WorldWideScience

Sample records for accountable priority setting

  1. Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework

    Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San;

    2010-01-01

    In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania. The...... objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees....

  2. Decentralized health care priority-setting in Tanzania: evaluating against the accountability for reasonableness framework.

    Maluka, Stephen; Kamuzora, Peter; San Sebastiån, Miguel; Byskov, Jens; Olsen, Øystein E; Shayo, Elizabeth; Ndawi, Benedict; Hurtig, Anna-Karin

    2010-08-01

    Priority-setting has become one of the biggest challenges faced by health decision-makers worldwide. Fairness is a key goal of priority-setting and Accountability for Reasonableness has emerged as a guiding framework for fair priority-setting. This paper describes the processes of setting health care priorities in Mbarali district, Tanzania, and evaluates the descriptions against Accountability for Reasonableness. Key informant interviews were conducted with district health managers, local government officials and other stakeholders using a semi-structured interview guide. Relevant documents were also gathered and group priority-setting in the district was observed. The results indicate that, while Tanzania has a decentralized public health care system, the reality of the district level priority-setting process was that it was not nearly as participatory as the official guidelines suggest it should have been. Priority-setting usually occurred in the context of budget cycles and the process was driven by historical allocation. Stakeholders' involvement in the process was minimal. Decisions (but not the reasoning behind them) were publicized through circulars and notice boards, but there were no formal mechanisms in place to ensure that this information reached the public. There were neither formal mechanisms for challenging decisions nor an adequate enforcement mechanism to ensure that decisions were made in a fair and equitable manner. Therefore, priority-setting in Mbarali district did not satisfy all four conditions of Accountability for Reasonableness; namely relevance, publicity, appeals and revision, and enforcement. This paper aims to make two important contributions to this problematic situation. First, it provides empirical analysis of priority-setting at the district level in the contexts of low-income countries. Second, it provides guidance to decision-makers on how to improve fairness, legitimacy, and sustainability of the priority-setting process. PMID

  3. Strengthening fairness, transparency and accountability in health care priority setting at district level in Tanzania

    Stephen Maluka

    2011-11-01

    Full Text Available Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are not considered by conventional priority-setting tools. In a five-year EU-supported project, which started in 2006, ways of strengthening fairness and accountability in priority setting in district health management were studied. This review is based on a PhD thesis that aimed to analyse health care organisation and management systems, and explore the potential and challenges of implementing Accountability for Reasonableness (A4R approach to priority setting in Tanzania. A qualitative case study in Mbarali district formed the basis of exploring the sociopolitical and institutional contexts within which health care decision making takes place. The study also explores how the A4R intervention was shaped, enabled and constrained by the contexts. Key informant interviews were conducted. Relevant documents were also gathered and group priority-setting processes in the district were observed. The study revealed that, despite the obvious national rhetoric on decentralisation, actual practice in the district involved little community participation. The assumption that devolution to local government promotes transparency, accountability and community participation, is far from reality. The study also found that while the A4R approach was perceived to be helpful in strengthening transparency, accountability and stakeholder engagement, integrating the innovation into the district health system was challenging. This study underscores the idea that greater involvement and accountability among local actors may increase the legitimacy and fairness of priority-setting

  4. What do District Health Planners in Tanzania think about improving priority setting using 'Accountability for Reasonableness'?

    Olsen Oystein

    2007-11-01

    Full Text Available Abstract Background Priority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD and cost-effectiveness analysis (CEA, which is helpful, but insufficient because it focuses on a narrow range of values – need and efficiency – and not the full range of relevant values, including legitimacy and fairness. 'Accountability for reasonableness' is a conceptual framework for legitimate and fair priority setting and is empirically based and ethically justified. It connects priority setting to broader, more fundamental, democratic deliberative processes that have an impact on social justice and equity. Can 'accountability for reasonableness' be helpful for improving priority setting in less wealthy countries? Methods In 2005, Tanzanian scholars from the Primary Health Care Institute (PHCI conducted 6 capacity building workshops with senior health staff, district planners and managers, and representatives of the Tanzanian Ministry of Health to discussion improving priority setting in Tanzania using 'accountability for reasonableness'. The purpose of this paper is to describe this initiative and the participants' views about the approach. Results The approach to improving priority setting using 'accountability for reasonableness' was viewed by district decision makers with enthusiastic favour because it was the first framework that directly addressed their priority setting concerns. High level Ministry of Health participants were also very supportive of the approach. Conclusion Both Tanzanian district and governmental health planners viewed the 'accountability for reasonableness' approach with enthusiastic favour because it was the first framework that directly addressed their concerns.

  5. The accountability for reasonableness approach to guide priority setting in health systems within limited resources

    Byskov, Jens; Marchal, Bruno; Maluka, Stephen;

    2014-01-01

    : relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT). METHODS: This...... intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. An implementing action research team of core health team members and supporting...

  6. Accountable priority setting for trust in health systems - the need for research into a new approach for strengthening sustainable health action in developing countries

    Olsen Øystein E

    2009-10-01

    Full Text Available Abstract Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed. Accountability for Reasonableness (AFR is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must identify and consider the full range of relevant values. AFR consists of four conditions: i relevance to the local setting, decided by agreed criteria; ii publicizing priority-setting decisions and the reasons behind them; iii the establishment of revisions/appeal mechanisms for challenging and revising decisions; iv the provision of leadership to ensure that the first three conditions are met. REACT - "REsponse to ACcountable priority setting for Trust in health systems" is an EU-funded five-year intervention study started in 2006, which is testing the application and effects of the AFR approach in one district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease and programme interventions and services and within human resources and health systems management. Qualitative and quantitative methods are being

  7. Priority setting for the implementation of artemisinin-based combination therapy policy in Tanzania: evaluation against the accountability for reasonableness framework

    Mori Amani

    2012-03-01

    Full Text Available Abstract Background Priority setting for artemisinin-based antimalarial drugs has become an integral part of malaria treatment policy change in malaria-endemic countries. Although these drugs are more efficacious, they are also more costly than the failing drugs. When Tanzania changed its National Malaria Treatment Policy in 2006, priority setting was an inevitable challenge. Artemether-lumefantrine was prioritised as the first-line drug for the management of uncomplicated malaria to be available at a subsidized price at public and faith-based healthcare facilities. Methods This paper describes the priority-setting process, which involved the selection of a new first-line antimalarial drug in the implementation of artemisinin-based combination therapy policy. These descriptions were further evaluated against the four conditions of the accountability for reasonableness framework. According to this framework, fair decisions must satisfy a set of publicity, relevance, appeals, and revision and enforcement conditions. In-depth interviews were held with key informants using pretested interview guides, supplemented with a review of the treatment guideline. Purposeful sampling was used in order to explore the perceptions of people with different backgrounds and perspectives. The analysis followed an editing organising style. Results Publicity: The selection decision of artemether-lumefantrine but not the rationale behind it was publicised through radio, television, and newspaper channels in the national language, Swahili. Relevance: The decision was grounded on evidences of clinical efficacy, safety, affordability, and formulation profile. Stakeholders were not adequately involved. There was neither an appeals mechanism to challenge the decision nor enforcement mechanisms to guarantee fairness of the decision outcomes. Conclusions The priority-setting decision to use artemether-lumefantrine as the first-line antimalarial drug failed to satisfy the four

  8. Healthcare priority setting in Kenya

    Bukachi, Salome A.; Onyango-Ouma, Washington; Siso, Jared Maaka;

    2014-01-01

    players in the Malindi district health system and a review of key policy documents and national guidelines show that the priority setting process in the district relies heavily on guidelines from the national level, making it more of a vertical, top-down orientation. Multilateral and donor agencies...

  9. Involving decision-makers in the research process: Challenges of implementing the accountability for reasonableness approach to priority setting at the district level in Tanzania.

    Maluka, Stephen; Kamuzora, Peter; Ndawi, Benedict; Hurtig, Anna-Karin

    2014-01-01

    The past two decades have seen a growing call for researchers, policy-makers and health care providers to collaborate in efforts to bridge the gaps between research, policy and practice. However, there has been a little attention focused on documenting the challenges of dealing with decision-makers in the course of implementing a research project. This paper highlights a collaborative research project aiming to implement the accountability for reasonableness (AFR) approach to priority setting in accordance with the Response to Accountable Priority Setting for Trust in Health Systems (REACT) project in Tanzania. Specifically, the paper examines the challenges of dealing with decision-makers during the project-implementation process and shows how the researchers dealt with the decision-makers to facilitate the implementation of the REACT project. Key informant interviews were conducted with the Council Health Management Team (CHMT), local government officials and other stakeholders, using a semi-structured interview guide. Minutes of the Action Research Team and CHMT were analysed. Additionally, project-implementation reports were analysed and group priority-setting processes in the district were observed. The findings show that the characteristics of the REACT research project, the novelty of some aspects of the AFR approach, such as publicity and appeals, the Action Research methodology used to implement the project and the traditional cultural contexts within which the project was implemented, created challenges for both researchers and decision-makers, which consequently slowed down the implementation of the REACT project. While collaboration between researchers and decision-makers is important in bridging gaps between research and practice, it is imperative to understand the challenges of dealing with decision-makers in the course of implementing a collaborative research project. Such analyses are crucial in designing proper strategies for improved communication

  10. Decentralized health care priority-setting in Tanzania

    Maluka, Stephen; Kamuzora, Peter; Sebastiån, Miguel San;

    2010-01-01

    care priorities in Mbarali district, Tanzania, and evaluates the descriptions against Accountability for Reasonableness. Key informant interviews were conducted with district health managers, local government officials and other stakeholders using a semi-structured interview guide. Relevant documents...... were also gathered and group priority-setting in the district was observed. The results indicate that, while Tanzania has a decentralized public health care system, the reality of the district level priority-setting process was that it was not nearly as participatory as the official guidelines suggest......Priority-setting has become one of the biggest challenges faced by health decision-makers worldwide. Fairness is a key goal of priority-setting and Accountability for Reasonableness has emerged as a guiding framework for fair priority-setting. This paper describes the processes of setting health...

  11. Accountable priority setting for trust in health systems--the need for research into a new approach for strengthening sustainable health action in developing countries

    Byskov, Jens; Bloch, Paul; Blystad, Astrid;

    2009-01-01

    identify and consider the full range of relevant values. AFR consists of four conditions: i) relevance to the local setting, decided by agreed criteria; ii) publicizing priority-setting decisions and the reasons behind them; iii) the establishment of revisions/appeal mechanisms for challenging and revising...... district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease...

  12. Promoting community participation in priority setting in district health systems

    Kamuzora, Peter; Maluka, Stephen; Ndawi, Benedict;

    2013-01-01

    Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting is...... perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience of...

  13. Setting Priorities Personal Values, Organizational Results

    (CCL), Center for Creative Leadership

    2011-01-01

    To be a successful leader, you need to get results. To get results, you need to set priorities. This book can help you do a better job of setting priorities, recognizing the personal values that motivate your decision making, the probable trade-offs and consequences of your decisions, and the importance of aligning your priorities with your organization's expectations. In this way you can successfully meet organizational objectives and consistently produce results.

  14. Overcoming barriers to priority setting using interdisciplinary methods.

    Peacock, Stuart; Mitton, Craig; Bate, Angela; McCoy, Bonnie; Donaldson, Cam

    2009-10-01

    Ten years ago, Holm's highly influential paper "Goodbye to the simple solutions: the second phase of priority setting" was published [Holm S. Goodbye to the simple solutions: the second phase of priority setting in health care. British Medical Journal 1998;317:1000-7]. Whilst attending the 2nd International Conference on Priorities in Health Care in London, Holm argued that the search for a rational set of decision-making rules was no longer adequate. Instead, the priority setting process itself was now thought to be more complex. Ten years later, the Conference returns to the UK for the first time, and it is timely to describe some new tools intended to assist both researchers and decision-makers seeking to develop both rational and fair and legitimate priority setting processes. In this paper we argue that to do so, researchers and decision-makers need to adopt an interdisciplinary and collaborative approach to priority setting. We focus on program budgeting and marginal analysis (PBMA) and bring together three hitherto separate interdisciplinary strands of the PBMA literature. Our aim is to assist researchers and decision-makers seeking to effectively develop and implement PBMA in practice. Specifically, we focus on the use of multi-criteria decision analysis, participatory action research, and accountability for reasonableness, drawn from the disciplines of decision analysis, sociology, and ethics respectively. PMID:19346024

  15. Priority setting for health in emerging markets.

    Glassman, Amanda; Giedion, Ursula; McQueston, Kate

    2013-05-01

    The use of health technology assessment research in emerging economies is becoming an increasingly important tool to determine the uses of health spending. As low- and middle-income countries' gross domestic product grows, the funding available for health has increased in tandem. There is growing evidence that comparative effectiveness research and cost-effectiveness can be used to improve health outcomes within a predefined financial space. The use of these evaluation tools, combined with a systematized process of priority setting, can help inform national and global health payers. This review of country institutions for health technology assessment illustrates two points: the efforts underway to use research to inform priorities are widespread and not confined to wealthier countries; and many countries' efforts to create evidence-based policy are incomplete and more country-specific research will be needed. Further evidence shows that there is scope to reduce these gaps and opportunity to support better incorporation of data through better-defined priority-setting processes. PMID:24236627

  16. Priority-setting in Finnish healthcare.

    Rissanen, P; Häkkinen, U

    1999-12-01

    The characteristics which affect priority setting in the Finnish healthcare system include strong municipal (local) administration, no clear separation between producers and purchasers, a duality in funding, and the potential for physicians in public hospitals to practice in the private sector. This system has its strengths, such as the possibility to effectively co-ordinate social and healthcare services, and a strong incentive to take care of local needs, because of municipal responsibility to finance these services largely through local taxes. However, the municipalities are typically too small to take advantage of these potentials, their knowledge is scarce especially of secondary care and their negotiating power with respect to hospitals is low. Local politicians also have a dual role: they represent the needs of the local population but simultaneously they are decision-makers in hospitals. Full-time physicians are allowed to act in a dual role as well; they can run a private practice, which is paid for on a fee-for-service basis, while the hospital pays (mostly) a fixed monthly salary. The share of financing which flows from the National Sickness Insurance system to healthcare users may have adverse effects on the local use of resources. The broad national consensus statement on patient-level priorities did not reach any general rules on priorities. Strong support was given to citizens' equal right to access all healthcare services. In healthcare practice, this general rule has some exemptions. First, the reimbursement schemes for prescribed drugs vary depending on the severity and chronic nature of the disease. Secondly, the tax-financed dental services for the young are clearly prioritised over those of older citizens. In the consensus statement, emphasis was put on improving the efficiency of producing health services in order to avoid having to impose patient-level priorities. PMID:10827305

  17. Setting priorities for global mental health research

    Mark Tomlinson

    2009-06-01

    Full Text Available OBJECTIVE: To set investment priorities in global mental health research and to propose a more rational use of funds in this under-resourced and under-investigated area. METHODS: Members of the Lancet Mental Health Group systematically listed and scored research investment options on four broad classes of disorders: schizophrenia and other major psychotic disorders, major depressive disorder and other common mental disorders, alcohol abuse and other substance abuse disorders, and the broad class of child and adolescent mental disorders. Using the priority-setting approach of the Child Health and Nutrition Research Initiative, the group listed various research questions and evaluated them using the criteria of answerability, effectiveness, deliverability, equity and potential impact on persisting burden of mental health disorders. Scores were then weighted according to the system of values expressed by a larger group of stakeholders. FINDINGS: The research questions that scored highest were related to health policy and systems research, where and how to deliver existing cost-effective interventions in a low-resource context, and epidemiological research on the broad categories of child and adolescent mental disorders or those pertaining to alcohol and drug abuse questions. The questions that scored lowest related to the development of new interventions and new drugs or pharmacological agents, vaccines or other technologies. CONCLUSION: In the context of global mental health and with a time frame of the next 10 years, it would be best to fill critical knowledge gaps by investing in research into health policy and systems, epidemiology and improved delivery of cost-effective interventions.

  18. Setting Priorities: Personal Values, Organizational Results. Ideas into Action Guidebooks

    Cartwright, Talula

    2007-01-01

    Successful leaders get results. To get results, you need to set priorities. This book can help you do a better job of setting priorities, recognizing the personal values that motivate your decision making, the probable trade-offs and consequences of your decisions, and the importance of aligning your priorities with your organization's…

  19. Community-Based Decision Making and Priority Setting Using the R Software: The Community Priority Index

    Hamisu M. Salihu; Abraham A. Salinas-Miranda; Arnut Paothong; Wei Wang,; Lindsey M. King

    2015-01-01

    This paper outlines how to compute community priority indices in the context of multicriteria decision making in community settings. A simple R function was developed and validated with community needs assessment data. Particularly, the first part of this paper briefly overviews the existing methods for priority setting and reviews the utility of a multicriteria decision-making approach for community-based prioritization. The second part illustrates how community priority indices can be calcu...

  20. Priority setting and health policy and systems research

    Bennett Sara C

    2009-12-01

    Full Text Available Abstract Health policy and systems research (HPSR has been identified as critical to scaling-up interventions to achieve the millennium development goals, but research priority setting exercises often do not address HPSR well. This paper aims to (i assess current priority setting methods and the extent to which they adequately include HPSR and (ii draw lessons regarding how HPSR priority setting can be enhanced to promote relevant HPSR, and to strengthen developing country leadership of research agendas. Priority setting processes can be distinguished by the level at which they occur, their degree of comprehensiveness in terms of the topic addressed, the balance between technical versus interpretive approaches and the stakeholders involved. When HPSR is considered through technical, disease-driven priority setting processes it is systematically under-valued. More successful approaches for considering HPSR are typically nationally-driven, interpretive and engage a range of stakeholders. There is still a need however for better defined approaches to enable research funders to determine the relative weight to assign to disease specific research versus HPSR and other forms of cross-cutting health research. While country-level research priority setting is key, there is likely to be a continued need for the identification of global research priorities for HPSR. The paper argues that such global priorities can and should be driven by country level priorities.

  1. Increased fairness in priority setting processes within the health sector

    Zulu, Joseph M.; Michelo, Charles; Msoni, Carol;

    2014-01-01

    enhance legitimate and fair PS was introduced by researchers and decision makers within the health sector in the EU funded research project entitled 'Response to Accountable priority setting for Trust in health systems' (REACT). The project aimed to strengthen fairness and accountability in the PS...... processes of health systems at district level in Zambia, Tanzania and Kenya. This paper focuses on local perceptions and practices of fair PS (baseline study) as well as at the evolution of such perceptions and practices in PS following an AFR based intervention (evaluation study), carried out at district...... administration, in non-governmental organizations (NGO) and in health facilities. RESULTS: During the baseline study, concepts of legitimacy and fairness in PS processes were found to be grounded in local values of equity and impartiality. Government and other organizational strategies strongly supported...

  2. Setting healthcare priorities in hospitals: a review of empirical studies.

    Barasa, Edwine W; Molyneux, Sassy; English, Mike; Cleary, Susan

    2015-04-01

    Priority setting research has focused on the macro (national) and micro (bedside) level, leaving the meso (institutional, hospital) level relatively neglected. This is surprising given the key role that hospitals play in the delivery of healthcare services and the large proportion of health systems resources that they absorb. To explore the factors that impact upon priority setting at the hospital level, we conducted a thematic review of empirical studies. A systematic search of PubMed, EBSCOHOST, Econlit databases and Google scholar was supplemented by a search of key websites and a manual search of relevant papers' reference lists. A total of 24 papers were identified from developed and developing countries. We applied a policy analysis framework to examine and synthesize the findings of the selected papers. Findings suggest that priority setting practice in hospitals was influenced by (1) contextual factors such as decision space, resource availability, financing arrangements, availability and use of information, organizational culture and leadership, (2) priority setting processes that depend on the type of priority setting activity, (3) content factors such as priority setting criteria and (4) actors, their interests and power relations. We observe that there is need for studies to examine these issues and the interplay between them in greater depth and propose a conceptual framework that might be useful in examining priority setting practices in hospitals. PMID:24604831

  3. Priority-setting for achieving universal health coverage.

    Chalkidou, Kalipso; Glassman, Amanda; Marten, Robert; Vega, Jeanette; Teerawattananon, Yot; Tritasavit, Nattha; Gyansa-Lutterodt, Martha; Seiter, Andreas; Kieny, Marie Paule; Hofman, Karen; Culyer, Anthony J

    2016-06-01

    Governments in low- and middle-income countries are legitimizing the implementation of universal health coverage (UHC), following a United Nation's resolution on UHC in 2012 and its reinforcement in the sustainable development goals set in 2015. UHC will differ in each country depending on country contexts and needs, as well as demand and supply in health care. Therefore, fundamental issues such as objectives, users and cost-effectiveness of UHC have been raised by policy-makers and stakeholders. While priority-setting is done on a daily basis by health authorities - implicitly or explicitly - it has not been made clear how priority-setting for UHC should be conducted. We provide justification for explicit health priority-setting and guidance to countries on how to set priorities for UHC. PMID:27274598

  4. Setting priorities for space research: An experiment in methodology

    1995-01-01

    In 1989, the Space Studies Board created the Task Group on Priorities in Space Research to determine whether scientists should take a role in recommending priorities for long-term space research initiatives and, if so, to analyze the priority-setting problem in this context and develop a method by which such priorities could be established. After answering the first question in the affirmative in a previous report, the task group set out to accomplish the second task. The basic assumption in developing a priority-setting process is that a reasoned and structured approach for ordering competing initiatives will yield better results than other ways of proceeding. The task group proceeded from the principle that the central criterion for evaluating a research initiative must be its scientific merit -- the value of the initiative to the proposing discipline and to science generally. The group developed a two-stage methodology for priority setting and constructed a procedure and format to support the methodology. The first of two instruments developed was a standard format for structuring proposals for space research initiatives. The second instrument was a formal, semiquantitative appraisal procedure for evaluating competing proposals. This report makes available complete templates for the methodology, including the advocacy statement and evaluation forms, as well as an 11-step schema for a priority-setting process. From the beginning of its work, the task group was mindful that the issue of priority setting increasingly pervades all of federally supported science and that its work would have implications extending beyond space research. Thus, although the present report makes no recommendations for action by NASA or other government agencies, it provides the results of the task group's work for the use of others who may study priority-setting procedures or take up the challenge of implementing them in the future.

  5. Clinical Practice Guidelines as Instruments for Sound Health Care Priority Setting.

    Lawler, Patrick R; Norheim, Ole F

    2015-11-01

    This editorial discusses the potential role that physician-authored clinical practice guidelines could play in health care priority setting decisions in the United States. We briefly review the challenges associated with increasingly obligate health care priority setting in the United States and discuss accountability for these decisions. We then propose a potential role for clinical practice guidelines in addressing these challenges, while considering the ethical foundations of such a proposal. PMID:26342516

  6. Setting priorities and selecting topics for clinical practice guidelines.

    Battista, R N; Hodge, M J

    1995-01-01

    Setting priorities and selecting topics are important steps in guidelines development, but they have received relatively little attention to date. Responses from a survey of guidelines stakeholders in Canada suggest that the health burden of a clinical condition on the population is an important factor in priority setting. Economic considerations, cast as either costs of treatment to the health care system or the economic burden of illness to society, are given varying importance by different...

  7. The state of health care priority setting and public participation

    Konrad Obermann; Keith Tolley

    1997-01-01

    A structured questionnaire survey of all 131 health authorities in England, Wales and Scotland was carried out between September 1995 and January 1996. The priority setting questionnaire was sent to chairpersons or chief executives of each health authority, although respondents had a variety of job titles. The objectives of the survey was to assess (i) To assess the extent to which health authorities in England, Wales and Scotland perceive themselves as involved in setting priorities for heal...

  8. Setting healthcare priorities in hospitals: a review of empirical studies

    Barasa, Edwine W.; Molyneux, Sassy; English, Mike; Cleary, Susan

    2014-01-01

    Priority setting research has focused on the macro (national) and micro (bedside) level, leaving the meso (institutional, hospital) level relatively neglected. This is surprising given the key role that hospitals play in the delivery of healthcare services and the large proportion of health systems resources that they absorb. To explore the factors that impact upon priority setting at the hospital level, we conducted a thematic review of empirical studies. A systematic search of PubMed, EBSCO...

  9. Tensions in setting health care priorities for South Africa's children.

    Landman, W A; Henley, L D

    1998-01-01

    The new South African constitution commits the government to guarantee "basic health services" for every child under 18. Primary health care for pregnant women and children under six and elements of essential primary health care have received priority. At present, there is little analysis of the moral considerations involved in making choices about more advanced or costly health care which may, arguably, also be "basic". This paper illustrates some of the tensions in setting priorities for a ...

  10. SARS and hospital priority setting: a qualitative case study and evaluation

    Upshur Ross EG

    2004-12-01

    Full Text Available Abstract Background Priority setting is one of the most difficult issues facing hospitals because of funding restrictions and changing patient need. A deadly communicable disease outbreak, such as the Severe Acute Respiratory Syndrome (SARS in Toronto in 2003, amplifies the difficulties of hospital priority setting. The purpose of this study is to describe and evaluate priority setting in a hospital in response to SARS using the ethical framework 'accountability for reasonableness'. Methods This study was conducted at a large tertiary hospital in Toronto, Canada. There were two data sources: 1 over 200 key documents (e.g. emails, bulletins, and 2 35 interviews with key informants. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results Participants described the types of priority setting decisions, the decision making process and the reasoning used. Although the hospital leadership made an effort to meet the conditions of 'accountability for reasonableness', they acknowledged that the decision making was not ideal. We described good practices and opportunities for improvement. Conclusions 'Accountability for reasonableness' is a framework that can be used to guide fair priority setting in health care organizations, such as hospitals. In the midst of a crisis such as SARS where guidance is incomplete, consequences uncertain, and information constantly changing, where hour-by-hour decisions involve life and death, fairness is more important rather than less.

  11. Qualitative methodologies in health-care priority setting research.

    Smith, Neale; Mitton, Craig; Peacock, Stuart

    2009-10-01

    Priority setting research in health economics has traditionally employed quantitative methodologies and been informed by post-positivist philosophical assumptions about the world and the nature of knowledge. These approaches have been rewarded with well-developed and validated tools. However, it is now commonly noted that there has been limited uptake of economic analysis into actual priority setting and resource allocation decisions made by health-care systems. There seem to be substantial organizational and political barriers. The authors argue in this paper that understanding and addressing these barriers will depend upon the application of qualitative research methodologies. Some efforts in this direction have been attempted; however these are theoretically under-developed and seldom rooted in any of the established qualitative research traditions. Two such approaches - narrative inquiry and discourse analysis - are highlighted here. These are illustrated with examples drawn from a real-world priority setting study. The examples demonstrate how such conceptually powerful qualitative traditions produce distinctive findings that offer unique insight into organizational contexts and decision-maker behavior. We argue that such investigations offer untapped benefits for the study of organizational priority setting and thus should be pursued more frequently by the health economics research community. PMID:18972324

  12. Health care priority setting in Norway a multicriteria decision analysis

    Defechereux, T.; Paolucci, F.; Mirelman, A.; Youngkong, S.; Botten, G.; Hagen, T.P.; Niessen, L.W.

    2012-01-01

    BACKGROUND: Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and tr

  13. Priority Setting for Improvement of Cervical Cancer Prevention in Iran

    Majidi, Azam; Ghiasvand, Reza; Hadji, Maryam; Nahvijou, Azin; Mousavi, Azam-Sadat; Pakgohar, Minoo; Khodakarami, Nahid; Abedini, Mehrandokht; Amouzegar Hashemi, Farnaz; Rahnamaye Farzami, Marjan; Shahsiah, Reza; Sajedinejhad, Sima; Mohagheghi, Mohammad Ali; Nadali, Fatemeh; Rashidian, Arash; Weiderpass, Elisabete; Mogensen, Ole; Zendehdel, Kazem

    2016-01-01

    Background: Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV) have been successful interventions for prevention of invasive cervical cancer (ICC). Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. Methods: We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. Results: From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. Conclusion: A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran.

  14. Priority Setting for Improvement of Cervical Cancer Prevention in Iran

    Azam Majidi

    2016-04-01

    Full Text Available Background Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV have been successful interventions for prevention of invasive cervical cancer (ICC. Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. Methods We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. Results From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. Conclusion A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran.

