WorldWideScience

Sample records for disease policy model-china

  1. Agricultural policy, food policy, and communicable disease policy.

    Science.gov (United States)

    Grant, Wyn

    2012-12-01

    Food and agricultural policy is an essential element of a communicable disease policy. The European Union has developed a more systematic and broadly based interest in questions of food safety and animal health and welfare linked to modernization of the Common Agricultural Policy, reflected in a new treaty obligation on animal welfare. Following the bovine spongiform encephalopathy crisis, moves were made to create a European competency, but implementation and enforcement resources reside with the member states. The European Animal Health Strategy is meant to lead to an EU animal health law, but this has already been constrained by fiscal austerity. The development of such a law may lead to a lowest common denominator formula that does little to enhance consumer protection or improve animal welfare. This is an inherent risk with top-down forms of Europeanization; more attention should be paid to lessons to be learned from bottom-up initiatives of the type used to counteract the bovine diarrhea virus. There will always be a tension among what is good policy for reducing the incidence of communicable disease, policy that is popular with EU citizens, and policy that is acceptable to member states.

  2. Public policy: effective treatment for tobacco disease.

    Science.gov (United States)

    Scheg, K E

    1996-01-01

    Public policy initiatives offer greater promise than other strategies for reducing the major public health problem of death and disease due to smoking. Three of the most critical public policy areas today are smoke-free environments, youth access, and advertising. While earlier laws separated smokers and nonsmokers into separate sections, the focus now is on smoke-free environments. Various places, however, most notably restaurants, often remain polluted with tobacco smoke and put women at heightened risk of disease and death. Restricting youth access to tobacco products has also gained momentum in the 1990s. The recently proposed Food and Drug Administration regulations designed to reduce smoking by minors by 50% over seven years are the most significant national public policy initiatives ever to address the problem of children smoking. Measures to counter the tobacco industry's massive advertising and promotion campaigns have also increased. The federal government has begun enforcing the prohibition on cigarette advertising on television, and local jurisdictions have restricted tobacco billboards and point-of-sale advertising.

  3. Linking Emerging Infectious Diseases Research and Policy ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In China and Southeast Asia, the lack of policy or regulation enforcements means that the use of antibiotics ... Building on past research on avian influenza and ongoing ... Chinese Academy of Sciences. Pays d' institution. China. Site internet.

  4. Issues surrounding orphan disease and orphan drug policies in Europe.

    Science.gov (United States)

    Denis, Alain; Mergaert, Lut; Fostier, Christel; Cleemput, Irina; Simoens, Steven

    2010-01-01

    An orphan disease is a disease with a very low prevalence. Although there are 5000-7000 orphan diseases, only 50 orphan drugs (i.e. drugs developed to treat orphan diseases) were marketed in the EU by the end of 2008. In 2000, the EU implemented policies specifically designed to stimulate the development of orphan drugs. While decisions on orphan designation and the marketing authorization of orphan drugs are made at the EU level, decisions on drug reimbursement are made at the member state level. The specific features of orphan diseases and orphan drugs make them a high-priority issue for policy makers. The aim of this article is to identify and discuss several issues surrounding orphan disease and drug policies in Europe. The present system of orphan designation allows for drugs for non-orphan diseases to be designated as orphan drugs. The economic factors underlying orphan designation can be questioned in some cases, as a low prevalence of a certain indication does not equal a low return on investment for the drug across its indications. High-quality evidence about the clinical added value of orphan drugs is rarely available at the time of marketing authorization, due to the low number of patients. A balance must be struck between ethical and economic concerns. To this effect, there is a need to initiate a societal dialogue on this issue, to clarify what society wants and accepts in terms of ethical and economic consequences. The growing budgetary impact of orphan drugs puts pressure on drug expenditure. Indications can be extended for an orphan drug and the total prevalence across indications is not considered. Finally, cooperation needs to be fostered in the EU, particularly through a standardized approach to the creation and use of registries. These issues require further attention from researchers, policy makers, health professionals, patients, pharmaceutical companies and other stakeholders with a view to optimizing orphan disease and drug policies in

  5. The long reach of Alzheimer's disease: patients, practice, and policy.

    Science.gov (United States)

    Bynum, Julie P W

    2014-04-01

    The impact of Alzheimer's disease and related dementias reaches well beyond the health care needs of the person with dementia. As dementia inexorably progresses, the patient becomes increasingly dependent on others for basic daily care and routine tasks, a physically safe environment, and protection from exploitation or abuse. Addressing the diverse medical and social care needs of the burgeoning US population with Alzheimer's disease and related dementias requires the adoption of a broad-based policy framework and agenda that explicitly acknowledge the complex and unique needs of people with dementia and the impacts of dementia on caregivers and society at large. Public policies related to social service providers, agencies that provide appropriate housing, financial and legal services, and law enforcement must complement other policies focused on prevention and risk reduction, effective treatment development, and efficient health care delivery.

  6. Bangladesh policy on prevention and control of non-communicable diseases: a policy analysis.

    Science.gov (United States)

    Biswas, Tuhin; Pervin, Sonia; Tanim, Md Imtiaz Alam; Niessen, Louis; Islam, Anwar

    2017-06-19

    This paper is aimed at critically assessing the extent to which Non-Communicable Disease NCD-related policies introduced in Bangladesh align with the World Health Organization's (WHO) 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. The authors reviewed all relevant policy documents introduced by the Government of Bangladesh since its independence in 1971. The literature review targeted scientific and grey literature documents involving internet-based search, and expert consultation and snowballing to identify relevant policy documents. Information was extracted from the documents using a specific matrix, mapping each document against the six objectives of the WHO 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. A total of 51 documents were identified. Seven (14%) were research and/or surveys, nine were on established policies (17%), while seventeen (33%) were on action programmes. Five (10%) were related to guidelines and thirteen (25%) were strategic planning documents from government and non-government agencies/institutes. The study covered documents produced by the Government of Bangladesh as well as those by quasi-government and non-government organizations irrespective of the extent to which the intended policies were implemented. The policy analysis findings suggest that although the government has initiated many NCD-related policies or programs, they lacked proper planning, implementation and monitoring. Consequently, Bangladesh over the years had little success in effectively addressing the growing burden of non-communicable diseases. It is imperative that future research critically assess the effectiveness of national NCD policies by monitoring their implementation and level of population coverage.

  7. Ebola Virus Disease: Ethics and Emergency Medical Response Policy.

    Science.gov (United States)

    Jecker, Nancy S; Dudzinski, Denise M; Diekema, Douglas S; Tonelli, Mark

    2015-09-01

    Caring for patients affected with Ebola virus disease (EVD) while simultaneously preventing EVD transmission represents a central ethical challenge of the EVD epidemic. To address this challenge, we propose a model policy for resuscitation and emergent procedure policy of patients with EVD and set forth ethical principles that lend support to this policy. The policy and principles we propose bear relevance beyond the EVD epidemic, offering guidance for the care of patients with other highly contagious, virulent, and lethal diseases. The policy establishes (1) a limited code status for patients with confirmed or suspected EVD. Limited code status means that a code blue will not be called for patients with confirmed or suspected EVD at any stage of the disease; however, properly protected providers (those already in full protective equipment) may initiate resuscitative efforts if, in their clinical assessment, these efforts are likely to benefit the patient. The policy also requires that (2) resuscitation not be attempted for patients with advanced EVD, as resuscitation would be medically futile; (3) providers caring for or having contact with patients with confirmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response; (5) patients with EVD and their proxies be involved in care discussions; and (6) care team and provider discretion guide the care of patients with EVD. We discuss ethical issues involving medical futility and the duty to avoid harm and propose a utilitarian-based principle of triage to address resource scarcity in the emergency setting.

  8. Conservation, biodiversity and infectious disease: scientific evidence and policy implications

    Science.gov (United States)

    Young, Hillary S.; Wood, Chelsea L.; Kilpatrick, A. Marm; Lafferty, Kevin D.; Nunn, Charles L.; Vincent, Jeffrey R.

    2017-01-01

    Habitat destruction and infectious disease are dual threats to nature and people. The potential to simultaneously advance conservation and human health has attracted considerable scientific and popular interest; in particular, many authors have justified conservation action by pointing out potential public health benefits . One major focus of this debate—that biodiversity conservation often decreases infectious disease transmission via the dilution effect—remains contentious. Studies that test for a dilution effect often find a negative association between a diversity metric and a disease risk metric, but how such associations should inform conservation policy remains unclear for several reasons. For one, diversity and infection risk have many definitions, making it possible to identify measures that conform to expectations. Furthermore, the premise that habitat destruction consistently reduces biodiversity is in question, and disturbance or conservation can affect disease in many ways other than through biodiversity change. To date, few studies have examined the broader set of mechanisms by which anthropogenic disturbance or conservation might increase or decrease infectious disease risk to human populations. Due to interconnections between biodiversity change, economics and human behaviour, moving from ecological theory to policy action requires understanding how social and economic factors affect conservation.This Theme Issue arose from a meeting aimed at synthesizing current theory and data on ‘biodiversity, conservation and infectious disease’ (4–6 May 2015). Ecologists, evolutionary biologists, economists, epidemiologists, veterinary scientists, public health professionals, and conservation biologists from around the world discussed the latest research on the ecological and socio-economic links between conservation, biodiversity and infectious disease, and the open questions and controversies in these areas. By combining ecological understanding

  9. The global nutrition transition: trends, disease burdens and policy interventions.

    Science.gov (United States)

    Ronto, Rimante; Wu, Jason Hy; Singh, Gitanjali M

    2018-03-06

    Non-communicable diseases (NCD) have increased dramatically in developed and developing countries. Unhealthy diet is one of the major factors contributing to NCD development. Recent evidence has identified deterioration in aspects of dietary quality across many world regions, including low- and middle-income countries (LMIC). Most burdens of disease attributable to poor diet can be prevented or delayed as they occur prematurely. Therefore, it is important to identify and target unhealthy dietary behaviours in order to have the greatest impact. National dietary-related programmes have traditionally focused on micronutrient deficiency and food security and failed to acknowledge unhealthy dietary intakes as a risk factor that contributes to the development of NCD. Inadequate intakes of healthy foods and nutrients and excess intakes of unhealthy ones are commonly observed across the world, and efforts to reduce the double burden of micronutrient deficiency and unhealthy diets should be a particular focus for LMIC. Interventions and policies targeting whole populations are likely to be the most effective and sustainable, and should be prioritized. Population-based approaches such as health information and communication campaigns, fiscal measures such as taxes on sugar-sweetened beverages, direct restrictions and mandates, reformulation and improving the nutrient profile of food products, and standards regulating marketing to children can have significant and large impacts to improve diets and reduce the incidence of NCD. There is a need for more countries to implement population-based effective approaches to improve current diets.

