Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Development Policy”

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 1,333 records · Page 74Linked to original sources
PubMed2004

Patterns and correlates of treatment: findings of the 2000-2001 NSW minimum dataset of clients of alcohol and other drug treatment services.

The aim of this study was to provide an overview of the first year of the NSW Minimum Dataset for Alcohol and Other Drug Treatment Services data collection, including describing the patterns and correlates of people having received treatment in New South Wales. All closed treatment episodes for the 2000-2001 financial year were included for descriptive, univariate and multivariate analyses. There were 33,459 closed episodes of care in New South Wales in the 2000/2001 financial year. The majority of clients (69%) were male and the mean age was almost 34 years. The majority of treatment is sought for problems related to alcohol (37%) and heroin (33%) use. More than a third (40%) of clients were new to drug and alcohol treatment. Half the clients had a history of injecting drug use with 6.3% of those with heroin as their principal drug of concern, never having injected. The most common main service provided was in-patient withdrawal (26%). Multivariate logistic regression revealed that being older, not homeless, non-indigenous and having heroin as the principal drug of concern predicted receiving out-patient withdrawal management. Analyses of length of stay in residential treatments and number of service contacts in non-residential treatments are reported. The NSW MDS AODTS is a critical information source for policy development, service planning and surveillance. The results of this paper illustrate the utility of the data collection for identifying emerging issues in the patterns of drug use and service delivery for clients with alcohol and other drug problems.

Adolescent↗
PubMed2005

The general practitioner pharmacotherapy prescribing workforce: examining sustainability from a systems perspective.

As prescribers of opioid pharmacotherapies, general practitioners (GPs) are pivotal to the sustainability of opioid pharmacotherapy treatment services. The goal of this study was to examine the nature and sustainability of the Australian GP prescriber workforce in order to inform future programmes and policy development in this area. Data were collected from four Australian states: South Australia, Queensland, Victoria and New South Wales. Key features of the available data were: a heavy client load carried by a small number of prescribers, a high proportion of trained but inactive prescribers, and a high proportion (one-third to two-thirds) of medical practitioners who undertake training but do not take up prescribing, i.e. a high attrition rate. Available data indicate significant shortfalls in the number of prescribers available in each state to service this patient population. Across all states a relatively small number of prescribers were providing services for the majority of methadone clients. In order to achieve sustainable, high quality prescriber service provision, workforce development strategies are needed which focus on recruitment of new prescribers, and the support and retention of existing and inactive prescribers. Establishment of systematic and detailed data collection systems should also be considered a priority.

Adult↗
PubMed2002

Occupational safety communication for hazardous goods: the development of a policy in Israel.

Israeli policy governing written occupational safety information for carriage and supply of hazardous goods, and procedures for implementation, are described and evaluated for their potential communicative effectiveness, in view of users' linguistic abilities and the language employed. We also consider whether the addressee should include the end-user and the reading-impaired. The evaluation is set in the context of broader Israeli language policy, and comparison is made with communication policies for hazardous goods adopted by the European Union, the UK, and the USA.

Communication↗
PubMed2004

Mortality from external causes in Lithuania: looking for critical points in time and place.

AIM: A study was undertaken to analyse trends in mortality from major external causes of death, and to detect urban/rural differences by cut points over the period of socioeconomic transition. METHODS: Information on deaths from major external causes (traffic accidents, suicides, and homicides) for the 1990-2000 period was obtained from Lithuanian Department of Statistics. Mortality rates were age standardized, using the European standard, and analysed, according to (urban/rural) residence and sex. The Jointpoint analysis was used to identify the best-fitting points, wherever a statistically significant change in mortality occurred. RESULTS: The most critical point for external causes of mortality during the period of transition was the year 1994, when an increasing mortality trend reversed to a decreasing one. Mortality from suicides primarily caused these positive changes. Changes in mortality from traffic accidents were not significantly associated with the period under analysis. Numerous less favourable trends in rural areas, including suicide rates, traffic accidents, and homicides, are likely to stratify urban/rural health outcomes in the future. CONCLUSION: Despite a recent decline, mortality from external causes remains at an extremely high level in Lithuania. Future progress requires sustained improvements in prevention, and serious attention to external causes of death in health policy development.

