Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Policy Making”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed2006

Enterococci predictions from partial least squares regression models in conjunction with a single-sample standard improve the efficacy of beach management advisories.

Beach health advisories are issued if enterococci (ENT) densities exceed the 30-d geometric mean or single-sample water quality criteria. Current ENT enumeration procedures require 1 day of incubation; therefore, beach managers make policy decisions using 1-day-old data. This is tantamount to using a model that assumes ENT density on day t is equal to ENT density on day t-1. Research has shown that ENT densities vary over time scales shorterthan a day, calling into question the usefulness of the current model for decision-making. We created Dynamic Partial Least Square Regression (DPLSR) models for ENT at water quality monitoring stations within two adjacent marine recreational sites, Huntington State Beach (HSB) and Huntington City (HCB) Beach, California, using publicly available environmental data and tested whether these models overcome the drawbacks of the current model. The DPLSR models provide a better prediction of ENT than the current models based on comparisons of root-mean-square errors of prediction and the numbers of type 1 and 2 errors. We compared outcomes in terms of predicted illness, swimmers deterred from entering the water, and net benefits to swimmers for hypothetical management scenarios where beach advisories were issued based on (a) the previously collected sample's ENT density in conjunction with the two water quality criteria, and (b) predictions from DPLSR models in conjunction with the single-sample standard. At both HSB and HCB the DPLSR scenario produced a more favorable balance between illness prevention and recreational access. The results call into question the current method of beach management and show that model-informed decision-making and elimination of the geometric mean standard will aid beach managers in achieving more favorable outcomes in terms of illness and access than are presently achieved using 1-day-old measurements, especially at beaches where water quality problems are chronic.

Animals↗
PubMed2003

A tap water turbidity crisis in Tel Aviv, Israel, due to technical failure: toxicological and risk management issues.

Herein, we report on the actual events linked to an ammonia spillage into the main waterline of the Tel-Aviv metropolitan area and its surrounding municipalities. Based upon a large magnitude increase of unknown origin in the turbidity and ammonia levels of the main drinking water supply, area residents were warned of possible serious contamination and advised to refrain from drinking tap water until further notice. Turbidity was later linked only to CaCO3, which was precipitated from the water due to the rise in pH caused by the excessive ammonia levels. The source of the ammonia (a malfunction of the measurement buoy in the ammonia tank) was not identified until several days after the warning was issued. The toxicological implications of the turbidity and ammonia elevations are considered and reconciled with the management strategies that followed. Of consequence to the management of this crisis was the approach of Ministry of Health officials to regard the ammonia, from the onset, as an indicator of several possible sources of origin rather than as a contaminant. Decision-making policies were hampered by ineffective communication between the national water supplier and government health officials. An outcome of this crisis was a heightened awareness of the potential of a water crisis occurring during peace time and not only in association with terrorist activities, to which Israeli citizens are highly sensitized. Finally, the present paper may serve to guide municipal environmental and health officials more appropriately in the event of similar drinking water crises in Israel or elsewhere.

Ammonia↗
PubMed1992

Health policy regimes and the single European market.

I examine the potential effects of the creation of a single European market on the health policy regimes of the twelve member states of the European Community (EC), arguing that few changes can be expected in the basic nature of those regimes and that a Community-wide health policy regime is unlikely to emerge in the near future. Domestic health policy regimes and care systems will remain the dominant approach to health care delivery, and it is not likely that the American approach will be adopted. However, EC legislation designed to create favorable trade, economic, and fiscal conditions may affect key industries like pharmaceuticals and health insurance, with consequences for national health policy regimes. Patterns in Community-wide policy-making suggest that it will become increasingly difficult to define health issues in purely domestic or international terms.

Consumer Behavior↗
PubMed1989

Evaluating community development programs for health promotion: problems illustrated by a New Zealand example.

This paper illustrates problems in the evaluation of community development programs for health promotion. It is based on the authors' retrospective process evaluation of the Wanganui Community Alcohol Action Program (WCAAP), a recent example of a health promotion program directed at reducing alcohol-related problems in a small New Zealand town. Described by its designers as a community-based program, it included coordination of community organizations, education, publicity and increased enforcement of drinking laws. Discussion of the problems in the evaluation of such programs puts them within the context of the substantial body of previous social science research in both evaluation and community development. This, it is argued, is a body of knowledge with which health promotion researchers need to be conversant. Community development programs usually stem from a process of negotiation between interest groups with differing objectives. This results in a changing definition of both the problem to be solved and the nature of the solution, making evaluation difficult. Community development is also likely to be seen as a new solution providing a panacea for old problems. This can lead to such programs being too ambitious. From the point of view of experimental design these programs are likely to have a number of technical problems. This paper argues that these problems are so significant that it often unwise to attempt large scale evaluations of community development programs. Rather, attention should be concentrated on critically assessing the policy-making process and disseminating previous knowledge about such programs.

