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Sample records for accountable priority setting

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    DEFF Research Database (Denmark)

    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...

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

    DEFF Research Database (Denmark)

    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...... of the potential of AFR in supporting priority-setting and other decision-making processes in health systems to achieve better agreed and more sustainable health improvements linked to a mutual democratic learning with potential wider implications....

  5. Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework: Perceptions of stakeholders.

    Science.gov (United States)

    Maluka, Stephen; Kamuzora, Peter; San Sebastián, Miguel; Byskov, Jens; Ndawi, Benedict; Hurtig, Anna-Karin

    2010-12-01

    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. Individual interviews were carried out with different categories of actors and stakeholders in the district. The interview guide consisted of a series of questions, asking respondents to describe their perceptions regarding each condition of the Accountability for Reasonableness framework in terms of priority setting. Interviews were analysed using thematic framework analysis. Documentary data were used to support, verify and highlight the key issues that emerged. Almost all stakeholders viewed Accountability for Reasonableness as an important and feasible approach for improving priority-setting and health service delivery in their context. However, a few aspects of Accountability for Reasonableness were seen as too difficult to implement given the socio-political conditions and traditions in Tanzania. Respondents mentioned: budget ceilings and guidelines, low level of public awareness, unreliable and untimely funding, as well as the limited capacity of the district to generate local resources as the major contextual factors that hampered the full implementation of the framework in their context. This study was one of the first assessments of the applicability of Accountability for Reasonableness in health care priority-setting in Tanzania. The analysis, overall, suggests that the Accountability for Reasonableness framework could be an important tool for improving priority-setting processes in the contexts of resource-poor settings

  6. Decentralized health care priority-setting in Tanzania

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...... 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...

  7. Healthcare priority setting in Kenya

    DEFF Research Database (Denmark)

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

    2014-01-01

    In resource-poor settings, the accountability for reasonableness (A4R) has been identified as an important advance in priority setting that helps to operationalize fair priority setting in specific contexts. The four conditions of A4R are backed by theory, not evidence, that conformance with them...... improves the priority setting decisions. This paper describes the healthcare priority setting processes in Malindi district, Kenya, prior to the implementation of A4R in 2008 and evaluates the process for its conformance with the conditions for A4R. In-depth interviews and focus group discussions with key...... 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...

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

    DEFF Research Database (Denmark)

    Byskov, Jens; Bloch, Paul; Blystad, Astrid

    2009-01-01

    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...

  9. Setting priorities for ambient air quality objectives

    International Nuclear Information System (INIS)

    2004-10-01

    Alberta has ambient air quality objectives in place for several pollutants, toxic substances and other air quality parameters. A process is in place to determine if additional air quality objectives are required or if existing objectives should be changed. In order to identify the highest priority substances that may require an ambient air quality objective to protect ecosystems and public health, a rigorous, transparent and cost effective priority setting methodology is required. This study reviewed, analyzed and assessed successful priority setting techniques used by other jurisdictions. It proposed an approach for setting ambient air quality objective priorities that integrates the concerns of stakeholders with Alberta Environment requirements. A literature and expert review were used to examine existing priority-setting techniques used by other jurisdictions. An analysis process was developed to identify the strengths and weaknesses of various techniques and their ability to take into account the complete pathway between chemical emissions and damage to human health or the environment. The key strengths and weaknesses of each technique were identified. Based on the analysis, the most promising technique was the tool for the reduction and assessment of chemical and other environmental impacts (TRACI). Several considerations for using TRACI to help set priorities for ambient air quality objectives were also presented. 26 refs, 8 tabs., 4 appendices

  10. Setting conservation priorities.

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    Wilson, Kerrie A; Carwardine, Josie; Possingham, Hugh P

    2009-04-01

    A generic framework for setting conservation priorities based on the principles of classic decision theory is provided. This framework encapsulates the key elements of any problem, including the objective, the constraints, and knowledge of the system. Within the context of this framework the broad array of approaches for setting conservation priorities are reviewed. While some approaches prioritize assets or locations for conservation investment, it is concluded here that prioritization is incomplete without consideration of the conservation actions required to conserve the assets at particular locations. The challenges associated with prioritizing investments through time in the face of threats (and also spatially and temporally heterogeneous costs) can be aided by proper problem definition. Using the authors' general framework for setting conservation priorities, multiple criteria can be rationally integrated and where, how, and when to invest conservation resources can be scheduled. Trade-offs are unavoidable in priority setting when there are multiple considerations, and budgets are almost always finite. The authors discuss how trade-offs, risks, uncertainty, feedbacks, and learning can be explicitly evaluated within their generic framework for setting conservation priorities. Finally, they suggest ways that current priority-setting approaches may be improved.

  11. Priority setting in HIV/AIDS control in West Java Indonesia: an evaluation based on the accountability for reasonableness framework.

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    Tromp, Noor; Prawiranegara, Rozar; Subhan Riparev, Harris; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-04-01

    Indonesia has insufficient resources to adequately respond to the HIV/AIDS epidemic, and thus faces a great challenge in prioritizing interventions. In many countries, such priority setting processes are typically ad hoc and not transparent leading to unfair decisions. Here, we evaluated the priority setting process in HIV/AIDS control in West Java province against the four conditions of the accountability for reasonableness (A4R) framework: relevance, publicity, appeals and revision, and enforcement. We reviewed government documents and conducted semi-structured qualitative interviews based on the A4R framework with 22 participants of the 5-year HIV/AIDS strategy development for 2008-13 (West Java province) and 2007-11 (Bandung). We found that criteria for priority setting were used implicitly and that the strategies included a wide range of programmes. Many stakeholders were involved in the process but their contribution could be improved and particularly the public and people living with HIV/AIDS could be better engaged. The use of appeal and publicity mechanisms could be more transparent and formally stated. Public regulations are not yet installed to ensure fair priority setting. To increase fairness in HIV/AIDS priority setting, West Java should make improvements on all four conditions of the A4R framework. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  12. Priority setting: what constitutes success? A conceptual framework for successful priority setting.

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    Sibbald, Shannon L; Singer, Peter A; Upshur, Ross; Martin, Douglas K

    2009-03-05

    The sustainability of healthcare systems worldwide is threatened by a growing demand for services and expensive innovative technologies. Decision makers struggle in this environment to set priorities appropriately, particularly because they lack consensus about which values should guide their decisions. One way to approach this problem is to determine what all relevant stakeholders understand successful priority setting to mean. The goal of this research was to develop a conceptual framework for successful priority setting. Three separate empirical studies were completed using qualitative data collection methods (one-on-one interviews with healthcare decision makers from across Canada; focus groups with representation of patients, caregivers and policy makers; and Delphi study including scholars and decision makers from five countries). This paper synthesizes the findings from three studies into a framework of ten separate but interconnected elements germane to successful priority setting: stakeholder understanding, shifted priorities/reallocation of resources, decision making quality, stakeholder acceptance and satisfaction, positive externalities, stakeholder engagement, use of explicit process, information management, consideration of values and context, and revision or appeals mechanism. The ten elements specify both quantitative and qualitative dimensions of priority setting and relate to both process and outcome components. To our knowledge, this is the first framework that describes successful priority setting. The ten elements identified in this research provide guidance for decision makers and a common language to discuss priority setting success and work toward improving priority setting efforts.

  13. The unfunded priorities: an evaluation of priority setting for noncommunicable disease control in Uganda.

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    Essue, Beverley M; Kapiriri, Lydia

    2018-02-20

    The double burden of infectious diseases coupled with noncommunicable diseases poses unique challenges for priority setting and for achieving equitable action to address the major causes of disease burden in health systems already impacted by limited resources. Noncommunicable disease control is an important global health and development priority. However, there are challenges for translating this global priority into local priorities and action. The aim of this study was to evaluate the influence of national, sub-national and global factors on priority setting for noncommunicable disease control in Uganda and examine the extent to which priority setting was successful. A mixed methods design that used the Kapiriri & Martin framework for evaluating priority setting in low income countries. The evaluation period was 2005-2015. Data collection included a document review (policy documents (n = 19); meeting minutes (n = 28)), media analysis (n = 114) and stakeholder interviews (n = 9). Data were analysed according to the Kapiriri & Martin (2010) framework. Priority setting for noncommunicable diseases was not entirely fair nor successful. While there were explicit processes that incorporated relevant criteria, evidence and wide stakeholder involvement, these criteria were not used systematically or consistently in the contemplation of noncommunicable diseases. There were insufficient resources for noncommunicable diseases, despite being a priority area. There were weaknesses in the priority setting institutions, and insufficient mechanisms to ensure accountability for decision-making. Priority setting was influenced by the priorities of major stakeholders (i.e. development assistance partners) which were not always aligned with national priorities. There were major delays in the implementation of noncommunicable disease-related priorities and in many cases, a failure to implement. This evaluation revealed the challenges that low income countries are

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

    DEFF Research Database (Denmark)

    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 implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions....

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    Byskov, Jens; Bloch, Paul; Blystad, Astrid; Hurtig, Anna-Karin; Fylkesnes, Knut; Kamuzora, Peter; Kombe, Yeri; Kvåle, Gunnar; Marchal, Bruno; Martin, Douglas K; Michelo, Charles; Ndawi, Benedict; Ngulube, Thabale J; Nyamongo, Isaac; Olsen, Oystein E; Onyango-Ouma, Washington; Sandøy, Ingvild F; Shayo, Elizabeth H; Silwamba, Gavin; Songstad, Nils Gunnar; Tuba, Mary

    2009-10-24

    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 applied in an action research

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Bell, Jennifer A H; Hyland, Sylvia; DePellegrin, Tania; Upshur, Ross E G; Bernstein, Mark; Martin, Douglas K

    2004-12-19

    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'. 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. 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. '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.

  19. Priority-setting in health systems

    DEFF Research Database (Denmark)

    Byskov, Jens

    2013-01-01

    improvements work similarly in the vast array of social and other local contextual factors. Local, fair and accountable priority setting processes are neccessary to make the best of ever shifting national level strategies and priorities. An approach is described, which can assist in the involvement......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 surveys in nearby villages have shown a high prevalence of intestinal helminthiasis and schistosomiasis. The HIV prevalence in similar rural settings is about 10% in her age group. She has been losing weight over the last months and now her one-year-old child feels hot and is not eating well. She has...

  20. Against proportional shortfall as a priority-setting principle.

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    Altmann, Samuel

    2018-05-01

    As the demand for healthcare rises, so does the need for priority setting in healthcare. In this paper, I consider a prominent priority-setting principle: proportional shortfall. My purpose is to argue that proportional shortfall, as a principle, should not be adopted. My key criticism is that proportional shortfall fails to consider past health.Proportional shortfall is justified as it supposedly balances concern for prospective health while still accounting for lifetime health, even though past health is deemed irrelevant. Accounting for this lifetime perspective means that the principle may indirectly consider past health by accounting for how far an individual is from achieving a complete, healthy life. I argue that proportional shortfall does not account for this lifetime perspective as it fails to incorporate the fair innings argument as originally claimed, undermining its purported justification.I go on to demonstrate that the case for ignoring past health is weak, and argue that past health is at least sometimes relevant for priority-setting decisions. Specifically, when an individual's past health has a direct impact on current or future health, and when one individual has enjoyed significantly more healthy life years than another.Finally, I demonstrate that by ignoring past illnesses, even those entirely unrelated to their current illness, proportional shortfall can lead to instances of double jeopardy, a highly problematic implication. These arguments give us reason to reject proportional shortfall. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Using evaluation theory in priority setting and resource allocation.

    Science.gov (United States)

    Smith, Neale; Mitton, Craig; Cornelissen, Evelyn; Gibson, Jennifer; Peacock, Stuart

    2012-01-01

    Public sector interest in methods for priority setting and program or policy evaluation has grown considerably over the last several decades, given increased expectations for accountable and efficient use of resources and emphasis on evidence-based decision making as a component of good management practice. While there has been some occasional effort to conduct evaluation of priority setting projects, the literatures around priority setting and evaluation have largely evolved separately. In this paper, the aim is to bring them together. The contention is that evaluation theory is a means by which evaluators reflect upon what it is they are doing when they do evaluation work. Theories help to organize thinking, sort out relevant from irrelevant information, provide transparent grounds for particular implementation choices, and can help resolve problematic issues which may arise in the conduct of an evaluation project. A detailed review of three major branches of evaluation theory--methods, utilization, and valuing--identifies how such theories can guide the development of efforts to evaluate priority setting and resource allocation initiatives. Evaluation theories differ in terms of their guiding question, anticipated setting or context, evaluation foci, perspective from which benefits are calculated, and typical methods endorsed. Choosing a particular theoretical approach will structure the way in which any priority setting process is evaluated. The paper suggests that explicitly considering evaluation theory makes key aspects of the evaluation process more visible to all stakeholders, and can assist in the design of effective evaluation of priority setting processes; this should iteratively serve to improve the understanding of priority setting practices themselves.

  2. Community Priority Index: utility, applicability and validation for priority setting in community-based participatory research

    Directory of Open Access Journals (Sweden)

    Hamisu M. Salihu

    2015-07-01

    Full Text Available Background. Providing practitioners with an intuitive measure for priority setting that can be combined with diverse data collection methods is a necessary step to foster accountability of the decision-making process in community settings. Yet, there is a lack of easy-to-use, but methodologically robust measures, that can be feasibly implemented for reliable decision-making in community settings. To address this important gap in community based participatory research (CBPR, the purpose of this study was to demonstrate the utility, applicability, and validation of a community priority index in a community-based participatory research setting. Design and Methods. Mixed-method study that combined focus groups findings, nominal group technique with six key informants, and the generation of a Community Priority Index (CPI that integrated community importance, changeability, and target populations. Bootstrapping and simulation were performed for validation. Results. For pregnant mothers, the top three highly important and highly changeable priorities were: stress (CPI=0.85; 95%CI: 0.70, 1.00, lack of affection (CPI=0.87; 95%CI: 0.69, 1.00, and nutritional issues (CPI=0.78; 95%CI: 0.48, 1.00. For non-pregnant women, top priorities were: low health literacy (CPI=0.87; 95%CI: 0.69, 1.00, low educational attainment (CPI=0.78; 95%CI: 0.48, 1.00, and lack of self-esteem (CPI=0.72; 95%CI: 0.44, 1.00. For children and adolescents, the top three priorities were: obesity (CPI=0.88; 95%CI: 0.69, 1.00, low self-esteem (CPI=0.81; 95%CI: 0.69, 0.94, and negative attitudes toward education (CPI=0.75; 95%CI: 0.50, 0.94. Conclusions. This study demonstrates the applicability of the CPI as a simple and intuitive measure for priority setting in CBPR.

  3. Priority setting in practice: participants opinions on vertical and horizontal priority setting for reallocation.

    Science.gov (United States)

    Waldau, Susanne; Lindholm, Lars; Wiechel, Anna Helena

    2010-08-01

    In the Västerbotten County Council in Sweden a priority setting process was undertaken to reallocate existing resources for funding of new methods and activities. Resources were created by limiting low priority services. A procedure for priority setting was constructed and fully tested by engaging the entire organisation. The procedure included priority setting within and between departments and political decision making. Participants' views and experiences were collected as a basis for future improvement of the process. Results indicate that participants appreciated the overall approach and methodology and wished to engage in their improvement. Among the improvement proposals is prolongation of the process in order to improve the knowledge base quality. The procedure for identification of new items for funding also needs to be revised. The priority setting process was considered an overall success because it fulfilled its political goals. Factors considered crucial for success are a wish among managers for an economic strategy that addresses existing internal resource allocation; process management characterized by goal orientation and clear leadership; an elaborate communications strategy integrated early in the process and its management; political unity in support of the procedure, and a strong political commitment throughout the process. Generalizability has already been demonstrated by several health care organisations that performed processes founded on this working model. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  4. A strategy to improve priority setting in developing countries.

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    Kapiriri, Lydia; Martin, Douglas K

    2007-09-01

    Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. Priority setting in developing countries is fraught with uncertainty due to lack of credible information, weak priority setting institutions, and unclear priority setting processes. Efforts to improve priority setting in these contexts have focused on providing information and tools. In this paper we argue that priority setting is a value laden and political process, and although important, the available information and tools are not sufficient to address the priority setting challenges in developing countries. Additional complementary efforts are required. Hence, a strategy to improve priority setting in developing countries should also include: (i) capturing current priority setting practices, (ii) improving the legitimacy and capacity of institutions that set priorities, and (iii) developing fair priority setting processes.

  5. Setting priorities for safeguards upgrades

    International Nuclear Information System (INIS)

    Al-Ayat, R.A.; Judd, B.R.; Patenaude, C.J.; Sicherman, A.

    1987-01-01

    This paper describes an analytic approach and a computer program for setting priorities among safeguards upgrades. The approach provides safeguards decision makers with a systematic method for allocating their limited upgrade resources. The priorities are set based on the upgrades cost and their contribution to safeguards effectiveness. Safeguards effectiveness is measured by the probability of defeat for a spectrum of potential insider and outsider adversaries. The computer program, MI$ER, can be used alone or as a companion to ET and SAVI, programs designed to evaluate safeguards effectiveness against insider and outsider threats, respectively. Setting the priority required judgments about the relative importance (threat likelihoods and consequences) of insider and outsider threats. Although these judgments are inherently subjective, MI$ER can analyze the sensitivity of the upgrade priorities to these weights and determine whether or not they are critical to the priority ranking. MI$ER produces tabular and graphical results for comparing benefits and identifying the most cost-effective upgrades for a given expenditure. This framework provides decision makers with an explicit and consistent analysis to support their upgrades decisions and to allocate the safeguards resources in a cost-effective manner

  6. Evaluating priority setting success in healthcare: a pilot study

    Directory of Open Access Journals (Sweden)

    Upshur Ross

    2010-05-01

    Full Text Available Abstract Background In healthcare today, decisions are made in the face of serious resource constraints. Healthcare managers are struggling to provide high quality care, manage resources effectively, and meet changing patient needs. Healthcare managers who are constantly making difficult resource decisions desire a way to improve their priority setting processes. Despite the wealth of existing priority setting literature (for example, program budgeting and marginal analysis, accountability for reasonableness, the 'describe-evaluate-improve' strategy there are still no tools to evaluate how healthcare resources are prioritised. This paper describes the development and piloting of a process to evaluate priority setting in health institutions. The evaluation process was designed to examine the procedural and substantive dimensions of priority setting using a multi-methods approach, including a staff survey, decision-maker interviews, and document analysis. Methods The evaluation process was piloted in a mid-size community hospital in Ontario, Canada while its leaders worked through their annual budgeting process. Both qualitative and quantitative methods were used to analyze the data. Results The evaluation process was both applicable to the context and it captured the budgeting process. In general, the pilot test provided support for our evaluation process and our definition of success, (i.e., our conceptual framework. Conclusions The purpose of the evaluation process is to provide a simple, practical way for an organization to better understand what it means to achieve success in its priority setting activities and identify areas for improvement. In order for the process to be used by healthcare managers today, modification and contextualization of the process are anticipated. As the evaluation process is applied in more health care organizations or applied repeatedly in an organization, it may become more streamlined.

  7. Priority setting and economic appraisal: whose priorities--the community or the economist?

    Science.gov (United States)

    Green, A; Barker, C

    1988-01-01

    Scarce resources for health require a process for setting priorities. The exact mechanism chosen has important implications for the type of priorities and plans set, and in particular their relationship to the principles of primary health care. One technique increasingly advocated as an aid to priority setting is economic appraisal. It is argued however that economic appraisal is likely to reinforce a selective primary health care approach through its espousal of a technocratic medical model and through its hidden but implicit value judgements. It is suggested that urgent attention is needed to develop approaches to priority setting that incorporate the strengths of economic appraisal, but that are consistent with comprehensive primary health care.

  8. Setting research priorities for Type 1 diabetes.

    Science.gov (United States)

    Gadsby, R; Snow, R; Daly, A C; Crowe, S; Matyka, K; Hall, B; Petrie, J

    2012-10-01

    Research priorities are often set by academic researchers or the pharmaceutical industry. The interests of patients, carers and clinicians may therefore be overlooked and research questions that matter may be neglected. The aims of this study were to collect uncertainties about the treatment of Type 1 diabetes from patients, carers and health professionals, and to collate and prioritize these uncertainties to develop a top 10 list of research priorities, using a structured priority-setting partnership of patients, carers, health professionals and diabetes organizations, as described by the James Lind Alliance. A partnership of interested organizations was set up, and from this a steering committee of 10 individuals was formed. An online and paper survey was used to identify uncertainties. These were collated, and the steering group carried out an interim priority-setting exercise with partner organizations. This group of uncertainties was then voted on to give a smaller list that went forward to the final priority-setting workshop. At this meeting, a final list of the top 10 research priorities was agreed. An initial 1141 uncertainties were described. These were reduced to 88 indicative questions, 47 of which went out for voting. Twenty-four were then taken forward to a final priority-setting workshop. This workshop resulted in a list of top 10 research priorities in Type 1 diabetes. We have shown that it is possible using the James Lind Alliance process to develop an agreed top 10 list of research priorities for Type 1 diabetes from health professionals, patients and carers. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  9. Setting Priorities Personal Values, Organizational Results

    CERN Document Server

    (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.

  10. Priority setting in clinical nursing practice: literature review.

    Science.gov (United States)

    Hendry, Charles; Walker, Anne

    2004-08-01

    Time is a valuable resource. When nurses experience demands on their services which exceed their available time, then 'rationing' must occur. In clinical practice such rationing requires practitioners to set priorities for care. The aim of this paper is establish what is currently known about priority setting in nursing, including how nurses set priorities and what factors influence this. CINAHL, Medline, ASSIA, and PsychLit databases for the years 1982-2002 were searched, using the terms (clinical decision-making or problem-solving or planning) and (setting priorities or prioriti*). The publications found were used in a selective, descriptive review. Priority setting is an important skill in nursing, and a skill deficit can have serious consequences for patients. Recent studies have suggested that it is a difficult skill for newly qualified nurses to acquire and may not be given sufficient attention in nurse education. Priority setting can be defined as the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions. A number of factors that may impact on priority setting have been identified in the literature. These include: the expertise of the nurse; the patient's condition; the availability of resources; ward organization; philosophies and models of care; the nurse-patient relationship; and the cognitive strategy used by the nurse to set priorities. However, very little empirical work has been conducted in this area. Further study of priority setting in a range of clinical practice settings is necessary. This could inform both practice and education, promote better use of limited resources and maximize patient outcomes.

  11. On Setting Priorities among Human Rights

    NARCIS (Netherlands)

    Philips, Jos

    2014-01-01

    Should conflicts among human rights be dealt with by including general principles for priority setting at some prominent place in the practice of human rights? This essay argues that neither setting prominent and principled priorities nor a case-by-case approach are likely to be defensible as

  12. Priority Setting in Indigenous Health: Why We Need an Explicit Decision Making Approach

    Directory of Open Access Journals (Sweden)

    Michael E. Otim

    2015-06-01

    Full Text Available Indigenous Australians have significantly poorer health outcomes than the non-Indigenous population worldwide. The Australian government has increased its investment in Indigenous health through the "Closing the Health Gap" initiative. Deciding where to invest scarce resources so as to maximize health outcomes for Indigenous peoples may require improved priority setting processes. Current government practice involves a mix of implicit and explicit processes to varying degrees at the macro and meso decision making levels. In this article, we argue that explicit priority setting should be emphasized in Indigenous health, as it can ensure that the decision making process is accountable, systematic, and transparent. Following a review of the literature, we outline four key issues that need to be considered for explicit priority setting: developing an Indigenous health "constitution," strengthening the evidence base, selecting mechanisms for priority setting, and establishing appropriate incentives and institutional structure. We then summarize our findings into a checklist that can help a decision makers ensure that explicit priority setting is undertaken in Indigenous health. By addressing these key issues, the benefits of an explicit approach, which include increased efficiency, equity, and use of evidence, can be realized, thereby maximizing Indigenous health outcomes.

  13. Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda.

    Science.gov (United States)

    Kapiriri, Lydia; Norheim, Ole Frithjof; Martin, Douglas K

    2007-06-01

    The objectives of this study were (1) to describe the process of healthcare priority setting in Ontario-Canada, Norway and Uganda at the three levels of decision-making; (2) to evaluate the description using the framework for fair priority setting, accountability for reasonableness; so as to identify lessons of good practices. We carried out case studies involving key informant interviews, with 184 health practitioners and health planners from the macro-level, meso-level and micro-level from Canada-Ontario, Norway and Uganda (selected by virtue of their varying experiences in priority setting). Interviews were audio-recorded, transcribed and analyzed using a modified thematic approach. The descriptions were evaluated against the four conditions of "accountability for reasonableness", relevance, publicity, revisions and enforcement. Areas of adherence to these conditions were identified as lessons of good practices; areas of non-adherence were identified as opportunities for improvement. (i) at the macro-level, in all three countries, cabinet makes most of the macro-level resource allocation decisions and they are influenced by politics, public pressure, and advocacy. Decisions within the ministries of health are based on objective formulae and evidence. International priorities influenced decisions in Uganda. Some priority-setting reasons are publicized through circulars, printed documents and the Internet in Canada and Norway. At the meso-level, hospital priority-setting decisions were made by the hospital managers and were based on national priorities, guidelines, and evidence. Hospital departments that handle emergencies, such as surgery, were prioritized. Some of the reasons are available on the hospital intranet or presented at meetings. Micro-level practitioners considered medical and social worth criteria. These reasons are not publicized. Many practitioners lacked knowledge of the macro- and meso-level priority-setting processes. (ii) Evaluation

  14. Setting research priorities by applying the combined approach matrix.

    Science.gov (United States)

    Ghaffar, Abdul

    2009-04-01

    Priority setting in health research is a dynamic process. Different organizations and institutes have been working in the field of research priority setting for many years. In 1999 the Global Forum for Health Research presented a research priority setting tool called the Combined Approach Matrix or CAM. Since its development, the CAM has been successfully applied to set research priorities for diseases, conditions and programmes at global, regional and national levels. This paper briefly explains the CAM methodology and how it could be applied in different settings, giving examples and describing challenges encountered in the process of setting research priorities and providing recommendations for further work in this field. The construct and design of the CAM is explained along with different steps needed, including planning and organization of a priority-setting exercise and how it could be applied in different settings. The application of the CAM are described by using three examples. The first concerns setting research priorities for a global programme, the second describes application at the country level and the third setting research priorities for diseases. Effective application of the CAM in different and diverse environments proves its utility as a tool for setting research priorities. Potential challenges encountered in the process of research priority setting are discussed and some recommendations for further work in this field are provided.

  15. Priority setting and health policy and systems research

    Directory of Open Access Journals (Sweden)

    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.

  16. Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature

    Science.gov (United States)

    Waithaka, Dennis; Tsofa, Benjamin; Barasa, Edwine

    2018-01-01

    Background: Decentralization of health systems has made sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review empirical literature that evaluated priority setting practice at the meso (sub-national) level of health systems. Methods: We systematically searched PubMed, ScienceDirect and Google scholar databases and supplemented these with manual searching for relevant studies, based on the reference list of selected papers. We only included empirical studies that described and evaluated, or those that only evaluated priority setting practice at the meso-level. A total of 16 papers were identified from LMICs and HICs. We analyzed data from the selected papers by thematic review. Results: Few studies used systematic priority setting processes, and all but one were from HICs. Both formal and informal criteria are used in priority-setting, however, informal criteria appear to be more perverse in LMICs compared to HICs. The priority setting process at the meso-level is a top-down approach with minimal involvement of the community. Accountability for reasonableness was the most common evaluative framework as it was used in 12 of the 16 studies. Efficiency, reallocation of resources and options for service delivery redesign were the most common outcome measures used to evaluate priority setting. Limitations: Our study was limited by the fact that there are very few empirical studies that have evaluated priority setting at the meso-level and there is likelihood that we did not capture all the studies. Conclusions: Improving priority setting practices at the meso level is crucial to strengthening health systems. This can be achieved through incorporating and adapting systematic priority setting processes and frameworks to the context where used, and making considerations of both process

  17. Leadership and priority setting: the perspective of hospital CEOs.

    Science.gov (United States)

    Reeleder, David; Goel, Vivek; Singer, Peter A; Martin, Douglas K

    2006-11-01

    The role of leadership in health care priority setting remains largely unexplored. While the management leadership literature has grown rapidly, the growing literature on priority setting in health care has looked in other directions to improve priority setting practices--to health economics and ethical approaches. Consequently, potential for improvement in hospital priority setting practices may be overlooked. A qualitative study involving interviews with 46 Ontario hospital CEOs was done to describe the role of leadership in priority setting through the perspective of hospital leaders. For the first time, we report a framework of leadership domains including vision, alignment, relationships, values and process to facilitate priority setting practices in health services' organizations. We believe this fledgling framework forms the basis for the sharing of good leadership practices for health reform. It also provides a leadership guide for decision makers to improve the quality of their leadership, and in so doing, we believe, the fairness of their priority setting.

  18. New directions in research priority-setting

    DEFF Research Database (Denmark)

    Nielsen, Morten Velsing

    2017-01-01

    The way governments set priorities for research and innovation in Europe is changing. The new focus on responsible research and innovation (RRI) emphasises broader inclusion, increased dialogue, and a focus on societal challenges. The case of RESEARCH2015 in Denmark is one of the first European...... priority-setting processes to incorporate such criteria. This paper develops a theoretical model to explore how RESEARCH2015 contributes to mutual responsiveness among actors, a main objective of RRI. Studying mutual responsiveness means going beyond the often-stated focus on policy impact to look...... at the creation of trust, interdependence and mutual understanding among participants. The study finds that mutual responsiveness is an important precondition for priority-setting, but that the process's contribution to mutual responsiveness is limited, due to the limited attention to social impacts. Still...

  19. Overall strategy for risk evaluation and priority setting of risk regulations

    International Nuclear Information System (INIS)

    Hokstad, Per; Steiro, Trygve

    2006-01-01

    This paper presents the framework of an approach to support planning and priority setting for risk control. Such an approach could assist government/regulatory authorities in their allocation of resources among different sectors. The term risk will here be used in a very wide sense, and it will include, but not restrict to, the traditional HES (Health, Environment and Safety) concept. An overall classification of risk ('loss categories'), to be used across sectors and directorates is suggested. The risk evaluation includes a number of factors not accounted for in a standard risk assessment, but should be taken into account when authorities set priorities regarding risk control. Sociological, psychological and ethical perspectives are included, and the need for a discourse during the decision process is pinpointed. The paper also discusses the potential inclusion of cost benefit analyses in such an approach. The indicated approach is denoted Risk Across Sectors (RAS), and suggestions regarding the process to implement it are given. Such an implementation process will by itself increase the knowledge and competence of the involved parties

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

    Directory of Open Access Journals (Sweden)

    Baltussen Rob

    2006-08-01

    Full Text Available 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 typically bad at solving rationally, unaided. They tend to use heuristic or intuitive approaches to simplify complexity, and in the process, important information is ignored. Next, policy makers may select interventions for only political motives. This indicates the need for rational and transparent approaches to priority setting. Over the past decades, a number of approaches have been developed, including evidence-based medicine, burden of disease analyses, cost-effectiveness analyses, and equity analyses. However, these approaches concentrate on single criteria only, whereas in reality, policy makers need to make choices taking into account multiple criteria simultaneously. Moreover, they do not cover all criteria that are relevant to policy makers. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research. In other scientific disciplines, multi-criteria decision analysis is well developed, has gained widespread acceptance and is routinely used. This paper presents the main principles of multi-criteria decision analysis. There are only a very few applications to guide resource allocation decisions in health. We call for a shift away from present priority setting tools in health – that tend to focus on single criteria – towards transparent and systematic approaches that take into account all relevant criteria

  1. [The Danish Debate on Priority Setting in Medicine--An Update].

    Science.gov (United States)

    Pornak, S C; Raspe, H

    2015-09-01

    In the last years, the Danish debate about priority setting in medicine has gained new strength. This paper shows the main focuses of the current discussion based on a research of Danish primary literature. For the first time since the 1990s the Danish Council of Ethics has been involved with priority setting in medicine in a project running from 2011 to 2013. The Council emphasises the importance of legitimate processes and calls for visible values and criteria. A focus of the debate is how to deal with new expensive drugs. Politicians, physicians, health economists and the Council of Ethics have called for a national institution for priority setting in medicine. They have mainly looked to the Norwegian National Council for Priority Setting in Health Care and the British National Institute for Health and Care Excellence for inspiration. The Danish Government considered establishing a national institute for priority setting, but the plans were not put into practice. In the year 2012 a new national project was launched to create clinical guidelines. Danish doctors welcome the guidelines as a good basis for priority setting. Just like in earlier Danish priority setting debates, a coordinating institution is lacking to bundle the discussion and keep it going. The debate seems to have come to an end once again. The fact that it was seriously considered to establish an institute for priority setting is a new development. It can be expected that the discussion will be resumed in the near future, possibly the idea of an institute for priority setting will be readopted. The general conditions for priority setting in health care have improved. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Priority setting for existing chemicals : automated data selection routine

    NARCIS (Netherlands)

    Haelst, A.G. van; Hansen, B.G.

    2000-01-01

    One of the four steps within Council Regulation 793/93/EEC on the evaluation and control of existing chemicals is the priority setting step. The priority setting step is concerned with selecting high-priority substances from a large number of substances, initially starting with 2,474

  3. Basic priority rating model 2.0: current applications for priority setting in health promotion practice.

    Science.gov (United States)

    Neiger, Brad L; Thackeray, Rosemary; Fagen, Michael C

    2011-03-01

    Priority setting is an important component of systematic planning in health promotion and also factors into the development of a comprehensive evaluation plan. The basic priority rating (BPR) model was introduced more than 50 years ago and includes criteria that should be considered in any priority setting approach (i.e., use of predetermined criteria, standardized comparisons, and a rubric that controls bias). Although the BPR model has provided basic direction in priority setting, it does not represent the broad array of data currently available to decision makers. Elements in the model also give more weight to the impact of communicable diseases compared with chronic diseases. For these reasons, several modifications are recommended to improve the BPR model and to better assist health promotion practitioners in the priority setting process. The authors also suggest a new name, BPR 2.0, to represent this revised model.

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

    Science.gov (United States)

    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. Setting stroke research priorities: The consumer perspective.

    Science.gov (United States)

    Sangvatanakul, Pukkaporn; Hillege, Sharon; Lalor, Erin; Levi, Christopher; Hill, Kelvin; Middleton, Sandy

    2010-12-01

    To test a method of engaging consumers in research priority-setting using a quantitative approach and to determine consumer views on stroke research priorities for clinical practice recommendations with lower levels of evidence (Level III and Level IV) and expert consensus opinion as published in the Australian stroke clinical practice guidelines. Survey Urban community Eighteen stroke survivors (n = 12) and carers (n = 6) who were members of the "Working Aged Group - Stroke" (WAGS) consumer support group. Phase I: Participants were asked whether recommendations were "worth" researching ("yes" or "no"); and, if researched, what potential impact they likely would have on patient outcomes. Phase II: Participants were asked to rank recommendations rated by more than 75% of participants in Phase I as "worth" researching and "highly likely" or "likely" to generate research with a significant effect on patient outcomes (n = 13) in order of priority for future stroke research. All recommendations were rated by at least half (n = 9, 50%) of participants as "worth" researching. The majority (67% to 100%) rated all recommendations as "highly likely" or "likely" that research would have a significant effect on patient outcomes. Thirteen out of 20 recommendations were ranked for their research priorities. Recommendations under the topic heading Getting to hospital were ranked highest and Organization of care and Living with stroke were ranked as a lower priority for research. This study provided an example of how to involve consumers in research priority setting successfully using a quantitative approach. Stroke research priorities from the consumer perspective were different from those of health professionals, as published in the literature; thus, consumer opinion should be considered when setting research priorities. Copyright © 2010 Society for Vascular Nursing, Inc. Published by Mosby, Inc. All rights reserved.

  6. Setting Research Priorities for Kidney Cancer.

    Science.gov (United States)

    Jones, Jennifer M; Bhatt, Jaimin; Avery, Jonathan; Laupacis, Andreas; Cowan, Katherine; Basappa, Naveen S; Basiuk, Joan; Canil, Christina; Al-Asaaed, Sohaib; Heng, Daniel Y C; Wood, Lori; Stacey, Dawn; Kollmannsberger, Christian; Jewett, Michael A S

    2017-12-01

    Defining disease-specific research priorities in cancer can facilitate better allocation of limited resources. Involving patients and caregivers as well as expert clinicians in this process is of value. We undertook this approach for kidney cancer as an example. The Kidney Cancer Research Network of Canada sponsored a collaborative consensus-based priority-setting partnership that identified ten research priorities in the management of kidney cancer. These are discussed in the context of current initiatives and gaps in knowledge. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  7. Priority Setting, Cost-Effectiveness, and the Affordable Care Act.

    Science.gov (United States)

    Persad, Govind

    2015-01-01

    The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA's provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the healthcare system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry.

  8. Conceptualizations of fairness and legitimacy in the context of Ethiopian health priority setting: Reflections on the applicability of accountability for reasonableness.

    Science.gov (United States)

    Petricca, Kadia; Bekele, Asfaw

    2017-05-22

    A critical element in building stronger health systems involves strengthening good governance to build capacity for transparent and fair health planning and priority setting. Over the past 20 years, the ethical framework Accountability for Reasonableness (A4R) has been a prominent conceptual guide in strengthening fair and legitimate processes of health decision-making. While many of the principles embedded within the framework are congruent with Western conceptualizations of what constitutes procedural fairness, there is a paucity in the literature that captures the degree of resonance between these principles and the views of decision makers from non-Western settings; particularly in Africa, where many countries have only recently, within the last 20-30 years, become more democratic. This paper contributes to the ethics literature by examining how Ethiopian decision makers conceptualize fair and legitimate health decision-making, and reflects on the degree of conceptual resonance between these views and the principles embedded in A4R. A qualitative case study approach from three districts in Ethiopia was undertaken. Fifty-eight decision makers from district, regional, zonal, and national levels were interviewed to describe their conceptualization of fairness and legitimacy in the district health planning process. Findings revealed that Ethiopians have a broad conception of fairness and legitimacy that while congruent with procedural justice, also aligned with principles of distributive and organizational justice. Researchers and practitioners seeking to strengthen procedural fairness in health priority setting must therefore recognize the significance of other philosophical dimensions influencing how fairness and legitimacy of health decision-making are constructed within the Ethiopian setting. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Gibson, Jennifer L; Martin, Douglas K; Singer, Peter A

    2004-09-08

    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. 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. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Setting practical conservation priorities for birds in the Western Andes of Colombia.

    Science.gov (United States)

    Ocampo-Peñuela, Natalia; Pimm, Stuart L

    2014-10-01

    We aspired to set conservation priorities in ways that lead to direct conservation actions. Very large-scale strategic mapping leads to familiar conservation priorities exemplified by biodiversity hotspots. In contrast, tactical conservation actions unfold on much smaller geographical extents and they need to reflect the habitat loss and fragmentation that have sharply restricted where species now live. Our aspirations for direct, practical actions were demanding. First, we identified the global, strategic conservation priorities and then downscaled to practical local actions within the selected priorities. In doing this, we recognized the limitations of incomplete information. We started such a process in Colombia and used the results presented here to implement reforestation of degraded land to prevent the isolation of a large area of cloud forest. We used existing range maps of 171 bird species to identify priority conservation areas that would conserve the greatest number of species at risk in Colombia. By at risk species, we mean those that are endemic and have small ranges. The Western Andes had the highest concentrations of such species-100 in total-but the lowest densities of national parks. We then adjusted the priorities for this region by refining these species ranges by selecting only areas of suitable elevation and remaining habitat. The estimated ranges of these species shrank by 18-100% after accounting for habitat and suitable elevation. Setting conservation priorities on the basis of currently available range maps excluded priority areas in the Western Andes and, by extension, likely elsewhere and for other taxa. By incorporating detailed maps of remaining natural habitats, we made practical recommendations for conservation actions. One recommendation was to restore forest connections to a patch of cloud forest about to become isolated from the main Andes. © 2014 Society for Conservation Biology.

  12. Application of economic principles in healthcare priority setting.

    Science.gov (United States)

    Bate, Angela; Mitton, Craig

    2006-06-01

    In healthcare, resources are often insufficient to meet all claims on them. In this respect, resources are considered scarce and have to be managed by prioritizing between competing claims. Economics as a discipline explicitly addresses this reality by acknowledging resource scarcity. However, the extent to which economics actually influences such prioritizing decisions in healthcare is unclear. The purpose of this paper is to review the use of economics in priority setting decision making. We outline the key principles of economics as they apply to priority setting and review the methods reported in the literature with respect to these. We find that these methods, even economic methods (e.g., those typically used in conducting economic evaluations such as cost-effectiveness analyses) do not tend to explicitly incorporate economic principles. We argue therefore that these methods, when applied to the context of priority setting, are not sufficient and that what is required is a broader framework that can incorporate the output from economic methods yet also be pragmatically applicable. We then go on to present an alternative approach - namely program budgeting and marginal analysis. Finally, we put forward our case for using program budgeting and marginal analysis in priority setting practice and set out some future research challenges.

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

    Science.gov (United States)

    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. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  14. [The Danish debate on priority setting in medicine - characteristics and results].

    Science.gov (United States)

    Pornak, S; Meyer, T; Raspe, H

    2011-10-01

    Priority setting in medicine helps to achieve a fair and transparent distribution of health-care resources. The German discussion about priority setting is still in its infancy and may benefit from other countries' experiences. This paper aims to analyse the Danish priority setting debate in order to stimulate the German discussion. The methods used are a literature analysis and a document analysis as well as expert interviews. The Danish debate about priority setting in medicine began in the 1970s, when a government committee was constituted to evaluate health-care priorities at the national level. In the 1980s a broader debate arose in politics, ethics, medicine and health economy. The discussions reached a climax in the 1990s, when many local activities - always involving the public - were initiated. Some Danish counties tried to implement priority setting in the daily routine of health care. The Council of Ethics was a major player in the debate of the 1990s and published a detailed statement on priority setting in 1996. With the new century the debate about priority setting seemed to have come to an end, but in 2006 the Technology Council and the Danish Regions resumed the discussion. In 2009 the Medical Association called for a broad debate in order to achieve equity among all patients. The long lasting Danish debate on priority setting has entailed only very little practical consequences on health care. The main problems seem to have been the missing effort to bundle the various local initiatives on a national level and the lack of powerful players to put results of the discussion into practice. Nevertheless, today the attitude towards priority setting is predominantly positive and even politicians talk freely about it. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Science.gov (United States)

    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…

  16. Priority Settings in patients with Chronic Diseases and Cancer

    DEFF Research Database (Denmark)

    Arreskov, Anne Beiter; Graungaard, Anette Hauskov; Søndergaard, Jens

    Priority setting in patients with cancer and comorbidities Background and aim As both the cancer incidence and the number of patients diagnosed with chronic diseases are increasing, a growing population of cancer survivors will also deal with comorbid chronic diseases. The period after completed...... to comorbidities. Some studies show that participation in regular follow-up consultations concerning comorbid chronic diseases and lifestyle are lower among cancer survivors than non-cancer patients. This could be explained by changes in the patient’s priority setting or in the doctor’s priority and attempt...... to spare the patient for further treatment burden, perhaps resulting in comorbidities falling down the agenda. The overall purpose is to explore patients’ and doctors’ priority settings of comorbidities in patients who have been diagnosed with non-metastatic cancer. Method: The study will consist of three...

  17. Priority Setting for Occupational Cancer Prevention

    Directory of Open Access Journals (Sweden)

    Cheryl E. Peters

    2018-06-01

    Full Text Available Background: Selecting priority occupational carcinogens is important for cancer prevention efforts; however, standardized selection methods are not available. The objective of this paper was to describe the methods used by CAREX Canada in 2015 to establish priorities for preventing occupational cancer, with a focus on exposure estimation and descriptive profiles. Methods: Four criteria were used in an expert assessment process to guide carcinogen prioritization: (1 the likelihood of presence and/or use in Canadian workplaces; (2 toxicity of the substance (strength of evidence for carcinogenicity and other health effects; (3 feasibility of producing a carcinogen profile and/or an occupational estimate; and (4 special interest from the public/scientific community. Carcinogens were ranked as high, medium or low priority based on specific conditions regarding these criteria, and stakeholder input was incorporated. Priorities were set separately for the creation of new carcinogen profiles and for new occupational exposure estimates. Results: Overall, 246 agents were reviewed for inclusion in the occupational priorities list. For carcinogen profile generation, 103 were prioritized (11 high, 33 medium, and 59 low priority, and 36 carcinogens were deemed priorities for occupational exposure estimation (13 high, 17 medium, and 6 low priority. Conclusion: Prioritizing and ranking occupational carcinogens is required for a variety of purposes, including research, resource allocation at different jurisdictional levels, calculations of occupational cancer burden, and planning of CAREX-type projects in different countries. This paper outlines how this process was achieved in Canada; this may provide a model for other countries and jurisdictions as a part of occupational cancer prevention efforts. Keywords: cancer prevention, carcinogen exposure, occupational health

  18. Priority setting for health in emerging markets.

    Science.gov (United States)

    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.

