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 1,585 records · Page 88Linked to original sources
PubMed2003

A conceptual model of the factors affecting the recreation and leisure participation of children with disabilities.

Participation in everyday activities is considered to be a vital part of children's development, which is related to their quality of life and future life outcomes. Research studies indicate that children with disabilities are at risk for lower participation in ordinary activities at home and in the community. This article presents a conceptual model of 11 environmental, family, and child factors that are thought to influence children's participation in recreation and leisure activities. The article outlines the existing evidence for the influence of these factors on one another and on children's participation. The review encompasses four bodies of literature: the participation of children or adults with disabilities, the risk and resilience of children facing adversity, the determinants of leisure and recreation activities, and the factors influencing physical activity and exercise. The proposed model is expected to be a useful tool for guiding future research studies and for developing policies and programs for children with disabilities and their families.

Child↗
PubMedDate not supplied

Restrictions on smoking: changes in knowledge, attitudes and predicted behaviour in metropolitan Toronto from 1983 to 1988.

To describe recent changes in knowledge, attitudes and behaviour with regard to restrictions on smoking, we compared the findings of population-based surveys conducted in Metropolitan Toronto in 1983 and 1988. In both surveys identical questions and similar data collection procedures were used. There were no changes in knowledge scores regarding the health effects of active smoking or environmental tobacco smoke (ETS), nor in smoking behaviour. In contrast, there were marked changes in attitudes. The population favoured more restrictions on smoking, including prohibition in specific locations, and there was greater support for restrictions on sales and advertising, for differential insurance rates favouring nonsmokers, and for higher taxes on cigarettes. Fewer 1988 respondents reported smoking among their associates and more reported being bothered by others' smoking. The implications for public health education and policy development are discussed.

Adolescent↗
PubMed2003

Functional status and health information in Canada: proposals and prospects.

The primary obstacle to evidence-based health care quality assessment in Canada is reliable data on health encounters and episodes of care. The recent Federal/Provincial Health Accord will enhance health data collection, including standardized functional status information (FSI) for administrative records. Canadian health policy developers also agree that FSI is needed to bridge data gaps since alterations in functional status create the continuity that links all episodes of care and health service utilization. Given Canada's universal, single-payer, health financing structure, the prospects for coherent and systemwide data collection are good. This article describes the Canadian health care from the perspective of health information, and surveys proposals in electronic health technology development, the obstacles that need to be faced, and the prospects of doing so.

Activities of Daily Living↗
PubMed2003

High blood pressure: the foundation for epidemic cardiovascular disease in African populations.

High-blood pressure is a powerful independent risk factor for death from heart disease and stroke. It is also a common clinical condition affecting more than 600 million persons worldwide and seen in nearly all populations. Although reliable, large-scale, population-based data on high blood pressure in sub-Saharan Africa (SSA) are limited, recent studies provide important and worrisome findings in both epidemiology and clinical outcomes. Although overall hypertension prevalence is between 10%-15%, prevalence rates as high as 30%-32% have been reported in middle-income urban and some rural areas. Importantly, hypertension awareness, treatment, and control rates as low as 20%, 10%, and 1%, respectively have also been found. Stroke has been by far the most common clinical sequela. In most SSA settings, hypertension control assumes a relatively low priority and little experience exists in implementing sustainable and successful programs for drug treatment. Rapid urbanization and transition from agrarian life to the wage-earning economy of city life continue to fuel increases in average blood pressure levels and prevalence of hypertension. Although the true burden of high blood pressure in sub-Saharan Africa remains largely unmeasured, compelling preliminary evidence suggests that it is the foundation for epidemic cardiovascular disease in Africa and already contributes substantively to death and disability from stroke, heart failure, and kidney failure in this region. Success in limiting this epidemic in SSA will depend heavily on the implementation of sustainable and aggressive population-based programs for high blood pressure awareness, prevention, treatment, and control. It will be critical to obtain investments in improved surveillance and program-relevant research to provide the evidence base for policy development and effective hypertension prevention and control.

Africa South of the Sahara↗
PubMedDate not supplied

Building evidence to promote educational competence of youth in foster care.

