Territory and Medicare expenditure by age group. Results: During 1998, 6.4% (5765.6 per 100 000) of private psychiatric services were to patients aged > 64 years. Patients aged 15–64 received 2.7 times the number of psychiatric services per capita than patients > 64 and 3.6 times that of patients aged > 74 years. Patients aged > 64 received more hospital and nursing home consultations, home visits and electroconvulsive therapy per capita, while younger adults used more office-based consultations, longer consultations, and group therapy. Victoria had the highest per capita rate (7659.2 per 100 000) and the Northern Territory the lowest (540.4 per 100 000), although the highest proportion of services to older patients was in Western Australia. Per capita the proportion of Medicare expenditure allocated to adults aged less than 65 years was 4.1 times that for adults over 64 years. Conclusions: Private psychiatric service provision to older people is inequitable when compared with younger adults. The proportion of Medicare private psychiatry expenditure on older adults has declined since 1985–1986.

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.

Objective: To determine the number and distribution of paediatricians in Nigeria. It also aims to determine the association between paediatrician workforce and under five mortality (U5MR) and immunization coverageacross the six geopolitical zones of the country.Methods: The part II fellowship examination pass list of the West African College of Physicians and the National Postgraduate Medical College and the register and financial records of the Paediatric Association of Nigeria were searched for the purpose of the study. Using a structured questionnaire, personal and professional data was obtained frommembers at the 2011 Annual Paediatric Association of Nigeria Conference or via the Association’s website, email network and phone calls to Departments of Paediatrics in institutions (private and public) across the Country. Data on the paediatricians residing within Nigeria was then extracted from the comprehensive database and subsequently analyzed.Population data, mortality and immunization rates were obtained from the National Population Commission census and their most recent National Demographic health survey in Nigeria. Correlations were drawn betweennumber of paediatricians and U5MR and diphtheria-pertussistetanus(DPT) vaccine coverage.Results: There were 492 practicing paediatricians in Nigeria at theend of year 2011, comprising 282 (57.3%) males and 210 (42.7%)females; 476 (96.7%). Majority (84.7%) worked for the governmentwith 97% of them in hospital settings, mostly tertiary centres (344=88%). Lagos State had the highest number (85; 17.9%) of practicing paediatricians followed by the Federal Capital Territory with 37 (7.8%) paediatricians. More than two thirds of the paediatricians (336; 70.6%) were practicing in the southern part of the country. The average child:p a e d i a t r i c i a n r a t i o wa s 157,878:1for the country. TheNorth East zone had the highest chi ld- to-pa ediat r ician rat io (718,412:1) while South West had the lowest ratio (95,682:1).Higher absolute numbers of paediatricians in each zone were associatedwi th lower U5MR (Spearman ñ=-0.94, p=0.0048), accounting for 84% of the variability among zones. Higher ratios of child-to-paediatrician were significantly associated with higher U5MR (Spearman ñ=0.82, p=0.04,linear R2=0.73) and marginally with lower DPT coverage by geopoliticalzone (Spearman ñ=-0.77, p=0.07, linear R2=0.59).Conclusion: The study reveals that the number of paediatricians inNigeria is grossly inadequate with a huge child-to-paediatrician ratio.There is also an uneven distribution of the paediatricians with higher numbers in the southern states. Zones of the country with lower child-to-paediatrician ratios also experienced lower U5MR. There is a need to train more paediatricians in Nigeria and promote an even distribution of the paediatrician workforceKey words: Paediatrician, workforce, child-to-paediatrician ratio, under-5 mortality, immunization, childhealth, Nigeria

The Liverpool City-region Health is Wealth Commission was established to examine the growing divergence between the City-region’s public health status and its marked economic growth, specifically looking at links between health and productivity, identifying knowledge-gaps, and encouraging a more focused and collaborative alignment between the business, research and public health agendas. Over 18 months of investigation, Commissioners considered a wide range of research-based and plenary evidence from a number of key witnesses. The Commission made 12 final recommendations within six core themes: Alcohol, Smoking & Obesity; Incapacity Benefit; Wellbeing at Work; Beyond the Built Environment; Procurement; and Knowledge Capital. The Commission’s findings were published in September 2008, as part of Liverpool’s European Capital of Culture programme.

