The politics of peanut butter.
Conflicting studies and special interest groups make developing policies to protect public health contentious and chaotic. How can lawmakers recognize 'sound' science and make good decisions?
Consumer Product Safety↗
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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.
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Nurses begin a national plan for the integration of supportive care in health research, practice, and policy.
The demand for and use of health, social, and other human services is related not to the type or severity of disease but rather to a person's socio-economic, cognitive, and emotional characteristics and environmental circumstances. A workshop on supportive care was held to promote a robust research environment, the creation of new knowledge, the setting of an integrated health research agenda, a focusing of attention on the evolving health-care system, and anticipation of emerging health challenges. While the workshop was intended to address a research mandate for the Canadian Institutes of Health Research, a larger vision emerged, to include advocacy, information system, surveillance, and policy development required by institutional, community, voluntary, private sector, family caregiver, and provider systems. The development of a national supportive care strategy will enable Canadians with disease and disability to live with all of their challenges, and could engage researchers, clinicians, advocacy groups, and people experiencing major health challenges.
Canada↗
Accelerated publication versus usual publication in 2 leading medical journals.
BACKGROUND: A number of medical journals have developed policies for accelerated publication of articles judged by the authors, the editors or the peer reviewers to be of special importance. However, the validity of these judgements is unknown. We therefore compared the importance of articles published on a "fast track" with those published in the usual way. METHODS: We identified 12 "case" articles--6 articles from the New England Journal of Medicine that were prereleased on the journal's Web site before publication in print and 6 "fast-tracked" articles from The Lancet. We then identified 12 "control" articles matched to the case articles according to journal, disease or procedure of focus, theme area and year of publication. Forty-two general internists rated the articles, using 10-point scales, on dimensions addressing the articles' importance, ease of applicability and impact on health outcomes. RESULTS: For each dimension, the mean score for the case articles was significantly higher than the mean score for the control articles: importance to clinical practice 7.6 v. 7.1 respectively (p = 0.001), importance from a public health perspective 6.5 v. 6.0 (p < 0.001), contribution to advancement of medical knowledge 6.2 v. 5.8 (p < 0.001), ease of applicability in practice 7.0 v. 6.5 (p < 0.001), potential impact on health outcomes 6.5 v. 5.9 (p < 0.001). Despite these general findings, in 5 of the 12 matched pairs of articles the control article had a higher mean score than the case article across all the dimensions. INTERPRETATION: The accelerated publication practices of 2 leading medical journals targeted articles that, on average, had slightly higher importance scores than similar articles published in the usual way. However, our finding of higher importance scores for control articles in 5 of the 12 matched pairs shows that current journal practices for selecting articles for expedited publication are inconsistent.
Diffusion of Innovation↗
Germany's long-term care insurance model: lessons for the United States.
The implementation of public long term care (LTC) insurance in 1995 in Germany is an important public policy development that offers lessons for the U.S. The German LTC model is comprehensive and mandatory, covering 88 percent of its population, by equal premium contributions on wages from employees and employers. The new German system has uniform eligibility and benefit criteria, covers both institutional and home care, pays for family caregivers, is financially solvent, and is considered a success by the public. In contrast, the U.S. financing of LTC is largely private, with the government serving as the safety net for the majority of the LTC costs after individuals spend down their resources. This paper considers whether a German-type LTC system is feasible and affordable and discusses the issues and complexities of public LTC insurance, including cost containment, home care services, quality control, and administrative structure.
Aged↗
Drug Treatment as a Crime Fighting Tool.