Alcoholism↗
PubMedDate not supplied

The physician's role in injury prevention: beyond the U.S. Preventive Services Task Force report.

Injuries and their prevention have received little attention by the medical community, despite the fact that injuries are the leading cause of premature death. However, much can be done to reduce the number and severity of injuries, and the practicing physician has an important role to play in this process. This report outlines the U.S. Preventive Services Task Force report recommendations for prevention strategies to reduce injuries and then seeks to define a broader role for the physician in prevention injuries that extends beyond the confines of office-based practice. While screening and counseling have proven effectiveness in certain situations, interventions that are passive or automatic in action, such as air bags, have proven to be more effective long-term solutions to reduce both the number and the severity of injuries. The author outlines and provides examples of seven areas where physicians can have a major impact either directly or through implementing effective injury-control strategies. These are: treatment, education, screening, hazard identification, research, advocacy, and policy making. Using all of these approaches, physicians can play a truly effective role in reducing the burden of injuries for their patients.

Accident Prevention↗
PubMed1993

Citizens' action for public health.

The European Public Health Alliance aims to ensure broad participation in health-related policy-making and to contribute to the promotion of public health. The origins of the Alliance and the ways in which it relates to official bodies are outlined below.

Community Participation↗
PubMed2000

Drug injectors and the cleaning of needles and syringes.

When people share needles and syringes they risk transmitting human immunodeficiency virus (HIV) and other infections including hepatitis B virus (HBV) and hepatitis C virus (HCV). Cleaning needles and syringes can help to reduce, although not eliminate, these risks. This article begins by engaging with some of the literature on the cleaning of needles and syringes. Drawing on qualitative research conducted with drug injectors in England, the article then goes on to explore drug injectors' perceptions and experiences of cleaning needles and syringes inside and outside prison. The article concludes by highlighting the implications for future research and policy making. Ultimately there should be a stronger policy response to reduce the risks associated with sharing needles and syringes inside prison, which should include the piloting of prison needle and syringe exchange schemes.

HIV Infections↗
PubMed2005

Decision-makers and the usefulness of research evidence in policy implementation--a case study from Lao PDR.

The involvement of researchers in the policy process and policy-makers in research is little studied, particularly in developing countries. In 1993, the Lao National Drug Policy (NDP) was endorsed in a consultative process involving many stakeholders. Lao People's Democratic Republic is a poor country in South East Asia. Five pilot provinces were selected for implementation of the policy, which had a health system research (HSR) component. This case study explores decision-makers' knowledge and attitudes regarding the usefulness of HSR in the NDP implementation process. Ninety decision-makers from different health institutions including hospitals, medical schools and main drug suppliers were surveyed using a self-administrated structured questionnaire, filled in during a NDP conference in 2001. Results from six HSR projects related to the NDP implementation had been presented during the conference, but also 6 months previously and through written reports. There were 75 respondents (83% of attendees, 90% of whom were men), 39% with medical, 50% with pharmacy and 11% with other background. Ninety-eight percent of the participants found operational research useful, and 87% supported it to be an element of the NDP. Two-thirds knew the objectives of the NDP. There was no significant difference in knowledge and attitudes between pilot and non-pilot provinces and between professions. Ninety-two percent were aware of the Essential Drug List, and 88% found it adequate to drug need. Ninety-seven percent agreed with generic drug prescribing. Seventy percent reported to have heard about Good Pharmacy Practice (GPP), but only a few could explain it. Although most participants agreed that HSR should be one main component of the NDP and found HSR results useful, few had heard about them before the conference, and research was not well understood. The paper discusses various factors influencing decision-makers' perceptions of usefulness of research in this case during the NDP implementation process. It is concluded that the acceptance of research and major NDP concepts probably is a result of close interaction between researchers and policy-makers and that the interface between research and policy-making needs further studies.

Administrative Personnel↗
PubMed2006

[An innovative proposal for health insurance policies based on research results: the case of unemployed in Medellin, Colombia].