Most health professionals are aware of the amazing diversity of the Australian population, which is made up of people from over 140 different countries. Of these, an increasing number have arrived as refugees under Australia's humanitarian resettlement program. Research indicates that at least 30% of the 12,000 or so people arriving in Australia under the humanitarian assistance programmes each year have been exposed to physical and emotional torture and trauma. They also have well documented health deficits relating to the health standards in their countries of origin, the level of deprivation experienced prior to arrival in Australia, and the time they have spent in transit before arriving in Australia. The purpose of this study was to review the health status of refugees from the former Yugoslavia, and to identify the perceived needs of this group, which represents one of Canberra's largest communities of recently arrived refugees. Utilising both qualitative and quantitative methodologies, findings showed that the cohort had significantly lower levels of both physical and mental health than the wider ACT and Australian population. The difficulties of socialisation of the refugees into the Australian lifestyle are highlighted. In particular, findings from the study have demonstrated the lack of appropriate information given to some refugees on arrival, and the struggles experienced by most of the group with learning a new language, and coping with unemployment and inadequate housing. The problem of covert political harassment in Canberra was also described during the interview process. Recommendations for improving the situation for these refugees were that information for refugees prior to, and following arrival in Australia needs to be consistent and readily available, and there needs to be provision of a formalised support system from the time of arrival, including a review of language facilities. The study also recommended that culturally sensitive health promotion and treatment programs should be incorporated into current health service provision. Nurses are identified as the appropriate health providers to take a leading role in developing such programs for refugees, although findings from this study indicate that current nurse education programs need to place more emphasis on a transcultural framework for the provision of care.

Three groups of health care professionals were canvassed for their views on euthanasia - student nurses, practising nurses and doctors. The aim of the research was to make a possible contribution to a formalised health policy on this issue for the ACT. The following forms of euthanasia were covered by the research: (i) voluntary active euthanasia: (ii) voluntary passive euthanasia: (iii) involuntary active euthanasia: (iv) involuntary passive euthanasia. Passive forms of euthanasia were found to be the most acceptable. Voluntary forms of euthanasia were not found, in general, to be more approved of than involuntary forms of euthanasia. However, active forms of euthanasia were much less acceptable than passive forms. In order to adapt the research findings to a methodology for policy use. Allison's models (1971) of public policy development were modified into a single model. This provided an application of the research results in such a way as to allow for the development of a possible formalised policy on euthanasia, and practical applications. The conclusions drawn from the research findings and the subsequent recommendations are supportive of law reform and the implementation of a new policy on the issue of euthanasia.

Master of Public Health - MPH
Nigeria is experiencing shortages of health care workers within its national health services, especially with respect to doctors, nurses and pharmacists. These shortages are traceable to, among other factors, low job satisfaction, which leads to health care workers exiting the national health services, as well as reduced entry of health care workers into the health care system. Understanding the nature of job satisfaction and its causes is critical to informing strategies to halt attrition of the health workforce. The current study surveyed job satisfaction among 180 health care workers, employed in 20randomly selected primary health care centres in the Bwari Area Council of Abuja in the Federal Capital Territory, Nigeria. An observational, descriptive cross-sectional survey was conducted using the abbreviated form of the Minnesota Satisfaction Questionnaire. Descriptive and inferential statistics were calculated using Epi Info v3.1 statistical software. The results from the study revealed that more than half of the respondents (53.2%), were dissatisfied to varying degrees with their current employment. Out of the respondents that said they were dissatisfied, 33.3% stated that they were likely to leave their current employment. The most salient causes for job dissatisfaction were: (1) Institutional factors such as management support (69%); (2) Implementation of policies and procedures (66%); (3) Employee benefits including salaries and wages (33%) and other benefits (56%). It is pertinent to note that issues related to poor implementation of policies and procedures in the work place, and poor conditions of employment need to be addressed urgently to prevent the imminent loss of a third of the workforce to either private health institutions in the country or international migration.

This thesis explores alienated students' perceptions of the organizational health of a Year 7 to 10 A.C.T. high school. The study emerged at the theoretical level from a concern that school effectiveness studies focussed too narrowly on student academic attainment as an indicator of an effective school. A broader view of effectiveness would hopefully show that in the case of comprehensive co-educational government high schools, student alienation could have a powerful effect in undermining the achievement of academic goals in such schools. Because these schools have little control over their student clientele and require compulsory student attendance until age 15, it seemed a degree of alienation was inevitable. The task for high school administrators, it was hypothesized, lay in minimizing these alienation levels in order to reduce the impact such student alienation might have on other school effectiveness indicators like teacher commitment, teacher morale and time on task in classes. My experience as a practitioner, in the Student Welfare area of a large ACT government high school, also indicated that the traditional "top down" strategy of much research in the field of Educational Administration that concentrated on the perspectives of principals and teachers only gave one view of the processes within a school. The other, complementary "bottom up" view came from students. In particular, it was hypothesized, the perspectives the most alienated students in a government high school held towards the organizational health of the school might represent an unusual test of school effectiveness. This was because the commitment of such students towards the school and its stated academic goals was most problematic. The promotion of a school "culture" or "ethos" that could integrate low level and high level alienation students, and thereby foster school effectiveness, appeared to be possible only to the extent that high level alienation students could be kept on side or neutralized by high school administrators. These speculations were largely confirmed in this study. Apart from the interaction of sex and year level with alienation, the other major finding was that teacher consideration, or the extent to which teachers show concern for students as individuals, was the only organizational health dimension that produced a significant difference between students on the basis of alienation level. In short, the study is not concerned with student alienation as such. Rather it is concerned with understanding how alienated students perceive a relatively effective school. This would hopefully enable that alienation to be minimized and managed.

