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At least 721 records · Page 40Linked to original sources
PubMed2001

Infection control policies and practice in Pakistan.

OBJECTIVE: Infectious diseases in Pakistan are one of the main contributors to the burden of disease. The objectives of this article were to examine the various facets of the issue and suggest relatively inexpensive improvements. SETTINGS: The status of infections/infectious diseases both in hospitals and community were considered. METHODS: Studies on infectious diseases from Pakistan published in national and international journals were reviewed and compared with those from more advanced countries. Anecdotal observation and common experience provided bases for some of the points made. RESULTS: The article argues for some cost-effective and readily workable infection control measures in hospital and community. Government department and other organizations that can be mobilized to develop policies on the relevant issues have been identified. CONCLUSION: The article highlights the need for establishing surveillance system for infections and antibiotics on which to base further policies. As with some other development in the country, a culture of accountability in healthcare might provide sound basis for future developments.

Cross Infection↗
PubMed2004

Defining the great debate.

Treatment guidelines offer a credible approach to MCO management of specialty pharmaceuticals by basing decisions on the best available scientific evidence. Drawbacks to using guidelines include lack of available evidence, bias on the part of the expert team, a lack of currency, and difficulties in implementation. Treatment guidelines can and often do serve, along with product labeling, as the basis for reimbursement and usage rules as specified in MCO medical policies. The relationship between provider-oriented guidelines and payment criteria varies by payer, with implications for care quality, cost, and access. Increased awareness of the advantages and disadvantages of using treatment guidelines to shape prescribing policies for specialty pharmaceuticals may lead to worthwhile non-product-specific discussions within MCOs about sources and methods used in medical policy development.

Drug Labeling↗
PubMed1991

Introducing healthy catering practice into hospitals: a case study from Wales.

This paper describes results from a study examining the introduction of policies to promote healthy catering in 102 hospitals in Wales. Policy development and implementation followed the publication of two major reports in the UK highlighting the relationship between poor nutrition and subsequent high levels of cardiovascular disease and cancer. Changes in hospital catering services were advocated in response to these reports. The study examines the translation of policy intentions into practical action in hospitals. It identifies achievements in implementing changes in catering practice, and promotion of healthier meals for staff, patients and visitors to hospitals. Important organisational problems and external constraints, including cost, are also highlighted. The authors recommend that greater effort is put into the implementation process following policy decisions, including consideration of training needs, the development of effective communication, and establishment of mechanisms for feedback and review.

Food Service, Hospital↗
PubMed1996

Development of a policy on sexuality for hospitalized chronic psychiatric patients.

OBJECTIVE: This paper describes the need for and development of a policy on patient sexuality implemented at a provincial psychiatric hospital. METHOD: The need for a policy was assessed by reviewing the literature and interviewing a sample of chronic psychiatric patients. Development of the policy involved surveying 38 Canadian psychiatric hospitals in search of an existing policy to use as a model, as well as soliciting input from a variety of stakeholders and 2 lawyers. RESULTS: Both the literature review and patient interviews indicated that a substantial number of hospitalized chronic psychiatric patients are sexuality active. Neither the literature nor the survey of Canadian psychiatric hospitals revealed an existing policy to use as a model. Consequently, a policy was drafted by a task force composed of stakeholders and 2 lawyers. Characteristics of the policy, possibly the first in Canada, are described. The legal basis for the sexual rights of patients is discussed, and the mechanisms for protecting patients from harm are also described. CONCLUSION: Fundamentally, a policy must balance the patient's right to sexual intimacy in a dignified setting with the hospital administration's duty to take reasonable steps to protect patients from harm.

Adult↗
PubMed1990

Creative policy-making. Strategies for working with the healthy chronically diseased employee.

As society ages and employees remain in the workplace longer, business managers must develop policies for maintaining the healthy chronically diseased employee in the workplace. With continuing increases in health care insurance costs, business should begin to look at chronic conditions which require repeat visits as well as "big ticket items." Based on an employee perspective approach, a model which presents three categories of healthy chronically diseased employees is utilized in teaching self care activities to insure a productive outcome for the employee. Self-care activities are a key component of the health promotion model, of which four aspects are included: information giving and seeking, encouraging self-responsibility, decision-making, and continued support and follow up.

Chronic Disease↗
PubMed1996

The new politics of child and family policies.

