ORCID Profile
0000-0002-0638-9438
Current Organisation
The University of Notre Dame Australia - Sydney Campus Broadway
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Publisher: Elsevier BV
Date: 02-1999
Publisher: Elsevier BV
Date: 07-2008
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/AH18153
Abstract: Climate change adaptation can be defined as a form of risk management (i.e. assessing climate change-related risks and responding appropriately so that the risks can be pre-emptively minimised and managed as they arise). Adapting to climate change by hospital and community health services will entail responding to changing health needs of the local population, and to the likely effects of climate change on health service resources, workforce and infrastructure. In this paper we apply a model that health services can use to predict and respond to climate change risks and illustrate this with reference to Sydney’s Local Health Districts (LHDs). We outline the climate change predictions for the Sydney metropolitan area, discuss the resulting vulnerabilities for LHDs and consider the potential of LHDs to respond. Three ‘core business’ categories are examined: (1) ambulance, emergency and acute health care (2) routine health care and (3) population and preventative health services. We consider the key climate change risks and vulnerabilities of the LHDs’ workforce, facilities and finances, and some important transboundary issues. Many Australian health services have existing robust disaster plans and management networks. These could be expanded to incorporate local climate and health adaptation plans. What is known about the topic? There is an inextricable relationship between climate change and human health, with important implications for the delivery of health services. Climate change will affect health service demand, and the resources, workforce and infrastructure of health services. What does this paper add? This paper outlines how local health services can use existing data sources and models for assessing their climate change-related risks and vulnerabilities to predict, prepare for and respond to those risks. This is illustrated with reference to Sydney’s LHDs. What are the implications for practitioners? Adaptation to climate change by health services is an important component of risk management. Local health services need to prepare for the effects of climate change by assessing the risks and developing and implementing climate and health adaptation plans.
Publisher: CSIRO Publishing
Date: 1996
DOI: 10.1071/AH960023
Abstract: While a health outcomes approach has the potential to improve the health status of Australians as well as health service efficiency, such a policy will be successful only if practice at the local level follows suit. This paper briefly reviews the health outcomes approach and describes how the Central Sydney Area Health Service has established a Needs Assessment & Health Outcomes Unit to help improve health outcomes. The paper discusses issues in working with population health outcomes at the local level, such as the usefulness and limitations of routinely collected data for planning and managing health services, problems of small area data, gaps in the documentation of national health goals and targets, problems of attribution of improved outcomes to specific interventions and definition of responsibilities for action at the local level. It offers some potential solutions relevant at the local level.
Publisher: BMJ
Date: 02-2000
DOI: 10.1136/JECH.54.2.82
Publisher: Informa UK Limited
Date: 12-04-2017
Publisher: Elsevier BV
Date: 10-2005
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.SOCSCIMED.2019.112594
Abstract: The purpose of this article is to investigate whether the neo-liberal goal of global economic competitiveness when included alongside image-inspired social goals such as liveability and environmental goals such as sustainability can lead to policies that impact positively on health and health equity. The paper presents an analysis of the content and intent of strategic planning and transport plans from two Australian state governments. The analysis was undertaken using a thematic document analysis of each plan and interviews with agents (n = 21) directly involved in the preparation of each document. Key strategic documents formulated under a neo-liberal hegemony simultaneously provided and reduced opportunities to promote and advance health. The policies viewed goals like liveability and sustainability as means of enhancing their cities' image in global competition for exogenous capital flows. Although liveability has many definitions, one definition was able to be used in one jurisdiction as an avenue to include a broad array of social determinants of health into urban planning policy. However, a productivity or a narrowly focussed image narrative can undermine the social determinants of health credentials of liveability. Overemphasising immediate city problems like road congestion as mechanisms to enhance global competitiveness can undermine necessary long-term strategies for city planning that are known to improve liveability and human health. Even where liveability is at the fore, there is a high risk of exacerbating spatial inequities through liveability investments for competitive advantage because they tend to flow to parts of cities with the greatest connections to the global economy, not those with the greatest social need. A neo-liberal-inspired competitive city paradigm provides opportunities for the advancement of health in urban development. However, when driven by the goals of productivity and/or liveability as image enhancement it can potentially exacerbate health inequities.
