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At least 379 records · Page 21Linked to original sources
PubMed2004

Differences, disparities, and biases: clarifying racial variations in health care use.

Studies documenting racial differences in health care use are common in the medical literature. However, observational studies of racial differences in health care use lack a framework for interpreting reports of variations in health care use, leading to various terms, ranging from "variations" to "bias," that suggest different causes, consequences, and, ultimately, remedies for such variations in treatment. We propose criteria to assess racial differences in health care use by using a clinical equity (equal treatment based on equal clinical need) framework. This framework differentiates between initial reports of racial differences and subsequent classifications of their findings as racial disparities or racial bias in health care use. Racial variations in health care use may be considered disparities after demonstrating that racial differences are not attributable to treatment eligibility, clinical contraindications, patient preferences, or confounding by other clinical factors and are associated with adverse consequences. Racial bias with adverse consequences in health care may be inferred if a racial variation in treatment that has been characterized as a disparity persists after accounting for health care system factors (for example, type of hospital at which the patient was treated). We apply this framework to published reports of racial differences in treatment to determine which studies provide evidence of differences, disparities, and bias. We discuss the use of such a framework in directing policy interventions for alleviating inappropriate racial variations in health care use.

Delivery of Health Care↗
PubMed2005

Safeguarding children.

Nurses are well placed to identify behaviour or circumstances that might signify a child is at risk and to contribute to measures designed to protect children. Legislation, guidance and local policies provide the framework for nurses to implement good practice in communication, documentation and multi-agency working to safeguard every child and young person with whom they have contact.

Child↗
PubMed1996

The future of cancer control research and translation.

The future holds great promise for translating advances in cancer control research to populations at risk-much is known about how to prevent cancer. Within the Institute of Medicines overall framework of assessment, policy development, and assurance, this article summarizes 10 cancer control priorities. Important themes include evaluation, cost-effectiveness analysis, shrinking the "latency period" between elucidation of preventive technologies and widespread application, coalition building, and development of adequate cancer control resources. Despite increased cancer control efforts among public health agencies over the past decade, little measurable progress has been made in reducing overall cancer mortality. A renewed commitment to controlling cancer is needed from health policy makers and even the public health community.

Decision Making, Computer-Assisted↗
PubMed1988

Circular DH/8 D/87 on maternity or adoption leave for and authorized absences by career and non-career employees of the establishments referred to in Section 2 of Law No. 86-33 of 9 January 1986 laying down regulations applicable to staff in the public service in the hospital sector, 7 October 1987.

This Circular is addressed by the Minister of Social Affairs and Employment of France to the regional and departmental authorities responsible for health and social affairs and repeals various earlier Circulars on the same subject. It describes a group of measures within the framework of government policy, relating to, among other things: reducing pregnancy-related risks by associating the occupational physician with measures to protect pregnant women, in particular, concerning the fitness of a pregnant woman for her occupation; entitling pregnant women to a leave of absence from the date of declaration of pregnancy in the case of pregnancies with pathological evolution; and improving the arrangements for leave of absence for pregnancy and birth which was hitherto conditional on obtaining the favorable opinion of the occupational physician, in particular with regard to according flexible working hours during pregnancy and leave of absence for prenatal examinations. It is also recalled, in connection with leave of absence, that administrations having appropriate facilities for baby-minding must enable the mother to breast feed her infant, allowing her leave of absence for this purpose for one hour per day, to be taken at two times during the day.

Biology↗
PubMed1992

U.S. census data uses.

"This article examines the principal applications of the statistics yielded by the 1990 U.S. Census of Population and Housing. Before doing so, however, a framework of census policy and operational features that directly influenced the content of the questionnaires will be outlined.... Having established this background, the uses of census data will be addressed, citing case examples in some instances, for...major groups of data users."

Americas↗
PubMed2003

[A specialistic database on research evaluation].

The evaluation of scientific research is an internationally wide debated subject but it is not well established in Italy so far. The need for evaluation practices sets up both to assess and verify the scientific production as well as the efficiency of the research process and, on the other side, for the assessment of resources and funds in the wider framework of research policies. This study illustrates the contents and structures of a specialistic database, published on the web, addressed to a specific target of users. The database has been designed to contribute to spread information on the evaluation practices, theory, disciplines and the big debate on science evaluation.

Databases, Bibliographic↗
PubMedDate not supplied

The report of the Task Force on the North Carolina Nursing Workforce--May 2004.