The Field Study reports on the research and development of a Health Assessment Program (HAP) for secondary school students over a period of three years in the ACT. The 'original' HAP is described, and its early implementation methods discussed. Changes are proposed and trialled, and further refinements made, then trialled again. Through this process a new HAP is developed. The 'Research and Development Cycle' (Borg and Gall 1983) provides the theoretical framework for the planning of the field study. (See 1.4). The 'new' HAP exhibits the characteristics of an 'education' program. The physical components have been developed to enable them to be administered by the teachers who are responsible for the organisation of the HAP in their school, and health professionals are only used for those components which require confidential counselling. This is in contrast to the 'original' HAP which was organised and conducted by health professionals. The process by which the changes took place has determined the quality of the new HAP. The developments have been based on the views of the teachers who used the HAP, the students who were tested, and the health professionals who participated. The literature has also been used to provide the direction for, and nature of, the changes. This process has ensured a program which is highly suitable for use in the school environment. It is not envisaged that the HAP has reached its final stage of development. Each school who uses the program is encouraged to modify and adapt it to suit the needs of their own teachers and students.

The study set out to determine the influenza vaccination rate and to identify factors important in the process of vaccination acceptance decision making for a group of the well elderly in the A.C.T. Prediction of vaccination acceptance was compared using three measures: stated behavioural intention, report of past vaccination acceptance and a multiattribute utility decision model. In this study no one method of prediction was obviously better than another. The most important findings of this study included the marked variations in vaccination rates based on type of residence of the group members. Of the 15 variables of the decision model, factors related to the infection of influenza and possible complications of influenza were seen as the most important factors by both acceptors and nonacceptors of the vaccine in making the decision to have the injection. These findings can be incorporated into an area vital for nursing intervention, the planning of nursing programmes of health promotion and health maintence for the well elderly population.

The study reviewed the provision of childbirth and parenting education in the ACT for indicators of effectiveness and needs. Users (n = 207) and providers (n = 7) were surveyed for information on educational and administrative aspects of the service. An original design questionnaire was based on the PRECEDE framework (predisposing, reinforcing and enabling factors in educational diagnosis and evaluation) and the social model of health. Items were drawn from the relevant literature, concerning individual, social and service delivery elements of the health fields concept interpreted for pregnancy, childbirth and parenting. Individual factors were related to Maslow's hierarchy and the valuing approach to health education. The provider survey covered information on organisational elements, comprising inputs, processes, products, outputs and outcomes of childbirth education. The study comprised a literature review, cross-sectional non-experimental surveys of users and providers, and a needs assessment combining information from each of the three sources. Descriptive statistical techniques, analysis of variance and valuing analysis were used to extract information on effectiveness indicators and needs from the user data. Comparisons were made between present and past users, and between women of different ages, experience of pregnancy and preferences for public or private methods of education for childbirth. No evidence was found of individual differences in the women's attitudes, beliefs and values that could be attributed to education. However, users expressed strong approval and positive views of the service and its providers. The level of personal health skills, confidence and emotional preparatiqn they achieved through childbirth and parenting education did not fully meet their expectations. The survey also found that the organisation of childbirth and parenting education has not developed professionally like other health services. Service goals and objectives are ill-defined; planning and coordinating are inadequate for an integrated maternal health care system. The service's main resources are its highly motivated and dedicated teachers and clients. Several recommendations are made for educational and administrative measures to enhance service effectiveness within present organisational constraints, based on the needs identified by the study.

