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At least 415 records · Page 23Linked to original sources
PubMed1996

A message to the labor movement: stop and think!

Trade unions and workers in North America have been objectified and instrumentalized by all political regimes, including the social-democratic New Democratic Party in Canada. And it is means-end non-thinking that characterizes government policies. Liberal elites and policy-making have marginalized ordinary workers making them "superfluous" without any vision of an "ethical community" and demonstrating contempt for democratic initiatives. There are oppositionary voices to the dominant social structures that oppress and undermine community and solidarity. However, trade unions and occupational health and safety "activists" have yet to reassess their strategies on workplace health and safety reforms, but are on the defensive in North America. Further, they are complicit with the dominant ideology and the occupational health and safety establishment, including the various and diverse professionals, who shape how we think about work environment matters; and they accommodate government regulators in mediating worker experiences and expectations with employer interests. The author suggests the beginning of a strategy that does not succumb to present-day liberal public policy-making and the atrophy of alternative options. In part, this strategy calls for a rudimentary phenomenology of moral judgment and a reconstruction of labor "tradition".

Canada↗
PubMed2004

Assessing public perceptions of computer-based models.

Although there is a solid body of research on both collaborative decision-making and on processes using models, there is little research on general public attitudes about models and their use in making policy decisions. This project assessed opinions about computer models in general and attitudes about a specific model being used in water planning in the Middle Rio Grande Region of New Mexico, United States. More than 1000 individuals were surveyed about their perceptions of computer-based models in general. Additionally, more than 150 attendees at public meetings related to the Middle Rio Grande planning effort were surveyed about their perceptions of the specific Rio Grande-based model. The results reveal that the majority of respondents are confident in their ability to understand models and most believe that models are appropriate tools for education and for making policy decisions. Responses also reveal that trust in who develops a model is a key issue related to public support. Regarding the specific model highlighted in this project, the public revealed tremendous support for its usefulness as a public engagement tool as well as a tool to assist decision-makers in regional water planning. Although indicating broad support for models, the results do raise questions about the role of trust in using models in contentious decisions.

Adult↗
PubMed1987

Avoidable burden of illness: how much can prevention contribute to health?

The WHO campaign for health for all by the year 2000 brought health back into the centre of attention in health policy making. Different authors have analysed the determinants of health in different models. One of these is the well-known model of Lalonde, in which health is seen as the result of four determinants: human biology, life style, environment and health care. Dever, in the U.S., has tried to quantify this model in order to compare the percentages of mortality attributable to each of the four determinants with the percentage of resources from the health care budget, allocated to them. The authors have, individually, tried to replicate these estimates, through a survey of Dutch experts. The results of these surveys are presented and discussed. The authors conclude that, although a quantification of the relative importance of the determinants of health would be extremely useful in health policy making, the methodology proposed by Dever does not yield suitable results. An alternative approach suggested, would be to subdivide the broad determinants into known risk factors and to arrive at a quantification through the utilization of known epidemiologic relationships between risk factors and disease.

Health Policy↗
PubMed2002

Infection control in Saudi Arabia: meeting the challenge.

Hospital-acquired infection poses significant clinical and economic burden worldwide. In the Kingdom of Saudi Arabia, infection control is a young, rapidly growing specialty. An infrastructure to expedite the growth of this important discipline is fast being established. The kingdom faces unique challenges when addressing infection control, which are the subject of this review. Much of the policy-making in domestic infection control is driven by the preventive medicine concerns of the annual pilgrimage (Hajj) to Mecca, which are unparalleled. The Saudi Ministry of Health acts to contain and control public health risks at this gathering of 2 million. Infectious hazards at the Hajj include meningococcal meningitis, respiratory tract infections, bloodborne diseases, and zoonotic diseases, all of which have international ramifications as pilgrimaging Muslims return home. In the wake of the extraordinary pace of modernization in Saudi Arabia, deficiencies in infection control remain, which are slowly being redressed. This review examines the anatomy of infection control and its evolution in the kingdom. Future goals and infection control policy-making are given particular emphasis. Saudi Arabia seeks increasing international partnership in the area of infection control and preventive medicine. The Saudi health care system was formed on the basis of Western models to resounding success. Saudi Arabia is now in a position to provide experience and knowledge in return. International dialogue in the infection control arena is of mutual value. Important public health progress is afoot in this young kingdom, and these advances translate both regionally and on the international platform.