  15. Health care priority setting: principles, practice and challenges

    Donaldson Cam

    2004-04-01

    Full Text Available Abstract Background Health organizations the world over are required to set priorities and allocate resources within the constraint of limited funding. However, decision makers may not be well equipped to make explicit rationing decisions and as such often rely on historical or political resource allocation processes. One economic approach to priority setting which has gained momentum in practice over the last three decades is program budgeting and marginal analysis (PBMA. Methods This paper presents a detailed step by step guide for carrying out a priority setting process based on the PBMA framework. This guide is based on the authors' experience in using this approach primarily in the UK and Canada, but as well draws on a growing literature of PBMA studies in various countries. Results At the core of the PBMA approach is an advisory panel charged with making recommendations for resource re-allocation. The process can be supported by a range of 'hard' and 'soft' evidence, and requires that decision making criteria are defined and weighted in an explicit manner. Evaluating the process of PBMA using an ethical framework, and noting important challenges to such activity including that of organizational behavior, are shown to be important aspects of developing a comprehensive approach to priority setting in health care. Conclusion Although not without challenges, international experience with PBMA over the last three decades would indicate that this approach has the potential to make substantial improvement on commonly relied upon historical and political decision making processes. In setting out a step by step guide for PBMA, as is done in this paper, implementation by decision makers should be facilitated.

  16. Setting priorities for exploration of uncertain water security outcomes

    Jakeman, A. J.; Guillaume, J. H.; Kelly, R. A.

    2013-12-01

    Water security and over-allocation of surface and groundwater are key policy issues worldwide. The management of these issues can be approached through evaluation of the system-wide outcomes of water supply and demand scenarios. Integrated modelling can support this evaluation. This presentation makes use of a model developed for the Namoi catchment, part of the Murray-Darling Basin, Australia. The model identifies social, economic and environmental trade-offs under various water policy decisions and climate variations. The integrated model is composed of a hydrological model, a social model of likely behaviours of farmers, an ecological model of hydrological suitability, a farm decision (economic) model and a crop production model. Each of these components and their inputs are uncertain, which potentially leads to uncertainty in predicted outcomes. These uncertain outcomes can be explored by varying the model's assumptions about the system and exogeneous variables. This presentation presents and illustrates a simple risk-based process for setting initial priorities on what variations of models should be explored first. Firstly, identify the conclusions that the user is interested in drawing and the consequences if the wrong conclusions are drawn. Secondly, create a modular view of the model to understand which parts can be changed to account for uncertainty. Thirdly, elicit from the user, the modeller and other stakeholders the combinations of changes to the model that they believe are most likely to change the conclusion. The modeller may draw on both their expert opinion and computational techniques. The variations of models that should be explored first are those that carry the greatest risk, i.e. that are most likely to change a conclusion and which have the greatest consequences if that conclusion is changed. This exploration should be approached iteratively, as initial steps may help identify other conclusions of greater importance, gaps in the modular view

  17. Setting priorities for development of emerging interventions against childhood diarrhoea

    Zulfiqar A. Bhutta

    2013-06-01

    Full Text Available An expert panel exercise was conducted to assess feasibility and potential effectiveness of 10 emerging health interventions against childhood diarrhoea. Twelve international experts were invited to take part in a CHNRI priority setting process. This group used 12 different criteria relevant to successful development and implementation of the emerging interventions, nine of which were retained in the final analysis. They showed most collective optimism towards developing household or community-level water treatment, followed by sustainable, affordable latrine options; those two emerging interventions were followed by antibiotic therapy of Cryptosporidium diarrhoea, and oral or transcutaneous enteric vaccine development.

  18. Ethical priority setting for universal health coverage: challenges in deciding upon fair distribution of health services

    Norheim, Ole F

    2016-01-01

    Priority setting is inevitable on the path towards universal health coverage. All countries experience a gap between their population’s health needs and what is economically feasible for governments to provide. Can priority setting ever be fair and ethically acceptable? Fairness requires that unmet health needs be addressed, but in a fair order. Three criteria for priority setting are widely accepted among ethicists: cost-effectiveness, priority to the worse-off, and financial risk protection...

  19. Participatory health system priority setting: Evidence from a budget experiment.

    Costa-Font, Joan; Forns, Joan Rovira; Sato, Azusa

    2015-12-01

    Budget experiments can provide additional guidance to health system reform requiring the identification of a subset of programs and services that accrue the highest social value to 'communities'. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making 'collective sacrifices'. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed 'willingness to assign') before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante "cost estimation" bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level. PMID:26517295

  20. Fit for purpose? Introducing a rational priority setting approach into a community care setting.

    Cornelissen, Evelyn; Mitton, Craig; Davidson, Alan; Reid, Colin; Hole, Rachelle; Visockas, Anne-Marie; Smith, Neale

    2016-06-20

    Purpose - Program budgeting and marginal analysis (PBMA) is a priority setting approach that assists decision makers with allocating resources. Previous PBMA work establishes its efficacy and indicates that contextual factors complicate priority setting, which can hamper PBMA effectiveness. The purpose of this paper is to gain qualitative insight into PBMA effectiveness. Design/methodology/approach - A Canadian case study of PBMA implementation. Data consist of decision-maker interviews pre (n=20), post year-1 (n=12) and post year-2 (n=9) of PBMA to examine perceptions of baseline priority setting practice vis-à-vis desired practice, and perceptions of PBMA usability and acceptability. Findings - Fit emerged as a key theme in determining PBMA effectiveness. Fit herein refers to being of suitable quality and form to meet the intended purposes and needs of the end-users, and includes desirability, acceptability, and usability dimensions. Results confirm decision-maker desire for rational approaches like PBMA. However, most participants indicated that the timing of the exercise and the form in which PBMA was applied were not well-suited for this case study. Participant acceptance of and buy-in to PBMA changed during the study: a leadership change, limited organizational commitment, and concerns with organizational capacity were key barriers to PBMA adoption and thereby effectiveness. Practical implications - These findings suggest that a potential way-forward includes adding a contextual readiness/capacity assessment stage to PBMA, recognizing organizational complexity, and considering incremental adoption of PBMA's approach. Originality/value - These insights help us to better understand and work with priority setting conditions to advance evidence-informed decision making. PMID:27296887

  1. Public involvement in health priority setting: future challenges for policy, research and society.

    Hunter, David James; Kieslich, Katharina; Littlejohns, Peter; Staniszewska, Sophie; Tumilty, Emma; Weale, Albert; Williams, Iestyn

    2016-08-15

    Purpose - The purpose of this paper is to reflect on the findings of this special issue and discusses the future challenges for policy, research and society. The findings suggest that challenges emerge as a result of legitimacy deficits of both consensus and contestatory modes of public involvement in health priority setting. Design/methodology/approach - The paper draws on the discussions and findings presented in this special issue. It seeks to bring the country experiences and case studies together to draw conclusions for policy, research and society. Findings - At least two recurring themes emerge. An underlying theme is the importance, but also the challenge, of establishing legitimacy in health priority setting. The country experiences suggest that we understand very little about the conditions under which representative, or authentic, participation generates legitimacy and under which it will be regarded as insufficient. A second observation is that public participation takes a variety of forms that depend on the opportunity structures in a given national context. Given this variety the conceptualization of public participation needs to be expanded to account for the many forms of public participation. Originality/value - The paper concludes that the challenges of public involvement are closely linked to the question of how legitimate processes and decisions can be generated in priority setting. This suggests that future research must focus more narrowly on conditions under which legitimacy are generated in order to expand the understanding of public involvement in health prioritization. PMID:27468775

  2. The Employers' Priorities. Vocational Skills and Capabilities for Management Accountants.

    Hassall, Trevor; Joyce, John; Montano, Jose Luis Arquero; Anes, Jose Antonio Donoso

    2001-01-01

    Responses from 214 of 950 British employers of management accountants were analyzed with a weighted importance indicator. Communication and time management skills were most important. Employers thought that entry workers had good information technology skills but oral and written communication was "just acceptable." Also needing development was…

  3. Setting priorities in health care organizations: criteria, processes, and parameters of success

    Martin Douglas K

    2004-09-01

    Full Text Available Abstract Background Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly. Discussion We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making. Summary Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly.

  4. Setting Priorities for Regional Conservation Planning in the Mediterranean Sea

    Micheli, Fiorenza; Coll, Marta

    2013-01-01

    Spatial prioritization in conservation is required to direct limited resources to where actions are most urgently needed and most likely to produce effective conservation outcomes. In an effort to advance the protection of a highly threatened hotspot of marine biodiversity, the Mediterranean Sea, multiple spatial conservation plans have been developed in recent years. Here, we review and integrate these different plans with the goal of identifying priority conservation areas that represent th...

  5. Setting Priorities for Space Research: Opportunities and Imperatives

    Dutton, John A.; Abelson, Philip H.; Beckwith, Steven V. W.; Bishop, William P.; Byerly, Radford, Jr.; Crowe, Lawson; Dews, Peter; Garriott, Owen K.; Lunine, Jonathan; Macauley, Molly K.

    1992-01-01

    This report represents the first phase of a study by a task group convened by the Space Studies Board to ascertain whether it should attempt to develop a methodology for recommending priorities among the various initiatives in space research (that is, scientific activities concerned with phenomena in space or utilizing observations from space). The report argues that such priority statements by the space research community are both necessary and desirable and would contribute to the formulation and implementation of public policy. The report advocates the establishment of priorities to enhance effective management of the nation's scientific research program in space. It argues that scientific objectives and purposes should determine how and under what circumstances scientific research should be done. The report does not take a position on the controversy between advocates of manned space exploration and those who favor the exclusive use of unmanned space vehicles. Nor does the report address questions about the value or appropriateness of Space Station Freedom or proposals to establish a permanent manned Moon base or to undertake a manned mission to Mars. These issues lie beyond the charge to the task group.

  6. An economic approach to clinical trial design and research priority-setting.

    Claxton, K; Posnett, J

    1996-01-01

    Whilst significant advances have been made in persuading clinical researchers of the value of conducting economic evaluation alongside clinical trials, a number of problems remain. The most fundamental is the fact that economic principles are almost entirely ignored in the traditional approach to trial design. For example, in the selection of an optimal sample size no consideration is given to the marginal costs or benefits of sample information. In the traditional approach this can lead to either unbounded or arbitrary sample sizes. This paper presents a decision-analytic approach to trial design which takes explicit account of the costs of sampling, the benefits of sample information and the decision rules of cost-effectiveness analysis. It also provides a consistent framework for setting priorities in research funding and establishes a set of screens (or hurdles) to evaluate the potential cost-effectiveness of research proposals. The framework permits research priority setting based explicitly on the budget constraint faced by clinical practitioners and on the information available prior to prospective research. It demonstrates the link between the value of clinical research and the budgetary restrictions on service provision, and it provides practical tools to establish the optimal allocation of resources between areas of clinical research or between service provision and research. PMID:9003938

  7. Cystic Fibrosis James Lind Alliance Priority Setting Partnership PROTOCOL [updated 13 July 2016

    Smyth, Alan R; Rowbotham, Nicola J.; McPhee, Margaret; Smith, Sherie

    2016-01-01

    The purpose of this protocol is to set out the aims, objectives and commitments of the Cystic Fibrosis Priority Setting Partnership (PSP) and the basic roles and responsibilities of the partners therein.

  8. Cystic Fibrosis James Lind Alliance Priority Setting Partnership PROTOCOL [5 February 2016

    Smyth, Alan R; Rowbotham, Nicola J.; McPhee, Margaret; Smith, Sherie

    2016-01-01

    The purpose of this protocol is to set out the aims, objectives and commitments of the Cystic Fibrosis Priority Setting Partnership (PSP) and the basic roles and responsibilities of the partners therein.

  9. A missing cornerstone in the Norwegian Priority Commission’s weighting scheme – Sub-treatment balancedness is a necessary property for priority setting criteria

    Mathias Barra

    2015-11-01

    Full Text Available The Norwegian government recently put in place a priority commission tasked with suggesting a set of explicit criteria for priority setting in the health care sector. The commission suggested three criteria, the first two of which equate to cost-effectiveness, where, essentially, the gain is measured in terms of Quality Adjusted Life Years (QALYs. The third criteria specifies that the number of QALYs be multiplied by a factor depending on the total health loss – also measured in QALYs – without the treatment in question.In this paper, we will show that the suggested weighting scheme creates contradictory situations in which the priority of treatment programmes will change based on arbitrary bundling (where two or more treatments are combined into one or sub-divisions (where a treatment is split up into two or more components.We show that these types of problems can be avoided or ameliorated if the QALY weighting scheme satisfies a property which we call sub-treatment balanced – informally, that the total weighted QALY gain is preserved when treatments are bundled or sub-divided. To our best knowledge, this property has not previously been discussed in the priority setting literature.We demonstrate that sub-treatment balance can easily be achieved in general, and in particular we show how to adapt the weighting scheme suggested by the Norwegian priority commission in order to satisfy this sub-treatment balance. Finally, we argue that any weighting scheme used in health care priority setting should be sub-treatment balanced with respect to any other attribute of a treatment which policy makers would want to take into account when making their decisions.At the time of writing, the Norwegian government has yet to conclude on a final set of criteria for prioritization, and a task-group, lead by professor Jon Magnussen, is re-evaluating the severity criterion suggested by the priority commission. However, sub-treatment balance is still relevant

  10. Health research priority setting in selected high income countries: a narrative review of methods used and recommendations for future practice

    Bryant, Jamie; Sanson-Fisher, Rob; Walsh, Justin; Stewart, Jessica

    2014-01-01

    Research priority setting aims to gain consensus about areas where research effort will have wide benefits to society. While general principles for setting health research priorities have been suggested, there has been no critical review of the different approaches used. This review aims to: (i) examine methods, models and frameworks used to set health research priorities; (ii) identify barriers and facilitators to priority setting processes; and (iii) determine the outcomes of priority setti...

  11. Monitoring drinking water, sanitation, and hygiene in non-household settings: Priorities for policy and practice.

    Cronk, Ryan; Slaymaker, Tom; Bartram, Jamie

    2015-11-01

    -household settings as a priority. National and international monitoring systems will be important to better understand status, trends, to identify priorities and target resources accordingly, and to improve accountability for progressive improvements in WaSH in non-household settings. PMID:25836758

  12. Improving the use of research evidence in guideline development: 2. Priority setting

    Fretheim Atle

    2006-11-01

    Full Text Available Abstract Background The World Health Organization (WHO, like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the second of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. Objectives We reviewed the literature on priority setting for health care guidelines, recommendations and technology assessments. Methods We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. Key questions and answers There is little empirical evidence to guide the choice of criteria and processes for establishing priorities, but there are broad similarities in the criteria that are used by various organisations and practical arguments for setting priorities explicitly rather than implicitly, What criteria should be used to establish priorities? • WHO has limited resources and capacity to develop recommendations. It should use these resources where it has the greatest chance of improving health, equity, and efficient use of healthcare resources. • We suggest the following criteria for establishing priorities for developing recommendations based on WHO's aims and strategic advantages: • Problems associated with a high burden of illness in low and middle-income countries, or new and emerging diseases. • No existing recommendations of good quality. • The feasibility of developing recommendations that will improve health outcomes, reduce inequities or reduce unnecessary costs if they are implemented. • Implementation is feasible, will not exhaustively

  13. Setting priorities for regional conservation planning in the Mediterranean Sea.

    Micheli, Fiorenza; Levin, Noam; Giakoumi, Sylvaine; Katsanevakis, Stelios; Abdulla, Ameer; Coll, Marta; Fraschetti, Simonetta; Kark, Salit; Koutsoubas, Drosos; Mackelworth, Peter; Maiorano, Luigi; Possingham, Hugh P

    2013-01-01

    Spatial prioritization in conservation is required to direct limited resources to where actions are most urgently needed and most likely to produce effective conservation outcomes. In an effort to advance the protection of a highly threatened hotspot of marine biodiversity, the Mediterranean Sea, multiple spatial conservation plans have been developed in recent years. Here, we review and integrate these different plans with the goal of identifying priority conservation areas that represent the current consensus among the different initiatives. A review of six existing and twelve proposed conservation initiatives highlights gaps in conservation and management planning, particularly within the southern and eastern regions of the Mediterranean and for offshore and deep sea habitats. The eighteen initiatives vary substantially in their extent (covering 0.1-58.5% of the Mediterranean Sea) and in the location of additional proposed conservation and management areas. Differences in the criteria, approaches and data used explain such variation. Despite the diversity among proposals, our analyses identified ten areas, encompassing 10% of the Mediterranean Sea, that are consistently identified among the existing proposals, with an additional 10% selected by at least five proposals. These areas represent top priorities for immediate conservation action. Despite the plethora of initiatives, major challenges face Mediterranean biodiversity and conservation. These include the need for spatial prioritization within a comprehensive framework for regional conservation planning, the acquisition of additional information from data-poor areas, species or habitats, and addressing the challenges of establishing transboundary governance and collaboration in socially, culturally and politically complex conditions. Collective prioritised action, not new conservation plans, is needed for the north, western, and high seas of the Mediterranean, while developing initial information-based plans

  14. Setting research priorities to reduce global mortality from preterm birth and low birth

    Rajiv Bahl Department of Child and Adolescent Health and Development, World Health Organization, Geneva, Switzerland; Jose Martines; Nita Bhandari; Zrinka Biloglav; Karen Edmond; Sharad Iyengar; Michael Kramer; Lawn, Joy E; Manandhar, D.S.; Rintaro Mori; Rasmussen, Kathleen M.; Sachdev, H.P.S.; Nalini Singhal; Mark Tomlinson; Cesar Victora

    2012-01-01

    This paper aims to identify health research priorities that could improve the rate of progress in reducing global neonatal mortality from preterm birth and low birth weight (PB/LBW), as set out in the UN's Millennium Development Goal 4.

  15. The knowledge, attitude, priority of usage, and benefits associated with management accounting practices

    Nielsen, Steen; Melander, Preben; Jakobsen, Morten

    2009-01-01

    There have been several studies of the diffusion of new management accounting practices. This study adds a new dimension: in order to indicate the number of practices associated with the respondents, their interrelationships, the respondents, were asked to answer questions in a questionnaire...... covering four variables: level of knowledge, level of attitude, priority of usage, and level of benefit for 15 new accounting practices. The survey includes a sample of 119 large and medium-sized privately owned manufacturing and non-manufacturing companies, comprising 15 new or recently developed...... management accounting practices. Our results reveal that companies in general experience a high level of benefit from the practices. However, significance differences between low priority of usage and high number of practices associated with the company are very likely to contribute to a more modest level of...

  16. INVESTMENT DECISIONS – AREAS AND PRIORITIES SET FOR ROMANIAN CRISIS

    Laura Vasilescu; Ana Popa

    2013-01-01

    Persistent crisis and pressing social and environmental challenges highlight once again the vital role of investment activity. A new concept about “New generation of investment policies” treats inclusive growth and sustainable development based on efforts to attract and benefit from investment. After joining the European Union, Romania has established a number of investment projects according to EU funding, which also set certain targets for economic and social development. This article discu...

  17. Identifying acne treatment uncertainties via a James Lind Alliance Priority Setting Partnership

    Layton, Alison; Eady, E. Anne; Peat, Maggie; Whitehouse, Heather; Levell, Nick; Ridd, Matthew; Cowdell, Fiona; Patel, Mahendra; Andrews, Stephen; Oxnard, Christine; Fenton, Mark; Firkins, Lester

    2015-01-01

    Objectives: The Acne Priority Setting Partnership (PSP) was set up to identify and rank treatment uncertainties by bringing together people with acne, and professionals providing care within and beyond the National Health Service (NHS). Setting: The UK with international participation. Participants: Teenagers and adults with acne, parents, partners, nurses, clinicians, pharmacists, private practitioners. Methods: Treatment uncertainties were collected via separat...

  18. Priority setting in health care: Lessons from the experiences of eight countries

    Lie Reidar K

    2008-01-01

    Full Text Available Abstract All health care systems face problems of justice and efficiency related to setting priorities for allocating a limited pool of resources to a population. Because many of the central issues are the same in all systems, the United States and other countries can learn from the successes and failures of countries that have explicitly addressed the question of health care priorities. We review explicit priority setting efforts in Norway, Sweden, Israel, the Netherlands, Denmark, New Zealand, the United Kingdom and the state of Oregon in the US. The approaches used can be divided into those centered on outlining principles versus those that define practices. In order to establish the main lessons from their experiences we consider (1 the process each country used, (2 criteria to judge the success of these efforts, (3 which approaches seem to have met these criteria, and (4 using their successes and failures as a guide, how to proceed in setting priorities. We demonstrate that there is little evidence that establishment of a values framework for priority setting has had any effect on health policy, nor is there evidence that priority setting exercises have led to the envisaged ideal of an open and participatory public involvement in decision making.

  19. Foresight for Science and Technology Priority Setting in Korea

    Moonjung Choi; Han-Lim Choi

    2015-01-01

    The main purpose of Technology Foresight (TF) in Korea is to predict the development of S&T and use the results in developing S&T policies. However, informing the public about what the future holds based on the development of S&T is an equally important role of TF. Since the introduction of the first TF in 1994, Korea has conducted four such studies. TF in Korea has become a key process in setting S&T policy, such as the Science and Technology Basic Plan (S&T Basic Plan). The S&T Basic Plan d...

  20. Foresight for Science and Technology Priority Setting in Korea

    Moonjung Choi; Han-Lim Choi

    2015-01-01

    The main purpose of Technology Foresight (TF) in Korea is to predict the development of S&T and use the results in developing S&T policies. However, informing the public about what the future holds based on the development of S&T is an equally important role of TF. Since the introduction of the first TF in 1994, Korea has conducted four such studies. TF in Korea has become a key process in setting S&T policy, such as the Science and Technology Basic ...

  1. Ethical priority setting for universal health coverage: challenges in deciding upon fair distribution of health services.

    Norheim, Ole F

    2016-01-01

    Priority setting is inevitable on the path towards universal health coverage. All countries experience a gap between their population's health needs and what is economically feasible for governments to provide. Can priority setting ever be fair and ethically acceptable? Fairness requires that unmet health needs be addressed, but in a fair order. Three criteria for priority setting are widely accepted among ethicists: cost-effectiveness, priority to the worse-off, and financial risk protection. Thus, a fair health system will expand coverage for cost-effective services and give extra priority to those benefiting the worse-off, whilst at the same time providing high financial risk protection. It is considered unacceptable to treat people differently according to their gender, race, ethnicity, religion, sexual orientation, social status, or place of residence. Inequalities in health outcomes associated with such personal characteristics are therefore unfair and should be minimized. This commentary also discusses a third group of contested criteria, including rare diseases, small health benefits, age, and personal responsibility for health, subsequently rejecting them. In conclusion, countries need to agree on criteria and establish transparent and fair priority setting processes. PMID:27170046

  2. Towards deep inclusion for equity-oriented health research priority-setting: A working model.

    Pratt, Bridget; Merritt, Maria; Hyder, Adnan A

    2016-02-01

    Growing consensus that health research funders should align their investments with national research priorities presupposes that such national priorities exist and are just. Arguably, justice requires national health research priority-setting to promote health equity. Such a position is consistent with recommendations made by the World Health Organization and at global ministerial summits that health research should serve to reduce health inequalities between and within countries. Thus far, no specific requirements for equity-oriented research priority-setting have been described to guide policymakers. As a step towards the explication and defence of such requirements, we propose that deep inclusion is a key procedural component of equity-oriented research priority-setting. We offer a model of deep inclusion that was developed by applying concepts from work on deliberative democracy and development ethics. This model consists of three dimensions--breadth, qualitative equality, and high-quality non-elite participation. Deep inclusion is captured not only by who is invited to join a decision-making process but also by how they are involved and by when non-elite stakeholders are involved. To clarify and illustrate the proposed dimensions, we use the sustained example of health systems research. We conclude by reviewing practical challenges to achieving deep inclusion. Despite the existence of barriers to implementation, our model can help policymakers and other stakeholders design more inclusive national health research priority-setting processes and assess these processes' depth of inclusion. PMID:26812416

  3. Development of a Method for Priority Setting in Forestry Research Projects in Turkey

    DAŞDEMİR, İsmet

    2005-01-01

    This paper deals with the priority-setting problem in public research projects in the Turkish forestry sector. For this aim, a combined method has been developed, that is scientific, objective, dynamic, consistent, multidimensional, easily applicable and understandable. The theoretical framework, peculiarities and criteria of the method and weighting of the criteria are explained. Assuring hierarchical multidimensional consistency between the purposes and priorities in the national and sector...

  4. Priority setting in healthcare: towards guidelines for the program budgeting and marginal analysis framework.

    Peacock, Stuart J; Mitton, Craig; Ruta, Danny; Donaldson, Cam; Bate, Angela; Hedden, Lindsay

    2010-10-01

    Economists' approaches to priority setting focus on the principles of opportunity cost, marginal analysis and choice under scarcity. These approaches are based on the premise that it is possible to design a rational priority setting system that will produce legitimate changes in resource allocation. However, beyond issuing guidance at the national level, economic approaches to priority setting have had only a moderate impact in practice. In particular, local health service organizations - such as health authorities, health maintenance organizations, hospitals and healthcare trusts - have had difficulty implementing evidence from economic appraisals. Yet, in the context of making decisions between competing claims on scarce health service resources, economic tools and thinking have much to offer. The purpose of this article is to describe and discuss ten evidence-based guidelines for the successful design and implementation of a program budgeting and marginal analysis (PBMA) priority setting exercise. PBMA is a framework that explicitly recognizes the need to balance pragmatic and ethical considerations with economic rationality when making resource allocation decisions. While the ten guidelines are drawn from the PBMA framework, they may be generalized across a range of economic approaches to priority setting. PMID:20950070

  5. Setting health research priorities using the CHNRI method: III. Involving stakeholders

    Sachiyo Yoshida

    2016-06-01

    Full Text Available Setting health research priorities is a complex and value–driven process. The introduction of the Child Health and Nutrition Research Initiative (CHNRI method has made the process of setting research priorities more transparent and inclusive, but much of the process remains in the hands of funders and researchers, as described in the previous two papers in this series. However, the value systems of numerous other important stakeholders, particularly those on the receiving end of health research products, are very rarely addressed in any process of priority setting. Inclusion of a larger and more diverse group of stakeholders in the process would result in a better reflection of the system of values of the broader community, resulting in recommendations that are more legitimate and acceptable.

  6. Setting research priorities to improve global newborn health and prevent stillbirths by 2025

    José Martines

    2016-06-01

    Full Text Available In 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013–2025.

  7. Political strategies in difficult times - The "backstage" experience of Swedish politicians on formal priority setting in healthcare.

    Garpenby, Peter; Nedlund, Ann-Charlotte

    2016-08-01

    This paper contributes to the knowledge on the governing of healthcare in a democratic context in times of austerity. Resource allocation in healthcare is a highly political issue but the political nature of healthcare is not always made clear and the role of politicians is often obscure. The absence of politicians in rationing/disinvestment arrangements is usually explained with blame-shifting arguments; they prefer to delegate "the burden of responsibility" to administrative agencies or professionals. Drawing on a case where Swedish regional politicians involved themselves in setting priorities at a more detailed level than previously, the findings suggest that the subject of "blame avoidance" is more complicated than usually assumed. A qualitative case study was designed, involving semi-structured interviews with 14 regionally elected politicians in one Swedish health authority, conducted in June 2011. The interviews were analysed through a thematic analysis in accordance with the "framework approach" by Ritchie and Lewis. Findings show that an overarching strategy among the politicians was to appear united and to suppress conflict, which served to underpin the vital strategy of bringing the medical profession into the process. A key finding is the importance that politicians, when appearing "backstage", attach to the prevention of blame from the medical profession. This case illustrates that one has to take into account that priority settings requires various types of skills and knowledges - not only technical but also political and social. Another important lesson points toward the need to broaden the political leadership repertoire, as leadership in the case of priority setting is not about politicians being all in or all out. The results suggest that in a priority-setting process it is of importance to have politics on-board at an early stage to secure loyalty to the process, although not necessarily being involved in all details. PMID:27404909

  8. Consensus and contention in the priority setting process: examining the health sector in Uganda.

    Colenbrander, Sarah; Birungi, Charles; Mbonye, Anthony K

    2015-06-01

    Health priority setting is a critical and contentious issue in low-income countries because of the high burden of disease relative to the limited resource envelope. Many sophisticated quantitative tools and policy frameworks have been developed to promote transparent priority setting processes and allocative efficiency. However, low-income countries frequently lack effective governance systems or implementation capacity, so high-level priorities are not determined through evidence-based decision-making processes. This study uses qualitative research methods to explore how key actors' priorities differ in low-income countries, using Uganda as a case study. Human resources for health, disease prevention and family planning emerge as the common priorities among actors in the health sector (although the last of these is particularly emphasized by international agencies) because of their contribution to the long-term sustainability of health-care provision. Financing health-care services is the most disputed issue. Participants from the Ugandan Ministry of Health preferentially sought to increase net health expenditure and government ownership of the health sector, while non-state actors prioritized improving the efficiency of resource use. Ultimately it is apparent that the power to influence national health outcomes lies with only a handful of decision-makers within key institutions in the health sector, such as the Ministries of Health, the largest bilateral donors and the multilateral development agencies. These power relations reinforce the need for ongoing research into the paradigms and strategic interests of these actors. PMID:24846947

  9. 75 FR 75469 - Priority Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA...