  10. Beyond policy networks: policy framing and the politics of expertise in the 2001 Foot and Mouth Disease crisis.

    Science.gov (United States)

    Wilkinson, Katy; Lowe, Philip; Donaldson, Andrew

    2010-01-01

    For the past decade, the policy community/issue network typology of pressure group interaction has been used to explain policy outcomes and the policy-making process. To re-examine the validity of this typology, the paper focuses on the UK government's response to the 2001 Foot and Mouth Disease (FMD) crisis, and in particular the decision to pursue contiguous culling rather than vaccination to overcome the epidemic. Rather than illustrating the emergence of an issue network in agricultural policy, the decision-making process of the FMD outbreak demonstrates continuity with prior crises. In addition, the politicization of scientific expertise is identified as an emerging trend in crisis management. Policy framing is used to explain the impetus behind the contiguous cull decision, concluding that the legacy of previous policy choices conditioned the crisis response to a far greater degree than contemporaneous pressure group action.

  11. Disease prevention policy under Medicare: a historical and political analysis.

    Science.gov (United States)

    Schauffler, H H

    1993-01-01

    I review the history and politics of Medicare disease prevention policy and identify factors associated with the success or failure of legislative initiatives to add preventive services benefits to Medicare. Between 1965 and 1990, 453 bills for Medicare preventive services were introduced in the U.S. Congress, but not until 1980, after 350 bills had failed, was the first preventive service added to the Medicare program. Medicare currently pays for only four of the 44 preventive services recommended for the elderly by the U.S. Preventive Services Task Force (pneumococcal and hepatitis B vaccinations, Pap smears, and mammography). In addition, Congress has funded demonstration programs for the influenza vaccine and comprehensive preventive services. The preventive services added to Medicare reflect the bias of the biomedical model toward screening and immunizations. Counseling services have received the least legislative attention. Factors associated with successful enactment include single-benefit bills, incorporation into budget-deficit reduction legislation, documented evidence of cost-effectiveness, public hearings, sponsorship by chairs of key congressional committees, and persistent congressional leadership. Factors associated with failure include lack of support from Medicare beneficiaries, lack of professional support, impact on total Medicare expenditures, disagreement over or failure to address payment and financing mechanisms, and competing congressional priorities.

  12. Sexually Transmitted Disease Prevention Policies in the United States: Evidence and Opportunities.

    Science.gov (United States)

    Leichliter, Jami S; Seiler, Naomi; Wohlfeiler, Dan

    2016-02-01

    Policies are an important part of public health interventions, including in the area of sexually transmitted disease (STD) prevention. Similar to other tools used in public health, policies are often evaluated to determine their usefulness. Therefore, we conducted a nonsystematic review of policy evidence for STD prevention. Our review considers assessments or evaluations of STD prevention-specific policies, health care system policies, and other, broader policies that have the potential to impact STD prevention through social determinants of health. We also describe potential policy opportunity in these areas. It should be noted that we found gaps in policy evidence for some areas; thus, additional research would be useful for public health policy interventions for STD prevention.

  13. An economic evaluation of salt reduction policies to reduce coronary heart disease in England: a policy modeling study.

    Science.gov (United States)

    Collins, Marissa; Mason, Helen; O'Flaherty, Martin; Guzman-Castillo, Maria; Critchley, Julia; Capewell, Simon

    2014-07-01

    Dietary salt intake has been causally linked to high blood pressure and increased risk of cardiovascular events. Cardiovascular disease causes approximately 35% of total UK deaths, at an estimated annual cost of £30 billion. The World Health Organization and the National Institute for Health and Care Excellence have recommended a reduction in the intake of salt in people's diets. This study evaluated the cost-effectiveness of four population health policies to reduce dietary salt intake on an English population to prevent coronary heart disease (CHD). The validated IMPACT CHD model was used to quantify and compare four policies: 1) Change4Life health promotion campaign, 2) front-of-pack traffic light labeling to display salt content, 3) Food Standards Agency working with the food industry to reduce salt (voluntary), and 4) mandatory reformulation to reduce salt in processed foods. The effectiveness of these policies in reducing salt intake, and hence blood pressure, was determined by systematic literature review. The model calculated the reduction in mortality associated with each policy, quantified as life-years gained over 10 years. Policy costs were calculated using evidence from published sources. Health care costs for specific CHD patient groups were estimated. Costs were compared against a "do nothing" baseline. All policies resulted in a life-year gain over the baseline. Change4life and labeling each gained approximately 1960 life-years, voluntary reformulation 14,560 life-years, and mandatory reformulation 19,320 life-years. Each policy appeared cost saving, with mandatory reformulation offering the largest cost saving, more than £660 million. All policies to reduce dietary salt intake could gain life-years and reduce health care expenditure on coronary heart disease. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. An environmental scan of policies in support of chronic disease self-management in Canada.

    Science.gov (United States)

    Liddy, C; Mill, K

    2014-02-01

    The evidence supporting chronic disease self-management warrants further attention. Our aim was to identify existing policies, strategies and frameworks that support self-management initiatives. This descriptive study was conducted as an environmental scan, consisting of an Internet search of government and other publicly available websites, and interviews with jurisdictional representatives identified through the Health Council of Canada and academic networking. We interviewed 16 representatives from all provinces and territories in Canada and found 30 publicly available and relevant provincial and national documents. Most provinces and territories have policies that incorporate aspects of chronic disease self-management. Alberta and British Columbia have the most detailed policies. Both feature primary care prominently and are not disease specific. Both also have provincial level implementation of chronic disease self-management programming. Canada's northern territories all lacked specific policies supporting chronic disease self-management despite a significant burden of disease. Engaging patients in self-management of their chronic diseases is important and effective. Although most provinces and territories have policies that incorporate aspects of chronic disease self-management, they were often embedded within other initiatives and/or policy documents framed around specific diseases or populations. This approach could limit the potential reach and effect of self-management.

  15. Obesity as a Socially Defined Disease: Philosophical Considerations and Implications for Policy and Care.

    Science.gov (United States)

    Hofmann, Bjørn

    2016-03-01

    Obesity has generated significant worries amongst health policy makers and has obtained increased attention in health care. Obesity is unanimously defined as a disease in the health care and health policy literature. However, there are pragmatic and not principled reasons for this. This warrants an analysis of obesity according to standard conceptions of disease in the literature of philosophy of medicine. According to theories and definitions of disease referring to (abnormal functioning of) internal processes, obesity is not a disease. Obesity undoubtedly can result in disease, making it a risk factor for disease, but not a disease per se. According to several social conceptions of disease, however, obesity clearly is a disease. Obesity can conflict with aesthetic, moral, or other social norms. Making obesity a "social disease" may very well be a wise health policy, assuring and improving population health, especially if we address the social determinants of obesity, such as the food supply and marketing system. However, applying biomedical solutions to social problems may also have severe side effects. It can result in medicalization and enhance stigmatization and discrimination of persons based on appearance or behavior. Approaching social problems with biomedical means may also serve commercial and professionals' interests more than the health and welfare of individuals; it may make quick fix medical solutions halt more sustainable structural solutions. This urges health insurers, health care professionals, and health policy makers to be cautious. Especially if we want to help and respect persons that we classify and treat as obese.

  16. More appropriate disease control policies for the developing world : policy and trade issues

    Directory of Open Access Journals (Sweden)

    J.C. Mariner

    2009-09-01

    Full Text Available Investment in disease control should be targeted to critical points that provide the greatest benefit to the livelihoods of livestock-dependent stakeholders. Risk-based targeting should balance the impacts of diseases against the feasibility of their control. This requires sensitive and specific surveillance systems that provide representative overviews of the animal health situation for accurate assessment of disease impact and transmission patterns. Assessment of impact should include household and market effects. The key in surveillance is involving livestock owners using active methods that ensure their disease priorities are addressed. Epidemiological targeting of interventions to critical points in disease transmission cycles should be done to obtain maximal disease reduction. Interventions should be delivered in full partnership with both private and community-based stakeholders to assure high uptake and sustainability. In developing countries, approaches such as participatory disease surveillance and community-based animal health programs have been effective and comply with international animal health standards.

  17. Alignment between chronic disease policy and practice: case study at a primary care facility.

    Science.gov (United States)

    Draper, Claire A; Draper, Catherine E; Bresick, Graham F

    2014-01-01

    Chronic disease is by far the leading cause of death worldwide and of increasing concern in low- and middle-income countries, including South Africa, where chronic diseases disproportionately affect the poor living in urban settings. The Provincial Government of the Western Cape (PGWC) has prioritized the management of chronic diseases and has developed a policy and framework (Adult Chronic Disease Management Policy 2009) to guide and improve the prevention and management of chronic diseases at a primary care level. The aim of this study is to assess the alignment of current primary care practices with the PGWC Adult Chronic Disease Management policy. One comprehensive primary care facility in a Cape Town health district was used as a case study. Data was collected via semi-structured interviews (n = 10), focus groups (n = 8) and document review. Participants in this study included clinical staff involved in chronic disease management at the facility and at a provincial level. Data previously collected using the Integrated Audit Tool for Chronic Disease Management (part of the PGWC Adult Chronic Disease Management policy) formed the basis of the guide questions used in focus groups and interviews. The results of this research indicate a significant gap between policy and its implementation to improve and support chronic disease management at this primary care facility. A major factor seems to be poor policy knowledge by clinicians, which contributes to an individual rather than a team approach in the management of chronic disease patients. Poor interaction between facility- and community-based services also emerged. A number of factors were identified that seemed to contribute to poor policy implementation, the majority of which were staff related and ultimately resulted in a decrease in the quality of patient care. Chronic disease policy implementation needs to be improved in order to support chronic disease management at this facility. It is possible that similar

  18. The European Union Policy in the Field of Rare Diseases.

    Science.gov (United States)

    Moliner, Antoni Montserrat; Waligora, Jaroslaw

    2017-01-01

    Rare diseases, are defined by the European Union as life-threatening or chronically debilitating diseases with low prevalence (less than 5 per 10,000). The specificities of rare diseases - limited number of patients and scarcity of relevant knowledge and expertise - single them out as a unique domain of very high European added-value.The legal instruments at the disposal of the European Union, in terms of the Article 168 of the Treaties, are very limited. However a combination of instruments using the research and the pharmaceutical legal basis and an intensive and creative use of funding from the Health Programmes has permitted to create a solid basis that Member States have considered enough to put rare diseases in a privileged position in the health agenda.The adoption of the Commission Communication, in November 2008, and of the Council Recommendation, in June 2009, and in 2011 the adoption of the Directive on Cross-border healthcare., have created an operational framework to act in the field of rare disease with European coordination in several areas (classification and codification, European Reference Networks, orphan medicinal products, the Commission expert group on rare diseases, etc.).Rare diseases is an area with high and practical potential for the European cooperation.