Although the academic difficulties of students living in foster care are well documented, few studies have examined factors influencing academic achievement of youth in foster care. This article reports the results of a study of educational competence in a sample of 152 foster youth in one midwestern state. Using five standardized instruments, the study explored predictors of reading ability of youth in foster care. Multiple regression analyses indicated that four factors--aspiration for higher education, placement in kinship care, participation in extracurricular activities, and drug use--accounted for 39% of the variance in reading ability scores. The article discusses implications of these findings for practice, research, and policy development.

Adolescent↗
PubMed2003

A systematic review of the effect of primary care-based service innovations on quality and patterns of referral to specialist secondary care.

BACKGROUND: Innovations are proliferating at the primary-secondary care interface, affecting referral to secondary care and resource use. Evidence about the range of effects and implications for the healthcare system of different types of innovation have not previously been summarised. AIM: To review the available evidence on initiatives affecting primary care referral to specialist secondary care. SETTING: Studies of primary-secondary care interface. METHOD: Systematic review of trials, using adapted Cochrane Collaboration (effective practice and organisation of care) criteria. Studies from 1980 to 2001 were identified from a wide range of sources. Strict inclusion criteria were applied, and relevant clinical, service and cost data extracted using an agreed protocol. The main outcome measures were referral rates to specialist secondary care. RESULTS: Of the 139 studies initially identified. 34 met the review criteria. An updated search added a further 10 studies. Two studies provided economic analysis only. Referral was not the primary outcome of interest in the majority of included studies. Professional interventions generally had an impact on referral rates consistent with the intended change in clinician behaviour. Similarly, specialist 'outreach' or other primary care-based specialist provider schemes had at least a small effect upon referral rates to secondary care with the direction of effect being that intended or rational from a clinical and sociological perspective. Of the financial interventions, one was aimed primarily at changing the numbers or proportion of referrals from primary to specialist secondary care, and the direction of change was as expected in all cases. The quality of the reporting of the economic components of the 14 studies giving economic data was poor in many cases. When grouped by intervention type, no overall pattern of change in referral costs or total costs emerged. CONCLUSION: The studies identified were extremely diverse in methodology, clinical subject, organisational form, and quality of evidence. The number of good quality evaluations of innovative schemes to enhance the existing capacity of primary care was small, but increasing. Well-evaluated service initiatives in this area should be supported. Organisational innovations in the structure of service provision need not increase total costs to the National Health Service (NHS), even though costs associated with referral may increase. This review provides limited, partial, and conditional support for current primary care-oriented NHS policy developments in the United Kingdom.

Family Practice↗
PubMed2003

Quality of care in African-American communities and the nursing shortage.

The National Black Nurses Foundation commissioned a research project to determine the effect of the nursing shortage on African-American communities. The W.K. Kellogg Foundation funded the project as part of a multiphase project aimed at identifying issues related to the nursing shortage among ethnic people of color communities and developing policy recommendations around the supply of nurses to serve those communities. The study was conducted over a six-month period by the nursing research investigative team at Cedars-Sinai Medical Center and Burns and Allen Research Institute in Los Angeles, California. One hundred (N=100) nurse leaders from communities across the United States participated in the research. Each leader completed a questionnaire regarding the existence of the nursing shortage in their community and the effect of the shortage on access to services, clinical quality and the retention and recruitment of nurses. Leaders were queried on nurse vacancy and turnover within their communities, incidence of adverse events and the ability of institutions to meet the demands for nursing and health services in their communities. Forty-five percent of the organizations in the study were reported to be single facilities and 55% consisted of integrated health systems. Respondents identified five major issues resulting from nurse vacancies in their communities: closure of acute care beds or clinical services, delays in providing treatment to patients, inability to retain nurses due to increased workload and decreased nurse satisfaction, diminished capacity to address chronic health problems in their communities and increased incidence of adverse patient events. African-American nurse leaders reported higher rates of nurse vacancy and turnover; higher incidence of adverse events and greater difficulty providing access to health care than was reported in the literature. Nurse vacancy and turnover rates are higher than reported national averages. The study suggests the need for further research at the community level in addition to acute care settings to ameliorate the potential adverse effects of nursing work force shortages on the health of African-American communities. Further research examining the effectiveness of interventions at increasing the supply, improving the retention of nurses at all levels and the effect of increased supply and the utilization of nurses in African-American communities should be conducted. The study reported in this edition of the Journal of the National Black Nurses Association is the first in a series of reports on the nursing shortage and its effect on access to care, the recruitment and retention of ethnic nurses in the pipeline and leadership and policy strategies required to assure the availability of a qualified work force to meet current and future health care demand.

