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At least 523 records · Page 29Linked to original sources
PubMed2000

Gauging the effects of mass media policies: what do we need to know?

This article explores the components of an effective mass media policy and the role of mass media campaigns as part of a comprehensive set of tobacco control strategies. First, the main findings of the empirical literature are briefly reviewed. Then a framework for understanding mass media policies is developed showing the influence of concurrent tobacco control policies and the interrelationship between the two. A model will be presented that draws on concepts and research from the advertising and marketing literature, as well as from public health studies. A discussion of limitations of the extant literature and issues that warrant further examination will conclude.

Advertising↗
PubMedDate not supplied

Beyond risk: an ecological paradigm to prevent global chemical pollution.

Since World War II, synthetic chemical pollutants have accumulated in the environment and food webs on a global basis, have damaged wildlife populations, and may pose large-scale hazards to human health. Despite the global nature of this problem, the vast majority of environmental regulations focus on preventing local risks using risk assessment of individual compounds, discharge permits, and control and disposal technologies. The current approach has failed to prevent global contamination and environmental damage because it underestimates the scale, complexity, and diversity of the hazards of chemical pollution. Fundamental shifts in the mode of chemical assessment and policy are required; a new framework should focus on chemical classes rather than individual substances, convert industrial processes to prevent the production and use of persistent and/or bioaccumulative substances, and shift the default state of pollution policy in the face of uncertainty from permission to restriction.

Environment↗
PubMedDate not supplied

Prevention and health policy: a view from the social sciences.

A theoretical framework is outlined which identifies four major problem areas which must be dealt with in the formulation, implementation, and evaluation of social policy. Certain issues relevant to policy concerning health promotion and disease prevention are discussed within this framework. The first problem area, adaptation, is concerned primarily with resources; the second area, goal attainment, deals with organizational issues; the third, integration, is concerned with motivations; the fourth, pattern maintenance, concentrates on questions of values. Policymaking is seen as an attempt by governing bodies to resolve problems in all these areas, and the success of any policy may be judged by the extent to which major issues in each area are dealt with equitably and reasonably.

Canada↗
PubMed1999

Targets and systems of health care cost control.

Discussion of health care cost control policy and politics tends to focus on terms such as "market," "government," and "managed care" that are either too general or too value laden to encourage sound analysis. This article proposes an alternative framework for classifying cost control policies. It first distinguishes targets from systems of control. Targets can then be divided into categories of service (e.g., hospital care, pharmaceutical treatment) and components of cost (e.g., price and volume). Systems can be classified in terms of the degree of pooling of finance, ranging from no insurance to a single pool of funds, and how payment of providers is organized, ranging from all payers paying all providers on the same terms to extensive selective contracting among payers and providers. The article analyzes examples of target policy and politics, system policy and politics, and how system choices can influence which targets are targeted how well, so as to show that both policy consequences and political alignments become clearer by using these terms. As one instance, discussions of "managed care" are often confused because the term has two meanings, one referring to target policy and one to system policy.

Cost Control↗
PubMed2006

An epidemic of abuse and violence: nurse on the front line.

This commentary paper highlights the every day reality for nurses facing episodes of violence and aggression while working in the health care system in Western Australia and identifies future research necessary to address the problem. Nurses, in a range of work environments, face the terrifying possibility of being victims of aggressive and violent incidents while caring for patients. The consequences of these events are far reaching and include an increased cost to the health care system, loss of experienced nurses from the workforce and the inability to attract nurses back to the bedside. Although the West Australian government has attempted to address the problems with quick fixes, no current initiatives have been effective and nurses are still experiencing assault in ever increasing numbers. To ensure that nurses stop being the victims of these events it is essential that nurses, government and the community refuse to accept that violence and aggression are 'just part of the job'. Sound research is important in raising awareness and providing direction for hospital policy and practice. Furthermore, future research in the area has to investigate the phenomenon as a whole taking into consideration all aspects of these events. The results of this research must then form the framework for future education programs, policies and best-practice guidelines for safety of nurses and ultimately patient care.

Benchmarking↗
PubMed2005

A decision support for an integrated multi-scale analysis of irrigation: DSIRR.