  19. Setting Priorities in Global Child Health Research Investments: Guidelines for Implementation of the CHNRI Method

    Science.gov (United States)

    Rudan, Igor; Gibson, Jennifer L.; Ameratunga, Shanthi; El Arifeen, Shams; Bhutta, Zulfiqar A.; Black, Maureen; Black, Robert E.; Brown, Kenneth H.; Campbell, Harry; Carneiro, Ilona; Chan, Kit Yee; Chandramohan, Daniel; Chopra, Mickey; Cousens, Simon; Darmstadt, Gary L.; Gardner, Julie Meeks; Hess, Sonja Y.; Hyder, Adnan A.; Kapiriri, Lydia; Kosek, Margaret; Lanata, Claudio F.; Lansang, Mary Ann; Lawn, Joy; Tomlinson, Mark; Tsai, Alexander C.; Webster, Jayne

    2008-01-01

    This article provides detailed guidelines for the implementation of systematic method for setting priorities in health research investments that was recently developed by Child Health and Nutrition Research Initiative (CHNRI). The target audience for the proposed method are international agencies, large research funding donors, and national governments and policy-makers. The process has the following steps: (i) selecting the managers of the process; (ii) specifying the context and risk management preferences; (iii) discussing criteria for setting health research priorities; (iv) choosing a limited set of the most useful and important criteria; (v) developing means to assess the likelihood that proposed health research options will satisfy the selected criteria; (vi) systematic listing of a large number of proposed health research options; (vii) pre-scoring check of all competing health research options; (viii) scoring of health research options using the chosen set of criteria; (ix) calculating intermediate scores for each health research option; (x) obtaining further input from the stakeholders; (xi) adjusting intermediate scores taking into account the values of stakeholders; (xii) calculating overall priority scores and assigning ranks; (xiii) performing an analysis of agreement between the scorers; (xiv) linking computed research priority scores with investment decisions; (xv) feedback and revision. The CHNRI method is a flexible process that enables prioritizing health research investments at any level: institutional, regional, national, international, or global. PMID:19090596

  20. Setting Healthcare Priorities at the Macro and Meso Levels: A Framework for Evaluation.

    Science.gov (United States)

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

    2015-09-16

    Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers. A total of 31 papers on evaluation of priority setting were identified. These were supplemented by broader theoretical literature related to evaluation of priority setting. A conceptual review of selected papers was undertaken. Based on a synthesis of the selected literature, we propose an evaluative framework that requires that priority setting practices at the macro and meso levels of the health system meet the following conditions: (1) Priority setting decisions should incorporate both efficiency and equity considerations as well as the following outcomes; (a) Stakeholder satisfaction, (b) Stakeholder understanding, (c) Shifted priorities (reallocation of resources), and (d) Implementation of decisions. (2) Priority setting processes should also meet the procedural conditions of (a) Stakeholder engagement, (b) Stakeholder empowerment, (c) Transparency, (d) Use of evidence, (e) Revisions, (f) Enforcement, and (g) Being grounded on community values. Available frameworks for the evaluation of priority setting are mostly grounded on procedural requirements, while few have included outcome requirements. There is, however, increasing recognition of the need to incorporate both consequential and procedural considerations in priority setting practices. In this review, we adapt an integrative approach to develop and propose a framework for the evaluation of priority setting practices at the macro and meso levels that draws from these complementary schools of thought. © 2015

  1. Setting Healthcare Priorities at the Macro and Meso Levels: A Framework for Evaluation

    Science.gov (United States)

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

    2015-01-01

    Background: Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. Methods: We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers. A total of 31 papers on evaluation of priority setting were identified. These were supplemented by broader theoretical literature related to evaluation of priority setting. A conceptual review of selected papers was undertaken. Results: Based on a synthesis of the selected literature, we propose an evaluative framework that requires that priority setting practices at the macro and meso levels of the health system meet the following conditions: (1) Priority setting decisions should incorporate both efficiency and equity considerations as well as the following outcomes; (a) Stakeholder satisfaction, (b) Stakeholder understanding, (c) Shifted priorities (reallocation of resources), and (d) Implementation of decisions. (2) Priority setting processes should also meet the procedural conditions of (a) Stakeholder engagement, (b) Stakeholder empowerment, (c) Transparency, (d) Use of evidence, (e) Revisions, (f) Enforcement, and (g) Being grounded on community values. Conclusion: Available frameworks for the evaluation of priority setting are mostly grounded on procedural requirements, while few have included outcome requirements. There is, however, increasing recognition of the need to incorporate both consequential and procedural considerations in priority setting practices. In this review, we adapt an integrative approach to develop and propose a framework for the evaluation of priority setting practices at the macro and meso levels that draws from these

  2. Setting Healthcare Priorities at the Macro and Meso Levels: A Framework for Evaluation

    Directory of Open Access Journals (Sweden)

    Edwine W. Barasa

    2015-11-01

    Full Text Available Background Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. Methods We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers. A total of 31 papers on evaluation of priority setting were identified. These were supplemented by broader theoretical literature related to evaluation of priority setting. A conceptual review of selected papers was undertaken. Results Based on a synthesis of the selected literature, we propose an evaluative framework that requires that priority setting practices at the macro and meso levels of the health system meet the following conditions: (1 Priority setting decisions should incorporate both efficiency and equity considerations as well as the following outcomes; (a Stakeholder satisfaction, (b Stakeholder understanding, (c Shifted priorities (reallocation of resources, and (d Implementation of decisions. (2 Priority setting processes should also meet the procedural conditions of (a Stakeholder engagement, (b Stakeholder empowerment, (c Transparency, (d Use of evidence, (e Revisions, (f Enforcement, and (g Being grounded on community values. Conclusion Available frameworks for the evaluation of priority setting are mostly grounded on procedural requirements, while few have included outcome requirements. There is, however, increasing recognition of the need to incorporate both consequential and procedural considerations in priority setting practices. In this review, we adapt an integrative approach to develop and propose a framework for the evaluation of priority setting practices at the macro and meso levels that draws from

  3. Setting priorities for reducing risk and advancing patient safety.

    Science.gov (United States)

    Gaffey, Ann D

    2016-04-01

    We set priorities every day in both our personal and professional lives. Some decisions are easy, while others require much more thought, participation, and resources. The difficult or less appealing priorities may not be popular, may receive push-back, and may be resource intensive. Whether personal or professional, the urgency that accompanies true priorities becomes a driving force. It is that urgency to ensure our patients' safety that brings many of us to work each day. This is not easy work. It requires us to be knowledgeable about the enterprise we are working in and to have the professional skills and competence to facilitate setting the priorities that allow our organizations to minimize risk and maximize value. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

  4. Communitarian claims and community capabilities: furthering priority setting?

    Science.gov (United States)

    Mooney, Gavin

    2005-01-01

    Priority setting in health care is generally not done well. This paper draws on ideas from Amartya Sen and Martha Nussbaum and adds some communitarian underpinnings to provide a way of improving on current uses of program budgeting and marginal analysis (PBMA) in priority setting. The paper suggests that shifting to a communitarian base for priority setting alters the distribution of property rights over health service decision making and increases the probability that recommendations from PBMA exercises will be implemented. The approach is built on a paradigm which departs from three tenets of welfarism as it is normally conceived: (i) individuals qua individuals seek to maximise their individual utility/well-being; (ii) individuals want to do this; and (iii) it is the values of individuals qua individuals that count. Some of the problems of PBMA, as it has been applied to date, are highlighted. It is argued that these are due largely to a lack of 'credible commitment'. Bringing in the community and communitarian values to PBMA priority setting exercises can help to overcome some of the barriers to getting PBMA recommendations implemented. The approach has the merit of reflecting Sen's concept of capabilities (but extending that to a community level). It avoids the often consequentialist base of a conventional welfarist framework, and it allows community values as opposed to individual values to come to the fore. How to elicit communitarian values is explored.

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

    DEFF Research Database (Denmark)

    Majidi, A.; Ghiasvand, R.; Hadji, M.

    2016-01-01

    , 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...

  6. Setting the top 10 research priorities to improve the health of people with Type 2 diabetes: a Diabetes UK-James Lind Alliance Priority Setting Partnership.

    Science.gov (United States)

    Finer, S; Robb, P; Cowan, K; Daly, A; Shah, K; Farmer, A

    2018-07-01

    To describe processes and outcomes of a priority setting partnership to identify the 'top 10 research priorities' in Type 2 diabetes, involving people living with the condition, their carers, and healthcare professionals. We followed the four-step James Lind Alliance Priority Setting Partnership process which involved: gathering uncertainties using a questionnaire survey distributed to 70 000 people living with Type 2 diabetes and their carers, and healthcare professionals; organizing the uncertainties; interim priority setting by resampling of participants with a second survey; and final priority setting in an independent group of participants, using the nominal group technique. At each step the steering group closely monitored and guided the process. In the first survey, 8227 uncertainties were proposed by 2587 participants, of whom 18% were from black, Asian and minority ethnic groups. Uncertainties were formatted and collated into 114 indicative questions. A total of 1506 people contributed to a second survey, generating a shortlist of 24 questions equally weighted to the contributions of people living with diabetes and their carers and those of healthcare professionals. In the final step the 'top 10 research priorities' were selected, including questions on cure and reversal, risk identification and prevention, and self-management approaches in Type 2 diabetes. Systematic and transparent methodology was used to identify research priorities in a large and genuine partnership of people with lived and professional experience of Type 2 diabetes. The top 10 questions represent consensus areas of research priority to guide future research, deliver responsive and strategic allocation of research resources, and improve the future health and well-being of people living with, and at risk of, Type 2 diabetes. © 2018 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  7. A checklist for health research priority setting: nine common themes of good practice.

    Science.gov (United States)

    Viergever, Roderik F; Olifson, Sylvie; Ghaffar, Abdul; Terry, Robert F

    2010-12-15

    Health research priority setting processes assist researchers and policymakers in effectively targeting research that has the greatest potential public health benefit. Many different approaches to health research prioritization exist, but there is no agreement on what might constitute best practice. Moreover, because of the many different contexts for which priorities can be set, attempting to produce one best practice is in fact not appropriate, as the optimal approach varies per exercise. Therefore, following a literature review and an analysis of health research priority setting exercises that were organized or coordinated by the World Health Organization since 2005, we propose a checklist for health research priority setting that allows for informed choices on different approaches and outlines nine common themes of good practice. It is intended to provide generic assistance for planning health research prioritization processes. The checklist explains what needs to be clarified in order to establish the context for which priorities are set; it reviews available approaches to health research priority setting; it offers discussions on stakeholder participation and information gathering; it sets out options for use of criteria and different methods for deciding upon priorities; and it emphasizes the importance of well-planned implementation, evaluation and transparency.

  8. A checklist for health research priority setting: nine common themes of good practice

    Directory of Open Access Journals (Sweden)

    Terry Robert F

    2010-12-01

    Full Text Available Abstract Health research priority setting processes assist researchers and policymakers in effectively targeting research that has the greatest potential public health benefit. Many different approaches to health research prioritization exist, but there is no agreement on what might constitute best practice. Moreover, because of the many different contexts for which priorities can be set, attempting to produce one best practice is in fact not appropriate, as the optimal approach varies per exercise. Therefore, following a literature review and an analysis of health research priority setting exercises that were organized or coordinated by the World Health Organization since 2005, we propose a checklist for health research priority setting that allows for informed choices on different approaches and outlines nine common themes of good practice. It is intended to provide generic assistance for planning health research prioritization processes. The checklist explains what needs to be clarified in order to establish the context for which priorities are set; it reviews available approaches to health research priority setting; it offers discussions on stakeholder participation and information gathering; it sets out options for use of criteria and different methods for deciding upon priorities; and it emphasizes the importance of well-planned implementation, evaluation and transparency.

  9. Public Issue Priority Formation: Media Agenda-Setting and Social Interaction.

    Science.gov (United States)

    Zhu, Jian-Hua; And Others

    1993-01-01

    Presents a mathematical model to explain the public's issue priority by integrating media agenda-setting and social interaction. Finds that the public's issue priority was influenced by both media and social interaction. (RS)

  10. [The national public discourse on priority setting in health care in German print media].

    Science.gov (United States)

    Liesching, Florian; Meyer, Thorsten; Raspe, Heiner

    2012-01-01

    Germany's Central Ethics Committee of the Federal Chamber of Physicians (FCP) and other relevant national actors called for a public discourse on priority setting in health care. Politicians, members of a Federal Joint Committee and health insurance representatives, however, refused to promote or participate in the establishment of a public discussion. A change to that attitude only became apparent after former FCP President Hoppe's opening speech at the annual FCP assembly in Mainz in 2009. The present paper applies the Sociology of Knowledge Approach to Discourse, implemented through Qualitative Content Analysis and elements of Grounded Theory, to examine the development of the national public discourse in leading German print media. It creates a matrix that represents the discourse development between May 2009 and May 2010 and reflects central actors, their "communicative phenomena" and their interactions. Additionally, the matrix has been extended to cover the period until December 2011. Hoppe's arguments for priority setting in health care are faced with a wide opposition assuming opposing prerequisites and thus demanding alternative remedies. The lack of interaction between the different parties prevents any development of the speakers' positions. Incorrect accounts, reductions and left-outs in the media representation add to this effect. Consequently, the public discussion on priority setting is far from being an evolving rational discourse. Instead, it constitutes an exchange of preformed opposing positions. Copyright © 2012. Published by Elsevier GmbH.

  11. Patients' views on priority setting in neurosurgery: A qualitative study.

    Science.gov (United States)

    Gunaratnam, Caroline; Bernstein, Mark

    2016-01-01

    Accountability for Reasonableness is an ethical framework which has been implemented in various health care systems to improve and evaluate the fairness of priority setting. This framework is grounded on four mandatory conditions: relevance, publicity, appeals, and enforcement. There have been few studies which have evaluated the patient stakeholders' acceptance of this framework; certainly no studies have been done on patients' views on the prioritization system for allocating patients for operating time in a system with pressure on the resource of inpatient beds. The aim of this study is to examine neurosurgical patients' views on the prioritization of patients for operating theater (OT) time on a daily basis at a tertiary and quaternary referral neurosurgery center. Semi-structured face-to-face interviews were conducted with thirty-seven patients, recruited from the neurosurgery clinic at Toronto Western Hospital. Family members and friends who accompanied the patient to their clinic visit were encouraged to contribute to the discussion. Interviews were audio recorded, transcribed verbatim, and subjected to thematic analysis using open and axial coding. Overall, patients are supportive of the concept of a priority-setting system based on fairness, but felt that a few changes would help to improve the fairness of the current system. These changes include lowering the level of priority given to volume-funded cases and providing scheduled surgeries that were previously canceled a higher level of prioritization. Good communication, early notification, and rescheduling canceled surgeries as soon as possible were important factors that directly reflected the patients' confidence level in their doctor, the hospital, and the health care system. This study is the first clinical qualitative study of patients' perspective on a prioritization system used for allocating neurosurgical patients for OT time on a daily basis in a socialized not-for-profit health care system with

  12. IMPORTANCE OF MULTIPLE CRITERIA FOR PRIORITY SETTING OF HIV/AIDS INTERVENTIONS.

    Science.gov (United States)

    Tromp, Noor; Prawiranegara, Rozar; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-01-01

    This study describes the views of various stakeholders on the importance of different criteria for priority setting of HIV/AIDS interventions in Indonesia. Based on a general list of criteria and a focus group discussion with stakeholders (n = 6), a list was developed of thirty-two criteria that play a role in priority setting in HIV/AIDS control in West-Java province. Criteria were categorized according to the World Health Organization's health system goals and building block frameworks. People living with HIV/AIDS (n = 49), healthcare workers (HCW) (n = 41), the general population (n = 43), and policy makers (n = 22) rated the importance of thirty-two criteria on a 5-point Likert-scale. Thereafter, respondents ranked the highest rated criteria to express more detailed preferences. Stakeholders valued the following criteria as most important for the priority setting of HIV/AIDS interventions: an intervention's impact on the HIV/AIDS epidemic, reduction of stigma, quality of care, effectiveness on individual level, and feasibility in terms of current capacity of the health system (i.e., HCW, product, information, and service requirements), financial sustainability, and acceptance by donors. Overall, stakeholders' preferences for the importance of criteria are similar. Our study design outlines an approach for other settings to identify which criteria are important for priority setting of health interventions. For Indonesia, these study results may be used in priority setting processes for HIV/AIDS control and may contribute to more transparent and systematic allocation of resources.

  13. Priority setting for orphan drugs: an international comparison.

    Science.gov (United States)

    Rosenberg-Yunger, Zahava R S; Daar, Abdallah S; Thorsteinsdóttir, Halla; Martin, Douglas K

    2011-04-01

    To describe the process of priority setting for two orphan drugs - Cerezyme and Fabrazyme - in Canada, Australia and Israel, in order to understand and improve the process based on stakeholder perspectives. We conducted qualitative case studies of how three independent drug advisory committees made decisions relating to the funding of Cerezyme and Fabrazyme. Interviews were conducted with 22 informants, including committee members, patient groups and industry representatives. (1) DESCRIPTION: Orphan drugs reimbursement recommendations by expert panels were based on clinical evidence, cost and cost-effectiveness analysis. (2) EVALUATION: Committee members expressed an overall preference for the current drug review process used by their own committee, but were concerned with the fairness of the process particularly for orphan drugs. Other informants suggested the inclusion of other relevant values (e.g. lack of alternative treatments) in order to improve the priority setting process. Some patient groups suggested the use of an alternative funding mechanism for orphan drugs. Priority setting for drugs is not solely a technical process (involving cost-effective analysis, evidence-based medicine, etc.). Understanding the process by which reimbursement decisions are made for orphan drugs may help improve the system for future orphan drugs. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  14. Setting priorities in primary health care - on whose conditions? A questionnaire study

    Directory of Open Access Journals (Sweden)

    Arvidsson Eva

    2012-11-01

    Full Text Available Abstract Background In Sweden three key criteria are used for priority setting: severity of the health condition; patient benefit; and cost-effectiveness. They are derived from the ethical principles established by the Swedish parliament 1997 but have been used only to a limited extent in primary care. The aim of this study was to describe and analyse: 1 GPs', nurses', and patients' prioritising in routine primary care 2 The association between the three key priority setting criteria and the overall priority assigned by the GPs and nurses to individual patients. Methods Paired questionnaires were distributed to all patients and the GPs or nurses they had contact with during a 2-week period at four health centres in Sweden. The staff registered the health conditions or health problem, and the planned intervention. Then they estimated the severity of the health condition, the expected patient benefit, and the cost-effectiveness of the planned intervention. Both the staff and the patients reported their overall prioritisation of the patient. In total, 1851 paired questionnaires were collected. Results Compared to the medical staff, the patients assigned relatively higher priority to acute/minor conditions than to preventive check-ups for chronic conditions. Severity of the health condition was the priority setting criterion that had the strongest association with the overall priority for the staff as a whole, but for the GPs it was cost-effectiveness. Conclusions The challenge for primary care providers is to balance the patients' demands with medical needs and cost-effectiveness. Transparent priority setting in primary care might contribute to a greater consensus between GPs and nurses on how to use the key priority setting criteria.

  15. Setting research priorities across science, technology, and health sectors: the Tanzania experience.

    Science.gov (United States)

    de Haan, Sylvia; Kingamkono, Rose; Tindamanyire, Neema; Mshinda, Hassan; Makandi, Harun; Tibazarwa, Flora; Kubata, Bruno; Montorzi, Gabriela

    2015-03-12

    Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. As such, the process of setting research priorities is of pivotal importance for favouring the science, technology, and innovation (STI)-driven development of low- and middle-income countries. We report herein on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a 'training-of-trainers' workshop, a demonstration workshop, and seven priority setting workshops delivered to representatives from public and private research and development institutions, universities, non-governmental organizations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting an STI research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, a key and much needed capacity for countries to make proper use of research investments.

  16. Setting priorities in primary health care--on whose conditions? A questionnaire study.

    Science.gov (United States)

    Arvidsson, Eva; André, Malin; Borgquist, Lars; Andersson, David; Carlsson, Per

    2012-11-26

    In Sweden three key criteria are used for priority setting: severity of the health condition; patient benefit; and cost-effectiveness. They are derived from the ethical principles established by the Swedish parliament 1997 but have been used only to a limited extent in primary care. The aim of this study was to describe and analyse: 1) GPs', nurses', and patients' prioritising in routine primary care 2) The association between the three key priority setting criteria and the overall priority assigned by the GPs and nurses to individual patients. Paired questionnaires were distributed to all patients and the GPs or nurses they had contact with during a 2-week period at four health centres in Sweden. The staff registered the health conditions or health problem, and the planned intervention. Then they estimated the severity of the health condition, the expected patient benefit, and the cost-effectiveness of the planned intervention. Both the staff and the patients reported their overall prioritisation of the patient. In total, 1851 paired questionnaires were collected. Compared to the medical staff, the patients assigned relatively higher priority to acute/minor conditions than to preventive check-ups for chronic conditions. Severity of the health condition was the priority setting criterion that had the strongest association with the overall priority for the staff as a whole, but for the GPs it was cost-effectiveness. The challenge for primary care providers is to balance the patients' demands with medical needs and cost-effectiveness. Transparent priority setting in primary care might contribute to a greater consensus between GPs and nurses on how to use the key priority setting criteria.

  17. What criteria do decision makers in Thailand use to set priorities for vaccine introduction?

    Science.gov (United States)

    Pooripussarakul, Siriporn; Riewpaiboon, Arthorn; Bishai, David; Muangchana, Charung; Tantivess, Sripen

    2016-08-02

    There is a need to identify rational criteria and set priorities for vaccines. In Thailand, many licensed vaccines are being considering for introduction into the Expanded Program on Immunization; thus, the government has to make decisions about which vaccines should be adopted. This study aimed to set priorities for new vaccines and to facilitate decision analysis. We used a best-worst scaling study for rank-ordering of vaccines. The candidate vaccines were determined by a set of criteria, including burden of disease, target age group, budget impact, side effect, effectiveness, severity of disease, and cost of vaccine. The criteria were identified from a literature review and by in-depth, open-ended interviews with experts. The priority-setting model was conducted among three groups of stakeholders, including policy makers, healthcare professionals and healthcare administrators. The vaccine data were mapped and then calculated for the probability of selection. From the candidate vaccines, the probability of hepatitis B vaccine being selected by all respondents (96.67 %) was ranked first. This was followed, respectively, by pneumococcal conjugate vaccine-13 (95.09 %) and Haemophilus influenzae type b vaccine (90.87 %). The three groups of stakeholders (policy makers, healthcare professionals and healthcare administrators) showed the same ranking trends. Most severe disease, high fever rate and high disease burden showed the highest coefficients for criterion levels being selected by all respondents. This result can be implied that a vaccine which can prevent most severe disease with high disease burden and has low safety has a greater chance of being selected by respondents in this study. The priority setting of vaccines through a multiple-criteria approach could contribute to transparency and accountability in the decision-making process. This is a step forward in the development of an evidence-based approach that meets the need of developing country. The

  18. What criteria do decision makers in Thailand use to set priorities for vaccine introduction?

    Directory of Open Access Journals (Sweden)

    Siriporn Pooripussarakul

    2016-08-01

    Full Text Available Abstract Background There is a need to identify rational criteria and set priorities for vaccines. In Thailand, many licensed vaccines are being considering for introduction into the Expanded Program on Immunization; thus, the government has to make decisions about which vaccines should be adopted. This study aimed to set priorities for new vaccines and to facilitate decision analysis. Methods We used a best-worst scaling study for rank-ordering of vaccines. The candidate vaccines were determined by a set of criteria, including burden of disease, target age group, budget impact, side effect, effectiveness, severity of disease, and cost of vaccine. The criteria were identified from a literature review and by in-depth, open-ended interviews with experts. The priority-setting model was conducted among three groups of stakeholders, including policy makers, healthcare professionals and healthcare administrators. The vaccine data were mapped and then calculated for the probability of selection. Results From the candidate vaccines, the probability of hepatitis B vaccine being selected by all respondents (96.67 % was ranked first. This was followed, respectively, by pneumococcal conjugate vaccine-13 (95.09 % and Haemophilus influenzae type b vaccine (90.87 %. The three groups of stakeholders (policy makers, healthcare professionals and healthcare administrators showed the same ranking trends. Most severe disease, high fever rate and high disease burden showed the highest coefficients for criterion levels being selected by all respondents. This result can be implied that a vaccine which can prevent most severe disease with high disease burden and has low safety has a greater chance of being selected by respondents in this study. Conclusions The priority setting of vaccines through a multiple-criteria approach could contribute to transparency and accountability in the decision-making process. This is a step forward in the development of an evidence

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Public engagement in setting healthcare priorities: a ranking exercise in Cyprus.

    Science.gov (United States)

    Farmakas, Antonis; Theodorou, Mamas; Galanis, Petros; Karayiannis, Georgios; Ghobrial, Stefanos; Polyzos, Nikos; Papastavrou, Evridiki; Agapidaki, Eirini; Souliotis, Kyriakos

    2017-01-01

    In countries such as Cyprus the financial crisis and the recession have severely affected the funding and priority setting of the health care system. There is evidence highlighting the importance of population' preferences in designing priorities for health care settings. Although public preferences have been thorough analysed in many countries, there is a research gap in terms of simultaneously investigating the relative importance and the weight of differing and competing criteria for determining healthcare priority settings. The main objective of the study was tο investigate public preferences for the relative utility and weight of differing and competing criteria for health care priority setting in Cyprus. The 'conjoint analysis' technique was applied to develop a ranking exercise. The aim of the study was to identify the preferences of the participants for alternative options. Participants were asked to grade in a priority order 16 hypothetical case scenarios of patients with different disease and of diverse socio-economic characteristics awaiting treatment. The sample was purposive and consisted of 100 Cypriots, selected from public locations all over the country. It was revealed that the "severity of the disease" and the " age of the patient" were the key prioritization criteria. Participants assigned the smallest relative value to the criterion " healthy lifestyle" . More precisely, participants older than 35 years old assigned higher relative importance to " age" , while younger participants to the " severity of the disease". The " healthy lifestyle" criterion was assigned to the lowest relative importance to by all participants. In Cyprus, public participation in health care priority setting is almost inexistent. Nonetheless, it seems that the public's participation in this process could lead to a wider acceptance of the healthcare system especially as a result of the financial crisis and the upcoming reforms implemented such as the establishment of the

  2. Setting priorities for zinc-related health research to reduce children's disease burden worldwide: an application of the Child Health and Nutrition Research Initiative's research priority-setting method.

    Science.gov (United States)

    Brown, Kenneth H; Hess, Sonja Y; Boy, Erick; Gibson, Rosalind S; Horton, Susan; Osendarp, Saskia J; Sempertegui, Fernando; Shrimpton, Roger; Rudan, Igor

    2009-03-01

    To make the best use of limited resources for supporting health-related research to reduce child mortality, it is necessary to apply a suitable method to rank competing research options. The Child Health and Nutrition Research Initiative (CHNRI) developed a new methodology for setting health research priorities. To broaden experience with this priority-setting technique, we applied the method to rank possible research priorities concerning the control of Zn deficiency. Although Zn deficiency is not generally recognized as a direct cause of child mortality, recent research indicates that it predisposes children to an increased incidence and severity of several of the major direct causes of morbidity and mortality. Leading experts in the field of Zn research in child health were identified and invited to participate in a technical working group (TWG) to establish research priorities. The individuals were chosen to represent a wide range of expertise in Zn nutrition. The seven TWG members submitted a total of ninety research options, which were then consolidated into a final list of thirty-one research options categorized by the type of resulting intervention. The identified priorities were dominated by research investment options targeting Zn supplementation, and were followed by research on Zn fortification, general aspects of Zn nutrition, dietary modification and other new interventions. In general, research options that aim to improve the efficiency of an already existing intervention strategy received higher priority scores. Challenges identified during the implementation of the methodology and suggestions to modify the priority-setting procedures are discussed.

  3. Probabilistic inversion in priority setting of emerging zoonoses.

    NARCIS (Netherlands)

    Kurowicka, D.; Bucura, C.; Cooke, R.; Havelaar, A.H.

    2010-01-01

    This article presents methodology of applying probabilistic inversion in combination with expert judgment in priority setting problem. Experts rank scenarios according to severity. A linear multi-criteria analysis model underlying the expert preferences is posited. Using probabilistic inversion, a

  4. Exploring the challenge of health research priority setting in partnership: reflections on the methodology used by the James Lind Alliance Pressure Ulcer Priority Setting Partnership.

    Science.gov (United States)

    Madden, Mary; Morley, Richard

    2016-01-01

    treatment. There is no formal evaluation yet to examine the different approaches used by individual PSPs and the impact these methods have on the quality of the partnership and subsequent outputs. There is no gold standard method for health research topic identification and priority setting and reporting on public involvement in this area is predominantly descriptive rather than evaluative. The JLA Pressure Ulcer PSP (JLAPUP) was developed and worked between 2009 and 2013 to identify and prioritise the top 10 'uncertainties' , or 'unanswered questions', about the effects of pressure ulcer interventions. JLAPUP identified a mismatch between the nature and quality of RCTs in pressure ulcer prevention and treatment and the kind of research evidence desired by patients or service users, carers and health professionals. Results and methods have been reported fully elsewhere. The consultative and deliberative methods used to establish health research priorities in PSPs are fundamentally interpretive. PSPs are therefore an arena in which 'hard' evidence-informed ideals meet 'soft' participatory practices. This article provides an account of the challenges faced in one particular PSP. We explain the rationale for the approaches taken, difficulties faced and the limitations at each stage, because these aspects are particularly under-reported. The JLAPUP case is used to identify possible areas for evaluation and reporting across PSPs. Engaging people with very different health and life experiences in the complexities of health science based discussions of uncertainty is challenging. This is particularly the case when engaging groups routinely excluded from participating in health research, for example, older people with multiple comorbidities. The JLA principles of transparency, inclusivity and avoiding waste in research require paying close critical attention to PSP methodology, including full evaluation and reporting of PSP processes and outcomes. Assessing the impact of PSPs is

  5. Involving patients in setting priorities for healthcare improvement: a cluster randomized trial.

    Science.gov (United States)

    Boivin, Antoine; Lehoux, Pascale; Lacombe, Réal; Burgers, Jako; Grol, Richard

    2014-02-20

    Patients are increasingly seen as active partners in healthcare. While patient involvement in individual clinical decisions has been extensively studied, no trial has assessed how patients can effectively be involved in collective healthcare decisions affecting the population. The goal of this study was to test the impact of involving patients in setting healthcare improvement priorities for chronic care at the community level. Cluster randomized controlled trial. Local communities were randomized in intervention (priority setting with patient involvement) and control sites (no patient involvement). Communities in a canadian region were required to set priorities for improving chronic disease management in primary care, from a list of 37 validated quality indicators. Patients were consulted in writing, before participating in face-to-face deliberation with professionals. Professionals established priorities among themselves, without patient involvement. A total of 172 individuals from six communities participated in the study, including 83 chronic disease patients, and 89 health professionals. The primary outcome was the level of agreement between patients' and professionals' priorities. Secondary outcomes included professionals' intention to use the selected quality indicators, and the costs of patient involvement. Priorities established with patients were more aligned with core generic components of the Medical Home and Chronic Care Model, including: access to primary care, self-care support, patient participation in clinical decisions, and partnership with community organizations (p Priorities established by professionals alone placed more emphasis on the technical quality of single disease management. The involvement intervention fostered mutual influence between patients and professionals, which resulted in a 41% increase in agreement on common priorities (95%CI: +12% to +58%, p priorities. Patient involvement can change priorities driving healthcare

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

    DEFF Research Database (Denmark)

    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...

  7. A systematic review of stated preference studies reporting public preferences for healthcare priority setting.

    Science.gov (United States)

    Whitty, Jennifer A; Lancsar, Emily; Rixon, Kylie; Golenko, Xanthe; Ratcliffe, Julie

    2014-01-01

    There is current interest in incorporating weights based on public preferences for health and healthcare into priority-setting decisions. The aim of this systematic review was to explore the extent to which public preferences and trade-offs for priority-setting criteria have been quantified, and to describe the study contexts and preference elicitation methods employed. A systematic review was performed in April 2013 to identify empirical studies eliciting the stated preferences of the public for the provision of healthcare in a priority-setting context. Studies are described in terms of (i) the stated preference approaches used, (ii) the priority-setting levels and contexts, and (iii) the criteria identified as important and their relative importance. Thirty-nine studies applying 40 elicitation methods reported in 41 papers met the inclusion criteria. The discrete choice experiment method was most commonly applied (n = 18, 45.0 %), but other approaches, including contingent valuation and the person trade-off, were also used. Studies prioritised health systems (n = 4, 10.2 %), policies/programmes/services/interventions (n = 16, 41.0 %), or patient groups (n = 19, 48.7 %). Studies generally confirmed the importance of a wide range of process, non-health and patient-related characteristics in priority setting in selected contexts, alongside health outcomes. However, inconsistencies were observed for the relative importance of some prioritisation criteria, suggesting context and/or elicitation approach matter. Overall, findings suggest caution in directly incorporating public preferences as weights for priority setting unless the methods used to elicit the weights can be shown to be appropriate and robust in the priority-setting context.

  8. RESEARCH PRIORITY-SETTING IN PAPUA NEW GUINEA: POLICIES, METHODS AND PRACTICALITIES

    OpenAIRE

    Omuru, Eric; Kingwell, Ross S.

    2000-01-01

    Agricultural research priority-setting at best promotes the effective and efficient use of scarce research resources. This paper reviews firstly the priority-setting methods used in Papua New Guinea for agricultural R&D and examines the practicalities of implementing these and other methods. Secondly, this paper reports on key factors affecting the strategic directions for agricultural R&D in Papua New Guinea. These factors include:(i) the long term trends in international crop prices; (ii) l...

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

    DEFF Research Database (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...... impact on health policy; such as the educational needs and organisational changes associated with the new technology. The proposed changes are regarded as an intermediate step in the process of producing a fully adapted instrument that can serve as a formal support for priority setting of new health technologies...

  10. Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study.

    Science.gov (United States)

    Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

    2007-11-16

    As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy) with special attention to public

  11. Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study

    Directory of Open Access Journals (Sweden)

    Laupacis Andreas

    2007-11-01

    Full Text Available Abstract Background As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. Methods This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1 over 25 documents (e.g. strategic planning reports, public updates, and (2 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system resulting from the Ontario Wait Times Strategy. Conclusion We described and evaluated a wait time management initiative (the Ontario

  12. Managing multiple projects: a literature review of setting priorities and a pilot survey of healthcare researchers in an academic setting.

    Science.gov (United States)

    Hopkins, Robert Borden; Campbell, Kaitryn; O'Reilly, Daria; Tarride, Jean-Eric; Bowen, Jim; Blackhouse, Gord; Goerre, Ron

    2007-05-16

    To summarize and then assess with a pilot study the use of published best practice recommendations for priority setting during management of multiple healthcare research projects, in a resource-constrained environment. Medical, economic, business, and operations literature was reviewed to summarize and develop a survey to assess best practices for managing multiple projects. Fifteen senior healthcare research project managers, directors, and faculty at an urban academic institution were surveyed to determine most commonly used priority rules, ranking of rules, characteristics of their projects, and availability of resources. Survey results were compared to literature recommendations to determine use of best practices. Seven priority-setting rules were identified for managing multiple projects. Recommendations on assigning priorities by project characteristics are presented. In the pilot study, a large majority of survey respondents follow best practice recommendations identified in the research literature. However, priority rules such as Most Total Successors (MTS) and Resource Scheduling Method (RSM) were used "very often" by half of the respondents when better performing priority rules were available. Through experience, project managers learn to manage multiple projects under resource constraints. Best practice literature can assist project managers in priority setting by recommending the most appropriate priority given resource constraints and project characteristics. There is room for improvement in managing multiple projects.

  13. Research priorities in mesothelioma: A James Lind Alliance Priority Setting Partnership.

    Science.gov (United States)

    Stephens, R J; Whiting, C; Cowan, K

    2015-08-01

    In the UK, despite the import and use of all forms of asbestos being banned more than 15 years ago, the incidence of mesothelioma continues to rise. Mesothelioma is almost invariably fatal, and more research is required, not only to find more effective treatments, but also to achieve an earlier diagnosis and improve palliative care. Following a debate in the House of Lords in July 2013, a package of measures was agreed, which included a James Lind Alliance Priority Setting Partnership, funded by the National Institute for Health Research. The partnership brought together patients, carers, health professionals and support organisations to agree the top 10 research priorities relating to the diagnosis, treatment and care of patients with mesothelioma. Following the established James Lind Alliance priority setting process, mesothelioma patients, current and bereaved carers, and health professionals were surveyed to elicit their concerns regarding diagnosis, treatment and care. Research questions were generated from the survey responses, and following checks that the questions were currently unanswered, an interim prioritisation survey was conducted to identify a shortlist of questions to take to a final consensus meeting. Four hundred and fifty-three initial surveys were returned, which were refined into 52 unique unanswered research questions. The interim prioritisation survey was completed by 202 responders, and the top 30 questions were taken to a final meeting where mesothelioma patients, carers, and health professionals prioritised all the questions, and reached a consensus on the top 10. The top 10 questions cover a wide portfolio of research (including assessing the value of immunotherapy, individualised chemotherapy, second-line treatment and immediate chemotherapy, monitoring patients with pleural thickening, defining the management of ascites in peritoneal mesothelioma, and optimising follow-up strategy). This list is an invaluable resource, which should be

  14. Priority Setting for Universal Health Coverage: We Need to Focus Both on Substance and on Process; Comment on “Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, not Just More Evidence on Cost-Effectiveness”

    Directory of Open Access Journals (Sweden)

    Jeremy A. Lauer

    2017-10-01

    Full Text Available In an editorial published in this journal, Baltussen et al argue that information on cost-effectiveness is not sufficient for priority setting for universal health coverage (UHC, a claim which is correct as far as it goes. However, their focus on the procedural legitimacy of ‘micro’ priority setting processes (eg, decisions concerning the reimbursement of specific interventions, and their related assumption that values for priority setting are determined only at this level, leads them to ignore the relevance of higher level, ‘macro’ priority setting processes, for example, consultations held by World Health Organization (WHO Member States and other global stakeholders that have resulted in widespread consensus on the principles of UHC. Priority setting is not merely about discrete choices, nor should the focus be exclusively (or even mainly on improving the procedural elements of micro priority setting processes. Systemic activities that shape the health system environment, such as strategic planning, as well as the substantive content of global policy instruments, are critical elements for priority setting for UHC.

  15. Setting priorities for environmental restoration at the DOE Nuclear Weapons Complex

    International Nuclear Information System (INIS)

    Ton, My K.; Morgan, Robert P.

    1992-01-01

    This paper provides an evaluation of the computerized methodologies and approaches that the Department of Energy (DOE) has developed to assist in setting cleanup priorities and in allocating Environmental Restoration funds to various activities within the DOE Nuclear Weapons Complex. Issues examined include the appropriateness of the methodologies for priority setting or budget planning, their strengths and weaknesses; the limitations to the use of such systems to aid decision making; public acceptance of these systems; and the level of participation by affected or interested parties and the public in the development and implementation processes. (author)

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

    Science.gov (United States)

    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. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Dijk, Albert van, E-mail: albert.vandijk@anu.edu.au [Australian National University, Canberra, ACT (Australia); Mount, Richard [Bureau of Meteorology, Hobart, Tasmania (Australia); University of Tasmania, Hobart, Tasmania (Australia); Gibbons, Philip [Australian National University, Canberra, ACT (Australia); Vardon, Michael [Australian Bureau of Statistics, Belconnen, ACT (Australia); Canadell, Pep [CSIRO Marine and Atmospheric Research, Canberra, ACT (Australia)

    2014-03-01

    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

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

    International Nuclear Information System (INIS)

    Dijk, Albert van; Mount, Richard; Gibbons, Philip; Vardon, Michael; Canadell, Pep

    2014-01-01

    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

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

    Science.gov (United States)

    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. Copyright © 2016 Elsevier

  20. Introducing priority setting and resource allocation in home and community care programs.

    Science.gov (United States)

    Urquhart, Bonnie; Mitton, Craig; Peacock, Stuart

    2008-01-01

    To use evidence from research to identify and implement priority setting and resource allocation that incorporates both ethical practices and economic principles. Program budgeting and marginal analysis (PBMA) is based on two key economic principles: opportunity cost (i.e. doing one thing instead of another) and the margin (i.e. resource allocation should result in maximum benefit for available resources). An ethical framework for priority setting and resource allocation known as Accountability for Reasonableness (A4R) focuses on making sure that resource allocations are based on a fair decision-making process. It includes the following four conditions: publicity; relevance; appeals; and enforcement. More recent literature on the topic suggests that a fifth condition, that of empowerment, should be added to the Framework. The 2007-08 operating budget for Home and Community Care, excluding the residential sector, was developed using PBMA and incorporating the A4R conditions. Recommendations developed using PBMA were forwarded to the Executive Committee, approved and implemented for the 2007-08 fiscal year operating budget. In addition there were two projects approved for approximately $200,000. PBMA is an improvement over previous practice. Managers of Home and Community Care are committed to using the process for the 2008-09 fiscal year operating budget and expanding its use to include mental health and addictions services. In addition, managers of public health prevention and promotion services are considering using the process.

  1. The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study.

    Science.gov (United States)

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

    2016-09-30

    Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long's actor interface analysis and VeneKlasen and Miller's expressions of power framework to examine and interpret our findings RESULTS: The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could

  2. Top ten research priorities for spinal cord injury: the methodology and results of a British priority setting partnership.

    Science.gov (United States)

    van Middendorp, J J; Allison, H C; Ahuja, S; Bracher, D; Dyson, C; Fairbank, J; Gall, A; Glover, A; Gray, L; Masri, W El; Uttridge, A; Cowan, K

    2016-05-01

    This is a mixed-method consensus development project. The objective of this study was to identify a top ten list of priorities for future research into spinal cord injury (SCI). The British Spinal Cord Injury Priority Setting Partnership was established in 2013 and completed in 2014. Stakeholders included consumer organisations, healthcare professional societies and caregivers. This partnership involved the following four key stages: (i) gathering of research questions, (ii) checking of existing research evidence, (iii) interim prioritisation and (iv) a final consensus meeting to reach agreement on the top ten research priorities. Adult individuals with spinal cord dysfunction because of trauma or non-traumatic causes, including transverse myelitis, and individuals with a cauda equina syndrome (henceforth grouped and referred to as SCI) were invited to participate in this priority setting partnership. We collected 784 questions from 403 survey respondents (290 individuals with SCI), which, after merging duplicate questions and checking systematic reviews for evidence, were reduced to 109 unique unanswered research questions. A total of 293 people (211 individuals with SCI) participated in the interim prioritisation process, leading to the identification of 25 priorities. At a final consensus meeting, a representative group of individuals with SCI, caregivers and health professionals agreed on their top ten research priorities. Following a comprehensive, rigorous and inclusive process, with participation from individuals with SCI, caregivers and health professionals, the SCI research agenda has been defined by people to whom it matters most and should inform the scope and future activities of funders and researchers for the years to come. The NIHR Oxford Biomedical Research Centre provided core funding for this project.

  3. Global health trials methodological research agenda:results from a priority setting exercise

    OpenAIRE

    Blazeby, Jane; Nasser, Mona; Soares-Weiser, Karla; Sydes, Matthew R.; Zhang, Junhua; Williamson, Paula R

    2018-01-01

    BackgroundMethodological research into the design, conduct, analysis and reporting of trials is essential to optimise the process. UK specialists in the field have established a set of top priorities in aid of this research. These priorities however may not be reflected in the needs of similar research in low to middle income countries (LMICs) with different healthcare provision, resources and research infrastructure. The aim of the study was to identify the top priorities for methodological ...

  4. Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

    Science.gov (United States)

    Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

    2015-01-01

    New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

  5. Priority setting in health care: trends and models from Scandinavian experiences.

    Science.gov (United States)

    Hofmann, Bjørn

    2013-08-01

    The Scandinavian welfare states have public health care systems which have universal coverage and traditionally low influence of private insurance and private provision. Due to raises in costs, elaborate public control of health care, and a significant technological development in health care, priority setting came on the public agenda comparatively early in the Scandinavian countries. The development of health care priority setting has been partly homogeneous and appears to follow certain phases. This can be of broader interest as it may shed light on alternative models and strategies in health care priority setting. Some general trends have been identified: from principles to procedures, from closed to open processes, and from experts to participation. Five general approaches have been recognized: The moral principles and values based approach, the moral principles and economic assessment approach, the procedural approach, the expert based practice defining approach, and the participatory practice defining approach. There are pros and cons with all of these approaches. For the time being the fifth approach appears attractive, but its lack of true participation and the lack of clear success criteria may pose significant challenges in the future.

  6. Ethics and equity in research priority-setting: stakeholder engagement and the needs of disadvantaged groups.

    Science.gov (United States)

    Bhaumik, Soumyadeep; Rana, Sangeeta; Karimkhani, Chante; Welch, Vivian; Armstrong, Rebecca; Pottie, Kevin; Dellavalle, Robert; Dhakal, Purushottam; Oliver, Sandy; Francis, Damian K; Nasser, Mona; Crowe, Sally; Aksut, Baran; Amico, Roberto D

    2015-01-01

    A transparent and evidence-based priority-setting process promotes the optimal use of resources to improve health outcomes. Decision-makers and funders have begun to increasingly engage representatives of patients and healthcare consumers to ensure that research becomes more relevant. However, disadvantaged groups and their needs may not be integrated into the priority-setting process since they do not have a "political voice" or are unable to organise into interest groups. Equitable priority-setting methods need to balance patient needs, values, experiences with population-level issues and issues related to the health system.

  7. Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective.

    Science.gov (United States)

    Park, So Youn; Kwon, Ivo; Oh, In Hwan

    2016-11-01

    When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities. In terms of ethical values in health priority setting in Korea, there is no reliable rationale for the judgment used in decision-making as well as for setting separate and distinct priorities for different government bodies. An important question, therefore, is which ethical values guiding the practice of decision-making should be reconciled with the economic evidence found in Korean healthcare. The health technology assessment core model from the European network for Health Technology Assessment (EUnetHTA) project is a good example of incorporating ethical values into decision-making. We suggest that a fair distribution of scarce healthcare resources in South Korea can be achieved by considering the ethical aspects of healthcare.

  8. Shared research priorities for pessary use in women with prolapse: results from a James Lind Alliance Priority Setting Partnership.

    Science.gov (United States)

    Lough, Kate; Hagen, Suzanne; McClurg, Doreen; Pollock, Alex

    2018-04-28

    To identify the shared priorities for future research of women affected by and clinicians involved with pessary use for the management of prolapse. A priority setting project using a consensus method. A James Lind Alliance Pessary use for prolapse Priority Setting Partnership (JLA Pessary PSP) conducted from May 2016 to September 2017 in the UK. The PSP was run by a Steering Group of three women with experience of pessary use, three experienced clinicians involved with management of prolapse, two researchers with relevant experience, a JLA adviser and a PSP leader. Two surveys were conducted in 2016 and 2017. The first gathered questions about pessaries, and the second asked respondents to prioritise a list of questions. A final workshop was held on 8 September 2017 involving 10 women and 13 clinician representatives with prolapse and pessary experience. A top 10 list of priorities for future research in pessary use for prolapse was agreed by consensus. Women with experience of pessary use and clinicians involved with prolapse management have worked together to determine shared priorities for future research. Aligning the top 10 results with existing research findings will highlight the gaps in current evidence and signpost future research to areas of priority. Effective dissemination of the results will enable research funding bodies to focus on gathering the evidence to answer the questions that matter most to those who will be affected. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Patient and public engagement in priority setting: A systematic rapid review of the literature

    Science.gov (United States)

    Vandall-Walker, Virginia; Mason-Lai, Ping

    2018-01-01

    Background Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify ‘high-level’ priorities in health ecosystem priority setting, and at the preparation phase for health research. Objective The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research. Data sources HealthStar (via OVID); CINAHL; Proquest Databases; and Scholar’s Portal. Study eligibility criteria i) published in English; ii) published within the timeframe of 2007—Current (10 years) unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii) conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries. Study appraisal and synthesis i) Is the research valid, sound, and applicable?; ii) what outcomes can we potentially expect if we implement the findings from this research?; iii) will the target population (i.e., health researchers and practitioners) be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research. Results Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1—Deliberative and Tier 2—Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK), Dialogue Method (Netherlands), Global Evidence Mapping (Australia), and the Deep

  10. Patient and public engagement in priority setting: A systematic rapid review of the literature.

    Directory of Open Access Journals (Sweden)

    Elizabeth Manafò

    Full Text Available Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify 'high-level' priorities in health ecosystem priority setting, and at the preparation phase for health research.The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research.HealthStar (via OVID; CINAHL; Proquest Databases; and Scholar's Portal.i published in English; ii published within the timeframe of 2007-Current (10 years unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries.i Is the research valid, sound, and applicable?; ii what outcomes can we potentially expect if we implement the findings from this research?; iii will the target population (i.e., health researchers and practitioners be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research.Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1-Deliberative and Tier 2-Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK, Dialogue Method (Netherlands, Global Evidence Mapping (Australia, and the Deep Inclusion Method/CHoosing All Together (US.The critical study limitations include challenges in comprehensively

  11. Bottom-up priority setting revised. A second evaluation of an institutional intervention in a Swedish health care organisation.

    Science.gov (United States)

    Waldau, Susanne

    2015-09-01

    Transparent priority setting in health care based on specific ethical principles is requested by the Swedish Parliament since 1997. Implementation has been limited. In this case, transparent priority setting was performed for a second time round and engaged an entire health care organisation. Objectives were to refine a bottom-up priority setting process, reach a political decision on service limits to make reallocation towards higher prioritised services possible, and raise systems knowledge. An action research approach was chosen. The national model for priority setting was used with addition of dimensions costs, volumes, gender distribution and feasibility. The intervention included a three step process and specific procedures for each step which were created, revised and evaluated regarding factual and functional aspects. Evaluations methods included analyses of documents, recordings and surveys. Vertical and horizontal priority setting occurred and resources were reallocated. Participants' attitudes remained positive, however less so than in the first priority setting round. Identifying low-priority services was perceived difficult, causing resentment and strategic behaviour. The horizontal stage served to raise quality of the knowledge base, level out differences in ranking of services and raise systems knowledge. Existing health care management systems do not meet institutional requirements for transparent priority setting. Introducing transparent priority setting constitutes a complex institutional reform, which needs to be driven by management/administration. Strong managerial commitment is required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Defining Priorities for Future Research: Results of the UK Kidney Transplant Priority Setting Partnership.