Cause of Death↗
PubMed2004

Investigating genetic discrimination in Australia: opportunities and challenges in the early stages.

Genetic discrimination, defined as the differential treatment of individuals or their relatives on the basis of actual or presumed genetic differences, is an emerging issue of interest in academic, clinical, social and legal contexts. While its potential significance has been discussed widely, verified empirical data are scarce. Genetic discrimination is a complex phenomenon to describe and investigate, as evidenced by the recent Australian Law Reform Commission inquiry in Australia. The authors research project, which commenced in 2002, aims to document the multiple perspectives and experiences regarding genetic discrimination in Australia and inform future policy development and law reform. Data are being collected from consumers, employers, insurers and the legal system. Attempted verification of alleged accounts of genetic discrimination will be a novel feature of the research. This paper overviews the early stages of the research, including conceptual challenges and their methodological implications.

Australia↗
PubMedDate not supplied

Risk assessment for benefits analysis: framework for analysis of a thyroid-disrupting chemical.

Benefit-cost analysis is of growing importance in developing policies to reduce exposures to environmental contaminants. To quantify health benefits of reduced exposures, economists generally rely on dose-response relationships estimated by risk assessors. Further, to be useful for benefits analysis, the endpoints that are quantified must be expressed as changes in incidence of illnesses or symptoms that are readily understood by and perceptible to the layperson. For most noncancer health effects and for nonlinear carcinogens, risk assessments generally do not provide the dose-response functions necessary for economic benefits analysis. This article presents the framework for a case study that addresses these issues through a combination of toxicology, epidemiology, statistics, and economics. The case study assesses a chemical that disrupts proper functioning of the thyroid gland, and considers the benefits of reducing exposures in terms of both noncancer health effects (hypothyroidism) and thyroid cancers. The effects are presumed to be due to a mode of action involving interference with thyroid-pituitary functioning that would lead to nonlinear dose response. The framework integrates data from animal testing, statistical modeling, human data from the medical and epidemiological literature, and economic methodologies and valuation studies. This interdisciplinary collaboration differs from the more typical approach in which risk assessments and economic analyses are prepared independently of one another. This framework illustrates particular approaches that may be useful for expanded quantification of adverse health effects, and demonstrates the potential of such interdisciplinary approaches. Detailed implementation of the case study framework will be presented in future publications.

Animals↗
PubMedDate not supplied

Unifying susceptibility, exposure, and time: discussion of unifying analytic approaches and future directions.

This article reviews design and analysis concepts associated with the following major issues in air pollution epidemiology: (1) time-related determinants of health effects, including duration of exposure and disentangling acute effects and total life-shortening associated with long-term exposure; and (2) the role of geographies of susceptibility and exposure including the relevance and impact of ecologic covariates in the assessment of long-term effects of ambient air pollution. The article identifies the potential contribution associated with improved information in these areas to air pollution policy development and argues that these issues should frame future approaches to assessing the total effects of ambient air pollution.

Air Pollutants↗
PubMedDate not supplied

Insanity acquittee outcomes in New Zealand.