In recent decades there has been an important academic debate on how to transfer research-based knowledge to the health policy-making process. Despite an intensive controversy and various approaches to the problem, there is basic consensus concerning both the academic relevance and the usefulness of further evaluation of concrete experiences that allow conclusions and clarification of what are still confusing issues. The current article discusses a joint research experience by professors and local and regional health policy-makers. The research focused on the socioeconomic conditions, duration of the employment/unemployment cycle, and features of health insurance for workers that lost their jobs in the Greater Metropolitan "Valle de Aburrá" Area (Antioquia, Colombia) in 2005, as the basis for a proposal to guarantee the maintenance of health insurance for these workers. The potentialities and difficulties of the interactive process are analyzed. The article is also intended to elucidate how scientific outcomes influence policymaking in health, as well as the difficulties imposed by concrete reality and the political process for implementing the innovative proposal.

Administrative Personnel↗
PubMed2003

Modernizing the British National Health Service (NHS) -- some ideological and policy considerations: a commentary and application.

The modernization of the British National Health Service, discussed by Peter Bradshaw in his paper, is having profound effects on nursing and patient care. The aim of this paper is to engage with the debate he has initiated in order to demonstrate its importance to nursing. The focus will be on key elements of the policy process not addressed by Peter Bradshaw as his emphasis was mainly on ideological concerns, but which nonetheless warrant consideration. These include the increasingly important role of evidence in policy making, and the role of nurses in the policy process. To this end four main themes are explored. First, specific comment is made on some of the points raised by Peter Bradshaw, in the context of the available evidence; secondly the role of evidence in the formulation and evaluation of policy is discussed; thirdly the policy process and nursing is examined; finally some tentative suggestions are made concerning the actions nurses and nurse managers can take to become more active in the health policy arena. The intention is to use Peter Bradshaw's work as a point of departure in examining further, some of the issues he highlights and to contribute to the debate.

Decision Making, Organizational↗
PubMedDate not supplied

From taxol to Taxol: the changing identities and ownership of an anti-cancer drug.

This paper analyzes the emergence and evolution of taxol, the world's bestselling anti-cancer drug. Over the years taxol has changed its identity, its status as property, and its association with different places (from the old-growth forests of Washington State to the government agencies of Washington, D.C., to laboratories in France). Taxol is not only a profitable pharmaceutical commodity and a substance injected into women with breast and/or ovarian cancer; it is also a natural product found in the bark of Taxus brevifolia (the Pacific yew, which is native to the North American Pacific Northwest) and a chemical substance that was discovered and brought to the point of commercial production in the public sector. We explore its role in several controversies: the destruction of old-growth forests, public participation in policy making, and the privatization of intellectual property and its effect on the price of drugs.

Antineoplastic Agents, Hormonal↗
PubMed2003

Health services research and development in practice: an Australian experience.

While there is a growing literature on how health services research can inform health policy decisions, the practical challenge is for health services researchers to develop an effective interface with health policy-making processes and to produce outputs that lead to outcomes. The experience of the Centre for Health Service Development at the University of Wollongong, Australia, is used to illustrate the issues so commonly described in the literature and to reflect on our experience of trying to remain viable while producing relevant and valid research. A case study in a specific policy area - namely, the development of case-mix classifications and information systems to inform policy and funding in the subacute and non-acute hospital and community care sectors - is used as a practical example of the research-policy interface.

Cooperative Behavior↗
PubMed2001

From irreversibility to participation: towards a participatory foresight for the governance of collective environmental risks.

This paper presents a reflection on the introduction of methods and tools of "participative foresight" for scientific and technology policy as well as environmental policy fields. Future studies have recently made a comeback under the label of foresight. Future technology studies no longer claim to forecast the future, but are presented as a strategic tool for improving interaction between key actors and for anticipatory policy making. They can be defined as a "process by which one comes to a fuller understanding of the forces shaping the long term future which should be taken into account in policy formulation, planning and decision-making" [Foresight in Federal Government Policymaking, Futures Res. Quart. (1985) 29]. We discuss applications of this approach for perspectives on environmental policy and sustainable development. Foresight opens up the possibility of negotiating a new and more fruitful relationship or 'social contract' between science and technology, on the one hand, and society on the other. The focus has moved from merely scientific and industrial insights to social demand, thus emphasizing the importance of both the production and "supply" of innovation, and the "demand" as signaled in the views of citizens.

Decision Making↗
PubMed1997

Climate change, human health, and sustainable development.

Human-induced climate change threatens ecosystems and human health on a global scale. In order to withstand the worldwide threats to ecosystems, the concept of sustainable development was introduced during the 1980s. Since then, this concept has been widely applied to guide and focus policy-making. The present article reviews the health consequences of human-induced climate change on sustainable development, particularly the potential impact of such change of food supply, natural disasters, infectious diseases, ecosystems, and sea level rise. Discussed is an integrated model containing the key indicators of sustainable development. The relevance of climate change, human health, and sustainable development for international climate change policy is also examined.

