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PubMed2004

Auto Action Learning: a tool for policy change. Building capacity across the developing regional system to improve health in the North East of England.

Health policy traditionally has tended to focus on health care policy. The World Health Organisation Investment for Health approach aims to influence policy development by locating health as both the outcome of, and an asset for, sustainable economic and social development. The policy context in England offers a range of drivers and opportunities to operationalise the Investment for Health approach through action to improve health and reduce inequalities, nationally and as importantly at a regional and local level. This paper traces developments in the North East of England April 2002-November 2002, from the perspective of an advocate for developing a systemic and systematic approach using an Investment for Health approach. The tool used to track change is based in action learning [M. Pedler, Action Learning for Managers, Lemos and Crane, London, 1996]. The Action Learning Problem Brief identifies why the goal is important, who to, how progress might be identified, difficulties and benefits. Generally, this acts as a starting point for problem solving within an Action Learning Set. This piece of work uses the framework for reflection and tracking, with input from a mentor, at four to eight weekly intervals, 'Auto Action Learning'. The authors pull out key learning points from the process, using a framework 'Towards a model for systematic learning from doing in the North East of England'.

Delivery of Health Care↗
PubMed1980

Health development and political policy: the lesson of Cuba.

In comparison to other Latin American countries at a similar or more advanced stage of economic development, Cuba has a relatively high ranking on major health status indicators. This paper examines the reasons for this contrast and concludes that they are largely political. This suggests that the severe health deficiencies of most developing countries are not inevitable consequences of poverty.

Adult↗
PubMed2001

National nutrition and public health policies: issues related to bioavailability of nutrients when developing dietary reference intakes.

Dietary reference intakes (DRI), like its predecessor, the recommended dietary allowances (RDA) and the Recommended Nutrient Intakes (RNIs), are reference values, based on the best scientific evidence available. They serve as reference amounts of specific nutrients and food components for use in assessing the adequacy of and in planning for nutritious diets. They have been used for over 50 y as the basis for national nutrition monitoring and intervention programs in the United States, Canada, and other countries and as the basis for dietary guidance developed for both individuals and for targeted groups of people. Thus, although not developed for specific policy applications, they have represented the best scientific perspectives regarding what should be the basis for nutrition and public health policy related to foods and supplements. In determining DRIs, as was the case with the RDA, significant attention must be paid to the form of the nutrient or food component that is evaluated. Research conducted to determine how much of a nutrient is needed must evaluate the chemical form provided, the matrix in which it is given and the effect of other food components on absorption and/or utilization. Because the DRI recommendations will be used in population-wide policy development, assumptions must be made explicitly about what is expected for all of these factors in a typical diet. At the same time, where data exist relative to nontypical but potentially very significant effects on bioavailability, these must also be delineated to be of use in a variety of settings. Finally, one of the most important aspects of determining bioavailability in developing reference intakes is that as new information emerges, new complexities enter into the process. As more chemical complexes of nutrients and food components become available in the marketplace, new bioavailability factors may need to be established. Examples of such changes exist in the DRI reports already published for vitamin B-12 and folate and in previous RDA for iron and protein. It is often the different assumptions related to bioavailability that alter the reference intakes used as the basis for public health policy in different countries, rather than the basic science from which the recommendation is derived.

Biological Availability↗
PubMed2004

Cardiopulmonary resuscitation policies in northwest England hospices: a telephone survey.

DESIGN: A survey into existence of resuscitation policies in hospices in Northwest England. METHODS: All 25 hospices in the region were contacted. The clinical services manager or equivalent person was interviewed by telephone by means of a structured questionnaire. RESULTS: The telephone survey had a 96% response rate. Sixteen (67%) hospices did not have a resuscitation policy although 50% of this group were developing a policy. Only eight (33%) hospices had a formal policy at the time of interview. Twenty hospices (83%) provided staff with annual training in basic resuscitation. One hospice (4%) discussed cardiopulmonary resuscitation (CPR) with all patients admitted, whereas six (25%) discussed CPR only if the patient raised the topic. Five hospices (21%) would advise the patients that they should be cared for in an acute hospital, as no resuscitation would be provided. Only four hospices (17%) had written information on resuscitation. DISCUSSION: There was significant variation in the production and adherence to guidelines on resuscitation, with some patients being denied access to specialist palliative care units, as they would wish resuscitation. Much anxiety and confusion regarding this topic existed and staff clearly required further education and guidance in order to develop policies within their units and to provide standard treatment within all specialist palliative care units.