Black or African American↗
PubMed2004

The burden of group A streptococcal pharyngitis in Melbourne families.

BACKGROUND & OBJECTIVES: There are no recent data from industrialised countries documenting the incidence and costs of group A streptococcal (GAS) pharyngitis. Such data are important in developing policy regarding management (e.g., whether or not to use antibiotics to treat sore throat) and in planning preventive strategies, including preparing for the arrival of GAS vaccines. The present study was undertaken to estimate the incidence and costs of GAS pharyngitis in school aged children in Melbourne, Australia. We report here the results after initial 11 months of surveillance. METHODS: A total of 202 families (852 individuals) with at least one child aged 3 to 12 yr were enrolled across Melbourne in a family-based cohort study, and are being followed prospectively for 24 months. Surveillance data for acute GAS pharyngitis (including serology), throat carriage, and costs of the disease were collected. Additional cases of GAS pharyngitis have been ascertained to improve the precision of costing estimates. RESULTS: Cohort retention was 97 per cent. The spring, summer and winter carriage rates for children were 13.0, 8.0 and 16.0 per cent respectively. The incidence of GAS pharyngitis was 14 per 100 person-years for children. For every primary case there were 0.7 secondary cases and 24 per cent of families experienced at least one episode of GAS pharyngitis per year. Preliminary costing data suggest that 46 per cent of cases lead to school absenteeism and a high rate of antibiotic use. INTERPRETATION & CONCLUSION: The present data suggest that GAS pharyngitis remains very common in childhood, and that it has further implications in terms of secondary cases and costs.

Cohort Studies↗
PubMed2003

Identification of ecologically significant habitats for urban nature conservation: a case study in Turkey.

Given the rapid urbanization of Turkey, sustained productivity of natural resources should be an integral part of any urban development policy. The biogeochemical cycles and ecosystem services link urban and rural ecosystems. It is, therefore, essential that ecologically significant habitats along urban-rural continuum be protected to secure public and environmental health. This necessitates their identification and the establishment of administrative and legal foundations for urban nature conservation in the management of urban habitats, should be established Ecological analysis of urban habitats of Karşiyaka led to the identification of 19 ecologically significant habitats. Nature conservation priority was rated, using rarity, species richness, stratification, site age, and area of the habitats. Ecologically significant habitats made up about 54 ha of the total urban green space of 289 ha in Karşiyaka. The total number of plant species was estimated to be 273.

Animals↗
PubMed2004

Representing public health nursing intervention concepts with HHCC and NIC.

PURPOSE: It is imperative that public health nurses define their services and provide evidence supporting the effectiveness of interventions. The purpose of this paper is to examine the ex-tent to which two standardized nursing terminologies--Home Health Care Classification (HHCC) and Nursing Interventions Classification (NIC)--represent public health nursing practice according to core public health function in Public Health Nursing Intervention model. METHODS: First, we divided all HHCC and NIC interventions into intervention focus levels: individual/family-focused, community-focused, and system-focused. Second, we categorized HHCC and NIC interventions according to core public health functions: assessment, policy development, and assurance and the categories of interventions in the PHI Model. RESULTS: We identified HHCC and NIC Nursing interventions that represented public health nursing concepts across core public health functions and categories of the PHI model. Analysis of the findings demonstrated that HHCC and NIC have terms for the concepts in the PHI model. CONCLUSION: Although HHCC and NIC cover many concepts in public health nursing practice, additional research is needed to extend these terminologies and to evaluate other standardized terminologies that can reflect more comprehensively public health nursing interventions.

Home Care Services↗
PubMed2004

The American Psychiatric Association's resource document on mental retardation and capital sentencing: implementing Atkins v. Virginia.

