General practice access in regional and remote Australia for ageing populations

Identifying and removing access barriers to the timely provision of comprehensive health care is increasingly important for the wellbeing of Australia's rapidly ageing and frail populations, particularly those in non‐metropolitan settings. This study has examined if current general practice (GP) locations in non‐metropolitan South Australia (SA) and Western Australia (WA) are geographically accessible to the rapidly growing frail and prefrail populations known to have a high level of health service use and reduced mobility. Geospatial analysis linking 60‐kilometre GP service catchments, 2016 population counts, and 2027 population projections has estimated that the size of the frail and prefrail population that live outside these GP service catchments will double, reaching 7,800 people by 2027. The maldistribution of GP locations was most evident in WA. As regional and remote populations continue to age, the challenge of health service provision, including geographic access to care, must be resolved to ensure that populations in these areas have the best opportunity to age well. Geospatial methods linking service and demographic information, such as the approach used in this analysis, can aid in planning the equitable provision of health care for older Australians.     

Institutional and Policy Responses to Uncertainty in Environmental Policy: A Comparison of Dutch and U.S. Styles

Uncertainties regarding problem definition and policy response are an endemic pan of environmental decisionmaking. Some standard responses to uncertainty in decisionmaking are analyzed and then used to suggest the importance of learning-oriented policy processes in open, flexible, and adaptive institutional environments. The institutional and policy responses to both types of uncertainties are explored in two different institutional settings: the consensus-oriented setting of the Netherlands and the more adversarial and pluralistic context of the United States. The examination displays tensions accompanying learning-oriented environmental policymaking and the complex impact of institutional environments. Conclusions sketch implications for how to accommodate learning-oriented environmental policy processes.     

La représentation de l’espace public par la photographie : Une étude de cas dans la région de Montréal (Québec,Canada)

Beyond the material forms that constitute public space, it is subject to representations or images that shape the types of use, forms of appropriation, and general perception that people have of it. Following a centre‐periphery gradient that allows us to compare three zones of the Montreal region (pericentral, periurban, and the northern ring), we analyzed photographs available within cyberspace (from different municipalities and boroughs, local newspapers, and social media) to draw out representations of public space. What can photographs available online tell us about how space is perceived? We have established a typology of images of public space (idyllic nature, urban scene, festive space, empty space, family portrait) that are representative of the overall corpus studied. We have compared these results with a correspondence analysis to clarify the structure of interaction between the variables. The analysis demonstrates that the representations are more differentiated between neighbourhoods than between regions, and that while newspapers and municipalities represent more themes of sociability and family life, social media shows more empty spaces, whether they be monumental spaces, or spaces of daily life.     

The Implementation of Public Policy: Still the Missing Link

Although theories of public policy and theories of governance both seek to establish relationships between policymaking and its consequences, they do not complement each other very well. Public policy models tend to de-emphasize that which governance theories tend to emphasize: the influence on government performance of implementation, broadly described as the actions taken by those engaged in administration (including managers at all levels, those engaged in service delivery, and third-party agents) after a policy has been lawfully promulgated by elected officials and interpreted by the courts. A comparison of a recently developed theory of public sector performance with several prominent theories of policymaking suggests that multilevel governance theories can supply what continues to be the missing link in public policy theories. At the same time, governance theories might be enriched by the process modeling of public policy theories.