Academic literature on the topic 'Community health services Australian Capital Territory'

This paper presents an outline of the socio-demographic features of the Australian Capital Territory (the ACT) and of its health care system. I describe how health care resources are allocated in the government sector, present a moredetailed description of the way that hospital services are purchased, and summarise the government's policy directions for health. I argue that the main directions are sensible, and particularly those that support more integrated care that is largely based in the community. There appear to be no major weaknesses in the budget-share output-based funding model used in the purchase of hospital services, although the rationale for some of the components might be clarified.In total, the ACT government appears to be on the right track. However, I argue that more rapid progress might bepossible if there were greater collaboration between the Territory health authority and the relatively powerful private medical profession.

The Australian Institute of Health and Welfare (AIHW) has recently released a report on the educational outcomes for children and young people on guardianship or custody orders. This report, four years in the making, represents one of the first comprehensive Australian assessments based on educational performance data from multiple jurisdictions for children on guardianship or custody orders. Developed for the National Child Protection and Support Services data group, the study was funded by the Community and Disability Services Ministers’ Advisory Council (AIHW 2007).This pilot study examines how children on guardianship/custody orders are performing compared with all Australian children in education department-based testing for reading and numeracy in years 3, 5 and 7. Mean test scores were examined in addition to the achievement of national benchmarks for reading and numeracy. These nationally agreed benchmarks are designed to assess whether children have achieved the minimum standards for years 3, 5 and 7 (AIHW 2007). Data on 895 children on guardianship or custody orders were collected from five jurisdictions - Queensland, Victoria, South Australia, Tasmania and the Australian Capital Territory - for August 2003 (AIHW 2007). The data were linked through collaborative efforts by state and territory education and community services departments.

Abstract Objectives There are a growing number of people aged over 55 years living in retirement communities in Australia. These communities typically consist of accommodation, services and community facilities which cater to older people and the desire to maintain independence. The Nutrition and Healthy Ageing Trajectories in Retirement Living (NutriHAT-RL) study aims to investigate the nutrition and lifestyle-based behaviours which contribute to healthy ageing and the maintenance of social and physical functioning among older people living in retirement communities. Methods This study will recruit a total of 2,770 people aged 55 years or over living in retirement communities in the Australian Capital Territory and southern New South Wales regions of Australia for a four-year prospective longitudinal study commencing in March 2021. A range of measures, including nutritional intake, health and lifestyle behaviours, cognitive and psychological function, and physical health, will be completed on three occasions over a total of four years. Participants will complete a face-to-face comprehensive, validated food frequency questionnaire at each time point. Risk of malnutrition and nutritional behaviour (emotional appetite and intuitive eating) will also be evaluated. Multiple mental, social, and physical health domains will be assessed at each time point. This will include cognitive and mental health (depression, anxiety, and loneliness) screening, social and occupational functioning questionnaires, self-reported and observed physical function assessments, and sleep quality. Bitter taste endophenotype, salivary C-reactive protein, telomere length, and blood biomarkers associated with healthy ageing will also be evaluated. Results Ethics approval has been obtained through the University of Canberra Human Ethics Research Committee (UCHREC-2306). To reduce risk of COVID-19 transmissions, a risk mitigation plan has been developed. Conclusions The NutriHAT-RL study will be the first Australian longitudinal study with a focus on nutrition and healthy ageing in people living in retirement communities. Findings from this study will contribute to understanding of nutrition and healthy ageing in this growing population and will inform policy and practice related to nutrition and ageing in place. Funding Sources N/A.