    Science.gov (United States)

    Knight, Simon R; Metcalfe, Leanne; O'Donoghue, Katriona; Ball, Simon T; Beale, Angela; Beale, William; Hilton, Rachel; Hodkinson, Keith; Lipkin, Graham W; Loud, Fiona; Marson, Lorna P; Morris, Peter J

    2016-01-01

    It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. The PSP methodology is as outlined by the James Lind Alliance. An initial survey collected unanswered research questions from patients, carers and clinicians. Duplicate and out-of-scope topics were excluded and the existing literature searched to identify topics answered by current evidence. An interim prioritisation survey asked patients and professionals to score the importance of the remaining questions to create a ranked long-list. These were considered at a final consensus workshop using a modified nominal group technique to agree a final top ten. The initial survey identified 497 questions from 183 respondents, covering all aspects of transplantation from assessment through to long-term follow-up. These were grouped into 90 unanswered "indicative" questions. The interim prioritisation survey received 256 responses (34.8% patients/carers, 10.9% donors and 54.3% professionals), resulting in a ranked list of 25 questions that were considered during the final workshop. Participants agreed a top ten priorities for future research that included optimisation of immunosuppression (improved monitoring, choice of regimen, personalisation), prevention of sensitisation and transplanting the sensitised patient, management of antibody-mediated rejection, long-term risks to live donors, methods of organ preservation, induction of tolerance and bioengineering of organs. There was evidence that patient and carer involvement had a significant impact on shaping the final priorities. The final list of priorities relates to all stages of the transplant process, including access to

  13. Theories of justice and their implications for priority setting in health care.

    Science.gov (United States)

    Olsen, J A

    1997-12-01

    The paper aims to show how three theories of distributive justice; utilitarianism, egalitarianism and maximum, can provide a clearer understanding of the normative basis of different priority setting regimes in the health service. The paper starts with a brief presentation of the theories, followed by their prescriptions for distribution, as illustrated with their respective preferred points on a utility possibility frontier. After this general discussion, attention is shifted from utils to health. The paper discusses how the recent Norwegian guidelines for priority setting can be understood in the light of the theories.

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

    DEFF Research Database (Denmark)

    Yoshida, Sachiyo; Martines, José; Lawn, Joy E

    2016-01-01

    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. METHODS: We used adapted Child Health and Nutrition Research Initiative (CHNRI) methods for this prioritization exercise. We identified and approached the 200 most productive researchers and 400 program experts, and 132 of them submitted research questions online. These were collated...... into a set of 205 research questions, sent for scoring to the 600 identified experts, and were assessed and scored by 91 experts. RESULTS: Nine out of top ten identified priorities were in the domain of research on improving delivery of known interventions, with simplified neonatal resuscitation program...

  15. Development of a new model to engage patients and clinicians in setting research priorities.

    Science.gov (United States)

    Pollock, Alex; St George, Bridget; Fenton, Mark; Crowe, Sally; Firkins, Lester

    2014-01-01

    Equitable involvement of patients and clinicians in setting research and funding priorities is ethically desirable and can improve the quality, relevance and implementation of research. Survey methods used in previous priority setting projects to gather treatment uncertainties may not be sufficient to facilitate responses from patients and their lay carers for some health care topics. We aimed to develop a new model to engage patients and clinicians in setting research priorities relating to life after stroke, and to explore the use of this model within a James Lind Alliance (JLA) priority setting project. We developed a model to facilitate involvement through targeted engagement and assisted involvement (FREE TEA model). We implemented both standard surveys and the FREE TEA model to gather research priorities (treatment uncertainties) from people affected by stroke living in Scotland. We explored and configured the number of treatment uncertainties elicited from different groups by the two approaches. We gathered 516 treatment uncertainties from stroke survivors, carers and health professionals. We achieved approximately equal numbers of contributions; 281 (54%) from stroke survivors/carers; 235 (46%) from health professionals. For stroke survivors and carers, 98 (35%) treatment uncertainties were elicited from the standard survey and 183 (65%) at FREE TEA face-to-face visits. This contrasted with the health professionals for whom 198 (84%) were elicited from the standard survey and only 37 (16%) from FREE TEA visits. The FREE TEA model has implications for future priority setting projects and user-involvement relating to populations of people with complex health needs. Our results imply that reliance on standard surveys may result in poor and unrepresentative involvement of patients, thereby favouring the views of health professionals.

  16. Setting health priorities in a community: a case example

    Directory of Open Access Journals (Sweden)

    Fábio Alexandre Melo do Rego Sousa

    Full Text Available ABSTRACT OBJECTIVE To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. METHODS Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1 grouping by level of similarity, (2 classification according to epidemiological criteria, (3 ordering by experts, and (4 application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. RESULTS The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence. The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. CONCLUSIONS The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community.

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

    Science.gov (United States)

    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. Copyright © 2015 Elsevier GmbH. All rights reserved.

  18. Rapid research and implementation priority setting for wound care uncertainties.

    Directory of Open Access Journals (Sweden)

    Trish A Gray

    Full Text Available People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services. We solicited practitioner and manager uncertainties in wound care and held a priority setting workshop to facilitate a collaborative approach to prioritising wound care-related uncertainties.We recruited healthcare professionals who regularly cared for patients with complex wounds, were wound care specialists or managed wound care services. Participants submitted up to five wound care uncertainties in consultation with their colleagues, via an on-line survey and attended a priority setting workshop. Submitted uncertainties were collated, sorted and categorised according professional group. On the day of the workshop, participants were divided into four groups depending on their profession. Uncertainties submitted by their professional group were viewed, discussed and amended, prior to the first of three individual voting rounds. Participants cast up to ten votes for the uncertainties they judged as being high priority. Continuing in the professional groups, the top 10 uncertainties from each group were displayed, and the process was repeated. Groups were then brought together for a plenary session in which the final priorities were individually scored on a scale of 0-10 by participants. Priorities were ranked and results presented. Nominal group technique was used for generating the final uncertainties, voting and discussions.Thirty-three participants attended the workshop comprising; 10 specialist nurses, 10 district

  19. Rapid research and implementation priority setting for wound care uncertainties

    Science.gov (United States)

    Dumville, Jo C.; Christie, Janice; Cullum, Nicky A.

    2017-01-01

    Introduction People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services. We solicited practitioner and manager uncertainties in wound care and held a priority setting workshop to facilitate a collaborative approach to prioritising wound care-related uncertainties. Methods We recruited healthcare professionals who regularly cared for patients with complex wounds, were wound care specialists or managed wound care services. Participants submitted up to five wound care uncertainties in consultation with their colleagues, via an on-line survey and attended a priority setting workshop. Submitted uncertainties were collated, sorted and categorised according professional group. On the day of the workshop, participants were divided into four groups depending on their profession. Uncertainties submitted by their professional group were viewed, discussed and amended, prior to the first of three individual voting rounds. Participants cast up to ten votes for the uncertainties they judged as being high priority. Continuing in the professional groups, the top 10 uncertainties from each group were displayed, and the process was repeated. Groups were then brought together for a plenary session in which the final priorities were individually scored on a scale of 0–10 by participants. Priorities were ranked and results presented. Nominal group technique was used for generating the final uncertainties, voting and discussions. Results Thirty-three participants attended the workshop comprising; 10 specialist nurses

  20. An Emergency Medicine Research Priority Setting Partnership to establish the top 10 research priorities in emergency medicine.

    Science.gov (United States)

    Smith, Jason; Keating, Liza; Flowerdew, Lynsey; O'Brien, Rachel; McIntyre, Sam; Morley, Richard; Carley, Simon

    2017-07-01

    Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Self-management priority setting and decision-making in adults with multimorbidity: a narrative review of literature.

    Science.gov (United States)

    Bratzke, Lisa C; Muehrer, Rebecca J; Kehl, Karen A; Lee, Kyoung Suk; Ward, Earlise C; Kwekkeboom, Kristine L

    2015-03-01

    The purpose of this narrative review was to synthesize current research findings related to self-management, in order to better understand the processes of priority setting and decision-making among adults with multimorbidity. A narrative literature review was undertaken, synthesizing findings from published, peer-reviewed empirical studies that addressed priority setting and/or decision-making in self-management of multimorbidity. A search of PubMed, PsychINFO, CINAHL and SocIndex databases was conducted from database inception through December 2013. References lists from selected empirical studies and systematic reviews were evaluated to identify any additional relevant articles. Full text of potentially eligible articles were reviewed and selected for inclusion if they described empirical studies that addressed priority setting or decision-making in self-management of multimorbidity among adults. Two independent reviewers read each selected article and extracted relevant data to an evidence table. Processes and factors of multimorbidity self-management were identified and sorted into categories of priority setting, decision-making, and facilitators/barriers. Thirteen articles were selected for inclusion; most were qualitative studies describing processes, facilitators, and barriers of multimorbidity self-management. The findings revealed that patients prioritize a dominant chronic illness and re-prioritize over time as conditions and treatments change; that multiple facilitators (e.g. support programs) and barriers (e.g. lack of financial resources) impact individuals' self-management priority setting and decision-making ability; as do individual beliefs, preferences, and attitudes (e.g., perceived personal control, preferences regarding treatment). Health care providers need to be cognizant that individuals with multimorbidity engage in day-to-day priority setting and decision-making among their multiple chronic illnesses and respective treatments. Researchers

  2. Setting priorities for the evolution of the market design

    International Nuclear Information System (INIS)

    2001-01-01

    This report, which examines the forces that will influence the evolution of the Ontario electric power market over the next 4 or 5 years, is intended for market participants and other stakeholders. It sets priorities for the next phase of market development. Some of the market rules that need more work were identified and participants and stakeholders were invited to present their comments on whether the list accurately reflects the critical market development issues that need to be addressed after market opening. The report also discusses criteria that can be used to evaluate market design changes and their relative priorities. The list of potential high priority issues include: the energy forward market; the capacity reserve market; locational marginal pricing; a capability for full assignment of physical bilateral contracts; the export of operating reserve; moving to real time bidding; encouraging dispatchability and demand side responsiveness; transmission expansion; and, introducing markets in ancillary services. This list includes the main market design issues that need to be addressed over the next several years. 1 fig., 2 tabs

  3. Relevance or Excellence? Setting Research Priorities for Mental Health and Psychosocial Support in Humanitarian Settings

    Science.gov (United States)

    Tol, Wietse A; Patel, Vikram; Tomlinson, Mark; Baingana, Florence; Galappatti, Ananda; Silove, Derrick; Sondorp, Egbert; van Ommeren, Mark; Wessells, Michael G; Catherine, Panter-Brick

    2012-01-01

    Background: Humanitarian crises are associated with an increase in mental disorders and psychological distress. Despite the emerging consensus on intervention strategies in humanitarian settings, the field of mental health and psychosocial support (MHPSS) in humanitarian settings lacks a consensus-based research agenda. Methods: From August 2009 to February 2010, we contacted policymakers, academic researchers, and humanitarian aid workers, and conducted nine semistructured focus group discussions with 114 participants in three locations (Peru, Uganda, and Nepal), in both the capitals and remote humanitarian settings. Local stakeholders representing a range of academic expertise (psychiatry, psychology, social work, child protection, and medical anthropology) and organizations (governments, universities, nongovernmental organizations, and UN agencies) were asked to identify priority questions for MHPSS research in humanitarian settings, and to discuss factors that hamper and facilitate research. Results: Thematic analyses of transcripts show that participants broadly agreed on prioritized research themes in the following order: (1) the prevalence and burden of mental health and psychosocial difficulties in humanitarian settings, (2) how MHPSS implementation can be improved, (3) evaluation of specific MHPSS interventions, (4) the determinants of mental health and psychological distress, and (5) improved research methods and processes. Rather than differences in research themes across countries, what emerged was a disconnect between different groups of stakeholders regarding research processes: the perceived lack of translation of research findings into actual policy and programs; misunderstanding of research methods by aid workers; different appreciation of the time needed to conduct research; and disputed universality of research constructs. Conclusions: To advance a collaborative research agenda, actors in this field need to bridge the perceived disconnect between

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

    NARCIS (Netherlands)

    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

  5. Setting research priorities to improve the health of children and young people with neurodisability: a British Academy of Childhood Disability-James Lind Alliance Research Priority Setting Partnership.

    Science.gov (United States)

    Morris, Christopher; Simkiss, Doug; Busk, Mary; Morris, Maureen; Allard, Amanda; Denness, Jacob; Janssens, Astrid; Stimson, Anna; Coghill, Joanna; Robinson, Kelly; Fenton, Mark; Cowan, Katherine

    2015-01-28

    To engage young people, parent carers and clinicians in a systematic process to identify and prioritise research questions regarding ways to improve the health and well-being of children and young people with neurodisability. British Academy of Childhood Disability (BACD)-James Lind Alliance research priority setting partnership bringing together patients, carers and clinicians as equal stakeholders. UK health service and community. The BACD Strategic Research Group formed the partnership. A Steering Group was established; charity and professional partner organisations were recruited. Suggestions were gathered in an open survey and from research recommendations for statutory guidance. Items were aggregated to formulate indicative research questions and verified as uncertainties from research evidence. An interim survey was used to rank the questions to shortlist topics. A mixed group of stakeholders discussed the top 25 questions at the final priority setting workshop agreeing a final rank order and the top 10 research priorities. Partner organisations were 13 charities and 8 professional societies. 369 people submitted suggestions (40% non-clinicians). 76 people participated in the interim prioritisation (26 parents, 1 young person, 10 charity representatives, 39 clinicians); 22 took part in the final workshop (3 young people, 7 parents, 3 charity representatives, 9 professionals). The top three research priorities related to (1) establishing the optimal frequency and intensity (dose) for mainstream therapies, (2) means for selecting and encouraging use of communication strategies and (3) ways to improve children's attitudes towards disability. The top 10 included evaluating interventions to promote mobility, self-efficacy, mental health, continence, physical fitness, educational inclusion and reduce impacts of sleep disturbance. The methodology provided a systematic and transparent process to identify research priorities that included stakeholders that have

  6. Research priority setting in Barrett's oesophagus and gastro-oesophageal reflux disease.

    Science.gov (United States)

    Britton, James; Gadeke, Lisa; Lovat, Laurence; Hamdy, Shaheen; Hawkey, Chris; McLaughlin, John; Ang, Yeng

    2017-11-01

    The incidence of gastro-oesophageal reflux disease and Barrett's oesophagus is increasing. Barrett's oesophagus is the main precursor to oesophageal adenocarcinoma, which has a poor prognosis. In view of the vast potential burden of these diseases on patients and health-care resources, there is a real need to define and focus research efforts. This priority setting exercise aimed to produce a list of the top ten uncertainties in the field that reflect the priorities of patients and health-care providers. We adopted the robust and transparent methodologies previously outlined by the James Lind Alliance. This qualitative approach firstly involves an ideas gathering survey that, once distilled, generates a longlist of research uncertainties. These uncertainties are then prioritised via an interim ranking survey and a final workshop to achieve consensus agreement. The initial 629 uncertainties, generated from a survey of 170 individual respondents (47% professional, 53% non-professional) and one workshop, were narrowed down to the final top ten uncertainties of priority for future research. These priorities covered a range of issues, including a need for improved patient risk stratification, alternative diagnostic and surveillance tests, efficacy of a dedicated service for Barrett's oesophagus, cost-effectiveness and appropriateness of current surveillance, advances in development of non-drug treatments for gastro-oesophageal reflux disease, safety of long-term drug treatment, and questions regarding the durability and role of different endoscopic therapies for dysplastic Barrett's oesophagus. This is the first patient-centred assessment of priorities for researchers in this chronic disease setting. We hope that recognition and dissemination of these results will shape the future direction of research and translate into meaningful gains for patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. A simplified approach to the PROMETHEE method for priority setting in management of mine action projects

    Directory of Open Access Journals (Sweden)

    Marko Mladineo

    2016-12-01

    Full Text Available In the last 20 years, priority setting in mine actions, i.e. in humanitarian demining, has become an increasingly important topic. Given that mine action projects require management and decision-making based on a multi -criteria approach, multi-criteria decision-making methods like PROMETHEE and AHP have been used worldwide for priority setting. However, from the aspect of mine action, where stakeholders in the decision-making process for priority setting are project managers, local politicians, leaders of different humanitarian organizations, or similar, applying these methods can be difficult. Therefore, a specialized web-based decision support system (Web DSS for priority setting, developed as part of the FP7 project TIRAMISU, has been extended using a module for developing custom priority setting scenarios in line with an exceptionally easy, user-friendly approach. The idea behind this research is to simplify the multi-criteria analysis based on the PROMETHEE method. Therefore, a simplified PROMETHEE method based on statistical analysis for automated suggestions of parameters such as preference function thresholds, interactive selection of criteria weights, and easy input of criteria evaluations is presented in this paper. The result is web-based DSS that can be applied worldwide for priority setting in mine action. Additionally, the management of mine action projects is supported using modules for providing spatial data based on the geographic information system (GIS. In this paper, the benefits and limitations of a simplified PROMETHEE method are presented using a case study involving mine action projects, and subsequently, certain proposals are given for the further research.

  8. The kidney cancer research priority-setting partnership: Identifying the top 10 research priorities as defined by patients, caregivers, and expert clinicians.

    Science.gov (United States)

    Jones, Jennifer; Bhatt, Jaimin; Avery, Jonathan; Laupacis, Andreas; Cowan, Katherine; Basappa, Naveen; Basiuk, Joan; Canil, Christina; Al-Asaaed, Sohaib; Heng, Daniel; Wood, Lori; Stacey, Dawn; Kollmannsberger, Christian; Jewett, Michael A S

    2017-12-01

    It is critically important to define disease-specific research priorities to better allocate limited resources. There is growing recognition of the value of involving patients and caregivers, as well as expert clinicians in this process. To our knowledge, this has not been done this way for kidney cancer. Using the transparent and inclusive process established by the James Lind Alliance, the Kidney Cancer Research Network of Canada (KCRNC) sponsored a collaborative consensus-based priority-setting partnership (PSP) to identify research priorities in the management of kidney cancer. The final result was identification of 10 research priorities for kidney cancer, which are discussed in the context of current initiatives and gaps in knowledge. This process provided a systematic and effective way to collaboratively establish research priorities with patients, caregivers, and clinicians, and provides a valuable resource for researchers and funding agencies.

  9. Differences between patients' and clinicians' research priorities from the Anaesthesia and Peri-operative Care Priority Setting Partnership.

    Science.gov (United States)

    Boney, O; Nathanson, M H; Grocott, M P W; Metcalf, L

    2017-09-01

    The James Lind Alliance Anaesthesia and Peri-operative Care Priority Setting Partnership was a recent collaborative venture bringing approximately 2000 patients, carers and clinicians together to agree priorities for future research into anaesthesia and critical care. This secondary analysis compares the research priorities of 303 service users, 1068 clinicians and 325 clinicians with experience as service users. All three groups prioritised research to improve patient safety. Service users prioritised research about improving patient experience, whereas clinicians prioritised research about clinical effectiveness. Clinicians who had experience as service users consistently prioritised research more like clinicians than like service users. Individual research questions about patient experience were more popular with patients and carers than with clinicians in all but one case. We conclude that patients, carers and clinicians prioritise research questions differently. All groups prioritise research into patient safety, but service users also favour research into patient experience, whereas clinicians favour research into clinical effectiveness. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  10. [Priority setting of health interventions. Review of criteria, approaches and role of assessment agencies].

    Science.gov (United States)

    Varela-Lema, Leonor; Atienza-Merino, Gerardo; López-García, Marisa

    This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting. An exhaustive review of the literature was carried out. For this purpose, a search of the main biomedical databases was performed and assessment agency websites were reviewed, among other sources. In general terms, it was found that there are no standardised criteria for priority setting, although some consensus and common trends have been identified regarding key elements (criteria, models and strategies, key actors, etc.). Globally, 8 key domains were identified: 1) need for intervention; 2) health outcomes; 3) type of benefit of the intervention; 4) economic consequences; 5) existing knowledge on the intervention/quality of and uncertainties regarding the evidence; 6) implementation and complexity of the intervention/feasibility; 7) priority, justice and ethics; and 8) overall context. The review provides a thorough analysis of the relevant issues and offers key recommendations regarding considerations for developing a national prioritisation framework. Findings are envisioned to be useful for different public organisations that are aiming to establish healthcare priorities. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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?

  12. Research priority setting for health policy and health systems strengthening in Nigeria: the policymakers and stakeholders perspective and involvement.

    Science.gov (United States)

    Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Ndukwe, Chinwendu Daniel; Oyibo, Patrick Gold; Onwe, Friday; Aulakh, Bhupinder Kaur

    2013-01-01

    Nigeria is one of the low and middle income countries (LMICs) facing severe resource constraint, making it impossible for adequate resources to be allocated to the health sector. Priority setting becomes imperative because it guides investments in health care, health research and respects resource constraints. The objective of this study was to enhance the knowledge and understanding of policymakers on research priority setting and to conduct a research priority setting exercise. A one-day evidence-to-policy research priority setting meeting was held. The meeting participants included senior and middle level policymakers and key decision makers/stakeholders in the health sector in Ebonyi State southeastern Nigeria. The priorities setting meeting involved a training session on priority setting process and conduction of priority setting exercise using the essential national health research (ENHR) approach. The focus was on the health systems building blocks (health workforce; health finance; leadership/governance; medical products/technology; service delivery; and health information/evidence). Of the total of 92 policymakers invited 90(97.8%) attended the meeting. It was the consensus of the policymakers that research should focus on the challenges of optimal access to health products and technology; effective health service delivery and disease control under a national emergency situation; the shortfalls in the supply of professional personnel; and the issues of governance in the health sector management. Research priority setting exercise involving policymakers is an example of demand driven strategy in the health policymaking process capable of reversing inequities and strengthening the health systems in LMICs.

  13. SUPPORT Tools for evidence-informed health Policymaking (STP) 3: Setting priorities for supporting evidence-informed policymaking.

    Science.gov (United States)

    Lavis, John N; Oxman, Andrew D; Lewin, Simon; Fretheim, Atle

    2009-12-16

    This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers have limited resources for developing--or supporting the development of--evidence-informed policies and programmes. These required resources include staff time, staff infrastructural needs (such as access to a librarian or journal article purchasing), and ongoing professional development. They may therefore prefer instead to contract out such work to independent units with more suitably skilled staff and appropriate infrastructure. However, policymakers may only have limited financial resources to do so. Regardless of whether the support for evidence-informed policymaking is provided in-house or contracted out, or whether it is centralised or decentralised, resources always need to be used wisely in order to maximise their impact. Examples of undesirable practices in a priority-setting approach include timelines to support evidence-informed policymaking being negotiated on a case-by-case basis (instead of having clear norms about the level of support that can be provided for each timeline), implicit (rather than explicit) criteria for setting priorities, ad hoc (rather than systematic and explicit) priority-setting process, and the absence of both a communications plan and a monitoring and evaluation plan. In this article, we suggest questions that can guide those setting priorities for finding and using research evidence to support evidence-informed policymaking. These are: 1. Does the approach to prioritisation make clear the timelines that have been set for addressing high-priority issues in different ways? 2. Does the approach incorporate explicit criteria for determining priorities? 3. Does the approach incorporate an explicit process for determining priorities? 4. Does the approach incorporate a communications strategy and a monitoring and evaluation plan?

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  16. Priority setting partnership to identify the top 10 research priorities for the management of Parkinson's disease.

    Science.gov (United States)

    Deane, Katherine H O; Flaherty, Helen; Daley, David J; Pascoe, Roland; Penhale, Bridget; Clarke, Carl E; Sackley, Catherine; Storey, Stacey

    2014-12-14

    This priority setting partnership was commissioned by Parkinson's UK to encourage people with direct and personal experience of the condition to work together to identify and prioritise the top 10 evidential uncertainties that impact on everyday clinical practice for the management of Parkinson's disease (PD). The UK. Anyone with experience of PD including: people with Parkinson's (PwP), carers, family and friends, healthcare and social care professionals. Non-clinical researchers and employees of pharmaceutical or medical devices companies were excluded. 1000 participants (60% PwP) provided ideas on research uncertainties, 475 (72% PwP) initially prioritised them and 27 (37% PwP) stakeholders agreed a final top 10. Using a modified nominal group technique, participants were surveyed to identify what issues for the management of PD needed research. Unique research questions unanswered by current evidence were identified and participants were asked to identify their top 10 research priorities from this list. The top 26 uncertainties were presented to a consensus meeting with key stakeholders to agree the top 10 research priorities. 1000 participants provided 4100 responses, which contained 94 unique unanswered research questions that were initially prioritised by 475 participants. A consensus meeting with 27 stakeholders agreed the top 10 research priorities. The overarching research aspiration was an effective cure for PD. The top 10 research priorities for PD management included the need to address motor symptoms (balance and falls, and fine motor control), non-motor symptoms (sleep and urinary dysfunction), mental health issues (stress and anxiety, dementia and mild cognitive impairments), side effects of medications (dyskinesia) and the need to develop interventions specific to the phenotypes of PD and better monitoring methods. These research priorities identify crucial gaps in the existing evidence to address everyday practicalities in the management of the

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

    Science.gov (United States)

    Yoshida, Sachiyo; Martines, José; Lawn, Joy E; Wall, Stephen; Souza, Joăo Paulo; Rudan, Igor; Cousens, Simon; Aaby, Peter; Adam, Ishag; Adhikari, Ramesh Kant; Ambalavanan, Namasivayam; Arifeen, Shams Ei; Aryal, Dhana Raj; Asiruddin, Sk; Baqui, Abdullah; Barros, Aluisio Jd; Benn, Christine S; Bhandari, Vineet; Bhatnagar, Shinjini; Bhattacharya, Sohinee; Bhutta, Zulfiqar A; Black, Robert E; Blencowe, Hannah; Bose, Carl; Brown, Justin; Bührer, Christoph; Carlo, Wally; Cecatti, Jose Guilherme; Cheung, Po-Yin; Clark, Robert; Colbourn, Tim; Conde-Agudelo, Agustin; Corbett, Erica; Czeizel, Andrew E; Das, Abhik; Day, Louise Tina; Deal, Carolyn; Deorari, Ashok; Dilmen, Uğur; English, Mike; Engmann, Cyril; Esamai, Fabian; Fall, Caroline; Ferriero, Donna M; Gisore, Peter; Hazir, Tabish; Higgins, Rosemary D; Homer, Caroline Se; Hoque, D E; Irgens, Lorentz; Islam, M T; de Graft-Johnson, Joseph; Joshua, Martias Alice; Keenan, William; Khatoon, Soofia; Kieler, Helle; Kramer, Michael S; Lackritz, Eve M; Lavender, Tina; Lawintono, Laurensia; Luhanga, Richard; Marsh, David; McMillan, Douglas; McNamara, Patrick J; Mol, Ben Willem J; Molyneux, Elizabeth; Mukasa, G K; Mutabazi, Miriam; Nacul, Luis Carlos; Nakakeeto, Margaret; Narayanan, Indira; Olusanya, Bolajoko; Osrin, David; Paul, Vinod; Poets, Christian; Reddy, Uma M; Santosham, Mathuram; Sayed, Rubayet; Schlabritz-Loutsevitch, Natalia E; Singhal, Nalini; Smith, Mary Alice; Smith, Peter G; Soofi, Sajid; Spong, Catherine Y; Sultana, Shahin; Tshefu, Antoinette; van Bel, Frank; Gray, Lauren Vestewig; Waiswa, Peter; Wang, Wei; Williams, Sarah LA; Wright, Linda; Zaidi, Anita; Zhang, Yanfeng; Zhong, Nanbert; Zuniga, Isabel; Bahl, Rajiv

    2016-06-01

    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. We used adapted Child Health and Nutrition Research Initiative (CHNRI) methods for this prioritization exercise. We identified and approached the 200 most productive researchers and 400 program experts, and 132 of them submitted research questions online. These were collated into a set of 205 research questions, sent for scoring to the 600 identified experts, and were assessed and scored by 91 experts. Nine out of top ten identified priorities were in the domain of research on improving delivery of known interventions, with simplified neonatal resuscitation program and clinical algorithms and improved skills of community health workers leading the list. The top 10 priorities in the domain of development were led by ideas on improved Kangaroo Mother Care at community level, how to improve the accuracy of diagnosis by community health workers, and perinatal audits. The 10 leading priorities for discovery research focused on stable surfactant with novel modes of administration for preterm babies, ability to diagnose fetal distress and novel tocolytic agents to delay or stop preterm labour. These findings will assist both donors and researchers in supporting and conducting research to close the knowledge gaps for reducing neonatal mortality, morbidity and long term impairment. WHO, SNL and other partners will work to generate interest among key national

  18. How Are Health Research Priorities Set in Low and Middle Income Countries? A Systematic Review of Published Reports

    Science.gov (United States)

    McGregor, Skye; Henderson, Klara J.; Kaldor, John M.

    2014-01-01

    Background Priority setting is increasingly recognised as essential for directing finite resources to support research that maximizes public health benefits and drives health equity. Priority setting processes have been undertaken in a number of low- and middle-income country (LMIC) settings, using a variety of methods. We undertook a critical review of reports of these processes. Methods and Findings We searched electronic databases and online for peer reviewed and non-peer reviewed literature. We found 91 initiatives that met inclusion criteria. The majority took place at the global level (46%). For regional or national initiatives, most focused on Sub Saharan Africa (49%), followed by East Asia and Pacific (20%) and Latin America and the Caribbean (18%). A quarter of initiatives aimed to cover all areas of health research, with a further 20% covering communicable diseases. The most frequently used process was a conference or workshop to determine priorities (24%), followed by the Child Health and Nutrition Initiative (CHNRI) method (18%). The majority were initiated by an international organization or collaboration (46%). Researchers and government were the most frequently represented stakeholders. There was limited evidence of any implementation or follow-up strategies. Challenges in priority setting included engagement with stakeholders, data availability, and capacity constraints. Conclusions Health research priority setting (HRPS) has been undertaken in a variety of LMIC settings. While not consistently used, the application of established methods provides a means of identifying health research priorities in a repeatable and transparent manner. In the absence of published information on implementation or evaluation, it is not possible to assess what the impact and effectiveness of health research priority setting may have been. PMID:25275315

  19. Environmental reporting and accounting in Australia: progress, prospects and research priorities.

    Science.gov (United States)

    van Dijk, Albert; Mount, Richard; Gibbons, Philip; Vardon, Michael; Canadell, Pep

    2014-03-01

    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

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

    DEFF Research Database (Denmark)

    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...... 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...... and those companies seldom use a theoretical concept but are inspired to design home-made models. This also confirms that accounting practices are used for inspiration of design. The findings can provide a further basis for the discussion and development of a theory for new management accounting models....

  1. Precision in Setting Cancer Prevention Priorities: Synthesis of Data, Literature, and Expert Opinion.

    Science.gov (United States)

    Girschik, Jennifer; Miller, Laura Jean; Addiscott, Tony; Daube, Mike; Katris, Paul; Ransom, David; Slevin, Terry; Threlfall, Tim; Weeramanthri, Tarun Stephen

    2017-01-01

    Cancer will continue to be a leading cause of ill health and death unless we can capitalize on the potential for 30-40% of these cancers to be prevented. In this light, cancer prevention represents an enormous opportunity for public health, potentially saving much of the pain, anguish, and cost associated with treating cancer. However, there is a challenge for governments, and the wider community, in prioritizing cancer prevention activities, especially given increasing financial constraints. This paper describes a method for identifying cancer prevention priorities. This method synthesizes detailed cancer statistics, expert opinion, and the published literature for the priority setting process. The process contains four steps: assessing the impact of cancer types; identifying cancers with the greatest impact; considering opportunities for prevention; and combining information on impact and preventability. The strength of our approach is that it is straightforward, transparent and reproducible for other settings. Applying this method in Western Australia produced a priority list of seven adult cancers which were identified as having not only the biggest impact on the community but also the best opportunities for prevention. Work conducted in an additional project phase went on to present data on these priority cancers to a public consultation and develop an agenda for action in cancer prevention.

  2. Setting Priorities for Gerontological Social Work Research: A National Delphi Study

    Science.gov (United States)

    Burnette, Denise; Morrow-Howell, Nancy; Chen, Li-Mei

    2003-01-01

    Purpose: An increasingly important task for all disciplines involved in aging research is to identify and prioritize areas for investigation. This article reports the results of a national Delphi study on setting research priorities for gerontological social work. Design and Methods: Delphi methodology, a structured process for eliciting and…

  3. Involving healthcare professionals and family carers in setting research priorities for end-of-life care.

    Science.gov (United States)

    Diffin, Janet; Spence, Michael; Spencer, Rebecca; Mellor, Peter; Grande, Gunn

    2017-02-02

    It is important to ensure regional variances are considered when setting future end-of-life research priorities, given the differing demographics and service provision. This project sought to identify end-of-life research priorities within Greater Manchester (United Kingdom). Following an initial scoping exercise, six topics within the 10 national priorities outlined by The Palliative and end-of-life care Priority Setting Partnership were selected for exploration. A workshop involving 32 healthcare professionals and a consultation process with 26 family carers was conducted. Healthcare professionals and carers selected and discussed the topics important to them. The topics selected most frequently by both healthcare professionals and carers were 'Access to 24 hour care', 'Planning end-of-life care in advance' and 'Staff and carer education'. Healthcare professionals also developed research questions for their topics of choice which were refined to incorporate carers' views. These questions are an important starting point for future end-of-life research within Greater Manchester.

  4. Increased fairness in priority setting processes within the health sector: the case of Kapiri-Mposhi District, Zambia.

    Science.gov (United States)

    Zulu, Joseph M; Michelo, Charles; Msoni, Carol; Hurtig, Anna-Karin; Byskov, Jens; Blystad, Astrid

    2014-02-18

    The challenge of priority setting (PS) in health care within contexts of severe resource limitations has continued to receive attention. Accountability for Reasonableness (AFR) has emerged as a useful framework to guide the implementation of PS processes. In 2006, the AFR approach to 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 level in Kapiri-Mposhi District in Zambia. Data was collected using in depth interviews (IDIs), focus group discussions (FGDs) and review of documents from national to district level. The study population for this paper consisted of health related stakeholders employed in the district administration, in non-governmental organizations (NGO) and in health facilities. 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 devolution of PS and decision making procedures. However, important gaps were identified in terms of experiences of stakeholder involvement and fairness in PS processes in practice. The evaluation study revealed that a transformation of the views and methods regarding fairness in PS processes was ongoing in the study district, which was partly attributed to the AFR based intervention. The study findings suggest that increased attention was given to fairness in PS processes at district level. The changes were linked to a

  5. The implications of fundamental cause theory for priority setting.

    Science.gov (United States)

    Goldberg, Daniel S

    2014-10-01

    Application of fundamental cause theory to Powers and Faden's model of social justice highlights the ethical superiority of upstream public health interventions. In this article, I assess the ramifications of fundamental cause theory specifically in context of public health priority setting. Ethically optimal public health policy simultaneously maximizes overall population health and compresses health inequalities. The fundamental cause theory is an important framework in helping to identify which categories of public health interventions are most likely to advance these twin goals.

  6. Comparison of national health research priority-setting methods and characteristics in Latin America and the Caribbean, 2002-2012.

    Science.gov (United States)

    Reveiz, Ludovic; Elias, Vanessa; Terry, Robert F; Alger, Jackeline; Becerra-Posada, Francisco

    2013-07-01

    To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012. This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG). Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions. Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.

  7. Comparison of national health research priority-setting methods and characteristics in Latin America and the Caribbean, 2002 - 2012

    Directory of Open Access Journals (Sweden)

    Ludovic Reveiz

    2013-07-01

    Full Text Available OBJECTIVE: To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012. METHODS: This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG. RESULTS: Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions. CONCLUSIONS: Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.

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

    Science.gov (United States)

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

    2009-11-20

    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

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

    Directory of Open Access Journals (Sweden)

    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

  10. Accounting Research in the Japanese Setting

    OpenAIRE

    Douglas J. Skinner

    2011-01-01

    In this commentary I offer some thoughts on the possibilities for accounting research that uses the Japanese setting. I argue that the uniqueness of the Japanese setting offers many opportunities for researchers, and hope that we can encourage more researchers to take advantage of this setting to advance the literature on financial reporting and disclosure.

  11. Stakeholder views on criteria and processes for priority setting in Norway: a qualitative study.

    Science.gov (United States)

    Aidem, Jeremy M

    2017-06-01

    Since 2013, Norway has engaged in political processes to revise criteria for priority setting. These processes have yielded key efficiency and equity criteria, but excluded potentially relevant social values. This study describes the views of 27 stakeholders in Norway's health system regarding a wider set of priority-setting criteria and procedural characteristics. Between January and February 2016, semi-structured interviews and focus groups were conducted with a purposive sample of policymakers, hospital administrators, practitioners, university students and seniors. Improving health among low-socioeconomic-status groups was considered an important policy objective: some favored giving more priority to diseases affecting socioeconomically disadvantaged groups, and some believed inequalities in health could be more effectively addressed outside the health sector. Age was not widely accepted as an independent criterion, but deemed relevant as an indicator of capacity to benefit, cost-effectiveness and health loss. Cost-effectiveness, severity and health-loss measures were judged relevant to policymaking, but cost-effectiveness and health loss were considered less influential to clinical decision-making. Public engagement was seen as essential yet complicated by media and stakeholder pressures. This study highlights how views on the relevance and implementation of criteria can vary significantly according to the health system level being evaluated. Further, the findings suggest that giving priority to socioeconomically disadvantaged groups and reducing inequalities in health may be relevant preferences not captured in recent policy proposals. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Disease management index of potential years of life lost as a tool for setting priorities in national disease control using OECD health data.

    Science.gov (United States)

    Jang, Sung-In; Nam, Jung-Mo; Choi, Jongwon; Park, Eun-Cheol

    2014-03-01

    Limited healthcare resources make it necessary to maximize efficiency in disease management at the country level by priority-setting according to disease burden. To make the best priority settings, it is necessary to measure health status and have standards for its judgment, as well as consider disease management trends among nations. We used 17 International Classification of Diseases (ICD) categories of potential years of life lost (YPLL) from Organization for Economic Co-operation and Development (OECD) health data for 2012, 37 disease diagnoses YPLL from OECD health data for 2009 across 22 countries and disability-adjusted life years (DALY) from the World Health Organization (WHO). We set a range of 1-1 for each YPLL per disease in a nation (position value for relative comparison, PARC). Changes over 5 years were also accounted for in this disease management index (disease management index, DMI). In terms of ICD categories, the DMI indicated specific areas for priority setting for different countries with regard to managing disease treatment and diagnosis. Our study suggests that DMI is a realistic index that reflects trend changes over the past 5 years to the present state, and PARC is an easy index for identifying relative status. Moreover, unlike existing indices, DMI and PARC make it easy to conduct multiple comparisons among countries and diseases. DMI and PARC are therefore useful tools for policy implications and for future studies incorporating them and other existing indexes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. Priority in Process Algebras

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Rudan, Igor

    2016-06-01

    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. The guiding principle of the CHNRI method is to expose the potential of many competing health research ideas to reduce disease burden and inequities that exist in the population in a feasible and cost-effective way. The CHNRI method introduced three key conceptual advances that led to its increased popularity in comparison to other priority-setting methods and processes. First, it proposed a systematic approach to listing a large number of possible research ideas, using the "4D" framework (description, delivery, development and discovery research) and a well-defined "depth" of proposed research ideas (research instruments, avenues, options and questions). Second, it proposed a systematic approach for discriminating between many proposed research ideas based on a well-defined context and criteria. The five "standard" components of the context are the population of interest, the disease burden of interest, geographic limits, time scale and the preferred style of investing with respect to risk. The five "standard" criteria proposed for prioritization between research ideas are answerability, effectiveness, deliverability, maximum potential for disease burden reduction and the effect on equity. However, both the context and the criteria can be flexibly changed to meet the specific needs of each priority-setting exercise. Third, it facilitated consensus development through measuring collective optimism on each component of each research idea among a larger group of experts using a simple scoring system. This enabled the use of the knowledge of

  15. Using geographical and taxonomic metadata to set priorities in specimen digitization

    Directory of Open Access Journals (Sweden)

    Walter G. Berendsohn

    2010-10-01

    Full Text Available Digitizing the information carried by specimens in natural history collections is a key endeavor providing falsifiable information about past and present biodiversity on a global scale, for application in a variety of research fields far beyond the current application in biosystematics. Existing digitization efforts are driven by individual institutional necessities and are not coordinated on a global scale. This led to an over-all information resource that is patchy in taxonomic and geographic coverage as well as in quality. Digitizing all specimens is not an achievable aim at present, so that priorities need to be set. Most biodiversity studies are both taxonomically and geographically restricted, but access to non-digitized collection information is almost exclusively by taxon name. Creating a “Geotaxonomic Index” providing metadata on the number of specimens from a specific geographic region belonging to a specific higher taxonomic category may provide a means to attract the attention of researchers and governments towards relevant non-digitized holdings of the collections and set priorities for their digitization according to the needs of information users outside the taxonomic community.

  16. Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness

    Directory of Open Access Journals (Sweden)

    Rob Baltussen

    2016-11-01

    Full Text Available Priority setting of health interventions is generally considered as a valuable approach to support low- and middle-income countries (LMICs in their strive for universal health coverage (UHC. However, present initiatives on priority setting are mainly geared towards the development of more cost-effectiveness information, and this evidence does not sufficiently support countries to make optimal choices. The reason is that priority setting is in reality a value-laden political process in which multiple criteria beyond cost-effectiveness are important, and stakeholders often justifiably disagree about the relative importance of these criteria. Here, we propose the use of ‘evidence-informed deliberative processes’ as an approach that does explicitly recognise priority setting as a political process and an intrinsically complex task. In these processes, deliberation between stakeholders is crucial to identify, reflect and learn about the meaning and importance of values, informed by evidence on these values. Such processes then result in the use of a broader range of explicit criteria that can be seen as the product of both international learning (‘core’ criteria, which include eg, cost-effectiveness, priority to the worse off, and financial protection and learning among local stakeholders (‘contextual’ criteria. We believe that, with these evidence-informed deliberative processes in place, priority setting can provide a more meaningful contribution to achieving UHC.

  17. Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness

    NARCIS (Netherlands)

    Baltussen, R.; Jansen, M.P.M.; Mikkelsen, E.; Tromp, N.; Hontelez, J.; Bijlmakers, L.; Wilt, G.J. van der

    2016-01-01

    Priority setting of health interventions is generally considered as a valuable approach to support low- and middle-income countries (LMICs) in their strive for universal health coverage (UHC). However, present initiatives on priority setting are mainly geared towards the development of more

  18. Priority setting for universal health coverage: We need evidence-informed deliberative processes, not just more evidence on cost-effectiveness

    NARCIS (Netherlands)

    R. Baltussen (R.); Jansen, M.P. (Maarten P.); T.S. Mikkelsen; N. Tromp; J.A.C. Hontelez (Jan); Bijlmakers, L. (Leon); G.-J. van der Wilt (Gert-Jan)

    2016-01-01

    textabstractPriority setting of health interventions is generally considered as a valuable approach to support low- and middle-income countries (LMICs) in their strive for universal health coverage (UHC). However, present initiatives on priority setting are mainly geared towards the development of

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

    NARCIS (Netherlands)

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

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Setting Priorities For Large Research Facility Projects Supported By the National Science Foundation

    National Research Council Canada - National Science Library

    2005-01-01

    ...) level has stalled in the face of a backlog of approved but unfunded projects. Second, the rationale and criteria used to select projects and set priorities among projects for MREFC funding have not been clearly and publicly articulated...

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

    Science.gov (United States)

    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. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  3. Setting priorities for EU healthcare workforce IT skills competence improvement.

    Science.gov (United States)

    Li, Sisi; Bamidis, Panagiotis D; Konstantinidis, Stathis Th; Traver, Vicente; Car, Josip; Zary, Nabil

    2017-04-01

    A major challenge for healthcare quality improvement is the lack of IT skills and knowledge of healthcare workforce, as well as their ambivalent attitudes toward IT. This article identifies and prioritizes actions needed to improve the IT skills of healthcare workforce across the EU. A total of 46 experts, representing different fields of expertise in healthcare and geolocations, systematically listed and scored actions that would improve IT skills among healthcare workforce. The Child Health and Nutrition Research Initiative methodology was used for research priority-setting. The participants evaluated the actions using the following criteria: feasibility, effectiveness, deliverability, and maximum impact on IT skills improvement. The leading priority actions were related to appropriate training, integrating eHealth in curricula, involving healthcare workforce in the eHealth solution development, improving awareness of eHealth, and learning arrangement. As the different professionals' needs are prioritized, healthcare workforce should be actively and continuously included in the development of eHealth solutions.

  4. Hypertension management research priorities from patients, caregivers, and healthcare providers: A report from the Hypertension Canada Priority Setting Partnership Group.

    Science.gov (United States)

    Khan, Nadia; Bacon, Simon L; Khan, Samia; Perlmutter, Sara; Gerlinsky, Carline; Dermer, Mark; Johnson, Lonni; Alves, Finderson; McLean, Donna; Laupacis, Andreas; Pui, Mandy; Berg, Angelique; Flowitt, Felicia

    2017-11-01

    Patient- and stakeholder-oriented research is vital to improving the relevance of research. The authors aimed to identify the 10 most important research priorities of patients, caregivers, and healthcare providers (family physicians, nurses, nurse practitioners, pharmacists, and dietitians) for hypertension management. Using the James Lind Alliance approach, a national web-based survey asked patients, caregivers, and care providers to submit their unanswered questions on hypertension management. Questions already answered from randomized controlled trial evidence were removed. A priority setting process of patient, caregiver, and healthcare providers then ranked the final top 10 research priorities in an in-person meeting. There were 386 respondents who submitted 598 questions after exclusions. Of the respondents, 78% were patients or caregivers, 29% lived in rural areas, 78% were aged 50 to 80 years, and 75% were women. The 598 questions were distilled to 42 unique questions and from this list, the top 10 research questions prioritized included determining the combinations of healthy lifestyle modifications to reduce the need for antihypertensive medications, stress management interventions, evaluating treatment strategies based on out-of-office blood pressure compared with conventional (office) blood pressure, education tools and technologies to improve patient motivation and health behavior change, management strategies for ethnic groups, evaluating natural and alternative treatments, and the optimal role of different healthcare providers and caregivers in supporting patients with hypertension. These priorities can be used to guide clinicians, researchers, and funding bodies on areas that are a high priority for hypertension management research for patients, caregivers, and healthcare providers. This also highlights priority areas for improved knowledge translation and delivering patient-centered care. ©2017 Wiley Periodicals, Inc.

  5. The trials methodological research agenda: results from a priority setting exercise

    Science.gov (United States)

    2014-01-01

    Background Research into the methods used in the design, conduct, analysis, and reporting of clinical trials is essential to ensure that effective methods are available and that clinical decisions made using results from trials are based on the best available evidence, which is reliable and robust. Methods An on-line Delphi survey of 48 UK Clinical Research Collaboration registered Clinical Trials Units (CTUs) was undertaken. During round one, CTU Directors were asked to identify important topics that require methodological research. During round two, their opinion about the level of importance of each topic was recorded, and during round three, they were asked to review the group’s average opinion and revise their previous opinion if appropriate. Direct reminders were sent to maximise the number of responses at each round. Results are summarised using descriptive methods. Results Forty one (85%) CTU Directors responded to at least one round of the Delphi process: 25 (52%) responded in round one, 32 (67%) responded in round two, 24 (50%) responded in round three. There were only 12 (25%) who responded to all three rounds and 18 (38%) who responded to both rounds two and three. Consensus was achieved amongst CTU Directors that the top three priorities for trials methodological research were ‘Research into methods to boost recruitment in trials’ (considered the highest priority), ‘Methods to minimise attrition’ and ‘Choosing appropriate outcomes to measure’. Fifty other topics were included in the list of priorities and consensus was reached that two topics, ‘Radiotherapy study designs’ and ‘Low carbon trials’, were not priorities. Conclusions This priority setting exercise has identified the research topics felt to be most important to the key stakeholder group of Directors of UKCRC registered CTUs. The use of robust methodology to identify these priorities will help ensure that this work informs the trials methodological research agenda, with

  6. What are the dietary treatment research priorities for inflammatory bowel disease? A short report based on a priority setting partnership with the James Lind Alliance.