Climate↗
PubMed2002

From the state to the family: reconfiguring the responsibility for long-term nursing care at home.

This paper discusses the implications of the shift in the location of the provision of healthcare services from healthcare institutions to the home, which has occurred or is projected to occur in coming years. It is argued that the responsibility for the provision of care and assistance needed by the elderly living at home and people with long-term conditions living at home has shifted from public services to the family. Studies of care-givers have shown that in many situations they experience tremendous burdens, financial difficulties and health problems. Their social lives have been confined to the home, and contacts with friends and neighbors have been significantly reduced. This situation needs to be addressed by nurses, who in many cases serve as the bridge between the home and the official healthcare system. Using Foucault's exploration of power, particularly his idea of governmentality, a genealogy of care-giving in the home in Iceland's health-care has been constructed. The main findings were that, although this is occurring somewhat later than in many other countries, the state is withdrawing from its previously defined responsibility for the health and well-being of the nation. At the same time the citizen's responsibility for maintaining health is emphasized. Based on these findings, the argument is made that nurses in Iceland can have a profound influence on policy-making in relation to the organization of services provided in those homes. Suggestions are made as to how this can be done, which may be of interest to nurses in other countries.

Aged↗
PubMed1996

Policy relevance of the health expectancy indicator; an inventory in European Union countries.

Due to epidemiological transitions in population health both an increase in life expectancy and in chronic morbidity and disability have been observed in many countries. Consequently the tension between 'living longer' on the one hand and the 'quality of life' on the other have become a central health policy problem. The introduction of the indicator 'health expectancy' (HE), a measurement that combines mortality data with morbidity and disability data, was a logical reaction to these changes and to the growing need of a present-day yardstick to estimate this problem. The HE indicator is still under development, a process being furthered by the international network of researchers, REVES. A European project, called Euro-REVES, aims to promote and harmonize future HE calculations in Europe. To begin this project and to gain more insight into the indicator's policy relevance, an inventory has been carried out among policy makers, National Statistical Institutes and researchers in countries of the European Union (EU). This paper presents the results of the inventory, attempts to place these within a provisional classification system of HE types, and discusses the consequences of the findings for further conceptual harmonization and development of the indicator. Already 11 of the 15 ER member states have HE results available. The actual use of such results for policy making is increasing. Notwithstanding a great diversity in sources and questions used for the calculations, there seems to be enough simularity to give the harmonization effort a good perspective.

Chronic Disease↗
PubMed2001

A consumer perspective on informed consent and third-party issues.

Our two children were diagnosed with a rare genetic disorder, which led us to establish a research foundation. This led to in-depth consideration of issues surrounding informed consent from a consumer perspective. Third-party issues arose as central to the formulation of ethical policy in the establishment of a blood and tissue bank and an epidemiologic study. We suggest that a number of myths--privacy is possible, samples can be stripped of identifiers, humans are subjects, voluntary informed consent is attainable, genetics is about the individual only, genetic information is different than other medical information, research is altruistic, the public will learn truths about genetic research via media, and research is culturally competent--make it difficult to resolve the issues intrinsic to informed consent. A number of important elements could make policy decisions less complicated. These include conducting culturally competent research; conveying noncoercive hope, not hype; contacting the voluntary informant only; asking the informant to extend contact to other family members; requiring a comprehensive informed consent process for all contacted; and engaging in state-of-the-art data protections. There is a need for a "Genomic Hippocratic Oath," creating an ethical basis for research similar to the one vowed by health care professionals. Establishing ethical policies as a result of the collaboration of policy makers, researchers, and consumers will allow research to progress ethically at a rapid rate. If regulations are oppressive, they will thwart research; if they are too lenient, participants will not receive protections needed to participate safely.

Child↗
PubMed1991

Can the government govern? Lessons from the formation of the Veterans Administration.

The federal hospital system for veterans, established in the aftermath of World War I in a context of decentralization, privatization, and rejection of compulsory health insurance, seems an anomaly in health care policy-making. It is actually a good case of how the federal government achieves results in an area fraught with conflict: via normalization of crisis, containment of political decision making, and the association of the program with previously accepted goals (in this instance, workers' compensation). In the veterans' case, political judgments were transformed into scientific and bureaucratic decisions via the pragmatic use of experts. The system worked; the federal government governed.

Government Agencies↗