Objective Government expenditure on and the number of aged care facilities in Australia have increased consistently since 1995. As a result, a range of aged care policy changes have been implemented. Data on demographics and utilisation are important in determining the effects of policy on residential aged care services. Yet, there are surprisingly few statistical summaries in the peer-reviewed literature on the profile of Australian aged care residents or trends in service utilisation. Therefore, the aim of the present study was to characterise the demographic profile and utilisation of a large cohort of residential aged care residents, including trends over a 3-year period. Methods We collected 3 years of data (2011–14) from 77 residential aged care facilities and assessed trends and differences across five demographic and three service utilisation variables. Results The median age at admission over the 3-year period remained constant at 86 years. There were statistically significant decreases in separations to home (z = 2.62, P = 0.009) and a 1.35% increase in low care admissions. Widowed females made up the majority (44.75%) of permanent residents, were the oldest and had the longest lengths of stay. One-third of permanent residents had resided in aged care for 3 years or longer. Approximately 30% of residents were not born in Australia. Aboriginal residents made up less than 1% of the studied population, were younger and had shorter stays than non-Aboriginal residents. Conclusion The analyses revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. There have been several changes in aged care policy over the decades. The analyses outlined herein illustrate how community, health services and public health data can be used to inform policy, monitor progress and assess whether intended policy has had the desired effects on aged care services. What is known about the topic? Characterisation of permanent residents and their utilisation of residential aged care facilities is poorly described in the peer-reviewed literature. Further, publicly available government reports are incomplete or characterised using incomplete methods. What does this paper add? The analyses in the present study revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. The most significant finding of the study is that one-third of permanent residents had resided in an aged care facility for ≥3 years. These findings add to the overall picture of residential aged care utilisation in Australia. What are the implications for practitioners? The analyses outlined herein illustrate how community, health services and public health data can be utilised to inform policy, monitor progress and assess whether or not intended policy has had the desired effects on aged care services.

The extraordinary (unplanned) review of clinical privileges is the means by which an organisation can manage specific complaints about individual practitioners’ clinical competence that require immediate investigation. To date, the extraordinary review of clinical privileges for doctors and dentists has not been the subject of much research and there is a pressing need for the evaluation and review of how different legislated and non-legislated administrative processes work and what they achieve. Although it seems a fair proposition that comprehensive processes for the evaluation of the clinical competence of doctors and dentists may improve the overall delivery of an organisation’s clinical services, in fact, little is known about the relationship between the safety and quality of specific clinical services, procedures and interventions and the efficiency or effectiveness of established methodologies for the routine or the extraordinary review of clinical privileges. The authors present a model of a structured approach to the extraordinary review of clinical privileges within a clinical governance framework in the Australian Capital Territory. The assessment framework uses a primarily qualitative methodology, underpinned by a process of systematic review of clinical competence against the agreed standards of the CanMEDS Physician Competency Framework. The model is a practical, working framework that could be implemented on a hospital-, area health service- or state- and territory-wide basis in any other Australian jurisdiction. What is known about the topic?In Australia, there is a national standard for credentialing and defining the scope of clinical practice for doctors working in hospital settings. However, there are no published reports in the national arena on established processes for the extraordinary review of clinical privileges for doctors or dentists and, despite the major inquiries investigating health system failures in Australian hospitals, the effectiveness and adequacy of existing processes for the extraordinary review of clinical privileges has not yet been prioritised nationally as an area for improvement or reform. Internationally, health care organisations have also been slow to establish frameworks for the management of complaints about doctors or dentists. What does this paper add?This paper makes a significant contribution to the national and international safety and quality literature by presenting an exposition of a working model for the extraordinary review of clinical privileges of doctors and dentists. The authors describe a methodology in the public health sector that is territory-wide (not hospital-based), peer-reviewed, objective, fair and responsive. Because the model is a practical, working framework that could be implemented on a hospital-, area health service- or state- and territory-wide basis in any other Australian jurisdiction, this paper provides an opportunity for policy makers and legislators to drive innovative change. Although incursions into the provision of care by other health professionals have been avoided, the model could be readily adopted by clinical leaders from the nursing and allied health professions. What are the implications for practitioners?An organisation dedicated to investigating serious complaints with a real sense of urgency, objectivity and transparency is far less likely to fester a climate of disquiet or anger amongst staff, or to trigger concerns of a ‘cover-up’ or disregard for accountability than an organisation not adopting such an approach. Anecdotal experience suggests the model has the potential to minimise, if not prevent, the occurrence of the kinds of complaints that become much-publicised in the media. This is positive because these types of damaging high profile cases often have the effect of diminishing community confidence in the health care system, in particular, confidence in the medical profession’s ability to self-regulate. Often, they also lead to a misrepresentation of the medical profession in the media, which is unfair since the overwhelming majority of doctors do meet the standards of their profession.