North Carolina is indeed fortunate to have avoided many of the extreme shortages of nurses reported in other states. Yet, even as this was noted, there were important developments on the horizon which had the potential to cause such shortages even here. The fact that there are so many pathways into this field and throughout an individual nurse's career made it necessary to organize our deliberations in a way that enabled the Task Force to deal with the special (often unique) situations faced by one form of nursing education, or one avenue of nursing practice. The Task Force then had to synthesize these findings and recommendations in a format that offered a potential framework for future policy decisions affecting the profession of nursing as a whole. It is a tribute to both the process and the participants that the way these discussions unfolded may have identified ways in which seemingly disjointed elements of North Carolina nursing might begin to see opportunities for collaboration, coordination, and ultimately greater levels of accomplishment in relation to the broad goals of this effort as a whole. In this report, as one would expect, there are identifiable needs: for additional financial support for nursing education (through support to our public and private institutions and their faculties offering different types of nursing credentials, as well as for the scholarship support of those who choose to enter this field), for programs and initiatives to enable recent nursing school graduates to enter nursing better prepared to render the professional services for which they were employed, and for concrete improvements in the nursing work environments. The fact that nursing, especially nursing at the bedside in hospitals and in long-term care, requires increasingly sophisticated technical skills and continues to demand intellectual, physical and emotional energy beyond what would be required in many other professions and occupations, the recruitment and retention of well-prepared and motivated nurses remains a challenge now and in the future. But, as these discussions and the interactions with Task Force members have demonstrated over and over again, nursing is both a dynamic and exciting field of professional practice. And North Carolina is considered by most to be one of the very best states within which to be a nurse. It is hoped that all the 47 recommendations offered in this report, only 16 of which are specified here, will serve as a template for a deliberate policy agenda through which the nursing workforce for North Carolina can continue to be the vibrant example of the highest standards of practice for which its reputation has been well-earned.

Advisory Committees↗
PubMed2005

Key concepts of demand-driven health care; an approach based on client's needs.

In most European countries we are witnessing a shift from supply-driven to demand-driven approaches in health care. According to these approaches, health care should contribute to the fulfillment of health-care-related needs of individuals and, therefore, to their perceived quality of life. The purpose of this study is to develop a conceptual framework for research in this new view of health care. The authors conclude that the 'felt need' should be the foundation of demand-driven care. The second part of the study is based on a widely used behavioral model resulting in a conceptual framework for research, policy and practice. This study makes a start at providing information about fundamental concepts that are at the heart of the demand-driven approach. In order to contribute to quality of life, health care providers should explore the underlying needs while developing services in order to fit the demand-driven approach.

Delivery of Health Care↗
PubMed2005

Global perspectives on animal welfare: Africa.

Livestock production systems, production objectives, the cultural values of livestock keepers, and the close relationship between keepers and their livestock have evolved over the years and have influenced the quality of animal welfare in Africa. An equivalent level and quality of care is not evident for companion animals, especially dogs and donkeys, who are often mistreated and physically abused. In the densely populated highland and humid coastal belts of Africa, profit-driven commercial large-scale intensive livestock production systems predominate. As the main production objective of these operations is to maximise profit, the operators of these production systems do not exhibit the same kind of attachment to their livestock as traditional farmers. In some large-scale commercial systems animals and birds are kept in sub-standard poorly constructed structures that greatly restrict the animals' movements. In Africa, conservation of wildlife habitats is part of animal welfare, but due to an increasing human population and a greater demand for land for grazing, cultivation, and housing, wildlife reserves are quickly diminishing. This essentially means that the land that was previously set aside for wildlife and forests is being encroached upon and previously unsettled plains and marginal lands are being used for agriculture and mining. In most places there is significant conflict between humans and wildlife, such that wildlife are considered to be pests that need to be destroyed. This is a particular problem in areas where wildlife have destroyed crops, attacked man and/or livestock, or there has been disease transmission between animals and humans. In situations and/or areas that do not have official animal control services, crude weapons, poisons, and traps are used to kill the wildlife. Animal welfare issues, domestic and wildlife related, need to be urgently addressed through policy and legal frameworks and supported by community awareness of, education about, and participation in, animal welfare issues.

Africa↗
PubMed2006

Testing the recommendations of the Washington State Nutrition and Physical Activity Plan: the Moses Lake case study.