Publisher: Wiley
Date: 27-10-2008
DOI: 10.1111/J.1440-1754.2008.01371.X
Abstract: The aim of this paper is to describe the implementation of a strategic plan, Health Gain for Children and Youth of Central Sydney, over a 10-year period to December 2005. Descriptive information was obtained from the records and minutes of all relevant committees, interviews with key workers who were involved with the committees, managers and senior health professionals, and from the involvement of the authors throughout the process of the implementation. An implementation steering committee was established to oversee the implementation of the plan. Rather than adopting a uniform approach to assigning responsibility for the implementation of each strategy in the plan or developing specific costs and time frames for each strategy, a more pragmatic, flexible and opportunistic approach was taken. Most of the plan's strategies were implemented over a 7-year time frame using a combination of service reorientation and implementation of new programmes, some of which were funded from sources not anticipated during the development of the plan. Implementation required a dedicated driver, commitment at senior level and participation by many staff at many levels. Outcomes, monitored through data collected at 5-year intervals, revealed positive trends in a number of child and youth health indicators. The successful implementation of the strategic plan required pragmatism, flexibility, opportunism and the commitment and involvement of staff at all organisational levels. It is envisaged that this approach provides a firm base for future evidence-based developments to benefit the health and well-being of children, youth and their families and reduce health inequities.
Publisher: Wiley
Date: 15-06-2010
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.SOCSCIMED.2014.02.033
Abstract: The last decade has seen increased use of health impact assessment (HIA) to influence public policies developed outside the Health sector. HIA has developed as a structured, linear and technical process to incorporate health, broadly defined, into policy. This is potentially incongruent with complex, non-linear and tactical policy making which does not necessarily consider health. HIA research has however not incorporated existing public policy theory to explain practitioners' experiences with HIA and policy. This research, therefore, used public policy theory to explain HIA practitioners' experiences and investigate 'What is the fit between HIA and public policy?' Empirical findings from nine in-depth interviews with international HIA practitioners were re-analysed against public policy theory. We reviewed the HIA literature for inclusion of public policy theories then compared these for compatibility with our critical realist methodology and the empirical data. The theory 'Policy Cycles and Subsystems' (Howlett et al., 2009) was used to re-analyse the empirical data. HIAs for policy are necessarily both tactical and technical. Within policy subsystems using HIA to influence public policy requires tactically positioning health as a relevant public policy issue and, to facilitate this, institutional support for collaboration between Public Health and other sectors. HIA fits best within the often non-linear public policy cycle as a policy formulation instrument. HIA provides, tactically and technically, a space for practical reasoning to navigate facts, values and processes underlying the substantive and procedural dimensions of policy. Re-analysing empirical experiential data using existing public policy theory provided valuable explanations for future research, policy and practice concerning why and how HIA fits tactically and technically with the world of public policy development. The use of theory and empiricism opens up important possibilities for future research in the search for better explanations of complex practical problems.
