Changes in perceptions of urban green space are related to changes in psychological well-being: Cross-sectional and longitudinal study of mid-aged urban residents.

We used data from 5,014 mid-aged adults in the HABITAT study, across two waves (2009 and 2011), to explore associations between perceptions of quantity of urban green space and psychological well-being. Linear regression revealed that perceptions of urban green space quantity were significantly and positively associated with psychological well-being at both time-points. A longitudinal, fixed effects, two-period difference regression revealed that within-person change in perceptions of green space quantity across two years was positively associated with psychological well-being. All associations remained significant after controlling for age, gender, household income, education, occupation and neighbourhood disadvantage. Our findings indicate that psychological well-being is associated with perceptions of local urban green space. Subjective measures of green space are an important factor that need to be considered when exploring the relationship between green space and mental health. These findings are timely given the growing interest in urban green space interventions for combating increasing mental ill-health rates as well as promoting well-being among expanding urban populations.

Community representation in hospital decision making: a literature review.

OBJECTIVE: Advancing quality in health services requires structures and processes that are informed by consumer input. Although this agenda is well recognised, few researchers have focussed on the establishment and maintenance of customer input throughout the structures and processes used to produce high-quality, safe care. We present an analysis of literature outlining the barriers and enablers involved in community representation in hospital governance. The review aimed to explore how community representation in hospital governance is achieved. METHODS: Studies spanning 1997-2012 were analysed using Donabedian' s model of quality systems as a guide for categories of interest: structure, in relation to administration of quality; process, which is particularly concerned with cooperation and culture; and outcome, considered, in this case, to be the achievement of effective community representation on quality of care. RESULTS: There are limited published studies on community representation in hospital governance in Australia. What can be gleaned from the literature is: 1) quality subcommittees set up to assist Hospital Boards are a key structure for involving community representation in decision making around quality of care, and 2) there are a number of challenges to effectively developing the process of community representation in hospital governance: ambiguity and the potential for escalated indecision; inadequate value and consideration given to it by decision makers resulting in a lack of time and resources needed to support the community engagement strategy (time, facilitation, budgets); poor support and attitude amongst staff; and consumer issues, such as feeling isolated and intimidated by expert opinion. CONCLUSIONS: The analysis indicates that: quality subcommittees set up to assist boards are a key structure for involving community representation in decision making around quality of care. There are clearly a number of challenges to effectively developing the process of community representation in hospital governance, associated with ambiguity, organisational and consumer issues. For an inclusive agenda to real life, work must be done on understanding the representatives' role and the decision making process, adequately supporting the representational process, and developing organisational cooperation and culture regarding community representation.