Objective: Although the efficacy of a number of psychotherapeutic interventions has been well established in tightly controlled, randomized trials, there remains a paucity of literature examining the effectiveness of these interventions in community practice settings. In light of this, the Australian Capital Territory Mental Health Services (Canberra, ACT) set out to investigate the effectiveness of an empirically supported psychotherapeutic intervention, interpersonal psychotherapy (IPT). The present study describes a pilot evaluation of the training programme for health professionals and the IPT treatment programme. Methods: Forty community mental health professionals participated in intensive IPT training. Clinicians who completed a course of supervision were asked to apply the treatment with non-psychotic acutely depressed patients. Measures of patients’ health outcomes were taken before and after treatment using a standardized outcome measure. Results: A total of 17 out of 21 patients who were selected completed a course of 12–16 weeks of IPT. The majority of the patients had a depression originating in the post-partum period. A comparison of pre- and post-treatment scores of treatment completers revealed a significant decrease in mean depression scores. Clinicians who completed a course of training and supervision found that they were able to confidently apply IPT in a clinical setting. Conclusions: Although there were a number of barriers and obstacles to the introduction of an evidenced-based treatment, the results are promising and demonstrate that IPT can be readily taught to experienced mental health professionals. Further study is required to determine the feasibility of IPT in other non-academic settings using larger sample sizes and homogenous groups of patients.

Objective: This paper reports on a study designed within the framework of the National Survey of Mental Health and Wellbeing to: estimate the prevalence of psychoses in urban areas of Australia; identify profiles of symptomatology, impairments and disabilities; collect information on services received and needed; and explore quality of life issues in a broadly representative sample of people with psychotic illnesses. Method: The study was conducted over four areas in the Australian Capital Territory, Queensland, Victoria and Western Australia, as a two-phase survey: (i) a census and screening for psychosis of all individuals who made contacts with mental health services during a period of 1 month in 1997; and (ii) interviews with a stratified random sample (n = 980) of the screen-positive individuals (n = 3800) using a standardised instrument. Results: The point prevalence (1 month) of psychotic disorders in the urban population aged 18–64 is in the range of 4–7 per 1000 with a weighted mean of 4.7 per 1000. People with psychotic disorders experience high rates of functional impairments and disability, decreased quality of life, persistent symptoms, substance-use comorbidity and frequent side effects of medication. Although the utilisation of hospital-based and community mental health services, as well as of public and non-governmental helping agencies, is high, the majority live in extreme social isolation and adverse socioeconomic circumstances. Among the many unmet needs, the limited availability of community-based rehabilitation, supported accommodation and employment opportunities is particularly prominent. Conclusions: The so-called ‘low-prevalence’ psychotic disorders represent a major and complex public health problem, associated with heavy personal and social costs. There is a need for a broad programmatic approach, involving various sectors of the community, to tackle the multiple dimensions of clinical disorder, personal functioning and socioeconomic environment that influence the course and outcome of psychosis and ultimately determine the effectiveness of service-based intervention.

