The planning and management of health for development:a model for Zimbabwe

In this thesis, I view the historical background of Zimbabwe to show the patterns of traditional life that existed prior to settlerism. The form, nature, pace and impact of settlerism and colonialism up to the time of independence are also discussed to show how they affected the health of the population and the pace of development of the country. The political, social and economic underdevelopment of the African people that occurred in Zimbabwe prior to independence was a result of deliberate, politically motivated and controlled policy initiatives. These led to inequatable, inadequate, inappropriate and inaccessible health care provision. It is submitted that since it was the politics that determined the pace of underdevelopment, it must be the politics that must be at the forefront of the development strategy adopted. In the face of the amed conflict that existed in Zimbabwe, existing frameworks of analyses are shown to be inadequate for planning purposes because of their inability to provide indications about the stability of future outcomes. The Metagame technique of analysis of options is proposed as a methology that can be applied in such situations. It rejects deterministic predicative models as misleading and advocates an interactive model based on objective and subjective valuation of human behaviour. In conclusion, the search for stable outcomes rather than optimal and best solutions strategies is advocated in decision making in organisations of all sizes.

Sustainability and the Multifunctional Landscape: An Assessment of the Cairngorms National Park Authority’s Approach to Planning and Management in Upland Scotland.

Upland Scotland contains some of Britain’s most prized areas of natural heritage value. However, although such areas may appear both ‘wild’ and ‘remote’, these are typically working landscapes which symbolise the interdependence of nature and society. The complexity of this relationship means that management responses will need to address a multitude of potentially conflicting priorities whilst at the same time ensuring that sufficient social and institutional capital exists to allow for the promotion of landscape integrity. The introduction of national parks to Scotland in the form of the National Parks (Scotland) Act 2000 allows for a high-level of protection for designated areas in upland Scotland. Yet, whilst the recent Act outlines the statutory purpose and direction national parks should take, it allows a significant degree of flexibility in theway in which the Actmay be implemented. This level of discretion allows for significant local distinctiveness within the model but also raises questions about the potential effectiveness of chosen responses. In order to assess the potential implications of a model rooted in self-determination,we provide a case study review of the institutional basis of the Cairngorms National Park along with an assessment of the strategic character of the first National Park Plan. It is argued that whilst the Cairngorms National Park Authority has developed a significant level of stakeholder engagement, the authority may struggle to bridge the policy-implementation gap. Although a number of shortcomings are identified, particular concerns relate to the potential mismatch between strategic ambition and local level capacity.

Land use conflict across the airport fence : competing urban policy, planning and priority in Australia

Land use planning within and surrounding privatised Australian capital city airports is a fragmented process as a result of: current legislative and policy frameworks; competing stakeholder priorities and interests; and inadequate coordination and disjointed decision-making. Three Australian case studies are examined to detail the context of airport and regional land use planning. Stakeholder Land Use Forums within each case study have served to inform the procedural dynamics and relationships between airport and regional land use decision-making. This article identifies significant themes and stakeholder perspectives regarding on-airport development and broader urban land use policy and planning. First, it outlines the concept of the “airport city” and examines the model of airport and regional “interfaces.” Then, it details the policy context that differentiates on-airport land use planning from planning within the surrounding region. The article then analyses the results of the Land Use Forums identifying key themes within the shared and reciprocal interfaces of governance, environment, economic development and infrastructure. The article concludes by detailing the implications of this research to broader urban planning and highlights the core issues contributing to the fragmentation of airport and regional land use planning policy.

An examinaton of how British local authorities are employing strategic planning and management in their economic development function

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Escolas Técnicas do SUS (ETSUS) no Brasil: regulação da integração ensino serviço e sustentabilidade administrativa

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Population health planning and health promotion: Opportunities and challenges to improve social determinants

Complex social factors and health issues challenge equitable health outcomes for many people, in particular those living in marginalised communities. Primary health care promises solutions through population health and health promotion approaches to improve social conditions (determinants) affecting health with emphasis on change at systems levels. Yet short-term efficiency focus policy decisions without long-term planning can undermine the effectiveness of primary health care. The workshop goal is to explore opportunities and share ideas about population health planning in Primary Health Networks and other community health care settings, so as to draw out opportunities, challenges and forward thinking health planning and health promotion strategies.