Psychotropic drugs are mind affecting compounds. They range in type from illegal narcotic analgesics such as heroin, to prescribed major tranquillisers used for treatment of psychotic states, to prescribed minor tranquillisers such as the benzodiazepines, Valium and Mogadon, to the freely available, over the counter drugs, Aspirin and Panadol. Overseas and Australian data show the minor tranquilliser group, benzodiazepines, first introduced on the pharmaceutical scene in the early 1960s, to be the most commonly prescribed psychotropic drugs. Their popularity with medical practitioners as prescription drugs for conditions of anxiety, stress, insomnia and some forms of epilepsy, arises from the advertised inference by drug companies that they are free from any side effects in the patient such as dependence, tolerance and on termination of treatment, absence of withdrawal syndrome. Benzodiazepines were first introduced as a substitute for the well known dependence producing barbiturate based sedatives. Overseas and Australian data show women are prescribed psychotropic drugs, particularly benzodiazepines, twice as often as men and in many instances for conditions unrelated to those for which the drugs are recommended. Australian data comes from two sources, official statistics such as the Pharmaceutical Benefits Scheme and from surveys of drug use. Both sources of data are incomplete, inaccurate and in many cases misleading. The true picture of prescribed psychotropic drug use in Australia therefore lacks resolution and in all probability underestimates prevalence and patterns of use in the community. There is no data on the prevalence and patterns of use of prescribed psychotropic drugs in the Australian Capital Territory. It was therefore deemed appropriate to conduct a survey to determine their prevalence and patterns of use. The survey was confined to women for several reasons: Women are a target group in the Commonwealth and State Government 'Drug Offensive'; evidence from studies overseas and in Australia shows that women are prescribed psychotropic drugs, particularly benzodiazepines, twice as often as men; Australian data suggests that this trend is uniform and therefore the Australian Capital Territory should be no different. Data shows that doctors, particularly General Practitioners, are the main source of prescribed psychotropic drugs. The main psychotropic drugs prescribed by general practitioners are benzodiazepines. It was therefore deemed appropriate to conduct a survey of general practitioner's attitudes, knowledge and beliefs about the appropriate use of benzodiazepines as these factors carry weight in a doctor's prescribing habits. The survey of women was conducted using a standardised, structured, telephone survey on a random sample of 120 women in the Australian Capital Territory. The results of the survey show that 40% of the sample had used prescribed psychotropics at some stage in their lives. Most users were older women, married, well educated and working full time. Level of knowledge about the drug was low, compliance with respect to use was high. Most prescribed psychotropic drugs were obtained from a doctor. There appears to be little drug sharing or concurrent drug use. Half of the prescribed psychotropics were benzodiazepines the other half were mostly anti-depressants. Use of over the counter psychotropics was very high. The survey of general practitioners was conducted using a standardised, structured mailed questionnaire distributed to a random sample of 25 general practitioners in the Australian Capital Territory. The results show the majority of doctors prescribe the drugs for common indications (anxiety, stress, insomnia and some forms of epilepsy) in excess of one week. For specific anxiety states however, most prescribe the drugs along with some form of counselling. The majority of doctors (77%) think counselling is not as effective as drug treatment. All doctors surveyed think patients should be advised of the drugs effects on driving and machinery operation; the drugs should not be shared with others; that the drugs should not be terminated abruptly; the drugs should not be used concurrently with alcohol. The majority (92%) believe benzodiazepines are over prescribed and most doctors (77%) believe the drugs produce dependence in patients. The majority (58%) believe women of child bearing age are at risk using benzodiazepines while 50% think pregnant women are at risk. The majority of doctors did not believe that people older than 60 years of age are at risk but most believe children are at risk. The findings of both surveys have implications for health educators and others with a concern for drug education in the community. Recommendations arising from this study have been made. They are presented at the conclusion of this thesis.

A Feminist Action Research methodology was used as a collaborative process with five ACT Health social workers based at the Community Health Centres and four at the Woden Valley Hospital. The primary purpose of the study was to investigate, both through critical reflection and action in their work setting, the participants' relevance or otherwise to Aboriginal people in the ACT and region. Behind this is the question of how encapsulated social work is by racism. The impetus for the study arose from my unresolved concerns regarding these issues, having been a social worker in ACT Health for 6 years, to 1990. Decisions on how to proceed involved a process of ongoing consultation between the participant social workers and myself. Exploratory meetings were held in March and April, with an ongoing program being held 2-3 weekly from June to September, followed by a review in December. Most gatherings were specific to the Woden Valley Hospital or Community Health settings. However two half-day workshops were held for all the participants. All the sessions from June were taped. Aboriginal leaders were consulted, as were several managers in ACT Health. The phenomena of institutional, cultural and personal racism were addressed by the social workers through discussion, exercises, and anti-racist initiatives in their work setting. They found that significant time restraints presented an example of institutional racism working against their good intentions. Another dimension arose from implicitly racist education in social work courses when most of the participants undertook their undergraduate courses in the 1960s and 1970s. Aspects related to professionalism such as its language and separation of a personal and professional self were indicative of cultural racism. Stories of personal racism were shared, in the context of raised awareness leading to changing those attitudes and behaviours. The fact that the study took place in 1993 - a watershed year for Aboriginal/white relations in Australia - seemed to lead to greater momentum for the project. The social workers found that participation in this study increased their knowledge of, and their confidence - both actual and potential - in interaction with Aboriginal people. However, they also understood these to be just small steps towards greater justice for the indigenous people. An outcome of the project has been involving some colleagues in similar anti-racist actions to those the social workers participated in during the time of the study. The action research project has continued on in different ways, beyond 1993, despite my withdrawal as 'the researcher' who took the initiative.