    2010-12-03

    ... these priorities. To meet the requirement for extensive stakeholder consultation, we are seeking general... methods and topics set by HHS and informed by the input of multiple stakeholders. Multi-stakeholder... described in clauses (i), (ii), and (iii) of subsection (a)(6)(A). Definition of healthcare quality...

  10. From the trenches: views from decision-makers on health services priority setting.

    Patten, San; Mitton, Craig; Donaldson, Cam

    2005-05-01

    Due to resource scarcity, health organizations worldwide must decide what services to fund and, conversely, what services not to fund. One approach to priority setting, which has been widely used in Britain, Australia, New Zealand and Canada, is programme budgeting and marginal analysis (PBMA). To date, such activity has primarily been based at a micro level, within programmes of care. In order to institute and refine the PBMA framework at a macro level across major service areas within a single health authority, researchers and decision-makers in Alberta embarked on a participatory action research project together. This paper identifies key issues of importance to decision-makers in a real-world priority-setting context. Themes discussed include making comparisons across disparate patient groups, dealing with political factors, using relevant forms of evidence, recognizing innovations and involving the public. The in-depth insight gained through this qualitative analysis will enable future refinement of PBMA at a macro level in the health authority under study, and should also serve to inform priority-setting activity in regionalized contexts elsewhere. In identifying aspects of priority setting that are important to decision-makers, researchers can also be better informed with respect to real-world processes. PMID:15901420

  11. Cost-effectiveness analysis for priority setting in health: penny-wise but pound-foolish.

    Baltussen, R.M.P.M.; Brouwer, W.; Niessen, L.

    2005-01-01

    Cost-effectiveness analysis has much conceptual attractiveness in priority setting but is not used to its full potential to assist policy-makers on making choices in health in developed or in developing countries. We call for a shift away from present economic evaluation activities-that tend to prod

  12. Decision maker views on priority setting in the Vancouver Island Health Authority

    Mitton Craig

    2008-07-01

    Full Text Available Abstract Background Decisions regarding the allocation of available resources are a source of growing dissatisfaction for healthcare decision-makers. This dissatisfaction has led to increased interest in research on evidence-based resource allocation processes. An emerging area of interest has been the empirical analysis of the characteristics of existing and desired priority setting processes from the perspective of decision-makers. Methods We conducted in-depth, face-to-face interviews with 18 senior managers and medical directors with the Vancouver Island Health Authority, an integrated health care provider in British Columbia responsible for a population of approximately 730,000. Interviews were transcribed and content-analyzed, and major themes and sub-themes were identified and reported. Results Respondents identified nine key features of a desirable priority setting process: inclusion of baseline assessment, use of best evidence, clarity, consistency, clear and measurable criteria, dissemination of information, fair representation, alignment with the strategic direction and evaluation of results. Existing priority setting processes were found to be lacking on most of these desired features. In addition, respondents identified and explicated several factors that influence resource allocation, including political considerations and organizational culture and capacity. Conclusion This study makes a contribution to a growing body of knowledge which provides the type of contextual evidence that is required if priority setting processes are to be used successfully by health care decision-makers.

  13. Towards a multi-criteria approach for priority setting: an application to Ghana.

    Baltussen, R.M.P.M.; Stolk, E.; Chisholm, D.; Aikins, M.

    2006-01-01

    BACKGROUND: Many criteria have been proposed to guide priority setting in health, but their relative importance has not yet been determined in a way that allows a rank ordering of interventions. METHODS: In an explorative study, a discrete choice experiment was carried out to determine the relative

  14. Setting research priorities to reduce global mortality from preterm birth and low birth

    Rajiv Bahl Department of Child and Adolescent Health and Development, World Health Organization, Geneva, Switzerland

    2012-06-01

    Full Text Available This paper aims to identify health research priorities that could improve the rate of progress in reducing global neonatal mortality from preterm birth and low birth weight (PB/LBW, as set out in the UN's Millennium Development Goal 4.

  15. Setting health research priorities using the CHNRI method: I. Involving funders

    Igor Rudan

    2016-06-01

    Full Text Available In 2007 and 2008, the World Health Organization's Department for Child and Adolescent Health and Development commissioned five large research priority setting exercises using the CHNRI (Child Health and Nutrition Research Initiative method. The aim was to define research priorities related to the five major causes of child deaths for the period up to the year 2015. The selected causes were childhood pneumonia, diarrhoea, birth asphyxia, neonatal infections and preterm birth/low birth weight. The criteria used for prioritization in all five exercises were the “standard” CHNRI criteria: answerability, effectiveness, deliverability, potential for mortality burden reduction and the effect on equity. Having completed the exercises, the WHO officers were left with another question: how “fundable” were the identified priorities, i.e. how attractive were they to research funders?

  16. Environmental reporting and accounting in Australia: Progress, prospects and research priorities

    Despite strong demand for information to support the sustainable use of Australia's natural resources and conserve environmental values and despite considerable effort and investment, nation-wide environmental data collection and analysis remains a substantially unmet challenge. We review progress in producing national environmental reports and accounts, identify challenges and opportunities, and analyse the potential role of research in addressing these. Australia's low and concentrated population density and the short history since European settlement contribute to the lack of environmental data. There are additional factors: highly diverse data requirements and standards, disagreement on information priorities, poorly measurable management objectives, lack of coordination, over-reliance on researchers and businesses for data collection, lack of business engagement, and short-term, project-based activities. New opportunities have arisen to overcome some of these challenges: enhanced monitoring networks, standardisation, data management and modelling, greater commitment to share and integrate data, community monitoring, increasing acceptance of environmental and sustainability indicators, and progress in environmental accounting practices. Successes in generating climate, water and greenhouse gas information appear to be attributable to an unambiguous data requirement, considerable investment, and legislative instruments that enhance data sharing and create a clearly defined role for operational agencies. Based on the analysis presented, we suggest six priorities for research: (1) common definitions and standards for information that address management objectives, (2) ecological measures that are scalable from local to national level, (3) promotion of long-term data collection and reporting by researchers, (4) efficient satellite and sensor network technologies and data analysis methods, (5) environmental modelling approaches that can reconcile multiple data

  17. Priority setting for horizon scanning of new health technologies in Denmark:

    Douw, Karla; Vondeling, Hindrik; Oortwijn, Wija

    2006-01-01

    In the context of the establishment of a Danish Horizon Scanning System (HSS) the views of health care stakeholders and health economists were solicitated by means of postal survey on the need for adaptation of a priority setting instrument for health technology assessment (HTA). The aim was to...... investigate if the instrument needed adaptation for priority setting in the context of a Danish HSS and, if so, how the instrument should be changed. A literature study served to enhance interpretation of the findings of the surveys and to formulate changes in the instrument that synthesize or bridge any...... differing views between the two groups. The results show that the instrument should apply a health care perspective, and that technologies should be prioritised on the basis of the criteria: marginal benefits, marginal costs, budget impact, impact on access to care, and additional criteria with an impact on...

  18. Lifetime QALY prioritarianism in priority setting: quantification of the inherent trade-off

    Ottersen, Trygve; Mæstad, Ottar; Norheim, Ole Frithjof

    2014-01-01

    Background: Multiple principles are relevant in priority setting, two of which are often considered particularly important. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. This principle is intimately linked to the goal of health maximization and standard cost-effectiveness analysis (CEA). According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse ...

  19. Beyond matrices and black-box algorithms : setting marketing priorities with marketing strategy conferences

    Martin S. Schilling; Schulze-Cleven, Paul J.

    2010-01-01

    With this paper, we introduce the Marketing Strategy Conference approach to set strategic marketing priorities effectively and allocate marketing-related resources accordingly. The system is based on managerial preference modelling with a decision model (analytical side) and communication-enhancing strategy conferencing (interactive side). After a review of alternative resource allocation frameworks, as rule-of-thumb approaches, matrix-based analyses, statistical analyses and management scien...

  20. Setting health research priorities using the CHNRI method: VI. Quantitative properties of human collective opinion

    Sachiyo Yoshida

    2016-06-01

    Full Text Available Crowdsourcing has become an increasingly important tool to address many problems – from government elections in democracies, stock market prices, to modern online tools such as TripAdvisor or Internet Movie Database (IMDB. The CHNRI method (the acronym for the Child Health and Nutrition Research Initiative for setting health research priorities has crowdsourcing as the major component, which it uses to generate, assess and prioritize between many competing health research ideas.

  1. Mapping of multiple criteria for priority setting of health interventions: an aid for decision makers

    Tromp Noor

    2012-12-01

    Full Text Available Abstract Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frameworks. This map can be an aid to decision makers to identify the relevant criteria for priority setting in their specific context. Methods We made an inventory of all possible criteria for priority setting on the basis of literature review. We categorized the criteria according to both health system frameworks that spell out a country’s health system goals and input. We reason that the criteria that decision makers use in priority setting exercises are a direct manifestation of this. Results Our map includes thirty-one criteria that are distributed among five categories that reflect the goals of a health system (i.e. to improve level of health, fair distribution of health, responsiveness, social & financial risk protection and efficiency and leadership/governance one category that reflects feasibiliy based on the health system building blocks (i.e. service delivery, health care workforce , information, medical products, vaccines & technologies, financing and. Conclusions This conceptual mapping of criteria, based on well-established health system frameworks, will further develop the field of priority setting by assisting decision makers in the identification of multiple criteria for selection of health interventions.

  2. Setting health research priorities using the CHNRI method: VI. Quantitative properties of human collective opinion

    Sachiyo Yoshida; Igor Rudan; Simon Cousens 3

    2016-01-01

    Crowdsourcing has become an increasingly important tool to address many problems – from government elections in democracies, stock market prices, to modern online tools such as TripAdvisor or Internet Movie Database (IMDB). The CHNRI method (the acronym for the Child Health and Nutrition Research Initiative) for setting health research priorities has crowdsourcing as the major component, which it uses to generate, assess and prioritize between many competing health research ideas.

  3. The EU’s Response to the Refugee Crisis: Taking Stock and Setting Policy Priorities

    Carrera, S.; Blockmans, S.; Gros, D.; Guild, E.

    2015-01-01

    What have been the most important EU policy and legal responses to the 2015 refugee crisis? Is Europe acting in compliance with its founding principles? This Essay takes stock of the main results and policy outputs from the EU’s interventions in the refugee crisis. It critically highlights the outstanding policy dilemmas confronting the adopted instruments and puts forwards a set of policy priorities to guide the next phases of the European Agenda on Migration.

  4. Priority setting of health interventions: the need for multi-criteria decision analysis.

    Baltussen Rob; Niessen Louis

    2006-01-01

    Abstract Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typic...

  5. Setting health research priorities using the CHNRI method: IV. Key conceptual advances

    Igor Rudan

    2016-06-01

    Full Text Available Child Health and Nutrition Research Initiative (CHNRI started as an initiative of the Global Forum for Health Research in Geneva, Switzerland. Its aim was to develop a method that could assist priority setting in health research investments. The first version of the CHNRI method was published in 2007–2008. The aim of this paper was to summarize the history of the development of the CHNRI method and its key conceptual advances.

  6. Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines

    Jurgita Januleviciute Gangstøe

    2016-06-01

    Full Text Available Background: Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i high priority with assigned individual maximum waiting time; (ii low priority without a maximum waiting time; and (iii refusal (not in need for specialized services. We study variation in priority status and waiting time of the first two groups across different medical disciplines. Methods: Data was extracted from the Norwegian Patient Register (NPR and contains information on elective referrals to 41 hospitals in the Western Norway Regional Health Authority in 2010. The hospital practice across different specialties was measured by patient priority status and waiting times. The distributions of assigned maximum waiting times and the actual ones were analyzed using standard Kernel density estimation. The perspective of the planning process was studied by measuring the time interval between the actual start of healthcare and the maximum waiting time. Results: Considerable variation was found across medical specialties concerning proportion of priority patients and their maximum waiting times. The degree of differentiation in terms of maximum waiting times also varied by medical discipline. We found that the actual waiting time was very close to the assigned maximum waiting time. Furthermore, there was no clear correspondence between the actual waiting time for patients and their priority status. Conclusion: Variations across medical disciplines are often interpreted as differences in clinical judgment and capacity. Alternatively they primarily reflect differences in patient characteristics, patient case-mix, as well as capacity. One hypothesis for further research is that the introduction of maximum waiting times may have contributed to push the actual

  7. Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines

    Gangstøe, Jurgita Januleviciute; Heggestad, Torhild; Norheim, Ole Frithjof

    2016-01-01

    Background: Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i) high priority with assigned individual maximum waiting time; (ii) low priority without a maximum waiting time; and (iii) refusal (not in need for specialized services). We study variation in priority status and waiting time of the first two groups across different medical disciplines. Methods: Data was extracted from the Norwegian Patient Register (NPR) and contains information on elective referrals to 41 hospitals in the Western Norway Regional Health Authority in 2010. The hospital practice across different specialties was measured by patient priority status and waiting times. The distributions of assigned maximum waiting times and the actual ones were analyzed using standard Kernel density estimation. The perspective of the planning process was studied by measuring the time interval between the actual start of healthcare and the maximum waiting time. Results: Considerable variation was found across medical specialties concerning proportion of priority patients and their maximum waiting times. The degree of differentiation in terms of maximum waiting times also varied by medical discipline. We found that the actual waiting time was very close to the assigned maximum waiting time. Furthermore, there was no clear correspondence between the actual waiting time for patients and their priority status. Conclusion: Variations across medical disciplines are often interpreted as differences in clinical judgment and capacity. Alternatively they primarily reflect differences in patient characteristics, patient case-mix, as well as capacity. One hypothesis for further research is that the introduction of maximum waiting times may have contributed to push the actual waiting time towards

  8. Priority setting in health authorities: a novel approach to a historical activity.

    Mitton, Craig; Patten, San; Waldner, Howard; Donaldson, Cam

    2003-11-01

    As resources in health care are scarce, health authorities and other health organizations are charged with determining how best to spend limited resources. While a number of formal approaches to priority setting within health authorities have been used internationally, there has been limited success with such activity, particularly across major service portfolios. This participatory action research project instituted a novel priority setting framework, coined macro-marginal analysis (MMA), in a fully integrated urban health region in Alberta, Canada. The focus of MMA is on identifying areas for service growth and areas for resource release, then determining, based on pre-defined, locally generated criteria, if actual shifts or re-allocation of resources should occur. For fiscal year 2002/03, the Calgary Health Region identified over 40 M dollars in resource releases (approximately 3% of the total budget), which were made available for servicing the deficit, and more importantly for our purposes, re-investing in service growth areas. The MMA framework is pragmatic in nature and has the ability to incorporate relevant evidence directly into the decision-making process. This work constitutes a significant advancement in health economics, and responds where previous priority setting approaches have failed in that it allows decision-makers to achieve genuine re-allocation of resources with the aim of improving population health or better meeting other important criteria. PMID:12948574

  9. A population-based model for priority setting across the care continuum and across modalities

    Mortimer Duncan

    2006-03-01

    Full Text Available Abstract Background The Health-sector Wide (HsW priority setting model is designed to shift the focus of priority setting away from 'program budgets' – that are typically defined by modality or disease-stage – and towards well-defined target populations with a particular disease/health problem. Methods The key features of the HsW model are i a disease/health problem framework, ii a sequential approach to covering the entire health sector, iii comprehensiveness of scope in identifying intervention options and iv the use of objective evidence. The HsW model redefines the unit of analysis over which priorities are set to include all mutually exclusive and complementary interventions for the prevention and treatment of each disease/health problem under consideration. The HsW model is therefore incompatible with the fragmented approach to priority setting across multiple program budgets that currently characterises allocation in many health systems. The HsW model employs standard cost-utility analyses and decision-rules with the aim of maximising QALYs contingent upon the global budget constraint for the set of diseases/health problems under consideration. It is recognised that the objective function may include non-health arguments that would imply a departure from simple QALY maximisation and that political constraints frequently limit degrees of freedom. In addressing these broader considerations, the HsW model can be modified to maximise value-weighted QALYs contingent upon the global budget constraint and any political constraints bearing upon allocation decisions. Results The HsW model has been applied in several contexts, recently to osteoarthritis, that has demonstrated both its practical application and its capacity to derive clear evidenced-based policy recommendations. Conclusion Comparisons with other approaches to priority setting, such as Programme Budgeting and Marginal Analysis (PBMA and modality-based cost

  10. Integrating habitat status, human population pressure, and protection status into biodiversity conservation priority setting

    Shi, H.; Singh, A.; Kant, S.; Zhu, Z.; Waller, E.

    2005-01-01

    Priority setting is an essential component of biodiversity conservation. Existing methods to identify priority areas for conservation have focused almost entirely on biological factors. We suggest a new relative ranking method for identifying priority conservation areas that integrates both biological and social aspects. It is based on the following criteria: the habitat's status, human population pressure, human efforts to protect habitat, and number of endemic plant and vertebrate species. We used this method to rank 25 hotspots, 17 megadiverse countries, and the hotspots within each megadiverse country. We used consistent, comprehensive, georeferenced, and multiband data sets and analytical remote sensing and geographic information system tools to quantify habitat status, human population pressure, and protection status. The ranking suggests that the Philippines, Atlantic Forest, Mediterranean Basin, Caribbean Islands, Caucasus, and Indo-Burma are the hottest hotspots and that China, the Philippines, and India are the hottest megadiverse countries. The great variation in terms of habitat, protected areas, and population pressure among the hotspots, the megadiverse countries, and the hotspots within the same country suggests the need for hotspot- and country-specific conservation policies. ??2005 Society for Conservation Biology.

  11. Identifying acne treatment uncertainties via a James Lind Alliance Priority Setting Partnership

    Layton, Alison; Eady, E Anne; Peat, Maggie; Whitehouse, Heather; Levell, Nick; Ridd, Matthew; Cowdell, Fiona; Patel, Mahenda; Andrews, Stephen; Oxnard, Christine; Fenton, Mark; Firkins, Lester

    2015-01-01

    Objectives The Acne Priority Setting Partnership (PSP) was set up to identify and rank treatment uncertainties by bringing together people with acne, and professionals providing care within and beyond the National Health Service (NHS). Setting The UK with international participation. Participants Teenagers and adults with acne, parents, partners, nurses, clinicians, pharmacists, private practitioners. Methods Treatment uncertainties were collected via separate online harvesting surveys, embedded within the PSP website, for patients and professionals. A wide variety of approaches were used to promote the surveys to stakeholder groups with a particular emphasis on teenagers and young adults. Survey submissions were collated using keywords and verified as uncertainties by appraising existing evidence. The 30 most popular themes were ranked via weighted scores from an online vote. At a priority setting workshop, patients and professionals discussed the 18 highest-scoring questions from the vote, and reached consensus on the top 10. Results In the harvesting survey, 2310 people, including 652 professionals and 1456 patients (58% aged 24 y or younger), made submissions containing at least one research question. After checking for relevance and rephrasing, a total of 6255 questions were collated into themes. Valid votes ranking the 30 most common themes were obtained from 2807 participants. The top 10 uncertainties prioritised at the workshop were largely focused on management strategies, optimum use of common prescription medications and the role of non-drug based interventions. More female than male patients took part in the harvesting surveys and vote. A wider range of uncertainties were provided by patients compared to professionals. Conclusions Engaging teenagers and young adults in priority setting is achievable using a variety of promotional methods. The top 10 uncertainties reveal an extensive knowledge gap about widely used interventions and the relative merits

  12. Congestion Control in WMSNs by Reducing Congestion and Free Resources to Set Accurate Rates and Priority

    Akbar Majidi

    2014-08-01

    Full Text Available The main intention of this paper is focus on mechanism for reducing congestion in the network by free resources to set accurate rates and priority data needs. If two nodes send their packets in the shortest path to the parent node in a crowded place, a source node must prioritize the data and uses data that have lower priorities of a suitable detour nodes consisting of low or non- active consciously. The proposed algorithm is applied to the nodes near the base station (which convey more traffic after the congestion detection mechanism detected the congestion. Obtained results from simulation test done by NS-2 simulator demonstrate the innovation and validity of proposed method with better performance in comparison with CCF, PCCP and DCCP protocols.

  13. An approach for setting evidence-based and stakeholder-informed research priorities in low- and middle-income countries

    Rehfuess, Eva A; Durão, Solange; Kyamanywa, Patrick; Joerg J Meerpohl; Young, Taryn; Rohwer, Anke; ,

    2015-01-01

    Abstract To derive evidence-based and stakeholder-informed research priorities for implementation in African settings, the international research consortium Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) developed and applied a pragmatic approach. First, an online survey and face-to-face consultation between CEBHA+ partners and policy-makers generated priority research areas. Second, evidence maps for these priority research areas identified gaps and related ...

  14. The influence of spatial grain size on the suitability of the higher-taxon approach in continental priority-setting

    Larsen, Frank Wugt; Rahbek, Carsten

    2005-01-01

    as effectively as species-based priority areas, genus-based areas perform considerably less effectively than species-based areas for the 1° and 2° grain size. Thus, our results favour the higher-taxon approach for continental priority-setting only when large grain sizes (= 4°) are used.......The higher-taxon approach may provide a pragmatic surrogate for the rapid identification of priority areas for conservation. To date, no continent-wide study has examined the use of higher-taxon data to identify complementarity-based networks of priority areas, nor has the influence of spatial......-longitudinal quadrates). Independent of spatial grain size, the selection of priority areas based on genus data is more effective than the random selection of these areas, while the selection of priority areas based on family data is less effective than random selection. Compared to selection based on species data...

  15. A Comparison between Fixed Priority and EDF Scheduling accounting for Cache Related Pre-emption Delays

    Will Lunniss

    2014-04-01

    Full Text Available In multitasking real-time systems, the choice of scheduling algorithm is an important factor to ensure that response time requirements are met while maximising limited system resources. Two popular scheduling algorithms include fixed priority (FP and earliest deadline first (EDF. While they have been studied in great detail before, they have not been compared when taking into account cache related pre-emption delays (CRPD. Memory and cache are split into a number of blocks containing instructions and data. During a pre-emption, cache blocks from the pre-empting task can evict those of the pre-empted task. When the pre-empted task is resumed, if it then has to re-load the evicted blocks, CRPD are introduced which then affect the schedulability of the task. In this paper we compare FP and EDF scheduling algorithms in the presence of CRPD using the state-of-the-art CRPD analysis. We find that when CRPD is accounted for, the performance gains offered by EDF over FP, while still notable, are diminished. Furthermore, we find that under scenarios that cause relatively high CRPD, task layout optimisation techniques can be applied to allow FP to schedule tasksets at a similar processor utilisation to EDF. Thus making the choice of the task layout in memory as important as the choice of scheduling algorithm. This is very relevant for industry, as it is much cheaper and simpler to adjust the task layout through the linker than it is to switch the scheduling algorithm.

  16. Introduction: priority setting, equitable access and public involvement in health care.

    Weale, Albert; Kieslich, Katharina; Littlejohns, Peter; Tugendhaft, Aviva; Tumilty, Emma; Weerasuriya, Krisantha; Whitty, Jennifer A

    2016-08-15

    Purpose - The purpose of this paper is to introduce the special issue on improving equitable access to health care through increased public and patient involvement (PPI) in prioritization decisions by discussing the conceptualization, scope and rationales of PPI in priority setting that inform the special issue. Design/methodology/approach - The paper employs a mixed-methods approach in that it provides a literature review and a conceptual discussion of the common themes emerging in the field of PPI and health priority setting. Findings - The special issue focuses on public participation that is collective in character, in the sense that the participation relates to a social, not personal, decision and is relevant to whole groups of people and not single individuals. It is aimed at influencing a decision on public policy or legal rules. The rationales for public participation can be found in democratic theory, especially as they relate to the social and political values of legitimacy and representation. Originality/value - The paper builds on previous definitions of public participation by underlining its collective character. In doing so, it develops the work by Parry, Moyser and Day by arguing that, in light of the empirical evidence presented in this issue, public participatory activities such as protests and demonstrations should no longer be labelled unconventional, but should instead be labelled as "contestatory participation". This is to better reflect a situation in which these modes of participation have become more conventional in many parts of the world. PMID:27468772

  17. MODEL OF DISTRIBUTION OF THE BUDGET OF THE PORTFOLIO OF IT PROJECTS TAKING IN-TO ACCOUNT THEIR PRIORITY

    Sotnikova, A

    2015-01-01

    Article is devoted to a problem of effective distribution of the general budget of a portfolio between the IT projects which are its part taking into ac-count their priority. The designated problem is actual in view of low results of activity of the consulting companies in the sphere of information technologies. For determination of priority of IT projects the method of analytical networks developed by T. Saati is used. For the purpose of application of this method the system of criteria (ind...

  18. Setting Priorities for Monitoring and Managing Non-native Plants: Toward a Practical Approach.

    Koch, Christiane; Jeschke, Jonathan M; Overbeck, Gerhard E; Kollmann, Johannes

    2016-09-01

    Land managers face the challenge to set priorities in monitoring and managing non-native plant species, as resources are limited and not all non-natives become invasive. Existing frameworks that have been proposed to rank non-native species require extensive information on their distribution, abundance, and impact. This information is difficult to obtain and often not available for many species and regions. National watch or priority lists are helpful, but it is questionable whether they provide sufficient information for environmental management on a regional scale. We therefore propose a decision tree that ranks species based on more simple albeit robust information, but still provides reliable management recommendations. To test the decision tree, we collected and evaluated distribution data from non-native plants in highland grasslands of Southern Brazil. We compared the results with a national list from the Brazilian Invasive Species Database for the state to discuss advantages and disadvantages of the different approaches on a regional scale. Out of 38 non-native species found, only four were also present on the national list. If management would solely rely on this list, many species that were identified as spreading based on the decision tree would go unnoticed. With the suggested scheme, it is possible to assign species to active management, to monitoring, or further evaluation. While national lists are certainly important, management on a regional scale should employ additional tools that adequately consider the actual risk of non-natives to become invasive. PMID:27272017

  19. Setting Priorities for Monitoring and Managing Non-native Plants: Toward a Practical Approach

    Koch, Christiane; Jeschke, Jonathan M.; Overbeck, Gerhard E.; Kollmann, Johannes

    2016-09-01

    Land managers face the challenge to set priorities in monitoring and managing non-native plant species, as resources are limited and not all non-natives become invasive. Existing frameworks that have been proposed to rank non-native species require extensive information on their distribution, abundance, and impact. This information is difficult to obtain and often not available for many species and regions. National watch or priority lists are helpful, but it is questionable whether they provide sufficient information for environmental management on a regional scale. We therefore propose a decision tree that ranks species based on more simple albeit robust information, but still provides reliable management recommendations. To test the decision tree, we collected and evaluated distribution data from non-native plants in highland grasslands of Southern Brazil. We compared the results with a national list from the Brazilian Invasive Species Database for the state to discuss advantages and disadvantages of the different approaches on a regional scale. Out of 38 non-native species found, only four were also present on the national list. If management would solely rely on this list, many species that were identified as spreading based on the decision tree would go unnoticed. With the suggested scheme, it is possible to assign species to active management, to monitoring, or further evaluation. While national lists are certainly important, management on a regional scale should employ additional tools that adequately consider the actual risk of non-natives to become invasive.