State legislatures need guidance in implementing the United States Supreme Court's decision in Atkins v. Virginia barring execution of mentally retarded offenders. In this Resource Document, the American Psychiatric Association's Council on Psychiatry and Law, the component charged with developing policies and positions relating to forensic psychiatry, recommends statutory language addressing the definition of mental retardation, procedures relating to its assessment, and qualifications of testifying experts.

Adult↗
PubMed2004

Physician assistant vocational satisfaction.

Physician assistants (PAs) are known to be highly satisfied with their vocational choices, but the reasons for this high degree of satisfaction are not known. The author mailed a survey to 2,323 PAs whose names were randomly chosen from the mailing list of the American Academy of Physician Assistants (AAPA) to examine the factors that PAs feel contribute to vocational satisfaction. The survey response rate was 50%. PAs were found to be highly satisfied with their careers, specialty choices, and jobs. From qualitative data, 21 factors for vocational satisfaction and 29 factors for dissatisfaction were identified. The identified variables could be used to guide PA professional policy development and aid PA employers in making organizational and management decisions.

Adult↗
PubMedDate not supplied

Health and well-being for Métis women in Manitoba.

BACKGROUND: Continuing compromised Aboriginal health status and increasing opportunity for new Aboriginal health surveys require that Aboriginal understandings of health and well-being be documented. This research begins exploration of whether the Aboriginal Life Promotion Framework may increase culturally pertinent planning, collection and analysis of health survey data. METHODS: A quasi-phenomenological tradition of enquiry was employed to gain understanding of the lived experience of participants. Data were collected through focus groups utilizing a 'talking circle' methodology. A participatory research approach involved three large Aboriginal organizations. RESULTS: Conceptions of health and of well-being are different entities for these Métis women. Health was most often more reflective of physical issues. Well-being was much broader, holistic and inclusive of the dimensions of spiritual, emotional, physical and mental/intellectual aspects of living, consistent with the first circle of the Aboriginal Life Promotion Framework. CONCLUSIONS: The implications of this study should be important to health providers, and policy developers regardless of sector. Métis women in this study show significant strengths in the spiritual, emotional and intellectual/mental aspects of life, areas that could be incorporated into health promotion approaches. Physical health was focussed on ensuring a healthy diet and exercise, yet most adult women in the study experienced stress around goals that are seen as relatively unattainable. The data produced in this study should be utilized to develop and test survey questions that can be applied to a larger portion of the Métis population. The Aboriginal Life Promotion Framework is useful as an organizing tool for systematically exploring elements of living.

Adult↗
PubMed2004

Bangkok 2004. Sex workers and law reform in South Africa.

The Sisonke movement in South Africa aims to galvanize sex workers to fight for equal rights and for improvements in their living and working conditions. This article, based on Jayne Arnott's presentation to a plenary session at the XV International AIDS Conference in Bangkok on 14 July 2004, outlines the legislation that governs the sex trade in South Africa; reviews related legal and policy developments since the end of apartheid in 1994; describes the present environment; and outlines the contribution that sex workers themselves are making to the fight for reform.

Humans↗
PubMed2005

Prevalence and predictors of smoking behavior among Samoans in three geographical regions.

OBJECTIVES: Provide comprehensive data on smoking behavior among Samoans. DESIGN: Cross-sectional, using systematic random sampling procedures, and in-person interviews. SETTING: US Territory of American Samoa, Hawaii, and Los Angeles, California. PARTICIPANTS: 1834 adult, non-institutionalized Samoans. INTERVENTION: None. MAIN OUTCOME MEASURES: Prevalence and independent predictors of smoking. RESULTS: Approximately one fourth (26.6%) of Samoans were current smokers, with 31.4% of men and 22.5% of women currently smoking. More current smokers were found in American Samoa (28.9%), followed by Hawaii (26.9%) and Los Angeles (24.1%, P<.001). At each site, Samoan men compared with the women were significantly more likely to smoke (P<.001), initiate smoking earlier (P<.05), and smoke more cigarettes (P<.05). Cessation rates for the sample were very low. Predictors of smoking included being younger, male, married, less educated, with lower income, and more acculturated. CONCLUSION: The high smoking and low cessation rates indicate that smoking-related diseases will be significant causes of morbidity and mortality for Samoans for many years. The findings further underscore the importance of documenting smoking patterns and their determinants for subgroups rather than aggregates such as Asian American and Pacific Islanders. If Samoans are to meet the Healthy People 2010 tobacco goals, there is a need to: 1) develop tailored tobacco awareness and cessation programs based on the recommendations made by the Taskforce on Community Preventive Services; 2) understand the complex interactions between social, cultural, and psychological determinants of smoking and cessation behaviors; and 3) develop policies to limit availability of tobacco, environmental exposure from tobacco, and increase cessation efforts.