    Science.gov (United States)

    Lomer, M C; Hart, A L; Verjee, A; Daly, A; Solomon, J; Mclaughlin, J

    2017-12-01

    Treatment of inflammatory bowel disease (IBD) involves a multidisciplinary approach comprising medical management and sometimes surgery. Although diet is central to IBD management, the optimal diet for patients with IBD is uncertain. A UK collaborative partnership within the James Lind Alliance was set up between patients, clinicians and other stakeholders to develop research priorities in IBD. The aim of this short report is to provide a comprehensive summary of the research priority findings relating to diet in the treatment of IBD. The James Lind Alliance Priority Setting Partnership process was used to develop research priorities in IBD. In brief, patients, clinicians and other stakeholders were invited to provide up to five treatment uncertainties in IBD. These uncertainties were collated, revised and ranked, leading to a final top 10 research questions in IBD. A total of 1671 uncertainties from 531 participants were collected and refined to exclude duplicates leaving 1253 uncertainties. Of these, 348 were categorised as diet-related and grouped according to topic. There were 206 uncertainties related to how diet can be used to treat IBD or alleviate symptoms. Seventy-two percent of diet-related questions came from patients. One broadly diet-related and two diet-specific treatment uncertainties were included in the top 10 research priorities for IBD. Dietary treatment options in the management of IBD are important research priorities. Almost three-quarters of diet related questions came from patients, who were particularly interested in how diet can impact disease activity and symptom control. © 2017 The British Dietetic Association Ltd.

  7. Combining evidence and values in priority setting: testing the balance sheet method in a low-income country.

    Science.gov (United States)

    Makundi, Emmanuel; Kapiriri, Lydia; Norheim, Ole Frithjof

    2007-09-24

    Procedures for priority setting need to incorporate both scientific evidence and public values. The aim of this study was to test out a model for priority setting which incorporates both scientific evidence and public values, and to explore use of evidence by a selection of stakeholders and to study reasons for the relative ranking of health care interventions in a setting of extreme resource scarcity. Systematic search for and assessment of relevant evidence for priority setting in a low-income country. Development of a balance sheet according to Eddy's explicit method. Eight group interviews (n-85), using a modified nominal group technique for eliciting individual and group rankings of a given set of health interventions. The study procedure made it possible to compare the groups' ranking before and after all the evidence was provided to participants. A rank deviation is significant if the rank order of the same intervention differed by two or more points on the ordinal scale. A comparison between the initial rank and the final rank (before deliberation) showed a rank deviation of 67%. The difference between the initial rank and the final rank after discussion and voting gave a rank deviation of 78%. Evidence-based and deliberative decision-making does change priorities significantly in an experimental setting. Our use of the balance sheet method was meant as a demonstration project, but could if properly developed be feasible for health planners, experts and health workers, although more work is needed before it can be used for laypersons.

  8. Research priorities for shoulder surgery: results of the 2015 James Lind Alliance patient and clinician priority setting partnership.

    Science.gov (United States)

    Rangan, Amar; Upadhaya, Sheela; Regan, Sandra; Toye, Francine; Rees, Jonathan L

    2016-04-11

    To run a UK based James Lind Alliance Priority Setting Partnership for 'Surgery for Common Shoulder Problems'. This was a nationally funded and conducted process. It was organised from a musculoskeletal research centre and Biomedical Research Unit in Oxford. UK shoulder patients, carers and clinicians, involved in treating patients with shoulder pain and shoulder problems that might require surgery. These were national electronic and paper surveys capturing treatment uncertainties that are important to shoulder patients, carers and clinicians. The outcomes relevant to this study were the survey results and rankings. The process took 18 months to complete, with 371 participants contributing 404 in scope questions. The James Lind process then produced a final 10 research priorities and uncertainties that relate to the scope of 'Surgery for Common Shoulder Problems'. The final top 10 UK research priorities have been produced and are now being disseminated to partner organisations and funders to guide funding of shoulder research for the next 5-10 years on topics that are important to patients, their carers and clinicians. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. The same-location cost is unrelated to attentional settings: an object-updating account.

    Science.gov (United States)

    Carmel, Tomer; Lamy, Dominique

    2014-08-01

    What mechanisms allow us to ignore salient yet irrelevant visual information has been a matter of intense debate. According to the contingent-capture hypothesis, such information is filtered out, whereas according to the salience-based account, it captures attention automatically. Several recent studies have reported a same-location cost that appears to fit neither of these accounts. These showed that responses may actually be slower when the target appears at the location just occupied by an irrelevant singleton distractor. Here, we investigated the mechanisms underlying this same-location cost. Our findings show that the same-location cost is unrelated to automatic attentional capture or strategic setting of attentional priorities, and therefore invalidate the feature-based inhibition and fast attentional disengagement accounts of this effect. In addition, we show that the cost is wiped out when the cue and target are not perceived as parts of the same object. We interpret these findings as indicating that the same-location cost has been previously misinterpreted by both bottom-up and top-down theories of attentional capture. We propose that it is better understood as a consequence of object updating, namely, as the cost of updating the information stored about an object when this object changes across time.

  10. Using Multiattribute Utility Theory as a Priority-Setting Tool in Human Services Planning.

    Science.gov (United States)

    Camasso, Michael J.; Dick, Janet

    1993-01-01

    The feasibility of applying multiattribute utility theory to the needs assessment and priority-setting activities of human services planning councils was studied in Essex County (New Jersey). Decision-making and information filtering processes are explored in the context of community planning. (SLD)

  11. Following Suit: Using Conversation Cards for Priority Setting in Pediatric Weight Management.

    Science.gov (United States)

    Kebbe, Maryam; Byrne, Jillian L S; Damanhoury, Samah; Ball, Geoff D C

    To describe families' selections of Conversation Cards (CCs), a priority-setting tool in pediatric weight management, and examine CC-related differences based on families' anthropometric and sociodemographic characteristics. A retrospective medical record review was conducted of 2- to 17-year-olds with obesity and their families who enrolled in a pediatric weight management clinic between January, 2012 and September, 2016. Medical records of 146 children were included. On average, families selected 10 ± 6 CCs (range, 3-32 CCs); only 50% of families (n = 73) indicated perceived readiness to make healthy changes. Adolescents (vs children) revealed less healthy eating behaviors (P = .001) and physical activity habits (P = .002). Goal setting was perceived to be a motivator across several sociodemographic characteristics (all P < .05). The CCs were useful in describing families' priorities. The diversity of issues identified by families highlighted the importance of multidisciplinary expertise in pediatric weight management. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives.

    Science.gov (United States)

    Silva, Diego S; Gibson, Jennifer L; Robertson, Ann; Bensimon, Cécile M; Sahni, Sachin; Maunula, Laena; Smith, Maxwell J

    2012-03-26

    Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.

  13. Managing in-hospital quality improvement: An importance-performance analysis to set priorities for ST-elevation myocardial infarction care.

    Science.gov (United States)

    Aeyels, Daan; Seys, Deborah; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Bruyneel, Luk; Vanhaecht, Kris

    2018-02-01

    A focus on specific priorities increases the success rate of quality improvement efforts for broad and complex-care processes. Importance-performance analysis presents a possible approach to set priorities around which to design and implement effective quality improvement initiatives. Persistent variation in hospital performance makes ST-elevation myocardial infarction care relevant to consider for importance-performance analysis. The purpose of this study was to identify quality improvement priorities in ST-elevation myocardial infarction care. Importance and performance levels of ST-elevation myocardial infarction key interventions were combined in an importance-performance analysis. Content validity indexes on 23 ST-elevation myocardial infarction key interventions of a multidisciplinary RAND Delphi Survey defined importance levels. Structured review of 300 patient records in 15 acute hospitals determined performance levels. The significance of between-hospital variation was determined by a Kruskal-Wallis test. A performance heat-map allowed for hospital-specific priority setting. Seven key interventions were each rated as an overall improvement priority. Priority key interventions related to risk assessment, timely reperfusion by percutaneous coronary intervention and secondary prevention. Between-hospital performance varied significantly for the majority of key interventions. The type and number of priorities varied strongly across hospitals. Guideline adherence in ST-elevation myocardial infarction care is low and improvement priorities vary between hospitals. Importance-performance analysis helps clinicians and management in demarcation of the nature, number and order of improvement priorities. By offering a tailored improvement focus, this methodology makes improvement efforts more specific and achievable.

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

    DEFF Research Database (Denmark)

    Larsen, Frank Wugt; Rahbek, Carsten

    2005-01-01

    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 gr...... grain size been assessed. We used data obtained from 939 sub-Saharan mammals to analyse the performance of higher-taxon data for continental priority-setting and to assess the influence of spatial grain sizes in terms of the size of selection units (1°× 1°, 2°× 2° and 4°× 4° latitudinal...... 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...

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

    International Nuclear Information System (INIS)

    Alonzo, Cristina; Laborde, Amalia

    2005-01-01

    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

  16. Research Priorities for the Intersection of Alcohol and HIV/AIDS in Low and Middle Income Countries: A Priority Setting Exercise.

    Science.gov (United States)

    Gordon, Sara; Rotheram-Borus, Mary Jane; Skeen, Sarah; Perry, Charles; Bryant, Kendall; Tomlinson, Mark

    2017-11-01

    The harmful use of alcohol is a component cause for more than 200 diseases. The association between alcohol consumption, risk taking behavior and a range of infectious diseases such as HIV/AIDS is well established. The prevalence of HIV/AIDS as well as harmful alcohol use in low and middle income countries is high. Alcohol has been identified as a modifiable risk factor in the prevention and treatment of HIV/AIDS. The objective of this paper is to define research priorities for the interaction of alcohol and HIV/AIDS in low and middle income countries. The Child Health and Nutrition Research Initiative (CHNRI) priority setting methodology was applied in order to assess research priorities of the interaction of alcohol and HIV/AIDS. A group of 171 global and local experts in the field of alcohol and or HIV/AIDS related research were identified and invited to generate research questions. This resulted in 205 research questions which have been categorized and refined by senior researchers into 48 research questions to be evaluated using five criteria: answerability, effectiveness, feasibility, applicability and impact, as well as equity. A total of 59 experts participated independently in the voluntary scoring exercise (a 34% response rate). There was substantial consensus among experts on priorities for research on alcohol and HIV. These tended to break down into two categories, those focusing on better understanding the nexus between alcohol and HIV and those directed towards informing practical interventions to reduce the impact of alcohol use on HIV treatment outcomes, which replicates what Bryant (Subst Use Misuse 41:1465-1507, 2006) and Parry et al. (Addiction 108:1-2, 2012) found. Responses from experts were stratified by location in order to determine any differences between groups. On average experts in the LMIC gave higher scores than the HIC experts. Recent research has shown the causal link between alcohol consumption and the incidence of HIV

  17. Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives

    Directory of Open Access Journals (Sweden)

    Silva Diego S

    2012-03-01

    Full Text Available Abstract Background Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. Methods To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Results Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Conclusions Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans.

  18. Priorities for research in miscarriage: a priority setting partnership between people affected by miscarriage and professionals following the James Lind Alliance methodology.

    Science.gov (United States)

    Prior, Matthew; Bagness, Carmel; Brewin, Jane; Coomarasamy, Arri; Easthope, Lucy; Hepworth-Jones, Barbara; Hinshaw, Kim; O'Toole, Emily; Orford, Julie; Regan, Lesley; Raine-Fenning, Nick; Shakespeare, Judy; Small, Rachel; Thornton, Jim; Metcalf, Leanne

    2017-08-23

    To identify and prioritise important research questions for miscarriage. A priority setting partnership using prospective surveys and consensus meetings following methods advocated by the James Lind Alliance. UK. Women and those affected by miscarriage working alongside healthcare professionals. In the initial survey, 1093 participants (932 women who have experienced miscarriage, 8 partners, 17 family members, friends or colleagues, 104 healthcare professionals and eight charitable organisations) submitted 3279 questions. A review of existing literature identified a further 64. Non-questions were removed, and the remaining questions were categorised and summarised into 58 questions. In an interim electronic survey, 2122 respondents chose their top 10 priorities from the 58 summary questions. The 25 highest ranked in the survey were prioritised at a final face-to-face workshop. In summary, the top 10 priorities were ranked as follows: research into preventative treatment, emotional aspects in general, investigation, relevance of pre-existing medical conditions, emotional support as a treatment, importance of lifestyle factors, importance of genetic and chromosomal causes, preconception tests, investigation after different numbers of miscarriage and male causal factors. These results should be the focus of future miscarriage research. Presently, studies are being conducted to address the top priority; however, many other priorities, especially psychological and emotional support, are less well researched areas. We hope our results will encourage both researchers and funders to focus on these priorities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Factors explaining priority setting at community mental health centres: a quantitative analysis of referral assessments.

    Science.gov (United States)

    Grepperud, Sverre; Holman, Per Arne; Wangen, Knut Reidar

    2014-12-14

    Clinicians at Norwegian community mental health centres assess referrals from general practitioners and classify them into three priority groups (high priority, low priority, and refusal) according to need where need is defined by three prioritization criteria (severity, effect, and cost-effectiveness). In this study, we seek to operationalize the three criteria and analyze to what extent they have an effect on clinical-level priority setting after controlling for clinician characteristics and organisational factors. Twenty anonymous referrals were rated by 42 admission team members employed at 14 community mental health centres in the South-East Health Region of Norway. Intra-class correlation coefficients were calculated and logistic regressions were performed. Variation in clinicians' assessments of the three criteria was highest for effect and cost-effectiveness. An ordered logistic regression model showed that all three criteria for prioritization, three clinician characteristics (education, being a manager or not, and "guideline awareness"), and the centres themselves (fixed effects), explained priority decisions. The relative importance of the explanatory factors, however, depended on the priority decision studied. For the classification of all admitted patients into high- and low-priority groups, all clinician characteristics became insignificant. For the classification of patients, into those admitted and non-admitted, one criterion (effect) and "being a manager or not" became insignificant, while profession ("being a psychiatrist") became significant. Our findings suggest that variation in priority decisions can be reduced by: (i) reducing the disagreement in clinicians' assessments of cost-effectiveness and effect, and (ii) restricting priority decisions to clinicians with a similar background (education, being a manager or not, and "guideline awareness").

  20. 75 FR 75469 - Priority Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA...

    Science.gov (United States)

    2010-12-03

    ... Advisor, Child Health and Quality Improvement, Office of Extramural Research, Education, and Priority...: Importance has several dimensions: To what extent is the topic important to children's health outcomes... Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA) Pediatric Quality...

  1. Setting Priorities for Diabetic Retinopathy Clinical Research and Identifying Evidence Gaps.

    Science.gov (United States)

    Le, Jimmy T; Hutfless, Susan; Li, Tianjing; Bressler, Neil M; Heyward, James; Bittner, Ava K; Glassman, Adam; Dickersin, Kay

    2017-01-01

    Prioritizing comparative effectiveness research may contribute to obtaining answers that clinicians perceive they need and may minimize research that could be considered wasteful. Our objective was to identify evidence gaps and set priorities for new systematic reviews and randomized controlled trials for managing diabetic retinopathy (DR), including diabetic macular edema (DME). Cross-sectional study. Diabetic Retinopathy Clinical Research Network (DRCR.net) investigators. We provided recommendations from the American Academy of Ophthalmology's 2012 Preferred Practice Patterns for Diabetic Retinopathy as 91 answerable clinical research questions about intervention effectiveness to 410 DRCR.net investigators to rate each question's importance from 0 (not important) to 10 (very important) using a 2-round Delphi survey and to suggest additional questions. We considered questions as high priority if at least 75% of respondents to both rounds assigned an importance rating of 5 or more in round 2. We also extracted outcome measures relevant to DR and asked respondents to identify those that must be measured in all studies. We mapped Cochrane reviews published up to March 2016 to high-priority clinical research questions. Ranking of importance of each clinical question. Thirty-two individuals completed rounds 1 and 2 and suggested 15 questions. Among the final list of 106 clinical research questions, 22 questions met our definition of high priority: 9 of 22 concerned the effectiveness of anti-VEGF therapy, and 13 of 22 focused on how often patients should be followed up (re-examination) and treatment effectiveness in patients with specific characteristics (e.g., DME). Outcomes that 75% or more of respondents marked as "must be measured in all studies" included visual acuity and visual loss, death of participants, and intraocular pressure. Only 1 prioritized question was associated with conclusive evidence from a Cochrane systematic review. A limited response rate among

  2. Setting priorities for improving the preoperative assessment clinic: the patients' and the professionals' perspective.

    NARCIS (Netherlands)

    Edward, G.M.; de Haes, J.C.J.M.; Oort, F.J.; Lemaire, L.C.; Hollmann, M.W.; Preckel, B.

    2008-01-01

    Background: The quality of the preoperative assessment clinic (PAC) is determined by many factors. Patients’ experiences are important indicators, but often overlooked. We prepare to set priorities to improve the PAC by obtaining detailed patients’ feedback on the quality of the PAC, and

  3. 45 CFR 2531.20 - Funding priorities.

    Science.gov (United States)

    2010-10-01

    ... priorities. The Corporation may choose to set priorities (and to periodically revise such priorities) that... given fiscal year. In setting these priorities, the Corporation will seek to concentrate funds on those... 45 Public Welfare 4 2010-10-01 2010-10-01 false Funding priorities. 2531.20 Section 2531.20 Public...

  4. The priorities for ANSTO

    International Nuclear Information System (INIS)

    Garnett, H.M.

    1999-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Defechereux Thierry

    2012-02-01

    Full Text Available Abstract 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 treatment. This study compares the values of the country's health policy makers with these three official principles. Methods In total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas. Results The group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health. Conclusions Norwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions.

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

    Science.gov (United States)

    Defechereux, Thierry; Paolucci, Francesco; Mirelman, Andrew; Youngkong, Sitaporn; Botten, Grete; Hagen, Terje P; Niessen, Louis W

    2012-02-15

    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 treatment. This study compares the values of the country's health policy makers with these three official principles. In total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas. The group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health. Norwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions.

  7. Identification and priority setting for health technology assessment in The Netherlands : Actors and activities

    NARCIS (Netherlands)

    Oortwijn, W.; Banta, D.; Vondeling, H.; Bouter, L.

    1999-01-01

    This article describes the actual situation at the beginning of 1999 with regard to identification and priority setting for health technology assessment (HTA) on a national level in the Netherlands. For this purpose the literature on HTA published in 1980-1998, mainly national, was thoroughly

  8. Using the Nine Common Themes of Good Practice checklist as a tool for evaluating the research priority setting process of a provincial research and program evaluation program.

    Science.gov (United States)

    Mador, Rebecca L; Kornas, Kathy; Simard, Anne; Haroun, Vinita

    2016-03-23

    Given the context-specific nature of health research prioritization and the obligation to effectively allocate resources to initiatives that will achieve the greatest impact, evaluation of priority setting processes can refine and strengthen such exercises and their outcomes. However, guidance is needed on evaluation tools that can be applied to research priority setting. This paper describes the adaption and application of a conceptual framework to evaluate a research priority setting exercise operating within the public health sector in Ontario, Canada. The Nine Common Themes of Good Practice checklist, described by Viergever et al. (Health Res Policy Syst 8:36, 2010) was used as the conceptual framework to evaluate the research priority setting process developed for the Locally Driven Collaborative Projects (LDCP) program in Ontario, Canada. Multiple data sources were used to inform the evaluation, including a review of selected priority setting approaches, surveys with priority setting participants, document review, and consultation with the program advisory committee. The evaluation assisted in identifying improvements to six elements of the LDCP priority setting process. The modifications were aimed at improving inclusiveness, information gathering practices, planning for project implementation, and evaluation. In addition, the findings identified that the timing of priority setting activities and level of control over the process were key factors that influenced the ability to effectively implement changes. The findings demonstrate the novel adaptation and application of the 'Nine Common Themes of Good Practice checklist' as a tool for evaluating a research priority setting exercise. The tool can guide the development of evaluation questions and enables the assessment of key constructs related to the design and delivery of a research priority setting process.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Anita V. Sotnikova

    2015-01-01

    Full Text Available 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 (indicators reflecting influence of IT projects of a portfolio on the most significant purposes of implementation of IT projects of a portfolio is developed. As system of criteria the key indicators of efficiency defined when developing the Balanced system of indicators which meet above-mentioned requirements are used. The essence of a method of analytical net-works consists in paired comparison of key indicators of efficiency concerning the purpose of realization of a portfolio and IT projects which are a part of a portfolio. Result of use of a method of analytical networks are coefficients of priority of each IT project of a portfolio. The received coefficients of priority of IT projects are used in the offered model of distribution of the budget of a portfolio between IT projects. Thus, the budget of a portfolio of IT projects is distributed between them taking into account not only the income from implementation of each IT project, but also other criteria, important for the IT company, for example: the degree of compliance of the IT project to strategic objectives of the IT company defining expediency of implementation of the IT project; the term of implementation of the IT project determined by the customer. The developed model of distribution of the budget of a portfolio between IT projects is approved on the example of distribution of the budget between IT projects of the portfolio consisting of three IT projects. Taking into account the received

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Pharmaceutical priority setting and the use of health economic evaluations: a systematic literature review.

    Science.gov (United States)

    Erntoft, Sandra

    2011-06-01

    To investigate which factors and criteria are used in priority setting of pharmaceuticals, in what contexts health economic evaluations are used, and barriers to the use of health economic evaluations at micro, meso, and macro health-care levels. The search for empirical articles was based on the MeSH index (Medical Substance Heading), including the search terms "economic evaluation," "cost-effectiveness analysis," "cost-utility analysis," "cost-benefit analysis," "pharmacoeconomic," AND "drug cost(s)," AND "eligibility determination," AND "decision-making," AND "rationing," AND formulary. The following databases were searched: PubMed, EconLit, Cochrane, Web of Science, CINAHL, and PsycINFO. More than 3100 studies were identified, 31 of which were included in this review. The use of health economic evaluations at all three health-care levels was investigated in three countries (United States [US], United Kingdom [UK], and Sweden). Postal and telephone survey methods dominated (n = 17) followed by interviews (n = 13), document analysis (n = 10), and observations of group deliberations (n = 9). The cost-effectiveness criterion was most important at the macro level. A number of contextual uses of health economic evaluations were identified, including importantly the legitimizing of decisions, structuring the priority-setting process, and requesting additional budgets to finance expensive pharmaceuticals. Factors that seem to support the increased use of health economic evaluations are well-developed frameworks for evaluations, the presence of health economic skills, and an explicit priority-setting process. Differences in how economic evaluations are used at macro, meso, and micro levels are attributed to differences in the preconditions at each level. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. Research Priority Setting for Social Determinants of Health Research Center of Shahid Beheshti University of Medical Sciences in 2013

    Directory of Open Access Journals (Sweden)

    Mohammad-Reza Sohrabi

    2015-02-01

    Full Text Available Background and objective: It is obvious that, because of the lack of resources, we should devote our limited resources to priorities in order to reach an acceptable level of health. The objective of this study was to research priority setting for Pediatric Surgery Research Center; with the participation of all stakeholders.Material and Methods: This is a Health System Research (HSR project in order to apply governance and leadership issues with the participation of 41 people including faculty members in Pediatric Surgery Research Center, Shahid Beheshti Medical University and the other pediatric specialists and health system stakeholders as well as the people associated with health system inside & outside the university. This was performed in 2010 using the Council on Health Research for Development COHRED( model with little change. Based on the model, at first the stakeholders were identified and the field situation of Pediatric Surgery was analyzed. Then, research areas and titles were specified and research priorities were set out by giving scores according to the criteria.Results: The seven obtained research areas in priority order are included pediatric trauma, pediatric cancers, pediatric urology diseases, undescended testicles in children, developmental genetics & congenital defects, emergency in children and application of laparoscopic surgery in children. Because each of the research areas is composed of multiple subareas, we managed to finally specify 43 research subareas as research priorities. These subareas included epidemiology, risk factors, prevention, screening, diagnosis and treatment. They also included follow-up, complications, knowledge & attitudes of parents, quality of life, economy aspects and data bank for further research.Conclusion: In this project, research priorities were set out for Pediatric Surgery Research Center of Shahid Beheshti University of Medical Sciences, with the participation of all the stakeholders

  14. Earnings Management and Participation in Accounting Standard-Setting

    NARCIS (Netherlands)

    Koenigsgruber, R.; Palan, S.

    2015-01-01

    Recent economic and political science research suggests that the way public policy is set, and in particular the participation of those affected by it, impacts upon the outcome of the policy. Accounting standard setting has long offered such a possibility to participate via the due process approach

  15. Setting research priorities to reduce global mortality from preterm birth and low birth weight by 2015.

    Science.gov (United States)

    Bahl, Rajiv; Martines, Jose; Bhandari, Nita; Biloglav, Zrinka; Edmond, Karen; Iyengar, Sharad; Kramer, Michael; Lawn, Joy E; Manandhar, D S; Mori, Rintaro; Rasmussen, Kathleen M; Sachdev, H P S; Singhal, Nalini; Tomlinson, Mark; Victora, Cesar; Williams, Anthony F; Chan, Kit Yee; Rudan, Igor

    2012-06-01

    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. We applied the Child Health and Nutrition Research Initiative (CHNRI) methodology for setting priorities in health research investments. In the process coordinated by the World Health Organization in 2007-2008, 21 researchers with interest in child, maternal and newborn health suggested 82 research ideas that spanned across the broad spectrum of epidemiological research, health policy and systems research, improvement of existing interventions and development of new interventions. The 82 research questions were then assessed for answerability, effectiveness, deliverability, maximum potential for mortality reduction and the effect on equity using the CHNRI method. The top 10 identified research priorities were dominated by health systems and policy research questions (eg, identification of LBW infants born at home within 24-48 hours of birth for additional care; approaches to improve quality of care of LBW infants in health facilities; identification of barriers to optimal home care practices including care seeking; and approaches to increase the use of antenatal corticosteriods in preterm labor and to improve access to hospital care for LBW infants). These were followed by priorities for improvement of the existing interventions (eg, early initiation of breastfeeding, including feeding mode and techniques for those unable to suckle directly from the breast; improved cord care, such as chlorhexidine application; and alternative methods to Kangaroo Mother Care (KMC) to keep LBW infants warm in community settings). The highest-ranked epidemiological question suggested improving criteria for identifying LBW infants who need to be cared for in a hospital. Among the new interventions, the greatest support was shown for the development of

  16. 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

    Directory of Open Access Journals (Sweden)

    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

  17. Setting research priorities for patients on or nearing dialysis.

    Science.gov (United States)

    Manns, Braden; Hemmelgarn, Brenda; Lillie, Erin; Dip, Sally Crowe P G; Cyr, Annette; Gladish, Michael; Large, Claire; Silverman, Howard; Toth, Brenda; Wolfs, Wim; Laupacis, Andreas

    2014-10-07

    With increasing emphasis among health care providers and funders on patient-centered care, it follows that patients and their caregivers should be included when priorities for research are being established. This study sought to identify the most important unanswered questions about the management of kidney failure from the perspective of adult patients on or nearing dialysis, their caregivers, and the health care professionals who care for these patients. Research uncertainties were identified through a national Canadian survey of adult patients on or nearing dialysis, their caregivers, and health care professionals. Uncertainties were refined by a steering committee that included patients, caregivers, researchers, and clinicians to assemble a short-list of the top 30 uncertainties. Thirty-four people (11 patients; five caregivers; eight physicians; six nurses; and one social worker, pharmacist, physiotherapist, and dietitian each) from across Canada subsequently participated in a workshop to determine the top 10 research questions. In total, 1570 usable research uncertainties were received from 317 respondents to the survey. Among these, 259 unique uncertainties were identified; after ranking, these were reduced to a short-list of 30 uncertainties. During the in-person workshop, the top 10 research uncertainties were identified, which included questions about enhanced communication among patients and providers, dialysis modality options, itching, access to kidney transplantation, heart health, dietary restrictions, depression, and vascular access. These can be used alongside the results of other research priority-setting exercises to guide researchers in designing future studies and inform health care funders. Copyright © 2014 by the American Society of Nephrology.

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

    Science.gov (United States)

    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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Setting Priorities for Space Research: Opportunities and Imperatives

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2010-12-20

    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. 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. 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 report of HCV-related diseases in the household, and perception of HCV as the most severe risk were significantly associated to setting HCV treatment as the first priority. The Cairo community prefers to further improving water supply as compared to improved outdoor air quality and screening and treatment of chronic hepatitis C.

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

    OpenAIRE

    Mamić-Sačer, Ivana

    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...

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

    Directory of Open Access Journals (Sweden)

    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

  4. Approaches of data combining for reliability assessments with taking into account the priority of data application

    International Nuclear Information System (INIS)

    Zelenyj, O.V.; Pecheritsa, A.V.

    2004-01-01

    Based upon the available experience on assessments of risk from Ukrainian NPP's operational events as well as on results of State review of PSA studies for pilot units it should be noted that historical information on domestic NPP's operation is not always available or used properly under implementation of mentioned activities. The several approaches for combining of available generic and specific information for reliability parameters assessment (taking into account the priority of data application) are briefly described in the article along with some recommendations how to apply those approaches

  5. Setting health priorities in a community: a case example.

    Science.gov (United States)

    Sousa, Fábio Alexandre Melo do Rego; Goulart, Maria José Garcia; Braga, Antonieta Manuela Dos Santos; Medeiros, Clara Maria Oliveira; Rego, Débora Cristina Martins; Vieira, Flávio Garcia; Pereira, Helder José Alves da Rocha; Tavares, Helena Margarida Correia Vicente; Loura, Marta Maria Puim

    2017-03-02

    To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1) grouping by level of similarity, (2) classification according to epidemiological criteria, (3) ordering by experts, and (4) application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence). The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community. Descrever a metodologia utilizada no processo de estabelecimento de prioridades em saúde para intervenção comunitária, numa comunidade idosa. Partindo dos resultados de um diagnóstico de saúde no âmbito da promoção do envelhecimento

  6. Using Economic Evidence to Set Healthcare Priorities in Low‐Income and Lower‐Middle‐Income Countries: A Systematic Review of Methodological Frameworks

    Science.gov (United States)

    Mitton, Craig; Doyle‐Waters, Mary M.; Drake, Tom; Conteh, Lesong; Newall, Anthony T.; Onwujekwe, Obinna; Jan, Stephen

    2016-01-01

    Abstract Policy makers in low‐income and lower‐middle‐income countries (LMICs) are increasingly looking to develop ‘evidence‐based’ frameworks for identifying priority health interventions. This paper synthesises and appraises the literature on methodological frameworks – which incorporate economic evaluation evidence – for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion. These covered a wide range of health interventions with only two studies including health systems strengthening interventions related to financing, governance and human resources. A little under half of the studies (39%) included multiple criteria for priority setting, most commonly equity, feasibility and disease severity. Most studies (91%) specified a measure of ‘efficiency’ defined as cost per disability‐adjusted life year averted. Ranking of health interventions using multi‐criteria decision analysis and generalised cost‐effectiveness were the most common frameworks for identifying priority health interventions. Approximately a third of studies discussed the affordability of priority interventions. Only one study identified priority areas for the release or redeployment of resources. The paper concludes by highlighting the need for local capacity to conduct evaluations (including economic analysis) and empowerment of local decision‐makers to act on this evidence. PMID:26804361

  7. Using Economic Evidence to Set Healthcare Priorities in Low-Income and Lower-Middle-Income Countries: A Systematic Review of Methodological Frameworks.

    Science.gov (United States)

    Wiseman, Virginia; Mitton, Craig; Doyle-Waters, Mary M; Drake, Tom; Conteh, Lesong; Newall, Anthony T; Onwujekwe, Obinna; Jan, Stephen

    2016-02-01

    Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop 'evidence-based' frameworks for identifying priority health interventions. This paper synthesises and appraises the literature on methodological frameworks--which incorporate economic evaluation evidence--for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion. These covered a wide range of health interventions with only two studies including health systems strengthening interventions related to financing, governance and human resources. A little under half of the studies (39%) included multiple criteria for priority setting, most commonly equity, feasibility and disease severity. Most studies (91%) specified a measure of 'efficiency' defined as cost per disability-adjusted life year averted. Ranking of health interventions using multi-criteria decision analysis and generalised cost-effectiveness were the most common frameworks for identifying priority health interventions. Approximately a third of studies discussed the affordability of priority interventions. Only one study identified priority areas for the release or redeployment of resources. The paper concludes by highlighting the need for local capacity to conduct evaluations (including economic analysis) and empowerment of local decision-makers to act on this evidence. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

  8. National Priority Setting of Clinical Practice Guidelines Development for Chronic Disease Management.

    Science.gov (United States)

    Jo, Heui-Sug; Kim, Dong Ik; Oh, Moo-Kyung

    2015-12-01

    By November 2013, a total of 125 clinical practice guidelines (CPGs) have been developed in Korea. However, despite the high burden of diseases and the clinical importance of CPGs, most chronic diseases do not have available CPGs. Merely 83 CPGs are related to chronic diseases, and only 40 guidelines had been developed in the last 5 yr. Considering the rate of the production of new evidence in medicine and the worsening burden from chronic diseases, the need for developing CPGs for more chronic diseases is becoming increasingly pressing. Since 2011, the Korean Academy of Medical Sciences and the Korea Centers for Disease Control and Prevention have been jointly developing CPGs for chronic diseases. However, priorities have to be set and resources need to be allocated within the constraint of a limited funding. This study identifies the chronic diseases that should be prioritized for the development of CPGs in Korea. Through an objective assessment by using the analytic hierarchy process and a subjective assessment with a survey of expert opinion, high priorities were placed on ischemic heart disease, cerebrovascular diseases, Alzheimer's disease and other dementias, osteoarthritis, neck pain, chronic kidney disease, and cirrhosis of the liver.

  9. The No-Destination Ship of Priority-Setting in Healthcare: A Call for More Democracy.

    Science.gov (United States)

    Seixas, Brayan V

    2017-10-11

    In dealing with scarcity of resources within healthcare systems, decision-makers inevitably have to make choices about which services to fund. Setting priorities represents a challenging task that requires systematic, explicit and transparent methodologies with focus on economic efficiency. In addition, the engagement of the general public in the process of decision-making has been regarded as one of the most important aspects of the management of publicly-funded health systems in liberal democracies. In the current essay, we aim to discuss the problematics of public engagement in the process of resource allocation and priority-setting within the context of publiclyfunded health systems. Our central argument is that although there may be a conflict between democratic mechanisms of citizen participation and economic efficiency, in the extra-welfarist sense, expected for/from the system, the solution for this tension does not seem to rely on more or novel authoritative technocratic approaches, but rather on the deepening and betterment of democratic participation. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  10. Eliciting preferences for priority setting in genetic testing: a pilot study comparing best-worst scaling and discrete-choice experiments

    OpenAIRE

    Severin, Franziska; Schmidtke, Jörg; Mühlbacher, Axel; Rogowski, Wolf H

    2013-01-01

    Given the increasing number of genetic tests available, decisions have to be made on how to allocate limited health-care resources to them. Different criteria have been proposed to guide priority setting. However, their relative importance is unclear. Discrete-choice experiments (DCEs) and best-worst scaling experiments (BWSs) are methods used to identify and weight various criteria that influence orders of priority. This study tests whether these preference eliciting techniques can be used f...

  11. Patients' self-interested preferences: empirical evidence from a priority setting experiment.

    Science.gov (United States)

    Alvarez, Begoña; Rodríguez-Míguez, Eva

    2011-04-01

    This paper explores whether patients act according to self-interest in priority setting experiments. The analysis is based on a ranking experiment, conducted in Galicia (Spain), to elicit preferences regarding the prioritization of patients on a waiting list for an elective surgical intervention (prostatectomy for benign prostatic hyperplasia). Participants were patients awaiting a similar intervention and members of the general populations. All of them were asked to rank hypothetical patients on a waiting list. A rank-ordered logit was then applied to their responses in order to obtain a prioritization scoring system. Using these estimations, we first test for differences in preferences between patients and general population. Second, we implement a procedure based on the similarity between respondents (true patients) and the hypothetical scenarios they evaluate (hypothetical patients) to analyze whether patients provide self-interested rankings. Our results show that patient preferences differ significantly from general population preferences. The findings also indicate that, when patients rank the hypothetical scenarios on the waiting list, they consider not only the explicit attributes but also the similarity of each scenario to their own. In particular, they assign a higher priority to scenarios that more closely match their own states. We also find that such a preference structure increases their likelihood of reporting "irrational" answers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Priority setting in general practice: health priorities of older patients differ from treatment priorities of their physicians.

    Science.gov (United States)

    Voigt, Isabel; Wrede, Jennifer; Diederichs-Egidi, Heike; Dierks, Marie-Luise; Junius-Walker, Ulrike

    2010-12-01

    To ascertain health priorities of older patients and treatment priorities of their general practitioners (GP) on the basis of a geriatric assessment and to determine the agreement between these priorities. The study included a sample of 9 general practitioners in Hannover, Germany, and a stratified sample of 35 patients (2-5 patients per practice, 18 female, average age 77.7 years). Patients were given a geriatric assessment using the Standardized Assessment for Elderly Patients in Primary Care (STEP) to gain an overview of their health and everyday problems. On the basis of these results, patients and their physicians independently rated the importance of each problem disclosed by the assessment. Whereas patients assessed the importance for their everyday lives, physicians assessed the importance for patients' medical care and patients' everyday lives. Each patient had a mean ± standard deviation of 18 ± 9.2 health problems. Thirty five patients disclosed a total of 634 problems; 537 (85%) were rated by patients and physicians. Of these 537 problems, 332 (62%) were rated by patients and 334 (62%) by physicians as important for patients' everyday lives. In addition, 294 (55%) were rated by physicians as important for patients' medical care. Although these proportions of important problems were similar between patients and physicians, there was little overlap in the specific problems that each group considered important. The chance-corrected agreement (Cohen κ) between patients and physicians on the importance of problems for patients' lives was low (κ=0.23). Likewise, patients and physicians disagreed on the problems that physicians considered important for patients' medical care (κ=0.18, Ppriorities between patients and physicians necessitates better communication between the two parties to strengthen mutual understanding.

  13. Identifying research priorities in anaesthesia and perioperative care: final report of the joint National Institute of Academic Anaesthesia/James Lind Alliance Research Priority Setting Partnership

    OpenAIRE

    Boney, O.; Bell, M.; Bell, N.; Conquest, A.; Cumbers, M.; Drake, S.; Galsworthy, M.; Gath, J.; Grocott, M. P.; Harris, E.; Howell, S.; Ingold, A.; Nathanson, M. H.; Pinkney, T.; Metcalf, L.

    2015-01-01

    Objective To identify research priorities for Anaesthesia and Perioperative Medicine. Design Prospective surveys and consensus meetings guided by an independent adviser. Setting UK. Participants 45 stakeholder organisations (25 professional, 20 patient/carer) affiliated as James Lind Alliance partners. Outcomes First ?ideas-gathering? survey: Free text research ideas and suggestions. Second ?prioritisation? survey: Shortlist of ?summary? research questions (derived from the first survey) rank...

  14. De la evidencia al desempeño: cómo fijar prioridades y tomar buenas decisiones From evidence to performance: setting priorities and making good decisions

    Directory of Open Access Journals (Sweden)

    Franklin White

    1998-07-01

    Full Text Available En esta época de respeto por la ciencia médica y por la responsabilidad gerencial, las organizaciones de salud deben rendir cuentas por sus acciones con creciente frecuencia. La época en que se determinaban las prioridades y se tomaban las decisiones sobre bases políticas o acatando el consejo intuitivo de asesores respetados y bien intencionados ha dado paso gradualmente a una era que valora la demostración de efectividad y eficiencia. Las decisiones relativas a las prioridades y a los programas deben basarse firmemente en conocimientos comprobados y someterse a evaluación continua. Esta transición requiere promover el pensamiento crítico en todos los ámbitos. Surge entonces la siguiente pregunta: ¿Cómo podemos promover el razonamiento crítico en los servicios de salud para fijar prioridades, adoptar decisiones acertadas y poner en práctica iniciativas efectivas? En otras palabras, ¿cómo podemos pasar de la evidencia al desempeño? Una pregunta aún más básica es ¿por qué debemos fijar prioridades?In today's world, with its respect for the medical sciences and demand for administrative accountability, health institutions are publicly responsible for their actions to an unprecedented degree. Making decisions and setting priorities on the basis of politics or unvalidated expert opinions is no longer acceptable. Instead, proven efficiency and effectiveness, as demonstrated by scientific evidence under continuous evaluation, are essential to decision-making. The need for applying rational criteria makes it necessary to explore a fundamental question: How can we promote critical reasoning within health services so as to adequately set priorities, make proper decisions, and launch effective interventions? In other words, how can we move from evidence to performance and why set priorities at all?

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

    DEFF Research Database (Denmark)

    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...

  16. The badness of death and priorities in health.

    Science.gov (United States)

    Solberg, Carl Tollef; Gamlund, Espen

    2016-04-14

    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-fertilisation between the academic fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities. Two questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, 'When is the worst time to die?' A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die. Deprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global

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

    Science.gov (United States)

    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.

  18. Evidence-informed capacity building for setting health priorities in low- and middle-income countries: A framework and recommendations for further research.

    Science.gov (United States)

    Li, Ryan; Ruiz, Francis; Culyer, Anthony J; Chalkidou, Kalipso; Hofman, Karen J

    2017-01-01

    Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders - not only the technical capacity to "do" research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE) framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values); academics need to understand and respond to decision-makers' needs to produce relevant research. The health system at all levels will need institutional capacity building to incentivise routine generation and use of evidence. Knowledge brokers, including priority-setting agencies (such as England's National Institute for Health and Care Excellence, and Health Interventions and Technology Assessment Program, Thailand) and the media can play an important role in facilitating engagement and knowledge transfer between the various actors. Especially at the outset but at every step, it is critical that patients and the public understand that trade-offs are inherent in priority-setting, and careful efforts should be made to engage them, and to hear their views throughout the process. There is thus no single approach to capacity building; rather a spectrum of activities that recognises the roles and skills of all stakeholders. A range of methods, including formal and informal training, networking and engagement, and support through collaboration on projects, should be flexibly employed (and tailored to specific needs of each country) to support institutionalisation of evidence-informed priority-setting. Finally, capacity building should be a two-way process; those who build capacity should also attend to their own capacity

  19. Developing risk-based priorities for reducing air pollution in urban settings in Ukraine.

    Science.gov (United States)

    Brody, Michael; Caldwell, Jane; Golub, Alexander

    2007-02-01

    Ukraine, when part of the former Soviet Union, was responsible for about 25% of its overall industrial production. This aging industrial infrastructure continues to emit enormous volumes of air and water pollution and wastes. The National Report on the State of Environment in Ukraine 1999 (Ukraine Ministry of Environmental Protection [MEP], 2000) shows significant air pollution. There are numerous emissions that have been associated with developmental effects, chronic long-term health effects, and cancer. Ukraine also has been identified as a major source of transboundary air pollution for the eastern Mediterranean region. Ukraine's Environment Ministry is not currently able to strategically target high-priority emissions and lacks the resources to address all these problems. For these reasons, the U.S. Environmental Protection Agency set up a partnership with Ukraine's Ministry of Environmental Protection to strengthen its capacity to set environmental priorities through the use of comparative environmental risk assessment and economic analysis--the Capacity Building Project. The project is also addressing improvements in the efficiency and effectiveness of the use of its National Environmental Protection Fund. The project consists of a series of workshops with Ukrainian MEP officials in comparative risk assessment of air pollutant emissions in several heavily industrialized oblasts; cost-benefit and cost-effectiveness analysis; and environmental finance. Pilot risk assessment analyses have been completed. At the end of the Capacity Building Project it is expected that the use of the National Environmental Protection fund and the regional level oblast environmental protection funds will begin to target and identify the highest health and environmental risk emissions.

  20. Setting health research priorities using the CHNRI method: VII. A review of the first 50 applications of the CHNRI method.

    Science.gov (United States)

    Rudan, Igor; Yoshida, Sachiyo; Chan, Kit Yee; Sridhar, Devi; Wazny, Kerri; Nair, Harish; Sheikh, Aziz; Tomlinson, Mark; Lawn, Joy E; Bhutta, Zulfiqar A; Bahl, Rajiv; Chopra, Mickey; Campbell, Harry; El Arifeen, Shams; Black, Robert E; Cousens, Simon

    2017-06-01

    Several recent reviews of the methods used to set research priorities have identified the CHNRI method (acronym derived from the "Child Health and Nutrition Research Initiative") as an approach that clearly became popular and widely used over the past decade. In this paper we review the first 50 examples of application of the CHNRI method, published between 2007 and 2016, and summarize the most important messages that emerged from those experiences. We conducted a literature review to identify the first 50 examples of application of the CHNRI method in chronological order. We searched Google Scholar, PubMed and so-called grey literature. Initially, between 2007 and 2011, the CHNRI method was mainly used for setting research priorities to address global child health issues, although the first cases of application outside this field (eg, mental health, disabilities and zoonoses) were also recorded. Since 2012 the CHNRI method was used more widely, expanding into the topics such as adolescent health, dementia, national health policy and education. The majority of the exercises were focused on issues that were only relevant to low- and middle-income countries, and national-level applications are on the rise. The first CHNRI-based articles adhered to the five recommended priority-setting criteria, but by 2016 more than two-thirds of all conducted exercises departed from recommendations, modifying the CHNRI method to suit each particular exercise. This was done not only by changing the number of criteria used, but also by introducing some entirely new criteria (eg, "low cost", "sustainability", "acceptability", "feasibility", "relevance" and others). The popularity of the CHNRI method in setting health research priorities can be attributed to several key conceptual advances that have addressed common concerns. The method is systematic in nature, offering an acceptable framework for handling many research questions. It is also transparent and replicable, because it

  1. Players' perceptions of accountability factors in secondary school sports settings.

    Science.gov (United States)

    Hastie, P A

    1993-06-01

    The purpose of this study was to gauge the extent to which students believed that the accountability strategies employed by their coaches had significant effects on their involvement in sports training sessions. Questionnaire data from 235 secondary school athletes were analyzed using linear structural relations to test a model of accountability hypothesized as operating in these coaching settings. The accountability strategy of active instruction was found to be a variable that significantly affected the students' valuing of their coaches as well as their task involvement. However, the rewards/consequences variable was not found to be a predictor of valuing or task involvement, suggesting that these athletes seemed more task oriented than reliant on external sanctions. The results of this study can only be generalized to team sport settings. Detailed examination needs to be made of the processes through which accountability factors operate for other contexts, including individual sports and competitive levels. Further research could also be undertaken into gender differences, especially in relation to the gender of coaches.

  2. Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya.

    Science.gov (United States)

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

    2017-04-01

    This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Setting and changing feature priorities in visual short-term memory.

    Science.gov (United States)

    Kalogeropoulou, Zampeta; Jagadeesh, Akshay V; Ohl, Sven; Rolfs, Martin

    2017-04-01

    Many everyday tasks require prioritizing some visual features over competing ones, both during the selection from the rich sensory input and while maintaining information in visual short-term memory (VSTM). Here, we show that observers can change priorities in VSTM when, initially, they attended to a different feature. Observers reported from memory the orientation of one of two spatially interspersed groups of black and white gratings. Using colored pre-cues (presented before stimulus onset) and retro-cues (presented after stimulus offset) predicting the to-be-reported group, we manipulated observers' feature priorities independently during stimulus encoding and maintenance, respectively. Valid pre-cues reliably increased observers' performance (reduced guessing, increased report precision) as compared to neutral ones; invalid pre-cues had the opposite effect. Valid retro-cues also consistently improved performance (by reducing random guesses), even if the unexpected group suddenly became relevant (invalid-valid condition). Thus, feature-based attention can reshape priorities in VSTM protecting information that would otherwise be forgotten.