Integrating Land-use Planning and Transportation in Belfast: A New Policy Agenda for Sustainable Development

Much of the interest in promoting sustainable development in planning for the city-region focuses on the apparently inexorable rise in the demand for car travel and the contribution that certain urban forms and land-use relationships can make to reducing energy consumption. Within this context, policy prescription has increasingly favoured a compact city approach with increasing urban residential densities to address the physical separation of daily activities and the resultant dependency on the private car. This paper aims to outline and evaluate recent efforts to integrate land use and transport policy in the Belfast Metropolitan Area in Northern Ireland. Although considerable progress has been made, this paper underlines the extent of existing car dependency in the metropolitan area and prevailing negative attitudes to public transport, and argues that although there is a rhetorical support for the principles of sustainability and the practice of land-use/transportation integration, this is combined with a selective reluctance to embrace local changes in residential environment or in lifestyle preferences which might facilitate such principles.

An application of life-cycle assessment for environmental planning and management: the potential environmental and human health impacts of growing genetically-modified herbicide-tolerant sugar beet

Life-Cycle Assessment (LCA) was used to assess the potential environmental and human health impacts of growing genetically-modified (GM), herbicide-tolerant sugar beet in the UK and Germany compared with conventional sugar beet varieties. The GM variety results in lower potential environmental impacts on global warming, airborne nutrification, ecotoxicity (of soil and water) and watercourse enrichment, and lower potential human health impacts in terms of production of toxic particulates, summer smog, carcinogens and ozone depletion. Although the overall contribution of GM sugar beet to reducing harmful emissions to the environment would be relatively small, the potential for GM crops to reduce pollution from agriculture, including diffuse water pollution, is highlighted.

The planning of airport regions and National Aviation Policy Issues and challenges in the Australian experience 2008-2009

The planning of airports has long been contentious because of their localisation of negative impacts. The globalisation, commercialisation and deregulation of the aviation industry has unleashed powerful new economic forces both on and offairport. Over the last two decades, many airports have evolved into airport cities located at the heart of the wider aerotropolis region. This shifts the appropriate scale of planning analysis towards broader regional concerns. However,governments have been slow to respond and airport planning usually remains poorly integrated with local, city and regional planning imperatives. The Australian experience exemplifies the divide. The privatization of major Australian airports from 1996 has seen billions of dollars spent on new airside and landside infrastructure but with little oversight from local and state authorities because the ultimate authority for on-airport development is the Federal Minister for Transport. Consequently, there have been growing tensions in many major airport regions between the private airport lessee and the broader community, exacerbated by both the building of highly conspicuous non-aeronautical developments and growing airport area congestion. This paper examines the urban planning content of Australia’s national aviation policy review (2008-09) with reference to current and potential opportunities for all-of-region collaboration in the planning process.

The ethics of regional water planning : planning and management of water resources in a growth region

Abstract Providing water infrastructure in times of accelerating climate change presents interesting new problems. Expanding demands must be met or managed in contexts of increasingly constrained sources of supply, raising ethical questions of equity and participation. Loss of agricultural land and natural habitats, the coastal impacts of desalination plants and concerns over re-use of waste water must be weighed with demand management issues of water rationing, pricing mechanisms and inducing behaviour change. This case study examines how these factors impact on infrastructure planning in South East Queensland, Australia: a region with one of the developed world’s most rapidly growing populations, which has recently experienced the most severe drought in its recorded history. Proposals to match forecast demands and potential supplies for water over a 20 year period are reviewed by applying ethical principles to evaluate practical plans to meet the water needs of the region’s activities and settlements.