Adolescent↗
PubMedDate not supplied

"Just therapy" with families on low incomes.

This article addresses the inadequacies of counseling, therapy, and social work that occurs with low-income families. The author argues that many families who seek help arrive with problems that are usually assessed separately from their socioeconomic and cultural contexts. Careful questioning will often lead to the discovery that the onset of many family problems are located in events external to the family, such as unemployment, bad housing, and racist, sexist, or heterosexist experiences. They can be extremely depressing ongoing experiences that eventually lead parents and children into a state of stress that opens them up to physical and mental illnesses. This article argues that a wide body of research supports such a view and that counseling, therapeutic, and social work practices should address these issues much more directly. It also argues that practitioners have an important role to play in social and economic policy development out of respect for their clients' struggles.

Culture↗
PubMed2003

The meaning of health and well-being: voices from older rural women.

INTRODUCTION: The impact of geographical location on the maintenance of older rural women's health and well-being has been largely unexamined in the research literature. Contextual explanations of environmental impact on health status have been traditionally been assigned to a narrow picture of rural life which emphasized occupational health at the expense of sociological aspects. There have been many research programs about ageing Australian people in urban areas but few concerning the older rural population. Few clues can be found as to how their needs and expectations may differ from those of their urban counterparts. The size of Australia's older population is increasing and steadily becoming feminised. Approximately 37% of these older women live outside capital cities in rural and remote areas. For those planning services for this group of older women, the influence of the rural and remote social and physical context on health and well-being must be understood and considered. METHODS: Data were collected in 2001 for this qualitative study from the five old (78-88 years), widowed rural women participants who had lived most of their lives on farms, by in-depth interviewing regarding life history, and by using personal document strategies. The life history research approach guided data collection, while thematic analysis was employed to avoid examining isolated themes. Social constructionism and socio-environmental theory of gerontology provided the philosophical boundaries to the central research question. RESULTS: While each informant's life history was unique, it was found that the informants' health and well-being were profoundly influenced by the geographical location of living on the land. CONCLUSION: This small study, which should be extended by a larger study, may be seen as a beginning step in defining health promotional activities, policy development and service programs for older rural women that are both person-centered and sensitive to their unique lifestyle.

Journal Article↗
PubMed2004

Working together for a sustainable urgent care system: a case study from south eastern Australia.

CONTEXT: A small, isolated community in the south east of Australia, Malacoota, had a long-standing concern about the adequacy of their emergency medical systems. There was no hospital, the local medical practitioners were under stress and their ambulance services were limited. Following an approach through the local Division of General Practice in August 2002, the School of Rural Health at Monash University was invited to assist. ISSUES: A policy development toolkit was used to improve the rural urgent care systems through engagement with community members. The process involved community consultation, a meeting of key stakeholders, and the formation of a representative Steering Committee to oversee the local management of the project. Project officers worked with a university facilitator and other stakeholders to implement the Transforming Rural Urgent Care Systems (TrUCs) process from August 2002 to June 2003. A proposal of recommendations was put to the Victorian State Minister of Health and this was accompanied by a degree of political action. The submission raised the issues of poor interstate communications, ambulance staffing, support for medical practitioners, facilities for the stabilisation of patients, and access to air ambulance services. Funding was obtained for the implementation of a community paramedic model. Ambulance service communications systems improved and an innovative model of ambulance service delivery for isolated communities was implemented. LESSONS: A number of lessons have been identified, including the crucial role of the project officers, and communication within the community and among specific stakeholders. The approach used could be adopted in other rural locations hoping to improve their emergency health services.

Journal Article↗