Can adaptation to ‘extraordinary’ times teach us about ways to strengthen community-based chronic disease prevention? Insights from the COVID-19 pandemic

The COVID-I9 pandemic represents a massive challenge to the ordinary work of community-based organisations. We present results from a study of the actions and experiences of community-based organisations and funding agencies in the context of a grants program for chronic disease prevention in Tasmania, Australia during 2020. Community-based organisations had just received funding to implement programs targeting smoking, obesity, nutrition and physical activity when the first lockdowns were put in place. Though the rapid changes triggered by the pandemic placed strain on organisations in certain ways, we record the adaptive practices that took place as the pandemic unfolded. We observed two levels of adaptation: 1) program-level adaptation, as new ways of reaching people and delivering planned services were devised; and 2) system-level adaptation, as funding agreements were revised and the range of organisational procedures were altered, new partnerships were formed and the span of operations were rewritten. The suspension of usual rules and activities gave permission to experiment with new roles and 'blue sky' ideas. Organisations who provided compelling accounts of adaptation had leaders and past history that enabled them to tap into wide networks to access resources and coordinate action. We suggest that these insights from 'extraordinary' times are helpful for priming or building greater adaptability and transformability in community-based prevention programs, their host organisations and their funders in 'ordinary' times. Drawing on the theoretical foundations of liminality theory, complexity, and viable systems theory, we consider how (better) system-level capability for chronic disease prevention is built

ASCIA guidelines for prevention of food anaphylactic reactions in schools, preschools and child-care centres

These guidelines have been developed by the anaphylaxis working party of the Australasian Society of Clinical Immunology and Allergy to provide advice for minimizing the risk of food-induced anaphylaxis in schools, preschools and child-care centres. The guidelines outline four steps for the prevention of food anaphylactic reactions in children at risk and food policy measures specific to school age and preschool age children

Three approaches to chronic fatigue syndrome in the United Kingdom, Australia, and Canada: Lessons for democratic policy

Decisions about diagnostic categories through clinical practice guidelines (CPGs) represent a central type of informal policy-making which affect the scope of publicly-regulated health services and directions for future research. We examine the development of three diverse sets of CPGs for chronic fatigue syndrome (CFS) in the United Kingdom, Canada, and Australia in order to examine diverse approaches to the development of such guidelines by medical professionals and other ‘experts’ in concert with inputs from the public, particularly those affected by the disease condition. We argue that the CPGs formulated for CFS in the United Kingdom, Australia, and Canada reflect three contrasting modes of policy development, and that the differential levels of acceptance of these guidelines by a range of relevant parties provide guidance as to which mode of policy development is likely to be most effective and acceptable particularly in the domain of controversial or contested domains within medicine.Rachel A. Ankeny and Fiona J. Mackenzi