  19. The International Rare Diseases Research Consortium: Policies and Guidelines to maximize impact.

    Science.gov (United States)

    Lochmüller, Hanns; Torrent I Farnell, Josep; Le Cam, Yann; Jonker, Anneliene H; Lau, Lilian Pl; Baynam, Gareth; Kaufmann, Petra; Dawkins, Hugh Js; Lasko, Paul; Austin, Christopher P; Boycott, Kym M

    2017-12-01

    The International Rare Diseases Research Consortium (IRDiRC) has agreed on IRDiRC Policies and Guidelines, following extensive deliberations and discussions in 2012 and 2013, as a first step towards improving coordination of research efforts worldwide. The 25 funding members and 3 patient umbrella organizations (as of early 2013) of IRDiRC, a consortium of research funders that focuses on improving diagnosis and therapy for rare disease patients, agreed in Dublin, Ireland in April 2013 on the Policies and Guidelines that emphasize collaboration in rare disease research, the involvement of patients and their representatives in all relevant aspects of research, as well as the sharing of data and resources. The Policies and Guidelines provide guidance on ontologies, diagnostics, biomarkers, patient registries, biobanks, natural history, therapeutics, models, publication, intellectual property, and communication. Most IRDiRC members-currently nearly 50 strong-have since incorporated its policies in their funding calls and some have chosen to exceed the requirements laid out, for instance in relation to data sharing. The IRDiRC Policies and Guidelines are the first, detailed agreement of major public and private funding organizations worldwide to govern rare disease research, and may serve as a template for other areas of international research collaboration. While it is too early to assess their full impact on research productivity and patient benefit, the IRDiRC Policies and Guidelines have already contributed significantly to improving transparency and collaboration in rare disease research.

  20. Public policy & the challenge of chronic noncommunicable diseases

    National Research Council Canada - National Science Library

    World Bank; Smith, Owen; Adeyi, Olusoji; Robles, Sylvia

    2007-01-01

    ... for Noncommunicable Diseases Evidence on the Economic Burden of NCDs Extent to Which NCDs Matter to the Poor NCDs and Health Financing Notes 59 59 60 64 70 72 Appendix 2 The Evidence Base for t...

  1. Regarding Obesity as a Disease: Evolving Policies and Their Implications

    Science.gov (United States)

    Dhurandhar, Emily J.; Allison, David B.

    2016-01-01

    Synopsis The 2013 decision of the American Medical Association (AMA) to recognize obesity as a complex, chronic disease that requires medical attention came as the result of developments over three decades. Defining a condition such as obesity to be a disease is a very public process that is largely driven by expectation of costs and benefits. Although the public has been slow to embrace defining obesity as a purely medical condition, evidence is emerging for broader awareness of factors beyond personal choice influencing obesity. The AMA decision appears to be working in concert with other factors to bring more access to care, less blame for people with the condition, and more favorable conditions for research to identify effective strategies for prevention and clinical care to reduce the impact of this disease. PMID:27519127

  2. Policy environment for prevention, control and management of cardiovascular diseases in primary health care in Kenya.

    Science.gov (United States)

    Asiki, Gershim; Shao, Shuai; Wainana, Carol; Khayeka-Wandabwa, Christopher; Haregu, Tilahun N; Juma, Pamela A; Mohammed, Shukri; Wambui, David; Gong, Enying; Yan, Lijing L; Kyobutungi, Catherine

    2018-05-09

    In Kenya, cardiovascular diseases (CVDs) accounted for more than 10% of total deaths and 4% of total Disability-Adjusted Life Years (DALYs) in 2015 with a steady increase over the past decade. The main objective of this paper was to review the existing policies and their content in relation to prevention, control and management of CVDs at primary health care (PHC) level in Kenya. A targeted document search in Google engine using keywords "Kenya national policy on cardiovascular diseases" and "Kenya national policy on non-communicable diseases (NCDs)" was conducted in addition to key informant interviews with Kenyan policy makers. Relevant regional and international policy documents were also included. The contents of documents identified were reviewed to assess how well they aligned with global health policies on CVD prevention, control and management. Thematic content analysis of the key informant interviews was also conducted to supplement the document reviews. A total of 17 documents were reviewed and three key informants interviewed. Besides the Tobacco Control Act (2007), all policy documents for CVD prevention, control and management were developed after 2013. The national policies were preceded by global initiatives and guidelines and were similar in content with the global policies. The Kenya health policy (2014-2030), The Kenya Health Sector Strategic and Investment Plan (2014-2018) and the Kenya National Strategy for the Prevention and Control of Non-communicable diseases (2015-2020) had strategies on NCDs including CVDs. Other policy documents for behavioral risk factors (The Tobacco Control Act 2007, Alcoholic Drinks Control (Licensing) Regulations (2010)) were available. The National Nutrition Action Plan (2012-2017) was available as a draft. Although Kenya has a tiered health care system comprising primary healthcare, integration of CVD prevention and control at PHC level was not explicitly mentioned in the policy documents. This review revealed

  3. Public policy for the control of tobacco-related disease.

    Science.gov (United States)

    Bierer, M F; Rigotti, N A

    1992-03-01

    Public policies concerning tobacco shape the environment of the smoker and nonsmoker alike. These policies use diverse means to achieve the common goal of reducing tobacco use and its attendant health consequences. Educational interventions such as warning labels, school curricula, and public service announcements serve to inform the public about the hazards of tobacco smoke. These are countered by the pervasive marketing of tobacco products by the tobacco industry, despite a ban on tobacco advertising on radio and television. Further restrictions on tobacco advertising and promotion have been proposed and await action. Cigarette excise taxes and smoker-nonsmoker insurance premium differentials discourage smoking by making it more costly to purchase cigarettes. Conversely, health insurance reimbursement for smoking cessation programs could reduce the cost of giving up the habit and might encourage cessation. Restricting or banning smoking in public places and workplaces decreases a smoker's opportunities to smoke, further inhibiting this behavior. Reducing the availability of cigarettes to children and adolescents may help to prevent them from starting to smoke. The environment of the smoker is conditioned by this pastiche of influences. Physicians who become involved in tobacco-control issues have the opportunity to alter the environmental influences on their patients. This is likely to be synergistic with physicians' efforts inside the office to encourage individual smokers to quit. As a first step toward advocacy outside the office, physicians can help to create a smoke-free health-care facility in their own institution. Beyond that, advocacy groups or the voluntary health organizations (e.g., American Lung Association) provide avenues for physicians to take a stand on community issues relevant to tobacco control. Physicians who take these steps to alter the environment of smokers beyond the office are likely to magnify the effect of their work with individual

  4. Intrapartum Antibiotic Chemoprophylaxis Policies for the Prevention of Group B Streptococcal Disease Worldwide: Systematic Review.

    Science.gov (United States)

    Le Doare, Kirsty; O'Driscoll, Megan; Turner, Kim; Seedat, Farah; Russell, Neal J; Seale, Anna C; Heath, Paul T; Lawn, Joy E; Baker, Carol J; Bartlett, Linda; Cutland, Clare; Gravett, Michael G; Ip, Margaret; Madhi, Shabir A; Rubens, Craig E; Saha, Samir K; Schrag, Stephanie; Sobanjo-Ter Meulen, Ajoke; Vekemans, Johan; Kampmann, Beate

    2017-11-06

    Intrapartum antibiotic chemoprophylaxis (IAP) prevents most early-onset group B streptococcal (GBS) disease. However, there is no description of how IAP is used around the world. This article is the sixth in a series estimating the burden of GBS disease. Here we aimed to review GBS screening policies and IAP implementation worldwide. We identified data through (1) systematic literature reviews (PubMed/Medline, Embase, Literature in the Health Sciences in Latin America and the Caribbean [LILACS], World Health Organization library database [WHOLIS], and Scopus) and unpublished data from professional societies and (2) an online survey and searches of policies from medical societies and professionals. We included data on whether an IAP policy was in use, and if so whether it was based on microbiological or clinical risk factors and how these were applied, as well as the estimated coverage (percentage of women receiving IAP where indicated). We received policy information from 95 of 195 (49%) countries. Of these, 60 of 95 (63%) had an IAP policy; 35 of 60 (58%) used microbiological screening, 25 of 60 (42%) used clinical risk factors. Two of 15 (13%) low-income, 4 of 16 (25%) lower-middle-income, 14 of 20 (70%) upper-middle-income, and 40 of 44 (91%) high-income countries had any IAP policy. The remaining 35 of 95 (37%) had no national policy (25/33 from low-income and lower-middle-income countries). Coverage varied considerably; for microbiological screening, median coverage was 80% (range, 20%-95%); for clinical risk factor-based screening, coverage was 29% (range, 10%-50%). Although there were differences in the microbiological screening methods employed, the individual clinical risk factors used were similar. There is considerable heterogeneity in IAP screening policies and coverage worldwide. Alternative global strategies, such as maternal vaccination, are needed to enhance the scope of global prevention of GBS disease. © The Author 2017. Published by Oxford

  5. Market failure, policy failure and other distortions in chronic disease markets

    Directory of Open Access Journals (Sweden)

    Segal Leonie

    2009-06-01

    Full Text Available Abstract Background The increasing prevalence of chronic disease represents a significant burden on most health systems. This paper explores the market failures and policy failures that exist in the management of chronic diseases. Discussion There are many sources of market failure in health care that undermine the efficiency of chronic disease management. These include incomplete information as well as information asymmetry between providers and consumers, the effect of externalities on consumer behaviour, and the divergence between social and private time preference rates. This has seen government and policy interventions to address both market failures and distributional issues resulting from the inability of private markets to reach an efficient and equitable distribution of resources. However, these have introduced a series of policy failures such as distorted re-imbursement arrangements across modalities and delivery settings. Summary The paper concludes that market failure resulting from a preference of individuals for 'immediate gratification' in the form of health care and disease management, rather than preventative services, where the benefits are delayed, has a major impact on achieving an efficient allocation of resources in markets for the management of chronic diseases. This distortion is compounded by government health policy that tends to favour medical and pharmaceutical interventions further contributing to distortions in the allocation of resources and inefficiencies in the management of chronic disease.

  6. Chronic disease and climate change: understanding co-benefits and their policy implications.

    Science.gov (United States)

    Capon, Anthony G; Rissel, Chris E

    2010-01-01

    Chronic disease and climate change are major public policy challenges facing governments around the world. An improved understanding of the relationship between chronic disease and climate change should enable improved policy formulation to support both human health and the health of the planet. Chronic disease and climate change are both unintended consequences of our way of life, and are attributable in part to the ready availability of inexpensive fossil fuel energy. There are co-benefits for health from actions to address climate change. For example, substituting physical activity and a vegetable-rich diet for motor vehicle transport and a meat-rich diet is both good for health and good for the planet. We should encourage ways of living that use less carbon as these can be healthy ways of living, for both individuals and society. Quantitative modelling of co-benefits should inform policy responses.

  7. Marine disease impacts, diagnosis, forecasting, management and policy

    Science.gov (United States)

    Lafferty, Kevin D.; Hofmann, Eileen E.