Anniversaries and Special Events↗
PubMed2005

The precautionary principle and pharmaceutical risk management.

Although it is often vigorously contested and has several different formulations, the precautionary principle has in recent decades guided environmental policy making in the face of scientific uncertainty. Originating from a criticism of traditional risk assessment, the key element of the precautionary principle is the justification for acting in the face of uncertain knowledge about risks. In the light of its growing invocation in various areas that are related to public health and recently in relation to drug safety issues, this article presents an introductory review of the main elements of the precautionary principle and some arguments conveyed by its advocates and opponents. A comparison of the characteristics of pharmaceutical risk management and environmental policy making (i.e. the setting within which the precautionary principle evolved), indicates that several important differences exist. If believed to be of relevance, in order to avoid arbitrary and unpredictable decision making, both the interpretation and possible application of the precautionary principle need to be adapted to the conditions of pharmaceutical risk management.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1995

Speaking truth to power: empowerment ideology as social intervention and policy.

The popularity, and subsequent ambiguity, in the use of the term "empowerment" has created an even greater need for reassessment in the applied context than in the theory and research literatures. This paper outlines some of the areas of community, organizational, and societal level social intervention and policy ostensibly based on the concept of empowerment. These include neighborhood voluntary associations (for environmental protection, community crime prevention, etc.), self-help groups, competence-building primary prevention, organizational management, health care and educational reforms, and national and international community service and community development policies. Issues in applying social research to community organizations and to legislative and administrative policy making are reviewed. Ten recommendations are offered, including the value of a dialectical analysis, for helping researchers and policy makers/administrators make more effective use of empowerment theory and research.

Community Networks↗
PubMed2001

Negotiating and managing partnership in primary care.

In the UK public service organisations are increasingly working together in new partnerships, networks and alliances, largely stimulated by government legislation, which aims to encourage 'joined-up' policy-making. This is particularly prevalent in health-care where local government, health authorities and trusts, voluntary and community groups are extending existing, and developing new, forms of partnership, particularly around Health Improvement Programmes and new primary care organisations. This paper explores two main aspects of how these new interorganizational relationships are being developed and managed and is based on research conducted in one case study locality. First, the new structures of partnership in primary care are mapped out, together with discussion on why these particular patterns of relationship between statutory and voluntary sector organisations have emerged, exploring both centrally and locally determined influences. Secondly, the paper explores the tensions associated with working within new policy-making and management structures, and how the additional demands of audit, performance measurement and the sheer pace of change, pose a potential threat to the partnership process.

England↗
PubMed1997

The state of adolescent health: looking back and planning ahead.

PURPOSE: A decade has passed since the 1986 Health Futures of Youth policy-making conference was held. The present study aimed to examine perceived changes in the field of adolescent health since this conference, as a basis for further planning in adolescent health and consideration of a possible follow-up conference. METHODS: The study included two parts: (a) a mailed survey which was completed by 68 of 90 conference participants; and (b) telephone interviews with a sample of leaders from federal agencies and major foundations and one professional organization serving youth in the United States. RESULTS: Respondents perceived that small to moderate improvements have occurred for 10 key recommendations made at the 1986 conference. There appears to be increased recognition of the special needs of youth and a greater understanding of the period of adolescence. Improvements in health-related activities and in research of health behaviors have occurred. However, perceived setbacks have occurred at the intersection of health and social welfare. The conference was viewed by respondents as having had a moderate influence on the field of adolescent health and on the participants' own work and working relationships. In addition, policy-making conferences were listed as the strongest source of influence on the agenda of national agencies and foundations serving youth. CONCLUSION: A follow-up conference is recommended and should focus on both health-related topics and issues of social welfare.

Adolescent↗
PubMed1998

Environmental characteristics of nursing homes and community-based settings, and the well-being of adults with intellectual disability.