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.SOCSCIMED.2015.11.029
Abstract: Framing health as a relevant policy issue for other sectors is not well understood. A recent review of the New South Wales (Australia) land-use planning system resulted in the drafting of legislation with an internationally unprecedented focus on human health. We apply a political science approach to investigate the question 'how and to what extent were health and wider issues framed in submissions to the review?' We investigated a range of stakeholder submissions including health focussed agencies (n = 31), purposively identified key stakeholders with influence on the review (n = 24), and a random s le of other agencies and in iduals (n = 47). Using qualitative descriptive analysis we inductively coded for the term 'health' and sub-categories. We deductively coded for 'wider concerns' using a locally endorsed 'Healthy Urban Development Checklist'. Additional inductive analysis uncovered further 'wider concerns'. Health was explicitly identified as a relevant issue for planning policy only in submissions by health-focussed agencies. This framing concerned the new planning system promoting and protecting health as well as connecting health to wider planning concerns including economic issues, transport, public open space and, to a slightly lesser extent, environmental sustainability. Key stakeholder and other agency submissions focussed on these and other wider planning concerns but did not mention health in detail. Health agency submissions did not emphasise infrastructure, density or housing as explicitly as others. Framing health as a relevant policy issue has the potential to influence legislative change governing the business of other sectors. Without submissions from health agencies arguing the importance of having health as an objective in the proposed legislation it is unlikely health considerations would have gained prominence in the draft bill. The findings have implications for health agency engagement with legislative change processes and beyond in land use planning.
Publisher: BMJ
Date: 08-2005
Publisher: Springer Science and Business Media LLC
Date: 04-01-2013
DOI: 10.1007/S11673-012-9423-6
Abstract: The prevalence of chronic diseases has increased in recent decades. Some forms of the built environment adopted during the 20th century-e.g., urban sprawl, car dependency, and dysfunctional streetscapes-have contributed to this. In this article, I summarise ways in which the built environment influences health and how it can be constructed differently to promote health. I argue that urban planning is inevitably a social and political activity with many ethical dimensions, and I illustrate this with two ex les: the construction of a hypothetical new suburb and a current review of planning legislation in Australia. I conclude that (1) constructing the built environment in ways that promote health can be ethically justified, (2) urban planners and public health workers should become more skilled in the application of ethical considerations to practical problems, and (3) the public health workforce needs to become more competent at influencing the activities of other sectors.
Publisher: Oxford University Press (OUP)
Date: 16-06-2008
DOI: 10.1093/NDT/GFN207
Publisher: Oxford University Press (OUP)
Date: 1992
DOI: 10.1093/IJE/21.2.427
Publisher: The Sax Institute
Date: 2018
DOI: 10.17061/PHRP2841830
Abstract: The scientific evidence for global warming is overwhelming. Health organisations, as large carbon polluters, are at significant 'carbon risk' and must act to reduce their carbon emissions. Many environmental sustainability initiatives, if properly implemented, would not only reduce harm, waste and pollution but also deliver health, social and financial benefits. We have been involved for more than a decade in efforts to reduce the greenhouse gas emissions of New South Wales (NSW) Health organisations in which we have worked. We draw on our collective experience to offer eight key lessons about implementing environmental sustainability initiatives in health organisations. Sustainability plans have been developed in at least three Area Health Services/Local Health Districts in NSW, but in each case they have been imperfectly implemented. Based on our experience, we offer eight key lessons relating to leadership, engagement and developing networks, data, complex adaptive systems, broadening the issue, and political factors.
Publisher: Springer International Publishing
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 22-03-2007
Publisher: Elsevier BV
Date: 12-2011
Publisher: BMJ
Date: 2012
Publisher: Oxford University Press (OUP)
Date: 05-09-2018
Abstract: Influencing healthy public policy through health advocacy remains challenging. This policy analysis research uses theories of agenda setting to understand how health came to be considered for specific mention in legislation arising from land-use planning system reform in New South Wales, Australia. This qualitative study follows critical realist methodology to conduct a policy analysis of the case. We collected data from purposively s led in-depth interviews (n = 9), a focus group and documentary analysis. We used three classic policy process (agenda setting) theories to develop an analytic framework for explaining the empirical data: Multiple Streams Punctuated Equilibrium Theory and Advocacy Coalition Framework. The reform process presented a window of opportunity that opened incrementally over a 2 year period. The opportunity was grasped by in idual policy entrepreneurs who subsequently formed a coalition of healthy planning advocates focused on strategically positioning 'health' as legislative objective for the new system. The actual point of influence seemed to appear suddenly when challenges to a perceived economic development agenda within the reforms peaked, and the health objective, see as non-threatening by all stakeholders, was taken up. Our analysis demonstrates how this particular point of influence followed sustained long-term activity by health advocates prior to and during the reform process. We demonstrate a theory-driven policy analysis of health advocacy efforts to influence an instance of major land-use planning reform. The application of multiple policy process theories enables deep understanding of what is required to effectively advocate for healthy public policy.