  20. Priority setting for risk assessment-The benefit of human experience

    The chemical risk assessment process plays an essential role in the potential human health risk evaluation. Setting priorities for this purpose is critical for better use of the available human and material resources. It has been generally accepted that all new chemicals require safety evaluation before manufacture and sale. This is a difficult task due to the large number of chemicals directly consumed by man, as well as those that are widely used. At present, more than 50% of chemicals do not have the minimum data requirements for risk assessment. Production and release volumes are well-established prioritization criteria, although volume itself does not directly reflect the likelihood of human exposure. This quantitative approach applied in setting priorities may be influenced by human experience. Human data provided by epidemiological investigations have been accepted as the most credible evidence for human toxicity although analytical studies are expensive and require long-term follow up. Unfortunately, some epidemiological studies continue to have difficulties with exposure documentation, controlling bias and confounding, and are not able to provide predictions of risk until humans are exposed. Clinical toxicology services and Poison Centres around the world accumulate a great amount of toxicological-related information that may contribute to the evidence-based medicine and research and so collaborate with all the risk assessment disciplines. The information obtained from these services and centers has the potential to prioritize existing chemical assessment processes or to influence scheduling of classes of chemicals. Prioritization process may be improved by evaluating Poisons Centres statistics about frequency of cases, severity of effects, detection of unusual circumstances of exposure, as well as vulnerable sub-populations. International efforts for the harmonization of these data offer a useful tool to take advantage of this global information. Case

  1. Using multicriteria decision analysis to support research priority setting in biomedical translational research projects.

    de Graaf, Gimon; Postmus, Douwe; Buskens, Erik

    2015-01-01

    Translational research is conducted to achieve a predefined set of economic or societal goals. As a result, investment decisions on where available resources have the highest potential in achieving these goals have to be made. In this paper, we first describe how multicriteria decision analysis can assist in defining the decision context and in ensuring that all relevant aspects of the decision problem are incorporated in the decision making process. We then present the results of a case study to support priority setting in a translational research consortium aimed at reducing the burden of disease of type 2 diabetes. During problem structuring, we identified four research alternatives (primary, secondary, tertiary microvascular, and tertiary macrovascular prevention) and a set of six decision criteria. Scoring of these alternatives against the criteria was done using a combination of expert judgement and previously published data. Lastly, decision analysis was performed using stochastic multicriteria acceptability analysis, which allows for the combined use of numerical and ordinal data. We found that the development of novel techniques applied in secondary prevention would be a poor investment of research funds. The ranking of the remaining alternatives was however strongly dependent on the decision maker's preferences for certain criteria. PMID:26495288

  2. Center for risk management sponsors conference on setting national environmental priorities

    On November 15, 16, and 17, 1992, the Center for Risk Management at Resources for the Future sponsored a conference on alternative ways to set environmental priorities for the United States. During the conference, held in Annapolis, Maryland, nearly 100 representatives from state and federal governments, academia, industry, and environmental organizations debated a plan of the U.S. Environmental Protection Agency (EPA) to focus its attention on those risks to human health and natural ecosystems that scientific evidence suggests can be reduced. Participants tackled the question of what weight government should give to risk assessment information, public opinion, economic and equity considerations, and the potential for technological solutions to environmental problems in setting the nation's environmental agenda. Among those who presented papers on these and related topics were Alice Rivlin, recently appointed deputy director of the Office of Management and Budget by the Clinton administration; F. Henry Habicht, outgoing IPA deputy administrator; and Barry Commoner, director of the Center for the Biology of Natural Systems at Queens College in Flushing, New York

  3. Proceduralism and its role in economic evaluation and priority setting in health.

    Jan, Stephen

    2014-05-01

    This paper provides a critical overview of Gavin Mooney's proceduralist approach to economic evaluation and priority setting in health. Proceduralism is the notion that the social value attached to alternative courses of action should be determined not only by outcomes, but also processes. Mooney's brand of proceduralism was unique and couched within a broader critique of 'neo-liberal' economics. It operated on a number of levels. At the micro level of the individual program, he pioneered the notion that 'process utility' could be valued and measured within economic evaluation. At a macro level, he developed a framework in which the social objective of equity was defined by procedural justice in which communitarian values were used as the basis for judging how resources should be allocated across the health system. Finally, he applied the notion of procedural justice to further our understanding of the political economy of resource allocation; highlighting how fairness in decision making processes can overcome the sometimes intractable zero-sum resource allocation problem. In summary, his contributions to this field have set the stage for innovative programs of research to help in developing health policies and programs that are both in alignment with community values and implementable. PMID:24647102

  4. Habitat evaluation of wild Amur tiger (Panthera tigris altaica) and conservation priority setting in north-eastern China.

    Xiaofeng, Luan; Yi, Qu; Diqiang, Li; Shirong, Liu; Xiulei, Wang; Bo, Wu; Chunquan, Zhu

    2011-01-01

    The Amur Tiger (Panthera tigris altaica) is one of the world's most endangered species. Recently, habitat fragmentation, food scarcity and human hunting have drastically reduced the population size and distribution areas of Amur tigers in the wild, leaving them on the verge of extinction. Presently, they are only found in the north-eastern part of China. In this study, we developed a reference framework using methods and technologies of analytic hierarchy process (AHP), remote sensing (RS), geographic information system (GIS), GAP analysis and Natural Break (Jenks) classification to evaluate the habitat and to set the conservation priorities for Amur tigers in eastern areas of Heilongjiang and Jilin Provinces of northeast China. We proposed a Habitat Suitability Index (HSI) incorporating 7 factors covering natural conditions and human disturbance. Based on the HSI values, the suitability was classified into five levels from the most to not suitable. Finally, according to results of GAP analysis, we identified six conservation priorities and designed a conservation landscape incorporating four new nature reserves, enlarging two existing ones, and creating four linkages for Amur tigers in northeast China. The case study showed that the core habitats (the most suitable and highly suitable habitats) identified for Amur tigers covered 35,547 km(2), accounting for approximately 26.71% of the total study area (1,33,093 km(2)). However, existing nature reserves protected only (7124 km(2) or) 20.04% of the identified core habitats. Thus, enlargement of current reserves is necessary and urgent for the tiger's conservation and restoration. Moreover, the establishment of wildlife corridors linking core habitats will provide an efficient reserve network for tiger conservation to maintain the evolutionary potential of Amur tigers facing environmental changes. PMID:20828917

  5. CRIMALDDI: a co-ordinated, rational, and integrated effort to set logical priorities in anti-malarial drug discovery initiatives

    Doerig Christian

    2010-07-01

    Full Text Available Abstract Despite increasing efforts and support for anti-malarial drug R&D, globally anti-malarial drug discovery and development remains largely uncoordinated and fragmented. The current window of opportunity for large scale funding of R&D into malaria is likely to narrow in the coming decade due to a contraction in available resources caused by the current economic difficulties and new priorities (e.g. climate change. It is, therefore, essential that stakeholders are given well-articulated action plans and priorities to guide judgments on where resources can be best targeted. The CRIMALDDI Consortium (a European Union funded initiative has been set up to develop, through a process of stakeholder and expert consultations, such priorities and recommendations to address them. It is hoped that the recommendations will help to guide the priorities of the European anti-malarial research as well as the wider global discovery agenda in the coming decade.

  6. Pharmacological interactions between rifampicin and antiretroviral drugs: challenges and research priorities for resource-limited settings.

    Semvua, Hadija H; Kibiki, Gibson S; Kisanga, Elton R; Boeree, Martin J; Burger, David M; Aarnoutse, Rob

    2015-02-01

    Coadministration of antituberculosis and antiretroviral therapy is often inevitable in high-burden countries where tuberculosis (TB) is the most common opportunistic infection associated with HIV/AIDS. Concurrent use of rifampicin and many antiretroviral drugs is complicated by pharmacokinetic drug-drug interactions. Rifampicin is a very potent enzyme inducer, which can result in subtherapeutic antiretroviral drug concentrations. In addition, TB drugs and antiretroviral drugs have additive (pharmacodynamic) interactions as reflected in overlapping adverse effect profiles. This review provides an overview of the pharmacological interactions between rifampicin-based TB treatment and antiretroviral drugs in adults living in resource-limited settings. Major progress has been made to evaluate the interactions between TB drugs and antiretroviral therapy; however, burning questions remain concerning nevirapine and efavirenz effectiveness during rifampicin-based TB treatment, treatment options for TB-HIV-coinfected patients with nonnucleoside reverse transcriptase inhibitor resistance or intolerance, and exact treatment or dosing schedules for vulnerable patients including children and pregnant women. The current research priorities can be addressed by maximizing the use of already existing data, creating new data by conducting clinical trials and prospective observational studies and to engage a lobby to make currently unavailable drugs available to those most in need. PMID:24943062

  7. Setting priorities for action plans at Los Alamos National Laboratory. Final report

    Miller, A.C.

    1992-09-30

    This report summarizes work done by Applied Decision Analysis (ADA) for Los Alamos National Laboratory (LANL) under Subcontract Number 9-XQ2-Y3837-1 with the University of California. The purpose of this work was to develop a method of setting priorities for environmental, safety, and health (ES&H) deficiencies at Los Alamos. The deficiencies were identified by a DOE Tiger Team that visited LANL in the fall of 1991, and by self assessments done by the Laboratory. ADA did the work described here between October 1991 and the end of September 1992. The ADA staff working on this project became part of a Risk Management Team in the Laboratory`s Integration and Coordination Office (ICO). During the project, the Risk Management Team produced a variety of documents describing aspects of the action-plan prioritization system. Some of those documents are attached to this report. Rather than attempt to duplicate their contents, this report provides a guide to those documents, and references them whenever appropriate.

  8. The Benefits of Improved Environmental Accounting: An Economic Framework to Identify Priorities

    Boyd, James

    1998-01-01

    Improved environmental accounting is increasingly seen by corporate managers and environmental advocates alike as a necessary complement to improved environmental decision-making within the private sector. This paper develops an economic approach to the evaluation of environmental accounting's benefits and derives the value, and determinants, of improved accounting information in several production and capital budgeting contexts. Using concepts from managerial economics, finance, and organiza...

  9. Strategic Priorities, Company Performance and Attitudes Towards Management Accounting Techniques: an Empirical Study

    Ekholm, Bo-Göran; Wallin, Jan

    2004-01-01

    The study investigates whether there is an association between different combinations of emphasis on generic strategies (product differentiation and cost efficiency) and perceived usefulness of management accounting techniques. Previous research has found that cost leadership is associated with traditional accounting techniques and product differentiation with a variety of modern management accounting approaches. The present study focuses on the possible existence of a strategy that mixes the...

  10. The regulatory framework of accounting and accounting standard-setting bodies in the European Union member states

    Ivana Mamić-Sačer

    2015-12-01

    Full Text Available One of the principal features of accounting in the 21st century is harmonisation and stanardisation. Regulation of the European Parliament and European Council No. 1606/2002 harmonizes financial reporting for certain companies in the EU. However, national accounting principles are of great importance for financial reporting. The main purpose of this research was to investigate the application of generally accepted accounting principles, the regulatory accounting framework and the standard-setting bodies of EU member states. The analysis of these accounting issues was conducted with respect to all 28 EU member states. The results indicate that EU member states regulate their principal accounting issues through separate accounting acts or implement those issues in companies acts. Some EU member states do not have national accounting standards, the national accounting principles being incorporated in companies acts and accounting acts. Nevertheless, national accounting standard-setting bodies are governmental organisations in almost half the member states.

  11. Pharmacoeconomics and its implication on priority-setting for essential medicines in Tanzania: a systematic review

    Mori Amani

    2012-09-01

    the ability to interpret and utilise pharmacoeconomic evidence. Relevant health authorities in Tanzania should also consider how to apply pharmacoeconomic analyses more consistently in the future priority-setting decisions for selection of essential medicines.

  12. Disseminating evidence-based treatments for PTSD in organizational settings: A high priority focus area.

    Ruzek, Josef I; Rosen, Raymond C

    2009-11-01

    Dissemination of evidence-based treatments for PTSD has become an important focus of activity in the aftermath of recent terrorist attacks (e.g., London underground and U.S. 9/11 attacks), natural disasters (e.g., Indian Ocean tsunami and Hurricane Katrina), and wars (e.g., in Iraq and Afghanistan). This has become a high priority need for all mental health training and service delivery organizations. Researchers and educators have begun to examine clinician and client perceptions and preferences regarding PTSD treatment processes, and health care systems are organizing more comprehensive efforts at training and system change. As this evolution of services moves forward, effective dissemination should be a major focus of health policy research for the next decade or more. This review critically evaluates the PTSD-related research and emerging theory related to four major sets of variables that affect dissemination: (1) Practitioner factors, (2) Training methods, (3) The practice innovation(s) being disseminated; and (4) Organization or system factors. We evaluate findings from recent studies in light of emerging models of dissemination, and in the final section of the paper, we consider five broad topics with particular implications for dissemination of PTSD-specific treatments. They are: (1) The content of dissemination (i.e., which treatment protocols or intervention methods should be prioritized); (2) Strict adherence versus flexibility in the use of treatment manuals and the role of fidelity assessment; (3) The need for collaboration with user audiences; (4) The potential role of web-based technologies in increasing the effectiveness and efficiency of dissemination; and (5) Development of dissemination infrastructures within organizations. PMID:19632668

  13. How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS

    Jenniskens Françoise; Tiendrebeogo Georges; Coolen Anne; Blok Lucie; Kouanda Seni; Sataru Fuseini; Ralisimalala Andriamampianina; Mwapasa Victor; Kiyombo Mbela; Plummer David

    2012-01-01

    Abstract Background Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders′ perceptions of health priorities, how priorities are defined in practic...

  14. Setting and meeting priorities in Indigenous health research in Australia and its application in the Cooperative Research Centre for Aboriginal health.

    Monk, Johanna M; Rowley, Kevin G; Anderson, Ian Ps

    2009-01-01

    Priority setting is about making decisions. Key issues faced during priority setting processes include identifying who makes these decisions, who sets the criteria, and who benefits. The paper reviews the literature and history around priority setting in research, particularly in Aboriginal health research. We explore these issues through a case study of the Cooperative Research Centre for Aboriginal Health (CRCAH)'s experience in setting and meeting priorities.Historically, researchers have made decisions about what research gets done. Pressures of growing competition for research funds and an increased public interest in research have led to demands that appropriate consultation with stakeholders is conducted and that research is of benefit to the wider society. Within Australian Aboriginal communities, these demands extend to Aboriginal control of research to ensure that Aboriginal priorities are met.In response to these demands, research priorities are usually agreed in consultation with stakeholders at an institutional level and researchers are asked to develop relevant proposals at a project level. The CRCAH's experience in funding rounds was that scientific merit was given more weight than stakeholders' priorities and did not necessarily result in research that met these priorities. After reviewing these processes in 2004, the CRCAH identified a new facilitated development approach. In this revised approach, the setting of institutional priorities is integrated with the development of projects in a way that ensures the research reflects stakeholder priorities.This process puts emphasis on identifying projects that reflect priorities prior to developing the quality of the research, rather than assessing the relevance to priorities and quality concurrently. Part of the CRCAH approach is the employment of Program Managers who ensure that stakeholder priorities are met in the development of research projects. This has enabled researchers and stakeholders to come

  15. Setting and meeting priorities in Indigenous health research in Australia and its application in the Cooperative Research Centre for Aboriginal Health

    Anderson Ian PS

    2009-11-01

    Full Text Available Abstract Priority setting is about making decisions. Key issues faced during priority setting processes include identifying who makes these decisions, who sets the criteria, and who benefits. The paper reviews the literature and history around priority setting in research, particularly in Aboriginal health research. We explore these issues through a case study of the Cooperative Research Centre for Aboriginal Health (CRCAH's experience in setting and meeting priorities. Historically, researchers have made decisions about what research gets done. Pressures of growing competition for research funds and an increased public interest in research have led to demands that appropriate consultation with stakeholders is conducted and that research is of benefit to the wider society. Within Australian Aboriginal communities, these demands extend to Aboriginal control of research to ensure that Aboriginal priorities are met. In response to these demands, research priorities are usually agreed in consultation with stakeholders at an institutional level and researchers are asked to develop relevant proposals at a project level. The CRCAH's experience in funding rounds was that scientific merit was given more weight than stakeholders' priorities and did not necessarily result in research that met these priorities. After reviewing these processes in 2004, the CRCAH identified a new facilitated development approach. In this revised approach, the setting of institutional priorities is integrated with the development of projects in a way that ensures the research reflects stakeholder priorities. This process puts emphasis on identifying projects that reflect priorities prior to developing the quality of the research, rather than assessing the relevance to priorities and quality concurrently. Part of the CRCAH approach is the employment of Program Managers who ensure that stakeholder priorities are met in the development of research projects. This has enabled

  16. An approach for setting evidence-based and stakeholder-informed research priorities in low- and middle-income countries.

    Rehfuess, Eva A; Durão, Solange; Kyamanywa, Patrick; Meerpohl, Joerg J; Young, Taryn; Rohwer, Anke

    2016-04-01

    To derive evidence-based and stakeholder-informed research priorities for implementation in African settings, the international research consortium Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) developed and applied a pragmatic approach. First, an online survey and face-to-face consultation between CEBHA+ partners and policy-makers generated priority research areas. Second, evidence maps for these priority research areas identified gaps and related priority research questions. Finally, study protocols were developed for inclusion within a grant proposal. Policy and practice representatives were involved throughout the process. Tuberculosis, diabetes, hypertension and road traffic injuries were selected as priority research areas. Evidence maps covered screening and models of care for diabetes and hypertension, population-level prevention of diabetes and hypertension and their risk factors, and prevention and management of road traffic injuries. Analysis of these maps yielded three priority research questions on hypertension and diabetes and one on road traffic injuries. The four resulting study protocols employ a broad range of primary and secondary research methods; a fifth promotes an integrated methodological approach across all research activities. The CEBHA+ approach, in particular evidence mapping, helped to formulate research questions and study protocols that would be owned by African partners, fill gaps in the evidence base, address policy and practice needs and be feasible given the existing research infrastructure and expertise. The consortium believes that the continuous involvement of decision-makers throughout the research process is an important means of ensuring that studies are relevant to the African context and that findings are rapidly implemented. PMID:27034523

  17. The regulatory framework of accounting and accounting standard-setting bodies in the European Union member states

    Ivana Mamić-Sačer

    2015-01-01

    One of the principal features of accounting in the 21st century is harmonisation and stanardisation. Regulation of the European Parliament and European Council No. 1606/2002 harmonizes financial reporting for certain companies in the EU. However, national accounting principles are of great importance for financial reporting. The main purpose of this research was to investigate the application of generally accepted accounting principles, the regulatory accounting framework and the standard-set...

  18. Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiveness analysis

    Norheim, O.F.; Baltussen, R.M.; Johri, M.; Chisholm, D.; Nord, E.; Brock, D.; Carlsson, P.; Cookson, R.; Daniels, N.; Danis, M.; Fleurbaey, M.; Johansson, K.A.; Kapiriri, L.; Littlejohns, P.; Mbeeli, T.; Rao, K.D.; Edejer, T.T.; Wikler, D.

    2014-01-01

    This Guidance for Priority Setting in Health Care (GPS-Health), initiated by the World Health Organization, offers a comprehensive map of equity criteria that are relevant to health care priority setting and should be considered in addition to cost-effectiveness analysis. The guidance, in the form o

  19. Priority in Process Algebras

    Cleaveland, Rance; Luettgen, Gerald; Natarajan, V.

    1999-01-01

    This paper surveys the semantic ramifications of extending traditional process algebras with notions of priority that allow for some transitions to be given precedence over others. These enriched formalisms allow one to model system features such as interrupts, prioritized choice, or real-time behavior. Approaches to priority in process algebras can be classified according to whether the induced notion of preemption on transitions is global or local and whether priorities are static or dynamic. Early work in the area concentrated on global pre-emption and static priorities and led to formalisms for modeling interrupts and aspects of real-time, such as maximal progress, in centralized computing environments. More recent research has investigated localized notions of pre-emption in which the distribution of systems is taken into account, as well as dynamic priority approaches, i.e., those where priority values may change as systems evolve. The latter allows one to model behavioral phenomena such as scheduling algorithms and also enables the efficient encoding of real-time semantics. Technically, this paper studies the different models of priorities by presenting extensions of Milner's Calculus of Communicating Systems (CCS) with static and dynamic priority as well as with notions of global and local pre- emption. In each case the operational semantics of CCS is modified appropriately, behavioral theories based on strong and weak bisimulation are given, and related approaches for different process-algebraic settings are discussed.

  20. Setting priorities for environmental sanitation interventions based on epidemiological criteria: a Brazilian study.

    Heller, Léo; Colosimo, Enrico A; Antunes, Carlos M F

    2005-09-01

    The present study addresses the use of analytical epidemiologic approaches to subsidize the establishment of priorities in environmental sanitation interventions. An epidemiological investigation was carried out in 1993 in the urban area of Betim, a southeast Brazilian City of 160,000 inhabitants. The case-control 'inclusive' (or case-cohort) design, with a sample of 997 cases and 999 controls, was employed. Cases were defined as children of less than five years of age presenting diarrhoea episodes, while controls were randomly selected among children of the same age, living in the study area. After logistic regression adjustment, 11 of several exposure variables analysed were significantly associated with diarrhoea. Four different criteria, using as risk measures the relative risk, the attributable risk, the standardized coefficient of the logistic regression and the cost standardized coefficient, were used in order to define intervention priorities. PMID:16209031

  1. From papers to practices: district level priority setting processes and criteria for family planning, maternal, newborn and child health interventions in Tanzania

    2011-01-01

    Background Successful priority setting is increasingly known to be an important aspect in achieving better family planning, maternal, newborn and child health (FMNCH) outcomes in developing countries. However, far too little attention has been paid to capturing and analysing the priority setting processes and criteria for FMNCH at district level. This paper seeks to capture and analyse the priority setting processes and criteria for FMNCH at district level in Tanzania. Specifically, we assess the FMNCH actor's engagement and understanding, the criteria used in decision making and the way criteria are identified, the information or evidence and tools used to prioritize FMNCH interventions at district level in Tanzania. Methods We conducted an exploratory study mixing both qualitative and quantitative methods to capture and analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively sampled the participants to be included in the study. We collected the data using the nominal group technique (NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data using both content analysis for qualitative data and correlation analysis for quantitative data. Results We found a number of shortfalls in the district's priority setting processes and criteria which may lead to inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting criteria and established the perceived relative importance of the identified criteria. However, we noted differences exist in judging the relative importance attached to the criteria by different stakeholders in the districts. Conclusions In Tanzania, FMNCH contents in both general development policies and sector policies are well articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects rendering the priority setting process for

  2. Is cost-effectiveness analysis preferred to severity of disease as the main guiding principle in priority setting in resource poor settings? The case of Uganda

    Norheim Ole

    2004-01-01

    Full Text Available Abstract Introduction Several studies carried out to establish the relative preference of cost-effectiveness of interventions and severity of disease as criteria for priority setting in health have shown a strong preference for severity of disease. These preferences may differ in contexts of resource scarcity, as in developing countries, yet information is limited on such preferences in this context. Objective This study was carried out to identify the key players in priority setting in health and explore their relative preference regarding cost-effectiveness of interventions and severity of disease as criteria for setting priorities in Uganda. Design 610 self-administered questionnaires were sent to respondents at national, district, health sub-district and facility levels. Respondents included mainly health workers. We used three different simulations, assuming same patient characteristics and same treatment outcome but with varying either severity of disease or cost-effectiveness of treatment, to explore respondents' preferences regarding cost-effectiveness and severity. Results Actual main actors were identified to be health workers, development partners or donors and politicians. This was different from what respondents perceived as ideal. Above 90% of the respondents recognised the importance of both severity of disease and cost-effectiveness of intervention. In the three scenarios where they were made to choose between the two, a majority of the survey respondents assigned highest weight to treating the most severely ill patient with a less cost-effective intervention compared to the one with a more cost-effective intervention for a less severely ill patient. However, international development partners in in-depth interviews preferred the consideration of cost-effectiveness of intervention. Conclusions In a survey among health workers and other actors in priority setting in Uganda, we found that donors are considered to have more say than

  3. Use of Cost-Effectiveness Data in Priority Setting Decisions: Experiences from the National Guidelines for Heart Diseases in Sweden

    Nathalie Eckard

    2014-11-01

    Full Text Available Background The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG, used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. Methods A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. Results This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Conclusion Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision

  4. Health sector priority setting at meso-level in lower and middle income countries: lessons learned, available options and suggested steps.

    Hipgrave, David B; Alderman, Katarzyna Bolsewicz; Anderson, Ian; Soto, Eliana Jimenez

    2014-02-01

    Setting priority for health programming and budget allocation is an important issue, but there is little consensus on related processes. It is particularly relevant in low resource settings and at province- and district- or "meso-level", where contextual influences may be greater, information scarce and capacity lower. Although recent changes in disease epidemiology and health financing suggest even greater need to allocate resources effectively, the literature is relatively silent on evidence-based priority-setting in low and middle income countries (LMICs). We conducted a comprehensive review of the peer-reviewed and grey literature on health resource priority-setting in LMICs, focussing on meso-level and the evidence-based priority-setting processes (PSPs) piloted or suggested there. Our objective was to assess PSPs according to whether they have influenced resource allocation and impacted the outcome indicators prioritised. An exhaustive search of the peer-reviewed and grey literature published in the last decade yielded 57 background articles and 75 reports related to priority-setting at meso-level in LMICs. Although proponents of certain PSPs still advocate their use, other experts instead suggest broader elements to guide priority-setting. We conclude that currently no process can be confidently recommended for such settings. We also assessed the common reasons for failure at all levels of priority-setting and concluded further that local authorities should additionally consider contextual and systems limitations likely to prevent a satisfactory process and outcomes, particularly at meso-level. Recent literature proposes a list of related attributes and warning signs, and facilitated our preparation of a simple decision-tree or roadmap to help determine whether or not health systems issues should be improved in parallel to support for needed priority-setting; what elements of the PSP need improving; monitoring, and evaluation. Health priority-setting at

  5. Setting Priorities: Functional and Substantive Dimensions of Irregular Immigration and Data Protection Under Co-decision

    Ariadna Ripoll Servent

    2009-08-01

    Full Text Available During the months leading to the end of the transitional period (January 2005, most academics and actors involved in the Area of Freedom, Security and Justice (ASFJ expected the introduction of co-decision as the normal decision-making procedure in this area to change the balance between security and liberty. The involvement of the European Parliament as a co-legislator was thought to be a positive aspect, since this institution had persistently adopted a pro-civil liberties stance. Since then, this question has not been systematically tackled in the literature and consequently the impact of co-decision on the AFSJ remains unclear. However, in 2007, Maurer and Parkes looked at the securitised policy-image governing European asylum policy in order to understand why the European Parliament had been unable to redress the balance and establish civil liberties as a priority. Following their line of reasoning, this paper develops the functional and substantive dimensions introduced by these scholars, in order to explain why the European Parliament, and especially the LIBE committee, has been equally unable to change priorities in the fields of irregular immigration and data protection. I argue that the persistent weakness of the European Parliament in the functional dimension, i.e. the need to legitimise its presence in negotiations dealt with under co-decision, has made changes in the substantive dimension difficult to attain. In those areas were the substantive dimension is weak, as was the case in the Returns directive, the need to legitimise the presence of the EP creates more polarisation among the members of the LIBE committee. In those cases where there is a strong substantive alternative in the LIBE committee, as was the case in the Data retention directive, change is hindered by the Plenary, which establishes the strengthening of the functional dimension as a priority for the institution. In both cases the introduction of co-decision led to

  6. Who Shall Not Be Treated: Public Attitudes on Setting Health Care Priorities by Person-Based Criteria in 28 Nations

    Rogge, Jana; Kittel, Bernhard

    2016-01-01

    The principle of distributing health care according to medical need is being challenged by increasing costs. As a result, many countries have initiated a debate on the introduction of explicit priority regulations based on medical, economic and person-based criteria, or have already established such regulations. Previous research on individual attitudes towards setting health care priorities based on medical and economic criteria has revealed consistent results, whereas studies on the use of person-based criteria have generated controversial findings. This paper examines citizens’ attitudes towards three person-based priority criteria, patients’ smoking habits, age and being the parent of a young child. Using data from the ISSP Health Module (2011) in 28 countries, logistic regression analysis demonstrates that self-interest as well as socio-demographic predictors significantly influence respondents’ attitudes towards the use of person-based criteria for health care prioritization. This study contributes to resolving the controversial findings on person-based criteria by using a larger country sample and by controlling for country-level differences with fixed effects models. PMID:27280775

  7. Allocating limited resources in a time of fiscal constraints: a priority setting case study from Dalhousie University Faculty of Medicine.