Cardiopulmonary Resuscitation↗
PubMed2006

[The effectiveness of mental health care in developing countries. Intervention and policy options at several levels].

BACKGROUND: In developing countries psychiatric disorders are a major cause of disability and reduced economic productivity. AIM: To present an overview of intervention and policy options in mental health care in developing countries. METHOD: We searched the literature using PubMed, supplementing our finding with what we have learned from experience in the field. RESULTS: Research data, though very limited, indicate that psychiatric disorders can be treated effectively in developing countries. Mental health care can be provided at three different levels: at the level of the existing health care system, at primary care level and at community level. We discuss interventions at each of these levels on the basis of three cases. CONCLUSION: More research is needed into the efficacy and cost-effectiveness of mental health care interventions in developing countries; research must be accompanied by the actual implementation of mental health programmes in these countries.

Community Mental Health Services↗
PubMed1989

Developing Do Not Resuscitate policies.

It is clear that nurse administrators must take a leadership role in developing a DNR policy. The establishment of written DNR policies are necessary, not only to meet Joint Commission Standards, but also to improve communication, reduce ethical dilemmas, legally clarify patient status, and maintain consistent quality of care. Although a DNR policy cannot address and anticipate all problems, the interdisciplinary process used to develop DNR policies can provide the health care team with a base on which to build the policies, guidelines, and support mechanisms needed to deal with future ethical issues.

Administrative Personnel↗
PubMed1978

Cognitive development and social policy.

The city of Warsaw was razed at the end of World War II and rebuilt under a socialist government whose policy was to allocate dwellings, schools, and health facilities without regard to social class. Of the 14,238 children born in 1963 and living in Warsaw, 96 percent were given the Raven's Progressive Matrices Test and an arithmetic and a vocabulary test in March to June of 1974. Information was collected on the families of the children, and on characteristics of schools and city districts. Parental occupation and education were used to form a family factor, and the district data were collapsed into two factors, one relating to social marginality, and the other to distance from city center. Analysis showed that the initial assumption of even distribution of family, school, and district attributes was reasonable. Mental performance was unrelated either to school or district factors; it was related to parental occupation and education in a strong and regular gradient. It is concluded that an egalitarian social policy executed over a generation failed to override the association of social and family factors with cognitive development that is characteristic of more traditional industrial societies.

Child↗
PubMed1995

Strategic developments in drug and alcohol policy.

This review of recent developments in drug and alcohol policy investigates the reasons behind those developments and questions some of the directions in which this policy is taking the services. There is a possibility that services may become superficial and it appears that there are clients who are effectively denied public health services.

Journal Article↗
PubMed2005

From neurons to King County neighborhoods: partnering to promote policies based on the science of early childhood development.

A diverse community partnership in the Seattle area developed a policy agenda based on science, organized community support, and committed to monitor policy changes. It found that public health agencies are well positioned to develop a common knowledge base on early childhood development and to initiate community coalitions promoting policies to strengthen environments. It was challenging to maintain participants' focus on environments over time. Providing access to conditions that promote optimal development for all children will require ongoing commitment and alignment of many sectors to move political will and mobilize for change.

Child↗
PubMed1981

Design and administration of a continuing education policy.

Personnel development by the laboratory administrator depends on well-established continuing education policies and procedures. This article assists in defining those policies and procedures, based on the authors' experience in developing a continuing education policy for a hospital laboratory. Ten categories of acceptable laboratory continuing education are defined, and a method for assigning credit to each category is presented. A decision-making scheme is outlined for distributing resources (such as time and money) for continuing education. The process for documenting and monitoring employee participation is described.

Curriculum↗