Publisher: Elsevier BV
Date: 2021
Publisher: The Sax Institute
Date: 2009
DOI: 10.1071/NB09018
Publisher: Informa UK Limited
Date: 22-03-2017
Publisher: Oxford University Press (OUP)
Date: 05-05-2019
Abstract: Notwithstanding the historical benefits of coal in aiding human and economic development, the negative health and environmental impacts of coal extraction and processing are of increasing concern. Environmental impact assessments (EIAs) are a regulated policy mechanism that can be used to predict and consider the health impacts of mining projects to determine if consent is given. The ways in which health is considered within EIA is unclear. This research investigated ‘How and to what extent are health, well-being and equity issues considered in Environmental Impact Assessments (EIAs) of major coal mining projects in New South Wales, Australia’. To this end we developed and applied a comprehensive coding framework designed to interrogate the publicly available environmental impact statements (EISs) of three mines in New South Wales (NSW), Australia, for their inclusion of health, well-being and equity issues. Analysis of the three EISs demonstrates that: the possible impacts of each mine on health and well-being were narrowly and inadequately considered when health and well-being were considered there was a failure to assess the possible impacts specific to the particular mine and the communities potentially affected the cumulative impacts on human health of multiple mines in the same geographical area were almost completely ignored the discussions of intragenerational and intergenerational equity did not demonstrate a sound understanding of equity and, it is essential that governments’ requirements for the EIA include detailed analysis of the health, well-being, equity and cumulative impacts specific to the proposed mine and relevant communities.
Publisher: BMJ
Date: 12-2005
Publisher: The Sax Institute
Date: 2002
DOI: 10.1071/NB02060
Publisher: Springer Science and Business Media LLC
Date: 14-10-2020
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S13643-021-01848-6
Abstract: Urban health is a field of research and practice that has attracted the interest of various disciplines. While it is encouraged for erse disciplines to contribute to a multidisciplinary field of study such as urban health, this often results in tensions, conflicts or competition between the different traditions that stem from different epistemological backgrounds. This meta-narrative review aims to identify and describe the multiple paradigms and articulate the underlying epistemological, ontological, methodological, and aetiological differences in their approaches. Articulating the paradigms not only contributes to the advancement of research, but also provides a framework for understanding the different policy beliefs and ideas policy actors hold and apply in the policy process. We apply the meta-narrative method to systematic literature review which includes the following six iterative phases. The planning phase includes the finalisation of the review protocol and assembly of review team. The search phase includes a comprehensive literature search in key databases and a double-sided systematic snowballing method. We will search multidisciplinary databases including Web of Science, Scopus and ProQuest, and topic-specific databases including Urban Studies Abstracts (EBSCO), MEDLINE, and EMBASE from their inception onwards. Bibliometric analyses of this literature will be used to triangulate the mapping of the paradigms. The mapping phase includes identifying the dominant paradigms and landmark publications through agreement with the review team. In the appraisal phase, the literature will be assessed by their respective quality standards, followed by data extraction to identify the in idual narratives in the conceptual, theoretical, methodological, and instrumental dimensions of each paradigm. The synthesis phase will review the data to compare and contrast and identify the overarching meta-narratives. The recommendation phase will include dissemination of the findings from the review. The meta-narrative review will reveal the how the different paradigms conceptualise, frame and prioritise urban health issues, their preferred methodologies to study the phenomenon, and the nature of the solutions to improve human health. This review will assist researchers and practitioners in understanding and interpreting evidence produced by other traditions that study urban health. Through this, urban health researchers and practitioners will be able to seek coherence in understanding, explaining, and exploring the urban health phenomenon. Open Science Framework ( osf/io/tn8vk )