Given the slowdown in the legislative process and the absence of any closure on the proposed congressional initiatives on social safety net programs, the specifics of the policy developments are still unclear. What is clear, however, is that the United States is entering a period of social policy devolution, federal (and probably state) funding cuts for social benefits and services, and a major philosophical shift in the premises underlying social policy. These policy trends have major implications for the social work profession, for practitioners at all levels, for educators, and most important for low-income and vulnerable children and their families. Social workers need to become informed about these developments if they are to be effective practitioners, teachers, and advocates.

Aid to Families with Dependent Children↗
PubMed1985

Social policy and drug dependence: an historical case study.

A detailed examination is presented of the background to the reports and policy developments concerning drug dependence which emerged in Britain during the 1960s. Analysis of documents and interviews with policy makers, officials and doctors involved in the events of the period, reveal that explanatory models in terms of 'moral panic' or 'power struggle' tend to oversimplify the complex processes involved. The role in policy formation of the media, government departments and groups within the medical profession is considered. The patterns of conflict and convergence are seen to overlap simple lines of 'interest'--we find conflict within the medical profession, convergence between the Home Office (legal) and elements of the medical professions (medical). The resulting legal and institutional framework involved only loose guidelines from the centre about treatment, and the shape of policy was determined by individual doctors in the new hospital treatment centres. The apparent re-run of the 1960s being staged in the 1980s will require detailed research in the future in order to avoid superficial comparisons.

History, 20th Century↗
PubMed1997

The lessons of user fee experience in Africa.

This paper reviews the experience of implementing user fees in Africa. It describes the two main approaches to implementing user fees that have been applied in African countries, the standard and the Bamako Initiative models, and their common objectives. It summarizes the evidence concerning the impact of fees on equity, efficiency and system sustainability (as opposed to financial sustainability), and the key bottlenecks to their effective implementation. On the basis of this evidence it then draws out three main sets of lessons, focusing on: where and when to implement fees; how to enhance the impact of fees on their objectives; and how to strengthen the process of implementation. If introduced by themselves, fees are unlikely to achieve equity, efficiency or sustainability objectives. They should, therefore, be seen as only one element in a broader health care financing package that should include some form of risk-sharing. This financing package is important in limiting the potential equity dangers clearly associated with fees. There is a greater potential role for fees within hospitals rather than primary facilities. Achievement of equity, efficiency and, in particular, sustainability will also require the implementation of complementary interventions to develop the skills, systems and mechanisms of accountability critical to ensure effective implementation. Finally, the process of policy development and implementation is itself an important influence over effective implementation.

Africa↗
PubMed1999

End-of-life decisions: the policy issue that will not die.

In most jurisdictions, public policy regarding assisted death has not advanced beyond simple prohibition. However, this issue is increasingly likely to reach the policy agenda. Policy-makers may be tempted to turn for guidance to the three places in the world with developed policy or legislation: the Netherlands; the American state of Oregon; and the Northern Territory in Australia. A review of their legislation and relevant guidelines reveals that they rest on four shared assumptions: the neutral assessor status of physicians; the primacy of pain as a validator of requests for assisted death; the need to exclude depression from influencing the decision-making process; and the exclusion of non-clinical existential factors in granting access to assisted death. Recent research in health services raises questions as to the validity of each of these assumptions. This, in turn, has implications for future public policy on assisted death.

Australia↗
PubMed1995

Delivery systems for preschool children.

The United States dental care delivery system generally performs well for those who gain access and can afford necessary care; however, many segments of the population with significant levels of dental disease find it difficult or impossible to avail themselves of the potential benefits that the system has to offer. Preschool children are no exception, and they often receive little or no consideration in epidemiologic studies or policy development. Increasing awareness and improving preschooler's access to needed services will require fundamental changes in attitudes, policies, and behaviors on the part of the public, public officials, and health care professionals, including those within the dental profession.

Child, Preschool↗
PubMed1999

Psychosocial rehabilitation services in community support systems: a review of outcomes and policy recommendations.