OBJECTIVE: This paper examines clinical and forensic outcomes for defendants found not guilty by reason of insanity in New Zealand, and explores the implications for policy development and clinical rehabilitation in this population. METHOD: All insanity acquittees disposed of by the courts as special patients after 1976 and released before 2004 are described. Their duration of inpatient care, rates of reconviction and rehospitalization following release are examined. The high resolution rate for violent crime reported to police suggests that reconviction rates are a reasonable proxy for violent reoffending. Factors predicting duration of inpatient care and reoffending are analysed. RESULTS: Severity of Index Offence was the only variable predicting duration of inpatient care of the 135 special patients. Offenders of more serious offences were securely detained for longer periods--averaging 6 years in the case of those charged with murder. Most patients were readmitted over the decade following discharge. Only 6% had violently reoffended 2 years after release into the community. Prior offending, age at release, ethnicity and gender predicted reoffending, but not diagnosis or duration of inpatient admission. CONCLUSIONS: Following discharge into the community, insanity acquittees are reconvicted of violent crimes at a very low rate, although readmission to hospital is common. It may be that insanity acquittees are initially detained in hospital longer than is clinically indicated, and that safe forensic community treatment can occur at an earlier stage of recovery without compromising public safety.

Adolescent↗
PubMed2004

Psychiatry and Islam.

OBJECTIVE: To explore psychiatry in Islam, with a view to informing Western psychiatrists working with Islamic patients, and Islamic medical students studying in Western countries. METHODS: The first necessary step was to acquire some understanding of Islam, Sharia and Sharia law, as the basis on which the available psychiatric literature was considered. Standard textbooks on Islam and English-language papers in the psychiatric literature were examined. Discussions with knowledgeable Muslim people were conducted. RESULTS: Islam shares roots with the other Abrahamic, monotheistic religions: Judaism and Christianity. A central issues is unity: the unity of God, unity with God and unity within the Islamic community. Islam is more than a religion, because it informs all aspects of behaviour and has been described as 'a comprehensive way of life'. Individualism is less important than the welfare of the community. The Sharia is a list of rules and regulations derived from authentic sources. Psychiatric services in Islam, according to Western standards, are somewhat limited. This issue is being addressed through epidemiological studies, provision of new services and policy development. Although mental health legislation is not universal, forensic psychiatry has a role, in many ways similar to that in the West. CONCLUSION: Islam is based on unity and core values of compassion, justice and benevolence. Islamic psychiatry has a proud early history, and advances are occurring. There is an opportunity for the profession of psychiatry to bridge religious, ethnic and cultural boundaries.

Australia↗
PubMedDate not supplied

World health organisation-international society of hypertension (WHO/ISH) hypertension guidelines.

Hypertension is now recognised as a very major contributor to disease burden globally. The close working relationship between the World Health Organisation (WHO) and the International Society of Hypertension (ISH) has existed for several decades and led to the production of a number of guidelines and statements. Since the publication of the 1999 WHO/ISH Guidelines for the Management of Hypertension, WHO determined in 2000 that in future the evidence base for all of its guidelines will be explicitly documented according to a defined methodology. In 2002 the World Health Report on Reducing Risks and Promoting Health Life documented the burden of disease (4.5%) related to blood pressure, and subsequently decided to establish comprehensive guidelines to help bring about a paradigm shift to a holistic multiple risk factor approach and facilitate policy development for implementation of population based strategies. ISH will be part of this process. The 2003 WHO/ISH Statement on Management of Hypertension focuses on key areas where new information has become available since the 1999 Guidelines, including establishment of thresholds and goals, treatment strategies and cost-effectiveness. It will be published in the Journal of Hypertension during 2003.

Global Health↗
PubMed1991

Collaborative education regarding prevention of human immunodeficiency virus transmission in healthcare settings--Ghana.

OBJECTIVE: To evaluate the effectiveness of a collaborative and participatory approach to professional training to reduce the risk of human immunodeficiency virus (HIV) transmission. SETTING: Healthcare settings in Ghana. METHODS: Two 5-day workshops were conducted for high-level nurse educators and leaders who could contribute to national policy development. A combination of didactics, skill development sessions, field experiences, and development of draft national guidelines and curriculum were used. Outcomes evaluated were pre-to-post training changes in HIV knowledge and attitudes and changes in practice within selected healthcare settings. One-month follow-up visits (times not specified to participants) were used to evaluate outcomes. RESULTS: At post-test, significantly fewer participants thought HIV was transmitted by saliva, sweat, or tears (chi square, p less than .0001), and significantly fewer reported hesitation to care for an HIV-infected patient because of lack of understanding about mode of transmission or because of lack of supplies, such as gloves (chi square, p less than .01). In field observations, there was an overall 42% improvement in specific infection control practices. CONCLUSIONS: A collaborative and participatory approach to training can result in significant changes in infection control practices, even in settings with limited resources.