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

    Science.gov (United States)

    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. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Use of demand for and spatial flow of ecosystem services to identify priority areas.

    Science.gov (United States)

    Verhagen, Willem; Kukkala, Aija S; Moilanen, Atte; van Teeffelen, Astrid J A; Verburg, Peter H

    2017-08-01

    Policies and research increasingly focus on the protection of ecosystem services (ESs) through priority-area conservation. Priority areas for ESs should be identified based on ES capacity and ES demand and account for the connections between areas of ES capacity and demand (flow) resulting in areas of unique demand-supply connections (flow zones). We tested ways to account for ES demand and flow zones to identify priority areas in the European Union. We mapped the capacity and demand of a global (carbon sequestration), a regional (flood regulation), and 3 local ESs (air quality, pollination, and urban leisure). We used Zonation software to identify priority areas for ESs based on 6 tests: with and without accounting for ES demand and 4 tests that accounted for the effect of ES flow zone. There was only 37.1% overlap between the 25% of priority areas that encompassed the most ESs with and without accounting for ES demand. The level of ESs maintained in the priority areas increased from 23.2% to 57.9% after accounting for ES demand, especially for ESs with a small flow zone. Accounting for flow zone had a small effect on the location of priority areas and level of ESs maintained but resulted in fewer flow zones without ES maintained relative to ignoring flow zones. Accounting for demand and flow zones enhanced representation and distribution of ESs with local to regional flow zones without large trade-offs relative to the global ES. We found that ignoring ES demand led to the identification of priority areas in remote regions where benefits from ES capacity to society were small. Incorporating ESs in conservation planning should therefore always account for ES demand to identify an effective priority network for ESs. © 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  7. ORIGINAL ARTICLES Cost-effectiveness analysis for priority-setting ...

    African Journals Online (AJOL)

    health outcomes and wasted resources.4-5 It was found that the cost- effectiveness of South ... Priorities for Developing Countries Project was that emergency (and even some elective) ... to control air pollutants found that in South Africa the most cost- effective ..... outdoor air pollution in South Africa in 2000. S Afr Med J ...

  8. Research priority setting for integrated early child development and violence prevention (ECD+) in low and middle income countries: An expert opinion exercise.

    Science.gov (United States)

    Tomlinson, Mark; Jordans, Mark; MacMillan, Harriet; Betancourt, Theresa; Hunt, Xanthe; Mikton, Christopher

    2017-10-01

    Child development in low and middle income countries (LMIC) is compromised by multiple risk factors. Reducing children's exposure to harmful events is essential for early childhood development (ECD). In particular, preventing violence against children - a highly prevalent risk factor that negatively affects optimal child development - should be an intervention priority. We used the Child Health and Nutrition Initiative (CHNRI) method for the setting of research priorities in integrated Early Childhood Development and violence prevention programs (ECD+). An expert group was identified and invited to systematically list and score research questions. A total of 186 stakeholders were asked to contribute five research questions each, and contributions were received from 81 respondents. These were subsequently evaluated using a set of five criteria: answerability; effectiveness; feasibility and/or affordability; applicability and impact; and equity. Of the 400 questions generated, a composite group of 50 were scored by 55 respondents. The highest scoring research questions related to the training of Community Health Workers (CHW's) to deliver ECD+ interventions effectively and whether ECD+ interventions could be integrated within existing delivery platforms such as HIV, nutrition or mental health platforms. The priority research questions can direct new research initiatives, mainly in focusing on the effectiveness of an ECD+ approach, as well as on service delivery questions. To the best of our knowledge, this is the first systematic exercise of its kind in the field of ECD+. The findings from this research priority setting exercise can help guide donors and other development actors towards funding priorities for important future research related to ECD and violence prevention. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Global conservation priorities for marine turtles.

    Directory of Open Access Journals (Sweden)

    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

  10. Setting priorities for research in medical nutrition education: an international approach.

    Science.gov (United States)

    Ball, Lauren; Barnes, Katelyn; Laur, Celia; Crowley, Jennifer; Ray, Sumantra

    2016-12-14

    To identify the research priorities for medical nutrition education worldwide. A 5-step stakeholder engagement process based on methodological guidelines for identifying research priorities in health. 277 individuals were identified as representatives for 30 different stakeholder organisations across 86 countries. The stakeholder organisations represented the views of medical educators, medical students, doctors, patients and researchers in medical education. Each stakeholder representative was asked to provide up to three research questions that should be deemed as a priority for medical nutrition education. Research questions were critically appraised for answerability, sustainability, effectiveness, potential for translation and potential to impact on disease burden. A blinded scoring system was used to rank the appraised questions, with higher scores indicating higher priority (range of scores possible 36-108). 37 submissions were received, of which 25 were unique research questions. Submitted questions received a range of scores from 62 to 106 points. The highest scoring questions focused on (1) increasing the confidence of medical students and doctors in providing nutrition care to patients, (2) clarifying the essential nutrition skills doctors should acquire, (3) understanding the effectiveness of doctors at influencing dietary behaviours and (4) improving medical students' attitudes towards the importance of nutrition. These research questions can be used to ensure future projects in medical nutrition education directly align with the needs and preferences of research stakeholders. Funders should consider these priorities in their commissioning of research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Identifying trial recruitment uncertainties using a James Lind Alliance Priority Setting Partnership - the PRioRiTy (Prioritising Recruitment in Randomised Trials) study.

    Science.gov (United States)

    Healy, Patricia; Galvin, Sandra; Williamson, Paula R; Treweek, Shaun; Whiting, Caroline; Maeso, Beccy; Bray, Christopher; Brocklehurst, Peter; Moloney, Mary Clarke; Douiri, Abdel; Gamble, Carrol; Gardner, Heidi R; Mitchell, Derick; Stewart, Derek; Jordan, Joan; O'Donnell, Martin; Clarke, Mike; Pavitt, Sue H; Guegan, Eleanor Woodford; Blatch-Jones, Amanda; Smith, Valerie; Reay, Hannah; Devane, Declan

    2018-03-01

    Despite the problem of inadequate recruitment to randomised trials, there is little evidence to guide researchers on decisions about how people are effectively recruited to take part in trials. The PRioRiTy study aimed to identify and prioritise important unanswered trial recruitment questions for research. The PRioRiTy study - Priority Setting Partnership (PSP) included members of the public approached to take part in a randomised trial or who have represented participants on randomised trial steering committees, health professionals and research staff with experience of recruiting to randomised trials, people who have designed, conducted, analysed or reported on randomised trials and people with experience of randomised trials methodology. This partnership was aided by the James Lind Alliance and involved eight stages: (i) identifying a unique, relevant prioritisation area within trial methodology; (ii) establishing a steering group (iii) identifying and engaging with partners and stakeholders; (iv) formulating an initial list of uncertainties; (v) collating the uncertainties into research questions; (vi) confirming that the questions for research are a current recruitment challenge; (vii) shortlisting questions and (viii) final prioritisation through a face-to-face workshop. A total of 790 survey respondents yielded 1693 open-text answers to 6 questions, from which 1880 potential questions for research were identified. After merging duplicates, the number of questions was reduced to 496. Questions were combined further, and those that were submitted by fewer than 15 people and/or fewer than 6 of the 7 stakeholder groups were excluded from the next round of prioritisation resulting in 31 unique questions for research. All 31 questions were confirmed as being unanswered after checking relevant, up-to-date research evidence. The 10 highest priority questions were ranked at a face-to-face workshop. The number 1 ranked question was "How can randomised trials become

  12. Implementing accountability for reasonableness framework at district level in Tanzania: a realist evaluation

    Directory of Open Access Journals (Sweden)

    Ndawi Benedict

    2011-02-01

    Full Text Available Abstract Background 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 processes and outcomes. As a result, the ability to draw scientifically sound lessons for the application of the framework to services and interventions is limited. This paper evaluates the experiences of implementing the A4R approach in Mbarali District, Tanzania, in order to find out how the innovation was shaped, enabled, and constrained by the interaction between contexts, mechanisms and outcomes. Methods This study draws on the principles of realist evaluation -- a largely qualitative approach, chiefly concerned with testing and refining programme theories by exploring the complex interactions of contexts, mechanisms, and outcomes. Mixed methods were used in data collection, including individual interviews, non-participant observation, and document reviews. A thematic framework approach was adopted for the data analysis. Results The study found that while the A4R approach to priority setting was helpful in strengthening transparency, accountability, stakeholder engagement, and fairness, the efforts at integrating it into the current district health system were challenging. Participatory structures under the decentralisation framework, central government's call for partnership in district-level planning and priority setting, perceived needs of stakeholders, as well as active engagement between researchers and decision makers all facilitated the adoption and implementation of the innovation. In contrast, however, limited local autonomy, low level of public awareness, unreliable and untimely funding, inadequate accountability mechanisms, and limited local resources were the major contextual factors that hampered the full

  13. A Mathematical Analysis of Air Traffic Priority Rules

    Science.gov (United States)

    Nakawicz, Anthony J.; Munoz, Cesar A.; Maddalon, Jeffrey M.

    2012-01-01

    This paper analyzes priority rules, such as those in Part 91.113 of the Federal Aviation Regulations. Such rules determine which of two aircraft should maneuver in a given conflict scenario. While the rules in 91.113 are well accepted, other concepts of operation for NextGen, such as self separation, may allow for different priority rules. A mathematical framework is presented that can be used to analyze a general set of priority rules and enables proofs of important properties. Specific properties considered in this paper include safety, effectiveness, and stability. A set of rules is said to be safe if it ensures that it is never the case that both aircraft have priority. They are effective if exactly one aircraft has priority in every situation. Finally, a set of rules is called stable if it produces compatible results even under small changes to input data.

  14. Positioning of Emotional Intelligence Skills within the Overall Skillset of Practice-Based Accountants: Employer and Graduate Requirements

    Science.gov (United States)

    Coady, Peggy; Byrne, Seán; Casey, John

    2018-01-01

    This paper presents evidence of employer and graduate attitudes on the skill set requirements for professional accountants, and whether university accounting programs develop these skills, and in particular emotional intelligence (EI) skills. We use priority indices and strategic mapping to evaluate the positioning of 31 skills. This analysis…

  15. Diseases of livestock in the Pacific Islands region: setting priorities for food animal biosecurity.

    Science.gov (United States)

    Brioudes, Aurélie; Warner, Jeffrey; Hedlefs, Robert; Gummow, Bruce

    2015-03-01

    Most Pacific Island countries and territories (PICTs) have developing economies and face a critical shortage of veterinarians with limited financial resources allocated to their animal disease surveillance programmes. Thus, animal health authorities have to set priorities for better focusing their scarce resources. The main objective of this study was to identify animal diseases perceived to be of importance by decision makers within selected PICTs, at the regional and national levels, to ensure better targeting of animal health resources. A second objective was to investigate whether the targeted surveillance programmes resulting from this rationalized approach would also benefit the local communities engaged in livestock production. A multi-criteria prioritization process was developed, involving local experts, to score and rank 132 animal diseases based on their priority at the regional and national levels for four PICTs: Fiji, Papua New Guinea, Solomon Islands, and Vanuatu, which form part of a regional Food Animal Biosecurity Network. In parallel interviews with farmers and field animal health and production workers were conducted to assess their perception of animal diseases. The list of the top-twenty ranked diseases for the Pacific Islands region shows a mix of endemic zoonotic diseases (such as leptospirosis ranked first; brucellosis third; tuberculosis sixth; and endoparasites and ectoparasites, respectively eleventh and thirteenth) with exotic diseases (such as HPAI ranked second, FMD fifth, and rabies ninth). There were different disease ranking lists for each of the four targeted PICTs, confirming different strategies of disease prevention and control may be required for each country, rather than a regional approach. Interviewed animal health and production workers were unfamiliar with most of the prioritized diseases and a majority acknowledged that they would not be able to recognize clinical signs if outbreaks were to occur in their area

  16. Creating a Research Agenda and Setting Research Priorities for Clinical Nurse Specialists.

    Science.gov (United States)

    Foster, Jan; Bautista, Cynthia; Ellstrom, Kathleen; Kalowes, Peggy; Manning, Jennifer; Pasek, Tracy Ann

    The purpose of this article is to describe the evolution and results of the process for establishing a research agenda and identification of research priorities for clinical nurse specialists, approved by the National Association of Clinical Nurse Specialists (NACNS) membership and sanctioned by the NACNS Board of Directors. Development of the research agenda and identification of the priorities were an iterative process and involved a review of the literature; input from multiple stakeholders, including individuals with expertise in conducting research serving as task force members, and NACNS members; and feedback from national board members. A research agenda, which is to provide an enduring research platform, was established and research priorities, which are to be applied in the immediate future, were identified as a result of this process. Development of a research agenda and identification of research priorities are a key method of fulfilling the mission and goals of NACNS. The process and outcomes are described in this article.

  17. Incorporating the effects of socioeconomic uncertainty into priority setting for conservation investment.

    Science.gov (United States)

    McBride, Marissa F; Wilson, Kerrie A; Bode, Michael; Possingham, Hugh P

    2007-12-01

    Uncertainty in the implementation and outcomes of conservation actions that is not accounted for leaves conservation plans vulnerable to potential changes in future conditions. We used a decision-theoretic approach to investigate the effects of two types of investment uncertainty on the optimal allocation of global conservation resources for land acquisition in the Mediterranean Basin. We considered uncertainty about (1) whether investment will continue and (2) whether the acquired biodiversity assets are secure, which we termed transaction uncertainty and performance uncertainty, respectively. We also developed and tested the robustness of different rules of thumb for guiding the allocation of conservation resources when these sources of uncertainty exist. In the presence of uncertainty in future investment ability (transaction uncertainty), the optimal strategy was opportunistic, meaning the investment priority should be to act where uncertainty is highest while investment remains possible. When there was a probability that investments would fail (performance uncertainty), the optimal solution became a complex trade-off between the immediate biodiversity benefits of acting in a region and the perceived longevity of the investment. In general, regions were prioritized for investment when they had the greatest performance certainty, even if an alternative region was highly threatened or had higher biodiversity value. The improved performance of rules of thumb when accounting for uncertainty highlights the importance of explicitly incorporating sources of investment uncertainty and evaluating potential conservation investments in the context of their likely long-term success.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 40 CFR 146.9 - Criteria for establishing permitting priorities.

    Science.gov (United States)

    2010-07-01

    ....9 Criteria for establishing permitting priorities. In determining priorities for setting times for... priorities. 146.9 Section 146.9 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER... (a), (c), (g) or § 144.22(f), the Director shall base these priorities upon consideration of the...

  20. Generalized cost-effectiveness analysis for national-level priority-setting in the health sector

    Directory of Open Access Journals (Sweden)

    Edejer Tessa

    2003-12-01

    Full Text Available Abstract Cost-effectiveness analysis (CEA is potentially an important aid to public health decision-making but, with some notable exceptions, its use and impact at the level of individual countries is limited. A number of potential reasons may account for this, among them technical shortcomings associated with the generation of current economic evidence, political expediency, social preferences and systemic barriers to implementation. As a form of sectoral CEA, Generalized CEA sets out to overcome a number of these barriers to the appropriate use of cost-effectiveness information at the regional and country level. Its application via WHO-CHOICE provides a new economic evidence base, as well as underlying methodological developments, concerning the cost-effectiveness of a range of health interventions for leading causes of, and risk factors for, disease. The estimated sub-regional costs and effects of different interventions provided by WHO-CHOICE can readily be tailored to the specific context of individual countries, for example by adjustment to the quantity and unit prices of intervention inputs (costs or the coverage, efficacy and adherence rates of interventions (effectiveness. The potential usefulness of this information for health policy and planning is in assessing if current intervention strategies represent an efficient use of scarce resources, and which of the potential additional interventions that are not yet implemented, or not implemented fully, should be given priority on the grounds of cost-effectiveness. Health policy-makers and programme managers can use results from WHO-CHOICE as a valuable input into the planning and prioritization of services at national level, as well as a starting point for additional analyses of the trade-off between the efficiency of interventions in producing health and their impact on other key outcomes such as reducing inequalities and improving the health of the poor.

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

    Science.gov (United States)

    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.

  2. Priority setting in the Austrian healthcare system: results from a discrete choice experiment and implications for mental health.

    Science.gov (United States)

    Mentzakis, Emmanouil; Paolucci, Francesco; Rubicko, Georg

    2014-06-01

    The impact of mental conditions is expected to be among the highest ranked causes of illness in high income countries by 2020. With changing health needs, policy makers have to make choices in an environment with increasingly constrained resources and competing demands. Discrete choice experiments have been identified as a useful approach to inform and support decision-making in health care systems and, in particular, its rationing. Policymakers, researchers and health practitioners from Austria participated in an experiment designed to elicit preferences for efficiency and equity in a generic priority setting framework. Using aggregate criteria an empirical measure of the efficiency/equity trade-off is calculated and a selection of health care interventions, including mental health, are ranked in composite league tables (CLTs). With the exception of severity of the condition, all equity parameters decrease attractiveness of an intervention, whereas the opposite holds for all three efficiency criteria. The efficiency/equity ratio (i.e. decision-makers' preference for efficiency over equity) is 3.5 and 5 for interventions targeted at younger and middle age populations, respectively, while for older populations this ratio is negative implying a rejection of all equity criteria. Irrespective of such differences interventions targeting mental health rank highly on all CLTs. Based on system-wide generic decision making criteria, mental health is shown to be a top priority for Austria. Preference-based approaches might offer complementary information to policymakers in priority setting decisions and a useful tool to support rationale rather than ad hoc decision-making.

  3. Research priorities by professional background - A detailed analysis of the James Lind Alliance Priority Setting Partnership.

    Science.gov (United States)

    Arulkumaran, Nishkantha; Reay, Hannah; Brett, Stephen J

    2016-05-01

    The Intensive Care Foundation, in partnership with the James Lind Alliance, has supported a national project to identify and prioritise unanswered questions about adult intensive care that are important to people who have been critically ill, their families, and the health professionals who care for them. We conducted a secondary analysis to explore differences in priorities determined by different respondent groups in order to identify different groups' perceptions of gaps in knowledge. There were two surveys conducted as part of the original project. Survey 1 comprised a single open question to identify important research topics; survey 2 aimed to prioritise these topics using a 10-point Likert scale. In survey 1, despite clear differences in suggestions amongst the respondent groups, themes of comfort/communication and post-ICU rehabilitation were the within the top 2 suggestions across all groups. Patients and relatives suggested research topics to which they could easily relate, whereas there was a greater breadth of suggestions from clinicians. In survey 2, the number of research priorities that received a mode score of 10 varied from 1 to 36. Patients scored 36 out of the 37 topics with a mode score of 10. All other groups scored topics with more discrimination, with the number of topics with a mode score of 10 ranging from 1 to 20. Differences in the proportions of the representative groups are therefore unlikely to have translated to an impartial conclusion. Clinicians, patients, and family members have jointly identified the research priorities for UK ICM practice.

  4. Benefits of integrating complementarity into priority threat management.

    Science.gov (United States)

    Chadés, Iadine; Nicol, Sam; van Leeuwen, Stephen; Walters, Belinda; Firn, Jennifer; Reeson, Andrew; Martin, Tara G; Carwardine, Josie

    2015-04-01

    Conservation decision tools based on cost-effectiveness analysis are used to assess threat management strategies for improving species persistence. These approaches rank alternative strategies by their benefit to cost ratio but may fail to identify the optimal sets of strategies to implement under limited budgets because they do not account for redundancies. We devised a multiobjective optimization approach in which the complementarity principle is applied to identify the sets of threat management strategies that protect the most species for any budget. We used our approach to prioritize threat management strategies for 53 species of conservation concern in the Pilbara, Australia. We followed a structured elicitation approach to collect information on the benefits and costs of implementing 17 different conservation strategies during a 3-day workshop with 49 stakeholders and experts in the biodiversity, conservation, and management of the Pilbara. We compared the performance of our complementarity priority threat management approach with a current cost-effectiveness ranking approach. A complementary set of 3 strategies: domestic herbivore management, fire management and research, and sanctuaries provided all species with >50% chance of persistence for $4.7 million/year over 20 years. Achieving the same result cost almost twice as much ($9.71 million/year) when strategies were selected by their cost-effectiveness ranks alone. Our results show that complementarity of management benefits has the potential to double the impact of priority threat management approaches. © 2014 Society for Conservation Biology.

  5. Water Accounting Priorities in the American West

    Science.gov (United States)

    Hanak, E.

    2017-12-01

    In regions facing water scarcity, understanding the water balance sheet—how much there is, who has claims to it, and what is actually being "spent"—is key to effectively managing supplies to meet a wide range of societal goals. This is a common challenge across the American West, a region needing to balance the water demands of large irrigated agricultural sectors, growing urban populations, and declining aquatic ecosystems—in a context of increasingly variable, and in some cases diminishing, water supplies. Many local urban water utilities, and some irrigation water suppliers, have developed sophisticated data systems for tracking water availability and use within their systems. But there are still major gaps in essential metrics at the scale of watersheds and river basins. On the supply side, key issues include understanding groundwater availability and surface-groundwater interactions. On the demand side, the biggest challenges relate to understanding groundwater use and return flows—the water that is returned to rivers or aquifers and is available for reuse. In addition, most states lack consistent accounting and data standards for sharing water availability, claims, and use information—and transparent systems for reporting information to users in ways that facilitates oversight and flexible tools such as water trading. Drawing on a detailed study of water accounting in 12 western states and 2 countries with similar water challenges (Escriva Bou et al. 2016, Accounting for Water in Dry Regions: A Comparative Review, Public Policy Institute of California), this talk provides insights on best practices that can help fill critical water accounting gaps.

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

    Science.gov (United States)

    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. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Chapman, Glyn

    2008-01-01

    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...

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

    Science.gov (United States)

    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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. A unifying property for distribution-sensitive priority queues

    DEFF Research Database (Denmark)

    Elmasry, Amr Ahmed Abd Elmoneim; Farzan, Arash; Iacono, John

    2011-01-01

    , before) the last access of x and are still in the priority queue at the time when the corresponding operation is performed. Our priority queue then has both the working-set and the queueish properties; and, more strongly, it satisfies these properties in the worst-case sense. We also argue...... that these bounds are the best possible with respect to the considered measures. Moreover, we modify our priority queue to satisfy a new unifying property - the time-finger property - which encapsulates both the working-set and the queueish properties. In addition, we prove that the working-set bound......We present a priority queue that supports the operations: insert in worst-case constant time, and delete, delete-min, find-min and decrease-key on an element x in worst-case O(lg(min{wx, qx} + 2)) time, where wx (respectively, qx) is the number of elements that were accessed after (respectively...

  10. Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity.

    Science.gov (United States)

    Tugwell, Peter; Petkovic, Jennifer; Welch, Vivian; Vincent, Jennifer; Bhutta, Zulfiqar A; Churchill, Rachel; deSavigny, Don; Mbuagbaw, Lawrence; Pantoja, Tomas

    2017-12-02

    A focus on equity in health can be seen in many global development goals and reports, research and international declarations. With the development of a relevant framework and methods, the Campbell and Cochrane Equity Methods Group has encouraged the application of an 'equity lens' to systematic reviews, and many organizations publish reviews intended to address health equity. The purpose of the Evidence for Equity (E4E) project was to conduct a priority-setting exercise and apply an equity lens by developing a knowledge translation product comprising summaries of systematic reviews from the Cochrane Library. E4E translates evidence from systematic reviews into 'friendly front end' summaries for policy makers. The following topic areas with high burdens of disease globally, were selected for the pilot: diabetes/obesity, HIV/AIDS, malaria, nutrition, and mental health/depression. For each topic area, a "stakeholder panel" was assembled that included policymakers and researchers. A systematic search of Cochrane reviews was conducted for each area to identify equity-relevant interventions with a meaningful impact. Panel chairs developed a rating sheet which was used by all panels to rank the importance of these interventions by: 1) Ease of Implementation; 2) Health System Requirements; 3)Universality/Generalizability/Share of Burden; and 4) Impact on Inequities/Effect on equity. The ratings of panel members were averaged for each intervention and criterion, and interventions were ordered according to the average overall ratings. Stakeholder panels identified the top 10 interventions from their respective topic areas. The evidence on these interventions is being summarized with an equity focus and the results posted online, at http://methods.cochrane.org/equity/e4e-series . This method provides an explicit approach to setting priorities by systematic review groups and funders for providing decision makers with evidence for the most important equity

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Jana Rogge

    Full Text Available 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.

  14. Setting research priorities in tobacco control: a stakeholder engagement project.

    Science.gov (United States)

    Lindson, Nicola; Richards-Doran, Dan; Heath, Laura; Hartmann-Boyce, Jamie

    2017-12-01

    The Cochrane Tobacco Addiction Group (TAG) conducts systematic reviews of the evidence for tobacco cessation and prevention interventions. In 2016 TAG conducted a priority-setting, stakeholder engagement project to identify where further research is needed in the areas of tobacco control and smoking cessation. The project comprised two surveys and a workshop. A range of stakeholders participated, including members of the public (smokers and ex-smokers), clinicians, researchers, research funders, health-care commissioners and public health organizations. The first survey phase identified unanswered research questions in the field of tobacco control. The second phase asked participants to rank these, with overall rankings calculated by combining scores across participants. The workshop allowed attendees to discuss prioritization of topics and questions in more depth. Workshop discussions were transcribed and analysed thematically, and a final voting activity at the close of the workshop allowed participants to choose topics to prioritize and to de-prioritize. A total of 304 stakeholders (researchers, health professionals, smokers and ex-smokers, guideline developers, research funders and policymakers, representing 28 countries) identified 183 unanswered research questions. These were categorized into 15 research categories. A total of 175 participants prioritized categories and questions in the second survey phase, with 'electronic cigarettes'; 'addressing inequalities'; and 'mental health and other substance abuse' prioritized as the top three categories. Forty-three stakeholders attended the workshop and discussed reasons for and against category prioritization. Prioritized research categories largely mirrored those in the survey stage, although 'treatment delivery' also emerged as a key category. Five cross-cutting themes emerged: efficacy; relative efficacy; cost effectiveness; addressing inequalities; and different types of evidence. There are many unanswered

  15. 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.

    Science.gov (United States)

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

    2012-12-11

    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. 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. 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-stakeholder processes were increasingly used to identify

  16. Priority-setting in New Zealand: translating principles into practice.

    Science.gov (United States)

    Ashton, T; Cumming, J; Devlin, N

    2000-07-01

    In May 1998 the New Zealand Health Funding Authority released a discussion paper which proposed a principles-based approach to setting purchasing priorities that incorporates the economic methods of programme budgeting and marginal analysis, and cost-utility analysis. The principles upon which the process was to be based are effectiveness, cost, equity of health outcomes, Maori health and acceptability. This essay describes and critiques issues associated with translating the principles into practice, most particularly the proposed methods for evaluating the effectiveness and measuring the cost of services. It is argued that the proposals make an important contribution towards the development of a method for prioritizing services which challenges our thinking about those services and their goals, and which is systematic, explicit, and transparent. The shift towards 'thinking at the margin' and systematically reviewing the value for money of competing claims on resources is likely to improve the quality of decision-making compared with the status quo. This does not imply that prioritization can, or should, be undertaken by means of any simple formula. Any prioritization process should always be guided by informed judgement. The approach is more appropriate for some services than for others. Key methodological issues that need further consideration include the choice of instrument for measuring health gains, the identification of marginal services, how to combine qualitative and quantitative information, and how to ensure consistency across different levels of decision-making.

  17. Mapping of Florida's Coastal and Marine Resources: Setting Priorities Workshop

    Science.gov (United States)

    Robbins, Lisa; Wolfe, Steven; Raabe, Ellen

    2008-01-01

    The importance of mapping habitats and bioregions as a means to improve resource management has become increasingly clear. Large areas of the waters surrounding Florida are unmapped or incompletely mapped, possibly hindering proper management and good decisionmaking. Mapping of these ecosystems is among the top priorities identified by the Florida Oceans and Coastal Council in their Annual Science Research Plan. However, lack of prioritization among the coastal and marine areas and lack of coordination of agency efforts impede efficient, cost-effective mapping. A workshop on Mapping of Florida's Coastal and Marine Resources was sponsored by the U.S. Geological Survey (USGS), Florida Department of Environmental Protection (FDEP), and Southeastern Regional Partnership for Planning and Sustainability (SERPPAS). The workshop was held at the USGS Florida Integrated Science Center (FISC) in St. Petersburg, FL, on February 7-8, 2007. The workshop was designed to provide State, Federal, university, and non-governmental organizations (NGOs) the opportunity to discuss their existing data coverage and create a prioritization of areas for new mapping data in Florida. Specific goals of the workshop were multifold, including to: * provide information to agencies on state-of-the-art technology for collecting data; * inform participants of the ongoing mapping programs in waters off Florida; * present the mapping needs and priorities of the State and Federal agencies and entities operating in Florida; * work with State of Florida agencies to establish an overall priority for areas needing mapping; * initiate discussion of a unified classification of habitat and bioregions; * discuss and examine the need to standardize terminology and data collection/storage so that data, in particular habitat data, can be shared; 9 identify opportunities for partnering and leveraging mapping efforts among agencies and entities; * identify impediments and organizational gaps that hinder collection

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. Priority Queues Resilient to Memory Faults

    DEFF Research Database (Denmark)

    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...

  20. ACCOUNTING AND CONTROL AS SCIENCES AND ACADEMIC SUBJECTS IN ACCOUNTING AND ANALYTICAL EDUCATION

    Directory of Open Access Journals (Sweden)

    V. Shvets

    2014-09-01

    Full Text Available The knowledge of accounting and control, analysis and audit as the main instruments of cognition and management functions is an integral part of economic education, science and practice and requires improving the training of the accounting personnel in accordance with the requirements of public administration and development of global information systems of business. Real European integration processes require high qualifications and competence of the teaching staff, the development of scientific schools, intellectualization of preparation of masters and PhDs based on the traditions of patriotism, democracy and self-sufficiency. We must form a new set of modern disciplines and economic specialties and optimize the network for universities on the basis of convergent-integrative structures (clusters in education on principles of transparency and openness. The priority should be the principle of continuity of professional and analytical accounting education for business managers and civil servants. Practical implementation of the Law of Ukraine "On Higher Education" and the principles of the Bologna Declaration while training specialists in accounting and auditing will somehow harmonize national education, improve and keep elements of own competitive advantages and enrich them by the best achievements of the world practice.

  1. A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

    OpenAIRE

    Thomas, K. S.; Batchelor, J. M.; Bath-Hextall, F.; Chalmers, J. R.; Clarke, T.; Crowe, S.; Delamere, F. M.; Eleftheriadou, V.; Evans, N.; Firkins, L.; Greenlaw, N.; Lansbury, L.; Lawton, S.; Layfield, C.; Leonardi-Bee, J.

    2016-01-01

    BACKGROUND: Skin diseases are very common and can have a large impact on the quality of life of patients and caregivers. This programme addressed four diseases: (1) eczema, (2) vitiligo, (3) squamous cell skin cancer (SCC) and (4) pyoderma gangrenosum (PG). OBJECTIVE: To set priorities and reduce uncertainties for the treatment and prevention of skin disease in our four chosen diseases. DESIGN: Mixed methods including eight systematic reviews, three prioritisation exercises, tw...

  2. 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

    Directory of Open Access Journals (Sweden)

    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

  3. Politicians’ priorities and the determinants of priorities in the Swedish social services

    Directory of Open Access Journals (Sweden)

    Marie Wörlén

    2012-04-01

    Full Text Available The setting of priorities is an integrated part of social-work politics in Sweden as well as internationally. This article explores Swedish social services and how politicians on the political boards wish to make priorities and what these priorities involve. The use of regression analyses also reveals which circumstances are of importance for allocative precedence and the impact different distributive principles have. It is hard to detect clear-cut patterns of circumstances that guide the judgements in any one direction. The results show that political affiliation overall is not a determining factor for attitudes towards how priorities are made. Another result is a manifest area bias, suggesting that respondents tend to see to the interests of their own professional domain, a result most visible among the politicians involved with Care for the Elderly and Disabled (CED. Yet, with regard to allocative principles, political colour seems to matter. Conservative politicians, as expected, agree with the principles of economy and of capacity to benefit, while the socialist block, less expectedly, seems to embrace the principle of deservingness.

  4. Research priorities for public mental health in Europe

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... field. METHODS: Experts were invited to compile and discuss research priorities in a series of topic-based scientific workshops. In addition, a Delphi process was carried out to reach consensus on the list of research priorities and their rank order. Three web-based surveys were conducted. Nearly 60...... 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...

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

    International Nuclear Information System (INIS)

    Hadorn, D.C.

    2002-01-01

    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 (R 2 = 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)

  6. Evidence-informed capacity building for setting health priorities in low- and middle-income countries: A framework and recommendations for further research [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Ryan Li

    2017-03-01

    Full Text Available Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders – not only the technical capacity to “do” research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values; academics need to understand and respond to decision-makers’ needs to produce relevant research. The health system at all levels will need institutional capacity building to incentivise routine generation and use of evidence. Knowledge brokers, including priority-setting agencies (such as England’s National Institute for Health and Care Excellence, and Health Interventions and Technology Assessment Program, Thailand and the media can play an important role in facilitating engagement and knowledge transfer between the various actors. Especially at the outset but at every step, it is critical that patients and the public understand that trade-offs are inherent in priority-setting, and careful efforts should be made to engage them, and to hear their views throughout the process. There is thus no single approach to capacity building; rather a spectrum of activities that recognises the roles and skills of all stakeholders. A range of methods, including formal and informal training, networking and engagement, and support through collaboration on projects, should be flexibly employed (and tailored to specific needs of each country to support institutionalisation of evidence-informed priority-setting. Finally, capacity building should be a two-way process; those who build capacity should also attend to

  7. Budget- and Priority-Setting Criteria at State Health Agencies in Times of Austerity: A Mixed-Methods Study

    Science.gov (United States)

    Resnick, Beth; Kass, Nancy; Sellers, Katie; Young, Jessica; Bernet, Patrick; Jarris, Paul

    2014-01-01

    Objectives. We examined critical budget and priority criteria for state health agencies to identify likely decision-making factors, pressures, and opportunities in times of austerity. Methods. We have presented findings from a 2-stage, mixed-methods study with state public health leaders regarding public health budget- and priority-setting processes. In stage 1, we conducted hour-long interviews in 2011 with 45 health agency executive and division or bureau leaders from 6 states. Stage 2 was an online survey of 207 executive and division or bureau leaders from all state health agencies (66% response rate). Results. Respondents identified 5 key criteria: whether a program was viewed as “mission critical,” the seriousness of the consequences of not funding the program, financing considerations, external directives and mandates, and the magnitude of the problem the program addressed. Conclusions. We have presented empirical findings on criteria used in state health agency budgetary decision-making. These criteria suggested a focus and interest on core public health and the largest public health problems with the most serious ramifications. PMID:24825212

  8. PERSPECTIVES: Accountability for Mental Health: The Australian Experience.

    Science.gov (United States)

    Rosenberg, Sebastian; Salvador-Carulla, Luis

    2017-03-01

    or are not value for money. New approaches are needed which ensure that chosen accountability indicators reflect national health and social priorities. Such priorities must be meaningful to a range of stakeholders and the community about the state of mental health. They must drive an agenda of continuous improvement relevant to those most affected by mental disorders. These approaches should be operable in emerging international contexts. Australia must further develop its approach to health accountability in relation to mental health. A limited set of new preferred national mental health indicators should be agreed. These should be tested, both domestically and internationally, for their capacity to inform and drive quality improvement processes in mental health. Existing systems of accountability are not fit for purpose, incapable of firing necessary quality improvement processes. Supported by adequate resources, realistic targets and a culture of openness, new accountability could drive real quality improvement processes for mental health, facilitate jurisdictional comparisons in Australia, and contribute to new efforts to benchmark mental health internationally.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Priority issues affecting operators' and suppliers' liens: the Alberta perspective

    International Nuclear Information System (INIS)

    Corbett, W.T.

    1996-01-01

    Selected aspects of priority issues in contractual obligations in the petroleum industry were discussed, focusing on the priority issues claimed by suppliers and operators with respect to Alberta properties. Discussions touched upon suppliers' lien rights in Alberta, operators' set-off rights, and on some of the priority issues involving operators' liens

  12. Priority Queues Resilient to Memory Faults

    DEFF Research Database (Denmark)

    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...... queues storing only structural information in the uncorruptible registers between operations....

  13. Cost accounting models used for price-setting of health services: an international review.

    Science.gov (United States)

    Raulinajtys-Grzybek, Monika

    2014-12-01

    The aim of the article was to present and compare cost accounting models which are used in the area of healthcare for pricing purposes in different countries. Cost information generated by hospitals is further used by regulatory bodies for setting or updating prices of public health services. The article presents a set of examples from different countries of the European Union, Australia and the United States and concentrates on DRG-based payment systems as they primarily use cost information for pricing. Differences between countries concern the methodology used, as well as the data collection process and the scope of the regulations on cost accounting. The article indicates that the accuracy of the calculation is only one of the factors that determine the choice of the cost accounting methodology. Important aspects are also the selection of the reference hospitals, precise and detailed regulations and the existence of complex healthcare information systems in hospitals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap.

    Science.gov (United States)

    Cooke, Jo; Ariss, Steven; Smith, Christine; Read, Jennifer

    2015-05-07

    International policy suggests that collaborative priority setting (CPS) between researchers and end users of research should shape the research agenda, and can increase capacity to address the research-practice translational gap. There is limited research evidence to guide how this should be done to meet the needs of dynamic healthcare systems. One-off priority setting events and time-lag between decision and action prove problematic. This study illustrates the use of CPS in a UK research collaboration called Collaboration and Leadership in Applied Health Research and Care (CLAHRC). Data were collected from a north of England CLAHRC through semi-structured interviews with 28 interviewees and a workshop of key stakeholders (n = 21) including academics, NHS clinicians, and managers. Documentary analysis of internal reports and CLAHRC annual reports for the first two and half years was also undertaken. These data were thematically coded. Methods of CPS linked to the developmental phase of the CLAHRC. Early methods included pre-existing historical partnerships with on-going dialogue. Later, new platforms for on-going discussions were formed. Consensus techniques with staged project development were also used. All methods demonstrated actual or potential change in practice and services. Impact was enabled through the flexibility of research and implementation work streams; 'matched' funding arrangements to support alignment of priorities in partner organisations; the size of the collaboration offering a resource to meet project needs; and the length of the programme providing stability and long term relationships. Difficulties included tensions between being responsive to priorities and the possibility of 'drift' within project work, between academics and practice, and between service providers and commissioners in the health services. Providing protected 'matched' time proved difficult for some NHS managers, which put increasing work pressure on them. CPS is more time

  16. Gore's Controversial Priorities for Higher Education.

    Science.gov (United States)

    Gose, Ben

    2000-01-01

    Evaluates presidential candidate Al Gore's priorities for higher education, noting criticism by some educators of his emphasis on benefits for the middle class and the large number of specific proposals he has offered, including the College Opportunity Tax Cut, 21st Century Teachers' Corps, 401(j) Educational Savings Accounts, the National Tuition…

  17. Determining a Consistent Set of Accounting and Financial Reporting Standards

    OpenAIRE

    Anne Le Manh-Béna; Olivier Ramond

    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 ...

  18. [Management accounting in hospital setting].

    Science.gov (United States)

    Brzović, Z; Richter, D; Simunić, S; Bozić, R; Hadjina, N; Piacun, D; Harcet, B

    1998-12-01

    The periodic income and expenditure accounts produced at the hospital and departmental level enable successful short term management, but, in the long run do not help remove tensions between health care demand and limited resources, nor do they enable optimal medical planning within the limited financial resources. We are trying to estabilish disease category costs based on case mixing according to diagnostic categories (diagnosis related groups, DRG, or health care resource groups, HRG) and calculation of hospital standard product costs, e.g., radiology cost, preoperative nursing cost etc. The average DRG cost is composed of standard product costs plus any costs specific to a diagnostic category. As an example, current costing procedure for hip artheroplasty in the University Hospital Center Zagreb is compared to the management accounting approach based on British Health Care Resource experience. The knowledge of disease category costs based on management accounting requirements facilitates the implementation of medical programs within the given financial resources and devolves managerial responsibility closer to the clinical level where medical decisions take place.

  19. Social welfare and the Affordable Care Act: is it ever optimal to set aside comparative cost?

    Science.gov (United States)

    Mortimer, Duncan; Peacock, Stuart

    2012-10-01

    The creation of the Patient-Centered Outcomes Research Institute (PCORI) under the Affordable Care Act has set comparative effectiveness research (CER) at centre stage of US health care reform. Comparative cost analysis has remained marginalised and it now appears unlikely that the PCORI will require comparative cost data to be collected as an essential component of CER. In this paper, we review the literature to identify ethical and distributional objectives that might motivate calls to set priorities without regard to comparative cost. We then present argument and evidence to consider whether there is any plausible set of objectives and constraints against which priorities can be set without reference to comparative cost. We conclude that - to set aside comparative cost even after accounting for ethical and distributional constraints - would be truly to act as if money is no object. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Utilization Bound of Non-preemptive Fixed Priority Schedulers

    Science.gov (United States)

    Park, Moonju; Chae, Jinseok

    It is known that the schedulability of a non-preemptive task set with fixed priority can be determined in pseudo-polynomial time. However, since Rate Monotonic scheduling is not optimal for non-preemptive scheduling, the applicability of existing polynomial time tests that provide sufficient schedulability conditions, such as Liu and Layland's bound, is limited. This letter proposes a new sufficient condition for non-preemptive fixed priority scheduling that can be used for any fixed priority assignment scheme. It is also shown that the proposed schedulability test has a tighter utilization bound than existing test methods.

  1. Top 10 research priorities in head and neck cancer: Results of an Alberta priority setting partnership of patients, caregivers, family members, and clinicians.

    Science.gov (United States)

    Lechelt, Leah A; Rieger, Jana M; Cowan, Katherine; Debenham, Brock J; Krewski, Bernie; Nayar, Suresh; Regunathan, Akhila; Seikaly, Hadi; Singh, Ameeta E; Laupacis, Andreas

    2018-03-01

    The epidemiology, etiology, and management of head and neck cancer are evolving. Understanding the perspectives and priorities of nonresearchers regarding treatment uncertainties is important to inform future research. Using the James Lind Alliance approach, patients, caregivers, and clinicians responded to a survey regarding their unanswered questions about treating and managing head and neck cancer. Distinct uncertainties were extracted from responses and sorted into themes. Uncertainties already answered in the literature were removed. Those remaining were ranked by patients and clinicians to develop a short list of priorities, which were discussed at a workshop and reduced to the top 10. One hundred sixty-one respondents posed 818 uncertainties, culminating in 77 for interim ranking and 27 for discussion at a workshop. Participants reached consensus on the top 10, which included questions on prevention, screening, treatment, and quality of life. Nonresearchers can effectively collaborate to establish priorities for future research in head and neck cancer. © 2017 Wiley Periodicals, Inc.

  2. Setting priorities for surveillance, prevention, and control of zoonoses in Bogotá, Colombia.

    Science.gov (United States)

    Cediel, Natalia; Villamil, Luis Carlos; Romero, Jaime; Renteria, Libardo; De Meneghi, Daniele

    2013-05-01

    To establish priorities for zoonoses surveillance, prevention, and control in Bogotá, Colombia. A Delphi panel of experts in veterinary and human medicine was conducted using a validated prioritization method to assess the importance of 32 selected zoonoses. This exercise was complemented by a questionnaire survey, using the knowledge, attitudes, and practices (KAP) methodology, administered in 19 districts of Bogotá from September 2009 to April 2010 to an at-risk population (workers at veterinary clinics; pet shops; butcher shops; and traditional food markets that sell poultry, meat, cheese, and eggs). A risk indicator based on level of knowledge about zoonoses was constructed using categorical principal component and logistic regression analyses. Twelve experts participated in the Delphi panel. The diseases scored as highest priority were: influenza A(H1N1), salmonellosis, Escherichia coli infection, leptospirosis, and rabies. The diseases scored as lowest priority were: ancylostomiasis, scabies, ringworm, and trichinellosis. A total of 535 questionnaires were collected and analyzed. Respondents claimed to have had scabies (21%), fungi (8%), brucellosis (8%), and pulicosis (8%). Workers with the most limited knowledge on zoonoses and therefore the highest health risk were those who 1) did not have a professional education, 2) had limited or no zoonoses prevention training, and 3) worked in Usme, Bosa, or Ciudad Bolívar districts. According to the experts, influenza A(H1N1) was the most important zoonoses. Rabies, leptospirosis, brucellosis, and toxoplasmosis were identified as priority diseases by both the experts and the exposed workers. This is the first prioritization exercise focused on zoonoses surveillance, prevention, and control in Colombia. These results could be used to guide decision-making for resource allocation in public health.

  3. Establishing and prioritizing research questions for the prevention, diagnosis and treatment of hair loss (excluding alopecia areata): the Hair Loss Priority Setting Partnership.

    Science.gov (United States)

    Macbeth, A; Tomlinson, J; Messenger, A; Moore-Millar, K; Michaelides, C; Shipman, A; Kassim, J; Brockley, J; Szczecinska, W; Farrant, P; Robinson, R; Rodgers, J; Chambers, J; Upadhyaya, S; Harries, M

    2018-02-01

    Hair and scalp problems are common. Unfortunately, many uncertainties exist around the most effective management and treatment strategies for these disorders. To identify uncertainties in hair-loss management, prevention, diagnosis and treatment that are important to both people with hair loss and healthcare professionals. A Hair Loss Priority Setting Partnership was established between patients, their carers and relatives, and healthcare professionals to identify the most important uncertainties in hair loss. The methodology of the James Lind Alliance was followed to ensure a balanced, inclusive and transparent process. In total, 2747 treatment uncertainties were submitted by 912 participants; following exclusions 884 uncertainties relating to hair loss (excluding alopecia areata) were analysed. Questions were combined into 'indicative uncertainties' following a structured format. A series of ranking exercises further reduced this list to a top 25 that was taken to a final prioritization workshop where the top 10 priorities were agreed. We present the top 10 research priorities for hair loss (excluding alopecia areata) to guide researchers and funding bodies to support studies important to both patients and clinicians. © 2017 British Association of Dermatologists.

  4. Model Checking Timed Automata with Priorities using DBM Subtraction

    DEFF Research Database (Denmark)

    David, Alexandre; Larsen, Kim Guldstrand; Pettersson, Paul

    2006-01-01

    In this paper we describe an extension of timed automata with priorities, and efficient algorithms to compute subtraction on DBMs (difference bounded matrices), needed in symbolic model-checking of timed automata with priorities. The subtraction is one of the few operations on DBMs that result...... in a non-convex set needing sets of DBMs for representation. Our subtraction algorithms are efficient in the sense that the number of generated DBMs is significantly reduced compared to a naive algorithm. The overhead in time is compensated by the gain from reducing the number of resulting DBMs since...... this number affects the performance of symbolic model-checking. The uses of the DBM subtraction operation extend beyond timed automata with priorities. It is also useful for allowing guards on transitions with urgent actions, deadlock checking, and timed games....

  5. Setting priorities in health research using the model proposed by the World Health Organization: development of a quantitative methodology using tuberculosis in South Africa as a worked example.

