Stillbirth in Australia 1: The road to now: Two decades of stillbirth research and advocacy in Australia

Stillbirth is a major public health problem with an enormous mortality burden and psychosocial impact on parents, families and the wider community both globally and in Australia. In 2015, Australia’s late gestation stillbirth rate was over 30% higher than that of the best-performing countries globally, highlighting the urgent need for action. We present an overview of the foundations which led to the establishment of Australia’s NHMRC Centre of Research Excellence in Stillbirth (Stillbirth CRE) in 2017 and highlight key activities in the following areas: Opportunities to expand and improve collaborations between research teams; Supporting the conduct and development of innovative, high quality, collaborative research that incorporates a strong parent voice; Promoting effective translation of research into health policy and/or practice; and the Regional and global work of the Stillbirth CRE. We highlight the first-ever Senate Inquiry into Stillbirth in Australia in 2018. These events ultimately led to the development of a National Stillbirth Action and Implementation Plan for Australia with the aims of reducing stillbirth rates by 20% over the next five years, reducing the disparity in stillbirth rates between advantaged and disadvantaged communities, and improving care for all families who experience this loss.     

空气污染治理与公众健康———来自“大气十条”政策的证据

为探究《大气污染防治行动计划》 (以下简称“大气十条”)的健康效应,本文基于中国健康与营养调查(CHNS)数据及省级面板数据,利用基于多项Logit模型的双重差分法(Logit-DID),从微观与宏观两个维度考察“大气十条”政策的健康改善效应及其传导机制,并进一步通过异质性分析探讨环境健康不平等的内在原因 研究发现:“大气十条”实施带来显著的健康效应,该政策不仅能有效控制与空气污染高度相关疾病的发病率和死亡占比,还能够间接降低受空气污染影响较小的疾病病情。其作用机理主要通过控制PM2.5浓度改善公众健康,同时该政策对二氧化硫(SO2)、氮氧化物、烟(粉)尘等其 他污染物浓度的下降起到了协同作用。进一步分析显示环境福利不公平的现象依然存在,“大气十条”政 策显著降低了疾病高发人群的发病率,且对女性、城镇居民和低、高年龄段等疾病高发人群的健康影响更显著。本文为政府构建环境健康公平发展路径,推进“健康中国”战略提供了经验证据和政策借鉴。     

Maternity waiting homes in times of crisis: Can current models meet women’s needs?

BackgroundMaternity waiting homes (MWHs) located close to birthing facilities are a conditional recommendation by the World Health Organisation, based on very low-quality evidence that they contribute to improvements in maternal or perinatal health outcomes. In addition, several studies suggest that more vulnerable women are less likely to use them. Yet significant investments continue to be made in building and running MWHs within conflict-affected and under-resourced health systems.AimsWe critically examine the literature to shed light on the challenges and opportunities provided by MWHs during health emergencies and in conflict situations.Findings and discussionMWHs are difficult to utilise during crises because they require women to be away from home, are often designed as dormitories, can lack security and be over-crowded. Some MWHs have been adapted during situations of political conflict to incorporate birthing and broader reproductive health care, thereby improving the availability of care away from over-burdened health facilities. How MWHs are adapted during times of crisis may provide insights into what systems of care are more appropriate in meeting women’s needs more broadly.ConclusionThe current global pandemic is an important time to reflect on whether MWHs are meeting the needs of a diverse range of women, in times of stability and during emergencies, and engage in genuine dialogue with women about the kinds of maternity care they want. We need to co-create those systems now so that they are more resilient during the inevitable crises we will face in the future.     

Community care for adults with severe mental disorders in rural China: A case study

In China, family care is the dominant form of care for people with mental disorders. Since 2004, the government has been developing a community‐care model that places more responsibility on community organisations and the local governments at the provincial, municipal and county levels for the provision of formal care. As a large number of people with severe mental disorders live in rural China, this case study was conducted in a rural county in order to examine the development of community care. It was found that, although family care remains dominant, families’ need for formal care is increasing. Community services have improved, but their development is constrained by several contextual and micro factors. In this study, it is argued that the community‐care model introduces a process of reconfiguration of the relative responsibility for care among the family, social organisations and the government, but progress depends on further administrative and fiscal reforms.     