In Australia and elsewhere, chlamydia screening rates for those aged between 16 and 30 years continue to be low. Innovative, age-appropriate approaches are necessary to increase chlamydia screening among this target group to prevent short- and long-term consequences of the infection such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Studies have demonstrated that offering chlamydia screening in community pharmacies may be a useful adjunct to current screening services. Approximately 90% of Australians visit a pharmacy at least once a year. Chlamydia screening and education in community pharmacies with remuneration may provide another option for opportunistic testing as part of a national chlamydia screening scheme. Compensation is an accepted practice in the field of research and has been demonstrated to improve adherence to health promotion activities. In 2011, a cross-sectional study of community pharmacy-based chlamydia screening offered in conjunction with an A$10 cash incentive to participate was conducted in the Australian Capital Territory. As part of this study young people were asked about their experience of, and views about, pharmacy-based chlamydia screening. The views of consented participants were collected using the one-page questionnaire consisting of 10 closed questions and one open-ended question. Participants completed the questionnaire when they returned their urine sample and before being given the cash incentive. Overall participants were highly satisfied with the pharmacy-based chlamydia screening service. Over 60% of questionnaire respondents felt that the payment did affect their decision to have the chlamydia test, and 23% stated that it made no difference. Young people reported that pharmacy-based screening is acceptable and convenient. Accessibility and the small cash incentive played significant roles in increasing participation.

Objective. The Serious and Continuing Illness Policy and Practice Study (SCIPPS) aims to improve the care and support for patients with chronic illness and their family carers. Here we describe the carers’ contribution to the self-management partnership and discuss the policy and practice implications that are relevant to improving the support available for informal care in Australia. Design. A secondary analysis of SCIPPS data. Fourteen carers of patients between 45 and 85 years with chronic heart failure, chronic obstructive pulmonary disease and diabetes were conveniently sampled from western Sydney and the Australian Capital Territory. Semi-structured interviews were conducted. Data were analysed using qualitative content analysis. Results. Key roles that carers perform in the self-management partnership included: home helper; lifestyle coach; advocate; technical care manager; and health information interpreter. Two negative consequences of juggling these roles included: self-neglect and conflict. Conclusions. Rigid eligibility criteria limit carers’ access to essential support programs which underestimates and undervalues their contributions to the self-management partnership. Support services should focus on the development of practical skills to perform the caregiving roles. In addition, health professionals require support to work more effectively with carers to minimise the conflict that can overshadow the care and self-management partnership. What is known about the topic? There is a body of research developed both internationally and in Australia that describes the role of family carers in assisting family members with disabilities and other chronic illnesses to maintain independence in the home and community and that deals with the negative implications of caregiving. Much of the existing research is focussed on the roles and responsibilities that family carers perform in order to compensate for their care recipient’s physical and cognitive impairments due to illness. What does this paper add? This paper adds a qualitative exploration of the contribution that family carers make to the self-management partnership with care recipients and health professionals in the home, community and health care settings. It provides additional insights on the exact roles that family carers perform as part of the self-management partnership with care recipients who have chronic heart failure, chronic obstructive pulmonary disease and complicated diabetes. Furthermore, it offers a detailed discussion of the policy and practice implications of our findings and their relevance to improving the support available for informal care in Australia. What are the implications for practitioners? Carers have a vital role to play in the provision of care and this role is expected to increase in parallel with the rising rates of chronic illness. The paper discusses policy recommendations for improving access, demand and appropriateness of support services for carers providing support for care recipients not traditionally recognised as having a genuine need for care. It also identifies the need for health professionals to work more effectively with family carers by making explicit their expectations of this role in order to minimise conflict in the care partnership.

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.

This thesis examines the arts of care in an asylum in New South Wales (NSW) and a mental health community in the Australian Capital Territory in twentieth-century Australia, and describes and compares a range of governmental responses for responding to persons deemed to be in need of care. The thesis explores similarities between twentieth-century Australian care techniques and the key principles underpinning a ‘care system’ that was developed over 200 years ago. It proposes three twentieth-century care regimes, each one characteristic of a certain period: Herd Care, set in an asylum era that emphasised custodialism and confinement (1925-1958); Therapeutic Community, a period during which the asylum was reconfigured into a facilitative community (1959-1983); and Community Care, beginning around 1983, when NSW asylums were ‘rationalised’, their care techniques fragmented and outsourced in diverse settings generally referred to collectively as the mental health community. Some of the dynamics, continuities and ruptures in twentieth-century care regimes are analysed. Chapters describe the landscapes of care. They explore how environmental settings have been designed to reinforce the care regimes in which they are mobilised and how they ‘make up’ the possibilities for action of the subject of care. The dynamics of care between care providers and their recipients are examined. Some of the continuities and discontinuities of meanings associated with ‘family’ and ‘community’ in each of the care regimes are observed. Fieldwork findings are combined with the cultural narrative of psychiatric primitivism to consider why subjects have been deemed in need of care, at times in need of protection and training and at other times in need of discipline and restraint. The new possibilities for action that have emerged in Australian twentieth-century mental health governance are considered, when subjects of care have been encouraged to learn how to be free