    Science.gov (United States)

    Hacking, Damian; Cleary, Susan

    2016-02-09

    Setting priorities is important in health research given the limited resources available for research. Various guidelines exist to assist in the priority setting process; however, priority setting still faces significant challenges such as the clear ranking of identified priorities. The World Health Organization (WHO) proposed a Disability Adjusted Life Year (DALY)-based model to rank priorities by research area (basic, health systems and biomedical) by dividing the DALYs into 'unavertable with existing interventions', 'avertable with improved efficiency' and 'avertable with existing but non-cost-effective interventions', respectively. However, the model has conceptual flaws and no clear methodology for its construction. Therefore, the aim of this paper was to amend the model to address these flaws, and develop a clear methodology by using tuberculosis in South Africa as a worked example. An amended model was constructed to represent total DALYs as the product of DALYs per person and absolute burden of disease. These figures were calculated for all countries from WHO datasets. The lowest figures achieved by any country were assumed to represent 'unavertable with existing interventions' if extrapolated to South Africa. The ratio of 'cost per patient treated' (adjusted for purchasing power and outcome weighted) between South Africa and the best country was used to calculate the 'avertable with improved efficiency section'. Finally, 'avertable with existing but non-cost-effective interventions' was calculated using Disease Control Priorities Project efficacy data, and the ratio between the best intervention and South Africa's current intervention, irrespective of cost. The amended model shows that South Africa has a tuberculosis burden of 1,009,837.3 DALYs; 0.009% of DALYs are unavertable with existing interventions and 96.3% of DALYs could be averted with improvements in efficiency. Of the remaining DALYs, a further 56.9% could be averted with existing but non

  6. Setting priorities for a research agenda to combat drug-resistant tuberculosis in children.

    Science.gov (United States)

    Velayutham, B; Nair, D; Ramalingam, S; Perez-Velez, C M; Becerra, M C; Swaminathan, S

    2015-12-21

    Numerous knowledge gaps hamper the prevention and treatment of childhood drug-resistant tuberculosis (TB). Identifying research priorities is vital to inform and develop strategies to address this neglected problem. To systematically identify and rank research priorities in childhood drug-resistant TB. Adapting the Child Health and Nutrition Research Initiative (CHNRI) methodology, we compiled 53 research questions in four research areas, then classified the questions into three research types. We invited experts in childhood drug-resistant TB to score these questions through an online survey. A total of 81 respondents participated in the survey. The top-ranked research question was to identify the best combination of existing diagnostic tools for early diagnosis. Highly ranked treatment-related questions centred on the reasons for and interventions to improve treatment outcomes, adverse effects of drugs and optimal treatment duration. The prevalence of drug-resistant TB was the highest-ranked question in the epidemiology area. The development type questions that ranked highest focused on interventions for optimal diagnosis, treatment and modalities for treatment delivery. This is the first effort to identify and rank research priorities for childhood drug-resistant TB. The result is a resource to guide research to improve prevention and treatment of drug-resistant TB in children.

  7. Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership.

    Science.gov (United States)

    Morris, Rebecca Lauren; Stocks, Susan Jill; Alam, Rahul; Taylor, Sian; Rolfe, Carly; Glover, Steven William; Whitcombe, Joanne; Campbell, Stephen M

    2018-02-28

    To identify the top 10 unanswered research questions for primary care patient safety research. A modified nominal group technique. UK. Anyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions. A top 10, and top 30, future research questions for primary care patient safety. 443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality. This study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Optimal purely functional priority queues

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Okasaki, Chris

    1996-01-01

    Brodal recently introduced the first implementation of imperative priority queues to support findMin, insert and meld in O(1) worst-case time, and deleteMin in O(log n) worst-case time. These bounds are asymptotically optimal among all comparison-based priority queues. In this paper, we adapt...... Brodal's data structure to a purely functional setting. In doing so, we both simplify the data structure and clarify its relationship to the binomial queues of Vuillemin, which support all four operations in O(log n) time. Specifically, we derive our implementation from binomial queues in three steps......: first, we reduce the running time of insert to O(1) by eliminating the possibility of cascading links; second, we reduce the running time of findMin to O(1) by adding a global root to hold the minimum element; and finally, we reduce the running time of meld to O(1) by allowing priority queues to contain...

  9. Gas priority users consultation : government response

    International Nuclear Information System (INIS)

    2007-01-01

    This consultation document presents the results of an updated analysis of gas priority users comments on the UK government's proposals for updating the current priority lists, amending the eligibility criteria for priority user status, and simplifying the administration of the scheme. The extension of Category C priority users to include sites where interruption of gas supplies would lead to damage exceeding fifty million pounds to a plant at another site is discussed. It is acknowledged that there is a preference for a reduction of gas demand as opposed to a cessation in the case of an emergency gas supply deficit and details are given of a Task Group set up to examine options for reducing demand rather than cessation for large industrial gas users. The role of the Network Emergency Co-ordinator, support for a more flexible approach, pre-agreed rota interruption, a long-duration emergency, demand reduction, and the establishment of a Government/Industry Gas/Electricity Task Group are discussed, and the raising of the load shedding threshold of 25,000 therms/yr is considered

  10. THE IMPLEMENTATION OF STRATEGIC MANAGEMENT ACCOUNTING BASED ON VALUE CHAIN ANALYSIS: VALUE CHAIN ACCOUNTING

    OpenAIRE

    KIRLI, Mustafa; GÜMÜŞ, Harun

    2011-01-01

    To compete successfully in today’s highly competitive global environment, companies have made customer satisfaction an overriding priority. They have also adopted new management approaches, changed their manufacturing systems and invested in new technologies. Strategic management accounting examines the decision-making linked with the business operations and strategic work of financial administration as support for the same. Strategic management accounting is a theory and practice of ac...

  11. Social accounting and social audit in the UK

    DEFF Research Database (Denmark)

    Spear, Roger

    2010-01-01

    There are many different types of evaluation. But evaluative frameworks are becoming increasingly elaborated: accountancy frameworks to include social/environmental accounting; public sector priorities now objectified and measurable with advent of NPM. Thus social economy organisations...

  12. Use of demand for and spatial flow of ecosystem services to identify priority areas

    NARCIS (Netherlands)

    Verhagen, Willem; Kukkala, Aija S.; Moilanen, Atte; van Teeffelen, Astrid J.A.; Verburg, Peter H.

    2017-01-01

    Policies and research increasingly focus on the protection of ecosystem services (ESs) through priority-area conservation. Priority areas for ESs should be identified based on ES capacity and ES demand and account for the connections between areas of ES capacity and demand (flow) resulting in areas

  13. Use of programme budgeting and marginal analysis to set priorities for local NHS dental services: learning from the north east of England.

    Science.gov (United States)

    Holmes, R D; Steele, J G; Exley, C; Vernazza, C R; Donaldson, C

    2018-05-03

    Priority setting is necessary where competing demands exceed the finite resources available. The aim of the study was to develop and test a prioritization framework based upon programme budgeting and marginal analysis (PBMA) as a tool to assist National Health Service (NHS) commissioners in their management of resources for local NHS dental services. Twenty-seven stakeholders (5 dentists, 8 commissioners and 14 patients) participated in a case-study based in a former NHS commissioning organization in the north of England. Stakeholders modified local decision-making criteria and applied them to a number of different scenarios. The majority of financial resources for NHS dental services in the commissioning organization studied were allocated to primary care dental practitioners' contracts in perpetuity, potentially constraining commissioners' abilities to shift resources. Compiling the programme budget was successful, but organizational flux and difficulties engaging local NHS commissioners significantly impacted upon the marginal analysis phase. NHS dental practitioners' contracts resemble budget-silos which do not facilitate local resource reallocation. 'Context-specific' factors significantly challenged the successful implementation and impact of PBMA. A local PBMA champion embedded within commissioning organizations should be considered. Participants found visual depiction of the cost-value ratio helpful during their initial priority setting deliberations.

  14. Setting Global Research Priorities for Developmental Disabilities, Including Intellectual Disabilities and Autism

    Science.gov (United States)

    Tomlinson, M.; Yasamy, M. T.; Emerson, E.; Officer, A.; Richler, D.; Saxena, S.

    2014-01-01

    Objectives: The prevalence of intellectual disabilities (ID) has been estimated at 10.4/1000 worldwide with higher rates among children and adolescents in lower income countries. The objective of this paper is to address research priorities for development disabilities, notably ID and autism, at the global level and to propose the more rational…

  15. Comparing the sustainability impacts of solar thermal and natural gas combined cycle for electricity production in Mexico: Accounting for decision makers' priorities

    Science.gov (United States)

    Rodríguez-Serrano, Irene; Caldés, Natalia; Oltra, Christian; Sala, Roser

    2017-06-01

    The aim of this paper is to conduct a comprehensive sustainability assessment of the electricity generation with two alternative electricity generation technologies by estimating its economic, environmental and social impacts through the "Framework for Integrated Sustainability Assessment" (FISA). Based on a Multiregional Input Output (MRIO) model linked to a social risk database (Social Hotspot Database), the framework accounts for up to fifteen impacts across the three sustainability pillars along the supply chain of the electricity production from Solar Thermal Electricity (STE) and Natural Gas Combined Cycle (NGCC) technologies in Mexico. Except for value creation, results show larger negative impacts for NGCC, particularly in the environmental pillar. Next, these impacts are transformed into "Aggregated Sustainability Endpoints" (ASE points) as a way to support the decision making in selecting the best sustainable project. ASE points obtained are later compared to the resulting points weighted by the reported priorities of Mexican decision makers in the energy sector obtained from a questionnaire survey. The comparison shows that NGCC achieves a 1.94 times worse negative score than STE, but after incorporating decision makerś priorities, the ratio increases to 2.06 due to the relevance given to environmental impacts such as photochemical oxidants formation and climate change potential, as well as social risks like human rights risks.

  16. Setting priorities in the health care sector - the case of oral anticoagulants in nonvalvular atrial fibrillation in Denmark.

    Science.gov (United States)

    Poulsen, Peter Bo; Johnsen, Søren Paaske; Hansen, Morten Lock; Brandes, Axel; Husted, Steen; Harboe, Louise; Dybro, Lars

    2017-01-01

    Resources devoted to health care are limited, therefore setting priorities is required. It differs between countries whether decision-making concerning health care technologies focus on broad economic perspectives or whether focus is narrow on single budgets ("silo mentality"). The cost perspective as one part of the full health economic analysis is important for decision-making. With the case of oral anticoagulants in patients with nonvalvular atrial fibrillation (NVAF), the aim is to discuss the implication of the use of different cost perspectives for decision-making and priority setting. In a cost analysis, the annual average total costs of five oral anticoagulants (warfarin and non-vitamin K oral anticoagulants [NOACs; dabigatran, rivaroxaban, apixaban, and edoxaban]) used in daily clinical practice in Denmark for the prevention of stroke in NVAF patients are analyzed. This is done in pairwise comparisons between warfarin and each NOAC based on five potential cost perspectives, from a "drug cost only" perspective up to a "societal" perspective. All comparisons of warfarin and NOACs show that the cost perspective based on all relevant costs, ie, total costs perspective, is essential for the choice of therapy. Focusing on the reimbursement costs of the drugs only, warfarin is the least costly option. However, with the aim of therapy to prevent strokes and limit bleedings, including the economic impact of this, all NOACs, except rivaroxaban, result in slightly lower health care costs compared with warfarin. The same picture was found applying the societal perspective. Many broad cost-effectiveness analyses of NOACs exist. However, in countries with budget focus in decision-making this information does not apply. The present study's case of oral anticoagulants has shown that decision-making should be based on health care or societal cost perspectives for optimal use of limited resources. Otherwise, the risk is that suboptimal decisions will be likely.

  17. Determining priorities of current and long-range pollution control projects

    Energy Technology Data Exchange (ETDEWEB)

    Clark, E O

    1977-01-01

    The dilemma facing corporations of setting priorities on pollution control projects is reviewed and procedural guidelines outlined. The management must support those assigned to analyze priorities so that they have the opportunity to experiment and make quantitative studies, to evaluate their results, and to make independent recommendations. Priority is then given to the problems of air, noise, water, and land pollution in accordance with the company's environmental record. Each of the four categories, however, has its own legal, technical, and financial aspects that require further priority analysis. Each company must adopt and publish a regularly updated environmental policy that will have public visibility. (DCK)

  18. Can wide consultation help with setting priorities for large-scale biodiversity monitoring programs?

    Directory of Open Access Journals (Sweden)

    Frédéric Boivin

    Full Text Available Climate and other global change phenomena affecting biodiversity require monitoring to track ecosystem changes and guide policy and management actions. Designing a biodiversity monitoring program is a difficult task that requires making decisions that often lack consensus due to budgetary constrains. As monitoring programs require long-term investment, they also require strong and continuing support from all interested parties. As such, stakeholder consultation is key to identify priorities and make sound design decisions that have as much support as possible. Here, we present the results of a consultation conducted to serve as an aid for designing a large-scale biodiversity monitoring program for the province of Québec (Canada. The consultation took the form of a survey with 13 discrete choices involving tradeoffs in respect to design priorities and 10 demographic questions (e.g., age, profession. The survey was sent to thousands of individuals having expected interests and knowledge about biodiversity and was completed by 621 participants. Overall, consensuses were few and it appeared difficult to create a design fulfilling the priorities of the majority. Most participants wanted 1 a monitoring design covering the entire territory and focusing on natural habitats; 2 a focus on species related to ecosystem services, on threatened and on invasive species. The only demographic characteristic that was related to the type of prioritization was the declared level of knowledge in biodiversity (null to high, but even then the influence was quite small.

  19. Can wide consultation help with setting priorities for large-scale biodiversity monitoring programs?

    Science.gov (United States)

    Boivin, Frédéric; Simard, Anouk; Peres-Neto, Pedro

    2014-01-01

    Climate and other global change phenomena affecting biodiversity require monitoring to track ecosystem changes and guide policy and management actions. Designing a biodiversity monitoring program is a difficult task that requires making decisions that often lack consensus due to budgetary constrains. As monitoring programs require long-term investment, they also require strong and continuing support from all interested parties. As such, stakeholder consultation is key to identify priorities and make sound design decisions that have as much support as possible. Here, we present the results of a consultation conducted to serve as an aid for designing a large-scale biodiversity monitoring program for the province of Québec (Canada). The consultation took the form of a survey with 13 discrete choices involving tradeoffs in respect to design priorities and 10 demographic questions (e.g., age, profession). The survey was sent to thousands of individuals having expected interests and knowledge about biodiversity and was completed by 621 participants. Overall, consensuses were few and it appeared difficult to create a design fulfilling the priorities of the majority. Most participants wanted 1) a monitoring design covering the entire territory and focusing on natural habitats; 2) a focus on species related to ecosystem services, on threatened and on invasive species. The only demographic characteristic that was related to the type of prioritization was the declared level of knowledge in biodiversity (null to high), but even then the influence was quite small.

  20. Research Priorities in Spasmodic Dysphonia

    Science.gov (United States)

    Ludlow, Christy L.; Adler, Charles H.; Berke, Gerald S.; Bielamowicz, Steven A.; Blitzer, Andrew; Bressman, Susan B.; Hallett, Mark; Jinnah, H. A.; Juergens, Uwe; Martin, Sandra B.; Perlmutter, Joel S.; Sapienza, Christine; Singleton, Andrew; Tanner, Caroline M.; Woodson, Gayle E.

    2009-01-01

    OBJECTIVE To identify research priorities for increasing understanding of the pathogenesis, diagnosis and improved treatment of spasmodic dysphonia. STUDY DESIGN AND SETTING A multidisciplinary working group was formed including both scientists and clinicians from multiple disciplines, otolaryngology, neurology, speech pathology, genetics and neuroscience, to review currently available information on spasmodic dysphonia and to identify research priorities. RESULTS Operational definitions for spasmodic dysphonia at different levels of certainty were recommended for diagnosis and recommendations made for a multi-center multidisciplinary validation study. CONCLUSIONS The highest priority is to characterize the disorder and identify risk factors that may contribute to its onset. Future research should compare and contrast spasmodic dysphonia with other forms of focal dystonia. Development of animal models is recommended to explore hypotheses related to pathogenesis. Improved understanding of the pathophysiology of SD should provide the basis for developing new treatment options and exploratory clinical trials. SIGNIFICANCE This document should foster future research to improve the care of patients with this chronic debilitating voice and speech disorder by otolaryngology, neurology, and speech pathology. PMID:18922334

  1. Approaches, tools and methods used for setting priorities in health research in the 21(st) century.

    Science.gov (United States)

    Yoshida, Sachiyo

    2016-06-01

    Health research is difficult to prioritize, because the number of possible competing ideas for research is large, the outcome of research is inherently uncertain, and the impact of research is difficult to predict and measure. A systematic and transparent process to assist policy makers and research funding agencies in making investment decisions is a permanent need. To obtain a better understanding of the landscape of approaches, tools and methods used to prioritize health research, I conducted a methodical review using the PubMed database for the period 2001-2014. A total of 165 relevant studies were identified, in which health research prioritization was conducted. They most frequently used the CHNRI method (26%), followed by the Delphi method (24%), James Lind Alliance method (8%), the Combined Approach Matrix (CAM) method (2%) and the Essential National Health Research method (priorities were set. A further 19% used a combination of expert panel interview and focus group discussion ("consultation process") but provided few details, while a further 2% used approaches that were clearly described, but not established as a replicable method. Online surveys that were not accompanied by face-to-face meetings were used in 8% of studies, while 9% used a combination of literature review and questionnaire to scrutinise the research options for prioritization among the participating experts. The number of priority setting exercises in health research published in PubMed-indexed journals is increasing, especially since 2010. These exercises are being conducted at a variety of levels, ranging from the global level to the level of an individual hospital. With the development of new tools and methods which have a well-defined structure - such as the CHNRI method, James Lind Alliance Method and Combined Approach Matrix - it is likely that the Delphi method and non-replicable consultation processes will gradually be replaced by these emerging tools, which offer more

  2. Approaches, tools and methods used for setting priorities in health research in the 21st century

    Science.gov (United States)

    Yoshida, Sachiyo

    2016-01-01

    Background Health research is difficult to prioritize, because the number of possible competing ideas for research is large, the outcome of research is inherently uncertain, and the impact of research is difficult to predict and measure. A systematic and transparent process to assist policy makers and research funding agencies in making investment decisions is a permanent need. Methods To obtain a better understanding of the landscape of approaches, tools and methods used to prioritize health research, I conducted a methodical review using the PubMed database for the period 2001–2014. Results A total of 165 relevant studies were identified, in which health research prioritization was conducted. They most frequently used the CHNRI method (26%), followed by the Delphi method (24%), James Lind Alliance method (8%), the Combined Approach Matrix (CAM) method (2%) and the Essential National Health Research method (priorities were set. A further 19% used a combination of expert panel interview and focus group discussion (“consultation process”) but provided few details, while a further 2% used approaches that were clearly described, but not established as a replicable method. Online surveys that were not accompanied by face–to–face meetings were used in 8% of studies, while 9% used a combination of literature review and questionnaire to scrutinise the research options for prioritization among the participating experts. Conclusion The number of priority setting exercises in health research published in PubMed–indexed journals is increasing, especially since 2010. These exercises are being conducted at a variety of levels, ranging from the global level to the level of an individual hospital. With the development of new tools and methods which have a well–defined structure – such as the CHNRI method, James Lind Alliance Method and Combined Approach Matrix – it is likely that the Delphi method and non–replicable consultation processes will gradually be

  3. Setting Quality Improvement Priorities for Women Receiving Systemic Therapy for Early-Stage Breast Cancer by Using Population-Level Administrative Data.

    Science.gov (United States)

    Enright, Katherine A; Taback, Nathan; Powis, Melanie Lynn; Gonzalez, Alejandro; Yun, Lingsong; Sutradhar, Rinku; Trudeau, Maureen E; Booth, Christopher M; Krzyzanowska, Monika K

    2017-10-01

    Purpose Routine evaluation of quality measures (QMs) can drive improvement in cancer systems by highlighting gaps in care. Targeting quality improvement at QMs that demonstrate substantial variation has the potential to make the largest impact at the population level. We developed an approach that uses both variation in performance and number of patients affected by the QM to set priorities for improving the quality of systemic therapy for women with early-stage breast cancer (EBC). Patients and Methods Patients with EBC diagnosed from 2006 to 2010 in Ontario, Canada, were identified in the Ontario Cancer Registry and linked deterministically to multiple health care databases. Individual QMs within a panel of 15 QMs previously developed to assess the quality of systemic therapy across four domains (access, treatment delivery, toxicity, and safety) were ranked on interinstitutional variation in performance (using interquartile range) and the number of patients who were affected; then the two rankings were averaged for a summative priority ranking. Results We identified 28,427 patients with EBC who were treated at 84 institutions. The use of computerized physician electronic order entry for chemotherapy, emergency room visits or hospitalizations during chemotherapy, and timely receipt of chemotherapy were identified as the QMs that had the largest potential to improve quality of care at a system level within this cohort. Conclusion A simple ranking system based on interinstitutional variation in performance and patient volume can be used to identify high-priority areas for quality improvement from a population perspective. This approach is generalizable to other health care systems that use QMs to drive improvement.

  4. Research priorities for the influence of gender on diagnostic imaging choices in the emergency department setting.

    Science.gov (United States)

    Ashurst, John V; Cherney, Alan R; Evans, Elizabeth M; Kennedy Hall, Michael; Hess, Erik P; Kline, Jeffrey A; Mitchell, Alice M; Mills, Angela M; Weigner, Michael B; Moore, Christopher L

    2014-12-01

    Diagnostic imaging is a cornerstone of patient evaluation in the acute care setting, but little effort has been devoted to understanding the appropriate influence of sex and gender on imaging choices. This article provides background on this issue and a description of the working group and consensus findings reached during the diagnostic imaging breakout session at the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." Our goal was to determine research priorities for how sex and gender may (or should) affect imaging choices in the acute care setting. Prior to the conference, the working group identified five areas for discussion regarding the research agenda in sex- and gender-based imaging using literature review and expert consensus. The nominal group technique was used to identify areas for discussion for common presenting complaints to the emergency department where ionizing radiation is often used for diagnosis: suspected pulmonary embolism, suspected kidney stone, lower abdominal pain with a concern for appendicitis, and chest pain concerning for coronary artery disease. The role of sex- and gender-based shared decision-making in diagnostic imaging decisions is also raised. © 2014 by the Society for Academic Emergency Medicine.

  5. ACCOUNTING STANDARD SETTING IN THE INTERNATIONAL ARENA: UPDATE ON THE CONVERGENCE PROJECT

    Directory of Open Access Journals (Sweden)

    Bonaci Carmen Giorgiana

    2012-07-01

    Full Text Available Our paper contributes to the literature on international accounting by focusing on the standard setting process. As documented by research literature, accounting regulation can enhance corporate governance (Melis and Carta, 2010, corporate reporting being expected to reduce information asymmetry. Based on accounting research and trade literature we first synthesize recent evolutions in the international accounting arena. We therefore position our study within current realities significantly marked by uncertainty in relation to the world wide globalization process. The objective of our paper is to perform an analysis that would help assess further developments of the convergence project. This is done by looking at the current status of the projects being developed under the IASB –FASB collaboration, as well as by developing a comparison between IFRS and US GAAP. The employed research methodology relies on analyzing data provided through the IASB and the FASB’s websites, as well as other official documents being issued by the two Boards. The assessment of the projects was done by reviewing exposure documents and monitoring the Boards’ deliberations, while the developed comparison requires accounting regulations content analysis. Concluding upon the Boards’ ongoing projects, we might identify areas in which convergence seems to be quite close (such as revenue recognition and leasing, but also areas in which convergence becomes even more challenging (such as financial instruments or the particular case of offsetting. Similar to other studies being developed within accounting research and trade literature (SEC 2011: 8 we may conclude that, generally, US GAAP present more detailed, specific requirements than IFRS.

  6. STRATEGIC PRIORITIES FOR THE INTERNAL MIGRATION PROCESSES REGULATION IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Olga Balueva

    2018-01-01

    Full Text Available As the result of the annexation of the Crimea and Donbass military conflict, there was an emergence of forced migration. It ought to be emphasized that today issues related to addressing problems of internally displaced persons (IDPs, are relevant and require an integrated approach. The increase in the number of IDPs in the country raises the issue of identifying the strategic priorities of the state policy. The purpose of this research is to formulate strategic priorities of the state policy of support for IDPs’. The subject of the study is theoretical and methodological principles of the state policy to support IDPs. The research methodology includes a set of scientific research methods that provide identifying the strategic priorities of the state policy for IDPs’ support, developing effective mechanisms for these priorities achievement, and conceptual vision of solving IDPs’ problems. In the course of investigations, the following methods are used: analysis while studying the main problems of internally displaced persons; logical synthesis and synthesis while drawing conclusions. Results. Scientific novelty of the article. In the article, the conceptual foundations of the IDPs support have been formed, an attention has been focused on the feasibility of using a strategic approach, which involves the formation and implementation of a set of strategically oriented measures aimed at solving the most acute issues and matters related to internal forced migration, directing the IDPs potential and internally displaced businesses to strengthen local communities and social and economic development of the resettlement territories. The main stages and conceptual foundations for the Strategy formation on the IDPs support have been proposed. The strategy is based on an integrated approach to addressing IDPs and internally displaced businesses, taking into account the interests of host communities. Practical implications. The result of the Strategy

  7. Priority pricing in electricity supply. An application for Israel

    Energy Technology Data Exchange (ETDEWEB)

    Beenstock, Michael; Goldin, Ephraim [Hebrew University of Jerusalem, Department of Economics, Mount Scopus, Jerusalem (Israel)

    1997-06-01

    It is well known that in the event of a shortage in generation capacity, it is inefficient if the electricity utility cuts off customers randomly. It is preferable to set up a market in service priority in which customers who have a greater need pay more for the right not to be cut off. We use an econometric model of outage costs in Israel to calculate the menu of priority rates by season and time of day. Top priority rates range from zero, when the loss-of-load probability (LOLP) is zero, to 8 cents (US) per kWh when the LOLP is greatest

  8. Biodiversity, Urban Areas, and Agriculture: Locating Priority Ecoregions for Conservation

    Directory of Open Access Journals (Sweden)

    Taylor Ricketts

    2003-12-01

    Full Text Available Urbanization and agriculture are two of the most important threats to biodiversity worldwide. The intensities of these land-use phenomena, however, as well as levels of biodiversity itself, differ widely among regions. Thus, there is a need to develop a quick but rigorous method of identifying where high levels of human threats and biodiversity coincide. These areas are clear priorities for biodiversity conservation. In this study, we combine distribution data for eight major plant and animal taxa (comprising over 20,000 species with remotely sensed measures of urban and agricultural land use to assess conservation priorities among 76 terrestrial ecoregions in North America. We combine the species data into overall indices of richness and endemism. We then plot each of these indices against the percent cover of urban and agricultural land in each ecoregion, resulting in four separate comparisons. For each comparison, ecoregions that fall above the 66th quantile on both axes are identified as priorities for conservation. These analyses yield four "priority sets" of 6-16 ecoregions (8-21% of the total number where high levels of biodiversity and human land use coincide. These ecoregions tend to be concentrated in the southeastern United States, California, and, to a lesser extent, the Atlantic coast, southern Texas, and the U.S. Midwest. Importantly, several ecoregions are members of more than one priority set and two ecoregions are members of all four sets. Across all 76 ecoregions, urban cover is positively correlated with both species richness and endemism. Conservation efforts in densely populated areas therefore may be equally important (if not more so as preserving remote parks in relatively pristine regions.

  9. Priority and Negotiation Based Dynamic Spectrum Allocation Scheme for Multiple Radio Access Network Operators

    Science.gov (United States)

    Kim, Hoon; Hyon, Taein; Lee, Yeonwoo

    Most of previous works have presented the dynamic spectrum allocation (DSA) gain achieved by utilizing the time or regional variations in traffic demand between multi-network operators (NOs). In this paper, we introduce the functionalities required for the entities related with the spectrum sharing and allocation and propose a spectrum allocation algorithm while considering the long-term priority between NOs, the priority between multiple class services, and the urgent bandwidth request. To take into account the priorities among the NOs and the priorities of multiple class services, a spectrum sharing metric (SSM) is proposed, while a negotiation procedure is proposed to treat the urgent bandwidth request.

  10. The role of sophisticated accounting system in strategy management

    OpenAIRE

    Naranjo Gil, David

    2004-01-01

    Organizations are designing more sophisticated accounting information systems to meet the strategic goals and enhance their performance. This study examines the effect of accounting information system design on the performance of organizations pursuing different strategic priorities. The alignment between sophisticated accounting information systems and organizational strategy is analyzed. The enabling effect of the accounting information system on performance is also examined. Relationships ...

  11. Involving citizens in priority setting for public health research: Implementation in infection research.

    Science.gov (United States)

    Rawson, Timothy M; Castro-Sánchez, Enrique; Charani, Esmita; Husson, Fran; Moore, Luke S P; Holmes, Alison H; Ahmad, Raheelah

    2018-02-01

    Public sources fund the majority of UK infection research, but citizens currently have no formal role in resource allocation. To explore the feasibility and willingness of citizens to engage in strategic decision making, we developed and tested a practical tool to capture public priorities for research. A scenario including six infection themes for funding was developed to assess citizen priorities for research funding. This was tested over two days at a university public festival. Votes were cast anonymously along with rationale for selection. The scenario was then implemented during a three-hour focus group exploring views on engagement in strategic decisions and in-depth evaluation of the tool. 188/491(38%) prioritized funding research into drug-resistant infections followed by emerging infections(18%). Results were similar between both days. Focus groups contained a total of 20 citizens with an equal gender split, range of ethnicities and ages ranging from 18 to >70 years. The tool was perceived as clear with participants able to make informed comparisons. Rationale for funding choices provided by voters and focus group participants are grouped into three major themes: (i) Information processing; (ii) Knowledge of the problem; (iii) Responsibility; and a unique theme within the focus groups (iv) The potential role of citizens in decision making. Divergent perceptions of relevance and confidence of "non-experts" as decision makers were expressed. Voting scenarios can be used to collect, en-masse, citizens' choices and rationale for research priorities. Ensuring adequate levels of citizen information and confidence is important to allow deployment in other formats. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  12. Consulting patients in setting priorities in Myalgic Encephalomyelitis (M.E.) research: findings from a national on-line survey.

    Science.gov (United States)

    Childs, Nicola; Robinson, Lisa; Chowdhury, Sonya; Ogden, Clare; Newton, Julia L

    2015-01-01

    Myalgic encephalitis (M.E.) is a common condition, the cause of which is not known and there are no treatments available. In this study the national patient support group Action for M.E. sought the opinions of their members via an online survey as to what they felt should be future priorities for M.E. Respondents were asked what they considered first, second and third research priorities to be from a list of 13 pre-defined options. Individuals were invited to provide additional free text comments about Action for M.E.'s research priorities in general. Of the 1144 respondents: 822 had M.E.; 94 were a supporting a member of Action for M.E. ; 66 were carers for someone with M.E.; 26 were professionals with an interest in M.E.; 136 had a family member or colleague with M.E. Individuals selected more than one category as applicable. The top five research priorities identified were: disease processes to achieve a better understanding of the causes of M.E.; more effective treatments; faster and more accurate diagnosis; clinical course of M.E.; outcomes and natural history; and severely affected patients. Least popular priorities were: sleep; economic research towards identifying the cost of ME; and psychological aspects. Much of the free text comments emphasised the importance of funding biomedical research into disease processes to achieve a better understanding of the causes of M.E. Three themes were identified in relation to this topic: accurate diagnosis and awareness; risk factors and causes; drug development and curative therapies. In conclusion; individuals affected by M.E. have clear views regarding priorities for research investment. These have informed Action for M.E.'s ongoing research strategy and ultimately will inform national and international research priorities.

  13. Accounting Information Systems Implementation and Management Accounting Change

    Directory of Open Access Journals (Sweden)

    Bredmar Krister

    2014-09-01

    Full Text Available Background: There is an on-going discussion within management accounting research regarding how to work with performance measures. In the process of developing new forms of performance measurement the task of choosing business metrics is central. This process is closely connected to the implementation of IT solutions. Objectives: In order to understand how new performance measurement solutions are implemented and used, it becomes crucial to understand how measures are selected and how new accounting information systems (AIS are developed and implemented. Methods/approach: The paper builds on the case of an on-going AIS project at a large, public university in Sweden. The empirical material was collected using a semi-action research approach over a two-year period. The majority of the material comes from written documentation and minutes. Results: Even though the implementation of a new AIS triggers a change in the management accounting practice, this study shows that this is done in more than one perspective. Conclusions: As the project develops, new priorities and objectives evolve, which in the end shape what management accounting change becomes.

  14. 78 FR 27038 - Final Priorities; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-05-09

    ... settings, including the community, rehabilitation service- delivery institutions, vocational rehabilitation...) Vocational rehabilitation (VR) practices that contribute to improved employment outcomes for individuals with... or more priorities, we designate the type of each priority as absolute, competitive preference, or...

  15. Collecting sustainability data in different organisational settings of the European Farm Accountancy Data Network

    NARCIS (Netherlands)

    Vrolijk, H.C.J.; Poppe, K.J.; Keszthelyi, Szilard

    2016-01-01

    The European Farm Accountancy Data Network (FADN) collects detailed financial economic information on a sample of farms in Europe. These data are used intensively for the evaluation of the European Union’s Common Agricultural Policy. Owing to changes in policies, there is a need for a broader set of

  16. Environmental contaminants in food. Volume II-part a: working papers. I. Priority setting of toxic substances for guiding monitoring programs. II. Five case studies of environmental food contamination

    International Nuclear Information System (INIS)

    1980-01-01

    This volume contains working papers written for Office of Technology Assessment (OTA) to assist in preparation of the report Environmental Contaminants in Food. The contents include: (1) Priority setting of toxic substances for guiding monitoring programs; and (2) Five case studies of environmental food contamination

  17. Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage.

    Science.gov (United States)

    Paolucci, Francesco; Redekop, Ken; Fouda, Ayman; Fiorentini, Gianluca

    2017-12-01

    Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Emotional debates about the reimbursement of cancer drugs, orphan drugs, and end-of-life treatments have revealed fundamental disagreements about what should and should not be considered in reimbursement decisions. Part of this disagreement seems related to the equity-efficiency tradeoff, which reflects fundamental differences in priorities. All in all, it is clear that countries aiming to improve UHC policies will have to go beyond the capacity building needed to utilize the available HTA toolbox. Multi-criteria decision analysis (MCDA) offers a more comprehensive tool for reimbursement decisions where different weights of different factors/attributes can give policymakers important insights to consider. Sooner or later, every country will have to develop their own way to carefully combine the results of those tools with their own priorities. In the end, all policymaking is based on a mix of facts and values.

  18. Setting priorities for non-regulatory animal health in Ireland: results from an expert Policy Delphi study and a farmer priority identification survey.

    Science.gov (United States)

    More, Simon J; McKenzie, Ken; O'Flaherty, Joe; Doherty, Michael L; Cromie, Andrew R; Magan, Mike J

    2010-07-01

    Agriculture is a very important contributor to the Irish economy. In Ireland, national animal health services have been a government, rather than an industry, responsibility. In 2009, Animal Health Ireland (AHI) was established to provide a partnership approach to national leadership of non-regulatory animal health issues (those not subject to national and/or EU regulation). The objectives of this study were to elicit opinion from experts and farmers about non-regulatory animal health issues facing Irish livestock industries, including prioritisation of animal health issues and identification of opportunities to maximise the effective use of AHI resources. The study was conducted with experts using Policy Delphi methodology over three rounds, and with farmers using a priority identification survey. Non-regulatory bovine diseases/conditions were prioritised by both experts and farmers based on impact and international competitiveness. For each high-priority disease/condition, experts were asked to provide an assessment based on cost, impact, international perception, impediment to international market access and current resource usage effectiveness. Further information was also sought from experts about resource allocation preferences, methods to improve education and coordination, and innovative measures to improve prevention and management. There was close agreement between responses from experts and dairy farmers: each gave highest priority to 3 diseases with a biosecurity risk (subsequently termed 'biosecure diseases') (bovine viral diarrhoea [BVD], infectious bovine rhinotracheitis [IBR], paratuberculosis) and 4 diseases/conditions generally without a biosecurity risk ('non-biosecure diseases/conditions') (fertility, udder health/milk quality, lameness, calf health). Beef farmers also prioritised parasitic conditions and weanling pneumonia. The adverse impact of biosecure diseases is currently considered relatively minor by experts, but would increase

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Best Practices and Processes for Choosing Research Priorities

    Science.gov (United States)

    Briscoe, M. G.

    2015-12-01

    Individuals, teams, departments, organizations, funding agencies, committees, and others all need to select desirable research priorities from many possible alternatives. One cannot do everything, one cannot afford everything, so what to select? Essays and reports since Weinberg (1963) have suggested criteria for choosing science topics. Popper et al (2000) reviewed and summarized all that had gone before in the subject of setting priorities; their main conclusions were that the underlying principles were the promotion of excellence and relevance. Sea Change (2015) from the NRC/OSB focused on four criteria. From most important to least important, they were transformative science, societal impacts, readiness, and partnership potential; these four criteria embodied the essence of the suggestions from Weinberg on, framed with the pragmatism of ORPISS (2007). Getting to the final set of priorities from many candidates involves a sequence of formal or informal processes, only the last of which is the application of the selected, weighted criteria. As developed by professional prioritization experts, the best-practice steps and processes are: Collection of input candidates from the community. Clustering and parsing/rephrasing of the input to eliminate redundancy and repetition and develop statements at a useful level of specificity. (NOTE:there is no counting of input to see how many times a particular topic was mentioned. The goal is diversity in the input, not a popularity contest.) Development of the selection criteria, and weighting the chosen criteria. Application of the selection criteria to the clustered/adjusted candidates. Finally, two more best practices: Do continuing sanity checks, to avoid losing sight of the goals of the effort. Resist the temptation to just sit around a table and talk about it to arrive at the priorities, which depends too much on who the specific members of the prioritization team are, and provides no transparency or explanation of why

  1. A set of constitutive relationships accounting for residual NAPL in the unsaturated zone.

    Science.gov (United States)

    Wipfler, E L; van der Zee, S E

    2001-07-01

    Although laboratory experiments show that non-aqueous phase liquid (NAPL) is retained in the unsaturated zone, no existing multiphase flow model has been developed to account for residual NAPL after NAPL drainage in the unsaturated zone. We developed a static constitutive set of saturation-capillary pressure relationships for water, NAPL and air that accounts for both this residual NAPL and entrapped NAPL. The set of constitutive relationships is formulated similarly to the set of scaled relationships that is frequently applied in continuum models. The new set consists of three fluid-phase systems: a three-phase system and a two-phase system, that both comply with the original constitutive model, and a newly introduced residual NAPL system. The new system can be added relatively easily to the original two- and three-phase systems. Entrapment is included in the model. The constitutive relationships of the non-drainable residual NAPL system are based on qualitative fluid behavior derived from a pore scale model. The pore scale model reveals that the amount of residual NAPL depends on the spreading coefficient and the water saturation. Furthermore, residual NAPL is history-dependent. At the continuum scale, a critical NAPL pressure head defines the transition from free, mobile NAPL to residual NAPL. Although the Pc-S relationships for water and total liquid are not independent in case of residual NAPL, two two-phase Pc-S relations can represent a three-phase residual system of Pc-S relations. A newly introduced parameter, referred to as the residual oil pressure head, reflects the mutual dependency of water and oil. Example calculations show consistent behavior of the constitutive model. Entrapment and retention in the unsaturated zone cooperate to retain NAPL. Moreover, the results of our constitutive model are in agreement with experimental observations.

  2. Potential High Priority Subaerial Environments for Mars Sample Return

    Science.gov (United States)

    iMOST Team; Bishop, J. L.; Horgan, B.; Benning, L. G.; Carrier, B. L.; Hausrath, E. M.; Altieri, F.; Amelin, Y.; Ammannito, E.; Anand, M.; Beaty, D. W.; Borg, L. E.; Boucher, D.; Brucato, J. R.; Busemann, H.; Campbell, K. A.; Czaja, A. D.; Debaille, V.; Des Marais, D. J.; Dixon, M.; Ehlmann, B. L.; Farmer, J. D.; Fernandez-Remolar, D. C.; Fogarty, J.; Glavin, D. P.; Goreva, Y. S.; Grady, M. M.; Hallis, L. J.; Harrington, A. D.; Herd, C. D. K.; Humayun, M.; Kleine, T.; Kleinhenz, J.; Mangold, N.; Mackelprang, R.; Mayhew, L. E.; McCubbin, F. M.; Mccoy, J. T.; McLennan, S. M.; McSween, H. Y.; Moser, D. E.; Moynier, F.; Mustard, J. F.; Niles, P. B.; Ori, G. G.; Raulin, F.; Rettberg, P.; Rucker, M. A.; Schmitz, N.; Sefton-Nash, E.; Sephton, M. A.; Shaheen, R.; Shuster, D. L.; Siljestrom, S.; Smith, C. L.; Spry, J. A.; Steele, A.; Swindle, T. D.; ten Kate, I. L.; Tosca, N. J.; Usui, T.; Van Kranendonk, M. J.; Wadhwa, M.; Weiss, B. P.; Werner, S. C.; Westall, F.; Wheeler, R. M.; Zipfel, J.; Zorzano, M. P.

    2018-04-01

    The highest priority subaerial environments for Mars Sample Return include subaerial weathering (paleosols, periglacial/glacial, and rock coatings/rinds), wetlands (mineral precipitates, redox environments, and salt ponds), or cold spring settings.

  3. Exploring stakeholders' views of medical education research priorities: a national survey.

    Science.gov (United States)

    Dennis, Ashley A; Cleland, Jennifer A; Johnston, Peter; Ker, Jean S; Lough, Murray; Rees, Charlotte E

    2014-11-01

    Setting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland. This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed. Views were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education. This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These

  4. PRIORITIES OF REGIONAL ENVIRONMENTAL POLICY: THE ISSUES OF DIAGNOSTICS

    Directory of Open Access Journals (Sweden)

    T. I. Kudryavtseva

    2010-03-01

    Full Text Available Methods of eliciting priority ecological problems are analyzed in the article. The problem of air pollution is considered to be the foreground issue for both the Ural Federal District and Russia; that was due substantiated. An extended technique of setting priorities for air pollutants and techniques for integral ecological and social assessment of air pollution acuteness extent in the region have been offered; calculations for the Ural Federal District have been made according to the techniques mentioned.

  5. What are the macro-social health research priorities?

    Directory of Open Access Journals (Sweden)

    Narges Tabrizchi

    2016-10-01

    Full Text Available   Background: Setting research priorities is a scientific process to allocate resources to the best use. In low- and middle-income countries, allocation of limited resources to fundamental issues is more important. So, the present study was conducted to determine social health research priorities.  Methods: In the first step, important issues and research topics of social health were extracted from documents and studies conducted at the national level.In qualitative phase, reciprocating questionnaires were sent and interviews were conducted with experts and stakeholders, social health issues (as members of Delphi. In the next step, the research topics extracted were discussed in small groups (suggested by Council on Health Research for Development to score the proposed priority topics by Delphi members. Finally, the list of priorities (titles that acquired more than 80% of the total score was sent to Delphi members for final approval.  Results: During the study, 220 topics were obtained in four research domains: “description of the problem and its consequences”, “cause finding”, “intervention to eliminate or reduce problems”, and “Management-Policymaking”. Finally, 30 of these topics remained as priority topics. High priority research topics in social health were equity, happiness, economics, and ethics, respectively.  Conclusion: The findings provide a list of research priorities that help researchers carrying out studies that will have the greatest social health impact. Some targeting areas such as happiness and ethics were identified as less attended subjects that need more investment in research policies, management, and governance.

  6. Comparing two sampling methods to engage hard-to-reach communities in research priority setting.

    Science.gov (United States)

    Valerio, Melissa A; Rodriguez, Natalia; Winkler, Paula; Lopez, Jaime; Dennison, Meagen; Liang, Yuanyuan; Turner, Barbara J

    2016-10-28

    Effective community-partnered and patient-centered outcomes research needs to address community priorities. However, optimal sampling methods to engage stakeholders from hard-to-reach, vulnerable communities to generate research priorities have not been identified. In two similar rural, largely Hispanic communities, a community advisory board guided recruitment of stakeholders affected by chronic pain using a different method in each community: 1) snowball sampling, a chain- referral method or 2) purposive sampling to recruit diverse stakeholders. In both communities, three groups of stakeholders attended a series of three facilitated meetings to orient, brainstorm, and prioritize ideas (9 meetings/community). Using mixed methods analysis, we compared stakeholder recruitment and retention as well as priorities from both communities' stakeholders on mean ratings of their ideas based on importance and feasibility for implementation in their community. Of 65 eligible stakeholders in one community recruited by snowball sampling, 55 (85 %) consented, 52 (95 %) attended the first meeting, and 36 (65 %) attended all 3 meetings. In the second community, the purposive sampling method was supplemented by convenience sampling to increase recruitment. Of 69 stakeholders recruited by this combined strategy, 62 (90 %) consented, 36 (58 %) attended the first meeting, and 26 (42 %) attended all 3 meetings. Snowball sampling recruited more Hispanics and disabled persons (all P research, focusing on non-pharmacologic interventions for management of chronic pain. Ratings on importance and feasibility for community implementation differed only on the importance of massage services (P = 0.045) which was higher for the purposive/convenience sampling group and for city improvements/transportation services (P = 0.004) which was higher for the snowball sampling group. In each of the two similar hard-to-reach communities, a community advisory board partnered with researchers

  7. Priority to End of Life Treatments? Views of the Public in the Netherlands.

    Science.gov (United States)

    Wouters, Sofie; van Exel, Job; Baker, Rachel; B F Brouwer, Werner

    2017-01-01

    Recent debates in the Netherlands on health care priority setting have focused on the relative value of gains generated by life-extending medicines for people with a terminal illness, mostly new cancer drugs. These treatments are generally expensive, provide relatively small health gains, and therefore usually do not meet common cost per QALY thresholds. Nevertheless, these drugs may be provided under the assumption that there is public support for making a special case for treatments for people with a terminal illness. This study investigated the views of the public in the Netherlands on a range of equity and efficiency considerations relevant to priority setting and examines whether there is public support for making such a special case. Using Q methodology, three viewpoints on important principles for priority setting were identified. Data were collected through ranking exercises conducted by 46 members of the general public in the Netherlands, including 11 respondents with personal experience with cancer. Viewpoint 1 emphasized that people have equal rights to healthcare and opposed priority setting on any ground. Viewpoint 2 emphasized that the care for terminal patients should at all times respect the patients' quality of life, which sometimes means refraining from invasive treatments. Viewpoint 3 had a strong focus on effective and efficient care and had no moral objection against priority setting under certain circumstances. Overall, we found little public support for the assumption that health gains in terminally ill patients are more valuable than those in other patients. This implies that the assumption that society is prepared to pay more for health gains in people who have only a short period of lifetime left does not correspond with societal preferences in the Netherlands. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Exploratory Study on the Capitalization of Accounting Information by Financial Constructions Determined on the Basis of the Balance Sheet

    Directory of Open Access Journals (Sweden)

    Ciuhureanu Alina-Teodora

    2017-12-01

    Full Text Available The capitalization of the information provided through the balance sheet should be one of the priorities of the organization’s manager. This is because the processed accounting information is the one that contributes to the setting of objectives and strategy and at the same time provides the necessary information capital for proper management of the activity. For these reasons, the article presents a series of financial constructions based on the accounting information provided through the financial accounting system and centralized in the balance sheet. The aim of the paper is to capture the benefits of using it by management and not to detail indicators / rates / tools in terms of calculation methods.