My study is of the provision of career education, health education, personal development and student development programmes for students from Years 7 to 10 in ACT high schools. My purpose was to identify why these programmes are not available to all students and what can be done to make them available. The methods I used were an examination of a longitudinal case study of "Bellbird" High School in parallel with a survey of the current system perspective. Although the study focuses on the ACT in Australia, reference is made to the international literature, as well as local, regarding the attitudes of students, parents and teachers to career education, health education, personal development and student development programmes; data collection and interpretation; and the implementation of change. I have used data from three different survey instruments administered at "Bellbird" High School, at five year intervals, in 1978/79, 1984 and 1989. I have used another instrument at system level twice, in two consecutive years, in 1988 and 1989. Each of the instruments was developed for a specific purpose and not for gathering data for this study. All three surveys at "Bellbird" High School were designed to determine the attitudes of students, parents and teachers to aspects of the curriculum. They provided both quantitative and qualitative data. Basically, I have compared the 1979 and 1989 numerical data, and used the 1984 material for confirmation of significant issues. In addition to using qualitative data from these three instruments, I have also used comments from curriculum committee and School Board documents and evaluation reports from the Living Skills Programme. At system level, a questionnaire was designed to gather data about the provision of career education and health education in high schools in the ACT. This instrument, included questions about barriers to these programmes and strategies for overcoming the barriers. The findings were distributed to the schools. The procedure was based on the 'Research, Development and Diffusion' model. People associated with the successful implementation of the programmes under investigation were interviewed to find out what barriers they had faced, how they overcame them and what suggestions they had for overcoming other baniers to these programmes. Using the data CO-jointly with the literature and my own knowledge of cumculum implementation, I have proposed an action plan for "Bellbird" High School to extend the provision of its student development programme to all students. In conclusion, the suitability of the proposed action plan for use in other ACT high schools is appraised and general principles for the system are drawn out.

This chapter considers how commissioners can frame the questions they pose of health information sources, so that they gain more meaningful answers to help commission for health gain. There is an overview of the three main purposes for using health information from a commissioning perspective. These are namely to help problem definition, plan and prioritize, or to monitor and evaluate actions taken. There then follows further practical guidance to assist fuller appreciation of the health information territory. This includes general themes covered by health information, example sources, and a salient reminder that whilst health information is important for commissioning, it is only one type of tangible knowledge that the commissioner needs for decision-making. Other salient knowledge that a commissioner needs for sense-making is also noted (a ‘Trio’ of knowledge is needed for commissioning). Finally there is also an orientation on making sense of economic evaluation information from a commissioning perspective.

The Australian Catholic University (ACU National at www.acu.edu.au) is a public university funded by the Australian Government. There are six campuses across the country, located in Brisbane, Queensland; North Sydney, New South Wales; Strathfield, New South Wales; Canberra, Australian Capital Territory (ACT); Ballarat, Victoria; and Melbourne, Victoria. The university serves a total of approximately 27,000 students, including both full- and part-time students, and those enrolled in undergraduate and postgraduate studies. Through fostering and advancing knowledge in education, health, commerce, the humanities, science and technology, and the creative arts, ACU National seeks to make specific and targeted contributions to its local, national, and international communities. The university explicitly engages the social, ethical, and religious dimensions of the questions it faces in teaching, research, and service. In its endeavors, it is guided by a fundamental concern for social justice, equity, and inclusivity. The university is open to all, irrespective of religious belief or background. ACU National opened its doors in 1991 following the amalgamation of four Catholic tertiary institutions in eastern Australia. The institutions that merged to form the university had their origins in the mid-17th century when religious orders and institutes became involved in the preparation of teachers for Catholic schools and, later, nurses for Catholic hospitals. As a result of a series of amalgamations, relocations, transfers of responsibilities, and diocesan initiatives, more than twenty historical entities have contributed to the creation of ACU National. Today, ACU National operates within a rapidly changing educational and industrial context. Student numbers are increasing, areas of teaching and learning have changed and expanded, e-learning plays an important role, and there is greater emphasis on research. In its 2005–2009 Strategic Plan, the university commits to the adoption of quality teaching, an internationalized curriculum, as well as the cultivation of generic skills in students, to meet the challenges of the dynamic university and information environment (ACU National, 2008). The Graduate Diploma of Education (Secondary) Program at ACU Canberra Situated in Australia’s capital city, the Canberra campus is one of the smallest campuses of ACU National, where there are approximately 800 undergraduate and 200 postgraduate students studying to be primary or secondary school teachers through the School of Education (ACT). Other programs offered at this campus include nursing, theology, social work, arts, and religious education. A new model of pre-service secondary teacher education commenced with the introduction of the Graduate Diploma of Education (Secondary) program at this campus in 2005. It marked an innovative collaboration between the university and a cohort of experienced secondary school teachers in the ACT and its surrounding region. This partnership was forged to allow student teachers undertaking the program to be inducted into the teaching profession with the cooperation of leading practitioners from schools in and around the ACT. In the preparation of novices for the teaching profession, an enduring challenge is to create learning experiences capable of transforming practice, and to instill in the novices an array of professional skills, attributes, and competencies (Putnam & Borko, 2000). Another dimension of the beginning teacher experience is the need to bridge theory and practice, and to apply pedagogical content knowledge in real-life classroom practice. During the one-year Graduate Diploma program, the student teachers undertake two four-week block practicum placements, during which they have the opportunity to observe exemplary lessons, as well as to commence teaching. The goals of the practicum include improving participants’ access to innovative pedagogy and educational theory, helping them situate their own prior knowledge regarding pedagogy, and assisting them in reflecting on and evaluating their own practice. Each student teacher is paired with a more experienced teacher based at the school where he/she is placed, who serves as a supervisor and mentor. In 2007, a new dimension to the teaching practicum was added to facilitate online peer mentoring among the pre-service teachers at the Canberra campus of ACU National, and provide them with opportunities to reflect on teaching prior to entering full-time employment at a school. The creation of an online community to facilitate this mentorship and professional development process forms the context for the present case study. While on their practicum, students used social software in the form of collaborative web logging (blogging) and threaded voice discussion tools that were integrated into the university’s course management system (CMS), to share and reflect on their experiences, identify critical incidents, and invite comment on their responses and reactions from peers.