    2016-01-01

    As Australians were spending millions of dollars in 2014 to remove the coral-eating crown of thorns sea star from the Great Barrier Reef, sea stars started washing up dead for free along North America's Pacific Coast. Because North American sea stars are important and iconic predators in marine communities, locals and marine scientists alike were alarmed by what proved to be the world's most widespread marine mass mortality in geographical extent and species affected, especially given its mysterious cause. Investigative research using modern diagnostic techniques implicated a never-before-seen virus [1]. The virus inspired international attention to marine diseases, including this theme issue.

  8. The Dutch gas policy: 'Dutch disease' or imaginary disease. CERI Studies Nr 11

    International Nuclear Information System (INIS)

    Crowley, John

    1998-04-01

    The Netherlands are the first European gas producer and exporter. The author proposes an analysis of the gas policy of this country. He first recalls some elements of context: peculiarities of energy as a domain of public policy, and characteristics of the Dutch political system. He recalls the historical development of the Dutch gas industry from the 1960's: political economics of natural gas and of competing fuels, development of the Groningen site as the keystone of the Dutch gas policy, and regulation of the industrial sector. In the next part, the author comments the emergence of energy as a topic of public debate from 1995, and how the Dutch gas policy has been put into question again: actors and interaction dynamics, stakes, present policy and perspectives

  9. Climate change and diarrhoeal disease: Perspectives for development policies

    DEFF Research Database (Denmark)

    Halsnæs, Kirsten; Føyn, Tullik Helene Ystanes

    2010-01-01

    This paper points to the key role of health in development programmes and illustrates through diarrhoeal diseases as a case example, how climate change can impose increasing risks, which particularly will hit young children and the poor. The increased incidence can both be expected to emerge from...... higher temperatures and from more extreme events in particularly flooding. The number of people affected is by WHO projected to be approximately 700,000 dead and 22 mill disability adjusted life years in 2030 without climate change, so it is very important to initiate climate change adaptation measures...... that can help to reduce these risks. An attempt to start such a process i.e. has been done by the Danish Overseas Development Assistance Programme, Danida, which has conducted a climate screening of programme activities in Bangladesh. The paper presents a number of conclusions from this climate screening...

  10. Applying Science: opportunities to inform disease management policy with cooperative research within a One Health framework

    Directory of Open Access Journals (Sweden)

    Jason K. Blackburn

    2016-01-01

    Full Text Available The ongoing Ebola outbreak in West Africa and the current saiga antelope die off in Kazakhstan each represent very real and difficult to manage public or veterinary health crises. They also illustrate the importance of stable and funded surveillance and sound policy for intervention or disease control. While these two events highlight extreme cases of infectious disease (Ebola or (possible environmental exposure (saiga, diseases such as anthrax, brucellosis, tularemia, and plague are all zoonoses that pose risks and present surveillance challenges at the wildlife-livestock-human interfaces. These four diseases are also considered important actors in the threat of biological terror activities and have a long history as legacy biowarfare pathogens. This paper reviews recent studies done cooperatively between American and institutions within nations of the Former Soviet Union (FSU focused on spatiotemporal, epidemiological, and ecological patterns of these four zoonoses. We examine recent studies and discuss the possible ways in which techniques, including ecological niche modeling, disease risk modeling, and spatio-temporal cluster analysis, can inform disease surveillance, control efforts and impact policy. Our focus is to posit ways to apply science to disease management policy and actual management or mitigation practices. Across these examples, we illustrate the value of cooperative studies that bring together modern geospatial and epidemiological analyses to improve our understanding of the distribution of pathogens and diseases in livestock, wildlife, and humans. For example, ecological niche modeling can provide national level maps of pathogen distributions for surveillance planning, while space-time models can identify the timing and location of significant outbreak events for defining active control strategies. We advocate for the need to bring the results and the researchers from cooperative studies into the meeting rooms where policy is

  11. Communicable disease policy development in response to changing European political frontiers in Finland, Norway and Sweden.

    Science.gov (United States)

    Bernitz, Brita Kaltenbrunner

    2008-11-01

    The European Union (EU) enlargement of 2004 brings both opportunities and challenges for public health. It is believed that further integration will bring direct health benefits, mainly through improved socioeconomic conditions, but there are also risks associated with the EU expansion, in particular cross-border health risks, such as the impact of the internal EU market policy of free movement and migration on communicable disease patterns. Against this background, this article examines communicable disease policy development in Finland, Norway and Sweden in response to changing European political frontiers, in particular the EU accession of the Baltic States. The emphasis is on HIV/AIDS and tuberculosis. The study is based on a qualitative and quantitative approach, using two complementary methods: documentary analysis and stakeholder analysis. The article identifies a distinct pattern in communicable disease policy development between 1990 and 2005. The turn of the new millennium saw a sharp increase in national attention and the priority assigned to communicable diseases in Finland, Norway and Sweden. The article argues that this development is likely to be related to the rising national, regional and European awareness of the public health challenges associated with communicable diseases in today's borderless Europe. It also shows that the Baltic health situation is a particular concern for Finland. Although there is increasing national and regional activity within the communicable disease area, there is a need for a more effective European approach to tackle the future communicable disease challenges that may follow in an increasingly interdependent and integrated Europe.

  12. Infectious diseases in the workplace: pointers for an ethical management policy.

    Science.gov (United States)

    Hamblin, J

    1990-01-01

    Infectious diseases in the workplace can present difficult dilemmas for employers, who must balance the rights of infected employees against obligations to protect other employees from infection. Anti-discrimination legislation imposes additional obligations on employers to ensure that any steps taken in response to the risk of infectious disease do not amount to unlawful discrimination against employees who may be disease carriers. This paper analyses the operation of anti-discrimination in this context and points to ways in which employers can formulate an infectious diseases policy that is both ethically and legally defensible.

  13. Women's experiences of developing musculoskeletal diseases: employment challenges and policy recommendations.

    Science.gov (United States)

    Crooks, Valorie A

    2007-07-30

    To answer three specific questions: (i) How do women experience the workplace after the onset of a musculoskeletal disease; (ii) What employment policy and programme suggestions can they offer for ways to better support chronically ill women in their abilities to maintain workforce participation; and (iii) How are these women's employment policy and programme recommendations informed by their own lived experiences and desires? In-depth interviews were conducted with 18 women who had developed musculoskeletal diseases while involved in the labour market. Data were coded and analysed thematically. Participants identified three common workplace barriers experienced and three types of workplace accommodations commonly requested. They offered four specific employment policy and programme recommendations for ways to better support women who develop musculoskeletal diseases in maintaining labour market participation. It is found that their employment policy and programme recommendations are informed by their own experiences in the workplace and desires for being supported in maintaining involvement in paid labour. Creating employment programmes and policies that support chronically ill women in their attempts to remain involved in the workforce based on how much paid labour they are able to perform and where they are best able to work is of the utmost importance.

  14. Promoting Evidence to Policy Link on the Control of Infectious Diseases of Poverty in Nigeria: Outcome of A Multi-Stakeholders Policy Dialogue

    Science.gov (United States)

    Uneke, Chigozie Jesse; Ebeh Ezeoha, Abel; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima

    2015-01-01

    Background: In Nigeria, malaria, schistosomiasis and lymphatic filariasis are among infectious diseases of poverty (IDP) with severe health burden and require effective policy strategies for their control. In this study, we investigated the value of policy brief and policy dialogue as excellent policymaking mechanisms that enable policymakers to adapt effective evidence informed policy for IDP control. Methods: A policy brief was developed on the control of malaria, schistosomiasis and lymphatic filariasis and subjected to deliberations in a one-day multi-stakeholder policy dialogue held in Ebonyi State Nigeria. A modified cross sectional intervention study design was used in this investigation. Structured pre-tested questionnaires were used to evaluate the policy brief document and policy dialogue process at the end of the policy dialogue. Results: Forty-seven policymakers participated in the dialogue. An analysis of the response on the policy brief regarding context, different features of the problem; policy options and key implementation considerations indicated the mean ratings (MNRs) mostly ranged from 6.40-6.85 on 7 point scale. The over-all assessment of the policy brief had MNR at 6.54. The analysis of the response on the policy dialogue regarding the level of priority of policy issue, opportunity to discuss different features of the problem and options for addressing the problem, and the MNRs mostly ranged from 6.50-6.82. The overall assessment of the policy dialogue had MNR at 6.72. Conclusion: Policy dialogues can allow research evidence to be considered together with views, experiences and tacit knowledge of policymakers and can enhance evidence-to-policy link. PMID:26290826

  15. Enhancing the Capacity of Policy-Makers to Develop Evidence-Informed Policy Brief on Infectious Diseases of Poverty in Nigeria

    Directory of Open Access Journals (Sweden)

    Chigozie Jesse Uneke

    2015-09-01

    Full Text Available Background The lack of effective use of research evidence in policy-making is a major challenge in most low- and middle-income countries (LMICs. There is need to package research data into effective policy tools that will help policy-makers to make evidence-informed policy regarding infectious diseases of poverty (IDP. The objective of this study was to assess the usefulness of training workshops and mentoring to enhance the capacity of Nigerian health policy-makers to develop evidence-informed policy brief on the control of IDP. Methods A modified “before and after” intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point Likert scale according to the degree of adequacy; 1 = “grossly inadequate,” 4 = “very adequate” was employed. The main parameter measured was participants’ perceptions of their own knowledge/understanding. This study was conducted at subnational level and the participants were the career health policy-makers drawn from Ebonyi State in the South-Eastern Nigeria. A oneday evidence-to-policy workshop was organized to enhance the participants’ capacity to develop evidence-informed policy brief on IDP in Ebonyi State. Topics covered included collaborative initiative; preparation and use of policy briefs; policy dialogue; ethics in health policy-making; and health policy and politics. Results The preworkshop mean of knowledge and capacity ranged from 2.49-3.03, while the postworkshop mean ranged from 3.42–3.78 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 20.10%–45%. Participants were divided into 3 IDP mentorship groups (malaria, schistosomiasis, lymphatic filariasis [LF] and were mentored to identify potential policy options/recommendations for control of the diseases for the policy briefs. These policy options were subjected to research

  16. Enhancing the Capacity of Policy-Makers to Develop Evidence-Informed Policy Brief on Infectious Diseases of Poverty in Nigeria

    Science.gov (United States)

    Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima

    2015-01-01

    Background: The lack of effective use of research evidence in policy-making is a major challenge in most low- and middle-income countries (LMICs). There is need to package research data into effective policy tools that will help policy-makers to make evidence-informed policy regarding infectious diseases of poverty (IDP). The objective of this study was to assess the usefulness of training workshops and mentoring to enhance the capacity of Nigerian health policy-makers to develop evidence-informed policy brief on the control of IDP. Methods: A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point Likert scale according to the degree of adequacy; 1 = "grossly inadequate," 4 = "very adequate" was employed. The main parameter measured was participants’ perceptions of their own knowledge/understanding. This study was conducted at subnational level and the participants were the career health policy-makers drawn from Ebonyi State in the South-Eastern Nigeria. A one-day evidence-to-policy workshop was organized to enhance the participants’ capacity to develop evidence-informed policy brief on IDP in Ebonyi State. Topics covered included collaborative initiative; preparation and use of policy briefs; policy dialogue; ethics in health policy-making; and health policy and politics. Results: The preworkshop mean of knowledge and capacity ranged from 2.49-3.03, while the postworkshop mean ranged from 3.42–3.78 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 20.10%–45%. Participants were divided into 3 IDP mentorship groups (malaria, schistosomiasis, lymphatic filariasis [LF]) and were mentored to identify potential policy options/recommendations for control of the diseases for the policy briefs. These policy options were subjected to research evidence synthesis by each

  17. Use of Pneumococcal Disease Epidemiology to Set Policy and Prevent Disease during 20 Years of the Emerging Infections Program.