Standard precautions are a set of guidelines that aim to protect health care workers from infections from blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes while providing care to patients. However, compliance to the standard precautions is often low in low-income countries in spite of the greater risk of infection. This study examined the knowledge and practice of standard precautions among health care workers in public secondary health facilities in Abuja, the Federal Capital Territory of Nigeria. A quantitative descriptive survey was conducted with 83 doctors and 194 nurses using a structured questionnaire. Findings show suboptimal knowledge and practice of the standard precautions among the health care workers. Knowledge of post-exposure prophylaxis for HIV was low as well as hepatitis B immunization among the respondents. A lack or irregular supply of essential materials, such as personal protective equipment, was the main reason the respondents did not comply to the precautions. This report recommends the development and implementation of a comprehensive infection prevention and control program in health facilities in order to ensure compliance to the standard precautions by health care workers.
Public Health
M.A. (Public Health)

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.

Information communications technology (ICT) has been identified as a key enabler in the achievement of regional and rural success, particularly in terms of economic and business development. The potential of achieving equity of service through improved communications infrastructure and enhanced access to government, health, education, and other services has been identified. ICT has also been linked to the aspiration of community empowerment, where dimensions include revitalizing a sense of community, building regional capacity, enhancing democracy, and increasing social capital. In Australia, there has been a vision for online services to be used to open up regional communities to the rest of the world. Government support has been seen “as enhancing the competence levels of local economies and communities so they become strong enough to deal equitably in an increasingly open marketplace” (McGrath & More, 2002, p. 40). In a regional and rural context, the availability of practical assistance is often limited. Identification of the most appropriate online services for a particular community is sometimes difficult (Ashford, 1999; Papandrea & Wade, 2000; Pattulock & Albury Wodonga Area Consultative Committee, 2000). Calls, however, continue for regional communities to join the globalized, online world. These are supported by the view that success today is based less and less on natural resource wealth, labor costs, and relative exchange rates, and more and more on individual knowledge, skills, and innovation. But how can regional communities “grab their share of this wealth” and use it to strengthen local communities (Simpson 1999, p. 6)? Should communities be moving, as Porter (2001, p. 18) recommends (for business), away from the rhetoric about “Internet industries,” “e-business strategies,” and the “new economy,” to see the Internet as “an enabling technology—a powerful set of tools that can be used, wisely or unwisely, in almost any industry and as part of almost any strategy?” Recent Australian literature (particularly government literature) does indeed demonstrate somewhat of a shift in terms of the expectations of ICT and e-commerce (National Office for the Information Economy, 2001; Multimedia Victoria, 2002; National Office for the Information Economy, 2002). Consistent with reflections on international industry experience, there is now a greater emphasis on identifying locally appropriate initiatives, exploring opportunities for improving existing communication and service quality, and for using the Internet and ICT to support more efficient community processes and relationships (Hunter, 1999; Municipal Association of Victoria and ETC Electronic Trading Concepts Pty Ltd., 2000; National Office for the Information Economy, 2002). The objective of this article is to explore whether welldeveloped and well-implemented online services can make a positive contribution to the future of regional and rural communities. This will be achieved by disseminating some of the learning from the implementation of the MainStreet Regional Portal project (www.mainstreet.net.au). To provide a context for this case study, the next section introduces some theory relevant to virtual communities and portals. The concept of online communities is introduced and then literature is reviewed to identify factors that have been acknowledged as important in the success of online community and portal initiatives.