1.1 Macroeconomic summary Economic recovery has consistently outperformed the technical staff’s expectations following a steep decline in activity in the second quarter of 2020. At the same time, total and core inflation rates have fallen and remain at low levels, suggesting that a significant element of the reactivation of Colombia’s economy has been related to recovery in potential GDP. This would support the technical staff’s diagnosis of weak aggregate demand and ample excess capacity. The most recently available data on 2020 growth suggests a contraction in economic activity of 6.8%, lower than estimates from January’s Monetary Policy Report (-7.2%). High-frequency indicators suggest that economic performance was significantly more dynamic than expected in January, despite mobility restrictions and quarantine measures. This has also come amid declines in total and core inflation, the latter of which was below January projections if controlling for certain relative price changes. This suggests that the unexpected strength of recent growth contains elements of demand, and that excess capacity, while significant, could be lower than previously estimated. Nevertheless, uncertainty over the measurement of excess capacity continues to be unusually high and marked both by variations in the way different economic sectors and spending components have been affected by the pandemic, and by uneven price behavior. The size of excess capacity, and in particular the evolution of the pandemic in forthcoming quarters, constitute substantial risks to the macroeconomic forecast presented in this report. Despite the unexpected strength of the recovery, the technical staff continues to project ample excess capacity that is expected to remain on the forecast horizon, alongside core inflation that will likely remain below the target. Domestic demand remains below 2019 levels amid unusually significant uncertainty over the size of excess capacity in the economy. High national unemployment (14.6% for February 2021) reflects a loose labor market, while observed total and core inflation continue to be below 2%. Inflationary pressures from the exchange rate are expected to continue to be low, with relatively little pass-through on inflation. This would be compatible with a negative output gap. Excess productive capacity and the expectation of core inflation below the 3% target on the forecast horizon provide a basis for an expansive monetary policy posture. The technical staff’s assessment of certain shocks and their expected effects on the economy, as well as the presence of several sources of uncertainty and related assumptions about their potential macroeconomic impacts, remain a feature of this report. The coronavirus pandemic, in particular, continues to affect the public health environment, and the reopening of Colombia’s economy remains incomplete. The technical staff’s assessment is that the COVID-19 shock has affected both aggregate demand and supply, but that the impact on demand has been deeper and more persistent. Given this persistence, the central forecast accounts for a gradual tightening of the output gap in the absence of new waves of contagion, and as vaccination campaigns progress. The central forecast continues to include an expected increase of total and core inflation rates in the second quarter of 2021, alongside the lapse of the temporary price relief measures put in place in 2020. Additional COVID-19 outbreaks (of uncertain duration and intensity) represent a significant risk factor that could affect these projections. Additionally, the forecast continues to include an upward trend in sovereign risk premiums, reflected by higher levels of public debt that in the wake of the pandemic are likely to persist on the forecast horizon, even in the context of a fiscal adjustment. At the same time, the projection accounts for the shortterm effects on private domestic demand from a fiscal adjustment along the lines of the one currently being proposed by the national government. This would be compatible with a gradual recovery of private domestic demand in 2022. The size and characteristics of the fiscal adjustment that is ultimately implemented, as well as the corresponding market response, represent another source of forecast uncertainty. Newly available information offers evidence of the potential for significant changes to the macroeconomic scenario, though without altering the general diagnosis described above. The most recent data on inflation, growth, fiscal policy, and international financial conditions suggests a more dynamic economy than previously expected. However, a third wave of the pandemic has delayed the re-opening of Colombia’s economy and brought with it a deceleration in economic activity. Detailed descriptions of these considerations and subsequent changes to the macroeconomic forecast are presented below. The expected annual decline in GDP (-0.3%) in the first quarter of 2021 appears to have been less pronounced than projected in January (-4.8%). Partial closures in January to address a second wave of COVID-19 appear to have had a less significant negative impact on the economy than previously estimated. This is reflected in figures related to mobility, energy demand, industry and retail sales, foreign trade, commercial transactions from selected banks, and the national statistics agency’s (DANE) economic tracking indicator (ISE). Output is now expected to have declined annually in the first quarter by 0.3%. Private consumption likely continued to recover, registering levels somewhat above those from the previous year, while public consumption likely increased significantly. While a recovery in investment in both housing and in other buildings and structures is expected, overall