  9. Оn the issue of setting priorities in the organization of risk-based supervision over the safety of consumer products traded on the common economic space of Russia, Belarus and Kazakhstan

    Directory of Open Access Journals (Sweden)

    А.Yu. Popova

    2015-09-01

    Full Text Available Significant volumes of mutual trade between the countries of the Eurasian Economic Union, combined with the urgency of protecting the population against the risks of negative impacts on the health products are aiming to optimize the supervision of the products traded in the market. One of the ways to optimize is the transition to a risk-based model of health service activities and choice of products for top-priority (priority control. The approaches to the selection of priorities are offered, based on the account of the product use, consumer contingent specificity, known types of hazards, results of inspection and enforcement activities. It was found that the priority products exported by EASE member countries on the common market and forming potentially the greatest risk of harm to the health of consumers may include: dairy products; bird eggs (FEACN group 04; fats and oils of animal or vegetable origin and their cleavage products; prepared edible fats; waxes of animal or vegetable origin (FEACN group 15; sugar and sugar confectionery (FEACN group 17; meat, fish or crustaceans, mollusks or other aquatic invertebrates (FEACN group 16; alcoholic and soft drinks and so on. (FEACN group 22; vegetables, roots and tubers (FEACN group 07; toys, games and sports equipment (FEACN group 95. In relation to these groups of products the priority study of the risk profile required, as well as the development of algorithms and regulations of the supervisory and control measures and improvement of laboratory support methods.

  10. Research priorities about stoma-related quality of life from the perspective of people with a stoma: A pilot survey.

    Science.gov (United States)

    Hubbard, Gill; Taylor, Claire; Beeken, Becca; Campbell, Anna; Gracey, Jackie; Grimmett, Chloe; Fisher, Abi; Ozakinci, Gozde; Slater, Sarah; Gorely, Trish

    2017-12-01

    There is a recognized need to include patients in setting research priorities. Research priorities identified by people with a stoma are rarely elicited. To improve the quality of life of people with a stoma through use of evidence-based practice based on research priorities set by patients. Online pilot survey publicized in 2016 via United Kingdom stoma charities. People ranked nine stoma-related quality of life topics in order of research priority. People 16 years of age and over who currently have or have had a stoma for treatment for any medical condition. Distributions of the priority scores for each of the nine research topics were examined. Group differences were explored using either the Mann-Whitney U-test or the Kruskal-Wallis test depending on the number of groups. In total, 225 people completed the survey. The most important research priority was pouch leak problems and stoma bag/appliance problems followed by hernia risk. There were statistically significant differences in ranking research priorities between males and females, age, underlying disease that led to a stoma, stoma type and length of time with a stoma. People with a stoma are willing to engage in and set research priorities. The results should contribute towards future research about setting the research agenda for the study of stoma-related concerns that impact quality of life. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  11. Accountability for Community-Based Programs for the Seriously Ill.

    Science.gov (United States)

    Teno, Joan M; Montgomery, Russ; Valuck, Tom; Corrigan, Janet; Meier, Diane E; Kelley, Amy; Curtis, J Randall; Engelberg, Ruth

    2018-03-01

    Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person- and family-centered care for persons who are seriously ill.

  12. Resources, attitudes and culture: an understanding of the factors that influence the functioning of accountability mechanisms in primary health care settings.

    Science.gov (United States)

    Cleary, Susan M; Molyneux, Sassy; Gilson, Lucy

    2013-08-16

    managers and providers from responding to patient and population priorities. Findings suggest that it is important to limit the potential negative impacts on responsiveness of new bureaucratic accountability mechanisms, and identify how these or other interventions might leverage the shifts in organizational culture necessary to encourage innovation and patient-centered care.

  13. Use of survey data to define regional and local priorities for management on national wildlife refuges

    Science.gov (United States)

    John R. Sauer; Jennifer Casey; Harold Laskowski; Jan D. Taylor; Jane Fallon

    2005-01-01

    National Wildlife Refuges must manage habitats to support a variety of species that often have conflicting needs. To make reasonable management decisions, managers must know what species are priorities for their refuges and the relative importance of the species. Unfortunately, species priorities are often set regionally, but refuges must develop local priorities that...

  14. Assessing the impact of defining a global priority research agenda to address HIV-associated tuberculosis.

    Science.gov (United States)

    Odone, Anna; Matteelli, Alberto; Chiesa, Valentina; Cella, Paola; Ferrari, Antonio; Pezzetti, Federica; Signorelli, Carlo; Getahun, Haileyesus

    2016-11-01

    In 2010, the WHO issued 77 priority research questions (PRQs) to address HIV-associated TB. Objective of the this study was to assess the impact of defining the research agenda in stimulating and directing research around priority research questions. We used number and type of scientific publications as a proxy to quantitatively assess the impact of research agenda setting. We conducted 77 single systematic reviews - one for every PRQ - building 77 different search strategies using PRQs' keywords. Multivariate logistic regression models were applied to assess the quantity and quality of research produced over time and accounting for selected covariates. In 2009-2015, PRQs were addressed by 1631 publications (median: 11 studies published per PRQ, range 1-96). The most published area was 'Intensified TB case finding' (median: 23 studies/PRQ, range: 2-74). The majority (62.1%, n = 1013) were published as original studies, and more than half (58%, n = 585) were conducted in the African region. Original studies' publication increased over the study period (P trend = <0.001). They focused more on the 'Intensified TB case finding' (OR = 2.17, 95% CI: 1.56-2.93) and 'Drug-resistant TB and HIV infection' (OR = 2.12, 95% CI: 1.47-3.06) areas than non-original studies. Original studies were published in journals of lower impact factor and received a smaller number of citations than non-original studies (OR = 0.54, 95% CI: 0.42-0.69). The generation of evidence to address PRQs has increased over time particularly in selected fields. Setting a priority research agenda for HIV-associated TB might have positively influenced the direction and the conduct of research and contributed to the global response to such a major threat to health. © 2016 John Wiley & Sons Ltd.

  15. Comparing two sampling methods to engage hard-to-reach communities in research priority setting

    Directory of Open Access Journals (Sweden)

    Melissa A. Valerio

    2016-10-01

    Full Text Available Abstract Background Effective community-partnered and patient-centered outcomes research needs to address community priorities. However, optimal sampling methods to engage stakeholders from hard-to-reach, vulnerable communities to generate research priorities have not been identified. Methods In two similar rural, largely Hispanic communities, a community advisory board guided recruitment of stakeholders affected by chronic pain using a different method in each community: 1 snowball sampling, a chain- referral method or 2 purposive sampling to recruit diverse stakeholders. In both communities, three groups of stakeholders attended a series of three facilitated meetings to orient, brainstorm, and prioritize ideas (9 meetings/community. Using mixed methods analysis, we compared stakeholder recruitment and retention as well as priorities from both communities’ stakeholders on mean ratings of their ideas based on importance and feasibility for implementation in their community. Results Of 65 eligible stakeholders in one community recruited by snowball sampling, 55 (85 % consented, 52 (95 % attended the first meeting, and 36 (65 % attended all 3 meetings. In the second community, the purposive sampling method was supplemented by convenience sampling to increase recruitment. Of 69 stakeholders recruited by this combined strategy, 62 (90 % consented, 36 (58 % attended the first meeting, and 26 (42 % attended all 3 meetings. Snowball sampling recruited more Hispanics and disabled persons (all P < 0.05. Despite differing recruitment strategies, stakeholders from the two communities identified largely similar ideas for research, focusing on non-pharmacologic interventions for management of chronic pain. Ratings on importance and feasibility for community implementation differed only on the importance of massage services (P = 0.045 which was higher for the purposive/convenience sampling group and for city improvements

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

    Directory of Open Access Journals (Sweden)

    Giulia Capotorti

    2015-04-01

    Full Text Available 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 provide comprehensive responses to ecological and social needs in any metropolitan context. The approach, which is based on interdisciplinary principles of landscape ecology, ecosystem geography and dynamic plant sociology, has been adopted in the Municipality of Rome (Italy. The first step entails defining an ecological framework for forestation plans by means of the ecological land classification and assessment of landscape conservation status. The second step entails setting forestation priorities according to both ecological and social criteria. The application of the method proved to effectively select limited areas requiring intervention within an extensive metropolitan area. Furthermore, it provided responses to sustainability issues such as long-term maintenance of restored habitats, landscape perspective of planning, greening of urban agriculture, improvement in urban resilience, and cost-effective improvement in ecosystem services provision.

  17. Assessment of environmental management accounting at South African universities: Case of Tshwane University of Technology

    Directory of Open Access Journals (Sweden)

    Cosmas M Ambe

    2015-09-01

    Full Text Available The overall objective of the paper is to assess the application of environmental management accounting (EMA at Tshwane University of Technology (TUT as a service organization and examine how the institution manages, account and report environmental cost. Data was collected by means of exploratory and explanatory research techniques using two data sets; documentary and fourteen in-depth individual face-to-face interviews employing a semi-structured questionnaire with closed and open ended questions to collect primary data. The results indicate that; the implementation of EMA and general governance for environmental responsibility and accountability is extremely weak. The potential use of EMA is neglected and, as such, EMA implementation is not considered a priority. Three barriers to the adoption of EMA within TUT were identified as: institutional pressures, a low profile of accounting for the environment, and management’s attitudes. A general ledger model and action plan for the implementation of EMA at TUT utilizing the use of activity based costing has been suggested.

  18. Identifying research priorities in anaesthesia and perioperative care: final report of the joint National Institute of Academic Anaesthesia/James Lind Alliance Research Priority Setting Partnership.

    Science.gov (United States)

    Boney, Oliver; Bell, Madeline; Bell, Natalie; Conquest, Ann; Cumbers, Marion; Drake, Sharon; Galsworthy, Mike; Gath, Jacqui; Grocott, Michael P W; Harris, Emma; Howell, Simon; Ingold, Anthony; Nathanson, Michael H; Pinkney, Thomas; Metcalf, Leanne

    2015-12-16

    To identify research priorities for Anaesthesia and Perioperative Medicine. Prospective surveys and consensus meetings guided by an independent adviser. UK. 45 stakeholder organisations (25 professional, 20 patient/carer) affiliated as James Lind Alliance partners. First 'ideas-gathering' survey: Free text research ideas and suggestions. Second 'prioritisation' survey: Shortlist of 'summary' research questions (derived from the first survey) ranked by respondents in order of priority. Final 'top ten': Agreed by consensus at a final prioritisation workshop. First survey: 1420 suggestions received from 623 respondents (49% patients/public) were refined into a shortlist of 92 'summary' questions. Second survey: 1718 respondents each nominated up to 10 questions as research priorities. Top ten: The 25 highest-ranked questions advanced to the final workshop, where 23 stakeholders (13 professional, 10 patient/carer) agreed the 10 most important questions: ▸ What can we do to stop patients developing chronic pain after surgery? ▸ How can patient care around the time of emergency surgery be improved? ▸ What long-term harm may result from anaesthesia, particularly following repeated anaesthetics?▸ What outcomes should we use to measure the 'success' of anaesthesia and perioperative care? ▸ How can we improve recovery from surgery for elderly patients? ▸ For which patients does regional anaesthesia give better outcomes than general anaesthesia? ▸ What are the effects of anaesthesia on the developing brain? ▸ Do enhanced recovery programmes improve short and long-term outcomes? ▸ How can preoperative exercise or fitness training, including physiotherapy, improve outcomes after surgery? ▸ How can we improve communication between the teams looking after patients throughout their surgical journey? Almost 2000 stakeholders contributed their views regarding anaesthetic and perioperative research priorities. This is the largest example of patient and public

  19. Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures.

    Science.gov (United States)

    Valuck, Tom; Blaisdell, David; Dugan, Donna P; Westrich, Kimberly; Dubois, Robert W; Miller, Robert S; McClellan, Mark

    2017-02-01

    Payment for health care services, including oncology services, is shifting from volume-based fee-for-service to value-based accountable care. The objective of accountable care is to support providers with flexibility and resources to reform care delivery, accompanied by accountability for maintaining or improving outcomes while lowering costs. These changes depend on health care payers, systems, physicians, and patients having meaningful measures to assess care delivery and outcomes and to balance financial incentives for lowering costs while providing greater value. Gaps in accountable care measure sets may cause missed signals of problems in care and missed opportunities for improvement. Measures to balance financial incentives may be particularly important for oncology, where high cost and increasingly targeted diagnostics and therapeutics intersect with the highly complex and heterogeneous needs and preferences of cancer patients. Moreover, the concept of value in cancer care, defined as the measure of outcomes achieved per costs incurred, is rarely incorporated into performance measurement. This article analyzes gaps in oncology measures in accountable care, discusses challenging measurement issues, and offers strategies for improving oncology measurement. Discern Health analyzed gaps in accountable care measure sets for 10 cancer conditions that were selected based on incidence and prevalence; impact on cost and mortality; a diverse range of high-cost diagnostic procedures and treatment modalities (e.g., genomic tumor testing, molecularly targeted therapies, and stereotactic radiotherapy); and disparities or performance gaps in patient care. We identified gaps by comparing accountable care set measures with high-priority measurement opportunities derived from practice guidelines developed by the National Comprehensive Cancer Network and other oncology specialty societies. We found significant gaps in accountable care measure sets across all 10 conditions. For

  20. Research priorities about stoma-related quality of life from the perspective of people with a stoma : a pilot survey

    OpenAIRE

    Hubbard, Gill; Taylor, Claire; Beeken, Becca; Campbell, Anna; Gracey, Jackie; Grimmett, Chloe; Fisher, Abi; Ozakinci, Gozde; Slater, Sarah; Gorely, Trish

    2017-01-01

    We thank the following charities for advertising the study: Ileostomy Association, Colostomy Association, Bowel and Cancer Research, Urostomy Association. Background There is a recognized need to include patients in setting research priorities. Research priorities identified by people with a stoma are rarely elicited. Objectives To improve the quality of life of people with a stoma through use of evidence-based practice based on research priorities set by patients.Design and Methods Online...

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

    OpenAIRE

    Ekholm, Bo-Göran

    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...

  2. Patient involvement in research priorities (PIRE)

    DEFF Research Database (Denmark)

    Piil, Karin; Jarden, Mary

    2016-01-01

    Introduction: Patient involvement in healthcare has expanded from the clinical practice setting to include collaboration during the research process. There has been a growing international interest in patient and public involvement in setting research priorities to reduce the risk of discrepancy...... between what patients with cancer and their relatives experience as important unanswered questions and those which are actually researched. This study aims to challenge the conventional research process by inviting patients with life-threatening cancer (primary malignant brain tumours or acute leukaemia......), relatives and patient organisations to join forces with clinical specialists and researchers to identify, discuss and prioritise supportive care and rehabilitation issues in future research. Methods and analysis: This is an exploratory qualitative study comprising two sets of three focus group interviews...

  3. Social welfare in one-sided matchings: Random priority and beyond

    DEFF Research Database (Denmark)

    Filos-Ratsikas, Aris; Frederiksen, Søren Kristoffer Stiil; Zhang, Jie

    2014-01-01

    We study the problem of approximate social welfare maximization (without money) in one-sided matching problems when agents have unrestricted cardinal preferences over a finite set of items. Random priority is a very well-known truthful-in-expectation mechanism for the problem. We prove...... that the approximation ratio of random priority is Theta(n^{-1/2}) while no truthful-in-expectation mechanism can achieve an approximation ratio better than O(n^{-1/2}), where n is the number of agents and items. Furthermore, we prove that the approximation ratio of all ordinal (not necessarily truthful......-in-expectation) mechanisms is upper bounded by O(n^{-1/2}), indicating that random priority is asymptotically the best truthful-in-expectation mechanism and the best ordinal mechanism for the problem....

  4. Quantitative analysis of a fault tree with priority AND gates

    International Nuclear Information System (INIS)

    Yuge, T.; Yanagi, S.

    2008-01-01

    A method for calculating the exact top event probability of a fault tree with priority AND gates and repeated basic events is proposed when the minimal cut sets are given. A priority AND gate is an AND gate where the input events must occur in a prescribed order for the occurrence of the output event. It is known that the top event probability of such a dynamic fault tree is obtained by converting the tree into an equivalent Markov model. However, this method is not realistic for a complex system model because the number of states which should be considered in the Markov analysis increases explosively as the number of basic events increases. To overcome the shortcomings of the Markov model, we propose an alternative method to obtain the top event probability in this paper. We assume that the basic events occur independently, exponentially distributed, and the component whose failure corresponds to the occurrence of the basic event is non-repairable. First, we obtain the probability of occurrence of the output event of a single priority AND gate by Markov analysis. Then, the top event probability is given by a cut set approach and the inclusion-exclusion formula. An efficient procedure to obtain the probabilities corresponding to logical products in the inclusion-exclusion formula is proposed. The logical product which is composed of two or more priority AND gates having at least one common basic event as their inputs is transformed into the sum of disjoint events which are equivalent to a priority AND gate in the procedure. Numerical examples show that our method works well for complex systems

  5. An empirical Bayes safety evaluation of tram/streetcar signal and lane priority measures in Melbourne.

    Science.gov (United States)

    Naznin, Farhana; Currie, Graham; Sarvi, Majid; Logan, David

    2016-01-01

    Streetcars/tram systems are growing worldwide, and many are given priority to increase speed and reliability performance in mixed traffic conditions. Research related to the road safety impact of tram priority is limited. This study explores the road safety impacts of tram priority measures including lane and intersection/signal priority measures. A before-after crash study was conducted using the empirical Bayes (EB) method to provide more accurate crash impact estimates by accounting for wider crash trends and regression to the mean effects. Before-after crash data for 29 intersections with tram signal priority and 23 arterials with tram lane priority in Melbourne, Australia, were analyzed to evaluate the road safety impact of tram priority. The EB before-after analysis results indicated a statistically significant adjusted crash reduction rate of 16.4% after implementation of tram priority measures. Signal priority measures were found to reduce crashes by 13.9% and lane priority by 19.4%. A disaggregate level simple before-after analysis indicated reductions in total and serious crashes as well as vehicle-, pedestrian-, and motorcycle-involved crashes. In addition, reductions in on-path crashes, pedestrian-involved crashes, and collisions among vehicles moving in the same and opposite directions and all other specific crash types were found after tram priority implementation. Results suggest that streetcar/tram priority measures result in safety benefits for all road users, including vehicles, pedestrians, and cyclists. Policy implications and areas for future research are discussed.

  6. Large-Scale Transit Signal Priority Implementation

    OpenAIRE

    Lee, Kevin S.; Lozner, Bailey

    2018-01-01

    In 2016, the District Department of Transportation (DDOT) deployed Transit Signal Priority (TSP) at 195 intersections in highly urbanized areas of Washington, DC. In collaboration with a broader regional implementation, and in partnership with the Washington Metropolitan Area Transit Authority (WMATA), DDOT set out to apply a systems engineering–driven process to identify, design, test, and accept a large-scale TSP system. This presentation will highlight project successes and lessons learned.

  7. 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

    OpenAIRE

    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...

  8. Eliciting preferences for priority setting in genetic testing: a pilot study comparing best-worst scaling and discrete-choice experiments.

    Science.gov (United States)

    Severin, Franziska; Schmidtke, Jörg; Mühlbacher, Axel; Rogowski, Wolf H

    2013-11-01

    Given the increasing number of genetic tests available, decisions have to be made on how to allocate limited health-care resources to them. Different criteria have been proposed to guide priority setting. However, their relative importance is unclear. Discrete-choice experiments (DCEs) and best-worst scaling experiments (BWSs) are methods used to identify and weight various criteria that influence orders of priority. This study tests whether these preference eliciting techniques can be used for prioritising genetic tests and compares the empirical findings resulting from these two approaches. Pilot DCE and BWS questionnaires were developed for the same criteria: prevalence, severity, clinical utility, alternatives to genetic testing available, infrastructure for testing and care established, and urgency of care. Interview-style experiments were carried out among different genetics professionals (mainly clinical geneticists, researchers and biologists). A total of 31 respondents completed the DCE and 26 completed the BWS experiment. Weights for the levels of the six attributes were estimated by conditional logit models. Although the results derived from the DCE and BWS experiments differed in detail, we found similar valuation patterns in the DCE and BWS experiments. The respondents attached greatest value to tests with high clinical utility (defined by the availability of treatments that reduce mortality and morbidity) and to testing for highly prevalent conditions. The findings from this study exemplify how decision makers can use quantitative preference eliciting methods to measure aggregated preferences in order to prioritise alternative clinical interventions. Further research is necessary to confirm the survey results.

  9. Improving accountability in vaccine decision-making.

    Science.gov (United States)

    Timmis, James Kenneth; Black, Steven; Rappuoli, Rino

    2017-11-01

    Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum. Areas covered: To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures. In this communication, we review the consequences and utility of stakeholder-centered core considerations to increase transparency in and accountability of decision-making procedures, in general, and of the benefits gained by their inclusion in Multi-Criteria-Decision-Analysis tools, exemplified by SMART Vaccines, specifically. Expert commentary: To increase effectiveness and comparability of health decision outcomes, decision procedures should be properly standardized across equivalent (national) decision bodies. To this end, including stakeholder-centered criteria in decision procedures would significantly increase their transparency and accountability, support international capacity building to improve health, and reduce societal costs and inequity resulting from suboptimal health decision-making.

  10. IRBA SERIES : Accounting In Japan

    OpenAIRE

    Arai, Kiyomitsu

    1994-01-01

    Preface / Legal and Conceptual Framework of Accounting in Japan / Setting Accounting Standards in Japan - The American Influence and The Present Status / Accounting Education and Profession in Japan / The International Harmonization of Accounting Standards / The Accounting Standard Setting in Japan and Its Responses to International Accounting Standards / Selected Bibliography for Accounting in Japan

  11. Setting research priorities for maternal, newborn, child health and nutrition in India by engaging experts from 256 indigenous institutions contributing over 4000 research ideas: a CHNRI exercise by ICMR and INCLEN.

    Science.gov (United States)

    Arora, Narendra K; Mohapatra, Archisman; Gopalan, Hema S; Wazny, Kerri; Thavaraj, Vasantha; Rasaily, Reeta; Das, Manoj K; Maheshwari, Meenu; Bahl, Rajiv; Qazi, Shamim A; Black, Robert E; Rudan, Igor

    2017-06-01

    Health research in low- and middle- income countries (LMICs) is often driven by donor priorities rather than by the needs of the countries where the research takes place. This lack of alignment of donor's priorities with local research need may be one of the reasons why countries fail to achieve set goals for population health and nutrition. India has a high burden of morbidity and mortality in women, children and infants. In order to look forward toward the Sustainable Development Goals, the Indian Council of Medical Research (ICMR) and the INCLEN Trust International (INCLEN) employed the Child Health and Nutrition Research Initiative's (CHNRI) research priority setting method for maternal, neonatal, child health and nutrition with the timeline of 2016-2025. The exercise was the largest to-date use of the CHNRI methodology, both in terms of participants and ideas generated and also expanded on the methodology. CHNRI is a crowdsourcing-based exercise that involves using the collective intelligence of a group of stakeholders, usually researchers, to generate and score research options against a set of criteria. This paper reports on a large umbrella CHNRI that was divided into four theme-specific CHNRIs (maternal, newborn, child health and nutrition). A National Steering Group oversaw the exercise and four theme-specific Research Sub-Committees technically supported finalizing the scoring criteria and refinement of research ideas for the respective thematic areas. The exercise engaged participants from 256 institutions across India - 4003 research ideas were generated from 498 experts which were consolidated into 373 research options (maternal health: 122; newborn health: 56; child health: 101; nutrition: 94); 893 experts scored these against five criteria (answerability, relevance, equity, innovation and out-of-box thinking, investment on research). Relative weights to the criteria were assigned by 79 members from the Larger Reference Group. Given India's diversity

  12. Publishing priorities of biomedical research funders

    Science.gov (United States)

    Collins, Ellen

    2013-01-01

    Objectives To understand the publishing priorities, especially in relation to open access, of 10 UK biomedical research funders. Design Semistructured interviews. Setting 10 UK biomedical research funders. Participants 12 employees with responsibility for research management at 10 UK biomedical research funders; a purposive sample to represent a range of backgrounds and organisation types. Conclusions Publicly funded and large biomedical research funders are committed to open access publishing and are pleased with recent developments which have stimulated growth in this area. Smaller charitable funders are supportive of the aims of open access, but are concerned about the practical implications for their budgets and their funded researchers. Across the board, biomedical research funders are turning their attention to other priorities for sharing research outputs, including data, protocols and negative results. Further work is required to understand how smaller funders, including charitable funders, can support open access. PMID:24154520

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  14. Determining Community Health Status Priorities in an Online Analytic Processing (OLAP) Environment

    Science.gov (United States)

    Studnicki, James; Fisher, John W.

    2013-01-01

    Introduction: The determination of priorities is an essential component of community health status assessment. Yet, there is an acknowledged need for a systematic method which will utilize data in standardized comparisons to yield priorities based on objective analyses. Method: We have deployed a web-based system with: a flexible online analytic processing (OLAP) interface; multiple sources of event-level data conformed to common definitions in a data warehouse structure; and, centralized technical infrastructure with distributed analytical capabilities. The PRIORITIZATION TOOL integrated into the system takes full advantage of the granularity of multidimensional sources of data to: apply a series of defined objective criteria; vary the weight of those criteria and detect the reordering of the rankings in real-time; and, apply the prioritization algorithm to different categories of health status outcomes. Results: In our example, mortality outcomes for Miami-Dade County, Florida, were considered with three different weighting combinations of the four primary ranking criteria. The resultant analyses return markedly different mortality priority rankings based upon the selection and weighting of the criteria. Conclusion: Rankings of community health outcomes based on a static set of criteria with fixed weighting factors may not provide sufficient information necessary for priority setting and may, in fact, be misleading. PMID:23923094

  15. Determining Community Health Status Priorities in an Online Analytic Processing (OLAP) Environment.

    Science.gov (United States)

    Studnicki, James; Fisher, John W

    2013-01-01

    The determination of priorities is an essential component of community health status assessment. Yet, there is an acknowledged need for a systematic method which will utilize data in standardized comparisons to yield priorities based on objective analyses. We have deployed a web-based system with: a flexible online analytic processing (OLAP) interface; multiple sources of event-level data conformed to common definitions in a data warehouse structure; and, centralized technical infrastructure with distributed analytical capabilities. The PRIORITIZATION TOOL integrated into the system takes full advantage of the granularity of multidimensional sources of data to: apply a series of defined objective criteria; vary the weight of those criteria and detect the reordering of the rankings in real-time; and, apply the prioritization algorithm to different categories of health status outcomes. In our example, mortality outcomes for Miami-Dade County, Florida, were considered with three different weighting combinations of the four primary ranking criteria. The resultant analyses return markedly different mortality priority rankings based upon the selection and weighting of the criteria. Rankings of community health outcomes based on a static set of criteria with fixed weighting factors may not provide sufficient information necessary for priority setting and may, in fact, be misleading.

  16. A fundamentalist perspective on accounting and implications for accounting

    Directory of Open Access Journals (Sweden)

    Guohua Jiang

    2013-12-01

    Full Text Available This paper presents a framework for addressing normative accounting issues for reporting to shareholders. The framework is an alternative to the emerging Conceptual Framework of the International Accounting Standards Board and the Financial Accounting Standards Board. The framework can be broadly characterized as a utilitarian approach to accounting standard setting. It has two main features. First, accounting is linked to valuation models under which shareholders use accounting information to values their stakes. Second, the desirable characteristics of accounting information are inferred from the demand of investors and analysts who use the information in practice. This stands in contrast to the “qualitative characteristics” in the Boards’ Framework which are embraced largely on the basis of their aesthetic appeal. These features lead to a set of broad accounting principles that resolve “recognition” and “measurement” issues at the core of the Boards’ Conceptual Framework and also the central issue of a balance sheet approach versus an income statement approach. The framework in the paper also frames the research questions for researchers interested in accounting policy.

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

    Science.gov (United States)

    Yoshida, Sachiyo; Rudan, Igor; Cousens, Simon

    2016-06-01

    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. We conducted a series of analyses using data from a group of 91 scorers to explore the quantitative properties of their collective opinion. We were interested in the stability of their collective opinion as the sample size increases from 15 to 90. From a pool of 91 scorers who took part in a previous CHNRI exercise, we used sampling with replacement to generate multiple random samples of different size. First, for each sample generated, we identified the top 20 ranked research ideas, among 205 that were proposed and scored, and calculated the concordance with the ranking generated by the 91 original scorers. Second, we used rank correlation coefficients to compare the ranks assigned to all 205 proposed research ideas when samples of different size are used. We also analysed the original pool of 91 scorers to to look for evidence of scoring variations based on scorers' characteristics. The sample sizes investigated ranged from 15 to 90. The concordance for the top 20 scored research ideas increased with sample sizes up to about 55 experts. At this point, the median level of concordance stabilized at 15/20 top ranked questions (75%), with the interquartile range also generally stable (14-16). There was little further increase in overlap when the sample size increased from 55 to 90. When analysing the ranking of all 205 ideas, the rank correlation coefficient increased as the sample size increased, with a median correlation of 0.95 reached at the sample size of 45 experts (median of the rank

  18. Health Priorities in French-Speaking Swiss Cantons

    Directory of Open Access Journals (Sweden)

    Philippe Chastonay

    2018-01-01

    Full Text Available In Switzerland, the federal authorities, the cantons, and the communes share the responsibility of healthcare, disease prevention and health promotion policies. Yet, the cantons are in most health matters independent in their decisions, thus defining as a matter of fact their own health priorities. We examined and analysed the content of the disease prevention and health promotion plans elaborated during the last decade in six French-speaking cantons with different political contexts and resources, but quite similar population health data, in order to identify the set health priorities. The plans appear significantly inhomogeneous in their structure, scope and priorities. Most of the formal documents are short, in the 16 to 40 pages range. Core values such as equity, solidarity and sustainability are explicitly put forward in 2/6 cantonal plans. Priority health issues shared by all 6 cantons are “physical activity/sedentariness” and “nutrition/food.” Mental health is explicitly mentioned in 5 cantonal plans, whereas tobacco and alcohol consumptions are mentioned 4 times. Less attention has been given to topics that appear as major public health challenges at present and in the future in Switzerland, eg, ageing of the population, rise of social inequalities, increase of vulnerable populations. Little attention has also been paid to issues like domestic violence or healthy work environments. Despite some heterogeneity, there is a common base that should make inter-cantonal collaborations possible and coordination with national strategies easily feasible.

  19. High priority tank sampling and analysis report

    Energy Technology Data Exchange (ETDEWEB)

    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

  20. High priority tank sampling and analysis report

    International Nuclear Information System (INIS)

    Brown, T.M.

    1998-01-01

    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

  1. System of Strategic Priorities and Indicators of Ecologically Sustainable Subsoil Use

    Directory of Open Access Journals (Sweden)

    Lebedev Yuriy

    2015-01-01

    Full Text Available The system of strategic priorities and indicators of ecologically sustainable subsoil use is based on a fundamental basis - biotic regulation and it has a systematic character defined by conceptual, ideological, political and economic levels of management. It also possesses strict priorities and is based on interrelated ecological, economic and social factors, it reflects space-time dynamics of development and subsoil use. The indicators of ecologically sustainable subsoil use are indicators that characterize the change of natural, social and economic environment at different times; they provide qualitative and quantitative characteristic of subsoil use problem. The majority of existing sets of indicators of sustainable subsoil use doesn’t give a complete picture, is weakly connected with each other and no priorities are distinguished among them.

  2. Research priorities for coordinating management of food safety and water quality.

    Science.gov (United States)

    Crohn, David M; Bianchi, Mary L

    2008-01-01

    Efforts to exclude disease organisms from farms growing irrigated lettuce and leafy vegetables on California's central coast are conflicting with traditionally accepted strategies to protect surface water quality. To begin resolving this dilemma, over 100 officials, researchers, and industry representatives gathered in April 2007 to set research priorities that could lead to effective co-management of both food safety and water quality. Following the meeting, research priorities were refined and ordered by way of a Delphi process completed by 35 meeting participants. Although water quality and food safety experts conceptualized the issues differently, there were no deep disagreements with respect to research needs. Top priority was given to investigating the fate of pathogens potentially present on farms. Intermediate priorities included characterizing the influence of specific farm management practices on food safety and improving our understanding of vector processes. A scientific subdiscipline focusing on competing risks is needed to characterize and resolve conflicts between human and environmental health.

  3. 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.

    Science.gov (United States)

    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].

  4. newspapers' agricultural agenda setting and extension agents ...

    African Journals Online (AJOL)

    p2333147

    Keywords: Newspapers', agricultural, extension agents' agenda setting. ABSTRACT ... from the priorities of political or other interest groups to the news priorities of media ... people. The questions that arise are-: what are the sources operating for ... The ADPs presently adopt the training and visit (T & V) system of extension.

  5. Planning a Family: Priorities and Concerns in Rural Tanzania ...

    African Journals Online (AJOL)

    Planning a Family: Priorities and Concerns in Rural Tanzania. T Marchant, AK Mushi, R Nathan, O Mukasa, S Abdulla, C Lengeler, JRM Armstrong Schellenberg. Abstract. A fertility survey using qualitative and quantitative techniques described a high fertility setting (TFR 5.8) in southern Tanzania where family planning use ...

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

    Science.gov (United States)

    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.

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

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Chapman, Glyn

    2008-01-01

    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...... a combination of step-down and micro-costing was applied. Effectiveness of health interventions was estimated based on published information on the efficacy adjusted for factors such as coverage and compliance. Results: Very cost-effective interventions were available for the major health problems. Using...... estimates of the burden of disease, the present paper developed packages of health interventions using the estimated cost-effectiveness ratios. These packages could avert a quarter of the burden of disease at total costs corresponding to one tenth of the public health budget in the financial year 1997...

  8. Conclusions on severe accident research priorities

    International Nuclear Information System (INIS)

    Klein-Heßling, W.; Sonnenkalb, M.; Jacquemain, D.; Clément, B.; Raimond, E.; Dimmelmeier, H.; Azarian, G.; Ducros, G.; Journeau, C.; Herranz Puebla, L.E.; Schumm, A.; Miassoedov, A.; Kljenak, I.; Pascal, G.; Bechta, S.; Güntay, S.; Koch, M.K.; Ivanov, I.; Auvinen, A.; Lindholm, I.

    2014-01-01

    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

  9. Control module and module for priority set-up for the CAMAC universal branch driver

    International Nuclear Information System (INIS)

    Nguen Fuk; Smirnov, V.A.

    1976-01-01

    Control module of BKD-871 universal branch driver operates as a controller in the control crate. This module performs synchronous data transmission to (from) the computer and shapes time signals for A-type controllers. The following regimes of data block transmission may be organized with the help of the control module: address scanning regime; repeated reference regime; stop regime. A priority driving module is required for organization of simultaneous operation from several control sources

  10. The nuclear safety account and the Chernobyl nuclear power plant

    International Nuclear Information System (INIS)

    Maltini, F.

    1996-01-01

    In 1993, the G-7 officially proposed that the European Bank for Reconstruction and Development set up the Nuclear Safety Account (NSA) and act as the Account's secretariat. The Bank's Board of Directors approved this proposal and the Rules of the NSA on 22 March 1993 and the NSA became effective on 14 April 1993. The NSA finances, through grants, operational and near-term technical safety improvements for Soviet-designed nuclear reactors in the countries of the former Soviet Union, central and eastern Europe. Priority is given to those reactors which present the highest level of risk that can be significantly reduced by short-term and cost-effective safety improvements, and which are necessary to ensure the continuing electricity supply in the region. Efforts are therefore focused on WWER 440/230 and RBMK types of reactors and on the purchase of equipment as opposed to studies, which a number of donors already fund. Finance from the NSA is not used to extend the operating lifetime of unsafe reactors

  11. Rationale set of indicators and prioritize relevant to assess competitive activity of hockey players of high qualification of different roles

    Directory of Open Access Journals (Sweden)

    A.P. Mikhnov

    2015-02-01

    Full Text Available Purpose: organize technical and tactical actions and determine their priority importance for high-end players of different roles. Establish their priority importance for the success of competitive activity hockey with the game roles. Material : the study involved 54 experts on hockey coaches and players of high class. The significance of technical and tactical actions evaluated for players of different roles. Results : systematic account of technical and tactical actions of athletes and prioritize them to assess the significance of competitive activity. Three groups of technical and tactical actions: 1 active attacks; 2 - active safety; 3 - organizational and maneuvering. Set priorities for technical and tactical actions for players of different roles. Conclusions : the proposed technical and tactical actions can be recommended for the evaluation of the effectiveness of competitive activity players. In the process of estimating the action game players need to consider their role playing. Identification of priority in the implementation of technical and tactical actions in the game can be used in integrated assessment of actions players different roles.

  12. M2 priority screening system for near-term activities: Project documentation. Final report December 11, 1992--May 31, 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-08-12

    From May through August, 1993, the M-2 Group within M Division at LANL conducted with the support of the LANL Integration and Coordination Office (ICO) and Applied Decision Analysis, Inc. (ADA), whose purpose was to develop a system for setting priorities among activities. This phase of the project concentrated on prioritizing near-tenn activities (i.e., activities that must be conducted in the next six months) necessary for setting up this new group. Potential future project phases will concentrate on developing a tool for setting priorities and developing annual budgets for the group`s operations. The priority screening system designed to address the near-term problem was developed, applied in a series of meeting with the group managers, and used as an aid in the assignment of tasks to group members. The model was intended and used as a practical tool for documenting and explaining decisions about near-term priorities, and not as a substitute for M-2 management judgment and decision-making processes.

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

    Science.gov (United States)

    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…

  14. Effects of Payment for Performance on accountability mechanisms: Evidence from Pwani, Tanzania.

    Science.gov (United States)

    Mayumana, Iddy; Borghi, Jo; Anselmi, Laura; Mamdani, Masuma; Lange, Siri

    2017-04-01

    Payment for Performance (P4P) aims to improve provider motivation to perform better, but little is known about the effects of P4P on accountability mechanisms. We examined the effect of P4P in Tanzania on internal and external accountability mechanisms. We carried out 93 individual in-depth interviews, 9 group interviews and 19 Focus Group Discussions in five intervention districts in three rounds of data collection between 2011 and 2013. We carried out surveys in 150 health facilities across Pwani region and four control districts, and interviewed 200 health workers, before the scheme was introduced and 13 months later. We examined the effects of P4P on internal accountability mechanisms including management changes, supervision, and priority setting, and external accountability mechanisms including provider responsiveness to patients, and engagement with Health Facility Governing Committees. P4P had some positive effects on internal accountability, with increased timeliness of supervision and the provision of feedback during supervision, but a lack of effect on supervision intensity. P4P reduced the interruption of service delivery due to broken equipment as well as drug stock-outs due to increased financial autonomy and responsiveness from managers. Management practices became less hierarchical, with less emphasis on bureaucratic procedures. Effects on external accountability were mixed, health workers treated pregnant women more kindly, but outreach activities did not increase. Facilities were more likely to have committees but their role was largely limited. P4P resulted in improvements in internal accountability measures through improved relations and communication between stakeholders that were incentivised at different levels of the system and enhanced provider autonomy over funds. P4P had more limited effects on external accountability, though attitudes towards patients appeared to improve, community engagement through health facility governing committees

  15. Priority of areas for agricultural radiovulnerability mapping

    Energy Technology Data Exchange (ETDEWEB)

    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)

  16. Priority of areas for agricultural radiovulnerability mapping

    International Nuclear Information System (INIS)

    Rochedo, Elaine R.R.; Igreja, Eduardo; Perez, Daniel V.; Rochedo, Pedro R.R.; Silva, Diogo N.G.

    2013-01-01

    The methodology for classifying areas according to soil properties for the vulnerability to a 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)

  17. 29 CFR 1990.132 - Factors to be considered.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) IDENTIFICATION, CLASSIFICATION, AND REGULATION OF POTENTIAL OCCUPATIONAL CARCINOGENS Priority Setting § 1990.132 Factors to be considered. (a) The setting of priorities is a complex matter which... respect to the setting of priorities. (b) Some factors which may be taken into account in setting...

  18. A fundamentalist perspective on accounting and implications for accounting research

    Institute of Scientific and Technical Information of China (English)

    Guohua; Jiang; Stephen; Penman

    2013-01-01

    This paper presents a framework for addressing normative accounting issues for reporting to shareholders. The framework is an alternative to the emerging Conceptual Framework of the International Accounting Standards Board and the Financial Accounting Standards Board. The framework can be broadly characterized as a utilitarian approach to accounting standard setting. It has two main features. First, accounting is linked to valuation models under which shareholders use accounting information to values their stakes. Second, the desirable characteristics of accounting information are inferred from the demand of investors and analysts who use the information in practice. This stands in contrast to the "qualitative characteristics" in the Boards’ Framework which are embraced largely on the basis of their aesthetic appeal. These features lead to a set of broad accounting principles that resolve "recognition"and "measurement" issues at the core of the Boards’ Conceptual Framework and also the central issue of a balance sheet approach versus an income statement approach. The framework in the paper also frames the research questions for researchers interested in accounting policy.

  19. Diversity as a common research priority for Nordic and Southern African Universities

    DEFF Research Database (Denmark)

    Petersen, Karen Bjerg

    This paper sets out to consider concepts of diversity as means to discuss and address the increasing diversity of modern societies and to reflect the development of research priorities for universities in Nordic and Southern African countries. Based on reconceptualisations of theoretical concepts...... like culture, multiculturalism and national identity the presentation will address and reflect upon how modern societies in South and North are becoming increasingly diverse with respect to demographic and ethno cultural composition of the population. The paper sets out to discuss how various European...... countries like e.g. Denmark have responded differently to diversification during the past decades. Based on this, challenges in deal-ing with diversity as a common research priority for Nordic and African universities will be shortly addressed....

  20. A traffic priority language for collision-free navigation of autonomous mobile robots in dynamic environments.

    Science.gov (United States)

    Bourbakis, N G

    1997-01-01

    This paper presents a generic traffic priority language, called KYKLOFORTA, used by autonomous robots for collision-free navigation in a dynamic unknown or known navigation space. In a previous work by X. Grossmman (1988), a set of traffic control rules was developed for the navigation of the robots on the lines of a two-dimensional (2-D) grid and a control center coordinated and synchronized their movements. In this work, the robots are considered autonomous: they are moving anywhere and in any direction inside the free space, and there is no need of a central control to coordinate and synchronize them. The requirements for each robot are i) visual perception, ii) range sensors, and iii) the ability of each robot to detect other moving objects in the same free navigation space, define the other objects perceived size, their velocity and their directions. Based on these assumptions, a traffic priority language is needed for each robot, making it able to decide during the navigation and avoid possible collision with other moving objects. The traffic priority language proposed here is based on a set of primitive traffic priority alphabet and rules which compose pattern of corridors for the application of the traffic priority rules.

  1. Establishing research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus.

    Science.gov (United States)

    Turner, Grace M; Backman, Ruth; McMullan, Christel; Mathers, Jonathan; Marshall, Tom; Calvert, Melanie

    2018-01-01

    that care should be delivered (clinical setting and follow-up pathway); impact on family members; and education/training for health care professionals. Background Clinical management after transient ischaemic attack (TIA) and minor stroke focuses on stroke prevention. However, evidence demonstrates that many patients experience ongoing residual impairments. Residual impairments post-TIA and minor stroke may affect patients' quality of life and return to work or social activities. Research priorities of patients, health care professionals and key stakeholders relating to the long-term impact of TIA and minor stroke are unknown. Methods Our objective was to establish the top shared research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus. A one-day priority setting consensus meeting took place with representatives from different stakeholder groups in October 2016 (Birmingham, UK). Nominal group technique was used to establish research priorities. This involved three stages: (i) gathering research priorities from individual stakeholders; (ii) interim prioritisation in three subgroups; and (iii) final priority setting. Results The priority setting consensus meeting was attended by 11 stakeholders. The individual stakeholders identified 34 different research priorities. During the interim prioritisation exercise, the three subgroups generated 24 unique research priorities which were discussed as a whole group. Following the final consensus discussion, 11 shared research priorities were unanimously agreed.The 11 research questions encompass a range of categories, including: understanding the existing care patients receive (according to diagnosis and geographical location); exploring what optimal care post-TIA/minor stroke should comprise (identifying and treating impairments, information giving and support groups) and how that care should be delivered (clinical setting and follow-up pathway); impact on family members

  2. Depreciation Accounting in the Uniform Chart of Accounts.

    Science.gov (United States)

    1982-12-01

    footage of building occupied. Reason( s ) for Compute full cost of Rate setting, cash accounting for patient care flow generation and fund- depreciation ing... Horngren , Charles T., Cost Accounting ; A Managerial Emphasis, Prentice-Hall Inc., 1972. 32. Sawyer, Lawrence B., The Practice of Modern Internal Auditing...Awd ubtlft) S . TYPE or RE PORT a PE*IoO CovIERWO Master’s Thesis; Depreciation Accounting in the Uniform Dembr18 Chart of Accounts .PSOiwON.EORlumm

  3. Priorities for Extension.

    Science.gov (United States)

    Hayward, J. A.

    Agricultural extension is one component in an array including research, training, education, marketing, international trade, etc. which develop together to bring about growth, and sustained growth determines the priorities for extension. These priorities depend inevitably on the stage of development of a country or region, and on the current…

  4. Research priorities in health communication and participation: international survey of consumers and other stakeholders

    Science.gov (United States)

    Bragge, Peter; Lowe, Dianne; Nunn, Jack S; O’Sullivan, Molly; Horvat, Lidia; Tong, Allison; Kay, Debra; Ghersi, Davina; McDonald, Steve; Poole, Naomi; Bourke, Noni; Lannin, Natasha; Vadasz, Danny; Oliver, Sandy; Carey, Karen; Hill, Sophie J

    2018-01-01

    Objective To identify research priorities of consumers and other stakeholders to inform Cochrane Reviews in ‘health communication and participation’ (including such concepts as patient experience, shared decision-making and health literacy). Setting International. Participants We included anyone with an interest in health communication and participation. Up to 151 participants (18–80 years; 117 female) across 12 countries took part, including 48 consumers (patients, carers, consumer representatives) and 75 professionals (health professionals, policymakers, researchers) (plus 25 people who identified as both). Design Survey. Methods We invited people to submit their research ideas via an online survey open for 4 weeks. Using inductive thematic analysis, we generated priority research topics, then classified these into broader themes. Results Participants submitted 200 research ideas, which we grouped into 21 priority topics. Key research priorities included: insufficient consumer involvement in research (19 responses), ‘official’ health information is contradictory and hard to understand (18 responses), communication/coordination breakdowns in health services (15 responses), health information provision a low priority for health professionals (15 responses), insufficient eliciting of patient preferences (14 responses), health services poorly understand/implement patient-centred care (14 responses), lack of holistic care impacting healthcare quality and safety (13 responses) and inadequate consumer involvement in service design (11 responses). These priorities encompassed acute and community health settings, with implications for policy and research. Priority populations of interest included people from diverse cultural and linguistic backgrounds, carers, and people with low educational attainment, or mental illness. Most frequently suggested interventions focused on training and cultural change activities for health services and health professionals

  5. Global research priorities for interpersonal violence prevention: a modified Delphi study.

    Science.gov (United States)

    Mikton, Christopher R; Tanaka, Masako; Tomlinson, Mark; Streiner, David L; Tonmyr, Lil; Lee, Bandy X; Fisher, Jane; Hegadoren, Kathy; Pim, Joam Evans; Wang, Shr-Jie Sharlenna; MacMillan, Harriet L

    2017-01-01

    To establish global research priorities for interpersonal violence prevention using a systematic approach. Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2, 280 international experts ranked the importance of research in the four steps, and the various substeps, of the public health approach. In round 3, 131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority in round 2. In round 2, "developing, implementing and evaluating interventions" was the step of the public health approach awarded the highest priority for four of the six types of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, "scaling up interventions and evaluating their cost-effectiveness" was ranked lowest for all types of violence. In round 3, research into "developing, implementing and evaluating interventions" that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. These findings suggest it is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority.

  6. Priorities of statutory claimants

    International Nuclear Information System (INIS)

    Pawluck, B.K.; Prowse, J.T.