Publisher: The Sax Institute
Date: 2005
DOI: 10.1071/NB05050
Publisher: Elsevier BV
Date: 02-2012
Publisher: Maad Rayan Publishing Company
Date: 10-05-2018
Publisher: Wiley
Date: 06-1992
Publisher: Springer International Publishing
Date: 2022
Publisher: Elsevier BV
Date: 11-2018
Publisher: The Sax Institute
Date: 2002
DOI: 10.1071/NB02016
Publisher: Elsevier BV
Date: 06-2014
Publisher: Springer Science and Business Media LLC
Date: 24-04-2009
Publisher: Elsevier BV
Date: 2020
Publisher: Wiley
Date: 09-1993
Publisher: Oxford University Press (OUP)
Date: 03-1996
DOI: 10.1093/OXFORDJOURNALS.PUBMED.A024467
Abstract: The measurement of atmospheric pollution for epidemiological studies is problematic. This study presents a new proxy measure of atmospheric pollution of industrial origin and uses it to determine, at electoral ward level, the relationship between atmospheric pollution and all-cause mortality. All-cause Standardized Mortality Ratios (SMR), all ages, and for persons under 65 years for the period 1984-1988, proportions of land in each ward utilized by industrial works (the proxy for atmospheric pollution) and levels of socioeconomic deprivation of the ward residents were compared in 104 electoral wards. The all-age SMR in the 22 wards containing the largest proportions of industrial land (113) was 9.7 per cent higher than the SMR (103) in the 60 wards with no industrial land. The under 65 years SMR in the 22 highly industrialized wards (120) was 22.4 per cent higher than the SMR (98) in the wards with no industrial land. After matching the levels of deprivation, the all-age SMR in the 15 wards containing over 10 per cent industrial land (116) was significantly higher than the SMR in 15 wards containing no industrial land (108) corresponding figures for the under 65 years SMR were 135 and 118. A greater proportion of industrial land in a ward is associated with a higher mortality of the ward residents, even after controlling for the level of socio-economic deprivation of the residents. The association between deprivation and mortality is stronger than the association between atmospheric pollution and mortality. There is an urgent need for better measures of atmospheric pollution which are usable in epidemiological studies.
Publisher: Oxford University Press (OUP)
Date: 29-08-2020
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.PUHE.2014.01.006
Abstract: Knowledge about health focussed policy collaboration to date has been either tactical or technical. This article focusses on both technical and tactical issues to describe the experience of cross-sectoral collaboration between health and housing stakeholders across the life of a housing master plan, including but not limited to a health impact assessment (HIA). A single explanatory case study of collaboration on a master plan to regenerate a deprived housing estate in Western Sydney was developed to explain why and how the collaboration worked or did not work. Data collection included stakeholder interviews, document review, and reflections by the health team. Following a realist approach, data was analysed against established public policy theory dimensions. Tactically we did not know what we were doing. Despite our technical knowledge and skills with health focussed processes, particularly HIA, we failed to appreciate complexities inherent in master planning. This limited our ability to provide information at the right points. Eventually however the HIA did provide substantive connections between the master plan and health. We use our analysis to develop technical and tactical rules of engagement for future cross-sectoral collaboration. This case study from the field provides insight for future health focussed policy collaboration. We demonstrate the technical and tactical requirements for future intersectoral policy and planning collaborations, including HIAs, with the housing sector on master planning. The experience also suggested how HIAs can be conducted flexibly alongside policy development rather than at a specific point after a policy is drafted.
