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At least 433 records · Page 24Linked to original sources
PubMed2003

Research and interventions to reduce domestic violence revictimization.

Despite decades of research on domestic violence, considerable challenges must be addressed to develop sound, theoretically and empirically based interventions for reducing domestic violence revictimization. Many basic and applied research issues remain unaddressed by existing studies, and evaluations frequently do not sufficiently highlight their limitations or program or policy implications. Nonetheless, progress has been made, and practitioners and policy makers increasingly have a wide range of promising interventions from which to select. This article reviews research on domestic violence and focuses particular attention on interventions aimed at reducing revictimization among individuals known to have been abused. It also provides a conceptual framework for practitioners and policy makers to situate existing evaluation research and highlights the need for better data to understand and assess efforts to reduce domestic violence revictimization. The author concludes by discussing directions for future research and recommendations for practice and policy.

Alcohol Drinking↗
PubMedDate not supplied

[Migration policies and population distribution in Mexico: regional implementation and impact].

The author begins by analyzing the legal framework of migration and population redistribution policies in Mexico since 1973, when the General Law on Population was passed. In that framework, she points out several institutional deficiencies and contradictions. In the second section, she discusses demographic planning in this field, and conducts a follow-up on implementation based on reports from the institutions involved and official documents. To conclude, she examines practical applications of policy instruments, comparing the behavior of governmental variables that had a bearing on the phenomenon before and after the implementation of said policy (1970 to 1990). One of her findings is that the basic elements making population policies on migration operational did not move in the desired direction, i.e., to modify migratory and population distribution so as to achieve expected goals. Despite the continuity of population policies on migration, the implementation of such policies still poses diverse obstacles.

Americas↗
PubMed2005

Promoting good governance through regulatory frameworks in African water utilities.

Most public utilities in Africa are operating at very low efficiency levels. This is mainly a result of poor governance leading to a downward spiral in terms of service to customers. Nearly in every case, studies have shown that the root cause of these problems is not necessarily lack of investment but poor choices with regard to sector policies, institutional and regulatory frameworks. The paper will seek to show the need for effective regulatory framework that promotes Good Governance of public utilities leading to their efficient performance. The paper will draw lessons from the Australian water services regulatory framework and apply it to the African water situation. The Australian regulatory framework has been instrumental in promoting Good Governance in the public utilities hence being run efficiently. It is recognised that the African Water and Sanitation Sector where most public utilities are not operating under a clearly defined regulatory framework can learn a lot from the Australian experience.

Africa↗
PubMed1998

Early intervention and early experience.

For 4 decades, vigorous efforts have been based on the premise that early intervention for children of poverty and, more recently, for children with developmental disabilities can yield significant improvements in cognitive, academic, and social outcomes. The history of these efforts is briefly summarized and a conceptual framework presented to understand the design, research, and policy relevance of these early interventions. This framework, biosocial developmental contextualism, derives from social ecology, developmental systems theory, developmental epidemiology, and developmental neurobiology. This integrative perspective predicts that fragmented, weak efforts in early intervention are not likely to succeed, whereas intensive, high-quality, ecologically pervasive interventions can and do. Relevant evidence is summarized in 6 principles about efficacy of early intervention. The public policy challenge in early intervention is to contain costs by more precisely targeting early interventions to those who most need and benefit from these interventions. The empirical evidence on biobehavioral effects of early experience and early intervention has direct relevance to federal and state policy development and resource allocation.

Child Development↗
PubMedDate not supplied

Achieving safe motherhood: applying a life course and multiple determinants perinatal health framework in public health.

Safe motherhood has begun to be identified as a priority for the health of American women. We argue that safe motherhood can be achieved through application of a life course and multiple determinants framework. This framework, with its focus on the preconception period, poses a dilemma in that it links together periods of life and domains of activities that have traditionally not been linked with maternal health. The interests of women and children have often been juxtaposed in the making of policy. Further, the domains of women's health, maternal and child health, and family planning have often clashed over policy priorities and funds. This framework shows that the research literature now links them inextricably to better health outcomes, albeit indirectly; there are no intervention studies that have demonstrated the empirical efficacy of this approach. Thus, although this framework creates a strong rationale for the linkages described, it also demands attention to a set of implementation strategies that will overcome existing barriers. Through a focus on one maternal factor, obesity, we discuss how a range of strategies grounded in the framework can be undertaken to address maternal morbidity and mortality. We then examine selected strategies at each level of the multiple determinants life course framework and emphasize how public policies and public and private sector professional practice can be reexamined to improve outcomes for women in all time periods and aspects of reproductive potential, which in turn might enhance outcomes for their offspring, both at birth and beyond. Our intent is to influence how policy makers, public health professionals, clinicians, and researchers approach safe motherhood.