    1996-01-01

    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

  7. Two Concepts of Accountability: Accountability as a Virtue and as a Mechanisme

    NARCIS (Netherlands)

    Bovens, M.A.P.|info:eu-repo/dai/nl/074257021

    2010-01-01

    This paper distinguishes between two main concepts of accountability: accountability as a virtue and accountability as a mechanism. In the former case, accountability is used primarily as a normative concept, as a set of standards for the evaluation of the behaviour of public actors. Accountability

  8. Identifying Priorities for Aging Policies in Two Portuguese Communities.

    Science.gov (United States)

    Bárrios, Maria João; Fernandes, Ana Alexandre; Fonseca, António Manuel

    2018-02-20

    The aging population has an impact on health, social, and economic issues in regard to individuals, communities, and organizations. The challenge for local policies in response to aging is to create sufficient resources to meet the population's needs, wishes, and rights as people age. Active aging constitutes one of the guiding perspectives on policies. Taking into account the local governance perspective, the Model for Aging Local Policies Analysis (MALPA) was created in order to convert the active aging paradigm into a practical approach, as a technique to evaluate and analyze local aging policies. In this research, the MALPA instrument was applied in two Portuguese communities (Coruche and Oeiras). The objective was to identify the intervention priorities of aging policies in both communities, determining whether the instrument can facilitate the development of proposals for the improvement of local aging policies. It was possible to evaluate the communities and programs, identifying the least appropriate policy actions regarding the intervention priorities. The results allowed us to identify 10 priorities about collaborative governance, involvement of the elderly in the policy-making process, lifelong learning, economic hardship, policies for all ages, isolated vulnerable and fragile groups, intergenerational contacts, safety in all policies, labor opportunities, and conditions and transport network improvement.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  11. Consistency endangered by FASB-GASB (Financial Accounting Standards Board, Government Accounting Standards Board ) dispute.

    Science.gov (United States)

    Garner, M; Grossman, W

    1991-02-01

    The Financial Accounting Foundation's (FAF's) November 1989 decision to uphold the 1984 jurisdictional arrangement between the Financial Accounting Standards Board (FASB) and the Government Accounting Standards Board (GASB) leaves little doubt that the healthcare industry will now be subject to two sets of accounting standards. The FAF's decision created a distinction between the accounting practices of government-owned hospitals and non-hospital governmental entities and their adherence to standards set by FASB, GASB, and the American Institute of Certified Public Accountants. A governmental healthcare organization should carefully determine which accounting rules it follows and remain attentive to further GASB developments.

  12. Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

    Science.gov (United States)

    Plint, Amy C; Stang, Antonia S; Calder, Lisa A

    2015-01-01

    Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

  13. Exploring Citizen Infrastructure and Environmental Priorities in Mumbai, India

    Energy Technology Data Exchange (ETDEWEB)

    Sperling, Joshua; Romero-Lankao, Patricia; Beig, Gufran

    2016-06-01

    Many cities worldwide seek to understand local policy priorities among their general populations. This study explores how differences in local conditions and among citizens within and across Mumbai, India shape local infrastructure (e.g. energy, water, transport) and environmental (e.g. managing pollution, climate-related extreme weather events) policy priorities for change that may or may not be aligned with local government action or global environmental sustainability concerns such as low-carbon development. In this rapidly urbanizing city, multiple issues compete for prominence, ranging from improved management of pollution and extreme weather to energy and other infrastructure services. To inform a broader perspective of policy priorities for urban development and risk mitigation, a survey was conducted among over 1200 citizens. The survey explored the state of local conditions, the challenges citizens face, and the ways in which differences in local conditions (socio-institutional, infrastructure, and health-related) demonstrate inequities and influence how citizens perceive risks and rank priorities for the future design and implementation of local planning, policy, and community-based efforts. With growing discussion and tensions surrounding the new urban sustainable development goal, announced by the UN in late September 2015, and a new global urban agenda document to be agreed upon at 'Habitat III', issues on whether sustainable urbanization priorities should be set at the international, national or local level remain controversial. As such, this study aims to first understand determinants of and variations in local priorities across one city, with implications discussed for local-to-global urban sustainability. Findings from survey results indicate the determinants and variation in conditions such as age, assets, levels of participation in residential action groups, the health outcome of chronic asthma, and the infrastructure service of piped

  14. Locating assistive technology research in a clinical setting: an occupational perspective.

    Science.gov (United States)

    Fowler-Davis, Sally; Evans, Laura; Cudd, Peter

    2015-01-01

    Peer research was used to identify the experience and perceptions of assistive technology and telecare adoption in a UK healthcare context. A narrative account of participation and learning is intended to provoke further dialogue. There have been a range of policy and implementation initiatives that are within the direct experience of organisational actors over the last 15 years and this engagement allows for specific reflection on the service achievements and some of the barriers to implementation of technology changes in rehabilitation practice and service design. Insights are presented that suggest a reification of research priorities and a need to align technology, through patient and public engagement, to provider priorities. In addition, an improvement in adoption would be based on sustained capacity building within the Occupational Therapy workforce and a re-focus on specific knowledge sharing and learning about technology. Given the shared desire to promote the sustained adoption of appropriate technology for assistance and rehabilitation it is suggested the voice of practitioners is strengthened through research and knowledge exchange in the clinical setting.

  15. Accounting Students' Perspective of Work-Relevant Communication Skills: Evidence from a Philippine University

    Science.gov (United States)

    Tenedero, Pia Patricia P.

    2017-01-01

    To further probe the alignment (or misalignment) of university and industry priorities in terms of English language skills development of future accountants, this study extends the earlier investigation of employers' perception on the communication skills needed by entry-level accountants. Using conjoint analysis, this research examines the…

  16. Hybrid task priority-based motion control of a redundant free-floating space robot

    Directory of Open Access Journals (Sweden)

    Cheng ZHOU

    2017-12-01

    Full Text Available This paper presents a novel hybrid task priority-based motion planning algorithm of a space robot. The satellite attitude control task is defined as the primary task, while the least-squares-based non-strict task priority solution of the end-effector plus the multi-constraint task is viewed as the secondary task. Furthermore, a null-space task compensation strategy in the joint space is proposed to derive the combination of non-strict and strict task-priority motion planning, and this novel combination is termed hybrid task priority control. Thus, the secondary task is implemented in the primary task’s null-space. Besides, the transition of the state of multiple constraints between activeness and inactiveness will only influence the end-effector task without any effect on the primary task. A set of numerical experiments made in a real-time simulation system under Linux/RTAI shows the validity and feasibility of the proposed methodology. Keywords: Base attitude control, Hybrid task-priority, Motion planning, Multiple constraints, Redundant space robot

  17. Final priority; Rehabilitation Services Administration--Assistive Technology Alternative Financing Program. Final priority.

    Science.gov (United States)

    2014-08-14

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Assistive Technology Alternative Financing Program administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. This priority is designed to ensure that the Department funds high-quality assistive technology (AT) alternative financing programs (AFPs) that meet rigorous standards in order to enable individuals with disabilities to access and acquire assistive technology devices and services necessary to achieve education, community living, and employment goals.

  18. The necessary guidance on the application of JUSTIFICATION and ALARA by the nuclear authorities, using 'Accountability for Reasonableness' as a decision making process

    International Nuclear Information System (INIS)

    Veuchelen, Ludo

    2008-01-01

    Full text: In all branches of law, but foremost in international nuclear law, the global economic system brings along a vast record of Soft Law covering General Principles and Standards. For a part we can find these Soft Law Principles and Standards back in the clothing of hard law, or in the licensing procedures, at the national level. The larger part however is never 'transposed' into national laws and especially the harmonization, the implementation and control of such Principles and Standards remain doubtful. In this paper the focus lies on JUSTIFICATION and ALARA, as the main nuclear safety principles, accepted world-wide. The regulatory guidance and demonstration of these Principles, indicating which (numerical) safety levels or safety objectives are mandatory and which are only guidance should be undertaken by the international regulators and authorities, but are often lacking. It is the aim of this paper to come up with a better procedural framework for a priority setting process by nuclear authorities. Establishing a fair process for priority setting is easier than agreeing on principles. We use the idea of 'Accountability for Reasonableness', developed in the field of Health Care Management. An ideal model of priority setting within the JUSTIFICATION/ALARA approach will need to specify what should be done (i.e. justified ethically) and how it can be done (i.e. based in empirical reality and on benchmarking), to reach optimal levels of nuclear safety. (author)

  19. Radiation exposure usage accountability and impact with respect to ALAP (ALARA) analysis

    International Nuclear Information System (INIS)

    Williams, M.C.

    1978-01-01

    A unique method has been developed for radiation exposure usage accounting at the N Reactor. This method accounts for exposure usage by specific job and working crafts. The accounting system provides information for use in job planning, exposure resource management, and ALAP (ALARA) analysis. It provides justification for ALAP expenditures, documentation of the effectiveness of exposure reduction efforts, and can be used to establish priorities for ALAP efforts

  20. Newborn health benefits or financial risk protection? An ethical analysis of a real-life dilemma in a setting without universal health coverage.

    Science.gov (United States)

    Onarheim, Kristine Husøy; Norheim, Ole Frithjof; Miljeteig, Ingrid

    2018-03-30

    High healthcare costs make illness precarious for both patients and their families' economic situation. Despite the recent focus on the interconnection between health and financial risk at the systemic level, the ethical conflict between concerns for potential health benefits and financial risk protection at the household level in a low-income setting is less understood. Using a seven-step ethical analysis, we examine a real-life dilemma faced by families and health workers at the micro level in Ethiopia and analyse the acceptability of limiting treatment for an ill newborn to protect against financial risk. We assess available evidence and ethical issues at stake and discuss the dilemma with respect to three priority setting criteria: health maximisation, priority to the worse-off and financial risk protection. Giving priority to health maximisation and extra priority to the worse-off suggests, in this particular case, that limiting treatment is not acceptable even if the total well-being gain from reduced financial risk is taken into account. Our conclusion depends on the facts of the case and the relative weight assigned to these criteria. However, there are problematic aspects with the premise of this dilemma. The most affected parties-the newborn, family members and health worker-cannot make free choices about whether to limit treatment or not, and we thereby accept deprivations of people's substantive freedoms. In settings where healthcare is financed largely out-of-pocket, families and health workers face tragic trade-offs. As countries move towards universal health coverage, financial risk protection for high-priority services is necessary to promote fairness, improve health and reduce poverty. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. QUEUEING DISCIPLINES BASED ON PRIORITY MATRIX

    Directory of Open Access Journals (Sweden)

    Taufik I. Aliev

    2014-11-01

    Full Text Available The paper deals with queueing disciplines for demands of general type in queueing systems with multivendor load. A priority matrix is proposed to be used for the purpose of mathematical description of such disciplines, which represents the priority type (preemptive priority, not preemptive priority or no priority between any two demands classes. Having an intuitive and simple way of priority assignment, such description gives mathematical dependencies of system operation characteristics on its parameters. Requirements for priority matrix construction are formulated and the notion of canonical priority matrix is given. It is shown that not every matrix, constructed in accordance with such requirements, is correct. The notion of incorrect priority matrix is illustrated by an example, and it is shown that such matrixes do not ensure any unambiguousness and determinacy in design of algorithm, which realizes corresponding queueing discipline. Rules governing construction of correct matrixes are given for canonical priority matrixes. Residence time for demands of different classes in system, which is the sum of waiting time and service time, is considered as one of the most important characteristics. By introducing extra event method Laplace transforms for these characteristics are obtained, and mathematical dependencies are derived on their basis for calculation of two first moments for corresponding characteristics of demands queueing

  2. International Occupational Therapy Research Priorities.

    Science.gov (United States)

    Mackenzie, Lynette; Coppola, Susan; Alvarez, Liliana; Cibule, Lolita; Maltsev, Sergey; Loh, Siew Yim; Mlambo, Tecla; Ikiugu, Moses N; Pihlar, Zdenka; Sriphetcharawut, Sarinya; Baptiste, Sue; Ledgerd, Richard

    2017-04-01

    Occupational therapy is a global profession represented by the World Federation of Occupational Therapists (WFOT). International research priorities are needed for strategic guidance on global occupational therapy practice. The objective of this study was to develop international research priorities to reflect global occupational therapy practice. A Delphi study using three rounds of electronic surveys, distributed to WFOT member organizations and WFOT accredited universities, was conducted. Data were analyzed after each round, and priorities were presented for rating and ranking in order of importance. Forty-six (53%) out of 87 WFOT member countries participated in the Delphi process. Eight research priorities were confirmed by the final electronic survey round. Differences were observed in rankings given by member organizations and university respondents. Despite attrition at Round 3, the final research priorities will help to focus research efforts in occupational therapy globally. Follow-up research is needed to determine how the research priorities are being adopted internationally.

  3. Harnessing the Potential to Quantify Public Preferences for Healthcare Priorities through Citizens’ Juries

    Directory of Open Access Journals (Sweden)

    Jennifer A. Whitty

    2014-07-01

    Full Text Available Despite progress towards greater public engagement, questions about the optimal approach to access public preferences remain unanswered. We review two increasingly popular methods for engaging the public in healthcare priority-setting and determining their preferences; the Citizens’ Jury (CJ and Discrete Choice Experiment (DCE. We discuss the theoretical framework from which each method is derived, its application in healthcare, and critique the information it can provide for decision-makers. We conclude that combining deliberation of an informed public via CJs and quantification of preferences using DCE methods, whilst it remains to be tested as an approach to engaging the public in priority-setting, could potentially achieve much richer information than the application of either method in isolation.

  4. Factoring economic costs into conservation planning may not improve agreement over priorities for protection.

    Science.gov (United States)

    Armsworth, Paul R; Jackson, Heather B; Cho, Seong-Hoon; Clark, Melissa; Fargione, Joseph E; Iacona, Gwenllian D; Kim, Taeyoung; Larson, Eric R; Minney, Thomas; Sutton, Nathan A

    2017-12-21

    Conservation organizations must redouble efforts to protect habitat given continuing biodiversity declines. Prioritization of future areas for protection is hampered by disagreements over what the ecological targets of conservation should be. Here we test the claim that such disagreements will become less important as conservation moves away from prioritizing areas for protection based only on ecological considerations and accounts for varying costs of protection using return-on-investment (ROI) methods. We combine a simulation approach with a case study of forests in the eastern United States, paying particular attention to how covariation between ecological benefits and economic costs influences agreement levels. For many conservation goals, agreement over spatial priorities improves with ROI methods. However, we also show that a reliance on ROI-based prioritization can sometimes exacerbate disagreements over priorities. As such, accounting for costs in conservation planning does not enable society to sidestep careful consideration of the ecological goals of conservation.

  5. A Survey on Priority Queues

    DEFF Research Database (Denmark)

    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 qu...

  6. Setting priorities for safe motherhood interventions in resource-scarce settings.

    Science.gov (United States)

    Prata, Ndola; Sreenivas, Amita; Greig, Fiona; Walsh, Julia; Potts, Malcolm

    2010-01-01

    Guide policy-makers in prioritizing safe motherhood interventions. Three models (LOW, MED, HIGH) were constructed based on 34 sub-Saharan African countries to assess the relative cost-effectiveness of available safe motherhood interventions. Cost and effectiveness data were compiled and inserted into the WHO Mother Baby Package Costing Spreadsheet. For each model we assessed the percentage in maternal mortality reduction after implementing all interventions, and optimal combinations of interventions given restricted budgets of US$ 0.50, US$ 1.00, US$ 1.50 per capital maternal health expenditures respectively for LOW, MED, and HIGH models. The most cost-effective interventions were family planning and safe abortion (fpsa), antenatal care including misoprostol distribution for postpartum hemorrhage prevention at home deliveries (anc-miso), followed by sepsis treatment (sepsis) and facility-based postpartum hemorrhage management (pph). The combination of interventions that avert the greatest number of maternal deaths should be prioritized and expanded to cover the greatest number of women at risk. Those which save the most number of lives in each model are 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for LOW; 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for MED; and 'fpsa, anc-miso, sepsis, eclampsia treatment, safe delivery' for HIGH settings. Safe motherhood interventions save a significant number of newborn lives.

  7. PHA Annual report and accounts 2014-2015

    OpenAIRE

    Public Health Agency

    2015-01-01

    The Public Health Agency Annual report 2014 2015 provides background information about the PHA, highlights the achievements during the�2014-2015 financial year and provides an overview of work undertaken in priority areas�within each directorate�of�the organisation.The�full financial accounts are included in this report as is�information on members of the PHA board.Click here for the PDF.

  8. PHA Annual report and accounts 2012-2013

    OpenAIRE

    Public Health Agency

    2013-01-01

    The Public Health Agency Annual report 2012-2013 provides background information about the PHA, highlights the achievements during the�2012-2013 financial year and provides an overview of work undertaken in priority areas�within each directorate�of�the organisation.The�full financial accounts are included in this report as is�information on members of the PHA board.Click here for the PDF

  9. Defining priorities

    CERN Multimedia

    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...

  10. Cash Flows versus Accounting Earnings in Managing Exchange Rate Exposures: An Empirical Study of Non-Financial Companies

    DEFF Research Database (Denmark)

    Aabo, Tom

    Financial theory argues that companies should manage cash flows and not accounting earnings when they hedge exchange rate exposures. Still, empirical evidence shows that a number of companies choose to manage accounting earnings. This empirical study of Danish, non-financial companies finds (1......) that when hedging the majority of companies expect to add value to their company by avoiding financial distress (reduce down side risk), (2) that when hedging managing cash flows versus managing accounting earnings as a first priority splits the companies in two, (3) a lack of difference (except...... for profitability) in company characteristics between the group of companies that manage cash flows versus the group of companies that manage accounting earnings as a first priority. The decision in real business on whether to manage cash flows or accounting earnings when hedging exchange rate exposures seems...

  11. 15 CFR 700.11 - Priority ratings.

    Science.gov (United States)

    2010-01-01

    ... OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE NATIONAL SECURITY INDUSTRIAL BASE REGULATIONS DEFENSE PRIORITIES AND ALLOCATIONS SYSTEM Industrial Priorities § 700.11 Priority ratings. (a) Levels of...

  12. Mammals on the EDGE: conservation priorities based on threat and phylogeny.

    Directory of Open Access Journals (Sweden)

    Nick J B Isaac

    2007-03-01

    Full Text Available Conservation priority setting based on phylogenetic diversity has frequently been proposed but rarely implemented. Here, we define a simple index that measures the contribution made by different species to phylogenetic diversity and show how the index might contribute towards species-based conservation priorities. We describe procedures to control for missing species, incomplete phylogenetic resolution and uncertainty in node ages that make it possible to apply the method in poorly known clades. We also show that the index is independent of clade size in phylogenies of more than 100 species, indicating that scores from unrelated taxonomic groups are likely to be comparable. Similar scores are returned under two different species concepts, suggesting that the index is robust to taxonomic changes. The approach is applied to a near-complete species-level phylogeny of the Mammalia to generate a global priority list incorporating both phylogenetic diversity and extinction risk. The 100 highest-ranking species represent a high proportion of total mammalian diversity and include many species not usually recognised as conservation priorities. Many species that are both evolutionarily distinct and globally endangered (EDGE species do not benefit from existing conservation projects or protected areas. The results suggest that global conservation priorities may have to be reassessed in order to prevent a disproportionately large amount of mammalian evolutionary history becoming extinct in the near future.

  13. Research priorities in mental health occupational therapy: A study of clinician perspectives.

    Science.gov (United States)

    Hitch, Danielle; Lhuede, Kate

    2015-10-01

    The evidence to support mental health occupational therapy has proliferated in the early years of this century, but this growth has tended to be organic rather than targeted. Previous efforts to identify research priorities in this area of practice are either out dated, or encompass discrete areas of practice. The aim of this study was to identify priority areas for research in mental health occupational therapy from clinician's perspectives. A Policy Delphi method was used to enable occupational therapists to define and differentiate their perspectives on research priorities. Forty-two occupational therapists took part in the first two rounds of this method, with 69% (n = 29) going on to complete the third and final round of data collection. A Likert scale was used to rate the importance of each priority, and descriptive quantitative analysis undertaken to identify those most consistently identified as being highly important. Four research priorities were identified as being highly important in this study: (i) working in an occupationally focussed way; (ii) consumer experience of therapy groups; (iii) identifying factors which increase consumer engagement in occupation; and (iv) engaging patients on the inpatient unit in meaningful and positive occupation. Two of the priority areas are already the subject of substantial evidence bases, but there has been far less research into consumer experiences of groups and occupational engagement in acute settings. Collaboration between research teams and greater consumer inclusion are recommended for the future. This study provides an updated indication of research priorities for mental health occupational therapy in Australia. © 2015 Occupational Therapy Australia.

  14. 75 FR 4375 - Transmission Loading Relief Reliability Standard and Curtailment Priorities

    Science.gov (United States)

    2010-01-27

    ... the curtailment priorities set forth in the Commission's pro forma open access transmission tariff... prevent or manage potential or actual system operating limit or interconnection reliability operating...). \\2\\ A System Operating Limit or SOL is the value (such as MW, MVar, amperes, frequency or volts) that...

  15. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis.

    Science.gov (United States)

    Tacconelli, Evelina; Carrara, Elena; Savoldi, Alessia; Harbarth, Stephan; Mendelson, Marc; Monnet, Dominique L; Pulcini, Céline; Kahlmeter, Gunnar; Kluytmans, Jan; Carmeli, Yehuda; Ouellette, Marc; Outterson, Kevin; Patel, Jean; Cavaleri, Marco; Cox, Edward M; Houchens, Chris R; Grayson, M Lindsay; Hansen, Paul; Singh, Nalini; Theuretzbacher, Ursula; Magrini, Nicola

    2018-03-01

    The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs. We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated. The final priority ranking of the antibiotic-resistant bacteria was established after a preference-based survey was used to obtain expert weighting of criteria. We selected 20 bacterial species with 25 patterns of acquired resistance and ten criteria to assess priority: mortality, health-care burden, community burden, prevalence of resistance, 10-year trend of resistance, transmissibility, preventability in the community setting, preventability in the health-care setting, treatability, and pipeline. We stratified the priority list into three tiers (critical, high, and medium priority), using the 33rd percentile of the bacterium's total scores as the cutoff. Critical-priority bacteria included carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, and carbapenem-resistant and third-generation cephalosporin-resistant Enterobacteriaceae. The highest ranked Gram-positive bacteria (high priority) were vancomycin-resistant Enterococcus faecium and meticillin-resistant Staphylococcus aureus. Of the bacteria typically responsible for community-acquired infections, clarithromycin-resistant Helicobacter pylori, and fluoroquinolone-resistant Campylobacter spp, Neisseria gonorrhoeae, and Salmonella typhi were included in the high-priority tier. Future development strategies should focus on

  16. Strategies for implementing transit priority

    International Nuclear Information System (INIS)

    2005-11-01

    Increased urbanization in Canada has placed pressure on an eroding, ageing infrastructure and raised concerns about declining air quality. In addition to reducing emissions, well-designed transit systems can reduce traffic and improve road safety. This paper presented a set of transit best practices which addressed the need to improve supply, influence demand, and make operational improvements with the least environmental impact. The objective of this paper was to gather the best implementation strategies for urban roads from municipalities across Canada, and to focus on solutions that can be applied to bus and streetcar systems to make better use of shared facilities. Bus bulbs, signal priority, queue jumps and green waves were recommended, as well as dedicated lanes and exclusive transit facilities. Advances in technology were reviewed, as well as the use of intelligent transportation systems to improve transit with little or no impact on other road users. Case studies were presented from various municipalities across Canada. Various stages of project development, design and construction, operations and maintenance strategies for the various projects were reviewed. The most successful installations were found to be in cities that have established a clear policy on transit improvements. It was suggested that defining the need for priority and determining where it can be implemented is central to the development of a strategic program. Dedicated programs looking at transit priority were recommended, and risks arising from integrating new infrastructure were reviewed. It was suggested that the range of stakeholders involved, and the internal organization of the implementing authority bore a significant impact on overall cost and schedule of transit projects. It was concluded that appropriate planning is needed to control risks. 20 refs., 3 figs

  17. [Intervention priorities in the acute stage of complex emergencies drafted by nine humanitarian aid agencies].

    Science.gov (United States)

    Carrillo Jaimes, Carmen Sofía; Arcos González, Pedro Ignacio

    2004-01-01

    Complex Emergencies are an international Public Health problem currently becoming increasingly more frequent and of growing proportions which lead to major death and disease rates, especially during the acute stage thereof. This study is aimed at identifying and analyzing the top-priority areas of intervention in the acute stage of a complex emergency drafted in the operating manuals of the main aid agencies, as well as the degree of development and structuring of the activities proposed in each area on which priority has been placed. The intervention manuals drafted by nine major aid agencies were used as study material. A quantitative analysis was then made of the 16 intervention priorities set out, as well as of the degree to which each priority was defined based on the development of 73 variables of aspects of the proposals set out in the manuals. The ACNUR manual includes 90% of the 73 variables for further expansion upon the priorities, the UN Humanitarian Affaire Coordination Office manual including 35% of the 73 variables. ACNUR better expands upon the non-healthcare variables, followed by MSF and USAID. Doctors without borders shows a 97.3% degree of expansion of the healthcare variables) followed by ACNUR (94.7%), USAID (92.1%). ACNUR has been found to have the most integral proposal, the UN Humanitarian Affairs Coordination Office having the most discreet. There is a general trend towad further expanding upon and unifying the health indicators, whilst other aspects are not further expanded upon.

  18. Research priorities for conservation and natural resource management in Oceania's small-island developing states.

    Science.gov (United States)

    Weeks, R; Adams, V M

    2018-02-01

    For conservation science to effectively inform management, research must focus on creating the scientific knowledge required to solve conservation problems. We identified research questions that, if answered, would increase the effectiveness of conservation and natural resource management practice and policy in Oceania's small-island developing states. We asked conservation professionals from academia, governmental, and nongovernmental organizations across the region to propose such questions and then identify which were of high priority in an online survey. We compared the high-priority questions with research questions identified globally and for other regions. Of 270 questions proposed by respondents, 38 were considered high priority, including: What are the highest priority areas for conservation in the face of increasing resource demand and climate change? How should marine protected areas be networked to account for connectivity and climate change? What are the most effective fisheries management policies that contribute to sustainable coral reef fisheries? High-priority questions related to the particular challenges of undertaking conservation on small-island developing states and the need for a research agenda that is responsive to the sociocultural context of Oceania. Research priorities for Oceania relative to elsewhere were broadly similar but differed in specific issues relevant to particular conservation contexts. These differences emphasize the importance of involving local practitioners in the identification of research priorities. Priorities were reasonably well aligned among sectoral groups. Only a few questions were widely considered answered, which may indicate a smaller-than-expected knowledge-action gap. We believe these questions can be used to strengthen research collaborations between scientists and practitioners working to further conservation and natural resource management in this region. © 2017 The Authors. Conservation Biology

  19. Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

    Science.gov (United States)

    Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

    2016-01-01

    Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting

  20. Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

    Directory of Open Access Journals (Sweden)

    John Odaga

    2016-05-01

    Full Text Available Background: Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs. The Community and District Empowerment for Scale-up (CODES project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design: Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results: All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions: In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying

  1. Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods.

    Science.gov (United States)

    Odaga, John; Henriksson, Dorcus K; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K; Valadez, Joseph J

    2016-01-01

    Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.

  2. IMPACT OF THE PRINCIPLES OF FINANCIAL ACCOUNTING ON THE MANAGEMENT ACCOUNTING

    Directory of Open Access Journals (Sweden)

    Daniela CREŢU

    2014-11-01

    Full Text Available The paper studied the impact of the financial accounting principles on the management accounting. There are similarities and differences between the financial accounting and management accounting. The differences are numerous, but in the present paper we are more interested in similarities that are very deep. Not accidentally, in other accounting systems, two types of accounting information form one functional, integrated circuit (accounting monism in U.S.A. or accounting systems of compromise between the accounting monism and dualism. Since there is not only one accounting system, but a set of accounting systems, the accounting principles are not absolute, but relative. This relativity is given by the assumed objectives of the accounting.

  3. Research priorities for nursing and midwifery in Southern Ireland.

    Science.gov (United States)

    McCarthy, G; Savage, E; Lehane, E

    2006-06-01

    To identify research priorities for nursing and midwifery in the Southern Health Board area in Ireland for the immediate and long term. Ten focus groups were conducted over a 2-month period with 70 nurses and midwives working in clinical, managerial and educational roles participating. Based on focus group findings and a literature review a multi-item Likert type questionnaire was constructed and administered to 520 nurses and midwives (response rate 95%n=494). Research priorities were identified as: (1) impact of staff shortages on retention of RNs/RM's (80%); (2) quality of life of chronically ill patients (76%); (3) stress and bullying in the workplace (76%); (4) assessment and management of pain (75%); (5) skill mix and staff burnout (73%); (6) cardio-pulmonary resuscitation decision making (72%); (7) coordination of care between hospital and primary care settings (69%); (8) medication errors (67%); and (9) promoting healthy lifestyles (64%). Respondents also indicated that these priorities warranted immediate attention. Implications for practice include the need for: (1) emphasis on quality pain control; (2) recognition and exploration of the ethical issues relating to resuscitation; and (3) management of the context within which clinical care is given.

  4. Conservation priorities of Iberoamerican pig breeds and their ancestors based on microsatellite information.

    Science.gov (United States)

    Cortés, O; Martinez, A M; Cañon, J; Sevane, N; Gama, L T; Ginja, C; Landi, V; Zaragoza, P; Carolino, N; Vicente, A; Sponenberg, P; Delgado, J V

    2016-07-01

    Criollo pig breeds are descendants from pigs brought to the American continent starting with Columbus second trip in 1493. Pigs currently play a key role in social economy and community cultural identity in Latin America. The aim of this study was to establish conservation priorities among a comprehensive group of Criollo pig breeds based on a set of 24 microsatellite markers and using different criteria. Spain and Portugal pig breeds, wild boar populations of different European geographic origins and commercial pig breeds were included in the analysis as potential genetic influences in the development of Criollo pig breeds. Different methods, differing in the weight given to within- and between-breed genetic variability, were used in order to estimate the contribution of each breed to global genetic diversity. As expected, the partial contribution to total heterozygosity gave high priority to Criollo pig breeds, whereas Weitzman procedures prioritized Iberian Peninsula breeds. With the combined within- and between-breed approaches, different conservation priorities were achieved. The Core Set methodologies highly prioritized Criollo pig breeds (Cr. Boliviano, Cr. Pacifico, Cr. Cubano and Cr. Guadalupe). However, weighing the between- and within-breed components with FST and 1-FST, respectively, resulted in higher contributions of Iberian breeds. In spite of the different conservation priorities according to the methodology used, other factors in addition to genetic information also need to be considered in conservation programmes, such as the economic, cultural or historical value of the breeds involved.

  5. An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

    Science.gov (United States)

    Cowman, Seamus; Gethin, Georgina; Clarke, Eric; Moore, Zena; Craig, Gerardine; Jordan-O'Brien, Julie; McLain, Niamh; Strapp, Helen

    2012-02-01

    To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. The study used a survey method. A four-round eDelphi technique was used to collect responses from an international population of health professionals across 24 countries. Responses were obtained from 360 professionals representing many health care settings. The top education priorities related to the standardisation of all foundation education programmes in wound care, the inclusion of wound care in all professional undergraduate and postgraduate education programmes, selecting dressings and the prevention of pressure ulcers. The top research priorities related to the dressing selection, pressure ulcer prevention and wound infection. conclusion: Professionals from different backgrounds and countries who are engaged in wound management share a common set of priorities for research and education. Most notably, the priorities identified relate to long-established clinical challenges in wound care and underpin the principles of good patient care practices. The priorities are closely allied to an ageing population and identify many challenges ahead for practitioners engaged in wound management services. The provision of wound care is a major investment of health service resources and remains a clinical challenge today. Research is essential to building evidence-based practice and fundamental to development of quality in standards of practice; education is central to achieving competence to deliver effective care. The determination of research and education priorities is therefore an absolute requirement

  6. An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

    LENUS (Irish Health Repository)

    2012-02-01

    Aim. To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. Background. A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. Design. The study used a survey method. Methods. A four-round eDelphi technique was used to collect responses from an international population of health professionals across 24 countries. Results. Responses were obtained from 360 professionals representing many health care settings. The top education priorities related to the standardisation of all foundation education programmes in wound care, the inclusion of wound care in all professional undergraduate and postgraduate education programmes, selecting dressings and the prevention of pressure ulcers. The top research priorities related to the dressing selection, pressure ulcer prevention and wound infection. Conclusion. Professionals from different backgrounds and countries who are engaged in wound management share a common set of priorities for research and education. Most notably, the priorities identified relate to long-established clinical challenges in wound care and underpin the principles of good patient care practices. The priorities are closely allied to an ageing population and identify many challenges ahead for practitioners engaged in wound management services. Relevance to clinical practice. The provision of wound care is a major investment of health service resources and remains a clinical challenge today. Research is essential to building evidence-based practice and fundamental to development of quality in standards of practice; education is central to achieving competence to deliver effective care. The

  7. Reconciling patient and provider priorities for improving the care of critically ill patients: A consensus method and qualitative analysis of decision making.

    Science.gov (United States)

    McKenzie, Emily; Potestio, Melissa L; Boyd, Jamie M; Niven, Daniel J; Brundin-Mather, Rebecca; Bagshaw, Sean M; Stelfox, Henry T

    2017-12-01

    Providers have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations. To describe the decision-making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list. We employed a modified Delphi process with a diverse group of panellists to reconcile priorities for improving care of critically ill patients in the intensive care unit (ICU). Proceedings were audio-recorded, transcribed and analysed using qualitative content analysis to explore the decision-making process for establishing consensus. Nine panellists including three providers, three decision makers and three family members of previously critically ill patients. Panellists rated and revised 28 priorities over three rounds of review and reached consensus on the "Top 5" priorities for quality improvement: transition of patient care from ICU to hospital ward; family presence and effective communication; delirium screening and management; early mobilization; and transition of patient care between ICU providers. Four themes were identified as important for establishing consensus: storytelling (sharing personal experiences), amalgamating priorities (negotiating priority scope), considering evaluation criteria and having a priority champion. Our study demonstrates the feasibility of incorporating families of patients into a multistakeholder prioritization exercise. The approach described can be used to guide consensus building and reconcile priorities of diverse stakeholder groups. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  8. Shifting spatial priorities for ecosystem services in Europe following land use change

    NARCIS (Netherlands)

    Verhagen, Willem; van Teeffelen, Astrid J.A.; Verburg, Peter H.

    2018-01-01

    Policy objectives to maintain ecosystem services are increasingly set. Methods to identify priority areas for ecosystem services can assist in the implementation of such policy objectives. While land use change is an important driver of changes in ecosystem services over time, most prioritization

  9. Range-wide network of priority areas for greater sage-grouse - a design for conserving connected distributions or isolating individual zoos?

    Science.gov (United States)

    Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.

    2015-09-08

    The network of areas delineated in 11 Western States for prioritizing management of greater sage-grouse (Centrocercus urophasianus) represents a grand experiment in conservation biology and reserve design. We used centrality metrics from social network theory to gain insights into how this priority area network might function. The network was highly centralized. Twenty of 188 priority areas accounted for 80 percent of the total centrality scores. These priority areas, characterized by large size and a central location in the range-wide distribution, are strongholds for greater sage-grouse populations and also might function as sources. Mid-ranking priority areas may serve as stepping stones because of their location between large central and smaller peripheral priority areas. The current network design and conservation strategy has risks. The contribution of almost one-half (n = 93) of the priority areas combined for less than 1 percent of the cumulative centrality scores for the network. These priority areas individually are likely too small to support viable sage-grouse populations within their boundary. Without habitat corridors to connect small priority areas either to larger priority areas or as a clustered group within the network, their isolation could lead to loss of sage-grouse within these regions of the network. 

  10. Reconstruction of an account's past

    International Nuclear Information System (INIS)

    Waterman, M.S.; Lowe, V.W.

    1977-01-01

    Historical records and data frequently have been reduced by combination of accounts. The problem addressed is that of finding all ways a given set of accounts could have been combined to give some given set of reduced accounts. An algorithm has been developed to accomplish this task and a computer code in FORTRAN is given. An example with some MUF data is also presented

  11. Priority for sustainability. Final report

    International Nuclear Information System (INIS)

    2007-12-01

    The Dutch Minister of Economic Affairs (EZ) has been asked to realize priority in connection to the grid for sustainable production capacity. Currently there are waiting lists for connection of new production capacity to the grid in some areas, due to a shortage in transport capacity. The Dutch connection policy (first come, first serve) may possibly lead to delays in connecting sustainable production capacity, which is not desirable in view of the incentivisation of sustainability. EZ and TenneT have asked Booz Allen to examine the options for giving priority to sustainability (wind and CHP). Priority in connection applies only to new sustainable production capacity, but priority in transport also applies to existing sustainable production capacity. [mk] [nl

  12. What should autism research focus upon? Community views and priorities from the United Kingdom

    Science.gov (United States)

    Dinsmore, Adam; Charman, Tony

    2014-01-01

    The rise in the measured prevalence of autism has been accompanied by much new research and research investment internationally. This study sought to establish whether the pattern of current UK autism research funding maps on to the concerns of the autism community. Interviews and focus groups were conducted with autistic adults, family members, practitioners and researchers to identify their priorities for research. We also captured the views of a large number of stakeholders via an online survey. There was a clear disparity between the United Kingdom’s pattern of funding for autism research and the priorities articulated by the majority of participants. There was general consensus that future priorities for autism research should lie in those areas that make a difference to people’s day-to-day lives. There needs to be greater involvement of the autism community both in priority setting and in research more broadly to ensure that resources reach where they are most needed and can make the most impact. PMID:24789871

  13. An ontology-based nurse call management system (oNCS) with probabilistic priority assessment

    Science.gov (United States)

    2011-01-01

    Background The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call. The aim of this research is (1) the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2) the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient. Methods The ontology-based Nurse Call System (oNCS) was developed as an extension of a Context-Aware Service Platform. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient. Results The oNCS system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the oNCS system and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed. Conclusions The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the oNCS system significantly improves the assignment of nurses

  14. An ontology-based nurse call management system (oNCS with probabilistic priority assessment

    Directory of Open Access Journals (Sweden)

    Verhoeve Piet

    2011-02-01

    Full Text Available Abstract Background The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call. The aim of this research is (1 the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2 the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient. Methods The ontology-based Nurse Call System (oNCS was developed as an extension of a Context-Aware Service Platform. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient. Results The oNCS system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the oNCS system and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed. Conclusions The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the oNCS system significantly improves

  15. 49 CFR 260.7 - Priority consideration.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Priority consideration. 260.7 Section 260.7... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Overview § 260.7 Priority consideration. When evaluating applications, the Administrator will give priority consideration (but not necessarily in the following order...

  16. Final priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Engineering Research Centers. Final priority.

    Science.gov (United States)

    2014-07-09

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Engineering Research Center (RERC) on Improving the Accessibility, Usability, and Performance of Technology for Individuals who are Deaf or Hard of Hearing. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to contribute to improving the accessibility, usability, and performance of technology for individuals who are deaf or hard of hearing.

  17. The Accounting Capstone Problem

    Science.gov (United States)

    Elrod, Henry; Norris, J. T.

    2012-01-01

    Capstone courses in accounting programs bring students experiences integrating across the curriculum (University of Washington, 2005) and offer unique (Sanyal, 2003) and transformative experiences (Sill, Harward, & Cooper, 2009). Students take many accounting courses without preparing complete sets of financial statements. Accountants not only…

  18. Massage Therapy and Canadians’ Health Care Needs 2020: Proceedings of a National Research Priority Setting Summit

    Science.gov (United States)

    Dryden, Trish; Sumpton, Bryn; Shipwright, Stacey; Kahn, Janet; Reece, Barbara (Findlay)

    2014-01-01

    Background The health care landscape in Canada is changing rapidly as forces, such as an aging population, increasingly complex health issues and treatments, and economic pressure to reduce health care costs, bear down on the system. A cohesive national research agenda for massage therapy (MT) is needed in order to ensure maximum benefit is derived from research on treatment, health care policy, and cost effectiveness. Setting A one-day invitational summit was held in Toronto, Ontario to build strategic alliances among Canadian and international researchers, policy makers, and other stakeholders to help shape a national research agenda for MT. Method Using a modified Delphi method, the summit organizers conducted two pre-summit surveys to ensure that time spent during the summit was relevant and productive. The summit was facilitated using the principles of Appreciative Inquiry which included a “4D” strategic planning approach (defining, discovery, dreaming, designing) and application of a SOAR framework (strengths, opportunities, aspirations, and results). Participants Twenty-six researchers, policymakers, and other stakeholders actively participated in the events. Results Priority topics that massage therapists believe are important to the Canadian public, other health care providers, and policy makers and massage therapists themselves were identified. A framework for a national massage therapy (MT) research agenda, a grand vision of the future for MT research, and a 12-month action plan were developed. Conclusion The summit provided an excellent opportunity for key stakeholders to come together and use their experience and knowledge of MT to develop a much-needed plan for moving the MT research and professionalization agenda forward. PMID:24592299

  19. Managing competing organizational priorities in clinical handover across organizational boundaries.

    Science.gov (United States)

    Sujan, Mark A; Chessum, Peter; Rudd, Michelle; Fitton, Laurence; Inada-Kim, Matthew; Cooke, Matthew W; Spurgeon, Peter

    2015-01-01

    Handover across care boundaries poses additional challenges due to the different professional, organizational and cultural backgrounds of the participants involved. This paper provides a qualitative account of how practitioners in emergency care attempt to align their different individual and organizational priorities and backgrounds when handing over patients across care boundaries (ambulance service to emergency department (ED), and ED to acute medicine). A total of 270 clinical handovers were observed in three emergency care pathways involving five participating NHS organizations (two ambulance services and three hospitals). Half-day process mapping sessions were conducted for each pathway. Semi-structured interviews were carried out with 39 participants and analysed thematically. The management of patient flow and the fulfilment of time-related performance targets can create conflicting priorities for practitioners during handover. Practitioners involved in handover manage such competing organizational priorities through additional coordination effort and dynamic trade-offs. Practitioners perceive greater collaboration across departments and organizations, and mutual awareness of each other's goals and constraints as possible ways towards more sustainable improvement. Sustainable improvement in handover across boundaries in emergency care might require commitment by leaders from all parts of the local health economy to work as partners to establish a culture of integrated, patient-centred care. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Data fusion of priority information using a dempster combination rule

    International Nuclear Information System (INIS)

    Kim, Seong Ho; Kim, Tae Woon; Ha, Jae Joo

    2005-01-01

    As a case study, a multiple criteria decision-making problem, a ranking of radionuclide release scenarios in a low and intermediate radioactive waste repository is taken into account. The ranking in terms of a relative degree of priority of scenario alternatives enables us to incorporate more effective safety measure in a design stage of the repository. To illustrate a proposed methodology for updating ranking priority of release scenarios, priority information from three individual methods as well as the combined Dempster method is compared. Three types of methods to be combined are as follows: 1) the weighted arithmetic mean (WAM) method, a linear aggregation of a preference score matrix and a weighting vector is based on the no-interaction among criteria. The weighting vector is viewed as additive probability measures. The WAM method is bound to be equivalent to an AHP model; 2) the belief-based Choquet integral (BCI) method represents the pessimistic attitude towards aggregation using the synergistic interaction among criteria; 3) the plausibility-based Choquet integral (PCI) method leads to the optimistic assessment along with the inhibitory interaction among criteria. The finite frame of discernment, all the possible states of the problem under consideration, is ={WAM, BCI, PCI}. The framework of the Dempster combination rule is depicted in Figure 1 for three sources of evidence such as the WAM model {WAM}, the belief model {BCI}, and the plausibility model {PCI}

  1. Future neutrino oscillation facilities: physics priorities and open issues

    International Nuclear Information System (INIS)

    Blondel, Alain

    2006-01-01

    The recent discovery that neutrinos have masses opens a wide new field of experimentation. Accelerator-made neutrinos are essential in this program. Ideas for future facilities include Superbeam, Beta-beam, or Neutrino Factory, each associated with one or several options for detector systems. We now begin a 'scoping study' aimed at determining a set of key R and D projects enabling the community to propose an ambitious accelerator neutrino program at the turn of this decade. As an introduction to this study, a set of physics priorities, a summary of the perceived virtues and shortcomings of the various options, and a number of open questions are presented

  2. Priorities to Advance Monitoring of Ecosystem Services Using Earth Observation.

    Science.gov (United States)

    Cord, Anna F; Brauman, Kate A; Chaplin-Kramer, Rebecca; Huth, Andreas; Ziv, Guy; Seppelt, Ralf

    2017-06-01

    Managing ecosystem services in the context of global sustainability policies requires reliable monitoring mechanisms. While satellite Earth observation offers great promise to support this need, significant challenges remain in quantifying connections between ecosystem functions, ecosystem services, and human well-being benefits. Here, we provide a framework showing how Earth observation together with socioeconomic information and model-based analysis can support assessments of ecosystem service supply, demand, and benefit, and illustrate this for three services. We argue that the full potential of Earth observation is not yet realized in ecosystem service studies. To provide guidance for priority setting and to spur research in this area, we propose five priorities to advance the capabilities of Earth observation-based monitoring of ecosystem services. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Governance factors in the identification of global conservation priorities for mammals.

    Science.gov (United States)

    Eklund, Johanna; Arponen, Anni; Visconti, Piero; Cabeza, Mar

    2011-09-27

    Global conservation priorities have often been identified based on the combination of species richness and threat information. With the development of the field of systematic conservation planning, more attention has been given to conservation costs. This leads to prioritizing developing countries, where costs are generally low and biodiversity is high. But many of these countries have poor governance, which may result in ineffective conservation or in larger costs than initially expected. We explore how the consideration of governance affects the selection of global conservation priorities for the world's mammals in a complementarity-based conservation prioritization. We use data on Control of Corruption (Worldwide Governance Indicators project) as an indicator of governance effectiveness, and gross domestic product per capita as an indicator of cost. We show that, while core areas with high levels of endemism are always selected as important regardless of governance and cost values, there are clear regional differences in selected sites when biodiversity, cost or governance are taken into account separately. Overall, the analysis supports the concentration of conservation efforts in most of the regions generally considered of high priority, but stresses the need for different conservation approaches in different continents owing to spatial patterns of governance and economic development.

  4. Evaluation and Selection of Best Priority Sequencing Rule in Job Shop Scheduling using Hybrid MCDM Technique

    Science.gov (United States)

    Kiran Kumar, Kalla; Nagaraju, Dega; Gayathri, S.; Narayanan, S.

    2017-05-01

    Priority Sequencing Rules provide the guidance for the order in which the jobs are to be processed at a workstation. The application of different priority rules in job shop scheduling gives different order of scheduling. More experimentation needs to be conducted before a final choice is made to know the best priority sequencing rule. Hence, a comprehensive method of selecting the right choice is essential in managerial decision making perspective. This paper considers seven different priority sequencing rules in job shop scheduling. For evaluation and selection of the best priority sequencing rule, a set of eight criteria are considered. The aim of this work is to demonstrate the methodology of evaluating and selecting the best priority sequencing rule by using hybrid multi criteria decision making technique (MCDM), i.e., analytical hierarchy process (AHP) with technique for order preference by similarity to ideal solution (TOPSIS). The criteria weights are calculated by using AHP whereas the relative closeness values of all priority sequencing rules are computed based on TOPSIS with the help of data acquired from the shop floor of a manufacturing firm. Finally, from the findings of this work, the priority sequencing rules are ranked from most important to least important. The comprehensive methodology presented in this paper is very much essential for the management of a workstation to choose the best priority sequencing rule among the available alternatives for processing the jobs with maximum benefit.

  5. Priority actions (Environmental protection in Macedonia)

    International Nuclear Information System (INIS)

    1997-01-01

    The priority actions were based on environmental needs in the short to medium term, keeping in mind that there are severe budgetary