Curriculum↗
PubMed1996

Management of healthcare workers with pharyngitis or suspected streptococcal infections.

The group A streptococcus may cause pharyngitis, rheumatic fever, streptococcal toxic shock syndrome, and serious skin and soft-tissue infections. More than 50 nosocomial outbreaks have been reported since 1966. For this reason, healthcare facilities should develop policies for the diagnosis and treatment of symptomatic hospital employees, and for the recognition and management of potential outbreaks. The clinical diagnosis of streptococcal pharyngitis is unreliable. Rapid streptococcal tests may be used for initial screening, but a negative rapid test should be confirmed with a properly obtained culture. Penicillin remains the treatment of choice, but new alternatives now include a 5-day course of either azithromycin or cefpodoxime.

Anti-Bacterial Agents↗
PubMed1999

A study of sex differences in presentation for care of HIV.

The current study examines sex differences in 183 male and 141 female patients presenting for care of HIV disease at an inner city hospital infectious disease clinic. Females (43%) were found to be less likely to have a history of illicit drug use (relative risk = .77, p < .01) and more likely to have become infected heterosexually (relative risk = 2.38, p < .01). However, a significant number of women reported both intravenous drug use (IVDU) and heterosexual exposure to an IVDU partner which complicates the analysis of the risk factors. Women sought testing because they knew that their sexual partners were HIV-positive (relative risk = 2.88, p < .01) Median CD4 counts at entry were significantly different (females = 340, males = 246; p < .01). Women were less likely to contract tuberculosis, the only infection which presented with a sex difference (relative risk = .38, p < .01) and to have previously had an AIDS defining infection (relative risk = .37, p < .01). Women took longer to progress to AIDS (42 vs. 19 months; p < .05). Survival of patients with AIDS was 51 months for females and 54 for males (p > 0.9). It did appear that the effect of a lower CD4 cell count on risk for death was magnified in patients who acquired their disease through heterosexual transmission. Women presented with higher CD4 counts, were more aware of their risk factors and fared better, with respect to progression to AIDS, than the men. The study underscored the impact of heterosexual transmission of the virus in women as well as the affect of this risk factor on disease progression. Hopefully, this information will initiate further studies on sex differences which will guide interventions and policy development.

AIDS-Related Opportunistic Infections↗
PubMed1999

Barriers to early detection of cervical-uterine cancer in Mexico.

In Mexico, a woman dies of cervical-uterine cancer every 2 hours, indicating a low impact by the national program for early detection of this cancer, principally because of problems related to quality and coverage. Through a qualitative study, we identified the principal barriers to use of the detection program from the point of view of actual and potential program users. Four focus groups were organized in standard conditions in Mexico City (urban, developed) and in the southern state of Oaxaca (rural, economically disadvantaged area). Participants were either women with at least one previous Papanicolaou (Pap) test or women who had never had the test. Barriers to Pap test use included (1) lack of knowledge about cervical-uterine cancer etiology, (2) not knowing that the Pap test exists, (3) the conception that cancer is an inevitably fatal disease, (4) problems in doctor/medical institution-patient relationships, (5) giving priority to unmet needs related to extreme poverty, (6) opposition by the male sexual partner, (7) rejection of the pelvic examination, (8) long waits for sample collection and receiving results, and (9) perceived high costs for care. To increase coverage of the early detection program for cervical-uterine cancer in Mexico, the needs, perceptions, and beliefs of women and their partners must be taken into account when developing policy and planning, given the role these factors play in the decision-making process that leads to their participation or nonparticipation in this program.