The paper presents a decision support designed to conduct an economic-environmental assessment of the agricultural activity focusing on irrigation called 'Decision Support for IRRigated Agriculture' (DSIRR). The program describes the effect at catchment scale of choices taken at micro scale by independent actors, the farmers, by simulating their decision process. The decision support (DS) has been thought of as a support tool for participatory water policies as requested by the Water Framework Directive and it aims at analyzing alternatives in production and technology, according to different market, policy and climate conditions. The tool uses data and models, provides a graphical user interface and can incorporate the decision makers' own insights. Heterogeneity in preferences is admitted since it is assumed that irrigators try to optimize personal multi-attribute utility functions, subject to a set of constraints. Consideration of agronomic and engineering aspects allows an accurate description of irrigation. Mathematical programming techniques are applied to find solutions. The program has been applied in the river Po basin (northern Italy) to analyze the impact of a pricing policy in a context of irrigation technology innovation. Water demand functions and elasticity to water price have been estimated. Results demonstrate how different areas and systems react to the same policy in quite a different way. While in the annual cropping system pricing seems effective to save the resource at the cost of impeding Water Agencies cost recovery, the same policy has an opposite effect in the perennial fruit system which shows an inelastic response to water price. The multidimensional assessment conducted clarified the trades-off among conflicting economic-social-environmental objectives, thus generating valuable information to design a more tailored mix of measures.

Agriculture↗
PubMed2006

Science-policy in environmental and health risk assessment: if we cannot do without, can we do better?

How can empirical evidence of adverse effects from exposure to noxious agents, which is often incomplete and uncertain, be used most appropriately to protect human health? We examine several important questions on the best uses of empirical evidence in regulatory risk management decision-making raised by the US Environmental Protection Agency (EPA)'s science-policy concerning uncertainty and variability in human health risk assessment. In our view, the US EPA (and other agencies that have adopted similar views of risk management) can often improve decision-making by decreasing reliance on default values and assumptions, particularly when causation is uncertain. This can be achieved by more fully exploiting decision-theoretic methods and criteria that explicitly account for uncertain, possibly conflicting scientific beliefs and that can be fully studied by advocates and adversaries of a policy choice, in administrative decision-making involving risk assessment. The substitution of decision-theoretic frameworks for default assumption-driven policies also allows stakeholder attitudes toward risk to be incorporated into policy debates, so that the public and risk managers can more explicitly identify the roles of risk-aversion or other attitudes toward risk and uncertainty in policy recommendations. Decision theory provides a sound scientific way explicitly to account for new knowledge and its effects on eventual policy choices. Although these improvements can complicate regulatory analyses, simplifying default assumptions can create substantial costs to society and can prematurely cut off consideration of new scientific insights (e.g., possible beneficial health effects from exposure to sufficiently low 'hormetic' doses of some agents). In many cases, the administrative burden of applying decision-analytic methods is likely to be more than offset by improved effectiveness of regulations in achieving desired goals. Because many foreign jurisdictions adopt US EPA reasoning and methods of risk analysis, it may be especially valuable to incorporate decision-theoretic principles that transcend local differences among jurisdictions.

Decision Theory↗
PubMed2002

Reproductive health and health sector reform in developing countries: establishing a framework for dialogue.

It is not clear how policy-making in the field of reproductive health relates to changes associated with programmes for the reform of the health sector in developing countries. There has been little communication between these two areas, yet policy on reproductive health has to be implemented in the context of structural change. This paper examines factors that limit dialogue between the two areas and proposes the following framework for encouraging it: the identification of policy groups and the development of bases for collaborative links between them; the introduction of a common understanding around relevant policy contexts; reaching agreement on compatible aims relating to reproductive health and health sector change; developing causal links between policy content in reproductive health and health sector change as a basis for evidence-based policy-making; and strengthening policy-making structures, systems, skills, and values.

Communication Barriers↗
PubMedDate not supplied

Health care technology in the Federal Republic of Germany.

The basic goal of the German health care system is equal access to all medical services for all citizens. The federal government sets the legal framework for the system, but most health policy decisions are made through bargaining between large organizations within a legal framework. The federal government took little active role in health care until the early 1990s, when it became increasingly apparent that budgeting and other cost containment measures seemed to be insufficient to successfully reduce the growth of mandatory sickness funds expenditures. A 1993 law has attempted to address some of the most obvious deficiencies in the system, while encouraging a market-oriented approach to health care. Health care technology assessment has almost no role in the German health care system. Attempts by professionals and politicians to introduce technology assessment into the health care arena have been largely unsuccessful.