Publisher: The Sax Institute
Date: 2002
DOI: 10.1071/NB02052
Publisher: Wiley
Date: 05-11-2015
DOI: 10.1071/HE15045
Publisher: Informa UK Limited
Date: 22-06-2020
Publisher: Elsevier BV
Date: 12-2020
Publisher: CSIRO Publishing
Date: 2007
DOI: 10.1071/HE07177
Abstract: Promoting mental health is a relatively new initiative being taken across the world, stimulated by concerns about the global burden of mental illness, inequalities in mental health and debate about the relationship between quality of life and economic growth. Social factors influence the health of populations but the distribution of these is determined by people who exercise political power through societies' institutions of governance. Inequalities in health (and mental health) arise from the unequal distribution of these social determinants of health. This paper aims to stimulate interest and debate on the role of democracy, a mechanism for allocating political power, as a determinant of health and of mental health in particular. Drawing principally on the political science literature, we briefly describe the development of democracy in some of its commoner current forms and relate this to the spread of political power and participation in collective decision making and improvements in public health over the past 200 years. We conducted a non-systematic literature search and identified 34 studies examining the link between democracy and health. Despite methodological weaknesses, these papers suggest that there is a weak empirical link between democracy and health, including mental health. We suggest mechanisms that might account for this. Historical, theoretical and empirical evidence suggests that democracy is a (frequently forgotten) determinant of health.
Publisher: SAGE Publications
Date: 02-2001
DOI: 10.1046/J.1440-1614.2001.00851.X
Abstract: Objective: The objective of this study was to conduct a multifaceted formative evaluation of the Central Sydney Area Health Service (CSAHS) Psychosis and Substance Use Project. Method: Four evaluative methods were used: (i) description and interpretation of the Project's documented processes and outcomes (ii) a benchmark comparison of the Project processes and outcomes against three of the 11 National Standards for Mental Health Services (iii) a survey of the Project's key stakeholders and (iv) interviews with 12 purposefully s led key informants. Results: The Project achieved its aim to develop a strategy to improve services for people with comorbid psychosis and problematic substance use. Three of the five Project objectives were fully achieved: examination of current clinical services, development of a clinical services plan, and development of a staff education programme. The Project partially achieved two objectives: development of an information system, and a research agenda. The Project and CSAHS performed well when measured against three of the National Mental Health Standards. Project participants perceived the Project to have been successful and worth continuing, identified some shortcomings and made recommendations for the second phase. Conclusions: The participatory approach to the Project and the evaluation was successful. With some improvements the Project is worth continuing into a second phase. A multifaceted approach and qualitative research methods are useful for formative evaluation of health service programmes.
Publisher: Wiley
Date: 07-11-2023
DOI: 10.1111/EPI.17449
Abstract: Childhood trauma has been implicated as a risk factor for the etiology of psychogenic nonepileptic seizures (PNES). Relatively little attention has been paid to whether profiles of specific trauma types differ between patients with epilepsy and PNES. Investigating childhood trauma profiles in these patient groups may identify psychological vulnerabilities that predispose to developing PNES, and aid early diagnoses, prevention, and treatment. Data were collected from two cohorts ( n Retrospective = 203 n Prospective = 209) admitted to video–electroencephalography (EEG) monitoring units in Melbourne Australia. The differences in Childhood Trauma Questionnaire domain score between patient groups were investigated using standardized effect sizes and general linear mixed‐effects models (GLMMs). Receiver‐operating characteristic curves were used to investigate classification accuracy. In the retrospective cohort, patients diagnosed with PNES reported greater childhood emotional abuse, emotional neglect, physical abuse, sexual abuse, and physical neglect relative to patients with epilepsy. These differences were replicated in the prospective cohort, except for physical abuse. GLMMs revealed significant main effects for group in both cohorts, but no evidence for any group by domain interactions. Reported sexual abuse showed the best screening performance of PNES, although no psychometric scores were adequate as isolated measures. Patients with PNES report a greater frequency of childhood trauma than patients with epilepsy. This effect appears to hold across all trauma types, with no strong evidence emerging for a particular trauma type that is more prevalent in PNES. From a practical perspective, inquiry regarding a history of sexual abuse shows the most promise as a screening measure.