Adult↗
PubMed2006

The U.S. Army telemedicine program: general overview and current status in Southwest Asia.

This paper presents and discusses the U.S. Army telemedicine support systems currently available to our deployed forces in Southwest Asia. Organization and structure of the support system are discussed, along with some of the business rules and policies developed for its use. Some of the lessons learned are directly applicable to any type of large-scale telemedicine deployment, civilian or military.

Asia, Western↗
PubMed1999

Introduction: the use of body mass index to assess obesity in children.

The International Obesity Task Force (IOTF) was established in 1994 to address the increase in the worldwide prevalence of obesity. The goals of the IOTF are to 1) raise awareness in the population and among governments that obesity is a serious medical condition, 2) develop policy recommendations for a coherent and effective global approach to the management and prevention of obesity, and 3) implement appropriate strategies to manage and prevent obesity on a population basis worldwide. To assess the global prevalence of obesity in children and adolescents, the IOTF convened a workshop on childhood obesity to determine the most appropriate measurement to assess obesity in populations of and adolescents around the world. At the workshop, a variety of issues related to this problem were considered--including the best measure of fatness, the effect of application of a variety of existing standards on the prevalence of obesity in the same population, and the role of factors such as visceral adiposity and natural history in the definition of obesity. This article and those that follow represent the information presented at the workshop. The workshop concluded that the body mass index (BMI; in kg/m2) offered a reasonable measure with which to assess fatness in children and adolescents and that the standards used to identify overweight and obesity in children and adolescents should agree with the standards used to identify grade 1 and grade 2 overweight (BMI of 25 and 30, respectively) in adults.

Adipose Tissue↗
PubMed2002

Commentary: what contributes to a successful career in epidemiology in the United States?

The authors conducted a study examining perceived enabling factors and barriers to a successful career in epidemiology, the role of mentoring in facilitating one's career, where graduates are most often being employed, and key competencies for future epidemiologic training. During June to August 2001, they surveyed senior epidemiologists across the United States (n = 248) in four sectors: state health departments, the Centers for Disease Control and Prevention, the National Institutes of Health, and schools of public health. The top enabling factors were dedication to hard work and having an intrinsic curiosity and a sense of discovery. The most frequently cited barrier was balancing career and family life, except among minority respondents, for whom an unsupportive supervisor was the leading obstacle. Influential characteristics of a mentor were high integrity and the provision of inspiration and encouragement. The top competencies anticipated for the next 10 years were skills working in multidisciplinary teams and in using modern information technologies. Important competencies varied somewhat according to work sector. These findings may be useful in training and career planning among aspiring epidemiologists and for educational policy development among organizations promoting training and mentoring.

Adult↗
PubMedDate not supplied

Tropical medicine or tropical health: the Heath Clark lectures, 1988.

Tropical medicine as a specialty began during colonialization of the tropics. From the outset, controversy focused on scientific research (tropical medicine) vs. public health (tropical health). The former became associated with parasitology to the relative exclusion of microbiology. Remarkable discoveries made before 1912 were followed by sixty years of slow progress. In the last decade, however, not only has parasitic disease research flourished, but the major importance of bacterial and viral diarrheas and respiratory infections has also been revealed. Tropical health did not evolve as a major strategy in the colonial era. Later, a global eradication policy developed, first for hookworm infection, then for yellow fever and malaria, but failure led to disillusionment with technology and development of an undifferentiated approach to primary health care. In the last decade a selective approach has focused on diseases for which cost-effective control measures exist. Moreover, several developing countries have achieved good health at low cost by equitable distribution of health care, education, and food. Today, the conflict between tropical medicine and tropical health is being resolved with the realization that they are truly complementary disciplines.

History, 19th Century↗