Cost Control↗
PubMed2004

A framework for the integration of ecosystem and human health in public policy: two case studies with infectious agents.

Despite that a significant body of published literature exists in the complex area of interconnection among the environment, ecosystems, and human activity, relatively little attention has been paid to the integration and analysis of ecological and human health data in the form of a conceptual model. Human and ecological health protection generally have been treated as separate domains of policy, with significant differences in both the analytic methods used to characterize risks and the policies developed for risk reduction. Understanding the relationships among population growth, development, natural resource use, the environment, human health, and ecosystems is an important area of both scientific inquiry and environmental policy. The present paper focuses on the development of a conceptual model for understanding disease causation, particularly infectious disease, and the implications of such a model for public policy. The conceptual model incorporates ecological and human health risk assessment information applied to case studies of two infectious diseases. This article takes an initial step toward formalizing the conceptual model so that research and assessment procedures can be developed.

Agriculture↗
PubMed2000

Introduction to classical swine fever: virus, disease and control policy.

Classical swine fever virus is a spherical enveloped particle of about 40-60 nm in diameter with a single stranded RNA genome of about 12,300 bases with positive polarity, classified as a pestivirus within the family Flaviviridae. Natural hosts are domestic and wild pigs. The virus causes one of the most severe diseases in pigs world wide with grave economic consequences. The clinical picture of classical swine fever is variable, depending on the age of the affected animals and viral virulence. The virus is well characterised and reliable laboratory diagnostic procedures are available. In many parts of the world live attenuated vaccines are being used as a safe and efficient prophylactic tool. However, in EU Member States and several other countries vaccination is prohibited and CSF is controlled by a strict stamping out policy. In order to overcome the disadvantages of conventional vaccination inactivated marker vaccines have been developed that enable the distinction between vaccinated and infected animals. Whether these vaccines will be accepted as an additional tool in the framework of the stamping out policy is not yet decided.

Animals↗
PubMedDate not supplied

[Analysis of health policies, a new field?].

Health policies are discussed within the framework of State Programs, reviewing its origins as a field of study in the United States, Latin America and Europe. The efforts to develop research and teaching in this area in Mexico are analyzed. A definition of health policies is proposed, as "the set of decisions, actions, and omissions that reflect, in a given time and place, the State's position on the health problems of the population". The difference between "policies" and "politics" is discussed, and the development of public policies is briefly reviewed. The reasons for including this area of study in the Master's degree in a public health curriculum are given.

Health Policy↗
PubMedDate not supplied

Reforms and child development.

Since their inception in the 1930s, U.S. welfare and income support programs have played an important role in providing benefits to children. Unlike programs directly targeted to children, however, welfare programs are designed to produce economic and employment impacts on adults, so that any effects on children would be indirect. This article explores the influence of such programs on children's well-being and development, first by defining goals for children's healthy development, then by proposing a framework for understanding the impact of welfare policies on children. A review of the literature within each component of this framework reveals the following: Measures of children's well-being should encompass physical, intellectual, social, and emotional development. The physical and material environment, family environment, and social and community environment can all affect a child's healthy development. Policies designed to increase maternal employment, reduce welfare use, and strengthen families do not necessarily lead to more positive environmental contexts and increased child well-being. The author concludes that to ensure positive impacts on children, welfare and income support policies must move beyond their exclusive emphasis on adults and include goals that focus on improving children's social and physical environments at home and in the community.

Adolescent↗
PubMed1995

How labour market experiences of migrants differ: Australia and Austria compared.

The author compares migration policies and their economic impact in Australia and Austria. "The second section of the article presents the framework of Austrian and Australian migration policy....A comparison of the Austrian and Australian Gross Domestic Product (GDP)/unemployment/foreign employment-relationships displays different forms of flexibility. The third section of the article examines some distinctive features of migrants in both countries, including labour force participation, distribution by industry, wage policy and unemployment. The final section is a brief summary and some political reflections." (SUMMARY IN FRE AND SPA)

Australia↗
PubMed1990

Overlooked connections: policy development and implementation in state-local relations.