    Mitton, Craig; Levy, Adrian; Gorsky, Diane; MacNeil, Christina; Dionne, Francois; Marrie, Tom

    2013-07-01

    Facing a projected $1.4M deficit on a $35M operating budget for fiscal year 2011/2012, members of the Dalhousie University Faculty of Medicine developed and implemented an explicit, transparent, criteria-based priority setting process for resource reallocation. A task group that included representatives from across the Faculty of Medicine used a program budgeting and marginal analysis (PBMA) framework, which provided an alternative to the typical public-sector approaches to addressing a budget deficit of across-the-board spending cuts and political negotiation. Key steps to the PBMA process included training staff members and department heads on priority setting and resource reallocation, establishing process guidelines to meet immediate and longer-term fiscal needs, developing a reporting structure and forming key working groups, creating assessment criteria to guide resource reallocation decisions, assessing disinvestment proposals from all departments, and providing proposal implementation recommendations to the dean. All departments were required to submit proposals for consideration. The task group approved 27 service reduction proposals and 28 efficiency gains proposals, totaling approximately $2.7M in savings across two years. During this process, the task group faced a number of challenges, including a tight timeline for development and implementation (January to April 2011), a culture that historically supported decentralized planning, at times competing interests (e.g., research versus teaching objectives), and reductions in overall health care and postsecondary education government funding. Overall, faculty and staff preferred the PBMA approach to previous practices. Other institutions should use this example to set priorities in times of fiscal constraints. PMID:23702521

  8. Public views on principles for health care priority setting: findings of a European cross-country study using Q methodology.

    van Exel, Job; Baker, Rachel; Mason, Helen; Donaldson, Cam; Brouwer, Werner

    2015-02-01

    Resources available to the health care sector are finite and typically insufficient to fulfil all the demands for health care in the population. Decisions must be made about which treatments to provide. Relatively little is known about the views of the general public regarding the principles that should guide such decisions. We present the findings of a Q methodology study designed to elicit the shared views in the general public across ten countries regarding the appropriate principles for prioritising health care resources. In 2010, 294 respondents rank ordered a set of cards and the results of these were subject to by-person factor analysis to identify common patterns in sorting. Five distinct viewpoints were identified, (I) "Egalitarianism, entitlement and equality of access"; (II) "Severity and the magnitude of health gains"; (III) "Fair innings, young people and maximising health benefits"; (IV) "The intrinsic value of life and healthy living"; (V) "Quality of life is more important than simply staying alive". Given the plurality of views on the principles for health care priority setting, no single equity principle can be used to underpin health care priority setting. Hence, the process of decision making becomes more important, in which, arguably, these multiple perspectives in society should be somehow reflected. PMID:25550076

  9. Mapping biodiversity and setting conservation priorities for SE Queensland's rainforests using DNA barcoding.

    Shapcott, Alison; Forster, Paul I; Guymer, Gordon P; McDonald, William J F; Faith, Daniel P; Erickson, David; Kress, W John

    2015-01-01

    Australian rainforests have been fragmented due to past climatic changes and more recently landscape change as a result of clearing for agriculture and urban spread. The subtropical rainforests of South Eastern Queensland are significantly more fragmented than the tropical World Heritage listed northern rainforests and are subject to much greater human population pressures. The Australian rainforest flora is relatively taxonomically rich at the family level, but less so at the species level. Current methods to assess biodiversity based on species numbers fail to adequately capture this richness at higher taxonomic levels. We developed a DNA barcode library for the SE Queensland rainforest flora to support a methodology for biodiversity assessment that incorporates both taxonomic diversity and phylogenetic relationships. We placed our SE Queensland phylogeny based on a three marker DNA barcode within a larger international rainforest barcode library and used this to calculate phylogenetic diversity (PD). We compared phylo- diversity measures, species composition and richness and ecosystem diversity of the SE Queensland rainforest estate to identify which bio subregions contain the greatest rainforest biodiversity, subregion relationships and their level of protection. We identified areas of highest conservation priority. Diversity was not correlated with rainforest area in SE Queensland subregions but PD was correlated with both the percent of the subregion occupied by rainforest and the diversity of regional ecosystems (RE) present. The patterns of species diversity and phylogenetic diversity suggest a strong influence of historical biogeography. Some subregions contain significantly more PD than expected by chance, consistent with the concept of refugia, while others were significantly phylogenetically clustered, consistent with recent range expansions. PMID:25803607

  10. The Impact of Sika Deer on Vegetation in Japan: Setting Management Priorities on a National Scale

    Ohashi, Haruka; Yoshikawa, Masato; Oono, Keiichi; Tanaka, Norihisa; Hatase, Yoriko; Murakami, Yuhide

    2014-09-01

    Irreversible shifts in ecosystems caused by large herbivores are becoming widespread around the world. We analyzed data derived from the 2009-2010 Sika Deer Impact Survey, which assessed the geographical distribution of deer impacts on vegetation through a questionnaire, on a scale of 5-km grid-cells. Our aim was to identify areas facing irreversible ecosystem shifts caused by deer overpopulation and in need of management prioritization. Our results demonstrated that the areas with heavy impacts on vegetation were widely distributed across Japan from north to south and from the coastal to the alpine areas. Grid-cells with heavy impacts are especially expanding in the southwestern part of the Pacific side of Japan. The intensity of deer impacts was explained by four factors: (1) the number of 5-km grid-cells with sika deer in neighboring 5 km-grid-cells in 1978 and 2003, (2) the year sika deer were first recorded in a grid-cell, (3) the number of months in which maximum snow depth exceeded 50 cm, and (4) the proportion of urban areas in a particular grid-cell. Based on our model, areas with long-persistent deer populations, short snow periods, and fewer urban areas were predicted to be the most vulnerable to deer impact. Although many areas matching these criteria already have heavy deer impact, there are some areas that remain only slightly impacted. These areas may need to be designated as having high management priority because of the possibility of a rapid intensification of deer impact.

  11. Intervention complexity: a conceptual framework to inform priority-setting in health

    Gericke Christian A.

    2005-01-01

    Full Text Available Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals.

  12. Defining Long Term Goals and Setting Priorities for Education and Outreach, 2003 to 2013 - Panel Report

    Grier, J. A.; Atkinson, D. H.; Barlow, N.; Griffin, I.; Hoffman, J.; Kelly-Serrato, B.; Kesthelyi, L.; Klein, M.; Klug, S.; Kolvoord, B.; Lanagan, P.; Lebofsky, L. A.; Lindstrom, M.; Lopes, R.; Lowes, L.; Manifold, J.; Mastrapa, R.; Milazzo, M.; Miner, E.; Morris, P.; Runyon, C.; Sohus, A.; Urquhart, M.; Warasila, R. L.; Withers, P.; Wood, Chuck

    2001-11-01

    Education and Public Outreach (E/PO) activities are an integral part of NASA's mandated mission and detailed in its Strategic Plan. The Office of Space Science Solar System Exploration (OSS SSE) E/PO program has made great strides in defining priorities and achieving its goals in the last five years. The Education and Public Outreach panel for NASA's Decadal Survey has generated a list of key issues to be addressed for the years 2003-2013 to assist the OSS SSE in future prioritization and planning. Key issues under discussion include: improving the involvement of planetary science professionals in E/PO activities; combating scientific elitism; examining the association between E/PO programs and public relations; re-examining funding E/PO activities from an audience perspective as opposed to a mission-centered perspective; improving access to resources for scientists, educators, students and partner organizations; promoting communication between educational programs at NASA; and reaching traditionally underrepresented groups, women, minorities and the disabled with science education programs. The panel is developing a list of specific recommendations to be implemented to improve OSS SSE E/PO activities in the next decade. These recommendations deal with topics such as: the production of evaluated resource web sites for scientists and educators; the development of a policy of long-term funding for the maintenance of web sites and other tools after they are created; methods for reaching those who do not have computer access through television and public programs; and the development of a reward system to recognize and encourage scientist involvement in E/PO activities. Such key issues and recommendations will be presented, along with materials from current programs and initiatives for E/PO in the OSS SSE.

  13. The moral relevance of personal characteristics in setting health care priorities

    Olsen, Jan Abel; Ricardson, Jeff; Dolan, Paul; Mentzel, Paul

    2009-01-01

    This paper discusses the moral relevance of accounting for various personal characteristics when prioritising between groups of patients. After a review of the results from empirical studies, we discuss the ethical reasons which might explain – and justify – the views expressed in these studies. The paper develops a general framework based upon the causes of ill health and the consequences of treatment. It then turns to the question of the extent to which a personal characteristic – and the e...

  14. Setting research priorities to reduce almost one million deaths from birth asphyxia by 2015.

    Lawn, Joy E.; Rajiv Bahl; Staffan Bergstrom; Bhutta, Zulfiqar A; Darmstadt, Gary L; Matthew Ellis; Mike English; Kurinczuk, Jennifer J.; Anne C C Lee; Mario Merialdi; Mohamed Mohamed; David Osrin; Robert Pattinson; Vinod Paul; Siddarth Ramji

    2011-01-01

    Intrapartum-related neonatal deaths (previously called “birth asphyxia”) are the fifth most common cause of deaths among children under 5 years of age, accounting for an estimated 814,000 deaths each year, and also associated with significant morbidity, resulting in a burden of 42 million disability adjusted life years (DALYs). This paper uses a systematic process developed by the Child Health Nutrition Research Initiative (CHNRI) to define and rank research options to reduce mortality...

  15. Lonely at the Top and Stuck in the Middle? The Ongoing Challenge of Using Cost-Effectiveness Information in Priority Setting; Comment on “Use of Cost-Effectiveness Data in Priority Setting Decisions: Experiences from the National Guidelines for Heart Diseases in Sweden”

    Iestyn Williams

    2015-03-01

    Full Text Available The topic of how cost-effectiveness information informs priority setting in healthcare remains important to both policy and practice. This commentary considers the study carried out by Eckard and colleagues in Sweden. In it we distinguish between the conditions at national and local levels and put forward some recommendations for research into local priority setting in particular

  16. Priority setting of public spending in developing countries: do not try to do everything for everybody.

    Baltussen, R.M.P.M.

    2006-01-01

    BACKGROUND: Public spending on health care in many developing countries falls short to provide a comprehensive set of essential health services, which indicates the need to target and prioritize resources. However, governments often attempt to provide free services to the whole population, and often

  17. The ICF as a common language for rehabilitation goal-setting: comparing client and professional priorities

    van der Merwe Aletia

    2011-10-01

    Full Text Available Abstract Background Joint rehabilitation goals are an important component for effective teamwork in the rehabilitation field. The activities and participation domain of the ICF provides a common language for professionals when setting these goals. Involving clients in the formulation of rehabilitation goals is gaining momentum as part of a person-centred approach to rehabilitation. However, this is particularly difficult when clients have an acquired communication disability. The expressive communication difficulties negatively affect the consensus building process. As a result, obtaining information regarding rehabilitation goals from professionals and their clients warrants further investigation for this particular population. Methods This comparative study investigated clients and their assigned rehabilitation professionals' perception of the importance of ICF activities and participation domains for inclusion in their rehabilitation program. Twelve clients in an acute rehabilitation centre and twenty of their corresponding rehabilitation professionals participated in an activity using the Talking Mats™ visual framework for goal setting. Each participant rated the importance of the nine activities and participation domains of the ICF for inclusion in their current rehabilitation program. Results The ICF domains which consistently appear as very important across these groups are mobility, self-care and communication. Domains which consistently appear in the lower third of the rankings include spare time, learning and thinking and domestic life. Results indicate however that no statistical significant differences exist in terms of the individual domains across each of the participant groups. Within group differences however indicated that amongst the speech-language therapists and physiotherapists there was a statistical significant difference between spare time activities and communication and mobility. Conclusions Findings indicate that

  18. Priority Setting and Policy Advocacy for Community Environmental Health by Nursing Associations: A Conceptual Framework to Guide Research

    JO-ANNE MACDONALD

    2012-01-01

    Full Text Available Nursing associations' choices to engage in community environmental health transpires in a complex decisionmaking context in which a number of issues compete for their attention and a number of factors influence their choices. Given the complexity of this decision environment, theoretically informed research can lead to understanding about the dynamics, supports, and constraints shaping nursing associations' decisions. We propose a conceptual framework to guide research to understand whether and how nursing associations' take action for community environmental health. The framework depicts nursing associations' priority setting and policy advocacy for community environmental health embedded in a policy decision-making context in which internal association factors and external factors at all system levels (local to global influence the organizational choices and actions taken.

  19. Setting global research priorities for integrated community case management (iCCM): Results from a CHNRI (Child Health and Nutrition Research Initiative) exercise

    Kerri Wazny; Salim Sadruddin; Alvin Zipursky; Davidson H Hamer; Troy Jacobs; Karin Kallander; Franco Pagnoni; Stefan Peterson; Shamim Qazi; Serge Raharison; Kerry Ross; Mark Young; Marsh, David R

    2014-01-01

    AIMS: To systematically identify global research gaps and resource priorities for integrated community case management (iCCM). METHODS: An iCCM Child Health and Nutrition Research Initiative (CHNRI) Advisory Group, in collaboration with the Community Case Management Operational Research Group (CCM ORG) identified experts to participate in a CHNRI research priority setting exercise. These experts generated and systematically ranked research questions for iCCM. Research questions were ranked us...

  20. Evaluating the impact of fair value accounting on financial institutions: implications for accounting standards setting and bank supervision

    Sanders Shaffer

    2012-01-01

    Recent standard-setting activity related to fair value accounting has injected new life into questions of whether fair value provides information useful for decision-making, and whether there might be unintended consequences on financial stability. This discussion paper provides insight into these questions by performing a holistic evaluation of fair value accounting’s usefulness, the potential impacts it may have on financial institutions and any broader macroeconomic effects. Materials revi...

  1. Key performance indicators (KPIs) and priority setting in using the multi-attribute approach for assessing sustainable intelligent buildings

    ALwaer, H. [The University of Dundee, School of Architecture, Matthew Building, 13 Perth Road, Dundee DD1 4HT (United Kingdom); Clements-Croome, D.J. [School of Construction Management and Engineering, The University of Reading, Whiteknights, PO Box 219, Reading RG6 6AW (United Kingdom)

    2010-04-15

    The main objectives of this paper are to: firstly, identify key issues related to sustainable intelligent buildings (environmental, social, economic and technological factors); develop a conceptual model for the selection of the appropriate KPIs; secondly, test critically stakeholder's perceptions and values of selected KPIs intelligent buildings; and thirdly develop a new model for measuring the level of sustainability for sustainable intelligent buildings. This paper uses a consensus-based model (Sustainable Built Environment Tool- SuBETool), which is analysed using the analytical hierarchical process (AHP) for multi-criteria decision-making. The use of the multi-attribute model for priority setting in the sustainability assessment of intelligent buildings is introduced. The paper commences by reviewing the literature on sustainable intelligent buildings research and presents a pilot-study investigating the problems of complexity and subjectivity. This study is based upon a survey perceptions held by selected stakeholders and the value they attribute to selected KPIs. It is argued that the benefit of the new proposed model (SuBETool) is a 'tool' for 'comparative' rather than an absolute measurement. It has the potential to provide useful lessons from current sustainability assessment methods for strategic future of sustainable intelligent buildings in order to improve a building's performance and to deliver objective outcomes. Findings of this survey enrich the field of intelligent buildings in two ways. Firstly, it gives a detailed insight into the selection of sustainable building indicators, as well as their degree of importance. Secondly, it tesst critically stakeholder's perceptions and values of selected KPIs intelligent buildings. It is concluded that the priority levels for selected criteria is largely dependent on the integrated design team, which includes the client, architects, engineers and facilities managers

  2. Goal Statements and Goal-Directed Behavior: A Relational Frame Account of Goal Setting in Organizations

    O'Hora, Denis; Maglieri, Kristen A.

    2006-01-01

    Goal setting has consistently been shown to increase performance under specific conditions. These goal setting effects have previously been explored from both a cognitive perspective and in terms of traditional behavioral concepts. We highlight limitations of these approaches and propose a novel account based on Relational Frame Theory. This…

  3. Analysis of Constraints to Agricultural Production in the Sudano Savanna Zone of Cameroon and Implication for Research Priority Setting

    M'biandoum, M.

    2005-01-01

    Full Text Available A participatory rural appraisal (PRA survey approach was used to identify the major constraints to agricultural production and to describe the major production systems in the sudano savanna and sudano sahelian zone of northern Cameroon. Relative emphasis was placed on the household level characterization to have a better understanding of the land use system, farmers' constraints to production and opportunities, so as to better target agricultural technologies and interventions in this vast agro-ecological zone. It was noted that, large variations exist in agriculture management practices between agro-ecological zones, among villages and households in terms of access to resources, such as labour, fertilizers, livestock, farm equipment, and land. Intensive and extensive farming practices might co-exist within the same village and households. The mains sources of vulnerability were identified. Results are used to set research priorities which will be directed towards the need of the majority of area's population; the improvement of sustainable food and feed crop production.

  4. Risk perception and priority setting for intervention among hepatitis C virus and environmental risks: a cross-sectional survey in the Cairo community

    Dewedar Sahar

    2010-12-01

    Full Text Available Abstract Background Hepatitis C virus (HCV recently emerged as a major public health hazard in Egypt. However, dramatic healthcare budget constraints limit access to the costly treatment. We assessed risk perception and priority setting for intervention among HCV, unsafe water, and outdoor air pollution in Cairo city. Methods A survey was conducted in the homes of a representative sample of household heads in Cairo city. Risk perception was assessed using the "psychometric paradigm" where health hazards are evaluated according to several attributes and then summarized by principal component analysis. Priority setting was assessed by individual ranking of interventions reducing health hazards by 50% over five years. The Condorcet method was used to aggregate individual rankings of the three interventions (main study or two of three interventions (validation study. Explanatory factors of priority setting were explored in multivariate generalized logistic models. Results HCV was perceived as having the most severe consequences in terms of illness and out-of-pocket costs, while outdoor air pollution was perceived as the most uncontrollable risk. In the main study (n = 2,603, improved water supply received higher priority than both improved outdoor air quality (60.1%, P P Conclusions The Cairo community prefers to further improving water supply as compared to improved outdoor air quality and screening and treatment of chronic hepatitis C.

  5. How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS

    Jenniskens Françoise

    2012-12-01

    Full Text Available Abstract Background Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders′ perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. Methods A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi. Key background documents were analysed and semi-structured interviews (n = 258 and focus group discussions (n = 45 were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Results Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs. Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi

  6. Setting priorities for mental health research in Brazil Agenda de prioridades de pesquisa para saúde mental no Brasil

    Guilherme Gregório

    2012-12-01

    Full Text Available BACKGROUND: The main aim of this study is to review the agenda for research priorities of mental health in Brazil. METHODOLOGY: The first step was to gather 28 experts (22 researchers, five policy makers, and the coordinator representing all mental health fields from different geographical areas of the country. Participants were asked to list what they considered to be the most relevant mental health research questions for the country to address in the next 10 years. Seventeen participants answered this question; after redundancies were excluded, a total of 110 responses were collected. As the second step, participants were asked to rank which questions were the 35 most significant. The final step was to score 15 items for each of the 35 selected questions to determine whether it would be a answerable, b effective, c deliverable, d equitable, and e effective at reducing the burden of mental health. The ten highest ranked questions were then selected. RESULTS: There were four questions addressing primary care with respect to a the effectiveness of interventions, b "matrix support", c comparisons of different models of stepped care, and d interventions to enhance identification and treatment of common mental disorders at the Family Health Program. The other questions were related to the evaluation of mental health services for adults and children/adolescents to clarify barriers to treatment in primary care, drug addiction, and severe mental disorders; to investigate the cost-benefit relationship of anti-psychotics; to design interventions to decrease alcohol consumption; and to apply new technologies (telemedicine for education and supervision of non-specialists. CONCLUSION: This priority-setting research exercise highlighted a need for implementing investments at the primary-care level, particularly in the family health program; the urgent need to evaluate services; and policies to improve equity by increasing accessibility to services and

  7. Using programme budgeting and marginal analysis (PBMA) to set priorities: reflections from a qualitative assessment in an English Primary Care Trust.

    Goodwin, Elizabeth; Frew, Emma J

    2013-12-01

    In England from 2002 to 2013, Primary Care Trusts (PCTs) were responsible for commissioning healthcare for their local populations. The NHS has recently undergone rapid organisational change whereby clinicians have assumed responsibility for local commissioning decisions. This change in commissioning arrangements alongside the current financial pressures facing the NHS provides an impetus for considering the use of technical prioritisation methods to enable the identification of savings without having a detrimental effect on the health of the population. This paper reports on the design and implementation of a technical prioritisation method termed PBMA applied within NHS Plymouth, an English PCT responsible for commissioning services for a population of approximately 270,000. We evaluated the effectiveness of the process, the extent to which it was appropriate for local healthcare commissioning and whether it identified budget savings. Using qualitative research methodology, we found the process produced clear strategic and operational priorities for 2010/11, providing staff with focus and structure, and delivered a substantial planned reduction in hospital activity levels. Participants expressed satisfaction with the process. NHS Plymouth adhered to the PBMA process, although concerns were raised about the evidence for some priorities, decibel rationing, and a lack of robust challenge at priority-setting meetings. Further work is required to enhance participants' understanding of marginal analysis. Participants highlighted several external benefits, particularly in terms of cultural change, and felt the process should encompass the whole local health and social care community. This evaluation indicates that the prioritisation method was effective in producing priorities for NHS Plymouth, and that PBMA provides an appropriate method for allocating resources at a local level. In order for PBMA to identify savings, cultural and structural barriers to disinvestment

  8. Risk perception and priority setting for intervention among hepatitis C virus and environmental risks: a cross-sectional survey in the Cairo community.

    Dewedar Sahar; Gad Rita R; Mohamed Mostafa K; Schwarzinger Michaël; Fontanet Arnaud; Carrat Fabrice; Luchini Stéphane

    2010-01-01

    Abstract Background Hepatitis C virus (HCV) recently emerged as a major public health hazard in Egypt. However, dramatic healthcare budget constraints limit access to the costly treatment. We assessed risk perception and priority setting for intervention among HCV, unsafe water, and outdoor air pollution in Cairo city. Methods A survey was conducted in the homes of a representative sample of household heads in Cairo city. Risk perception was assessed using the "psychometric paradigm" where he...

  9. Setting priorities for the health care sector in Zimbabwe using cost-effectiveness analysis and estimates of the burden of disease

    Hansen Kristian; Chapman Glyn

    2008-01-01

    Abstract Background This study aimed at providing information for priority setting in the health care sector of Zimbabwe as well as assessing the efficiency of resource use. A general approach proposed by the World Bank involving the estimation of the burden of disease measured in Disability-Adjusted Life Years (DALYs) and calculation of cost-effectiveness ratios for a large number of health interventions was followed. Methods Costs per DALY for a total of 65 health interventions were estimat...

  10. Setting the global health agenda: The influence of advocates and ideas on political priority for maternal and newborn survival.

    Smith, Stephanie L; Shiffman, Jeremy

    2016-10-01

    This study investigates a puzzle concerning global health priorities-why do comparable issues receive differential levels of attention and resources? It considers maternal and neonatal mortality, two high-burden issues that pertain to groups at risk at birth and whose lives could be saved with effective intrapartum care. Why did maternal survival gain status as a global health priority earlier and to a greater degree than newborn survival? Higher mortality and morbidity burdens among newborns and the cost-effectiveness of interventions would seem to predict that issue's earlier and higher prioritization. Yet maternal survival emerged as a priority two decades earlier and had attracted considerably more attention and resources by the close of the Millennium Development Goals era. This study uses replicative process-tracing case studies to examine the emergence and growth of political priority for these two issues, probing reasons for unexpected variance. The study finds that maternal survival's grounding as a social justice issue spurred growth of a strong and diverse advocacy network and aligned the issue with powerful international norms (e.g. expectations to advance women's rights and the Millennium Development Goals), drawing attention and resources to the issue over three decades. Newborn survival's disadvantage stems from its long status as an issue falling under the umbrellas of maternal and child survival but not fully adopted by these networks, and with limited appeal as a public health issue advanced by a small and technically focused network; network expansion and alignment with child survival norms have improved the issue's status in the past few years. PMID:27543685

  11. Share your story, shape your care: engaging the diverse and disperse population of Northwestern Ontario in healthcare priority setting.

    Shields, Kristin; DuBois-Wing, Gwen; Westwood, Ellis

    2010-01-01

    In 2009, the North West Local Health Integration Network hosted Share Your Story, Shape Your Care, an innovative community engagement initiative. Over 800 residents and health service providers in Northwestern Ontario participated and identified healthcare priorities, reacted to proposed strategies and shared ideas and stories. Primarily web-based (with a Choicebook, message board, blog and YouTube video), paper copies and conversation guides supported informed and reflective participation. This project enabled community-level participation in healthcare, supporting local planning and decision-making, and was awarded the inaugural Innovation Using Technology Award by the International Association for Public Participation. PMID:20523159

  12. Failure of the extended contingent attentional capture account in multimodal settings

    Rob H.J. Van der Lubbe

    2006-01-01

    Full Text Available Sudden changes in our environment like sound bursts or light flashes are thought to automatically attract our attention thereby affecting responses to subsequent targets, although an alternative view (the contingent attentional capture account holds that stimuli only capture our attention when they match target features. In the current study, we examined whether an extended version of the latter view can explain exogenous cuing effects on speed and accuracy of performance to targets (uncued-cued in multimodal settings, in which auditory and visual stimuli co-occur. To this end, we determined whether observed effects of visual and auditory cues, which were always intermixed, depend on top-down settings in "pure" blocks, in which only one target modality occurred, as compared to "mixed" blocks, in which targets were either visual or auditory. Results revealed that unimodal and crossmodal cuing effects depend on top-down settings. However, our findingswerenot in accordance with predictions derived from the extended contingent attentional capture account. Specifically,visual cues showed comparable effects for visual targets in pure and mixed blocks, but also a comparable effect for auditory targets in pure blocks, and most surprisingly, an opposite effect in mixed blocks. The latter result suggests that visual stimuli may distract attention from the auditory modality in case when the modality of the forthcoming target is unknown. The results additionally revealed that the Simon effect, the influence of correspondence or not between stimulus and response side, is modulated by exogenous cues in unimodal settings, but not in crossmodal settings. These findings accord with the view that attention plays an important role for the Simon effect, and additionally questions the directness of links between maps of visual and auditory space.

  13. Graduate and Employer Attitudes on the Skill Set Requirements for Professional Accountants: Should Emotional Intelligence be Developed in University Accounting Programs?

    Coady, Peggy Ann

    2014-01-01

    This Doctorate of Business Administration (DBA) thesis investigated graduate and employer attitudes on the skill set requirements for professional accountants and specifically whether university accounting programs provide the emotional intelligence (EI) skills an accounting graduate needs. Emotional intelligence is the effective awareness, control and management of one's own emotions, and those of other people. Theories of emotional intelligence assert that EI is more important t...

  14. Constituents' formal participation in the due process of international accounting standard setting: A longitudinal analysis of stakeholder and geographical diversity.

    Jorissen, Ann; Lybaert, Nadine; ORENS, Raf; Van der Tas, Leo

    2011-01-01

    Since IOSCO’s decision (May, 2000) to accept IASs for cross-border listing and since governments started to hand over accounting standard setting authority to the International Accounting Standards Board (IASB) (EU Regulation EC N° 1606/2002, Australia FRC July 2002), the IASB is well under way to become the global accounting standard setter. For the IASB, being a private organization, widespread constituents’ participation in its due process of standard setting is a key element to reinforce ...

  15. External influences and priority-setting for anti-cancer agents: a case study of media coverage in adjuvant trastuzumab for breast cancer

    Fralick John

    2007-06-01

    Full Text Available Abstract Background Setting priorities for the funding of new anti-cancer agents is becoming increasingly complex. The funding of adjuvant trastuzumab for breast cancer has brought this dilemma to the fore. In this paper we review external factors that may influence decision-making bodies and present a case study of media response in Ontario, Canada to adjuvant trastuzumab for breast cancer. Methods A comprehensive search of the databases of Canadian national and local newspapers and television was performed. Articles pertaining to trastuzumab in adjuvant breast cancer as well as 17 other anti-cancer drugs and indications were retrieved. The search period was from the date when individual trial results were announced to the date funding was made available in Ontario. Results During the 2.6 months between the release of the trastuzumab results to funding approval in Ontario, we identified 51 episodes of media coverage. For the 17 other drugs/indications (7 breast and 10 non-breast, the median time to funding approval was 31 months (range 14–46. Other recent major advances in oncology such as adjuvant vinorelbine/cisplatin for resected NSCLC and docetaxel for advanced prostate cancer received considerably less media attention (17 media reports for each than trastuzumab. The median number of media reports for breast cancer drugs was 4.5 compared to 2.5 for non-breast cancer drugs (p = 0.56. Conclusion Priority-setting for novel anti-cancer agents is a complex process that tries to ensure fair use of constrained resources to fund therapies with the best evidence of clinical benefit. However, this process is subject to external factors including the influence of media, patient advocates, politicians, and industry. The data in this case study serve to illustrate the significant involvement one (or all of these external factors may play in the debate over priority-setting.

  16. Set-based Tasks within the Singularity-robust Multiple Task-priority Inverse Kinematics Framework: General Formulation, Stability Analysis and Experimental Results

    Signe eMoe

    2016-04-01

    Full Text Available Inverse kinematics algorithms are commonly used in robotic systems to transform tasks to joint references, and several methods exist to ensure the achievement of several tasks simultaneously. The multiple task-priority inverse kinematicsframework allows tasks to be considered in a prioritized order by projecting task velocities through the nullspaces of higherpriority tasks. This paper extends this framework to handle setbased tasks, i.e. tasks with a range of valid values, in addition to equality tasks, which have a specific desired value. Examples of set-based tasks are joint limit and obstacle avoidance. The proposed method is proven to ensure asymptotic convergence of the equality task errors and the satisfaction of all high-priority set-based tasks. The practical implementation of the proposed algorithm is discussed, and experimental results are presented where a number of both set-based and equality tasks have been implemented on a 6 degree of freedom UR5 which is an industrial robotic arm from Universal Robots. The experiments validate thetheoretical results and confirm the effectiveness of the proposed approach.