The present study examined whether characteristics of the environment of nursing homes and community-based residential settings are associated with the adaptive behaviour, health and community integration of adults with intellectual disability living in those settings. The specific characteristics of the environment were type of facility, size, level of residential involvement in policy-making, and the degree of variety and stimulation of the physical environment. The study assessed 249 residents with intellectual disability over a 3-year period who lived in nursing homes at baseline. At follow-up, 50 of the residents had moved to community-based facilities while 199 of the residents remained in nursing homes. The results indicated that type, size and characteristics of the environment were related to the level of adaptive behaviour and community integration at follow-up. Residents living in community-based settings had better health and greater levels of community integration than residents living in nursing homes. Residents living in smaller facilities had greater adaptive behaviour at follow-up than residents living in larger facilities. More variety and stimulation in the residential physical environment was associated with greater adaptive behaviour among residents at follow-up. Residential facilities that permitted greater resident involvement in policy-making, and had greater variety and stimulation in their physical environment were associated with greater levels of community integration among their residents at follow-up.

Adaptation, Psychological↗
PubMed1998

The meaning of the act: reflections on the expressive force of reproductive decision making and policies.

Prenatal and preconceptual testing and screening programs provide information on the basis of which people can choose to avoid the birth of children likely to face disabilities. Some disabilities advocates have objected to such programs and to the decisions made within them, on the grounds that measures taken to avoid the birth of children with disabilities have an "expressive force" that conveys messages disrespectful to people with disabilities. Assessing such a claim requires careful attention to general considerations relating meaning, intention, and social practices; it has only begun to receive such attention. Building on work by Allen Buchanan, who has challenged this claim, I further consider the disabilities advocates' objection, ultimately concluding that it is misplaced; neither individual actions nor general practices of this type necessarily express disrespectful messages.

Abortion, Eugenic↗
PubMed1985

Hospital ethics committees: a pediatric neurosurgical perspective.

The Pediatric Neurosurgical Section of the American Association of Neurological Surgeons was polled regarding the status of hospital ethics committees. Twenty-four committees were identified in 74 pediatric neurosurgical centers in the United States. (Thirteen of these were formed between October 1983 and February 1984.) In addition, 21 are in the planning stages. Physicians predominate, with nurses, hospital administrators, the clergy, social workers, attorneys and lay persons usually represented. Functions include review of ethical and patient care decisions and providing counsel and support primarily to physicians and nurses. Rarely do committees make policy, determine prognosis or make final decisions regarding life-support systems. Approximately one case per year is reviewed. Committee formation frequently appears to be a crisis response to highly publicized pediatric cases and recent positions of the Department of Health and Human Services. Their purpose, construct, function and utilization raise serious questions as to their usefulness and necessity.

Canada↗
PubMed1997

Regulating biotechnology: a rational-political model of policy development.

While technology assessment is seen as a mechanism for achieving effective and efficient use of health care resources, it has not as yet made the impact on policy decisions that its potential would suggest. Considerable barriers have been encountered in translating assessment results into policy concerning the adoption and use of technologies, with 'political' factors often being decisive. This paper places technology assessment in the content of the policy process to clarify both (a) how conflicting interests and organizational features can often hinder the selection of optimal policies, and (b) the potential roles technology assessment could nonetheless play. The resulting framework is termed the 'rational-political' model of policy development. The paper uses the example of policy making about the regulation of biotechnology, drawing on information from a survey of decision-makers (n = 561) involved in issues concerning the development, approval, and payment for pharmaceutical products.

Biotechnology↗
PubMed1985

Hard choices: who lives, how, and who decides? The ethics of making national policy.

Technological advances in medicine and biomedical research have been both exhilarating and depressing. They have heralded prolonged life and with it a moral dilemma regarding the quality of that life. These moral issues are relatively trouble-free on the individual level; however, they become extremely problematic when a policy must be developed which will affect the lives of thousands or millions of people. The persistent problem which is likely to haunt us for decades is the question of allocation of our health care resources--should these health care resources be rationed, and if so, by whom.

Ethics, Medical↗
PubMed1985

Shaping public policy from the perspective of a data builder.

During the past six decades, data analysis and research studies have been instrumental in shaping public and private health care policy. Policymakers obtain the knowledge they need for making policy decisions through exposure to and examination of data generated through research studies, experimentation, demonstrations, and analyses. In this article, U.S. hospital care policy has been divided into phases. As the development of health care policy has progressed in each phase, decisionmakers have consistently increased their reliance on data.

Health Policy↗