OBJECTIVE: This review examines the place of psychosocial rehabilitation services within community support systems in light of the need for mental health service systems to develop policies to direct the use of limited resources. METHODS: Literature reporting experimental or quasi-experimental outcome studies of psychosocial rehabilitation interventions for persons with severe and persistent mental illnesses was reviewed, with a focus on skills training, family psychoeducation, and supported employment. A meta-analysis of the findings from recent outcomes studies was done. An integrative cost-outcome analysis examined allocation of resources among various levels of service intensity. RESULTS: The clinical characteristics and service needs of persons with serious and persistent mental illness vary significantly throughout the life cycle and course of the illness. Outcomes research strongly supports use of psychosocial rehabilitation but is insufficiently developed to determine the effects of service components used at varying levels of intensity and the interaction of those components with client characteristics, medication levels, or phase of the illness. Cost-effectiveness studies of psychosocial rehabilitation show an average reduction of more than 50 percent in cost of care due to reduced hospitalizations. CONCLUSIONS: Continued research is required to further specify the effects of psychosocial interventions and to determine the most effective amount and intensity of those interventions. Current evidence supports a policy of funding the psychosocial rehabilitation components of community support systems and balancing allocations for these systems among various levels of service intensity.

Cognitive Behavioral Therapy↗
PubMedDate not supplied

[The "Participatory" Movement: a contribution to the history of Brazilian nursing].

This study outlines the beginnings and principles of the "Participatory" Movement (MP), which was created in opposition to the policies developed by the administration of the Brazilian Association of Nursing (ABEn). It starts in the 1980's, and criticizes ABEn for: a) reproducing the official policies and the medical industry's interest; b) being a centralizing and authoritarian organization; c) focusing mainly on the scientific and cultural development of nurses, while minimizing the importance of political-professional reflection, as well as the role of the profession and professional associations in the social-historical context; d) not participating in the formulation of public health policies. The "Participatory" Movement wins the elections of ABEn and takes over the association in 1986. The results of this new practice are still under construction. The achievements and withdrawals of ABEn will depend on our capacity of building a profession that is technically competent, critical, creative and, above all, socially acknowledged as an ally in the defense of the right to health.

Brazil↗
PubMed2004

Nailing health planks into the foreign policy platform: the Canadian experience.

Foreign policy, especially trade policy, can have dramatic but rarely considered effects on public health. International human rights covenants oblige governments to scrutinise their foreign policy, including trade policy, for its impact on the progressive realisation of the right to health. Health is both a means and an end of development policy, but government investments in health are inadequate to reduce health disparities within and between nations. Few donor countries provide the agreed target of 0.7% of gross national income for development aid or toward reaching the Millennium Development Goals. The progressive liberalisation requirement of the General Agreement on Trade in Services (GATS), if applied to commitments in health care, education, and water and sanitation services, may conflict with the progressive realisation obligation of the right to health. Alternatives to regulating trade in such essential services are proposed in this article.

Canada↗
PubMed2002

Managing for health: why health care?

Health and health care are increasingly big business. The challenge is to apply our knowledge and skills to meet people's needs, if not their demands as efficiently, effectively and beneficially as possible. "Value for money" is the slogan. For those who deliver the goods as required, the converse. "money for value" should equally apply, and not only in a market driven system. This paper offers a very personal view of these issues in the light of recent UK policy developments.

Delivery of Health Care↗
PubMed1997

Health, Society and Alcohol.

The European Conference, Health, Society and Alcohol held in Paris, 12-14 December 1995, was a meeting point between science and policy. Science informed the policy process. As a tool for policy implementation, the Conference adopted the European Charter on Alcohol, a set of ethical principles and strategies for action. Of a number of important issues that frame policy, three deserve mention. First, market forces, as opposed to health and social policy decisions are increasingly influencing the policy debate. Second, existing policy options to reduce alcohol-related harm are unlikely to lead to an increased risk of coronary heart disease among older age groups. And third, policy developments and changes in drinking patterns in countries of southern Europe are an important driving force in European policy on alcohol.

Alcohol Drinking↗
PubMed2002

Does the school nurse have a role to play in school discipline?

Student discipline has become a subject of increasing concern at local, state, and national levels. This article is a discussion of current federal, state, and local school district legal requirements for student discipline in public schools with examples that illustrate several issues that could or should involve a school nurse. A brief history of the legal developments in school discipline includes key U.S. Supreme Court decisions and Acts of Congress. School district options in policy development and disciplinary procedures are discussed. Some of the discipline incidents include issues of nurse-patient confidentiality.

Confidentiality↗