  17. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    M. Chersich (Matthew); S. Luchters (Stanley); I. Ntaganira (Innocent); A. Gerbase (Antonio); Y-R. Lo (Ying-Ru); F. Scorgie (Fiona); R. Steen (Richard)

    2012-01-01

    textabstractIntroduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for

  18. Blended Learning versus Traditional Classroom Settings: Assessing Effectiveness and Student Perceptions in an MBA Accounting Course.

    Clement C. Chen

    2007-01-01

    Full Text Available A survey was conducted of Master of Business Administration (MBA students in an accounting class at a university in the Northern United States to compare students’ assessments of course effectiveness and overall satisfaction with the course. One group of students were enrolled in a traditional in-class section, and another group in a “blended-learning” section in which the primary course delivery method was online, but in which students met in class on a limited number of occasions. Overall perceptions of the course, instructor and learning outcomes were positive for both groups. Students also felt strongly that they would use the material in their careers. The majority of students in the blended learning section indicated that they would take another accounting course using that approach if it were offered. However, some interesting differences were noted. Specifically, students in the traditional setting were more satisfied with the clarity of instruction. On the other hand, students in the blended-learning section felt more strongly that they gained an appreciation of the concepts in the field. Blended-learning students also indicated more strongly that their analytical skills improved as a result of the course. The results suggest that the two delivery methods were similar in terms of final learning outcomes, but that both may be improved by incorporating aspects of the other. The Journal of Educators Online, Volume 4, Number 1, January 2007 1

  19. Contemprorary Russian Environmental policy: problems, players and priorities. The case of Pskov Region and environmental agenda-setting process.

    Lundqvist, Anastasia

    2003-01-01

    From the beginning of nineties, when significant changes took place, Russia began to elaborate new environmental policy and designed new patterns for responding the environmental problems. The paper tried to make a contribution to our understanding of environmental policy and policy processes within the Russia in general terms and to the nature of environmental agenda setting in Pskov region in more specific terms. This thesis is therefore explores environmental agenda setting process in Russ...

  20. Introducing New Priority Setting and Resource Allocation Processes in a Canadian Healthcare Organization: A Case Study Analysis Informed by Multiple Streams Theory

    Neale Smith

    2016-01-01

    Full Text Available Background In this article, we analyze one case instance of how proposals for change to the priority setting and resource allocation (PSRA processes at a Canadian healthcare institution reached the decision agenda of the organization’s senior leadership. We adopt key concepts from an established policy studies framework – Kingdon’s multiple streams theory – to inform our analysis. Methods Twenty-six individual interviews were conducted at the IWK Health Centre in Halifax, NS, Canada. Participants were asked to reflect upon the reasons leading up to the implementation of a formal priority setting process – Program Budgeting and Marginal Analysis (PBMA – in the 2012/2013 fiscal year. Responses were analyzed qualitatively using Kingdon’s model as a template. Results The introduction of PBMA can be understood as the opening of a policy window. A problem stream – defined as lack of broad engagement and information sharing across service lines in past practice – converged with a known policy solution, PBMA, which addressed the identified problems and was perceived as easy to use and with an evidence-base from past applications across Canada and elsewhere. Conditions in the political realm allowed for this intervention to proceed, but also constrained its potential outcomes. Conclusion Understanding in a theoretically-informed way how change occurs in healthcare management practices can provide useful lessons to researchers and decision-makers whose aim is to help health systems achieve the most effective use of available financial resources.

  1. The priorities for ANSTO

    As Australia's major centre of expertise in nuclear science, technology and its applications, ANSTO's priorities take account of the stated strategic and tactical needs of its various stakeholders, which in turn are considered as the Government (as owner), industry - including the health sector, the academic and research community and the public at large. Its priorities also take account of the opportunities perceived by its own staff in the light of the organisation's strengths, the activities of the international scientific, technology and industry community and a rapidly changing socioeconomic environment where environmental management and social accountability are becoming as important as fiscal responsibility and accountability

  2. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    Matthew F Chersich

    2013-03-01

    Full Text Available Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed and non-indexed journals were searched for studies with quantitative study outcomes. Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers’ access to care and antiretroviral treatment (ART, but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers’ control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions: There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services – including peer interventions, condom promotion and STI screening – would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers

  3. The Role of Management as a User of Accounting Information: Implications for Standard Setting

    Eierle, Brigitte; Wolfgang SCHULTZE

    2013-01-01

    The aim of this paper is to analyze the question of whether the sole focus of standard setters developing accounting standards that are useful to external users for making decisions about providing resources to the entity result in useful accounting information. To answer this question, we analyzed the relationship between the stewardship function of financial accounting and the demand for information useful in making economic decisions on resource allocation (decision-making demand; decision...

  4. Regulatory theory insights into the past, present and future of general purpose water accounting standard setting

    Keryn Chalmers; Jayne M. Godfrey; Barbara Lynch

    2012-01-01

    Purpose – Accounting and water industry experts are developing general-purpose water accounting (GPWA) to report information about water and rights to water. The system has the potential to affect water policies, pricing and management, and investment and other decisions that are affected by GPWA report users' understanding of water risks faced by an entity. It may also affect financial returns to accounting and auditing firms and firms in water industries. In this paper the authors aim to ex...

  5. Setting global research priorities for integrated community case management (iCCM: Results from a CHNRI (Child Health and Nutrition Research Initiative exercise

    Kerri Wazny

    2014-11-01

    Full Text Available Aims: to systematically identify global research gaps and resource priorities for integrated community case management (iCCM. Methods: an iCCM Child Health and Nutrition Research Initiative (CHNRI Advisory Group, in collaboration with the Community Case Management Operational Research Group (CCM ORG identified experts to participate in a CHNRI research priority setting exercise. These experts generated and systematically ranked research questions for iCCM. Research questions were ranked using a “Research Priority Score” (RPS and the “Average Expert Agreement” (AEA was calculated for every question. Our groups of experts were comprised of both individuals working in Ministries of Health or Non Governmental Organizations (NGOs in low– and middle–income countries (LMICs and individuals working in high–income countries (HICs in academia or NGO headquarters. A Spearman's Rho was calculated to determine the correlation between the two groups' research questions' ranks. Results: The overall RPS ranged from 64.58 to 89.31, with a median score of 81.43. AEA scores ranged from 0.54 to 0.86. Research questions involving increasing the uptake of iCCM services, research questions concerning the motivation, retention, training and supervision of Community Health Workers (CHWs and concerning adding additional responsibilities including counselling for infant and young child feeding (IYCF and treatment of severe acute malnutrition (SAM ranked highly. There was weak to moderate, statistically significant, correlation between scores by representatives of high–income countries and those working in–country or regionally (Spearman's ρ = 0.35034, P < 0.01. Conclusions: Operational research to determine optimal training, supervision and modes of motivation and retention for the CHW is vital for improving iCCM, globally, as is research to motivate caregivers to take advantage of iCCM services. Experts working in–country or regionally in

  6. Abundance of red-listed species in infrastructure habitats – ”responsibility species” as a priority-setting tool for transportation agencies´ conservation action

    Jan-Olof Helldin

    2015-07-01

    Full Text Available Road and railroad verges may contribute to nature conservation by providing habitat for many species, but due to limited resources, there is a need to select the most important road and railroad stretches for adapted management. We explore the responsibility species concept as a tool for the Swedish Transport Administration to make this selection. We propose lists of candidate responsibility species based on relative abundance of conservation priority species in the vicinity of roads and railroads, respectively. Abundance data were derived from crowd-sourced species observations. Species with ≥20% of observations in infrastructure habitats were included as candidate responsibility species. For roads 32 species were included in the list, for railroads seven species, with an overlap of three species between the lists. We analyzed habitat and management requirements of the listed species to try identifying functional groups. Most of the species require open or semi-open habitats, mainly dry grassland or heathland on sandy or limy soil, un-sprayed crop fields, or solitary trees. Host plants or substrates include broom (genus Genista, patches of bare soil, and sun exposed wood. Conservation actions prescribed for the species include, e.g., late or irregular mowing, removal of the field layer, planting of host species, protecting and providing particular substrates, and special protection of certain sites. We argue that road and railroad managers are particularly well suited to conduct most of these actions. We consider the responsibility species concept to be a useful tool for transportation agencies to set priorities for adapted verge management, and the current method to be effective in identifying a first list of candidate species. We discuss the possibility of also identifying responsibility habitats or general management measures based on the results.

  7. MISUNDERSTANDING OF ROLE AND POSITION OF ACCOUNTING STANDARD SETTING AUTHORITIES TO REDUCE INFORMATION ASYMMETRY: EMPIRICAL EVIDENCE OF IRAN

    Hamidreza VAKILIFARD; Hashem NIKOOMARAM; Rostami, Vahab; Mahdi SALEHI; Daniela MITRAN

    2010-01-01

    Purpose - Critical role of accounting and financial reporting is providing useful information for different and entitled users to help them in making economical decisions. While repeatedly it is stressed that the quality of financial information is a function of both the quality of accounting standards and the regulatory enforcement, it is vital that standard setting authorities bodies to have independence and suitable enforcement power to guarantee their issued standards implementation with ...

  8. Accounting for PMD Temporal Correlation During Lightpath Set Up in Transparent Optical Networks

    Sambo, Nicola; Secondini, Marco; Andriolli, Nicola;

    2010-01-01

    stochastic characteristics. Moreover, PMD depends on time-variant factors, such as the temperature and the fiber stress. When implementing a dynamic GMPLS-controlled transparent optical network, the GMPLS protocol suite must take into account physical impairment information in order to establish lightpaths...... account for PMD. In this paper we propose a novel lightpath provisioning scheme based on a PMD prediction model which accounts for PMD temporal correlation properties. The proposed PMD-temporal-correlation (PTC) based lightpath provisioning scheme is compared with a scheme based on a classical PMD model...

  9. The control gap : the role of budgets, accounting information and (non-) decisions in hospital settings

    2004-01-01

    This paper investigates the link between budgets, accounting information and the decisionmaking processes at both strategic and operational levels in a large Norwegian hospital, as this hospital now is facing the New Public Management reforms which are introduced in Norway. The study has examined the use of budget and accounting information in the management control process. The empirical data are based on interviews with key actors in the decision-making process at all management levels in t...

  10. Distributed Priority Synthesis

    Harald Ruess

    2012-11-01

    Full Text Available Given a set of interacting components with non-deterministic variable update and given safety requirements, the goal of priority synthesis is to restrict, by means of priorities, the set of possible interactions in such a way as to guarantee the given safety conditions for all possible runs. In distributed priority synthesis we are interested in obtaining local sets of priorities, which are deployed in terms of local component controllers sharing intended next moves between components in local neighborhoods only. These possible communication paths between local controllers are specified by means of a communication architecture. We formally define the problem of distributed priority synthesis in terms of a multi-player safety game between players for (angelically selecting the next transition of the components and an environment for (demonically updating uncontrollable variables. We analyze the complexity of the problem, and propose several optimizations including a solution-space exploration based on a diagnosis method using a nested extension of the usual attractor computation in games together with a reduction to corresponding SAT problems. When diagnosis fails, the method proposes potential candidates to guide the exploration. These optimized algorithms for solving distributed priority synthesis problems have been integrated into the VissBIP framework. An experimental validation of this implementation is performed using a range of case studies including scheduling in multicore processors and modular robotics.

  11. The Cultural Influence in Accounting Standard Setting: A Comparative Analysis of the United States, Canada, and England.

    Bloom, Robert; And Others

    A study of the processes for establishing the principles and policies of measurement and disclosure in preparing financial reports examines differences in these processes in the United States, Canada, and England. Information was drawn from international accounting literature on standard setting. The differences and similarities in the…

  12. Constructing Isosurfaces from 3D Data Sets Taking Account of Depth Sorting of Polyhedra

    周勇; 唐泽圣

    1994-01-01

    Creating and rendering intermediate geometric primitives is one of the approaches to visualisze data sets in 3D space.Some algorithms have been developed to construct isosurface from uniformly distributed 3D data sets.These algorithms assume that the function value varies linearly along edges of each cell.But to irregular 3D data sets,this assumption is inapplicable.Moreover,the detth sorting of cells is more complicated for irregular data sets,which is indispensable for generating isosurface images or semitransparent isosurface images,if Z-buffer method is not adopted.In this paper,isosurface models based on the assumption that the function value has nonlinear distribution within a tetrahedron are proposed.The depth sorting algorithm and data structures are developed for the irregular data sets in which cells may be subdivided into tetrahedra.The implementation issues of this algorithm are discussed and experimental results are shown to illustrate potentials of this technique.

  13. Combining RP and SP data while accounting for large choice sets and travel mode

    Abildtrup, Jens; Olsen, Søren Bøye; Stenger, Anne

    2015-01-01

    This paper analyses the use of forests for recreational purposes in Lorraine, France, a region with many forests and easy access for recreational users. This implies that residents in Lorraine can choose between a large set of forests if they decide to visit a forest. The abundance of forests in ...

  14. RANKED SET SAMPLING FOR ECOLOGICAL RESEARCH: ACCOUNTING FOR THE TOTAL COSTS OF SAMPLING

    Researchers aim to design environmental studies that optimize precision and allow for generalization of results, while keeping the costs of associated field and laboratory work at a reasonable level. Ranked set sampling is one method to potentially increase precision and reduce ...

  15. High performance in healthcare priority setting and resource allocation: A literature- and case study-based framework in the Canadian context.

    Smith, Neale; Mitton, Craig; Hall, William; Bryan, Stirling; Donaldson, Cam; Peacock, Stuart; Gibson, Jennifer L; Urquhart, Bonnie

    2016-08-01

    Priority setting and resource allocation, or PSRA, are key functions of executive teams in healthcare organizations. Yet decision-makers often base their choices on historical patterns of resource distribution or political pressures. Our aim was to provide leaders with guidance on how to improve PSRA practice, by creating organizational contexts which enable high performance. We carried out in-depth case studies of six Canadian healthcare organizations to obtain from healthcare leaders their understanding of the concept of high performance in PSRA and the factors which contribute to its achievement. Individual and group interviews were carried out (n = 62) with senior managers, middle managers and Board members. Site observations and document review were used to assist researchers in interpreting the interview data. Qualitative data were analyzed iteratively with the literature on empirical examples of PSRA practice, in order to develop a framework of high performance in PSRA. The framework consists of four domains - structures, processes, attitudes and behaviours, and outcomes - within which are 19 specific elements. The emergent themes derive from case studies in different kinds of health organizations (urban/rural, small/large) across Canada. The elements can serve as a checklist for 'high performance' in PSRA. This framework provides a means by which decision-makers in healthcare might assess their practice and identify key areas for improvement. The findings are likely generalizable, certainly within Canada but also across countries. This work constitutes, to our knowledge, the first attempt to present a full package of elements comprising high performance in health care PSRA. PMID:27367899

  16. Roles of accounting practice in a public setting: the case of the Parisian Great Exhibitions (1855-1900)

    Michaïlesco, Céline; Fabre, Karine

    2008-01-01

    The five Universal Exhibitions held in Paris between 1855 and 1900 share the particularity of having been, unlike their British counterparts, financed first wholly, then in part, by the Government. Public financing led to public finance principles (budgetary and public accounting) being applied to the organisation of the Exhibitions. Along with these, the organisation in charge of running these events imported a set of well-formatted techniques. However, these techniques (budgeting and accoun...

  17. Accounting for baryonic effects in cosmic shear tomography: Determining a minimal set of nuisance parameters using PCA

    Eifler, Tim; Krause, Elisabeth; Dodelson, Scott; Zentner, Andrew; Hearin, Andrew; Gnedin, Nickolay

    2014-05-28

    Systematic uncertainties that have been subdominant in past large-scale structure (LSS) surveys are likely to exceed statistical uncertainties of current and future LSS data sets, potentially limiting the extraction of cosmological information. Here we present a general framework (PCA marginalization) to consistently incorporate systematic effects into a likelihood analysis. This technique naturally accounts for degeneracies between nuisance parameters and can substantially reduce the dimension of the parameter space that needs to be sampled. As a practical application, we apply PCA marginalization to account for baryonic physics as an uncertainty in cosmic shear tomography. Specifically, we use CosmoLike to run simulated likelihood analyses on three independent sets of numerical simulations, each covering a wide range of baryonic scenarios differing in cooling, star formation, and feedback mechanisms. We simulate a Stage III (Dark Energy Survey) and Stage IV (Large Synoptic Survey Telescope/Euclid) survey and find a substantial bias in cosmological constraints if baryonic physics is not accounted for. We then show that PCA marginalization (employing at most 3 to 4 nuisance parameters) removes this bias. Our study demonstrates that it is possible to obtain robust, precise constraints on the dark energy equation of state even in the presence of large levels of systematic uncertainty in astrophysical processes. We conclude that the PCA marginalization technique is a powerful, general tool for addressing many of the challenges facing the precision cosmology program.

  18. Defining priorities

    2013-01-01

    Last week the European Strategy Group met in Erice (Italy) to distil reams of input and months of discussion into a concise document outlining an updated Strategy for European Particle Physics. The result is a document that will be presented to the Council for feedback next month, before final approval by the Council at a special meeting in Brussels on 29 May. The Strategy process was important when it began in 2005, and is even more so today with important discoveries behind us and a changing global landscape for particle physics ahead.   The draft update, it’s fair to say, contains few surprises, but there are nevertheless some weighty issues for the Council to deliberate. The top priority is, of course, the full exploitation of the LHC, but the Strategy goes further, stating unambiguously that Europe’s top priority should be the high-luminosity upgrade of the machine. Other high-priority items are accelerator R&D to ensure the long-term global future of the field. O...

  19. Membrane Automata with Priorities

    Luděk Cienciala; Lucie Ciencialová

    2004-01-01

    In this paper the one-way P automata with priorities are introduced. Such automata are P systemshere the membranes are only allowed to consume objects from parent membranes, under the given conditions. The result of computation of these systems is the set of multiset sequences consumed by skin membrane intc the system. The rules associated in some order with each membrane cannot modify any objects, they can only move them through membrane. We show that P automata with priorities and two membranes can accept every recursively enumerated language.

  20. Are there priority competencies for preparation of accountants?: A study about Brazilian accountants ¿Existen competencias que deben ser prioridad en el desarrollo del contador?: Un estudio sobre los contadores Existem competências a serem priorizadas no desenvolvimento do contador?: Um estudo sobre os contadores brasileiros

    Ricardo Lopes Cardoso; Edson Luiz Riccio

    2010-01-01

    This study sought to determine the need for priority of competencies in preparation of accountants as well as variations between men and women. This question is motivated by Hardern (1995), Morgan (1997), Moramed and Lashine (2003)and IFAC (2003) with a theoretical foundation of competencies related to McClelland (1973, 1998) and Boyatzis (1982). Professional references are Hardern (1995), AICPA (1999) and IFAC (2003). It was based on 18 competencies that were collected from 24 articles for q...

  1. Usage pattern-based exposure screening as a simple tool for the regional priority-setting in environmental risk assessment of veterinary antibiotics: a case study of north-western Germany.

    Menz, J; Schneider, M; Kümmerer, K

    2015-05-01

    Veterinary antibiotics (VAs) are widely recognized as important environmental contaminants. Despite the extensive use of antibiotic agents in meat and poultry production and the known resistance problems in human and veterinary medicine, detailed knowledge about usage patterns of VAs in Germany is still scarce. This lack of knowledge severely impacts current research on the environmental risk of VAs, but it is expected that recently established surveillance programs for antimicrobial drug usage will close this knowledge gap. Therefore, a spatially more precise environmental risk assessment and management might become possible in the near future. In this study, a new usage pattern-based exposure screening (UPES) approach for the comprehensive environmental exposure assessment of veterinary antibiotics was preliminarily assessed using approximated scenarios of antimicrobial substance usage in German meat and poultry production. Resulting predicted manure concentrations covered seven orders of magnitude ranging from ng kg(-1) to g kg(-1) dry weight (dw). Beyond that 14 antibiotic substances of 10 different antimicrobial classes were predicted to have the potential to occur in soil concentrations higher than 100 μg kg(-1) dw. These findings raise further questions regarding the environmental exposure and risks of frequently used VAs, especially in regions with higher-than-average livestock density. With this case study we demonstrate that UPES simplifies to account for differing local agricultural factors and therefore facilitates priority-setting on a regional level. In this context a simple prioritization scheme for environmental assessment of VAs, considering both the expected environmental concentration and the frequency of application, is proposed in this paper. PMID:25655696

  2. How to do (or not to do) … translation of national health accounts data to evidence for policy making in a low resourced setting.

    Price, Jennifer A; Guinness, Lorna; Irava, Wayne; Khan, Idrish; Asante, Augustine; Wiseman, Virginia

    2016-05-01

    For more than a decade, the Organization for Economic Co-operation and Development (OECD), the World Health Organization (WHO) and the World Bank have promoted the international standardization of National Health Accounts (NHA) for reporting global statistics on public, private and donor health expenditure and improve the quality of evidence-based decision-making at country level. A 2010-2012 World Bank review of NHA activity in 50 countries found structural and technical constraints (rather than cost) were key impediments to institutionalizing NHA in many low- and middle-income countries (LMICs). Pilot projects focused resources on data production, neglecting longer-term capacity building for analysing the data, developing ownership among local stakeholders and establishing routine production, utilization and dissemination of NHA data. Hence, genuine institutionalization of NHA in most LMICs has been slow to materialize. International manuals focus on the production of NHA data and do not include practical, incremental and low-cost strategies to guide countries in translating the data into evidence for policy-making. The main aim of this article is to recommend strategies for bridging this divide between production and utilization of NHA data in low-resource settings. The article begins by discussing the origins and purpose of NHA, including factors currently undermining their uptake. The focus then turns to the development and application of strategies to assist LMICs in 'unlocking' the hidden value of their NHA. The article draws on the example of Fiji, a country currently attempting to integrate their NHA data into policy formulation, despite minimal resources, training and familiarity with economic analysis of health systems. Simple, low cost recommendations such as embedding health finance indicators in planning documents, a user-friendly NHA guide for evaluating local health priorities, and sharing NHA data for collaborative research have helped translate

  3. Setting Priorities for Urban Forest Planning. A Comprehensive Response to Ecological and Social Needs for the Metropolitan Area of Rome (Italy)

    Giulia Capotorti; Barbara Mollo; Laura Zavattero; Ilaria Anzellotti; Laura Celesti-Grapow

    2015-01-01

    Urban forests represent key elements of green infrastructure and provide essential ecosystem services in both the ecological and social spheres. Therefore, forestation planning plays a decisive role in the sustainable development strategies of metropolitan areas and addresses the challenge of maintaining biodiversity while improving human health and well-being. The aim of this work is to present a methodological approach that can be used to identify priorities in urban forest planning and can...

  4. Accounting for the Multiple Natures of Missing Values in Label-Free Quantitative Proteomics Data Sets to Compare Imputation Strategies.

    Lazar, Cosmin; Gatto, Laurent; Ferro, Myriam; Bruley, Christophe; Burger, Thomas

    2016-04-01

    Missing values are a genuine issue in label-free quantitative proteomics. Recent works have surveyed the different statistical methods to conduct imputation and have compared them on real or simulated data sets and recommended a list of missing value imputation methods for proteomics application. Although insightful, these comparisons do not account for two important facts: (i) depending on the proteomics data set, the missingness mechanism may be of different natures and (ii) each imputation method is devoted to a specific type of missingness mechanism. As a result, we believe that the question at stake is not to find the most accurate imputation method in general but instead the most appropriate one. We describe a series of comparisons that support our views: For instance, we show that a supposedly "under-performing" method (i.e., giving baseline average results), if applied at the "appropriate" time in the data-processing pipeline (before or after peptide aggregation) on a data set with the "appropriate" nature of missing values, can outperform a blindly applied, supposedly "better-performing" method (i.e., the reference method from the state-of-the-art). This leads us to formulate few practical guidelines regarding the choice and the application of an imputation method in a proteomics context. PMID:26906401

  5. Change priorities!

    Association du personnel

    2006-01-01

    Throughout the current five-yearly review, the Staff Association has made every effort to devise and propose numerous alternative solutions which take into account the data collected. Once more, at the last SCC meeting, the Management refused to accept the slightest compromise on salary levels. It is standing its ground and, even though it is its duty, does not put forward any concrete proposal to provide a way out of a crisis situation which is getting yet worse and worse.

  6. Antecedents to agenda setting and framing in health news: an examination of priority, angle, source, and resource usage from a national survey of U.S. health reporters and editors.

    Wallington, Sherrie Flynt; Blake, Kelly; Taylor-Clark, Kalahn; Viswanath, K

    2010-01-01

    The influence of news media on audience cognitions, attitudes, and behaviors in the realm of politics, race relations, science, and health has been extensively documented.Agenda setting and framing studies show that news media influence how people develop schema and place priorities on issues, with media stories serving as a major source of issue frames. Although news media are an important intermediary in the translation of scientific knowledge to different publics, little has been documented about the production of health news and factors that may predict media agenda setting and framing in health journalism. We used data from a 2005 national survey of U.S. health reporters and editors to examine predictors of source, resource, story angle, and frame usage among reporters and editors by variables such as organizational structure, individual characteristics of respondents (such as education and years working as a journalist),and perceptions of occupational autonomy. Multivariable logistic regression models revealed several differences among U.S. health reports and editors in the likelihood of using a variety of news sources, resources, priorities, and angles in reporting. Media agenda setting and framing theories suggest that practitioners familiar with media processes can work with journalists to frame messages, thereby increasing the probability of accurate and effective reporting. Results from this study may help to inform interactions between public health and medical practitioners and the press [corrected]. PMID:20390978

  7. Pros and Cons of Using the Informed Basis Set to Account for Hemodynamic Response Variability with Developmental Data

    Cignetti, Fabien; Salvia, Emilie; Anton, Jean-Luc; Grosbras, Marie-Hélène; Assaiante, Christine

    2016-01-01

    Conventional analysis of functional magnetic resonance imaging (fMRI) data using the general linear model (GLM) employs a neural model convolved with a canonical hemodynamic response function (HRF) peaking 5 s after stimulation. Incorporation of a further basis function, namely the canonical HRF temporal derivative, accounts for delays in the hemodynamic response to neural activity. A population that may benefit from this flexible approach is children whose hemodynamic response is not yet mature. Here, we examined the effects of using the set based on the canonical HRF plus its temporal derivative on both first- and second-level GLM analyses, through simulations and using developmental data (an fMRI dataset on proprioceptive mapping in children and adults). Simulations of delayed fMRI first-level data emphasized the benefit of carrying forward to the second-level a derivative boost that combines derivative and nonderivative beta estimates. In the experimental data, second-level analysis using a paired t-test showed increased mean amplitude estimate (i.e., increased group contrast mean) in several brain regions related to proprioceptive processing when using the derivative boost compared to using only the nonderivative term. This was true especially in children. However, carrying forward to the second-level the individual derivative boosts had adverse consequences on random-effects analysis that implemented one-sample t-test, yielding increased between-subject variance, thus affecting group-level statistic. Boosted data also presented a lower level of smoothness that had implication for the detection of group average activation. Imposing soft constraints on the derivative boost by limiting the time-to-peak range of the modeled response within a specified range (i.e., 4–6 s) mitigated these issues. These findings support the notion that there are pros and cons to using the informed basis set with developmental data. PMID:27471441

  8. Research priorities for Indian psychiatry.

    Patel, Vikram

    2010-01-01

    This article summarises the findings of recent priority setting exercises for psychiatric research and of a mapping of research capacity and resources in south Asia. The priorities for research in the region, as in other developing countries, are related to ‘implementation’ science, i.e. the field of inquiry investigating acceptable and affordable methods of delivering effective treatments for mental disorders, which aims to help close the large treatment gap. “Discovery” research which aims ...

  9. Preservation Priority

    2009-01-01

    China ratified the UNESCO Convention Concerning the Protection of World Cultural and Natural Heritage in 1985. This set the tone for a course of action aimed at protecting the common heritage of mankind in tandem with the international community. Recently, Chao Huashan, a renowned expert on world heritage studies in China, spoke to Beijing Review reporter Zan Jifang, sharing his understanding about the value of the World Heritage Convention and his suggestions for China’s future work on preserving its heritage. Excerpts follow:

  10. Priorities for Venus Exploration

    Glaze, L. S.; Beauchamp, P. M.; Chin, G.; Crisp, D.; Grimm, R. E.; Herrick, R. R.; Johnston, S.; Limaye, S. S.; Smrekar, S. E.; Ocampo, A.; Thompson, T. W.