Female↗
PubMed2000

Advocating healthy public policy: implications for baccalaureate nursing education.

Advocating healthy public policy is increasingly recognized as an essential strategy for enhancing the health of populations. The purpose of this paper is to discuss the implications this priority area portends for the educational preparation of public health nurses (PHNs). Population health is central to public health nursing, and as such, it is imperative that PHNs employ policy advocacy strategies to influence positively the determinants that affect the health of populations. In this paper, we introduce the concept of healthy public policy and its relevance for public health nursing and baccalaureate nursing education. We outline substantive content areas that are fundamental to policy advocacy, such as determinants of health and their interrelationships, the policy process, and theoretical frameworks consistent with a socioenvironmental approach to health. In addition, we detail examples of specific learning experiences that provide students with opportunities to apply the content. Some of these activities include analysis of a population health issue, developing a position paper or resolution, writing letters to policy makers and the media, and working with lobbyists and policy makers.

Canada↗
PubMed2001

System, environmental, and policy changes: using the social-ecological model as a framework for evaluating nutrition education and social marketing programs with low-income audiences.

A variety of nutrition education interventions and social marketing initiatives are being used by the Food Stamp Program to improve food resource management, food safety, dietary quality, and food security for low-income households. The Social-Ecological Model is proposed as a theory-based framework to characterize the nature and results of interventions conducted through large public/private partnerships with the Food Stamp Program. In particular, this article suggests indicators and measures that lend themselves to the pooling of data across counties and states, with special emphasis on systems, environment, and public policy change within organizations at the community and state levels.

Food Services↗
PubMed2004

Human immuno-deficiency virus and infant feeding in complex humanitarian emergencies: priorities and policy considerations.

Issues surrounding mother-to-child transmission of HIV/AIDS pose considerable challenges in complex humanitarian emergencies. The risk of vertical transmission through breastfeeding is well recognised, but safe alternatives are limited by the social, economic and environmental conditions of emergency situations. In 2000, the World Health Organisation published a technical report on behalf of the UNFPA/UNICEF/WHO/UNAIDS Inter-agency Task Team on Mother-to-child Transmission of HIV which outlined revised recommendations for infant feeding by HIV-positive women. This paper outlines reasons why these recommendations may be insufficient during the initial stages of complex humanitarian emergencies and proposes recommendations for establishing infant-feeding policy. Methods of mother-to-child transmission of HIV are reviewed and recent research findings are discussed. Rationale for modifying the 2000 UNFPA/UNICEF/WHO/UNAIDS infant-feeding recommendations in complex emergency situations is explored from the perspective of the infant, the mother and humanitarian field staff. Ethical limitations and future priorities are considered. The paper concludes with recommendations and a policy decision-making framework for consideration during the initial stages of humanitarian crises.

Adult↗
PubMed2006

Massachusetts health reform: beauty is in the eye of the beholder.

The Massachusetts plan to extend health insurance coverage to nearly all of the state's residents offers several lessons related to health reform, including the following: Bipartisan cooperation is possible; multiple policy mechanisms must be employed to achieve meaningful change; the starting point-in terms of the rate of uninsurance, the degree of insurance market regulation, and so on-matters; and implementation details are critical. In addition to these lessons, we argue that objective analysis and a comprehensive framework for evaluating alternative policy options are needed for similar reforms to be enacted elsewhere.

Cooperative Behavior↗
PubMed1991

Health challenges for the year 2000: health promotion and AIDS.

This article examines how the concept of health promotion can be of value to professionals who have a special responsibility to promote the health of young people and adults. What does it mean to address the issue of AIDS within the broad concept of health promotion? A key message of health promotion is that health cannot be ensured by the health sector alone. The confrontation with AIDS--the new global threat to health--and the response to it with the Global AIDS Strategy have underlined the necessity for a broad involvement of many different sectors of society. Health promotion needs a comprehensive strategy of action oriented towards the development and implementation of various measures concerning the prevention of HIV/AIDS. The five activity areas of the Ottawa Charter for Health Promotion provide a framework to introduce concrete examples of good practice. The main objective of these activities is the development of personal skills that will enable young people and adults to make choices conducive to health, to cope with problems, to find imaginative solutions, and to become aware of the interdependence that exists between all individuals. This means involvement and participation. In turn, participation opens up on a broad perspective of community action, of supportive environment, and of social public policy. This is the framework of action that the health promotion concept can provide.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Policy networks and the implementation of community care policy for people with mental handicaps.