    Science.gov (United States)

    Moore, Matthew R; Whitney, Cynthia G

    2015-09-01

    Two decades ago, the Emerging Infections Program of the US Centers for Disease Control and Prevention implemented what seemed like a simple yet novel idea: a population- and laboratory-based surveillance system designed to identify and characterize invasive bacterial infections, including those caused by Streptococcus pneumoniae. This system, known as Active Bacterial Core surveillance, has since served as a flexible platform for following trends in invasive pneumococcal disease and studying vaccination as the most effective method for prevention. We report the contributions of Active Bacterial Core surveillance to every pneumococcal vaccine policy decision in the United States during the past 20 years.

  18. Health education policy 1916-1926: venereal disease and the prophylaxis dilemma.

    Science.gov (United States)

    Towers, B A

    1980-01-01

    This paper seeks to account for the development of a public health education policy with respect to venereal disease during the period 1916-1926. Two competing pressure groups, the National Council for Combatting Venereal Disease and the Society for the Prevention of Venereal Disease, defended opposing programmes; the one based on moral education (NCCVD) and the other (SPVD) on medical prophylaxis. Many of the interests represented by the groups and the political dimensions that they took, were influenced by factors only very tangentially connected to health education. Any account of the development of policy in this field needs placing in the context of the early history of nineteenth-century anti-vice crusades; the role of the Army Medical Corps during the 1914-18 war; and the bureaucratic protectionism of the Ministry of Health personnel.

  19. Fiscal policy to improve diets and prevent noncommunicable diseases: from recommendations to action.

    Science.gov (United States)

    Thow, Anne Marie; Downs, Shauna M; Mayes, Christopher; Trevena, Helen; Waqanivalu, Temo; Cawley, John

    2018-03-01

    The World Health Organization has recommended that Member States consider taxing energy-dense beverages and foods and/or subsidizing nutrient-rich foods to improve diets and prevent noncommunicable diseases. Numerous countries have either implemented taxes on energy-dense beverages and foods or are considering the implementation of such taxes. However, several major challenges to the implementation of fiscal policies to improve diets and prevent noncommunicable diseases remain. Some of these challenges relate to the cross-sectoral nature of the relevant interventions. For example, as health and economic policy-makers have different administrative concerns, performance indicators and priorities, they often consider different forms of evidence in their decision-making. In this paper, we describe the evidence base for diet-related interventions based on fiscal policies and consider the key questions that need to be asked by both health and economic policy-makers. From the health sector's perspective, there is most evidence for the impact of taxes and subsidies on diets, with less evidence on their impacts on body weight or health. We highlight the importance of scope, the role of industry, the use of revenue and regressive taxes in informing policy decisions.

  20. Integrating natural and social science perspectives on plant disease risk, management and policy formulation

    Science.gov (United States)

    Mills, Peter; Dehnen-Schmutz, Katharina; Ilbery, Brian; Jeger, Mike; Jones, Glyn; Little, Ruth; MacLeod, Alan; Parker, Steve; Pautasso, Marco; Pietravalle, Stephane; Maye, Damian

    2011-01-01

    Plant diseases threaten both food security and the botanical diversity of natural ecosystems. Substantial research effort is focused on pathogen detection and control, with detailed risk management available for many plant diseases. Risk can be assessed using analytical techniques that account for disease pressure both spatially and temporally. We suggest that such technical assessments of disease risk may not provide an adequate guide to the strategies undertaken by growers and government to manage plant disease. Instead, risk-management strategies need to account more fully for intuitive and normative responses that act to balance conflicting interests between stakeholder organizations concerned with plant diseases within the managed and natural environments. Modes of effective engagement between policy makers and stakeholders are explored in the paper, together with an assessment of such engagement in two case studies of contemporary non-indigenous diseases in one food and in one non-food sector. Finally, a model is proposed for greater integration of stakeholders in policy decisions. PMID:21624923

  1. Reducing US cardiovascular disease burden and disparities through national and targeted dietary policies: A modelling study.

    Directory of Open Access Journals (Sweden)

    Jonathan Pearson-Stuttard

    2017-06-01

    Full Text Available Large socio-economic disparities exist in US dietary habits and cardiovascular disease (CVD mortality. While economic incentives have demonstrated success in improving dietary choices, the quantitative impact of different dietary policies on CVD disparities is not well established. We aimed to quantify and compare the potential effects on total CVD mortality and disparities of specific dietary policies to increase fruit and vegetable (F&V consumption and reduce sugar-sweetened beverage (SSB consumption in the US.Using the US IMPACT Food Policy Model and probabilistic sensitivity analyses, we estimated and compared the reductions in CVD mortality and socio-economic disparities in the US population potentially achievable from 2015 to 2030 with specific dietary policy scenarios: (a a national mass media campaign (MMC aimed to increase consumption of F&Vs and reduce consumption of SSBs, (b a national fiscal policy to tax SSBs to increase prices by 10%, (c a national fiscal policy to subsidise F&Vs to reduce prices by 10%, and (d a targeted policy to subsidise F&Vs to reduce prices by 30% among Supplemental Nutrition Assistance Program (SNAP participants only. We also evaluated a combined policy approach, combining all of the above policies. Data sources included the Surveillance, Epidemiology, and End Results Program, National Vital Statistics System, National Health and Nutrition Examination Survey, and published meta-analyses. Among the individual policy scenarios, a national 10% F&V subsidy was projected to be most beneficial, potentially resulting in approximately 150,500 (95% uncertainty interval [UI] 141,400-158,500 CVD deaths prevented or postponed (DPPs by 2030 in the US. This far exceeds the approximately 35,100 (95% UI 31,700-37,500 DPPs potentially attributable to a 30% F&V subsidy targeting SNAP participants, the approximately 25,800 (95% UI 24,300-28,500 DPPs for a 1-y MMC, or the approximately 31,000 (95% UI 26,800-35,300 DPPs for a 10

  2. Understanding and benchmarking health service achievement of policy goals for chronic disease

    Science.gov (United States)

    2012-01-01

    Background Key challenges in benchmarking health service achievement of policy goals in areas such as chronic disease are: 1) developing indicators and understanding how policy goals might work as indicators of service performance; 2) developing methods for economically collecting and reporting stakeholder perceptions; 3) combining and sharing data about the performance of organizations; 4) interpreting outcome measures; 5) obtaining actionable benchmarking information. This study aimed to explore how a new Boolean-based small-N method from the social sciences—Qualitative Comparative Analysis or QCA—could contribute to meeting these internationally shared challenges. Methods A ‘multi-value QCA’ (MVQCA) analysis was conducted of data from 24 senior staff at 17 randomly selected services for chronic disease, who provided perceptions of 1) whether government health services were improving their achievement of a set of statewide policy goals for chronic disease and 2) the efficacy of state health office actions in influencing this improvement. The analysis produced summaries of configurations of perceived service improvements. Results Most respondents observed improvements in most areas but uniformly good improvements across services were not perceived as happening (regardless of whether respondents identified a state health office contribution to that improvement). The sentinel policy goal of using evidence to develop service practice was not achieved at all in four services and appears to be reliant on other kinds of service improvements happening. Conclusions The QCA method suggested theoretically plausible findings and an approach that with further development could help meet the five benchmarking challenges. In particular, it suggests that achievement of one policy goal may be reliant on achievement of another goal in complex ways that the literature has not yet fully accommodated but which could help prioritize policy goals. The weaknesses of QCA can be

  3. Lower Socio-economic Status and Cardiovascular Disease: Role of Healthcare Facility and Policy in India

    Directory of Open Access Journals (Sweden)

    Arti Singh

    2016-09-01

    Full Text Available Background: Cardio-vascular disease (CVD is one of the main cause of mortality Worldwide and India is no exception. Unlike developed countries, where both CVD prevalence and mortality has been established to affect lower socio-economic status (SES, in India there is no consensus among researchers over socio-economic patterning of CVD prevalence but the mortality rate has been reported to disproportionately affect the economically weaker sections. Aims & Objectives: This article, focuses at the issue of how lack of good healthcare facilities and non-supportive health policies are affecting CVD mortality positively among lower SES of India. Challenges of the Indian healthcare system in context of lower SES can be described in terms of the issue of availability, accessibility and affordability. Inadequate policy and public healthcare system either leads to the problem of high Out-of-Pocket Payments (OPP or opting out of the treatment, which further increases poverty and mortality among them. Moreover, limited insurance coverage and inadequate regulatory policies for alcohol and tobacco-leading CVD risk factors among lower SES groups – do little to discourage its use among them. Conclusion: Since, lower SES people in India are already under the burden of communicable diseases, government should take immediate steps to control the mortality among them by creating a supportive environment through pro-poor health policies and healthcare facilities.

  4. The social and political lives of zoonotic disease models: narratives, science and policy.

    Science.gov (United States)

    Leach, Melissa; Scoones, Ian

    2013-07-01

    Zoonotic diseases currently pose both major health threats and complex scientific and policy challenges, to which modelling is increasingly called to respond. In this article we argue that the challenges are best met by combining multiple models and modelling approaches that elucidate the various epidemiological, ecological and social processes at work. These models should not be understood as neutral science informing policy in a linear manner, but as having social and political lives: social, cultural and political norms and values that shape their development and which they carry and project. We develop and illustrate this argument in relation to the cases of H5N1 avian influenza and Ebola, exploring for each the range of modelling approaches deployed and the ways they have been co-constructed with a particular politics of policy. Addressing the complex, uncertain dynamics of zoonotic disease requires such social and political lives to be made explicit in approaches that aim at triangulation rather than integration, and plural and conditional rather than singular forms of policy advice. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Advancing Strategies for Agenda Setting by Health Policy Coalitions: A Network Analysis of the Canadian Chronic Disease Prevention Survey.

