Amegbor, PM, Kuuire, VZ, Robertson, H & Kuffuor, OA 2018, 'Predictors of basic self-care and intermediate self-care functional disabilities among older adults in Ghana', Archives of Gerontology and Geriatrics, vol. 77, pp. 81-88.View/Download from: UTS OPUS or Publisher's site
© 2018 Elsevier B.V. The number of older adults in Ghana is growing rapidly. Associated with this growth, is the rise in age-related chronic diseases such as cardiovascular and musculoskeletal conditions. However, there is limited knowledge in the Ghanaian context on the effect of chronic diseases on functional disabilities among older adults. In this study, we examine the association between chronic diseases, socioeconomic status, and functional disabilities. Data from 4107 Ghanaian older adults (persons aged 50 years and above) who participated in the World Health Organization's Global Ageing and Adult Health survey (SAGE-Wave 1) were used to fit random effect multivariate logistic and complementary log-log regression. Stroke was significantly associated with difficulty in performing both basic self-care functions and intermediate self-care functions. Hypertension and arthritis, on the other hand, were associated with basic self-care functional disability only. Socioeconomically vulnerable groups such as females, those with less education and low-incomes were more likely to have functional disabilities associated with basic self-care and intermediate self-care activities. In order to reduce functional disabilities among older persons in Ghana, efforts should be aimed at reducing chronic conditions as well as improving socioeconomic status.
Robertson, H, Debono, D, Nicholas, N, Hinchcliff, R & Travaglia, J 2018, 'Health informatics as a spatial science: reflecting on technological and systemic change', HIM-Interchange Online, vol. 3, no. 8, pp. 26-29.View/Download from: UTS OPUS
The field of health informatics has generally been seen
as developing separately from the spatial sciences.
Geography, cartography, surveying and a variety of
applied disciplines make enormous use of spatial
technologies, concepts and methods in their work.
These technologies are increasingly pervasive and
central to our emerging 'big data' environment in
which locational data quality and accuracy are central.
Health informatics is also a field now going beyond
the traditional hospital environment, especially as
factors such as population ageing and rising chronic
disease require outreach programs of various kinds and
growing sophistication. In this scenario, we suggest
that health information technology (HIT) and the spatial
sciences are converging at a rapid rate such that health
informatics will become increasingly spatial in character
In this short piece, we explore some of the factors
leading to this convergence and suggest that it is
not quite as novel as it might at first seem. Medical
geography and medical informatics, for example,
have a deeper history than is commonly known by
many health professionals. Cartographic methods
have long been utilised in some areas of public health,
international health and epidemiology. Climate change
and the demographic transition are also leading to
much more engagement between these two fields
of practice and healthcare. Climate change because
the flow-on effects of rising temperatures, and water
levels, are hugely significant for human health, and the
demographic transition because health status is closely
correlated with both affluence and ageing. Obviously,
in our increasingly complex world, information
management is central to our capacity to cope with and
address new problems arising from these complexities.
Health information management as a skill and
knowledge base can only grow in importance as the
systemic problems we face (and contribute to) become
more tightly interwoven.
Robertson, H, Nicholas, N, Dhagat, A & Travaglia, J 2017, 'A Spatial Dashboard for Alzheimer's Disease in New South Wales.', Studies in Health Technology and Informatics, vol. 239, pp. 126-132.View/Download from: UTS OPUS or Publisher's site
This paper illustrates a proof of concept scenario for the application of comprehensive data visualisation methods in the rapidly changing aged care sector. The scenario we explored is population ageing and the dementias with an emphasis on the spatial effects of change over time at the Statistical Area 2 (SA2) level for the state of New South Wales. We did this using a combination of methods, culminating in the use of the Tableau software environment to explore the intersections of demography, epidemiology and their formal cost of care implications. In addition, we briefly illustrate how key infrastructure data can be included in the same data management context by showing how service providers can be integrated and mapped in conjunction with other analyses. This is an innovative and practical approach to some of the complex issues already faced in the health and aged care sectors which can only become more pronounced as population ageing progresses.
Robertson, H, Nicholas, N, Travaglia, J, Hayen, A & Georgiou, A 2017, 'A Virtual Earth Model of the Dementias in China.', Studies in Health Technology and Informatics, vol. 245, pp. 569-572.View/Download from: UTS OPUS or Publisher's site
This developmental project was undertaken to explore how applying spatial science analysis and visualisation methods might inform societies undergoing significant structural and demographic change. China is rapidly transitioning to an aged society. It already exceeds all other countries in its population aged 65 years and over. Dementia is closely correlated with ageing and intersects with a variety of physical and cognitive disabilities. Information dashboards are a growing part of health and social policy data environments. These visual data applications increasingly include mapping capabilities. In this paper, we explore the utility of a geographic modelling approach to exploring the complex nature of population ageing and the dementias in China.