The evolving landscape of natural resource planning and governance in Australia

Australia’s governance of land and natural resources involves multiple polycentric domains of decision-making from global through to local levels. Although certainly complex, these arrangements have not necessarily translated into better decision-making or better environmental outcomes as evidenced by the growing concerns over the health and future of the Great Barrier Reef, (GBR). However within this system, arrangements for natural resource management (NRM) and reef water quality, which both use Australia’s integrated regional NRM model, have showed signs of improving decision-making and environmental outcomes in the GBR. In this paper we describe the latest evolutions in the governance and planning for natural resource use and management in Australia. We begin by reviewing the experience with first generation NRM as published in major audits and evaluations. As our primary interest is the health and future of the GBR, we then consider the impact of changes of second generation planning and governance outcomes in Queensland. We find that first generation plans, although developed under a relatively cohesive governance context, faced substantial problems in target setting, implementation, monitoring and review. Despite this, they were able to progress improvements in water quality in the Great Barrier Reef Regions. Second generation plans, currently being developed, face an even greater risk of failure due to the lack of bilateralism and cross-sectoral cooperation across the NRM governance system. The findings highlight the critical need to re-build and enhance the regional NRM model for NRM planning to have a positive impact on environmental outcomes in the GBR.

The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: A systematic review

- BACKGROUND Chronic diseases are increasing worldwide and have become a significant burden to those affected by those diseases. Disease-specific education programs have demonstrated improved outcomes, although people do forget information quickly or memorize it incorrectly. The teach-back method was introduced in an attempt to reinforce education to patients. To date, the evidence regarding the effectiveness of health education employing the teach-back method in improved care has not yet been reviewed systematically. - OBJECTIVES This systematic review examined the evidence on using the teach-back method in health education programs for improving adherence and self-management of people with chronic disease. - INCLUSION CRITERIA Types of participants: Adults aged 18 years and over with one or more than one chronic disease. Types of intervention: All types of interventions which included the teach-back method in an education program for people with chronic diseases. The comparator was chronic disease education programs that did not involve the teach-back method. Types of studies: Randomized and non-randomized controlled trials, cohort studies, before-after studies and case-control studies. Types of outcomes: The outcomes of interest were adherence, self-management, disease-specific knowledge, readmission, knowledge retention, self-efficacy and quality of life. - SEARCH STRATEGY Searches were conducted in CINAHL, MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, ProQuest Nursing and Allied Health Source, and Google Scholar databases. Search terms were combined by AND or OR in search strings. Reference lists of included articles were also searched for further potential references. - METHODOLOGICAL QUALITY Two reviewers conducted quality appraisal of papers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. - DATA EXTRACTION Data were extracted using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument data extraction instruments. - DATA SYNTHESIS There was significant heterogeneity in selected studies, hence a meta-analysis was not possible and the results were presented in narrative form. - RESULTS Of the 21 articles retrieved in full, 12 on the use of the teach-back method met the inclusion criteria and were selected for analysis. Four studies confirmed improved disease-specific knowledge in intervention participants. One study showed a statistically significant improvement in adherence to medication and diet among type 2 diabetics patients in the intervention group compared to the control group (p < 0.001). Two studies found statistically significant improvements in self-efficacy (p = 0.0026 and p < 0.001) in the intervention groups. One study examined quality of life in heart failure patients but the results did not improve from the intervention (p = 0.59). Five studies found a reduction in readmission rates and hospitalization but these were not always statistically significant. Two studies showed improvement in daily weighing among heart failure participants, and in adherence to diet, exercise and foot care among those with type 2 diabetes. - CONCLUSION Overall, the teach-back method showed positive effects in a wide range of health care outcomes although these were not always statistically significant. Studies in this systematic review revealed improved outcomes in disease-specific knowledge, adherence, self-efficacy and the inhaler technique. There was a positive but inconsistent trend also seen in improved self-care and reduction of hospital readmission rates. There was limited evidence on improvement in quality of life or disease related knowledge retention.