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- Briggs, Andrew M., et al.
(author)
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Health systems strengthening to arrest the global disability burden : Empirical development of prioritised components for a global strategy for improving musculoskeletal health
- 2021
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In: BMJ Global Health. - : BMJ. - 2059-7908. ; 6:6
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Journal article (peer-reviewed)abstract
- Introduction Despite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health. Methods Design: mixed-methods, three-phase design. Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response. Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci. Phase 3: informed by phases 1-2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions. Results Phase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action. Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model. Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening. Conclusion An empirically derived framework, co-designed and strongly supported by multisectoral stakeholders, can now be used as a blueprint for global and country-level responses to improve MSK health and prioritise system strengthening initiatives.
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- Dodou, Katherina
(author)
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Childhood Without Children : Ian McEwan and the Critical Study of the Child
- 2009
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Doctoral thesis (other academic/artistic)abstract
- This study has a twofold ambition. First, it offers a new perspective on Ian McEwan’s works by focusing on his treatment of childhood. Second, by using McEwan’s writing as an example, it seeks to challenge the current critical preoccupation with childhood in the novel in terms solely of child characters. The dissertation argues that it is more productive to understand childhood as an entity distinct from children. Focusing on figurative uses of the child in fiction, it considers the significance of childhood in works that do not treat child characters. It shows that the inclusion of images and metaphors of childhood has significant thematic and formal implications for the overall meanings of literary artefacts. The thesis draws on recent scholarship in sociology and cultural studies which views images of children as documenting societal assumptions. The dissertation employs this approach to the child figure in culture to account for the use of childhood imagery in McEwan's novels. The discussion is comprised of two parts. Part one provides a critical and historical background to the field of childhood studies, the portrayal of childhood in the British novel and McEwan criticism. Part two begins by analysing the representation of a child in Atonement, then continues with the thematisation of childhood in the absence of children in The Child in Time, and then considers the figurative employment of childhood images in The Innocent and Saturday. The dissertation demonstrates that perceptions of childhood are key to McEwan’s critique of post-war British culture and notions of national identity, history, citizenship and civic disorder. More importantly, the dissertation offers a new paradigm for the critical examination of childhood in the novel – one which sheds light on the metaphorical uses of childhood. Ultimately, the thesis illuminates childhood’s capacity to define as well as to disseminate societal values.
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