BACKGROUND: The Washington State Nutrition and Physical Activity Plan provides a framework in which policy makers can work together to build and support healthy environments for nutrition and physical activity. The city of Moses Lake, Wash, was chosen to serve as a pilot site to test the conceptual approaches and recommendations of the plan and to develop a model for healthy communities elsewhere in the state. CONTEXT: Moses Lake is an ethnically diverse, geographically isolated town with a population of about 15,000. METHODS: An advisory committee used data from an inventory of local policies and environments, along with the recommendations from the state plan, to develop a plan for Healthy Communities Moses Lake. Three initiatives were chosen for the first actions: a connected system of trails and paths, enhanced facilities for breastfeeding in the community, and a community garden. CONSEQUENCES: Records of cumulative actions demonstrated that Healthy Communities Moses Lake continued to be an active and productive project. Initial measures of success were collected by each of the three first action teams. Environmental changes will be monitored by comparison with the initial inventory of local policies. Long-term health outcomes in Moses Lake will be monitored by the Washington State Department of Health. INTERPRETATION: Healthy Communities Moses Lake was successful because the city had leaders and volunteers who were committed to making the city a healthier place. Lessons learned about community-based planning and evaluation are now being applied to Healthy Communities initiatives.

Community Health Services↗
PubMedDate not supplied

Job satisfaction among neonatal nurses.

PURPOSE: The purpose of this study was to understand the job satisfaction of nurses who work in intensive care nurseries. The design used a convenience sample of eight nurses with an average of 11 years of active and current experience as neonatal intensive care nurses. METHOD/DATA COLLECTION: Human rights were protected according to the institutional guidelines. Data collection included semi-structured, intensive face-to-face interviews, observation, and field notes. The interviews were tape recorded and transcribed. Collaizzi's (1978) interpretation method was used to interpret and analyze the data using significant statements, formulated meanings, and clustering. Each participant was allowed to review the typed interview as one means of credibility. RESULTS: Analysis of the described experiences revealed that nurses were able to identify enough satisfying situations that compelled them to continue working in the neonatal intensive care unit (NICU). These rewards included compensation, team spirit, support from physicians, and advocacy. CONCLUSION: Knowledge of the factors that contribute to nurses' job satisfaction can provide a useful framework to implement policies to improve working conditions for nurses.

Adaptation, Psychological↗
PubMedDate not supplied

Evaluation and implementation of public health registries.

A rapid proliferation of registries has occurred during the last 20 years. Given the long-term commitment of resources associated with registries and limited public health funding, proposals for new registries should be carefully considered before being funded. A registry is defined as a data base of identifiable persons containing a clearly defined set of health and demographic data collected for a specific public health purpose. Criteria for evaluating whether a registry is needed, feasible, or the most effective and efficient means of collecting a specific set of health data are presented. They include an evaluation of the stated purpose; a review of the function, duration, and scope of the registry; consideration of existing alternative data sources; an assessment of the practical feasibility of the registry; the likelihood of sufficient start-up and long-term funding; and an evaluation of the cost effectiveness of the registry. Creating a public health registry is a complex process. A range of technical and organizational skills is required for a registry to be successfully implemented. Eight requirements are identified as crucial for the successful development of a new registry. They include an implementation plan, adequate documentation, quality control procedures, case definition and case-finding (ascertainment) procedures, determination of data elements, data collection and processing procedures, data access policy, and a framework for dissemination of registry data and findings.

Evaluation Studies as Topic↗
PubMed1989

[Perspectives in the development of health care in Czechoslovakia].

The finding that the health status of the population is shaped in particular by social and cultural conditions is accepted not only by health workers but also by political and executive authorities of the State. For the further development health care of the people is of revolutionary importance. If society will find adequate political will to take the appropriate measures, we may expect radical changes in all spheres of national economy, social life, science and culture. The basic demand is that health workers must acquire new sociomedical thinking which supplements and at the same time replaces the out-dated biomedical pattern. Structural changes will pertain in particular to mechanisms and organizational measures which will ensure the implementation of the health policy beyond the framework of the health services. In the system of health services we may anticipate that the centre of gravity in health care will shift from the traditional hospital to out-patient facilities with emphasis on the newly conceived function of primary health care. Training of health workers will have to be modified to the effect that graduates will be better prepared to meet actual needs of health care focused on prevention, economy, effectiveness and quality. It will be necessary to create favourable conditions for the development of socio-ecological, epidemiological and operational research. The democratization of health care will call for greater interest and initiative on the part of the public as regards collective and individual health. Our partial health projects should be re-arranged into a single comprehensive nation-wide programme which will include all spheres of health care in the sense of the WHO programme in its modification for Europe.

Czechoslovakia↗
PubMed1985

[Health personnel research: analysis of priorities and political orientations].