Travaglia, J, Robertson, H, Nicholas, N & DHAGAT, A 2017, 'A Spatial Dashboard for Alzheimer's Disease in New South Wales.', Studies in Health Technology and Informatics, vol. 239, pp. 126-132.View/Download from: UTS OPUS or Publisher's site
Robertson, H & Nicholas, N 2017, 'Digital landscapes of health and disability', GEO: connexion, vol. 16, no. 4, pp. 38-41.
Robertson, H 2017, 'Space, time and demographic change: A geographical approach to integrating health and social care', Journal of Integrated Care, vol. 25, no. 1, pp. 39-48.View/Download from: Publisher's site
© Emerald Publishing Limited. Purpose - The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented domains of health and social care provision. The issue of focus for this purpose is population ageing because it challenges existing information and practice silos. Better integration, the author proposes, needs to adopt a geographic approach to deal with the challenges that population ageing present to health and social care as they currently function in many countries. Design/methodology/approach - The approach utilised here explores the role that could be played by enhancing spatial perspectives in care integration. Spatial and temporal strategies need to be coordinated to produce systems of integrated care that are needed to meet the needs of growing numbers of older people. Findings - The author's premise is that, with some rare exceptions, geographies of care are needed to address important shifts in demography such as population ageing and their epidemiological consequences. The rising intersection between the ageing and disability concepts illustrates how the fluid nature of health and social care client groups will challenge existing systems and their presuppositions. Health and medical geography offer a theoretical and practical response to some of these emerging problems. Research limitations/implications - This is a brief conceptual piece in favour of integrating geographic concepts and methods in the context of changing demography and the social, economic and service implications of such changes. It is limited in scope and a more detailed explanation would be required for a proof of concept. Practical implications - Practically we know that all human services vary across space as do both healthcare and related social services and supports. Issues of quality and safety are numerous in these policy domains generally, with aged care evidencing ...
Robertson, H & Nicholas, N 2016, 'Older and wiser', GEO: connexion, vol. 15, no. 3, pp. 34-36.
Spatial dashboard systems can help combine older patients living far away and young doctors. Dashboards can also integrate geographic visualizations, as well as the usual bar charts and line graphs with which most people are already familiar. This means users can quickly move from the already familiar to the completely new, in terms of data access and visualizations. It also provides a platform for building spatial skills and methods as a growing audience becomes much more familiar with spatial science, technology and visual data access. A variety of basic spatial functions need to be integrated into standard health information systems to begin the trend to greater spatial literacy in the health sector. Basic spatial functions such as heat mapping, travel area or travel route analyses will become integral to both acute and non-acute healthcare systems management. Emerging technologies such a mobile monitoring devices will produce increasing volumes of real time health status data.
Travaglia, J, Robertson, H, Davidson, PM & Daly, J 2016, 'Problematizing the practice of policy.', Journal of nursing management, vol. 24, no. 4, pp. 435-438.View/Download from: UTS OPUS or Publisher's site
Robertson, H & Nicholas, N 2015, 'A healthy opportunity', GEO: connexion, vol. 14, no. 3, pp. 31-33.
The health and medical sector has a very mixed history of understanding and applying spatial concepts methods and technology to its problems. The heavy focus on clinical practices and administrative data has limited the range of opportunities for and understanding of the value of spatial knowledge in this sector, despite a variety of innovative projects including the Dartmouth Health Atlas and the Spanish Cancer Mapping project that illustrate the value of spatially enabled data to healthcare. One area of opportunity is to capitalize on periods of change and disruption in these complex and bureaucratic industries.
Robertson, H, Nicholas, N, Georgiou, A, Johnson, J & Travaglia, J 2014, 'Globalising health informatics: the role of GIScience.', Studies in health technology and informatics, vol. 205, pp. 1168-1172.View/Download from: UTS OPUS
Health systems globally are undergoing significant changes. New systems are emerging in developing countries where there were previously limited healthcare options, existing systems in emerging and developed economies are under significant resource pressures and population dynamics are creating significant pressures for change. As health systems expand and intensify, information quality and timeliness will be central to their sustainability and continuity. Information collection and transfer across diverse systems and international borders already presents a significant challenge for health system operations and logistics. Geographic information science (giscience) has the potential to support and enhance health informatics in the coming decades as health information transfers become increasingly important. In this article we propose a spatially enabled approach to support and increasingly globalised health informatics environment. In a world where populations are ageing and urbanising and health systems are linked to economic and social policy shifts, knowing where patients, diseases, health care workers and facilities are located becomes central to those systems operational capacities. In this globalising environment, health informatics needs to be spatially enabled informatics.