Publisher: Elsevier BV
Date: 04-2009
Publisher: American Public Health Association
Date: 04-2007
Abstract: In public health, the generation, management, and transfer of knowledge all need major improvement. Problems in generating knowledge include an imbalance in research funding, publication bias, unnecessary studies, adherence to fashion, and undue interest in novel and immediate issues. Impaired generation of knowledge, combined with a dated and inadequate process for managing knowledge and an inefficient system for transferring knowledge, mean a distorted body of evidence available for decisionmaking in public health. This article hopes to stimulate discussion by proposing a Global Registry of Anticipated Public Health Studies. This prospective, comprehensive system for tracking research in public health could help enhance collaboration and improve efficiency. Practical problems must be discussed before such a vision can be further developed.
Publisher: BMJ
Date: 04-12-2008
DOI: 10.1136/BMJ.A1957
Publisher: Wiley
Date: 06-1993
Publisher: Elsevier BV
Date: 2018
Publisher: The Sax Institute
Date: 2012
DOI: 10.1071/NB12066
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2008
Abstract: OBJECTIVE. The objective of this study was to describe the experiences of parents who have children with chronic kidney disease. METHODS. We conducted a systematic review and meta-ethnography of studies that had used in-depth interviews or focus groups to explore experiences of parents with children who have chronic kidney disease (predialysis, hemodialysis, peritoneal dialysis, or after kidney transplantation). We searched 5 electronic databases (through to August 2005), Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Sociofile/Sociological Abstract, and reference lists of relevant articles. RESULTS. Sixteen articles that reported the experiences of parents of 358 children with chronic kidney disease were included. Ten themes emerged, which we grouped into 3 interrelated clusters: intrapersonal (living with constant uncertainty, stress, and maintaining vigilance despite experiencing fatigue), interpersonal (medicalization of the parental role, dependence on and conflict with staff, and disrupted peer relationships), and external issues (management of the medical regimen, pursuit of information, organizing transportation, accommodation and finances, adhering to the child's liquid and diet restrictions, and balancing medical care with domestic responsibilities). CONCLUSIONS. In addition to “normal” parental roles, being a parent of a child with chronic kidney disease demands a high-level health care provider, problem solving, information seeking, and financial and practical skills at a time when the capacity to cope is threatened by physical tiredness, uncertainty, and disruption to peer support within and outside the family structure. Parents of children with chronic kidney disease need multidisciplinary care, which may lead to improved outcomes for their children.
Publisher: Oxford University Press (OUP)
Date: 16-09-2007
Publisher: Cambridge University Press
Date: 12-12-2019
Publisher: Wiley
Date: 08-2019
DOI: 10.1111/IMJ.14380
Abstract: The visit to Australia by Dr David Pencheon, Founding Director of the National Health Service (NHS) Sustainable Development Unit, in April-May 2018 generated considerable interest and engagement. Dr Pencheon's overarching messages were that climate change is a health issue and that doctors and health systems have an opportunity, and responsibility, to lead climate action. This article distils Dr Pencheon's presentations into three themes: (i) carbon accounting (ii) transformational change in our systems of healthcare and (iii) a health system fit for the future. For each theme, we highlight promising initiatives that are already underway in Australia that are starting to transform our health system into one fit for a future environmentally sustainable world. We suggest practical ways in which doctors can lead the transformation through personal action and influence broader systems.