BACKGROUND: The primary approach to reducing crime in the US has been through the criminal justice system. However, drug treatment may be an effective tool in reducing crime. In order to make better use of treatment as an alternative approach, one needs to know if reducing drug use through treatment results in decreased crime. AIMS OF THE STUDY: The objective of this paper is to model and empirically investigate the extent to which a change in drug use that results from treatment reduces crime and whether a change in drug use is causally related to change in crime. We focus on crime-for-profit. METHODS: We use a multi-site dataset of 3,502 inner-city drug users entering treatment. We analyze the change in drug use and crime pre and post treatment. We take first differences to address the omitted variable problem. RESULTS: We find that treatment reduces drug use and that, in turn, reduced drug use has a significant impact on crime. For our study population, reduced drug use seems to be causally related to reduced crime. This finding is robust to specification and subsamples. We estimate that reduced drug use due to treatment is associated with 54% fewer days of crime for profit, ceteris paribus. DISCUSSION: We use a longitudinal data set and a novel approach to analyze the relationship between crime and drugs. We analyze a low-income, inner-city, drug-addicted sample. We use self-reported crime. For our purposes, the use of individual data is an improvement over the use of aggregate level data that has been used in much of the related literature. Limitations of our paper include that we do not have a random sample and that our measure is self-reported in the previous 30 days. IMPLICATIONS FOR HEALTH POLICIES: Our findings suggest that drug treatment may be an effective crime-fighting tool. Treatment reduces not only the crime of drug possession, but also crime-for-profit. Current public policy emphasizes use of the criminal justice system, incarceration in particular, as a mechanism to combat crime. Given the huge and growing expense of the criminal justice system, drug treatment might be cost-effective relative to incarceration. California s so called Proposition 36 is based on this yet to be proven premise. Although additional research is required, our findings may help inform the debate on treatment versus criminal justice. We have provided empirically-based findings that reduced drug use due to treatment can result in important reductions in crime. Our findings can serve as a building block for policy development.
Journal Article↗
Political support in F.W. Programme: need and willingness.
Explore the source record for details and available documents.
Attitude↗
Rapid methods for detection and enumeration of Campylobacter spp. in foods.
Campylobacter spp. are the most commonly reported bacterial cause of acute diarrheal disease in humans throughout the world. Traditional cultural methods for the detection and quantitation of Campylobacterspp. are slow and tedious; therefore, specific, sensitive, and rapid methods for campylobacters are needed to collect sufficient data for risk assessment and food safety policy development. We developed several rapid methods based on polymerase chain reaction (PCR), DNA hybridization, hydrophobic grid membrane filters (HGMFs), and enzyme immunoassays (EIAs). A PCR assay targeting C. jejuni, combined with a simple sample preparation procedure, detects as few as 0.3 most probable number (MPN)/mL C. jejuni in naturally contaminated chicken rinses after 20-24 h enrichment. An HGMF-EIA method using a commercial polyclonal antibody for Campylobacter detects and enumerates thermophilic Campylobacter spp. from spiked chicken rinse and milk, and naturally contaminated chicken rinses. A C. jejuni-specific probe in an HGMF-DNA hybridization protocol specifically detects and quantitates C. jejuni in food samples. A dot-blot EIA combined with an MPN procedure quantitates thermophilic campylobacters from samples that might be difficult to filter through HGMFs.
Animals↗
Signing of HIV / AIDS strategy.
The Philippines has scored a very important success in controlling the spread of HIV as it launched the Philippine National HIV/AIDS Strategy. This document will serve as a guide to all the policies and programs that will be created in relation to HIV/AIDS. President Fidel Ramos, who personally launched the strategy in Malacanang Palace, said that it is not too late to prevent a large-scale epidemic at this point, although he admitted that the solutions would not be simple. He said that the fight against HIV/AIDS must be universal and should not be left to the Department of Health alone. Since HIV affects all sectors of society, the president stressed the importance of multisectoral responses to slow down the HIV epidemic. Secretary Ramiro, for his part, said that the strategy prescribes the national response to the epidemic and reduces its impact on individuals, families, and communities. A project of the Philippine National AIDS Council through its Committee on Policy Development (CPD), the National HIV/AIDS Strategy had undergone months of thorough nationwide consultative workshops and researches. With its launching, this unified multisectoral approach will eventually create a greater impact in the fight against HIV/AIDS.