Although community care has been the professed policy of successive governments over three decades, according to the Prime Minister's own adviser, Sir Roy Griffiths, 'in few areas can the gap between political rhetoric and policy on the one hand or between policy and reality in the field on the other hand have been so great'. This paper examines the extent and causes of this 'implementation gap' in respect of services for people with mental handicaps--a consistent priority group for national policymakers. We examine centre-periphery relations in the health and personal social services in the light of Rhodes' power-dependence framework and his concepts of policy networks and policy communities. The NHS has been described as the archetypal professionalised policy network but we conclude that it is possible to account for implementation failures in community care only partly in terms of the dominance of the medical professions' values and interests and the deficiencies of accountability and control due to clinical autonomy. Such failures are due also to the inherently limited power of the centre. Sub-central units are not merely its meek agents. Moreover, the centre must explicitly structure local environments by itself providing a coherent framework of service and resource policies compatible with the national objectives it is seeking to achieve.

Community Mental Health Services↗
PubMed1993

An ethical perspective on health care insurance reform.

Much recent analysis of health care insurance reform emphasizes economic and policy issues. In contrast, this Article examines health policy issues from the viewpoint of medical ethics. The critical ethical "problem" in health care today is that ability to pay determines the availability and quality of care. This Article discusses three types of proposed solutions: health care insurance reform, health care financing reform, and health care cost reform. It sketches an ethical framework for evaluating health policy and presents seven specific propositions that an ethical analysis of health care reform proposals raises. This Article concludes that remedying the unethical treatment of certain classes of patients requires both health care financing reform and health care cost reform; health care insurance reform will not suffice.

Beneficence↗
PubMed1994

Priorities for pharmaceutical policies in developing countries: results of a Delphi survey.

The use of the Delphi method as a systematic and logical approach to establishing consensus among international experts on the priorities for interventions in national drug policies in developing countries is described. The Delphi survey showed a high degree of reliability, as evidenced by the high response rate, the quality of respondents, and the high standard for consensus. In addition to creating consensus on key issues and key components for priority intervention, the study identified six components that could constitute a basic framework for designing drug policy in developing countries. The study's conclusions have important implications for decision-makers within international development agencies and national governments.

Delphi Technique↗
PubMed2005

Disclosure of medical errors: ethical considerations for the development of a facility policy and organizational culture change.

The Institute of Medicine report, To Err Is Human: Building a Safer Health System, has spurred public concern over hospitals' ability to deliver safe care. The health care industry continues to struggle to address these concerns. These efforts have driven the growing expectation that health care practitioners or systems disclose unanticipated outcomes to patients and family members. Although the tort system has been cited as an impediment to medical error disclosure, some organizations and systems have successfully implemented policies calling for full disclosure of errors and unanticipated outcomes. However, most organizations have yet to develop policies concerning error disclosure. This article provides an overview of error disclosure and a model framework for an error disclosure policy. The ethical principle of respect for patient autonomy is emphasized as the driving force in developing an institutional disclosure policy and changing the organizational culture to one that supports development and implementation of such a policy.

Ethics, Institutional↗
PubMed2002

Life cycle impact assessment: a challenge for risk analysts.

Modern technology, together with an advanced economy, can provide a good or service in myriad ways, giving us choices on what to produce and how to produce it. To make those choices more intelligently, society needs to know not only the market price of each alternative, but the associated health and environmental consequences. A fair comparison requires evaluating the consequences across the whole "life cycle"--from the extraction of raw materials and processing to manufacture/construction, use, and end-of-life--of each alternative. Focusing on only one stage (e.g., manufacture) of the life cycle is often misleading. Unfortunately, analysts and researchers still have only rudimentary tools to quantify the materials and energy inputs and the resulting damage to health and the environment. Life cycle assessment (LCA) provides an overall framework for identifying and evaluating these implications. Since the 1960s, considerable progress has been made in developing methods for LCA, especially in characterizing, qualitatively and quantitatively, environmental discharges. However, few of these analyses have attempted to assess the quantitative impact on the environment and health of material inputs and environmental discharges Risk analysis and LCA are connected closely. While risk analysis has characterized and quantified the health risks of exposure to a toxicant, the policy implications have not been clear. Inferring that an occupational or public health exposure carries a nontrivial risk is only the first step in formulating a policy response. A broader framework, including LCA, is needed to see which response is likely to lower the risk without creating high risks elsewhere. Even more important, LCA has floundered at the stage of translating an inventory of environmental discharges into estimates of impact on health and the environment. Without the impact analysis, policymakers must revert to some simple rule, such as that all discharges, regardless of which chemical, which medium, and where they are discharged, are equally toxic. Thus, risk analysts should seek LCA guidance in translating a risk analysis into policy conclusions or even advice to those at risk. LCA needs the help of RA to go beyond simplistic assumptions about the implications of a discharge inventory. We demonstrate the need and rationale for LCA, present a brief history of LCA, present examples of the application of this tool, note the limitations of LCA models, and present several methods for incorporating risk assessment into LCA. However, we warn the reader not to expect too much. A comprehensive comparison of the health and environmental implications of alternatives is beyond the state of the art. LCA is currently not able to provide risk analysts with detailed information on the chemical form and location of the environmental discharges that would allow detailed estimation of the risks to individuals due to toxicants. For example, a challenge for risk analysts is to estimate health and other risks where the location and chemical speciation are not characterized precisely. Providing valuable information to decisionmakers requires advances in both LCA and risk analysis. These two disciplines should be closely linked, since each has much to contribute to the other.

