16,978 research outputs found
Implementing Health Impact Assessment as a Required Component of Government Policymaking: A Multi-Level Exploration of the Determinants of Healthy Public Policy
It is widely understood that the public policies of ‘non-health’ government sectors have greater impacts on population health than those of the traditional healthcare realm. Health Impact Assessment (HIA) is a decision support tool that identifies and promotes the health benefits of policies while also mitigating their unintended negative consequences. Despite numerous calls to do so, the Ontario government has yet to implement HIA as a required component of policy development. This dissertation therefore sought to identify the contexts and factors that may both enable and impede HIA use at the sub-national (i.e., provincial, territorial, or state) government level.
The three integrated articles of this dissertation provide insights into specific aspects of the policy process as they relate to HIA. Chapter one details a case study of purposive information-seeking among public servants within Ontario’s Ministry of Education (MOE). Situated within Ontario’s Ministry of Health (MOH), chapter two presents a case study of policy collaboration between health and ‘non-health’ ministries. Finally, chapter three details a framework analysis of the political factors supporting health impact tool use in two sub-national jurisdictions – namely, Québec and South Australia.
MOE respondents (N=9) identified four components of policymaking ‘due diligence’, including evidence retrieval, consultation and collaboration, referencing, and risk analysis. As prospective HIA users, they also confirmed that information is not routinely sought to mitigate the potential negative health impacts of education-based policies. MOH respondents (N=8) identified the bureaucratic hierarchy as the brokering mechanism for inter-ministerial policy development. As prospective HIA stewards, they also confirmed that the ministry does not proactively flag the potential negative health impacts of non-health sector policies. Finally, ‘lessons learned’ from case articles specific to Québec (n=12) and South Australia (n=17) identified the political factors supporting tool use at different stages of the policy cycle, including agenda setting (‘policy elites’ and ‘political culture’), implementation (‘jurisdiction’), and sustained implementation (‘institutional power’).
This work provides important insights into ‘real life’ policymaking. By highlighting existing facilitators of and barriers to HIA use, the findings offer a useful starting point from which proponents may tailor context-specific strategies to sustainably implement HIA at the sub-national government level
Animating potential for intensities and becoming in writing: challenging discursively constructed structures and writing conventions in academia through the use of storying and other post qualitative inquiries
Written for everyone ever denied the opportunity of fulfilling their academic potential, this is ‘Chloe’s story’. Using composite selves, a phrase chosen to indicate multiplicities and movement, to story both the initial event leading to ‘Chloe’s’ immediate withdrawal from a Further Education college and an imaginary second chance to support her whilst at university, this Deleuzo-Guattarian (2015a) ‘assemblage’ of post qualitative inquiries offers challenge to discursively constructed structures and writing conventions in academia. Adopting a posthuman approach to theorising to shift attention towards affects and intensities always relationally in action in multiple ‘assemblages’, these inquiries aim to decentre individual ‘lecturer’ and ‘student’ identities. Illuminating movements and moments quivering with potential for change, then, hoping thereby to generate second chances for all, different approaches to writing are exemplified which trouble those academic constraints by fostering inquiry and speculation: moving away from ‘what is’ towards ‘what if’.
With the formatting of this thesis itself also always troubling the rigid Deleuzo-Guattarian (2015a) ‘segmentary lines’ structuring orthodox academic practice, imbricated in these inquiries are attempts to exemplify Manning’s (2015; 2016) ‘artfulness’ through shifts in thinking within and around an emerging PhD thesis. As writing resists organising, the verb thesisising comes into play to describe the processes involved in creating this always-moving thesis. Using ‘landing sites’ (Arakawa and Gins, 2009) as a landscaping device, freely creating emerging ‘lines of flight’ (Deleuze and Guattari, 2015a) so often denied to students forced to adhere to strict academic conventions, this ‘movement-moving’ (Manning, 2014) opens up opportunities for change as in Manning’s (2016) ‘research-creation’. Arguing for a moving away from writing-representing towards writing-inquiring, towards a writing ‘that does’ (Wyatt and Gale, 2018: 127), and toward writing as immanent doing, it is hoped to animate potential for intensities and becoming in writing, offering opportunities and glimmerings of the not-yet-known
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Co-design As Healing: Exploring The Experiences Of Participants Facing Mental Health Problems
This thesis is an exploration of the healing role of co-design in mental health. Although co-design projects conducted within mental health settings are rising, existing literature tends to focus on the object of design and its outcomes while the experiences of participants per se remain largely unexplored. The guiding research question of this study is not how we design things that improve mental health, but how co-designing, as an act, might do so.
