Governance of the wildlife trade and the prevention of emerging zoonoses: a mixed methods network analysis of transnational organisations, silos, and power dynamics.

Introduction: The wildlife trade is an important arena for intervention in the prevention of emerging zoonoses, and leading organisations have advocated for more collaborative, multi-sectoral approaches to governance in this area. The aim of this study is to characterise the structure and function of the network of transnational organisations that interact around the governance of wildlife trade for the prevention of emerging zoonoses, and to assess these network characteristics in terms of how they might support or undermine progress on these issues.

Methods: This study used a mixed methods social network analysis of transnational organisations.

Public awareness of One Health in China.

One Health is recognized as an increasingly important approach to global health. It has the potential to inform interventions and governance approaches to prevent future pandemics. Successfully implementing the One Health approach in policy will require active engagement from the public, which begs the question: how aware is the public of One Health? In this study, we examine the level and distribution of One Health awareness among the general public in China using a survey conducted in Beijing ( = 1820).

From "learning from the field" to jointly driving change.

The theme of the 8th edition of the Geneva Health Forum (GHF) was Improving access to health: learning from the field. While 'the field' often denotes people, patients, communities, and healthcare workers, we challenge the notion and its usage. A group of like-minded conference participants set up a working group to examine the term 'the field' and look at questions related to language, power, participation, and rights.

COVID-19 - An Opportunity to Redesign Health Policy Thinking.

Coronavirus disease 2019 (COVID-19) dramatically unveiled the fragile state of the world's health and social systems - the lack of emergency health crisis preparedness (under-resourced, weak leadership, strategic plans without clear lines of authority), siloed policy frameworks (focus on individual diseases and the lack of integration of health into the whole of societal activity and its impact on individual as well as community well-being and prosperity), and unclear communication (misguided rationale of policies, inconsistent interpretation of data). The net result is fear - about the disease, about risks and survival, and about economic security. We discuss the interdependencies among these domains and their emergent dynamics and emphasise the need for a robust distributed health system and for transparent communication as the basis for trust in the system.

Reconceptualising Person-Centered Service Models as Social Ecology Networks in Supporting Integrated Care.

Efforts to address problems such as mental health, poverty, social exclusion, and chronic disease have often proven resistant to traditional policies or interventions. In this paper, we take up the challenge and present a pioneering new method of analysis in drawing on theoretical and methodological extensions of two prominent approaches, namely, social network analysis and developmental social ecology. Considered in combination, these two seemingly disparate approaches frame a powerful new way of thinking about person-centred care, as well as offer a methodologically more rigorous set of analytical tools.

Conceptualizing type 2 diabetes and its management.

Type 2 diabetes is growing worldwide due to population growth, increased rates of obesity, unhealthy diet, and physical inactivity. Risk assessment methods can effectively evaluate the risk of diabetes, and a healthy lifestyle can significantly reduce risk or prevent complications of type 2 diabetes. However, risk assessment alone has not significantly improved poor adherence to recommended medical interventions and lifestyle changes.

Reframing the challenges to integrated care: a complex-adaptive systems perspective.

Introduction: Despite over two decades of international experience and research on health systems integration, integrated care has not developed widely. We hypothesized that part of the problem may lie in how we conceptualize the integration process and the complex systems within which integrated care is enacted. This study aims to contribute to discourse regarding the relevance and utility of a complex-adaptive systems (CAS) perspective on integrated care.

Outcome mapping for health system integration.

Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions.

CAM in Canadian hospitals: the new frontier?

The provision in hospitals of traditional, complementary and alternative medicine (TCAM), as recognized by the World Health Organization, is now widespread in many of the world's healthcare systems. As a significant part of integrative medicine (IM) or healthcare (IHC), research has now begun to focus on the varied parameters of hospital-based TCAM, however, little research has been conducted on the topic in the Canadian context. Drawing on a multi-site case study of four Canadian hospitals, qualitative observation was conducted at hospital sites, and interviews were conducted with senior hospital leaders and biomedical and TCAM hospital practitioners.

Chronic disease management and the home-care alternative in Ontario, Canada.

The pressure on our health-care system to deliver efficient, quality and cost-effective care is increasing. The debate on its sustainability is also expanding. These challenges can be managed with revisions to our health-care policy frameworks governing how and what public health-care services are delivered.

Using the balanced scorecard in the development of community partnerships.

The benefits of community partnerships have been well established in the health service literature. However, measuring these benefits and associated outcomes is relatively new. This paper presents an innovative initiative in the application of a balanced scorecard framework for measuring and monitoring partnership activity at the community level, while adopting principles of evidence-based practice to the partnership process.

A critical review of financial measures as reported in the Ontario hospital balanced scorecard.

For Ontario hospitals in Canada, the Financial Performance and Condition measures in the Ontario hospital balanced scorecard are especially of interest since in the foreseeable future, they may be linked to provincial government funding decisions. However, we find that these measures lack valuable information on key attributes that affect organizational performance. We suggest changes that focus on key drivers of performance and reflect the operational realities of Ontario hospitals.

Management of complex chronic disease: facing the challenges in the Canadian health-care system.

This paper discusses the challenges that those living with complex chronic disease present to the Canadian health-care system. The literature suggests home care and the management of complex chronic disease can together ease many of the present and future pressures facing the health-care system in dealing with this new health-care phenomenon. A review of current literature and dialogue with key informants reveals that the current level of investment and the present policy environment are not sustainable to support the health-care system.

Organizational change through Lean Thinking.

In production and manufacturing plants, Lean Thinking has been used to improve processes by eliminating waste and thus enhancing efficiency. In health care, Lean Thinking has emerged as a comprehensive approach towards improving processes embedded in the diagnostic, treatment and care activities of health-care organizations with cost containment results. This paper provides a case study example where Lean Thinking is not only used to improve efficiency and cost containment, but also as an approach to effective organizational change.

Using the balanced scorecard to mobilize human resources in organizational transformation.

Traditionally, the balanced scorecard (BSC) has been an effective tool in linking measurement to strategy. However, what is least understood is how the BSC can be used to redefine organizational relationships, re-engineer fundamental processes and transform organizational culture, for superior performance in an organization with the same people, services and technology that previously delivered dismal performance. This paper highlights the process and uses York Central Hospital in Toronto, Ontario, Canada as an illustrative example.

Vulnerability and risk perception in the management of HIV/AIDS: Public priorities in a global pandemic.

Understanding the way perception of risk is shaped and constructed is crucial in understanding why it has been so difficult to mitigate the spread of HIV/AIDS. This paper uses the Pressure and Release (PAR) model, used to predict the onset of natural disasters as the conceptual framework. It substitutes vulnerability and risk perception as the trigger factors in the model, in making the case that HIV/AIDS can be characterized as a slow onset disaster.

Chronic disease: shifting the focus of healthcare in Canada.

The pressure on the Canadian healthcare system to deliver quality and cost-effective care is escalating at a time of an increasing prevalence of chronic diseases. The healthcare system's traditional focus on acute care falls short of meeting the needs of those suffering from chronic diseases, which represent a sizeable portion of the population. This article highlights the impending issues and explores how shifting the focus of healthcare can have a profound impact on meeting the needs of those suffering from chronic diseases in the province of Ontario.