Asia↗
Employment predictors among Indochinese refugees.
"The influx of Indochinese refugees into the United States since 1975 has forced policy development in various resettlement areas. Considerable emphasis has been placed on employment and employment barriers. This article investigates the refugee employment process. A multivariate model is used to distinguish employed from unemployed refugees. Early arrivals, recent arrivals, and each of the four major ethnic groups are investigated separately."
Americas↗
IUCN action.
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Conservation of Natural Resources↗
UNAIDS guidelines update includes expanded agenda. Changes occur with sixth guideline.
Recent changes made to the 'HIV/AIDS and Human Rights International Guidelines' include recommendations that hold governments accountable for developing policies that will improve HIV treatment and care.
Guidelines as Topic↗
Saskatchewan public health nursing survey. Perceptions of roles and activities.
OBJECTIVE: To explore perceived roles and activities of Saskatchewan public health nurses (PHNs). METHODS: This replication study surveyed Saskatchewan PHNs using the instrument developed by the Hamilton-Wentworth Social and Public Health Services Division in a 1992 survey of Ontario PHNs. This instrument is based on the roles and activities for community/public health nurses described by the Canadian Public Health Association (1990). Descriptive statistics were used to analyze the 124 responses received. RESULTS: Most of the nurses perceived that they were at least somewhat prepared for all of the roles. The activities of: caring for individuals and families; immunizing; educating individuals, families, and groups; acting as a resource person for clients and lay helpers; linking those needing services to appropriate community resources; and using marketing strategies were carried out most often by PHNs. Activities within the roles of community developer, policy formulator, researcher and evaluator, and resource manager/planner/coordinator were carried out to a much lesser degree. The roles and activities being done less often were also the ones PHNs felt less prepared to do. INTERPRETATION: It is important, as health authorities begin to support a more preventive approach to health care, that PHNs are competent in the roles outlined by the Canadian Public Health Association. As well as preparing new graduates for these roles, it is essential to provide continuing education for practicing PHNs. Public health administrators must also support public health nurses in carrying out these roles.
Community-Institutional Relations↗
HIV/AIDS, prisons and the Human Rights Act.
This article considers current practice in the treatment of HIV positive prisoners, in light of the rights contained in the Human Rights Act, and of international standards. In particular, the article considers the current practice of the prison service in relation to measures to prevent the spread of HIV, including the provision of condoms, and needle exchange programmes, and considers the extent of positive obligations on the prison service to take such preventative measures. The adequacy of medical care available to HIV positive prisoners, and the obligations on the prison service in relation to medical confidentiality, are also examined. The author assesses the possibilities for legal challenges under the Human Rights Act, and suggests that the Convention may be a useful tool for policy development in this area.
Condoms↗
Psychological autopsies: the current Department of Defense effort to standardize training and quality assurance.
Psychological autopsies have been gathered by the US military for a long time, both for lessons learned after a known suicide and to investigate an equivocal death. The term "psychological autopsies" is now being restricted to define an investigation by mental health to help determine, in an equivocal death, if the manner of death is a homicide, suicide, an accident, or from natural causes. The Department of Defense has developed policy, and is now implementing training and peer review. A sample model curriculum, report format and quality assurance standards are included.
Autopsy↗
Protecting subjects, preserving trust, promoting progress II: principles and recommendations for oversight of an institution's financial interests in human subjects research.