investment levels in this case likely continued to be low, and gross fixed capital formation is expected to continue to show significant annual declines. Imports likely recovered to again outpace exports, though both are expected to register significant annual declines. Economic activity that outpaced projections, an increase in oil prices and other export products, and an expected increase in public spending this year account for the upward revision to the 2021 growth forecast (from 4.6% with a range between 2% and 6% in January, to 6.0% with a range between 3% and 7% in April). As a result, the output gap is expected to be smaller and to tighten more rapidly than projected in the previous report, though it is still expected to remain in negative territory on the forecast horizon. Wide forecast intervals reflect the fact that the future evolution of the COVID-19 pandemic remains a significant source of uncertainty on these projections. The delay in the recovery of economic activity as a result of the resurgence of COVID-19 in the first quarter appears to have been less significant than projected in the January report. The central forecast scenario expects this improved performance to continue in 2021 alongside increased consumer and business confidence. Low real interest rates and an active credit supply would also support this dynamic, and the overall conditions would be expected to spur a recovery in consumption and investment. Increased growth in public spending and public works based on the national government’s spending plan (Plan Financiero del Gobierno) are other factors to consider. Additionally, an expected recovery in global demand and higher projected prices for oil and coffee would further contribute to improved external revenues and would favor investment, in particular in the oil sector. Given the above, the technical staff’s 2021 growth forecast has been revised upward from 4.6% in January (range from 2% to 6%) to 6.0% in April (range from 3% to 7%). These projections account for the potential for the third wave of COVID-19 to have a larger and more persistent effect on the economy than the previous wave, while also supposing that there will not be any additional significant waves of the pandemic and that mobility restrictions will be relaxed as a result. Economic growth in 2022 is expected to be 3%, with a range between 1% and 5%. This figure would be lower than projected in the January report (3.6% with a range between 2% and 6%), due to a higher base of comparison given the upward revision to expected GDP in 2021. This forecast also takes into account the likely effects on private demand of a fiscal adjustment of the size currently being proposed by the national government, and which would come into effect in 2022. Excess in productive capacity is now expected to be lower than estimated in January but continues to be significant and affected by high levels of uncertainty, as reflected in the wide forecast intervals. The possibility of new waves of the virus (of uncertain intensity and duration) represents a significant downward risk to projected GDP growth, and is signaled by the lower limits of the ranges provided in this report. Inflation (1.51%) and inflation excluding food and regulated items (0.94%) declined in March compared to December, continuing below the 3% target. The decline in inflation in this period was below projections, explained in large part by unanticipated increases in the costs of certain foods (3.92%) and regulated items (1.52%). An increase in international food and shipping prices, increased foreign demand for beef, and specific upward pressures on perishable food supplies appear to explain a lower-than-expected deceleration in the consumer price index (CPI) for foods. An unexpected increase in regulated items prices came amid unanticipated increases in international fuel prices, on some utilities rates, and for regulated education prices. The decline in annual inflation excluding food and regulated items between December and March was in line with projections from January, though this included downward pressure from a significant reduction in telecommunications rates due to the imminent entry of a new operator. When controlling for the effects of this relative price change, inflation excluding food and regulated items exceeds levels forecast in the previous report. Within this indicator of core inflation, the CPI for goods (1.05%) accelerated due to a reversion of the effects of the VAT-free day in November, which was largely accounted for in February, and possibly by the transmission of a recent depreciation of the peso on domestic prices for certain items (electric and household appliances). For their part, services prices decelerated and showed the lowest rate of annual growth (0.89%) among the large consumer baskets in the CPI. Within the services basket, the annual change in rental prices continued to decline, while those services that continue to experience the most significant restrictions on returning to normal operations (tourism, cinemas, nightlife, etc.) continued to register significant price declines. As previously mentioned, telephone rates also fell significantly due to increased competition in the market. Total inflation is expected to continue to be affected by ample excesses in productive capacity for the remainder of 2021 and 2022, though less so than projected in January. As a result, convergence to the inflation target is now expected to be somewhat faster than estimated in the previous report, assuming the absence of significant additional outbreaks of COVID-19. The technical staff’s year-end inflation projections for 2021 and 2022 have increased, suggesting figures around 3% due largely to variation in food and