    Science.gov (United States)

    McGetrick, Jennifer Ann; Raine, Kim D; Wild, T Cameron; Nykiforuk, Candace I J

    2018-06-11

    Health in all policies can address chronic disease morbidity and mortality by increasing population-level physical activity and healthy eating, and reducing tobacco and alcohol use. Both governmental and nongovernmental policy influencers are instrumental for health policy that modifies political, economic, and social environments. Policy influencers are informed and persuaded by coalitions that support or oppose changing the status quo. Empirical research examining policy influencers' contact with coalitions, as a social psychological exposure with health policy outcomes, can benefit from application of health communication theories. Accordingly, we analyzed responses to the 2014 Chronic Disease Prevention Survey for 184 Canadian policy influencers employed in provincial governments, municipalities, large workplaces, school boards, and the media. In addition to contact levels with coalitions, respondents' jurisdiction, organization, and ideology were analyzed as potential moderators. Calculating authority score centrality using network analysis, we determined health policy supporters to be more central in policy influencer networks, and theorized their potential to impact health policy public agenda setting via priming and framing processes. We discuss the implications of our results as presenting opportunities to more effectively promote health policy through priming and framing by coordinating coalitions across risk behaviors to advance a societal imperative for chronic disease prevention.

  6. [Patient's role and chronic disease in Mali: between policies and expert and lay practices].

    Science.gov (United States)

    Gobatto, Isabelle; Tijou Traoré, Annick; Martini, Jessica

    2016-01-01

    The growing burden of non-communicable diseases challenges health systems of low-and middle-income countries and requires health care reform by the introduction of models focused on patient participation. This article puts into perspective the management of two chronic diseases, diabetes and HIV/AIDS, in Mali. It explores the way in which the patient’s role is conceived and implemented at three levels: policy-makers, healthcare professionals and patients, in order to more clearly understand the dynamics and rationales underlying promotion of the patient’s role in the context of a low-income country. Results were derived from qualitative interviews conducted between 2010 and 2012 with key stakeholders involved in policy, healthcare professionals and patients, and from observations of healthcare relationships in two specialized healthcare structures in Bamako. The chronic nature of the disease is not sufficient to define the patient’s role in healthcare. Other factors also influence the emergence and practice of an active patient care model: the political, clinical and social history of the disease; the institutional work contexts of healthcare professionals; patients’ representations and practices. Patients are well aware of the role they need to play in the management of a chronic disease and they develop resources to remain active. These various dynamics should be better taken into account to make effective changes in the health care system and to strengthen patients’ autonomy.

  7. Desire or Disease? Framing Obesity to Influence Attributions of Responsibility and Policy Support.

    Science.gov (United States)

    McGlynn, Joseph; McGlone, Matthew S

    2018-02-01

    The way we describe health threats affects perceptions of severity and preferred solutions to reduce risk. Most people agree obesity is a problem, but differ in how they attribute responsibility for development and decline of the disease. We explored effects of message framing on attributions of responsibility and support for public obesity policies using a 3 × 2 factorial design. Participants read one of six versions of a health message describing the negative effects of obesity. Message frames influenced respondent attributions and their support for policies to reduce obesity. Those who read a message that assigned agency to the disease (e.g., Obesity causes health problems) endorsed genetics as the cause to a greater degree than those who read a semantically equivalent message that instead assigned agency to people (e.g., Obese people develop health problems). In contrast, assigning agency to people rather than to the disease prompted higher attributions of individual responsibility and support for public policies. Explicit message frames that directly connected responsibility for obesity to either individual or societal factors had no effect on respondent perceptions. Findings suggest explicit arguments may be less effective in shifting perceptions of health threats than arguments embedded in agentic message frames. The results demonstrate specific message features that influence how people attribute responsibility for the onset and solution of obesity.

  8. Policy, practice and decision making for zoonotic disease management: water and Cryptosporidium.

    Science.gov (United States)

    Austin, Zoë; Alcock, Ruth E; Christley, Robert M; Haygarth, Philip M; Heathwaite, A Louise; Latham, Sophia M; Mort, Maggie; Oliver, David M; Pickup, Roger; Wastling, Jonathan M; Wynne, Brian

    2012-04-01

    Decision making for zoonotic disease management should be based on many forms of appropriate data and sources of evidence. However, the criteria and timing for policy response and the resulting management decisions are often altered when a disease outbreak occurs and captures full media attention. In the case of waterborne disease, such as the robust protozoa, Cryptosporidium spp, exposure can cause significant human health risks and preventing exposure by maintaining high standards of biological and chemical water quality remains a priority for water companies in the UK. Little has been documented on how knowledge and information is translated between the many stakeholders involved in the management of Cryptosporidium, which is surprising given the different drivers that have shaped management decisions. Such information, coupled with the uncertainties that surround these data is essential for improving future management strategies that minimise disease outbreaks. Here, we examine the interplay between scientific information, the media, and emergent government and company policies to examine these issues using qualitative and quantitative data relating to Cryptosporidium management decisions by a water company in the North West of England. Our results show that political and media influences are powerful drivers of management decisions if fuelled by high profile outbreaks. Furthermore, the strength of the scientific evidence is often constrained by uncertainties in the data, and in the way knowledge is translated between policy levels during established risk management procedures. In particular, under or over-estimating risk during risk assessment procedures together with uncertainty regarding risk factors within the wider environment, was found to restrict the knowledge-base for decision-making in Cryptosporidium management. Our findings highlight some key current and future challenges facing the management of such diseases that are widely applicable to other

  9. Agricultural policy and social returns to eradication programs: the case of Aujeszky's disease in Sweden.

    Science.gov (United States)

    Andersson, H; Lexmon, A; Robertsson, J A; Lundeheim, N; Wierup, M

    1997-02-01

    Economic-welfare analysis of animal disease prevention programs frequently ignore the constraints of the agricultural policy environment. Prevention programs affect producers, consumers and the government. The policy environment to a large extent determines the magnitude as well as the distribution of benefits of the program among these groups. The Swedish hog industry has been exposed to three major policy changes during the 1990-1995 period. These scenarios involve various degrees of government intervention in the agricultural sector including internal market deregulation and EU-membership. Aujeszky's disease is a virus disease with swine as the natural infection reservoir. Piglets are the most fragile and an outbreak of the disease results in symptoms such as shaking, cramps and convulsions with an increase in the mortality rate. Slaughter hogs suffer from coughing, fever and reduce their feed consumption. During the last 20-25 years the incidence of Aujeszky's disease (AD) has been increasing in Sweden. In 1989 an eradication program was undertaken. A model is developed to analyze social benefits of an eradication program given variations in agricultural policy. The model refers to the specifics of the AD-program implemented in Sweden. The expected benefits of the program are evaluated using a welfare-economic analysis applying cost-benefit analysis. Total benefits of the program are evaluated across herd and size categories and different regions. Data concerning the frequency of the virus among various categories of herds prior to enacting the program were used (Wahlström et al., 1990). In addition, data from an agricultural insurance company were used to estimate the conditional probability of an outbreak given that the herd is infected. Biological and technical parameter values were collected from a variety of sources. The results of the analysis indicate that the program is economically viable given a social rate of discount in the range of 3-5% without

  10. Alzheimer's disease legislation and policy--now and in the future.

    Science.gov (United States)

    Hoffman, David

    2014-04-01

    Recent studies have pointed to the large and increasingly complex issues surrounding dementia in American society in general and health care in particular. The initial foray into the federal policy arena, the National Alzheimer's Project Act, is a good first step but remains limited in scope and resources. Seeing the need for greater effort, thirty-three states have convened advisory groups and published their own plans for coordinating state-level activity to address Alzheimer's disease across service systems. This article examines the current federal and state policy statements on dementia-related issues and offers an outlook and suggestions for next steps along with the imperative for action on a significant scale. This is necessary to address issues in a meaningful way today instead of simply holding out hope for a treatment or cure in the future. Dementia in general and Alzheimer's disease in particular affect individuals and every facet of families, health care, business, states, and communities. While public policy statements at all levels call for increased coordination of resources, better communication, awareness, and essential linkages, more effort is required.

  11. Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity – A Comprehensive Review

    Science.gov (United States)

    Mozaffarian, Dariush

    2015-01-01

    Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not just obesity and blood lipids; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (e.g., sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to-date supports cardiometabolic relevance of other popular priorities: e.g., local, organic, grass-fed, farmed/wild, non-GMO. Evidence-based personalized nutrition appears to depend more on non-genetic characteristics (e.g., physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies, including those targeting economic incentives, schools and workplaces

  12. Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review.

    Science.gov (United States)

    Mozaffarian, Dariush

    2016-01-12

    Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes mellitus. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not only blood lipids or obesity; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (eg, sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on the cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to date supports the cardiometabolic relevance of other popular priorities: eg, local, organic, grass-fed, farmed/wild, or non-genetically modified. Evidence-based personalized nutrition appears to depend more on nongenetic characteristics (eg, physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies targeting economic incentives, schools and

  13. Exploring public perceptions of solutions to tree diseases in the UK: Implications for policy-makers.

    Science.gov (United States)

    Jepson, Paul; Arakelyan, Irina

    2017-10-01

    Tree diseases are on the increase in many countries and the implications of their appearance can be political, as well as ecological and economic. Preventative policy approaches to tree diseases are difficult to formulate because dispersal pathways for pest and pathogens are numerous, poorly known and likely to be beyond human management control. Genomic techniques could offer the quickest and most predictable approach to developing a disease tolerant native ash. The population of European Ash ( Fraxinus Excelsi or) has suffered major losses in the last decade, due to the onset of Hymenoscyphus fraxineus (previously called Chalara Fraxinea ) commonly known in the UK as ash dieback. This study presents evidence on the public acceptability of tree-breed solutions to the spread of Chalara , with the main aim to provide science and policy with an up-stream 'steer' on the likely public acceptability of different tree breeding solutions. The findings showed that whilst there was a firm anti-GM and ' we shouldn't tamper with nature ' attitude among UK publics, there was an equally firm and perhaps slightly larger pragmatic attitude that GM (science and technology) should be used if there is a good reason to do so, for example if it can help protect trees from disease and help feed the world. The latter view was significantly stronger among younger age groups (Millennials), those living in urban areas and when the (GM)modified trees were destined for urban and plantation, rather than countryside settings. Overall, our findings suggest that the UK government could consider genomic solutions to tree breeding with more confidence in the future, as large and influential publics appear to be relaxed about the use of genomic techniques to increase tolerance of trees to disease.