The thesis presents two projects that were organized in collaboration with the mental health charity Islington Mind and the Psychosis Therapy Project (PTP) in London.
The project at Islington Mind used a structured design process inviting participants to design for wellbeing. A case study analysis provides insights on how participants were impacted, summarizing key challenges and opportunities.
The design at PTP worked towards creating a collective brief in an emergent fashion, finally culminating in a board game. The experiences of participants were explored through Interpretative Phenomenological Analysis (IPA), using semi-structured interview data. The analysis served to identify key themes characterising the experience of co-design such as contributing, connecting, thinking and intentioning. In addition, a mixed-methods analysis of questionnaires and interview data exploring participants' wellbeing, showed that all participants who engaged fairly consistently in the project improved after the project ended, although some participants' scores returned to baseline six months later.
Reflecting on both projects, an approach to facilitation within mental health is outlined, detailing how the dimensions of weaving and layered participation, nurturing mattering and facilitating attitudes interlace. This contribution raises awareness of tacit dimensions in the practice of facilitation, articulating the nuances of how to encourage and sustain meaningful and ethical engagement and offering insights into a range of tools. It highlights the importance of remaining reflexive in relation to attitudes and emotions and discusses practical methodological and ethical challenges and ways to resolve them which can be of benefit to researchers embarking on a similar journey.
The thesis also offers detailed insights on how methodologies from different fields were integrated into a whole, arguing for transparency and reflexivity about epistemological assumptions, and how underlying paradigms shift in an interdisciplinary context.
Based on the overall findings, the thesis makes a case for considering design as healing (or a designerly way of healing), highlighting implications at a systems, social and individual level. It makes an original contribution to our understanding of design, highlighting its healing character, and proposes a new way to support mental health. The participants in this study not only had increased their own wellbeing through co-designing, but were also empowered and contributed towards healing the world. Hence, the thesis argues for a unique, holistic perspective of design and mental health, recognizing the interconnectedness of the individual, social and systemic dimensions of the healing processes that are ignited
The developing maternal-infant relationship: a qualitative longitudinal study
Aim
The study aimed to explore maternal perceptions and the use of knowledge relating to their infant’s mental health over time using qualitative longitudinal research.
Background
There has been a growing interest in infant mental health over recent years. Much of this interest is directed through the lens of infant determinism, through knowledge regarding neurological development resulting in biological determinism. Research and policy in this field are directed toward individual parenting behaviours, usually focused on the mother. Despite this, there is little attention given to maternal perspectives of infant mental health, indicating that a more innovative approach to methodology is required.
Methods
This study took a qualitative longitudinal approach, and interviews were undertaken with seven mothers from the third trimester of pregnancy and then throughout the first year of the infant’s life. Interviews were conducted at 34 weeks of pregnancy, and then when the infant was 6 and 12 weeks, 6, 9, and 12 months, alongside the collection of researcher field notes—a total of 41 interviews. Data were analysed by creating case profiles, memos, and summaries, and then cross-comparison of the emerging narratives. A psycho-socially informed approach was taken to the analysis of data.
Findings
Three interrelated themes emerged from the data: evolving maternal identity, growing a person, and creating a safe space. The theme of evolving maternal identity dominated the other themes of growing a person and creating a safe space in a way that met perceived socio-cultural requirements for mothering and childcare practices. Participants’ personal stories give voice to their perceptions of the developing maternal-infant relationship in the context of their socio-cultural setting, relationships with others, and experiences over time.
Conclusions
This study adds new knowledge by giving mothers a voice to express how the maternal-infant relationship develops over time. The findings demonstrate how the developing maternal-infant relationship grows in response to their mutual needs as the mother works to create and sustain identities for herself and the infant that will fit within their socio-cultural context and individual situations. Additionally, the findings illustrate the importance of temporal considerations, social networks, and intergenerational relationships to this evolving process. Recommendations for practice, policy, and education are made that reflect the unique relationship between mother and infant and the need to conceptualise this using an ecological approach
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Enhancement Approach: Success Stories of EFL Teachers from Bangladesh and Nepal
The Role of English and Welsh INGOs: A Field Theory-Based Exploration of the Sector
This thesis takes a field theory-based approach to exploring the role of English and Welsh international non-governmental organisations (INGOs), using the lens of income source form.