    2013-12-01

    Venus remains one of the most enigmatic bodies in our Solar System. Important questions remain regarding the origin and evolution of the atmosphere, the history of the surface and interior, and how the surface and atmosphere interact. In a broader context, understanding Venus has implications for understanding the evolution of terrestrial planets in our Solar System as well as for interpreting the growing set of observations of extra-solar planets. The Venus Exploration Analysis Group (VEXAG), established in 2005, is chartered by NASA's Planetary Science Division and reports its findings to the NASA Advisory Council. Open to all interested scientists, VEXAG regularly evaluates Venus exploration goals, scientific objectives, investigations and critical measurement requirements, including especially recommendations in the NRC Decadal Survey and the Solar System Exploration Strategic Roadmap. At the last general meeting in November 2012, VEXAG resolved to update the scientific priorities and strategies for Venus exploration. To achieve this goal, three major tasks were defined for 2013, (1) update the document prioritizing Goals, Objectives and Investigations for Venus Exploration, (2) develop a Roadmap for Venus exploration that is consistent with VEXAG priorities as well as Planetary Decadal Survey priorities, and (3) develop a white paper on technologies for Venus missions. Proposed versions of all three documents were presented at the VEXAG general meeting in November 2013. Here, we present the findings and final versions of all three documents for community comment and feedback. A follow-on Workshop on Venus Exploration Targets is also being planned for the early summer of 2014. The workshop will provide a forum for the Venus science community to discuss approaches for addressing high priority investigations. Participants will be encouraged to present their ideas for specific targets on Venus (interior, surface and atmosphere) as well as to present specific data

  11. Definición de prioridades para las intervenciones de salud en el Sistema de Protección Social en Salud de México Priority setting for health interventions in Mexico's System of Social Protection in Health

    Eduardo González-Pier

    2007-01-01

    Full Text Available La definición explícita de prioridades en intervenciones de salud representa una oportunidad para México de equilibrar la presión y la complejidad de una transición epidemiológica avanzada, con políticas basadas en evidencias generadas por la inquietud de cómo optimizar el uso de los recursos escasos para mejorar la salud de la población. La experiencia mexicana en la definición de prioridades describe cómo los enfoques analíticos estandarizados en la toma de decisiones, principalmente los de análisis de la carga de la enfermedad y de costo-efectividad, se combinan con otros criterios -tales como dar respuesta a las expectativas legítimas no médicas de los pacientes y asegurar un financiamiento justo para los hogares-, para diseñar e implementar un grupo de tres paquetes diferenciados de intervenciones de salud. Éste es un proceso clave dentro de un conjunto más amplio de elementos de reforma dirigidos a extender el aseguramiento en salud, especialmente a los pobres. Las implicaciones más relevantes en el ámbito de políticas públicas incluyen lecciones sobre el uso de las herramientas analíticas disponibles y probadas para definir prioridades nacionales de salud; la utilidad de resultados que definan prioridades para guiar el desarrollo de capacidades a largo plazo; la importancia de favorecer un enfoque para institucionalizar el análisis ex-ante de costo-efectividad; y la necesidad del fortalecimiento de la capacidad técnica local como un elemento esencial para equilibrar los argumentos sobre maximización de la salud con criterios no relacionados con la salud en el marco de un ejercicio sistemático y transparente.Explicit priority setting presents Mexico with the opportunity to match the pressure and complexity of an advancing epidemiological transition with evidence-based policies driven by a fundamental concern for how to make the best use of scarce resources to improve population health. The Mexican priority-setting

  12. Modern going near setting of medical physical culture taking into account etiology, type, form, degree and clinical displays of scoliotic illness for children

    Olga Peshkova

    2015-12-01

    Full Text Available Authors in the article are consider the basic going near setting of medical physical culture at scoliostic illness of І–ІІ degree for children taking into account a type, form, etiology, degree and clinical displays. Purpose: to describe the modern going near setting of medical physical culture taking into account etiology, type, form, degree and clinical displays of scoliostic illness for children. Material and Methods: analysis of the modern special literature on issue of physical rehabilitation of children at scoliostic illness; analysis of medical cards. Results: description of scoliosis is given on an etiologic sign, form, type, degrees and clinical displays. The features of methods of medical physical culture are presented taking into account the afore-named signs of scoliotic illness. Conclusions: setting of facilities and forms of medical physical culture at scoliotic illness depends on etiology, form and type of scoliosis, degree and clinical displays of disease

  13. ClimateQUAL® and Thinklets: Using ClimateQUAL® with Group Support Systems to Facilitate Discussion and Set Priorities for Organizational Change at Criss Library

    Nora Hillyer

    2013-06-01

    Full Text Available Objective – This article discusses a series of actions taken by the Criss Library at the University of Nebraska at Omaha to implement organizational change, using the ClimateQUAL® survey and facilitated discussions with ThinkTank™ group decision software. The library had experienced significant changes over a five-year period, with a renovation of the facility and three reorganizations resulting in a 50% staff turnover. Recognizing the strain that years of construction and personnel changes had placed on the organization, there was a desire to uncover the mood of the employees and reveal the issues behind low morale, uneasiness, and fear.Methods – In November 2009, the library conducted a ClimateQUAL® survey to develop a baseline to assess the effectiveness of any changes. After the results were distributed to library faculty and staff, a series of two-hour facilitated discussions was held to gather opinions and ideas for solutions using thinkLets, a pattern language for reasoning toward a goal. The group support system ThinkTank™ software was loaded onto computers, and employees were able to add their ideas anonymously during the sessions. Finally, 12 employees (29% completed a four-question survey on their perceptions of the facilitated discussions.Results – The facilitated discussions returned 76 sub-themes in 12 categories: staffing and scheduling issues, staff unity/teamwork, communication, goodwill/morale, accountability, decision-making, policy issues, skills and training, leadership, ergonomics/physical work environment, respect, and bullying. An advisory team culled the 76 sub-themes into 40 improvement strategies. Five were implemented immediately, and the remaining 35 were scheduled to be presented to the faculty and staff via an online survey. Participants’ perceptions of the facilitated discussions were mixed. Eighty-three percent of respondents reported that they did not feel safe speaking out about issues, most

  14. The Accounts Setting of the New University’s Accounting System%新高校会计制度实行中会计科目的处理

    林加祝

    2014-01-01

    2013年12月30日财政部颁布了《高等学校会计制度》,并于2014年1月1日正式执行。本文立足实际工作,针对新高校会计制度中会计科目的设置及衔接中存在的问题进行分析,并提出建议,以保证新高校会计制度的顺利过渡实施。%On December 30, 2013, the Ministry of Finance issued “High School Accounting System” and formally implemented it on January 1, 2014. Based on the practice, this paper analyzes the problems of the settings and cohesion from the new university's accounting system, then makes recommendations to ensure a smooth transition for the new accounting system implementation at universities.

  15. Serbia Priorities Report 2013

    OECD

    2013-01-01

    As a continuation of the 2013 SIGMA assessments and as part of a longer-term programme of work, SIGMA has identified country priorities for public administration reform (PAR) for Serbia. Priorities cover the overall PAR needs of the country, including areas which were not covered by the assessments. Priorities in areas outside the scope of SIGMA assessments are based on other analytical sources and SIGMA’s practical experience of working with the country. SIGMA proposes priority 2020 targets ...

  16. Kosovo Priorities Report 2013

    OECD

    2013-01-01

    As a continuation of the 2013 SIGMA assessments and as part of a longer-term programme of work, SIGMA has identified country priorities for public administration reform (PAR) for Kosovo*. Priorities cover the overall PAR needs of the country, including areas which were not covered by the assessments. Priorities in areas outside the scope of SIGMA assessments are based on other analytical sources and SIGMA’s practical experience of working with the country. SIGMA proposes priority 2020 targets...

  17. Turkey Priorities Report 2013

    OECD

    2013-01-01

    As a continuation of the 2013 SIGMA assessments and as part of a longer-term programme of work, SIGMA has identified country priorities for public administration reform (PAR) for Turkey. Priorities cover the overall PAR needs of the country, including areas which were not covered by the assessments. Priorities in areas outside the scope of SIGMA assessments are based on other analytical sources and SIGMA’s practical experience of working with the country. SIGMA proposes priority 2020 targets ...

  18. Albania Priorities Report 2013

    OECD

    2013-01-01

    As a continuation of the 2013 SIGMA assessments and as part of a longer-term programme of work, SIGMA has identified country priorities for public administration reform (PAR) for Albania. Priorities cover the overall PAR needs of the country, including areas which were not covered by the assessments. Priorities in areas outside the scope of SIGMA assessments are based on other analytical sources and SIGMA’s practical experience of working with the country. SIGMA proposes priority 2020 targets...

  19. Montenegro Priorities Report 2013

    OECD

    2013-01-01

    As a continuation of the 2013 SIGMA assessments and as part of a longer-term programme of work, SIGMA has identified country priorities for public administration reform (PAR) for Montenegro. Priorities cover the overall PAR needs of the country, including areas which were not covered by the assessments. Priorities in areas outside the scope of SIGMA assessments are based on other analytical sources and SIGMA’s practical experience of working with the country. SIGMA proposes priority 2020 targ...

  20. Priority Queues Resilient to Memory Faults

    Jørgensen, Allan Grønlund; Moruz, Gabriel; Mølhave, Thomas

    2007-01-01

    In the faulty-memory RAM model, the content of memory cells can get corrupted at any time during the execution of an algorithm, and a constant number of uncorruptible registers are available. A resilient data structure in this model works correctly on the set of uncorrupted values. In this paper we...... introduce a resilient priority queue. The deletemin operation of a resilient priority queue returns either the minimum uncorrupted element or some corrupted element. Our resilient priority queue uses $O(n)$ space to store $n$ elements. Both insert and deletemin operations are performed in $O(\\log n......+\\delta)$ time amortized, where $\\delta$ is the maximum amount of corruptions tolerated. Our priority queue matches the performance of classical optimal priority queues in the RAM model when the number of corruptions tolerated is $O(\\log n)$. We prove matching worst case lower bounds for resilient priority...

  1. Priority-setting in health systems

    Byskov, Jens

    2013-01-01

    tried herbal remedies for both of them for a week but without effect. The family permits her to travel with her child quite some distance to a fairly run down health centre ---- (Cont. with her meeting services, but going home unserved) WHAT ARE HEALTH SYSTEMS AND HEALTH SYSTEMS RESEARCH? Health systems...... include all organisations that influence health, whether they provide health services, address broader conditions for improved health or represent the users and communities that strive for better health. However health systems simply lack the capacity to measure or understand their own weaknesses and......DBL - under core funding from Danish International Development Agency (Danida) 2013 WHY HAVE HEALTH SYSTEMS WHEN EFFECTIVE INTERVENTIONS ARE KNOWN? Case: A teenage mother lives in a poor sub-Saharan village next to a big lake. The area is known to have malaria transmission all year around, and...

  2. Democracy and Teacher Education: Setting Priorities

    Goodman, Jesse H.

    2009-01-01

    As John Dewey noted in his last book, each generation, in its turn, must assume responsibility as caretaker of democracy. He noted that one should never take democracy for granted. Everyone lives in an imperfect democracy, and teacher educators should play their part in protecting, nurturing, and advancing democratic ideals, rituals, values, and…

  3. Priority arbitration mechanism

    Garmire, Derrick L.; Herring, Jay R.; Stunkel, Craig B.

    2007-03-06

    A method is provided for selecting a data source for transmission on one of several logical (virtual) lanes embodied in a single physical connection. Lanes are assigned to either a high priority class or to a low priority class. One of six conditions is employed to determine when re-arbitration of lane priorities is desired. When this occurs a next source for transmission is selected based on a the specification of the maximum number of high priority packets that can be sent after a lower priority transmission has been interrupted. Alternatively, a next source for transmission is selected based on a the specification of the maximum number of high priority packets that can be sent while a lower priority packet is waiting. If initialized correctly, the arbiter keeps all of the packets of a high priority packet contiguous, while allowing lower priority packets to be interrupted by the higher priority packets, but not to the point of starvation of the lower priority packets.

  4. Identification of sources of priority substances set out in Article 16 of the Water Framework Directive and estimation of their discharges into the German aquatic environment; Ermittlung der Quellen fuer die prioritaeren Stoffe nach Artikel 16 der Wasserrahmenrichtlinie und Abschaetzung ihrer Eintragsmengen in die Gewaesser in Deutschland

    Boehm, E.; Hillenbrand, T.; Marscheider-Weidemann, F.; Mueller, B.; Wiederhold, J.; Herrchen, M.; Klein, M.

    2002-12-01

    The Water Framework Directive (2000/60/EC) is a new instrument, that inter alia has replaced, harmonized and further developed the control and reduction of point and diffuse discharges of dangerous substances according to Council Directive 76/464/EEC. Article 16 of the Water Framework Directive set out a 'Strategy against pollution of water' which demands specific measures against pollution of water by individual pollutants or groups of pollutants presenting a significant risk to or via the aquatic environment (e.g. by drinking water consumed). For these priority substances community-wide water quality standards and emission controls have to be established. On the basis of Article 16 of Directive 2000/60/EC a list of 33 priority substances has been adopted by the decision of the European Parliament and of the Council of November 2001. This list identifies 11 priority hazardous substances, 14 substances subject to a review for identification as possible priority hazardous substance and 8 priority substances. The Commission will make a proposal for the final classification of the 'substances subject to a review' (priority hazardous or priority substances) not later than 12 months after adoption of this list. The planned measures aim at the cessation or phasing out of discharges, emissions and losses to the aquatic environment within 20 years for the priority hazardous substances and at the progressive reduction for the priority substances. In this project the available data for these 33 substances resp. groups of substances for the Federal Republic of Germany were put forward and described in a standardized pattern. This pattern includes the following items: nomenclature and properties of the substances, monitoring data, production and fields of application of these substances, existing regulations in Germany, releases to environment and possibilities to reduce discharges to the aquatic environment. The basis of the data is the year 2000 as far as

  5. Determining a Consistent Set of Accounting and Financial Reporting Standards : A Research Note Based on the IASB-FASB Conceptual Framework Revision Project

    Le Manh-Béna, Anne; Ramond, Olivier

    2011-01-01

    Following the debate on the Conceptual Framework revision undertaken by the IASB and the FASB, this paper discusses three major concerns about the way financial reporting standards should be determined: (1) What is the role a Conceptual Framework?; (2) For whom and for which needs are accounting and financial reporting standards made?; and (3) What information set should financial reporting provide? We show that the perceived need of a Framework has resulted in practice in weak usefulness We ...

  6. Global Conservation Priorities for Marine Turtles

    Bryan P Wallace; Dimatteo, Andrew D.; Alan B Bolten; Chaloupka, Milani Y.; Hutchinson, Brian J.; F Alberto Abreu-Grobois; Jeanne A Mortimer; Seminoff, Jeffrey A.; Diego Amorocho; Bjorndal, Karen A; Jérôme Bourjea; Bowen, Brian W; Raquel Briseño Dueñas; Paolo Casale; Choudhury, B. C.

    2011-01-01

    Where conservation resources are limited and conservation targets are diverse, robust yet flexible priority-setting frameworks are vital. Priority-setting is especially important for geographically widespread species with distinct populations subject to multiple threats that operate on different spatial and temporal scales. Marine turtles are widely distributed and exhibit intra-specific variations in population sizes and trends, as well as reproduction and morphology. However, current global...

  7. Implementing accountability for reasonableness framework at district level in Tanzania

    Maluka, Stephen; Kamuzora, Peter; SanSebastián, Miguel;

    2011-01-01

    Despite the growing importance of the Accountability for Reasonableness (A4R) framework in priority setting worldwide, there is still an inadequate understanding of the processes and mechanisms underlying its influence on legitimacy and fairness, as conceived and reflected in service management...

  8. Priority Setting and Influential Factors on Acceptance of Pharmaceutical Recommendations in Collaborative Medication Reviews in an Ambulatory Care Setting – Analysis of a Cluster Randomized Controlled Trial (WestGem-Study)

    Rose, Olaf; Mennemann, Hugo; John, Carina; Lautenschläger, Marcus; Mertens-Keller, Damaris; Richling, Katharina; Waltering, Isabel; Hamacher, Stefanie; Felsch, Moritz; Herich, Lena; Czarnecki, Kathrin; Schaffert, Corinna; Jaehde, Ulrich; Köberlein-Neu, Juliane

    2016-01-01

    Background Medication reviews are recognized services to increase quality of therapy and reduce medication risks. The selection of eligible patients with potential to receive a major benefit is based on assumptions rather than on factual data. Acceptance of interprofessional collaboration is crucial to increase the quality of medication therapy. Objective The research question was to identify and prioritize eligible patients for a medication review and to provide evidence-based criteria for patient selection. Acceptance of the prescribing general practitioner to implement pharmaceutical recommendations was measured and factors influencing physicians’ acceptance were explored to obtain an impression on the extent of collaboration in medication review in an ambulatory care setting. Methods Based on data of a cluster-randomized controlled study (WestGem-study), the correlation between patient parameters and the individual performance in a medication review was calculated in a multiple logistic regression model. Physician’s acceptance of the suggested intervention was assessed using feedback forms. Influential factors were analyzed. Results The number of drugs in use (p = 0.001), discrepancies between prescribed and used medicines (p = 0.014), the baseline Medication Appropriateness Index score (p0.05) and a low kidney function (p>0.05) do not predetermine the outcome. Longitudinal patient care with repeated reviews showed higher interprofessional acceptance and superior patient benefit. A total of 54.9% of the recommendations in a medication review on drug therapy were accepted for implementation. Conclusions The number of drugs in use and medication reconciliation could be a first rational step in patient selection for a medication review. Most elderly, multimorbid patients with polymedication experience a similar chance of receiving a benefit from a medication review. Longitudinal patient care should be preferred over confined medication reviews. The acceptance

  9. Shadow prices for the Priority methodology for environmental Measures (SPM)

    The title method has been developed for the chemical industry ICI Holland in Rotterdam, Netherlands, to prioritize measures by means of which the environment can be improved. The central criterion in SPM for the selection of appropriate environmental measures is cost-effectiveness. The cost effectiveness is determined by means of so-called shadow prices, which take into account the development of the future price for resources, energy and the environment. Based on the results the management of ICI Holland can set priorities for the internal environmental policy. The results can also be used in consultation with the Dutch government on the subject of licenses. 55 refs

  10. Accounting and Accounting Policy

    Demidenko Leonid P.

    2013-01-01

    The article considers essence and contents of accounting policy. Its provides information with respect to main aspects of formation and application of accounting policy in Ukraine. It studies the structure of regulations on accounting policy that were developed in a company. It specifies correlation of accounting policy and organisation of accounting. It explains the determining role of the top manager and chief accountant in formation of accounting policy of a company. It identifies regulati...

  11. Global conservation priorities for marine turtles.

    Wallace, Bryan P; DiMatteo, Andrew D; Bolten, Alan B; Chaloupka, Milani Y; Hutchinson, Brian J; Abreu-Grobois, F Alberto; Mortimer, Jeanne A; Seminoff, Jeffrey A; Amorocho, Diego; Bjorndal, Karen A; Bourjea, Jérôme; Bowen, Brian W; Briseño Dueñas, Raquel; Casale, Paolo; Choudhury, B C; Costa, Alice; Dutton, Peter H; Fallabrino, Alejandro; Finkbeiner, Elena M; Girard, Alexandre; Girondot, Marc; Hamann, Mark; Hurley, Brendan J; López-Mendilaharsu, Milagros; Marcovaldi, Maria Angela; Musick, John A; Nel, Ronel; Pilcher, Nicolas J; Troëng, Sebastian; Witherington, Blair; Mast, Roderic B

    2011-01-01

    Where conservation resources are limited and conservation targets are diverse, robust yet flexible priority-setting frameworks are vital. Priority-setting is especially important for geographically widespread species with distinct populations subject to multiple threats that operate on different spatial and temporal scales. Marine turtles are widely distributed and exhibit intra-specific variations in population sizes and trends, as well as reproduction and morphology. However, current global extinction risk assessment frameworks do not assess conservation status of spatially and biologically distinct marine turtle Regional Management Units (RMUs), and thus do not capture variations in population trends, impacts of threats, or necessary conservation actions across individual populations. To address this issue, we developed a new assessment framework that allowed us to evaluate, compare and organize marine turtle RMUs according to status and threats criteria. Because conservation priorities can vary widely (i.e. from avoiding imminent extinction to maintaining long-term monitoring efforts) we developed a "conservation priorities portfolio" system using categories of paired risk and threats scores for all RMUs (n = 58). We performed these assessments and rankings globally, by species, by ocean basin, and by recognized geopolitical bodies to identify patterns in risk, threats, and data gaps at different scales. This process resulted in characterization of risk and threats to all marine turtle RMUs, including identification of the world's 11 most endangered marine turtle RMUs based on highest risk and threats scores. This system also highlighted important gaps in available information that is crucial for accurate conservation assessments. Overall, this priority-setting framework can provide guidance for research and conservation priorities at multiple relevant scales, and should serve as a model for conservation status assessments and priority-setting for

  12. Global conservation priorities for marine turtles.

    Bryan P Wallace

    Full Text Available Where conservation resources are limited and conservation targets are diverse, robust yet flexible priority-setting frameworks are vital. Priority-setting is especially important for geographically widespread species with distinct populations subject to multiple threats that operate on different spatial and temporal scales. Marine turtles are widely distributed and exhibit intra-specific variations in population sizes and trends, as well as reproduction and morphology. However, current global extinction risk assessment frameworks do not assess conservation status of spatially and biologically distinct marine turtle Regional Management Units (RMUs, and thus do not capture variations in population trends, impacts of threats, or necessary conservation actions across individual populations. To address this issue, we developed a new assessment framework that allowed us to evaluate, compare and organize marine turtle RMUs according to status and threats criteria. Because conservation priorities can vary widely (i.e. from avoiding imminent extinction to maintaining long-term monitoring efforts we developed a "conservation priorities portfolio" system using categories of paired risk and threats scores for all RMUs (n = 58. We performed these assessments and rankings globally, by species, by ocean basin, and by recognized geopolitical bodies to identify patterns in risk, threats, and data gaps at different scales. This process resulted in characterization of risk and threats to all marine turtle RMUs, including identification of the world's 11 most endangered marine turtle RMUs based on highest risk and threats scores. This system also highlighted important gaps in available information that is crucial for accurate conservation assessments. Overall, this priority-setting framework can provide guidance for research and conservation priorities at multiple relevant scales, and should serve as a model for conservation status assessments and priority-setting

  13. Global Conservation Priorities for Marine Turtles

    Wallace, Bryan P.; DiMatteo, Andrew D.; Bolten, Alan B.; Chaloupka, Milani Y.; Hutchinson, Brian J.; Abreu-Grobois, F. Alberto; Mortimer, Jeanne A.; Seminoff, Jeffrey A.; Amorocho, Diego; Bjorndal, Karen A.; Bourjea, Jérôme; Bowen, Brian W.; Briseño Dueñas, Raquel; Casale, Paolo; Choudhury, B. C.; Costa, Alice; Dutton, Peter H.; Fallabrino, Alejandro; Finkbeiner, Elena M.; Girard, Alexandre; Girondot, Marc; Hamann, Mark; Hurley, Brendan J.; López-Mendilaharsu, Milagros; Marcovaldi, Maria Angela; Musick, John A.; Nel, Ronel; Pilcher, Nicolas J.; Troëng, Sebastian; Witherington, Blair; Mast, Roderic B.

    2011-01-01

    Where conservation resources are limited and conservation targets are diverse, robust yet flexible priority-setting frameworks are vital. Priority-setting is especially important for geographically widespread species with distinct populations subject to multiple threats that operate on different spatial and temporal scales. Marine turtles are widely distributed and exhibit intra-specific variations in population sizes and trends, as well as reproduction and morphology. However, current global extinction risk assessment frameworks do not assess conservation status of spatially and biologically distinct marine turtle Regional Management Units (RMUs), and thus do not capture variations in population trends, impacts of threats, or necessary conservation actions across individual populations. To address this issue, we developed a new assessment framework that allowed us to evaluate, compare and organize marine turtle RMUs according to status and threats criteria. Because conservation priorities can vary widely (i.e. from avoiding imminent extinction to maintaining long-term monitoring efforts) we developed a “conservation priorities portfolio” system using categories of paired risk and threats scores for all RMUs (n = 58). We performed these assessments and rankings globally, by species, by ocean basin, and by recognized geopolitical bodies to identify patterns in risk, threats, and data gaps at different scales. This process resulted in characterization of risk and threats to all marine turtle RMUs, including identification of the world's 11 most endangered marine turtle RMUs based on highest risk and threats scores. This system also highlighted important gaps in available information that is crucial for accurate conservation assessments. Overall, this priority-setting framework can provide guidance for research and conservation priorities at multiple relevant scales, and should serve as a model for conservation status assessments and priority-setting for

  14. Priorities of statutory claimants

    The statutory rights that unpaid creditors have when an oil or gas operator is placed in bankruptcy, were evaluated. Those statutory rights may give priority to their claims against the operator. Fifteen topics dealing with statutory priorities were examined, focusing on the change in priorities which would occur if the insolvent operator were placed in bankruptcy. The topics were: (1) Summary of statutory federal and provincial priorities, (2) Revenue Canada - source deductions/deemed trust, (3) Revenue Canada - source deductions/enhanced requirement to pay, (4) Revenue Canada - goods and service tax (GST)/deemed trust, (5) Revenue Canada - GST/enhanced requirement to pay, (6) Federal income taxes, (7) Validity of provincially legislated priority provisions in bankruptcy, (8) Provincially authorized municipal taxes - real property, (9) Provincial workers' compensation board, (10) Provincially legislated wages, overtime pay and holiday pay, (11) Provincially legislated severance/termination pay, (12) Provincially legislated successor employer obligations, (13) Provincially legislated private employment pension plans, (14) Provincial health care insurance premiums, and (15) Provincial freehold mineral rights tax

  15. Fast meldable priority queues

    Brodal, Gerth Stølting

    1995-01-01

    We present priority queues that support the operations Find-Min, Insert, MakeQueue and Meld in worst case time O(1) and Delete and DeleteMin in worst case time O(log n). They can be implemented on the pointer machine and require linear space. The time bounds are optimal for all implementations wh...... where Meld takes worst case time o(n). To our knowledge this is the first priority queue implementation that supports Meld in worst case constant time and DeleteMin in logarithmic time....

  16. Are there priority competencies for preparation of accountants?: A study about Brazilian accountants ¿Existen competencias que deben ser prioridad en el desarrollo del contador?: Un estudio sobre los contadores Existem competências a serem priorizadas no desenvolvimento do contador?: Um estudo sobre os contadores brasileiros

    Ricardo Lopes Cardoso

    2010-09-01

    Full Text Available This study sought to determine the need for priority of competencies in preparation of accountants as well as variations between men and women. This question is motivated by Hardern (1995, Morgan (1997, Moramed and Lashine (2003and IFAC (2003 with a theoretical foundation of competencies related to McClelland (1973, 1998 and Boyatzis (1982. Professional references are Hardern (1995, AICPA (1999 and IFAC (2003. It was based on 18 competencies that were collected from 24 articles for questions submitted to 159 accountants and the data collection instrument showed a 0.8774 Cronbach alpha. Replies were submitted to the Kruskal-Wallis test which showed a significance level of El objetivo principal de este estudio es verificar si existen competencias que deben ser prioridad en el desarrollo del contador, como también analizar si esa prioridad se altera entre hombres y mujeres. Ese cuestionamiento tiene como motivación las observaciones de Hardern (1995, Morgan (1997 y IFAC (2003. El fundamento teórico sobre competencias está relacionado al estudio de McClelland (1973,1998, Boyatzis (1982 y Spencer y Spencer (1993. Los estudios relacionados a las competencias del contador no están basados en fundamentos de la Psicología y de Recursos Humanos, y ni siquiera en el análisis de estructuras genéricas de competencias o en la determinación de prioridades en el desarrollo de competencias de los contadores, esta última es el objetivo de este trabajo. La investigación está basada en el estudio de 18 competencias del contador y fue submetida a 159 contadores. El instrumento de recolección de los datos presentó un Alfa de Cronbach de 0,8774. A partir de las respuestas se realizó el test de Kruskal-Wallis, que demostró un nivel de significancia O objetivo principal deste estudo é verificar se existem competências a serem priorizadas no desenvolvimento do contador, bem como analisar se essa prioridade se altera entre homens e mulheres. Esse

  17. Panel discussion: regional action priorities.

    Martorell, Reynaldo

    2002-04-01

    Action priorities for reducing iron deficiency vary across regions. Some regions have limited experience with national programs, such as in the republics of Central Asia, where the focus since independence has been on assessment, advocacy and scaling up of interventions. In more developed regions the priorities are improving established programs and addressing the needs of the remaining subpopulations with high rates of iron deficiency. The etiology of anemia, whether multi-factorial as in Sub-Saharan Africa or mostly due to iron deficiency as in the Middle East and North Africa, is an important factor shaping the choice of strategies. Some interventions are particularly feasible in some settings and are being promoted aggressively, such as flour fortification in Latin America and the Middle East and North Africa, or the fortification of condiments in Asia. The quality of the health infrastructure and resources in general also determine the mix and scale of interventions implemented. A lesson for all regions is that countries in North America and Europe, where diets are varied and abundant and infections nearly absent, generally support multiple strategies that include nutrition education, supplementation and fortification of a variety of staples consumed by toddlers and the general population. Monitoring and evaluation efforts have proven necessary for improving quality and for advocacy. PMID:11925501

  18. Equality, priority, and aggregation

    Hirose, Iwao

    2004-01-01

    In this dissertation, I discuss two distributive principles in moral philosophy: Derek Parfit's Prioritarianism and Egalitarianism. I attempt to defend a version of Egalitarianism, which I call Weighted Egalitarianism. Although Parfit claims that Egalitarianism is subject to what he calls the Levelling Down Objection, I show (a) that my proposed Weighted Egalitarianism is not subject to the Objection, and (b) that it gives priority to the worse off people. The real differenc...

