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.     

A comprehensive health service evaluation and monitoring framework

ObjectiveTo develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services.MethodA targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders.ResultsThe framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable.ConclusionData collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle.     

A PEP grant’s influence on change in a school district: One year post funding

This study examined teachers’ and administrators’ perceptions of the institutionalization phase of the Carol M. White Physical Education for Progress (PEP) grant. A qualitative exploratory single case study (Yin, 2014) was utilized to examine the elements of the PEP grant that sustained or did not sustain after its conclusion, along with elements that were institutionalized and influences on this process. The findings were represented in the following three themes: (a) positive shifts, (b) backsliding, and (c) new directions, each with their own subthemes. Positive shifts includes sub-themes: (a) philosophy, (b) instruction, assessment and curriculum, (c) collaboration, and (d) respect. Backsliding includes sub-themes: (a) wellness team functioning, (b) the loss of PD and collaboration time, and (c) reduced data collection. New directions includes sub-themes: (a) mastery learning, (b) during school physical activity, (c) stress, and (d) administrative support. The factors that were institutionalized were quality physical education leadership roles, change in teachers’ philosophies that influenced their instruction and assessment, and garnered administrative support. These elements were embedded into the physical education program and the school so much so that principals now expect the same type of programming from any new hire.     

对构建干旱区绿洲信息资源可持续利用系统的思考

绿洲信息资源可持续利用系统的建设,对促进绿洲进入有序、科学、良性和可持续发展意义重大。这个系统建设的总体目标是“数字绿洲”,即利用RS、GIS、GPS及其它高新技术,形成关于绿洲的信息化数据产品,建成为绿洲开发和发展的现代化科学技术平台。     

川西林盘CSA社区发展探索

川西林盘作为川西平原特有的复合型农村聚落形态,在城市化和农业产业化快速发展的背景下正逐步走向衰落,本文引入CSA模式,带动林盘本土经济发展,促进三效的统一发展,探求林盘保护和可持续发展自我繁衍的道路,为成都周边川西林盘的保护和发展提供借鉴思路。     

我国养老保险覆盖面扩大及可持续性分析

 基于我国现有政策及2020年覆盖城乡的战略目标,通过建立人口预测模型和基本养老保险收支预测模型,课题组引入相关的政策变量,对我国未来近50年基本养老保险收支及其可持续性进行预测,分析不同政策变量对于养老保险可持续性的影响,最后提出了具有针对性的政策建议。     

Tomorrow's Leaders and Today's Agents of Change? Children,Sustainability Education and Environmental Governance

Children are central to the rhetoric supporting global climate agreements, yet they are also envisaged to play a strategic role in materialising such agreements. Along with other household actors, children are implicated in localised efforts to manage global resource sustainability. As learners in educational systems that are being redesigned to encompass messages of sustainability, children are moreover positioned as ‘agents of change’ through sustainability education. Drawing on theoretical work on children's agency and interdependence, this review calls for greater attention to the structural and relational dimensions of environmental knowledge transmission to inform sustainability education. This is presented as one move towards constructing what Middlemiss (2014) terms a more ‘socially sensitive’ model of sustainable development.