Increased public demand for health services, combined with fiscal and operating restraints, has led to the need for programs that will operate efficiently and effectively to achieve their objectives. Establishing such programs requires an understanding of the factors that contribute to their development and implementation. This in turn requires a greater understanding of the policy formulation and policy implementation processes. This paper uses a case study of Michigan's State/Local Cost Sharing Program to explore how policy formulation links to and influences implementation; it considers the interaction between the administrative and political processes and how they are affected by shifting power relations, constituencies, and the environment, and how in turn these affect program leadership and operating policies. The paper develops a model as a framework for monitoring the course of the program through the policy cycle and recommends that the policy process be considered as dynamic, interactive, and evolutionary. The case study approach allows for a greater understanding of the phases of the process, their interaction, and their impact on specific policy outcomes.

Community Participation↗
PubMed2006

Building the evidence base for effective tobacco control policies: the International Tobacco Control Policy Evaluation Project (the ITC Project).

The Framework Convention on Tobacco Control (FCTC) is a seminal event in tobacco control and in global health. Scientific evidence guided the creation of the FCTC, and as the treaty moves into its implementation phase, scientific evidence can be used to guide the formulation of evidence-based tobacco control policies. The International Tobacco Control Policy Evaluation Project (ITC Project) is a transdisciplinary international collaboration of tobacco control researchers who have created research studies to evaluate and understand the psychosocial and behavioural impact of FCTC policies as they are implemented in participating ITC countries, which together are inhabited by over 45% of the world's smokers. This introduction to the ITC Project supplement of Tobacco Control presents a brief outline of the ITC Project, including a summary of key findings to date. The overall conceptual model and methodology of the ITC Project--involving representative national cohort surveys created from a common conceptual model, with common methods and measures across countries--may hold promise as a useful paradigm in efforts to evaluate and understand the impact of population-based interventions in other important domains of health, such as obesity.

Evidence-Based Medicine↗
PubMed2002

The elderly nutrition program: an effective national framework for preventive nutrition interventions.

OBJECTIVE: To guide national policy, Congress mandated the 1992 research evaluation of the Elderly Nutrition Program (ENP), the nation's oldest framework for providing community- and home-based preventive nutrition and health-related services to older persons. This article summarizes key findings on the program's influence on nutritional health, the targeting and costs of its nutrition services, and the study's policy implications. DESIGN: The research included a nationally representative sample of ambulatory and homebound ENP participants And a matched sample of nonparticipants drawn from the US Health Care Financing Administration's Medicare beneficiary listings. Interviews conducted in respondents' homes considered demographic and health characteristics and assessed anthropometry and physical functioning, nutrient intake and socialization patterns, and utilization of ENP program services (participants only). Administrative and service delivery data were gathered from all levels of the ENP infrastructure. RESULTS: The ENP program currently provides congregate and home-delivered meals and other nutrition- and health-related services to about 7% of the older population overall, including an estimated 20% of the nation's poor elders. Compared with nonparticipants, ambulatory and homebound ENP participants are better nourished (4% to 31% higher mean daily nutrient intakes; P<.001) and achieve higher levels of socialization (17% higher average monthly social contacts; P<.001). Federal spending on ENP nutrition services is efficiently leveraged by funding from other public and private sources, allowing ENP to more than double the nutrition services it provides to program participants. CONCLUSIONS: ENP is a well-targeted, effective, and efficient federal program available to dietetics and other professionals for providing elderly persons with community-based and home-delivered nutrition and related services. The ENP infrastructure offers a potential model for preventive nutrition intervention programs in ambulatory and homebound at-risk older populations.

Activities of Daily Living↗
PubMed2006

Reproductive health policies in President Bush's second term: old battles and new fronts in the United States and internationally.

The current Bush Administration has made dramatic changes in US domestic and international reproductive health policies. This paper discusses the issues involved in some of these changes, and it considers likely developments in this area during the remainder of George W. Bush's second term. The first section of the paper defines the term reproductive health and presents a framework for classifying reproductive health policies. The second section examines changes that the Administration has made in domestic family planning policies. The third section looks at analogous changes in American assistance for reproductive health internationally. The final section considers the implications of these trends for future policy and women's health.

Abortion, Induced↗