Robertson, H, Nicholas, N, Rosenfeld, T, Georgiou, A, Johnson, J & Travaglia, J 2014, 'A virtual aged care system: when health informatics and spatial science intersect.', Studies in health technology and informatics, vol. 204, pp. 137-142.View/Download from: UTS OPUS
Healthcare systems are increasingly adapting to address the issues associated with population ageing. The shift to chronic diseases and a rise in neuroepidemiological conditions, associated with rising life expectancies, means that continued change and accommodation will be required of our health and social support systems. Current social policy environments developed out of early approaches to state-supported health and welfare service provision, most now a century or more old. A feature of these systems has often been a formal separation between them, into silos, that does not and cannot effectively address the issues raised by a growing population of older people. This is especially true in the context of community-based care where the majority of older people currently live and where governments hope to keep more elderly people living into the future. This objective will require a far more sophisticated and responsive approach to the health information environment than is currently the case. One strategy for improving this scenario is the development of augmented and virtual environments that collect and analyse real-time data on which health professionals and support staff can act in a timely manner. In this paper we explore some aspects of a virtualised aged care system and provide some examples of how this would enhance our current strategies for aged care.
Robertson, H & Nicholas, N 2014, 'Older and wiser', GEO: connexion, vol. 13, no. 6, pp. 36-38.
The article suggests ways in which advances in technology combined with geospatial techniques can help society to help its older members. Recent developments in spatial science have yet to be integrated into healthcare. Spatial technologies will soon be applicable not just to the analysis of health system problems, disease outbreaks and uneven treatment patterns but also to the real-time monitoring of infections in acute care hospitals or potential drug interactions in community dwelling older people. The huge growth in e-health, m-health and t-health technologies have the capacity to monitor the changing condition of frail older people and people with serious disabilities living in their own homes in the context of whole societies that are growing older. Another more developmental area to consider is if advances in spatial technology might assist older people in compensating for aspects of their physical and cognitive decline.
Radford, K, Mack, HA, Robertson, H, Draper, B, Chalkley, S, Daylight, G, Cumming, R, Bennett, H, Jackson Pulver, L & Broe, GA 2014, 'The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.', International psychogeriatrics, vol. 26, no. 6, pp. 1033-1043.View/Download from: Publisher's site
Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians.We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random sample of those scoring above (i.e. "normal" range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of "gold standard" clinical consensus determinations of cognitive impairment and dementia.This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.
Robertson, H & Nicholas, N 2013, 'A healthy understanding', GEO: connexion, vol. 12, no. 10, pp. 30-33.
Hamish Robertson and Nick Nicholas examine how the healthcare sector is finding it difficult to adopt geospatial technologies due to the lack of even basic knowledge about their principles and potential. Health system comparison data is now integral to the World Health Organization, national health providers, health insurers and all the way down to individual hospitals and clinics. In an industry where costs only ever seem to rise, the need for continued and improved monitoring of costs and outcomes will only grow. And important societal trends, such as population ageing, will also require these developments and improvements. Disability characteristics, proxied here by need for assistance, are unevenly distributed in space and health care facilities need to understand who and where these people are. Uneven distribution entails uneven patterns of service demand including acute admissions through emergency departments, outpatient treatment demand and referrals as well as the need for outreach services and unmet needs in the community.
Robertson, H, Nicholas, N, Rosenfeld, T & Travaglia, JF 2014, 'Materiality, health informatics and the limits of knowledge production', IFIP Advances in Information and Communication Technology, 5th Working Conference on Information Systems and Organizations (ISO), pp. 132-148.View/Download from: UTS OPUS
© IFIP International Federation for Information Processing 2014 Contemporary societies increasingly rely on complex and sophisticated information systems for a wide variety of tasks and, ultimately, knowledge about the world in which we live. Those systems are central to the kinds of problems our systems and sub-systems face such as health and medical diagnosis, treatment and care. While health information systems represent a continuously expanding field of knowledge production, we suggest that they carry forward significant limitations, particularly in their claims to represent human beings as living creatures and in their capacity to critically reflect on the social, cultural and political origins of many forms of data 'representation'. In this paper we take these ideas and explore them in relation to the way we see healthcare information systems currently functioning. We offer some examples from our own experience in healthcare settings to illustrate how unexamined ideas about individuals, groups and social categories of people continue to influence health information systems and practices as well as their resulting knowledge production. We suggest some ideas for better understanding how and why this still happens and look to a future where the reflexivity of healthcare administration, the healthcare professions and the information sciences might better engage with these issues. There is no denying the role of health informatics in contemporary healthcare systems but their capacity to represent people in those datascapes has a long way to go if the categories they use to describe and anal yse human beings are to produce meaningful knowledge about the social world and not simply to replicate past ideologies of those same categories.
Robertson, H, Nicholas, N, Georgiou, A, Johnson, J & Travaglia, J 2013, 'A spatial informatics for aged care.', Health Informatics: Digital Health Service Delivery - The Future is Now!, Health Informatics Conference (HIC), IOS Press, Adelaide, Australia, pp. 102-107.View/Download from: UTS OPUS or Publisher's site
Population ageing is the demographic process that characterises the first half of the twenty-first century. Australia's population is already ageing and the states and territories are ageing at different rates. Our understanding of the dementias remains limited and diagnosis in primary care settings is poor. Locating where older people with dementia are and how they are coping is an emerging need in health information management. In this paper we discuss how a spatially informed health information management system could support population ageing and the disconnected systems that address ageing. We illustrate this with examples from our work to show how spatial informatics can advance our understanding of and response to the implications of population ageing.