First, the thesis presents new income source data drawn from 933 Annual Accounts published by 316 INGOs over three years (2015-2018). The research then draws on qualitative data from 90 Leaders' letters include within the Annual Reports published by 39 INGOS, as well as supplementary quantitative and qualitative data, to explore the ways in which INGOs represent their role.
Analysis of this income source data demonstrates that government funding is less important to most INGOs than has previously been assumed, while income from individuals is more important than has been recognised in the extant development studies literature. Funding from other organisations within the voluntary sector is the third most important source of income for these INGOs, while income from fees and trading is substantially less important than the other income source forms.
Using this income source data in concert with other quantitative data on INGO characteristics as well as qualitative data drawn from the Leaders' letters, I then show that the English and Welsh INGO sector is a heterogenous space, divided into multiple fields. The set of fields identified by this thesis is arranged primarily around income source form, which is also associated with size, religious affiliation, and activities of focus and ways of working. As Bourdieusian field theory suggests, within these fields individual INGOs are engaged in an ongoing struggle for position: competing to demonstrate their maximal possession of the symbolic capitals they perceive to be valued by (potential) donors to that field.
Further analysis of these Leaders' letters, alongside additional Annual Reports and Accounts data, also reveals a dissonance in the way in which INGOs describe their relationship with local partners in these different communication types. While these Leaders' letters and narrative reports tell stories of collaborative associations with locally-based partners, this obscures the nature of these relationships as competitive and hierarchical.
The thesis draws on the above findings to reflect on the role of INGOs as suggested in the extant literature. This discussion highlights how the various potential INGO fields identified are associated with differing theoretical roles for INGOs. Finally, the thesis considers how INGO role representations continue to contribute to unequal power relations between INGOs and their partners
A productive response to legacy system petrification
Requirements change. The requirements of a legacy information system change, often in unanticipated ways, and at a more rapid pace than the rate at which the information system itself can be evolved to support them. The capabilities of a legacy system progressively fall further and further behind their evolving requirements, in a degrading process termed petrification. As systems petrify, they deliver diminishing business value, hamper business effectiveness, and drain organisational resources. To address legacy systems, the first challenge is to understand how to shed their resistance to tracking requirements change. The second challenge is to ensure that a newly adaptable system never again petrifies into a change resistant legacy system. This thesis addresses both challenges. The approach outlined herein is underpinned by an agile migration process - termed Productive Migration - that homes in upon the specific causes of petrification within each particular legacy system and provides guidance upon how to address them. That guidance comes in part from a personalised catalogue of petrifying patterns, which capture recurring themes underlying petrification. These steer us to the problems actually present in a given legacy system, and lead us to suitable antidote productive patterns via which we can deal with those problems one by one. To prevent newly adaptable systems from again degrading into legacy systems, we appeal to a follow-on process, termed Productive Evolution, which embraces and keeps pace with change rather than resisting and falling behind it. Productive Evolution teaches us to be vigilant against signs of system petrification and helps us to nip them in the bud. The aim is to nurture systems that remain supportive of the business, that are adaptable in step with ongoing requirements change, and that continue to retain their value as significant business assets
From stress to resistance: Challenging the capitalist underpinnings of mental unhealth in work and organizations
The worldwide spread of work-related mental unhealth suggests that this is a major problem affecting organizations and employees on a global scale. In this paper, we therefore provide a thematic review of the literatures that address this issue in management and organization studies (MOS) and related fields. While these literatures examine how employee mental health is affected by organizational and occupational structures and managed by organizations and employees, they have paid relatively little attention to the capitalist labour relations which underpin the unhealthy conditions of contemporary working life. They have paid even less attention to how these conditions may be resisted. To help future scholarship in MOS challenge this state of affairs, we draw on some of the most basic but central notions of exploitation, alienation and resistance in classic and current critiques of capitalism, optimistic that this may help strengthen the field's capacity to confront mental unhealth in settings of work and organization
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