Health-care Work in Globalization: News Reports on Care Worker Migration to Japan

Health-care worker migration has emerged as a social issue in Japan, contrary to it has in Indonesia. This article shows how national contexts affected by globalization have shaped social understandings and policies towards health-care worker migration in the two societies over time. Analyses of news coverage in the Japanese and Indonesian national media reveal a gap of social responses toward this change. The Japanese are more likely to respond negatively to health-care worker migration; yet they intend to face cross-cultural challenges, although slowly, making revisions to related policies. In contrast, in Indonesia, from where health-care workers migrate to Japan and many other countries, this tends to be understood positively, overall, as providing economic benefits and permitting Indonesian professionals to contribute to the worker shortage in Japan. I interpret these results based on the literature on health-care worker migration, emerging global norms and local changes, and comparative research on employment and care work. This study contributes to the sociological understanding of worker migration and health-care issues.     

Psychometric properties of the Transitions from Foster Care Key Leader Survey

This study summarizes the development and piloting of the Transitions from Foster Care Key Leader Survey (TFC-KLS), an instrument designed to measure change in systems serving young people transitioning from foster care to adulthood. The Jim Casey Youth Opportunity Initiative’s logic model was used as a basis for instrument development. The instrument was piloted with 119 key leaders in six communities. Seven of eight latent scales performed well in psychometric testing. The relationships among the 24 measures of system change were explored. A CFA testing overall model fit was satisfactory following slight modifications. Finally, a test of inter-rater reliability between two raters did not find reliable reporting of service availability in a supplemental portion of the survey. The findings were generally positive and supported the validity and utility of the instrument for measuring system change, following some adaptations. Implications for the field are discussed.     

Narrating Sustainability in Canadian Health Care Reform Discourse

In Canada, as in other industrialized welfare states, definitions of health system sustainability reflect different goals and correspondingly diverse ways of understanding exactly what is to be sustained and how. In this article, we report on results from a survey of documents and groups involved in and/or concerned about sustainability of the healthcare system. We identify four broad narratives of sustainability in Canadian healthcare reform discourse, and explore what these different sustainability narratives tell us about the character and contours of these often‐fractious debates. We argue that sustainability itself may not be a paradigm shift, as has been suggested, but a plot device that helps to steer the story in a particular direction, ‘black‐boxing’ certain aspects of context and emphasizing others.     

Vision and state health department public relations practitioners: Prepared to lead?

Visions are important to organizational effectiveness. Although providing vision has been identified as one of the behaviors that best captures organization-wide public relations leadership, little public relations research has focused on vision. Similarly, state health departments have drawn little interest among public relations scholars even though states are a central part of the nation's public health system. This study addressed the perceptions of the top public relations professionals at state health departments concerning vision and their involvement in the visioning process. The practitioners were nearly unanimous in their belief that organizational visions are important. However, results indicate that some top public relations practitioners at state health departments are not prepared to make optimal contributions to the visioning process. In order to take full advantage of opportunities to serve as organization-wide leaders, public relations practitioners should seek out information about visioning in order help chart their organization's future and enhance their careers.     

Food in Foster Families: Care,Communication and Conflict

This study explores the significance of food and mealtimes in relation to the transition into foster care and the therapeutic settling of the child in a new family. In doing so, we draw upon an in‐depth, qualitative case study of 10 experienced foster families in the UK focusing on what helped them to be successful. At the time of the study, there were 16 foster children, aged 9–16, living with the families. Data collection included semi‐structured qualitative interviews and audio‐diaries with all family members who wished to be involved as well as eco‐maps produced by the young people. Thematic analysis and data extracts are reproduced in the study to demonstrate that meals and food preferences can function to affirm identities, membership and boundaries of family life as well as provide a site of conflict and control.