  14. Does evidence influence policy? Resource allocation and the Indigenous Burden of Disease study.

    Science.gov (United States)

    Doran, Christopher M; Ling, Rod; Searles, Andrew; Hill, Peter

    2016-01-01

    Objective The Indigenous Burden of Disease (IBoD) report is the most comprehensive assessment of Indigenous disease burden in Australia. The aim of the present study was to investigate the potential effect of the IBoD report on Australian Indigenous health policy, service expenditure and research funding. Findings have significance for understanding factors that may influence Indigenous health policy. Methods The potential effect of the IBoD report was considered by: (1) conducting a text search of pertinent documents published by the federal government, Council of Australian Governments and the National Health and Medical Research Council of Australia (NHMRC) and observing the quantity and quality of references to IBoD; (2) examining data on government Indigenous healthcare expenditure for trends consistent with the findings and policy implications of the IBoD report; and (3) examining NHMRC Indigenous grant allocation trends consistent with the findings and policy implications of the IBoD report. Results Of 110 government and NHMRC documents found, IBoD was cited in 27. Immediately after publication of the IBoD report, federal and state governments increased Indigenous health spending (relative to non-Indigenous), notably for community health and public health at the state level. Expenditure on Indigenous hospital separations for chronic diseases also increased. These changes are broadly consistent with the findings of the IBoD report on the significance of chronic disease and the need to address certain risk factors. However, there is no evidence that such changes had a causal connection with the IBoD study. After publication of the IBoD report, changes in NHMRC Indigenous research funding showed little consistency with the findings of the IBoD report. Conclusions The present study found only indirect and inconsistent correlational evidence of the potential influence of the IBoD report on Indigenous health expenditure and research funding. Further assessment of

  15. How do demographic transitions and public health policies affect patients with Parkinson's disease in Brazil?

    Science.gov (United States)

    Bovolenta, Tânia M; Felicio, Andre C

    2017-01-01

    Brazil is currently experiencing a significant demographic transition characterized by a decrease in fertility rates and an exponential increase in the number of elderly citizens, which presents a special challenge for the health care professionals. More than other portions of the population, the elderly are most commonly affected by chronic diseases such as Parkinson's disease. Policymakers contend that Brazil is reasonably well-prepared regarding elderly health care, with policies that aim to ensure the quality of life and the well-being of this portion of the population. However, what happens in practice falls short of what the Brazilian Constitution sets forth. Specifically, there is a clear contradiction between what the law recognizes as being a citizen's rights and the implementation of guidelines. Because health financing in Brazil remains relatively low, the civil society tries to fill in the gaps as much as possible in the treatment of elderly patients suffering from chronic diseases such as Parkinson's disease. In this review, we outline the current legislation in Brazil regarding the elderly and in particular, patients with Parkinson's disease, in the context of a rapidly aging population.

  16. Lung Cancer Workshop XI: Tobacco-Induced Disease: Advances in Policy, Early Detection and Management.

    Science.gov (United States)

    Mulshine, James L; Avila, Rick; Yankelevitz, David; Baer, Thomas M; Estépar, Raul San Jose; Ambrose, Laurie Fenton; Aldigé, Carolyn R

    2015-05-01

    The Prevent Cancer Foundation Lung Cancer Workshop XI: Tobacco-Induced Disease: Advances in Policy, Early Detection and Management was held in New York, NY on May 16 and 17, 2014. The two goals of the Workshop were to define strategies to drive innovation in precompetitive quantitative research on the use of imaging to assess new therapies for management of early lung cancer and to discuss a process to implement a national program to provide high quality computed tomography imaging for lung cancer and other tobacco-induced disease. With the central importance of computed tomography imaging for both early detection and volumetric lung cancer assessment, strategic issues around the development of imaging and ensuring its quality are critical to ensure continued progress against this most lethal cancer.

  17. Cellular therapies for heart disease: unveiling the ethical and public policy challenges.

    Science.gov (United States)

    Raval, Amish N; Kamp, Timothy J; Hogle, Linda F

    2008-10-01

    Cellular therapies have emerged as a potential revolutionary treatment for cardiovascular disease. Promising preclinical results have resulted in a flurry of basic research activity and spawned multiple clinical trials worldwide. However, the optimal cell type and delivery mode have not been determined for target patient populations. Nor have the mechanisms of benefit for the range of cellular interventions been clearly defined. Experiences to date have unveiled a myriad of ethical and public policy challenges which will affect the way researchers and clinicians make decisions for both basic and clinical research. Stem cells derived from embryos are at the forefront of the ethical and political debate, raising issues of which derivation methods are morally and socially permissible to pursue, as much as which are technically feasible. Adult stem cells are less controversial; however, important challenges exist in determining study design, cell processing, delivery mode, and target patient population. Pathways to successful commercialization and hence broad accessibility of cellular therapies for heart disease are only beginning to be explored. Comprehensive, multi-disciplinary and collaborative networks involving basic researchers, clinicians, regulatory officials and policymakers are required to share information, develop research, regulatory and policy standards and enable rational and ethical cell-based treatment approaches.

  18. Cardiovascular disease - risk benefits of clean fuel technology and policy. A statistical analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gallagher, Paul; Fischer, Amelia [Economics Department, 481 Heady Hall, Iowa State University, Ames Iowa 50011 (United States); Lazarus, William; Bachewe, Fantu [Applied Economics Department, 253 COB, University of Minnesota, St. Paul, MN 55455 (United States); Shapouri, Hosein; Conway, Roger [Office of Energy Policy and New Uses, 400 Independence Avenue, SW (Rm.4059 So. Bldg), United States Department of Agriculture, Washington, DC 20250 (United States)

    2010-02-15

    The hypothesis of this study is that there is a statistical relationship between the cardiovascular disease mortality rate and the intensity of fuel consumption (measured in gallons/square mile) at a particular location. We estimate cross-sectional regressions of the mortality rate due to cardiovascular disease against the intensity of fuel consumption using local data for the entire US, before the US Clean Air Act (CAA) in 1974 and after the most recent policy revisions in 2004. The cardiovascular disease rate improvement estimate suggests that up to 60 cardiovascular disease deaths per 100,000 residents are avoided in the largest urban areas with highest fuel consumption per square mile. In New York City, for instance, the mortality reduction may be worth about $30.3 billion annually. Across the US, the estimated Value of Statistical Life (VSL) benefit is $202.7 billion annually. There are likely three inseparable reasons that contributed importantly to this welfare improvement. First, the CAA regulations banned leaded gasoline, and mandated reduction in specific chemicals and smog components. Second, technologies such as the Catalytic Converter (CC) for the automobile and the low particulate diesel engine were adopted. Third, biofuels have had important roles, making the adoption of clean air technology possible and substituting for high emission fuels. (author)

  19. Cardiovascular disease-risk benefits of clean fuel technology and policy: A statistical analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gallagher, Paul, E-mail: paulg@iastate.ed [Economics Department, 481 Heady Hall, Iowa State University, Ames Iowa 50011 (United States); Lazarus, William [Applied Economics Department, 253 COB, University of Minnesota, St. Paul, MN 55455 (United States); Shapouri, Hosein; Conway, Roger [Office of Energy Policy and New Uses, 400 Independence Avenue, SW (Rm.4059 So. Bldg), United States Department of Agriculture, Washington, DC 20250 (United States); Bachewe, Fantu [Applied Economics Department, 253 COB, University of Minnesota, St. Paul, MN 55455 (United States); Fischer, Amelia [Economics Department, 481 Heady Hall, Iowa State University, Ames Iowa 50011 (United States)

    2010-02-15

    The hypothesis of this study is that there is a statistical relationship between the cardiovascular disease mortality rate and the intensity of fuel consumption (measured in gallons/square mile) at a particular location. We estimate cross-sectional regressions of the mortality rate due to cardiovascular disease against the intensity of fuel consumption using local data for the entire US, before the US Clean Air Act (CAA) in 1974 and after the most recent policy revisions in 2004. The cardiovascular disease rate improvement estimate suggests that up to 60 cardiovascular disease deaths per 100,000 residents are avoided in the largest urban areas with highest fuel consumption per square mile. In New York City, for instance, the mortality reduction may be worth about $30.3 billion annually. Across the US, the estimated Value of Statistical Life (VSL) benefit is $202.7 billion annually. There are likely three inseparable reasons that contributed importantly to this welfare improvement. First, the CAA regulations banned leaded gasoline, and mandated reduction in specific chemicals and smog components. Second, technologies such as the Catalytic Converter (CC) for the automobile and the low particulate diesel engine were adopted. Third, biofuels have had important roles, making the adoption of clean air technology possible and substituting for high emission fuels.

  20. Cardiovascular disease-risk benefits of clean fuel technology and policy: A statistical analysis

    International Nuclear Information System (INIS)

    Gallagher, Paul; Lazarus, William; Shapouri, Hosein; Conway, Roger; Bachewe, Fantu; Fischer, Amelia

    2010-01-01

    The hypothesis of this study is that there is a statistical relationship between the cardiovascular disease mortality rate and the intensity of fuel consumption (measured in gallons/square mile) at a particular location. We estimate cross-sectional regressions of the mortality rate due to cardiovascular disease against the intensity of fuel consumption using local data for the entire US, before the US Clean Air Act (CAA) in 1974 and after the most recent policy revisions in 2004. The cardiovascular disease rate improvement estimate suggests that up to 60 cardiovascular disease deaths per 100,000 residents are avoided in the largest urban areas with highest fuel consumption per square mile. In New York City, for instance, the mortality reduction may be worth about $30.3 billion annually. Across the US, the estimated Value of Statistical Life (VSL) benefit is $202.7 billion annually. There are likely three inseparable reasons that contributed importantly to this welfare improvement. First, the CAA regulations banned leaded gasoline, and mandated reduction in specific chemicals and smog components. Second, technologies such as the Catalytic Converter (CC) for the automobile and the low particulate diesel engine were adopted. Third, biofuels have had important roles, making the adoption of clean air technology possible and substituting for high emission fuels.

  1. Cardiovascular diseases in women: a statement from the policy conference of the European Society of Cardiology.

    Science.gov (United States)

    Stramba-Badiale, Marco; Fox, Kim M; Priori, Silvia G; Collins, Peter; Daly, Caroline; Graham, Ian; Jonsson, Benct; Schenck-Gustafsson, Karin; Tendera, Michal

    2006-04-01

    Cardiovascular diseases (CVD) are the leading cause of mortality both in men and women. In Europe, about 55% of all females' deaths are caused by CVD, especially coronary heart disease and stroke. Unfortunately, however, the risk of heart disease in women is underestimated because of the perception that women are 'protected' against ischaemic heart disease. What is not fully understood is that women during the fertile age have a lower risk of cardiac events, but this protection fades after menopause thus leaving women with untreated risk factors vulnerable to develop myocardial infarction, heart failure, and sudden cardiac death. Furthermore, clinical manifestations of ischaemic heart disease in women may be different from those commonly observed in males and this factor may account for under-recognition of the disease. The European Society of Cardiology has recently initiated an extensive 'Women at heart' program to coordinate research and educational initiatives on CVD in women. A Policy Conference on CVD in Women was one of the first steps in the development of this program. The objective of the conference was to collect the opinion of experts in the field coming from the European Society of Cardiology member countries to: (1) summarize the state-of-the-art from an European perspective; (2) to identify the scientific gaps on CVD in women; and (3) to delineate the strategies for changing the misperception of CVD in women, improving risk stratification, diagnosis, and therapy from a gender perspective and increasing women representation in clinical trials. The Policy Conference has provided the opportunity to review and comment on the current status of knowledge on CVD in women and to prioritize the actions needed to advance this area of knowledge in cardiology. In the preparation of this document we intend to provide the medical community and the stakeholders of this field with an overview of the more critical aspects that have emerged during the discussion. We

  2. Fifty communities putting prevention to work: accelerating chronic disease prevention through policy, systems and environmental change.