Publisher: The Sax Institute
Date: 2003
DOI: 10.1071/NB03058
Publisher: Oxford University Press (OUP)
Date: 23-06-2020
Abstract: Rapid urbanization requires health promotion practitioners to understand and engage with strategic city planning. This policy analysis research investigated how and why health was taken up into strategic land use planning in Sydney, Australia, between 2013 and 2018. This qualitative study develops two case studies of consecutive instances of strategic planning in Sydney. Data collection was done via in-depth stakeholder interviews (n = 11) and documentary analysis. Data collection and analysis revolved around core categories underpinning policy institutions (actors, structures, ideas, governance and power) to develop an explanatory narrative of the progress of ‘health’ in policy discourse over the study period. The two strategic planning efforts shifted in policy discourse. In the earlier plan, ‘healthy built environments’ was positioned as a strategic direction, but without a mandate for action the emphasis was lost in an economic growth agenda. The second effort shifted that agenda to ecological sustainability, a core aspect of which was ‘Liveability’, having greater potential for health promotion. However, ‘health’ remained underdeveloped as a core driver for city planning remaining without an institutional mandate. Instead, infrastructure coordination was the defining strategic city problem and this paradigm defaulted to emphasizing ‘health precincts’ rather than positioning health as core for the city. This research demonstrates the utility in institutional analysis to understanding positioning health promotion in city planning. Despite potential shifts in policy discourse and a more sophisticated approach to planning holistically, the challenge remains of embedding health within the institutional mandates driving city planning.
Publisher: Elsevier BV
Date: 08-2011
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.HEALTHPLACE.2021.102711
Abstract: 'City Deals' are new governance instruments for urban development. Vast evidence exists on the relationship between urban factors and health equity, but little research applies a health equity lens to urban policy-making. This paper does precisely that for the Western Sydney City Deal (WSCD) in Australia. We conducted a critical discourse analysis of publicly available documents and interviews with the WSCD's main architects, applying insights from relevant theories. We find 'pro-growth' discourse to encourage economic investment dominates any references to disadvantage. Interviewees maintained the WSCDs fundamental purpose is to rebalance urban investment toward the historically disadvantaged West. However, the WSCD makes limited reference to health and none to equity. Institutionalised governance practices that favour private investments in infrastructure remain the dominant force behind the WSCD. We document how a shift to 'place-based' infrastructure has promise for equity but struggles to overcome institutionalised approaches to urban investments.
Publisher: Elsevier BV
Date: 08-2011
Publisher: Elsevier BV
Date: 04-1999
DOI: 10.1111/J.1467-842X.1999.TB01220.X
Abstract: To describe the reasons for the formation of isions of population health in NSW, their functional units, how they might be evaluated, and some future challenges to stimulate critical appraisal of the isions. Personal observation review of documentation and organisational charts. Area health services (AHSs) were established in NSW in 1986 there are now 17. Divisions of population health attempt to overcome the marginalisation and fragmentation that often characterise population health workers within AHSs. Divisions aim to strengthen an AHS's capacity to meet its legislated responsibility to protect and promote the health of the local population. Each of the 13 isions established since 1994 contains a different mix of services. Public health, health promotion and health services planning units are most commonly included in isions. Formal evaluations of organisational structures are not common in health services. Evaluations of isions of population health should focus on their success at creating organisational structures and processes which are conducive to the implementation of population health strategies improving health outcomes and improving the personal, social and environmental preconditions for health. Establishing isions of population health has highlighted the lack of evidence regarding the effectiveness of different organisational structures for delivering population health services. Greater effort is needed to evaluate existing organisational structures and to develop and implement optimal structures for population health services.
Publisher: Oxford University Press (OUP)
Date: 16-07-2008
DOI: 10.1093/NDT/GFN415
Publisher: Bristol University Press
Date: 2009
Abstract: Understanding the ‘evidence’ for policy is complicated. This article examines the relationship between evidence and policies on early childhood interventions in two states of Australia, revealing powerful insights into what constitutes the evidence for policy and the importance of ‘killer facts’ to decision makers. The nature of evidence in the policy environment is broad and complex, going well beyond research to incorporate policy context and processes. These findings reinforce an evidence-informed approach to health policy making and the need for researchers to develop a more sophisticated understanding of the policy context.
Publisher: Elsevier BV
Date: 02-2015
Location: Australia
No related grants have been discovered for Peter Sainsbury.