Environmental Health↗
PubMed1998

Evaluation of welfare reform. A framework for addressing the urgent and the important.

Assessing the effects of changes still emerging under welfare reform and its overarching policy of devolution presents a challenge to evaluators. Given such features as time limits and benefits caps that vary widely across states and communities, it is necessary not only to attend to urgent issues of immediate relevance for individuals on public assistance but also to focus on important long-term analyses of this complex intergovernmental set of policies. The authors present a conceptual framework based on evaluation utilization and illustrate it with research questions under the rubric of welfare reform. The approach crosses three types of utilization--conceptual, instrumental, and political--with two utilization settings--policy adoption and program implementation. Evaluation strategies are linked to the utilization framework and illustrated with examples from studies of welfare reform. In the aggregate, evaluation studies represent a reasonable range of urgent and important issues across most utilization types and settings.

Health Care Reform↗
PubMed1996

Paradigm shifts in Medicare reform.

Reforms passed by Congress and vetoed by the president during the past year would have accelerated initiatives already transforming Medicare. Operating in a rapidly changing insurance marketplace, Medicare is shifting from a social insurance model toward a private individual insurance model-expanding the number and type of alternative health plans it offers-and growing numbers of beneficiaries are enrolling in these plans. Such reforms, especially if bolstered by legislative reforms that are likely to resurface after the November elections, will rewrite the social contract enacted more than 30 years ago. They require fundamental shifts in ways of thinking about the federal government's responsibilities; the Medicare program's management; relations between the Medicare program and doctors, hospitals, and other health care providers; and the role of beneficiaries in the Medicare program. The likely deferral of further legislative attempts to reform Medicare affords an opportunity to step back and consider these ongoing changes. It is not easy to describe paradigm shifts accurately, but there are advantages to trying. First, conceptual comparisons can allow public discussion to go beyond budget scorekeeping and media soundbites to consider how different the Medicare program will be if it evolves in the new ways being proposed. Second, a conceptual framework can assist health policy analysts to target what to watch for in tracking changes, to assess the tradeoffs involved, and to advise about the needs for refining legislation. This paper includes examples of what to watch for in tracking the implemented changes. The paradigm shifts are summarized below, then described individually in terms of directions of change along a number of continuums. Note that complete paradigm shifts, from one end of a continuum to the other, are seldom completely realized nor even far advanced. But Medicare's ongoing reforms, accelerated by legislative proposals, seem likely predecessors of future changes. For developing this framework, the authors have drawn on the Medicare provisions of the Conference Agreement on the Balanced Budget Act of 1995, the president's proposals as presented in December 1995, and current and proposed Health Care Financing Administration practices.

Consumer Behavior↗
PubMed2005

Nurses and the genomic revolution.

PURPOSE: To increase nurses' genetics and genomics literacy through a series of articles focused on genomic research discoveries and their importance for nursing education, practice, policy, and research. ORGANIZING FRAMEWORK: "Genomics for Health " is one of three themes, along with genomes to biology and genomes to society, emanating from applications of the Human Genome Project (HGP). METHODS: In this series of articles, nurse scientists who are experts in genetics and genomics sciences explain terminology, provide background information about the HGP, discuss clinical examples, and recommend changes in nursing practice, education, and research. CONCLUSIONS: The HGP has already led to major changes in clinical practice, research, education, and policy, and even more dramatic changes are predicted for people throughout the world. Mastering this information is necessary for nurses globally because genomic information will ultimately pervade all of health care.

Education, Nursing↗