regulated items prices. The projection for inflation excluding food and regulated items also increased, but remains below 3%. Price relief measures on indirect taxes implemented in 2020 are expected to lapse in the second quarter of 2021, generating a one-off effect on prices and temporarily affecting inflation excluding food and regulated items. However, indexation to low levels of past inflation, weak demand, and ample excess productive capacity are expected to keep core inflation below the target, near 2.3% at the end of 2021 (previously 2.1%). The reversion in 2021 of the effects of some price relief measures on utility rates from 2020 should lead to an increase in the CPI for regulated items in the second half of this year. Annual price changes are now expected to be higher than estimated in the January report due to an increased expected path for fuel prices and unanticipated increases in regulated education prices. The projection for the CPI for foods has increased compared to the previous report, taking into account certain factors that were not anticipated in January (a less favorable agricultural cycle, increased pressure from international prices, and transport costs). Given the above, year-end annual inflation for 2021 and 2022 is now expected to be 3% and 2.8%, respectively, which would be above projections from January (2.3% and 2,7%). For its part, expected inflation based on analyst surveys suggests year-end inflation in 2021 and 2022 of 2.8% and 3.1%, respectively. There remains significant uncertainty surrounding the inflation forecasts included in this report due to several factors: 1) the evolution of the pandemic; 2) the difficulty in evaluating the size and persistence of excess productive capacity; 3) the timing and manner in which price relief measures will lapse; and 4) the future behavior of food prices. Projected 2021 growth in foreign demand (4.4% to 5.2%) and the supposed average oil price (USD 53 to USD 61 per Brent benchmark barrel) were both revised upward. An increase in long-term international interest rates has been reflected in a depreciation of the peso and could result in relatively tighter external financial conditions for emerging market economies, including Colombia. Average growth among Colombia’s trade partners was greater than expected in the fourth quarter of 2020. This, together with a sizable fiscal stimulus approved in the United States and the onset of a massive global vaccination campaign, largely explains the projected increase in foreign demand growth in 2021. The resilience of the goods market in the face of global crisis and an expected normalization in international trade are additional factors. These considerations and the expected continuation of a gradual reduction of mobility restrictions abroad suggest that Colombia’s trade partners could grow on average by 5.2% in 2021 and around 3.4% in 2022. The improved prospects for global economic growth have led to an increase in current and expected oil prices. Production interruptions due to a heavy winter, reduced inventories, and increased supply restrictions instituted by producing countries have also contributed to the increase. Meanwhile, market forecasts and recent Federal Reserve pronouncements suggest that the benchmark interest rate in the U.S. will remain stable for the next two years. Nevertheless, a significant increase in public spending in the country has fostered expectations for greater growth and inflation, as well as increased uncertainty over the moment in which a normalization of monetary policy might begin. This has been reflected in an increase in long-term interest rates. In this context, emerging market economies in the region, including Colombia, have registered increases in sovereign risk premiums and long-term domestic interest rates, and a depreciation of local currencies against the dollar. Recent outbreaks of COVID-19 in several of these economies; limits on vaccine supply and the slow pace of immunization campaigns in some countries; a significant increase in public debt; and tensions between the United States and China, among other factors, all add to a high level of uncertainty surrounding interest rate spreads, external financing conditions, and the future performance of risk premiums. The impact that this environment could have on the exchange rate and on domestic financing conditions represent risks to the macroeconomic and monetary policy forecasts. Domestic financial conditions continue to favor recovery in economic activity. The transmission of reductions to the policy interest rate on credit rates has been significant. The banking portfolio continues to recover amid circumstances that have affected both the supply and demand for loans, and in which some credit risks have materialized. Preferential and ordinary commercial interest rates have fallen to a similar degree as the benchmark interest rate. As is generally the case, this transmission has come at a slower pace for consumer credit rates, and has been further delayed in the case of mortgage rates. Commercial credit levels stabilized above pre-pandemic levels in March, following an increase resulting from significant liquidity requirements for businesses in the second quarter of 2020. The consumer credit portfolio continued to recover and has now surpassed February 2020 levels, though overall growth in the portfolio remains low. At the same time, portfolio projections and default indicators have increased, and credit establishment earnings have come down. Despite this, credit disbursements continue to recover and solvency indicators remain well above regulatory minimums. 1.2 Monetary policy decision In its meetings in March and April the BDBR left the benchmark interest rate unchanged at 1.75%.