Evaluation of partnership working in cities in phase IV of the WHO healthy cities network

An intersectoral partnership for health improvement is a requirement of the WHO European Healthy Cities Network of municipalities. A review was undertaken in 59 cities based on responses to a structured questionnaire covering phase IV of the network (2003–2008). Cities usually combined formal and informal working partnerships in a pattern seen in previous phases. However, these encompassed more sectors than previously and achieved greater degrees of collaborative planning and implementation. Additional WHO technical support and networking in phase IV significantly enhanced collaboration with the urban planning sector. Critical success factors were high-level political commitment and a well-organized Healthy City office. Partnerships remain a successful component of Healthy City working. The core principles, purpose and intellectual rationale for intersectoral partnerships remain valid and fit for purpose. This applied to long-established phase III cities as well as newcomers to phase IV. The network, and in particular the WHO brand, is well regarded and encourages political and organizational engagement and is a source of support and technical expertise. A key challenge is to apply a more rigorous analytical framework and theory-informed approach to reviewing partnership and collaboration parameters.

The role of hegemony in secessionist movements : the case study of the Moldovan Republic of Transnistria

The aim of the article is to analyse the secessionist phenomenon by applying the concept of hegemony. Based on critical realist interpretations of the concept, it is argued that hegemonic practice incorporates both inter-subjective and structural aspects. The inter-subjective aspect of hegemony places emphasis on the relations between social groups and the way hegemonic practice leads social agents towards political projects that secure consensus in favour of the interest of particular elites. The structural character of hegemonic practice is evident in the reproduction of social conditions and values that underlie the relations between social agents both globally and domestically. Accordingly, the inter-subjective character of secession as hegemonic practice is evident in the organization of social agents towards a political option (territorial separatism) to the extent that it serves the goals of certain elites. The sturctural aspect of secessionist practice is hegeminic because it reproduces international structures that tend to associate political organization with ethnicity at the state level. The analysis then turns to the case study of Transnistria in Moldova as an empirical illustration of the two tendencies of hegemonic practice in secessionist politics leading ot useful conclusions both for the case study in particular and the study of secession in general. 

Who uses new walking and cycling infrastructure and how? Longitudinal results from the UK iConnect study

Objective
To examine how adults use new local walking and cycling routes, and what characteristics predict use.

Methods
1849 adults completed questionnaires in 2010 and 2011, before and after the construction of walking and cycling infrastructure in three UK municipalities. 1510 adults completed questionnaires in 2010 and 2012. The 2010 questionnaire measured baseline characteristics; the follow-up questionnaires captured infrastructure use.

Results
32% of participants reported using the new infrastructure in 2011, and 38% in 2012. Walking for recreation was by far the most common use. In both follow-up waves, use was independently predicted by higher baseline walking and cycling (e.g. 2012 adjusted rate ratio 2.09 (95% CI 1.55, 2.81) for > 450 min/week vs. none). Moreover, there was strong specificity by mode and purpose, e.g. baseline walking for recreation specifically predicted walking for recreation on the infrastructure. Other independent predictors included living near the infrastructure, better general health and higher education or income.

Conclusions
The new infrastructure was well-used by local adults, and this was sustained over two years. Thus far, however, the infrastructure may primarily have attracted existing walkers and cyclists, and may have catered more to the socio-economically advantaged. This may limit its impacts on population health and health equity.

A good place to raise a family? Comparing parents, service-providers', and media perspectives of the inner and outer suburban areas of Melbourne

In Australia, the suburbs have historically been the favoured place to raise children. However this is being challenged both by social change and government policy encouraging innerurban renewal. We examined how inner-urban areas compare with more traditional suburban locations as places to raise a family. Recognising that there are many influences on perceptions of place, we included the opinions of parents, service-providers and the media in the two locations.

Research focused on two municipalities in Melbourne, one located >25km and the other <10km from the CBD. Themes were obtained and compared from in-depth interviews with parents, serviceproviders and analysis of municipality-specific and state-wide newspaper articles.

Service provision was the only theme common at all levels of analysis. For all other themes, differences occurred between perspectives of service-providers, media and parents, as well as between the two residential locations. These in-depth snapshots on the challenges and rewards of raising children in different urban locations can help inform government in planning healthy neighbourhoods that better serve the needs of contemporary Australian families.

More yuppy stuff coming soon: gentrification, cultural policy, social inclusion and the arts

Responding to gentrification has become a key planning issue for many urban municipalities. Local governments need to balance the often-competing agendas of urban regeneration, social inclusion and arts access and participation. This paper argues that arts and cultural units within local government bear the impact of such tensions. More importantly, however, local government policies and their implementation represent a third position in the polarised discussion on the cultural impact of gentrification. The example discussed here is the rapidly gentrifying City of Maribyrnong in Melbourne’s western suburbs: a municipality where any potential realisation of the economic benefits of gentrification is balanced against the needs of a significant population of resident professional artists, and the social inclusion needs of socio-economically disadvantaged residents. Maribyrnong’s arts and cultural unit, like those within many municipalities in the developed world, has had to develop cultural policies and plans as tools for negotiating complex relationships and diverse needs of community members by considering the economic, social and cultural benefits of the arts for all residents.