The authors endeavor to determine the right priorities for research on health personnel in the framework of the policies on science and technology of the countries in the Region. Although it is difficult to work out a common systematic approach for the analysis, definition and location of the infinity of variables that make up a health system, it is clear that the Region's ever evolving manpower situation has three effects that are ineluctably bound up with the socioeconomic development of the society served: the planning, education and training, and utilization of those resources. The article considers the lack of definite policies on just these three key elements in the development of health personnel and services in relation to both the supply of and demand for them. The authors point out that a genuine solution to the problems requires imperatively the satisfaction of the great need for high priority to serious and thorough research on the health care system, on mutual responsiveness between care services and training systems, and the economic, political and social aspects of the health field itself. The paper also considers the policy guidelines required by the research priorities, and identifies possible activities in the short and middle run for carrying forward programs and projects of social research in those subjects.

Health Occupations↗
PubMed2025

A decentralized future for the open-science databases.

The continuous and reliable open access to curated biological data repositories is indispensable for accelerating rigorous scientific inquiry and fostering reproducible research outcomes. However, the current paradigm, which relies heavily on centralized infrastructure for the storage and distribution of foundational biomedical datasets, inherently introduces significant vulnerabilities. This centralized model is susceptible to single points of failure, including cyberattacks, technical malfunctions, natural disasters, and even political or funding uncertainties. Such disruptions can lead to widespread data unavailability, data loss, integrity compromises, and substantial delays in critical research, ultimately impeding scientific progress. The downstream effect of such interruptions can be the widespread paralysis of diverse research activities, including computational, clinical, molecular, and climate studies. This scenario vividly illustrates the inherent dangers of consolidating essential scientific resources within a single geopolitical or institutional locus. As data generation is accelerating and the global landscape continues to fluctuate, the sustainability of centralized models must be critically re-evaluated. A shift toward federated and decentralized architectures may offer a robust and forward-looking approach to enhancing the resilience of scientific data infrastructures by reducing exposure to governance instability, infrastructural fragility, and funding volatility, while also promoting equity and global accessibility. Inspired by established models such as ELIXIR's federated infrastructure and the policy and funding frameworks developed by CODATA and the Global Biodata Coalition (GBC), emerging Decentralized Science (DeSci) initiatives can contribute to building more resilient, fair, and incentive-aligned data ecosystems. The future of open science depends on integrating these complementary approaches to establish a globally distributed, economically sustainable, and institutionally robust infrastructure that safeguards scientific data as a public good, further ensuring continued accessibility, interoperability, and preservation for generations to come. Here, we examine the structural limitations of centralized repositories, evaluate federated and decentralized models, and propose a hybrid framework for resilient, fair, and sustainable scientific data stewardship.

data accessibility↗
PubMedDate not supplied

Assessing population exposures to motor vehicle exhaust.

The need is growing for a better assessment of population exposures to motor vehicle exhaust in proximity to major roads and highways. This need is driven in part by emerging scientific evidence of adverse health effects from such exposures and policy requirements for a more targeted assessment of localized public health impacts related to road expansions and increasing commercial transportation. The momentum for improved methods in measuring local exposures is also growing in the scientific community, as well as for discerning which constituents of the vehicle exhaust mixture may exert greater public health risks for those who are exposed to a disproportionate share of roadway pollution. To help elucidate the current state-of-the-science in exposure assessments along major roadways and to help inform decision makers of research needs and trends, we provide an overview of the emerging policy requirements, along with a conceptual framework for assessing exposure to motor-vehicle exhaust that can help inform policy decisions. The framework includes the pathway from the emission of a single vehicle, traffic emissions from multiple vehicles, atmospheric transformation of emissions and interaction with topographic and meteorologic features, and contact with humans resulting in exposure that can result in adverse health impacts. We describe the individual elements within the conceptual framework for exposure assessment and discuss the strengths and weaknesses of various approaches that have been used to assess public exposures to motor vehicle exhaust.

Environment↗
PubMed2005

Twelve essentials of science-based policy.

This article presents a systematic framework of 12 essentials, or basic elements, of science-based policy. The 12 essentials are grouped into three categories, or areas, as follows: 1) knowledge generation, which includes credible design, accurate data, sound analysis, and comprehensive synthesis; 2) knowledge exchange, which includes relevant content, appropriate translation, timely dissemination, and modulated release; and 3) knowledge uptake, which includes accessible information, readable message, motivated user, and rewarding outcome.

Bias↗