The AAMC Task Force on Financial Conflicts of Interest in Clinical Research issued this report, the second of two, in October 2002. (The first report is also published in this issue of Academic Medicine.) This report offers a unique perspective on the new phenomenon of "institutional" conflicts of interest. The task force acknowledges the diverse obligations of academic institutions that conduct research and also invest in-and accept the philanthropy of-commercial research sponsors. The task force emphasizes the importance of disclosing institutional financial interests as an integral part of the research process, critical to allaying public concerns, and to strengthening the trust relationship between research subjects, the public and the scientific community. The task force found that the safety and welfare of research subjects and the objectivity of the research could be-or could appear to be-compromised whenever an institution holds a significant financial interest that may be affected by the outcome of the research. Thus, the task force recommends separating the functional and administrative responsibilities related to human subjects research from those related to investment managing and technology licensing, and encourages the establishment of institutional conflicts-of-interest committees. As in the first report, the task force recommends that institutions should develop policies establishing a rebuttable presumption against the conduct of research at or under the auspices of an institution where potential conflicts in human subjects research are identified. This presumption against engaging in the research is to be balanced against compelling circumstances in favor of the conduct of the proposed research activity.
Clinical Trials as Topic↗
Exposure to environmental tobacco smoke and children health.
This paper reviews the investigations of the effects of pre- and/or postnatal exposure to environmental tobacco smoke (ETS) on children health reported in the literature. The evidence from epidemiological studies demonstrate that children's exposure to ETS is a risk factor for a variety of diseases, including respiratory disorders and middle ear disease. However, the current research base on the ETS-associated risks is still inadequate to fully support strategies, programs and policy development in this area. For example, it is not definitively determined what methods should be used for assessing ETS exposure and predicting potential health risks of exposed children. Based on the available data, we tried to find out which methods seem to be most desirable for quantifying ETS exposure in children. It is our opinion that among all biomarkers, the measurements of blood, saliva or urinary cotinine and hair nicotine are, as for today, the most specific and sensitive methods for an objective assessment of ETS exposure in children. A combination of the measurement of body fluids cotinine and hair nicotine with the questionnaire and interview-derived information seems to be the optimal method for assessing ETS exposure in children.
Air Pollution, Indoor↗
Screening for pulmonary tuberculosis among military conscripts in Taiwan.
BACKGROUND AND PURPOSE: Military service is obligatory for young men who are medically fit in Taiwan. Each year, all 19-year-old men are notified to undergo a required health check to determine their eligibility for military service. This study determined the prevalence of pulmonary tuberculosis (TB) among military conscripts in 1997 and 1998 and evaluated the effect of the mass radiographic screening program for military conscripts on the reported TB case rate. METHODS: During the annual health check, all 19-year-old men in Taiwan undergo miniature (70 x 70 mm) chest roentgenography (CXR). Those who have suspicious lesions on miniature films are notified to undergo follow-up CXR (14 x 14 inch) and sputum examinations. All these data for the period from 1997 to 1998 were analyzed to determine the prevalence of pulmonary TB. To evaluate the effect of the mass radiographic screening program among military conscripts on the reported TB case rates, annual data for newly diagnosed pulmonary TB in 1997 and 1998 were obtained from the National TB Register and analyzed by age and sex. RESULTS: A total of 305, 140 men eligible for military service underwent the required examination in 1997 and 1998. Pulmonary TB was diagnosed in 237 (0.08%) of these men, and 21 (6.9/100,000) had positive bacteriologic findings. In 1997 and 1998, the annual reported TB case rates for males and females were similar in both children and young adults, except for an early peak among men aged 19 years. CONCLUSION: The screening program resulted in a significant increase in the reported TB case rate among males aged 19 years. However, a low bacteriologic confirmation rate implies the possibility of over-diagnosis with CXR. Mass radiographic screening at the health check for military conscripts is inefficient in detecting bacteriologically confirmed TB, an observation with implications for screening policy development by the national TB program.
Adult↗
Beyond cultural competence: what child protection managers need to know and do.
This article addresses issues for child protection managers, such as hiring, program design, service evaluation, and policy development. It presents three frameworks for levels of organizational change: cultural sensitivity, which modifies existing services to better meet the needs of target populations; self-reflective cultural sensitivity, which calls for managers to be aware of personal and organizational cultural values; and cultural solidarity, which acknowledges that organizational power is vested in managers, which can oppress clients.
Administrative Personnel↗