Conclusion : The Iraq legacies and the roots of the ‘Islamic State’

With the deadly ISIS advance, the sudden rousing of Shia militias and the threat of Kurdish secession, Iraq faces a host of deep-seated and intractable problems. Together, these events raise a number of serious questions, not just for Iraq and its future but also for the broader Middle East, the United States and its Coalition partners and the international community. While these challenges and questions will drive much academic debate, political analysis and media discussion in the months and years ahead, they are not the central purpose of this chapter. While there is always a risk in commenting on unfolding events, including the potential to overstate their significance and likely long-term impact, it is difficult to ignore the significance of the deadly ISIS advance and all that has happened since. This chapter argues that key to understanding these events is coming to terms with the three varied and complex legacies of the 2003 Iraq War. The first central legacy of the Iraq War is the ongoing consequences of several critical mistakes made by the US-led Coalition before, during and immediately after the 2003 intervention. The second legacy addressed here is the fact that the 2003 war shattered – perhaps irreversibly - Iraqis fragile cultural mosaic and its rich and complex history of overlapping and intersecting communities, ideologies and narratives. The third and final legacy of the 2003 Iraq War detailed in this chapter is its significant regional and global consequences – from spiralling sectarianism across the Middle East to a profound challenge to America’s status as the last remaining superpower and its use of military power for ‘humanitarian’ ends. The argument here is that these three important legacies set in train a sequence of events that have served as the collective catalyst for the expansion of the ‘Islamic State’ from mid-2014.

Self-determination and collective responsibility in the secessionist struggle

The often violent emergence of new independent states following the end of the Cold War generated discussion about the normative grounds of territorial separatism. A number of opposing approaches surfaced debating whether and under which circumstances there is a right for a community to secede from its host country. Overwhelmingly, these studies placed emphasis on the right to secession and neglected the moral stance of secessionist movements as agents in international relations. In this book Costas Laoutides explores the collective moral agency involved in secessionist struggles offering a theoretical model for the collective responsibility of secessionist groups. Case-studies on the Kurds and the people of Moldova-Transdniestria illustrate the author’s theoretical arguments as he seeks to establish how, although the principle of self-determination was envisaged as a means of gradually bestowing political power upon the people, it never managed to realize its full potential because it was interpreted strictly within a framework of exclusionary politics of identity.

Place-based initiatives to tackle mature-age workers’ long-term unemployment in Australia, drawing on successful Nordic precedents

In order to tackle unemployment for the at-risk group of mature-age workers displaced by industry sector restructuring, exemplary place-based initiatives are needed focusing on a selected area of high disadvantage identified by Professor Tony Vinson’s 2015 Jesuit Social Services report Dropping off the Edge, with an Australian state government committed to supporting the initiative, as that report recommends. In order to make such a place-based initiative exemplary in its outcomes, so that it leads to uptake in other areas of high disadvantage, it needs to be thoroughly informed by successful Nordic precedents. In particular, the new Australian place-based initiative needs to be informed by Danish regionally-focused large-scale job skills programs involving transition into a proximate sector of employment growth; and by Norwegian measures for more even population distribution outside capital cities or in particular hard-hit regions within capital cities. An advantage of the proposed initiative is that it will also produce measurable results for children in families in which neither parent works, whose needs are normally tackled (if at all) by separate policy actions in separate tiers or departments of government. Australian children are disproportionately disadvantaged by the internationally extreme concentration of joblessness. Denmark’s Løntilskud and Virksomhedspraktik job training programs subsidised by municipalities and the national government, and supported by Danish trade unions, will be discussed in this paper for the positive effects they have for participants, including establishing or re-establishing unemployed people’s structured work habits and routines, improving their networks along with their social skills, and boosting their confidence. This paper will outline in detail the types of features the proposed new Australian place-based initiative will require, drawing on and drilling down further into data and analysis presented in the author’s recent book: Northern Lights: The Positive Policy Example of Sweden, Finland, Denmark and Norway.

The construction of a subset of ICNP® for patients with dementia: a Delphi consensus and a group interview study

BACKGROUND: The International Classification for Nursing Practice (ICNP®) 2013 includes over 4000 concepts for global nursing diagnoses, outcomes and interventions and is a large and complex set of standardised nursing concepts and expressions. Nurses may use subsets from the ICNP as concepts and expressions for research, education and clinical practice. The objective of this study was to identify and validate concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia.

METHOD: The process model for developing ICNP subsets was followed, according to the guidelines adopted by the International Council of Nursing (ICN). To identify relevant and useful concepts for the subset, a modified form of the Delphi method was used. Six nurses working in healthcare services in three municipalities in Norway with postgraduate education in geriatric psychiatry and dementia care participated in two Delphi sessions. The participants reviewed and scored the concepts included in the suggested subset and had an opportunity to rewrite them and offer alternatives. To validate the subset after the Delphi study, a group interview was conducted with six other nurses with postgraduate education in geriatric psychiatry and dementia care. The group interview was recorded and transcribed, and summative content analysis was used.

RESULTS: Suitable concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia were identified. In total, 301 concepts were identified, including 77 nursing diagnoses, 78 outcomes and 146 nursing interventions. An increased focus on concepts to describe basic psychosocial needs such as identity, comfort, connection, inclusion and engagement was recommended by nurses in the validation process.

CONCLUSIONS: Relevant and pre-formulated nursing diagnoses, goals and interventions were identified, which can be used to develop care plans and facilitate accuracy in the documentation of individuals with dementia. The participants believed that it may be difficult to find formulations for all steps of the nursing process. In particular, nursing diagnoses and psychosocial needs are often inadequately documented. The participants highlighted the need for the subset to contain essential information about psychosocial needs and communication.