  19. Micronutrient bioavailability research priorities.

    Casgrain, Amélie; Collings, Rachel; Harvey, Linda J; Boza, Julio J; Fairweather-Tait, Susan J

    2010-05-01

    A micronutrient bioavailability workshop, which involved international experts and members of the scientific community and the food industry, with interactive breakout sessions based on synectics principles, was organized by the International Life Sciences Institute Europe Addition of Nutrients to Food Task Force and the European Commission Network of Excellence European Micronutrient Recommendations Aligned. After presentations by experts, a series of "challenge statements" was discussed. The aim was to address topical issues, in particular those that linked bioavailability with the derivation of micronutrient requirements and dietary recommendations, to identify gaps in knowledge and to consider research priorities. Several generic research priorities were identified, including improving the quality of dietary surveys/food composition tables, the need for more metabolic studies that use stable isotopes and high-quality longer-term interventions, and the development of multifactorial mathematical models. Among the common recurrent factors identified as important were polymorphisms/genotype, consideration of the whole diet, chemical form of the micronutrient, and the determination of physiologic requirements. The involvement of all participants in the structured discussions ensured a broad overview of current knowledge, state-of-the-art research, and consideration of priorities for future research. PMID:20200267

  20. Problems of priority change in kidney allocation and beyond.

    Ahlert, Marlies; Kliemt, Hartmut

    2013-06-01

    Standardized and transparent priority setting in medicine, desirable as it is, will generally exacerbate inter-temporal equity problems arising from changes in treatment priorities: when can it be fair that the treatment of already waiting patients who would have had priority under an established system should be postponed (withheld) for an extended period of time to advance the treatment of others under a reformed system? The reform of the Eurotransplant system of priority setting in kidney allocation (ETKAS), which is in many respects ideal, is a case in point. To give due weight to new medical knowledge, waiting time after the onset of end state renal failure should change from a priority-enhancing to a priority-reducing factor. Since those who have gained in priority by waiting under the present system would be set back under the new, severe problems of transitional justice must be overcome when responding to advances in medical knowledge. The paper explores conceptually some possible ways of rule change and indicates their general relevance from an ethical and a practical point of view for future problems of medical resource allocation under transparent, standardized priority-setting rules. PMID:22358456

  1. Representing biodiversity: data and procedures for identifying priority areas for conservation

    C R Margules; R L Pressey; P H Williams

    2002-07-01

    Biodiversity priority areas together should represent the biodiversity of the region they are situated in. To achieve this, biodiversity has to be measured, biodiversity goals have to be set and methods for implementing those goals have to be applied. Each of these steps is discussed. Because it is impossible to measure all of biodiversity, biodiversity surrogates have to be used. Examples are taxa sub-sets, species assemblages and environmental domains. Each of these has different strengths and weaknesses, which are described and evaluated. In real-world priority setting, some combination of these is usually employed. While a desirable goal might be to sample all of biodiversity from genotypes to ecosystems, an achievable goal is to represent, at some agreed level, each of the biodiversity features chosen as surrogates. Explicit systematic procedures for implementing such a goal are described. These procedures use complementarity, a measure of the contribution each area in a region makes to the conservation goal, to estimate irreplaceability and flexibility, measures of the extent to which areas can be substituted for one another in order to take competing land uses into account. Persistence and vulnerability, which also play an important role in the priority setting process, are discussed briefly.

  2. A Survey on Priority Queues

    Brodal, Gerth Stølting

    2013-01-01

    Back in 1964 Williams introduced the binary heap as a basic priority queue data structure supporting the operations Insert and ExtractMin in logarithmic time. Since then numerous papers have been published on priority queues. This paper tries to list some of the directions research on priority...

  3. Priority sector lending in Asia

    Creehan, Sean

    2014-01-01

    This Asia Focus discusses Asia’s experience with priority sector lending, reviews the current state-level priority sector lending policies in several Asian economies, assesses the implications for the respective domestic banking systems, and examines potential alternative mechanisms to encourage lending to priority sectors.

  4. Implementing Distributed Controllers for Systems with Priorities

    Imene Ben-Hafaiedh

    2010-07-01

    Full Text Available Implementing a component-based system in a distributed way so that it ensures some global constraints is a challenging problem. We consider here abstract specifications consisting of a composition of components and a controller given in the form of a set of interactions and a priority order amongst them. In the context of distributed systems, such a controller must be executed in a distributed fashion while still respecting the global constraints imposed by interactions and priorities. We present in this paper an implementation of an algorithm that allows a distributed execution of systems with (binary interactions and priorities. We also present a comprehensive simulation analysis that shows how sensitive to changes our algorithm is, in particular changes related to the degree of conflict in the system.

  5. Research priorities for public mental health in Europe

    Forsman, Anna K; Wahlbeck, Kristian; Aarø, Leif Edvard;

    2015-01-01

    BACKGROUND: The ROAdmap for MEntal health Research in Europe project aimed to create an integrated European roadmap for mental health research. Leading mental health research experts across Europe have formulated consensus-based recommendations for future research within the public mental health...... experts were involved in the priority setting process. RESULTS: Twenty priorities for public mental health research were identified through the consensus process. The research priorities were divided into summary principles-encompassing overall recommendations for future public mental health research...... in Europe-and thematic research priorities, including area-specific top priorities on research topics and methods. The priorities represent three overarching goals mirroring societal challenges, that is, to identify causes, risk and protective factors for mental health across the lifespan; to advance...

  6. Social accountability mechanisms and access to public service delivery in rural Africa

    Friis-Hansen, Esbern; Cold-Ravnkilde, Signe Marie

    2013-01-01

    This study rationale is to fill a knowledge gap about the performance of social accountability initiatives in rural Africa South of Sahara supported by foreign aid in the context of decentralization. Based on a review of available literature the study focuses on the experience of social accountability initiatives, namely public expenditure tracking surveys (PETS), participatory budgeting, community-based monitoring, participatory planning and priority setting and demand drive service provisio...

  7. Priorities for global felid conservation.

    Dickman, Amy J; Hinks, Amy E; Macdonald, Ewan A; Burnham, Dawn; Macdonald, David W

    2015-06-01

    Conservation resources are limited, necessitating prioritization of species and locations for action. Most prioritization approaches are based solely on biologically relevant characteristics of taxa or areas and ignore geopolitical realities. Doing so risks a poor return on conservation investment due to nonbiological factors, such as economic or political instability. We considered felids, a taxon which attracts intense conservation attention, to demonstrate a new approach that incorporates both intrinsic species traits and geopolitical characteristics of countries. We developed conservation priority scores for wild felids based on their International Union for Conservation of Nature status, body mass, habitat, range within protected area, evolutionary distinctiveness, and conservation umbrella potential. We used published data on governance, economics and welfare, human population pressures, and conservation policy to assign conservation-likelihood scores to 142 felid-hosting countries. We identified 71 countries as high priorities (above median) for felid conservation. These countries collectively encompassed all 36 felid species and supported an average of 96% of each species' range. Of these countries, 60.6% had below-average conservation-likelihood scores, which indicated these countries are relatively risky conservation investments. Governance was the most common factor limiting conservation likelihood. It was the major contributor to below-median likelihood scores for 62.5% of the 32 felid species occurring in lower-likelihood countries. Governance was followed by economics for which scores were below median for 25% of these species. An average of 58% of species' ranges occurred in 43 higher-priority lower-likelihood countries. Human population pressure was second to governance as a limiting factor when accounting for percentage of species' ranges in each country. As conservation likelihood decreases, it will be increasingly important to identify relevant

  8. Determining a Consistent Set of Accounting and Financial Reporting Standards: A Research Note Based on the IASB-FASB Conceptual Framework Revision Project

    Le Manh, Anne; Ramond, Olivier

    2011-01-01

    Following the debate surrounding the Conceptual Framework revision jointly undertaken by the IASB and the FASB in May 2008, this paper identifies and discusses three major concerns about the way accounting and financial reporting standards should be determined for listed companies evolving in a global context, namely: (1) What is the role and purpose of a Conceptual Framework?; (2) For whom and for which needs are accounting and financial reporting standards made?; and (3) What information se...

  9. Developing priority criteria for magnetic resonance imaging: results from the Western Canada Waiting List project

    The Western Canada Waiting List (WCWL) Project is a federally funded partnership of 19 organizations, including medical associations, health authorities, ministries of health and research organizations, that was created to develop tools to assist in assessing the relative urgency and priority of patients on waiting lists. The WCWL panel on magnetic resonance imaging (MRI) was 1 of 5 panels constituted under this project. The panel developed and tested a set of standardized clinical criteria for setting priorities among patients awaiting MRI. The criteria were applied to 407 patients in the 4 western provinces. Regression analysis was used to determine the set of criteria weights that collectively best predicted clinicians' overall ratings of patients' urgency for MRI. Reliability was assessed using clinicians' ratings of 6 hypothetical paper cases. The resulting weighted criteria accounted for about two-fifths of the observed variance in overall urgency ratings (R2 = 39.9%). The panel then modified the criteria on the basis of regression results and clinical judgment. Most of the revised criteria items showed poor inter-rater reliability, but test-retest reliability (over a 2-month interval) was relatively good. Criteria items requiring probability judgments were a challenge for clinicians. Further development and testing of the tool appears warranted, although considerable question remains concerning the utility of priority criteria for MRI and other diagnostic services. (author)

  10. Implementing accountability for reasonableness--the case of pharmaceutical reimbursement in Sweden.

    Jansson, Sandra

    2007-04-01

    This paper aims to describe the priority-setting procedure for new original pharmaceuticals practiced by the Swedish Pharmaceutical Benefits Board (LFN), to analyse the outcome of the procedure in terms of decisions and the relative importance of ethical principles, and to examine the reactions of stakeholders. All the 'principally important' decisions made by the LFN during its first 33 months of operation were analysed. The study is theoretically anchored in the theory of fair and legitimate priority-setting procedures by Daniels and Sabin, and is based on public documents, media articles, and semi-structured interviews. Only nine cases resulted in a rejection of a subsidy by the LFN and 15 in a limited or conditional subsidy. Total rejections rather than limitations gave rise to actions by stakeholders. Primarily, the principle of cost-effectiveness was used when limiting/conditioning or totally rejecting a subsidy. This study suggests that implementing a priority-setting process that fulfils the conditions of accountability for reasonableness can result in a priority-setting process which is generally perceived as fair and legitimate by the major stakeholders and may increase social learning in terms of accepting the necessity of priority setting in health care. The principle of cost-effectiveness increased in importance when the demand for openness and transparency increased. PMID:18634660

  11. Social Priorities as Data

    Grubert, E.

    2015-12-01

    Decision makers' responses to local risks and expected changes to a community from circumstances like natural hazards, human developments, and demographic changes can greatly affect social and environmental outcomes in a community. Translating physical data based in disciplines like engineering and geosciences into positive outcomes for communities can be challenging and often results in conflict that appears to pit "science" against "the public." Scientists can be reluctant to offer recommendations for action based on their work, often (and often correctly) noting that their role is not to make value judgments for a community - particularly for a community that is not their own. Conversely, decision makers can be frustrated by the lack of guidance they receive to help translate data into effective and acceptable action. The solution posed by this submission, given the goal of co-production of knowledge by scientists and decision makers to foster better community outcomes, is to involve the community directly by integrating social scientific methods that address decision making and community engagement to the scientist-decision maker interaction. Specifically, the missing dataset in many scientist-decision maker interactions is the nature of community priorities. Using scientifically valid methods to rigorously collect and characterize community priorities to help recommend tradeoffs between different outcomes indicated by the work of physical and natural scientists can bridge the gap between science and action by involving the community in the process. This submission presents early work on US preferences for different types of social and environmental outcomes designed to integrate directly with engineering and physical science frameworks like Life Cycle Assessment and Environmental Impact Statements. Cardinal preference data are based on surveys of US adults using tools like the Analytical Hierarchy Process, budget allocation, and ranking.

  12. Fuzzy Priority CPU Scheduling Algorithm

    Bashir Alam; M.N. Doja; R. Biswas; Mansaf Alam

    2011-01-01

    There are several CPU scheduling algorithms like FCFS, SRTN,RR , priority etc. Scheduling decision of these algorithms are based on parameters which are assumed to be crisp. However, in many circumstances these parameters are vague. The vagueness of these parameters suggests that scheduler should use fuzzy logic in scheduling the jobs. A fuzzy priority CPU scheduling algorithm has been proposed. This proposed algorithm improves the priority based CPU scheduling algorithm as obvious from simul...

  13. Students' Accounts of School-Performance Stress: A Qualitative Analysis of a High-Achieving Setting in Stockholm, Sweden

    Låftman, Sara Brolin; Almquist, Ylva B.; Östberg, Viveca

    2013-01-01

    The aim of the study is to examine students' experiences of school performance as a stressor. Accounts of school-performance stress at both the individual level and in relation to group mechanisms are studied through qualitative interviews with eighth-grade students in a high-performing school in Stockholm, Sweden (n = 49). Using qualitative…

  14. 29 CFR 1990.131 - Priority lists for regulating potential occupational carcinogens.

    2010-07-01

    ... review or be the basis for any legal action. The Secretary may regulate a potential occupational... 29 Labor 9 2010-07-01 2010-07-01 false Priority lists for regulating potential occupational... POTENTIAL OCCUPATIONAL CARCINOGENS Priority Setting § 1990.131 Priority lists for regulating...

  15. AMERICAN ACCOUNTING

    Mihaela Onica

    2005-01-01

    Full Text Available The international Accounting Standards already contribute to the generation of better and more easily comparable financial information on an international level, supporting thus a more effective allocationof the investments resources in the world. Under the circumstances, there occurs the necessity of a consistent application of the standards on a global level. The financial statements are part of thefinancial reporting process. A set of complete financial statements usually includes a balance sheet,a profit and loss account, a report of the financial item change (which can be presented in various ways, for example as a status of the treasury flows and of the funds flows and those notes, as well as those explanatory situations and materials which are part of the financial statements.

  16. Cuban experiences in the establishment of a legal support to set up a national system of accounting for an control of nuclear materials

    It is described the legal support existing in Cuba for the establishment of the National System of Accounting for and Control of nuclear materials (SSAC). The current functional structure fits the particularities of the peaceful use of nuclear energy. The new legal instruments in the subject of accounting for and control (a Decree and a Guide), in force since 1996, enhance the capabilities of before existing legal support for the establishment and functioning of the SSAC. It is described the general aspects of both new legal instruments. The peaceful character of the Cuban nuclear program has been demonstrated since their beginning. Then the most capital importance was given to aspects related with the accomplishment of the compromises of the signed safeguards agreements between Cuba and the International Atomic Energy Agency (IAEA). All the achievements had reached such level that our legal basis suits the compromises of comprehensive safeguards agreements. (author)

  17. Our top priority

    2012-01-01

    After three years of LHC running, we are still at the beginning of a long research programme with our flagship facility, and hopefully 4 July 2012 will go down in history as the date of one of many landmark discoveries spanning several years. CERN’s top priority for the next decade and more is the full exploitation of the LHC. With speculation about potential future facilities mounting in the light of the discovery of a new Higgs-like particle, it’s important to state that most clearly. Of course, this will rely on continued global collaboration, and it’s important that CERN engage constructively with other regions.   It is important to plan ahead, particularly since the lead times for new projects in particle physics are long, and our field is increasingly global in nature. That’s why the European particle physics community is currently engaged in updating its long-term strategy. Planning ahead allowed us to be ready technologically to build the LHC whe...

  18. Process Accounting

    Gilbertson, Keith

    2002-01-01

    Standard utilities can help you collect and interpret your Linux system's process accounting data. Describes the uses of process accounting, standard process accounting commands, and example code that makes use of process accounting utilities.

  19. La oferta de la prueba rápida del VIH en la calle dentro del ámbito universitario: ¿una estrategia prioritaria? Street outreach rapid HIV testing in university settings: a priority strategy?

    Juan Hoyos

    2012-04-01

    analyzing the prevalence of infection, risk behaviors and history of sexually transmitted infections and by performing HIV tests. Methods: During October-November of 2008 and November-December of 2009, 1668 persons received rapid HIV testing in a mobile unit located in university campuses in the cities of Madrid, Málaga and Salamanca (Spain. While waiting for the test results, participants completed a brief questionnaire. Results: A total of 15.7% were men who had sex with men (MSM, 28.6% were exclusively heterosexual men (HTX, and 55.7% were women. Nearly three-quarters (73.3% were under 25 years of age, 8.5% were born abroad and only 4% had no secondary education. Fifty-one percent of HTX, 42% of women and 6.3% of MSM had casual sexual partners in the past 12 months without always using a condom. This behavior was also reported by 41.5% of MSM with same sex partners. A sexually transmitted infection had previously been diagnosed in 24.7% of MSMs, 14.7% of women and 5.6% of HTX. Four positive results were found, all in MSM who had been tested in the previous 2 years. The prevalence was 1.6% (95% CI: 0.43-3.95 within this group, and 0.2% overall (95% CI: 0.07-0.62. Conclusions: Despite the high frequency of risk behaviors, the low prevalence of HIV infection and the history of HIV testing suggest that university campuses are not a priority location to develop these programs, which would achieve greater impact and efficiency in more vulnerable populations.

  20. Priority of areas for agricultural radiovulnerability mapping

    The methodology for classifying areas according to soil properties for the vulnerability to a 137Cs contamination is of high importance to the preparedness related to nuclear and/or radiological accidents that lead to release of radionuclides to the environment with the consequent contamination of agricultural areas. The priority of research for agricultural areas should then focus on the surrounding areas of nuclear power plant that have higher probability of public exposure through the ingestion pathway. The objective of this work was to create a rank order for priority of areas to be mapped based on EMBRAPA database on soil properties. The 16 municipalities previously selected to define parameters for dose assessment simulations related to the Brazilian Nuclear Power Plants, located in the district of Angra dos Reis, Rio de Janeiro, have been investigated in order to create this rank order to direct the research on radio vulnerability mapping, considering their relevance to public exposure based on their agricultural productivity. The two aspects selected in this study account for the maximum loss of income and to the collective doses that can be averted due to the banning of agricultural products. These quantities are inputs to optimization analysis. The priority defined shall then guide research on both the adequate values for the transfer factors and on the agricultural countermeasures suitable to each area according to the cause(s) of their vulnerability and their typical agricultural crops. (author)

  1. Priority of areas for agricultural radiovulnerability mapping

    Rochedo, Elaine R.R.; Igreja, Eduardo, E-mail: elainerochedo@gmail.com, E-mail: eduigreja@gmail.com [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Wasserman, Maria Angelica V., E-mail: mwasserman@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Perez, Daniel V., E-mail: chpd@cnps.embrapa.br [Empresa Brasileira de Pesquisa Agropecuaria (EMBRAPA), Rio de Janeiro, RJ (Brazil). Centro Nacional de Pesquisa de Solos; Rochedo, Pedro R.R., E-mail: rochedopedro@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Programa de Planejamento Energetico; Silva, Diogo N.G., E-mail: diogongs@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Biofisica Carlos Chagas Filho

    2013-07-01

    The methodology for classifying areas according to soil properties for the vulnerability to a {sup 137}Cs contamination is of high importance to the preparedness related to nuclear and/or radiological accidents that lead to release of radionuclides to the environment with the consequent contamination of agricultural areas. The priority of research for agricultural areas should then focus on the surrounding areas of nuclear power plant that have higher probability of public exposure through the ingestion pathway. The objective of this work was to create a rank order for priority of areas to be mapped based on EMBRAPA database on soil properties. The 16 municipalities previously selected to define parameters for dose assessment simulations related to the Brazilian Nuclear Power Plants, located in the district of Angra dos Reis, Rio de Janeiro, have been investigated in order to create this rank order to direct the research on radio vulnerability mapping, considering their relevance to public exposure based on their agricultural productivity. The two aspects selected in this study account for the maximum loss of income and to the collective doses that can be averted due to the banning of agricultural products. These quantities are inputs to optimization analysis. The priority defined shall then guide research on both the adequate values for the transfer factors and on the agricultural countermeasures suitable to each area according to the cause(s) of their vulnerability and their typical agricultural crops. (author)

  2. The badness of death and priorities in health

    Solberg, Carl T; Gamlund, Espen

    2016-01-01

    Background The state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-f...

  3. Monitoring and modelling the occurrence of priority substances in wastewater

    Jones, Lisa; Regan, Fiona

    2011-01-01

    In 2000 the Water Framework Directive (WFD), 2000/60/EC, was introduced and a group of 66 chemicals, including pesticides, polycyclic aromatic hydrocarbons, and metals were listed as chosen priority pollutants. The levels of these priority pollutants in the environment are regulated by set environmental quality standards (EQSs) and are affected by a number of emission factors including anthropogenic activities, population equivalents, and weather. In order for these EQSs to be enforced, regul...

  4. Exclusion in a priority queue

    We introduce the prioritising exclusion process, a stochastic scheduling mechanism for a priority queueing system in which high priority customers gain advantage by overtaking low priority customers. The model is analogous to a totally asymmetric exclusion process with a dynamically varying lattice length. We calculate exact local density profiles for an unbounded queue by deriving domain wall dynamics from the microscopic transition rules. The structure of the unbounded queue carries over to bounded queues where, although no longer exact, we find the domain wall theory is in very good agreement with simulation results. Within this approximation we calculate average waiting times for queueing customers. (paper)

  5. Conclusions on severe accident research priorities

    Highlights: • Estimation of research priorities related to severe accident phenomena. • Consideration of new topics, partly linked to the severe accidents at Fukushima. • Consideration of results of recent projects, e.g. SARNET, ASAMPSA2, OECD projects. - Abstract: The objectives of the SARNET network of excellence are to define and work on common research programs in the field of severe accidents in Gen. II–III nuclear power plants and to further develop common tools and methodologies for safety assessment in this area. In order to ensure that the research conducted on severe accidents is efficient and well-focused, it is necessary to periodically evaluate and rank the priorities of research. This was done at the end of 2008 by the Severe Accident Research Priority (SARP) group at the end of the SARNET project of the 6th Framework Programme of European Commission (FP6). This group has updated this work in the FP7 SARNET2 project by accounting for the recent experimental results, the remaining safety issues as e.g. highlighted by Level 2 PSA national studies and the results of the recent ASAMPSA2 FP7 project. These evaluation activities were conducted in close relation with the work performed under the auspices of international organizations like OECD or IAEA. The Fukushima-Daiichi severe accidents, which occurred while SARNET2 was running, had some effects on the prioritization and definition of new research topics. Although significant progress has been gained and simulation models (e.g. the ASTEC integral code, jointly developed by IRSN and GRS) were improved, leading to an increased confidence in the predictive capabilities for assessing the success potential of countermeasures and/or mitigation measures, most of the selected research topics in 2008 are still of high priority. But the Fukushima-Daiichi accidents underlined that research efforts had to focus still more to improve severe accident management efficiency

  6. NRPC ServCat priorities

    US Fish and Wildlife Service, Department of the Interior — This document lists the Natural Resource Program Centers priority ServCat documents. It is recommended that these documents which include annual narrative reports,...

  7. TALENT MANAGEMENT - A STRATEGIC PRIORITY

    Matei Mirabela-Constanta; Abrudan Maria-Madela

    2009-01-01

    Companies facing the new economic world, dominated by demographic, macroeconomic, and technological changes need to see talent management as a business priority in order to survive. At the same time, the world economic crisis ads pressure over managers, f

  8. Control System Query Oriented Accounting Tasks

    Mykhaylo Prodanchuk

    2013-01-01

    The role of accounting for the purposes of company management has been studied. According to the author, rather than on accounting, the object focuses participants of the economic process: owners, managers, accountants, investors, and other economic players interested in obtaining complete, true and impartial accounting information. Based on the analysis of existing approaches to identifying accountancy and managerial objectives the tasks of higher priority have been singled out. General acco...

  9. High priority tank sampling and analysis report

    Brown, T.M.

    1998-03-05

    In July 1993, the Defense Nuclear Facilities Safety Board (DNFSB) transmitted Recommendation 93-5 (Conway 1993) to the US Department of Energy (DOE). Recommendation 93-5 noted that there was insufficient tank waste technical information and the pace to obtain it was too slow to ensure that Hanford Site wastes could be safely stored, that associated operations could be conducted safely, and that future disposal data requirements could be met. In May 1996, the DOE issued Revision 1 of the Recommendation 93-5 Implementation Plan (DOE-RL 1996). The Implementation Plan revision presented a modified approach to achieve the original plan`s objectives. The approach concentrated on actions necessary to ensure that wastes can be safely stored, that operations can be safely conducted, and that timely characterization information for the tank waste Disposal Program could be obtained. The Implementation Plan proposed 28 High Priority tanks, which, if sampled and analyzed, were expected to provide information to answer questions regarding safety and disposal issues. The High Priority tank list was originally developed in Section 9.0 of the Tank Waste Characterization Basis (Brown et al. 1995) by integrating the needs of the various safety and disposal programs. The High Priority tank list represents a set of tanks that were expected to provide the highest information return for characterization resources expended. The High Priority tanks were selected for near-term core sampling and were not expected to be the only tanks that would provide meaningful information. Sampling and analysis of non-High Priority tanks also could be used to provide scientific and technical data to confirm assumptions, calibrate models, and measure safety related phenomenological characteristics of the waste. When the sampling and analysis results of the High Priority and other tanks were reviewed, it was expected that a series of questions should be answered allowing key decisions to be made. The first

  10. High priority tank sampling and analysis report

    In July 1993, the Defense Nuclear Facilities Safety Board (DNFSB) transmitted Recommendation 93-5 (Conway 1993) to the US Department of Energy (DOE). Recommendation 93-5 noted that there was insufficient tank waste technical information and the pace to obtain it was too slow to ensure that Hanford Site wastes could be safely stored, that associated operations could be conducted safely, and that future disposal data requirements could be met. In May 1996, the DOE issued Revision 1 of the Recommendation 93-5 Implementation Plan (DOE-RL 1996). The Implementation Plan revision presented a modified approach to achieve the original plan's objectives. The approach concentrated on actions necessary to ensure that wastes can be safely stored, that operations can be safely conducted, and that timely characterization information for the tank waste Disposal Program could be obtained. The Implementation Plan proposed 28 High Priority tanks, which, if sampled and analyzed, were expected to provide information to answer questions regarding safety and disposal issues. The High Priority tank list was originally developed in Section 9.0 of the Tank Waste Characterization Basis (Brown et al. 1995) by integrating the needs of the various safety and disposal programs. The High Priority tank list represents a set of tanks that were expected to provide the highest information return for characterization resources expended. The High Priority tanks were selected for near-term core sampling and were not expected to be the only tanks that would provide meaningful information. Sampling and analysis of non-High Priority tanks also could be used to provide scientific and technical data to confirm assumptions, calibrate models, and measure safety related phenomenological characteristics of the waste. When the sampling and analysis results of the High Priority and other tanks were reviewed, it was expected that a series of questions should be answered allowing key decisions to be made. The first