    Science.gov (United States)

    Bunnell, Rebecca; O'Neil, Dara; Soler, Robin; Payne, Rebecca; Giles, Wayne H; Collins, Janet; Bauer, Ursula

    2012-10-01

    The burden of preventable chronic diseases is straining our nation's health and economy. Diseases caused by obesity and tobacco use account for the largest portions of this preventable burden. CDC funded 50 communities in 2010 to implement policy, systems, and environmental (PSE) interventions in a 2-year initiative. Funded communities developed PSE plans to reduce obesity, tobacco use, and second-hand smoke exposure for their combined 55 million residents. Community outcome objectives and milestones were categorized by PSE interventions as they related to media, access, promotion, pricing, and social support. Communities estimated population reach based on their jurisdiction's census data and target populations. The average proportion of each community's population that was reached was calculated for each intervention category. Outcome objectives that were achieved within 12 months of program initiation were identified from routine program records. The average proportion of a community's jurisdictional population reached by a specific intervention varied across interventions. Mean population reach for obesity-prevention interventions was estimated at 35%, with 14 (26%) interventions covering over 50% of the jurisdictional populations. For tobacco prevention, mean population reach was estimated at 67%, with 16 (84%) interventions covering more than 50% of the jurisdictional populations. Within 12 months, communities advanced over one-third of their obesity and tobacco-use prevention strategies. Tobacco interventions appeared to have higher potential population reach than obesity interventions within this initiative. Findings on the progress and potential reach of this major initiative may help inform future chronic disease prevention efforts.

  3. Promoting healthy diets and tackling obesity and diet-related chronic diseases: what are the agricultural policy levers?

    Science.gov (United States)

    Hawkes, Corinna

    2007-06-01

    Diet-related chronic diseases are now a serious global public health problem. Public health groups are calling for the agricultural sector to play a greater role in tackling the threat. To identify potential points of policy intervention in the agricultural sector that could be leveraged to promote healthy diets and tackle obesity and diet-related chronic diseases. A review of the literature on the dietary implications of agriculture, a conceptual analysis of the issues, and the identification of relevant examples. There are two main potential points of intervention in the agricultural sector that could be leveraged to promote healthy diets: agricultural policies and agricultural production practices. Agricultural policies and practices affect diet through their influence on food availability, price, and nutrient quality, which in turn affects food choices available to consumers. Agricultural policies amenable to intervention include input, production, and trade policies; agricultural production practices amenable to intervention include crop breeding, crop fertilization practices, livestock-feeding practices, and crop systems diversity. It is well-known that agricultural policies and production practices influence what farmers choose to grow. Agricultural policies and production practices could also play a role in influencing what consumers choose to eat. To identify how agricultural policies and practices can usefully contribute toward promoting healthy diets and tackling obesity and diet-related chronic diseases, health policymakers need to examine whether current agricultural policies and production practices are contributing to-or detracting from-efforts to attain dietary goals; where and how could agricultural intervention help achieve dietary goals; and whether there are trade-offs between these interventions and other important concerns, such as undernutrition and the livelihoods of agricultural producers. Given the potential of agriculture to contribute to

  4. Policy, Research and Residents’ Perspectives on Built Environments Implicated in Heart Disease: A Concept Mapping Approach

    Directory of Open Access Journals (Sweden)

    Ivana Stankov

    2017-02-01

    Full Text Available An underrepresentation of stakeholder perspectives within urban health research arguably limits our understanding of what is a multi-dimensional and complex relationship between the built environment and health. By engaging a wide range of stakeholders using a participatory concept mapping approach, this study aimed to achieve a more holistic and nuanced understanding of the built environments shaping disease risk, specifically cardiometabolic risk (CMR. Moreover, this study aimed to ascertain the importance and changeability of identified environments through government action. Through the concept mapping process, community members, researchers, government and non-government stakeholders collectively identified eleven clusters encompassing 102 built environmental domains related to CMR, a number of which are underrepresented within the literature. Among the identified built environments, open space, public transportation and pedestrian environments were highlighted as key targets for policy intervention. Whilst there was substantive convergence in stakeholder groups’ perspectives concerning the built environment and CMR, there were disparities in the level of importance government stakeholders and community members respectively assigned to pedestrian environments and street connectivity. These findings support the role of participatory methods in strengthening how urban health issues are understood and in affording novel insights into points of action for public health and policy intervention.

  5. Is violence a disease? Situating violence prevention in public health policy and practice.

    Science.gov (United States)

    Williams, D J; Donnelly, P D

    2014-11-01

    The paper provides a review of some of the thoughts, ideas, and opinions that pervade the public health literature concerning how to classify or conceptualise violence. It is argued that violence transcends classic distinctions between communicable and non-communicable diseases, distinguishes itself from the discipline of injury control, and is influenced by wider, social determinants. Through a discussion of these varied perspectives it is concluded that a fourth revolution in public health is needed - a 'change in scope' revolution - that recognizes the influence of social justice, economics, and globalization in the aetiology of premature death and ill health, into which violence fits. However, rather than be shackled by debates of definition or classification, it is important that public health acknowledges the role it can play in preventing violence through policy and practice, and takes unified action. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. News media coverage of U.S. Ebola policies: Implications for communication during future infectious disease threats.

    Science.gov (United States)

    Sell, Tara Kirk; Boddie, Crystal; McGinty, Emma E; Pollack, Keshia; Smith, Katherine Clegg; Burke, Thomas A; Rutkow, Lainie

    2016-12-01

    The Ebola outbreak of 2014-2015 raised concerns about the disease's potential spread in the U.S. and received significant news media coverage. Prior research has shown that news media coverage of policy options can influence public opinion regarding those policies, as well as public attitudes toward the broader social issues and target populations addressed by such policies. To assess news media coverage of Ebola policies, the content of U.S.-focused news stories (n=1262) published between July 1 and November 30, 2014 from 12 news sources was analyzed for 13 policy-related messages. Eight-two percent of news stories mentioned one or more policy-related messages. The most frequently appearing policy-related messages overall were those about isolation (47%) and quarantine (40%). The least frequently mentioned policy-related message described dividing potentially exposed persons into distinct groups based on their level of Ebola risk in order to set different levels of restrictions (5%). Message frequency differed depending on whether news sources were located in an area that experienced an Ebola case or controversy, by news sources' political ideological perspective, and by type of news source (print and television). All policy-related messages showed significant increases in frequency after the first case of Ebola was diagnosed in the U.S. on September 30, 2014, with the exception of messages related to isolation, which showed a significant decrease. Results offer insight into how the news media covers policies to manage emerging disease threats. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The Development of Public Policies to Address Non-communicable Diseases in the Caribbean Country of Barbados: The Importance of Problem Framing and Policy Entrepreneurs

    Directory of Open Access Journals (Sweden)

    Nigel Unwin

    2017-02-01

    Full Text Available Background Government policy measures have a key role to play in the prevention and control of noncommunicable diseases (NCDs. The Caribbean, a middle-income region, has the highest per capita burden of NCDs in the Americas. Our aim was to examine policy development and implementation between the years 2000 and 2013 on NCD prevention and control in Barbados, and to investigate factors promoting, and hindering, success. Methods A qualitative case study design was used involving a structured policy document review and semistructured interviews with key informants, identified through stakeholder analysis and ‘cascading.’ Documents were abstracted into a standard form. Interviews were recorded, transcribed verbatim and underwent framework analysis, guided by the multiple streams framework (MSF. There were 25 key informants, from the Ministry of Health (MoH, other government Ministries, civil society organisations, and the private sector. Results A significant policy window opened between 2005 and 2007 in which new posts to address NCDs were created in the MoH, and a government supported multi-sectoral national NCD commission was established. Factors contributing to this government commitment and funding included a high level of awareness, throughout society, of the NCD burden, including media coverage of local research findings; the availability of policy recommendations by international bodies that could be adopted locally, notably the framework convention on tobacco control (FCTC; and the activities of local highly respected policy entrepreneurs with access to senior politicians, who were able to bring together political concern for the problem with potential policy solutions. However, factors were also identified that hindered multi-sectoral policy development in several areas, including around nutrition, physical activity, and alcohol. These included a lack of consensus (valence on the nature of the problem, often framed as being

  8. The Development of Public Policies to Address Non-communicable Diseases in the Caribbean Country of Barbados: The Importance of Problem Framing and Policy Entrepreneurs.

    Science.gov (United States)

    Unwin, Nigel; Samuels, T Alafia; Hassell, Trevor; Brownson, Ross C; Guell, Cornelia

    2016-06-15

    Government policy measures have a key role to play in the prevention and control of non-communicable diseases (NCDs). The Caribbean, a middle-income region, has the highest per capita burden of NCDs in the Americas. Our aim was to examine policy development and implementation between the years 2000 and 2013 on NCD prevention and control in Barbados, and to investigate factors promoting, and hindering, success. A qualitative case study design was used involving a structured policy document review and semi-structured interviews with key informants, identified through stakeholder analysis and 'cascading.' Documents were abstracted into a standard form. Interviews were recorded, transcribed verbatim and underwent framework analysis, guided by the multiple streams framework (MSF). There were 25 key informants, from the Ministry of Health (MoH), other government Ministries, civil society organisations, and the private sector. A significant policy window opened between 2005 and 2007 in which new posts to address NCDs were created in the MoH, and a government supported multi-sectoral national NCD commission was established. Factors contributing to this government commitment and funding included a high level of awareness, throughout society, of the NCD burden, including media coverage of local research findings; the availability of policy recommendations by international bodies that could be adopted locally, notably the framework convention on tobacco control (FCTC); and the activities of local highly respected policy entrepreneurs with access to senior politicians, who were able to bring together political concern for the problem with potential policy solutions. However, factors were also identified that hindered multi-sectoral policy development in several areas, including around nutrition, physical activity, and alcohol. These included a lack of consensus (valence) on the nature of the problem, often framed as being predominantly one of individuals needing to take

  9. The Development of Public Policies to Address Non-communicable Diseases in the Caribbean Country of Barbados: The Importance of Problem Framing and Policy Entrepreneurs

    Science.gov (United States)

    Unwin, Nigel; Samuels, T. Alafia; Hassell, Trevor; Brownson, Ross C.; Guell, Cornelia

    2017-01-01

    Background: Government policy measures have a key role to play in the prevention and control of non-communicable diseases (NCDs). The Caribbean, a middle-income region, has the highest per capita burden of NCDs in the Americas. Our aim was to examine policy development and implementation between the years 2000 and 2013 on NCD prevention and control in Barbados, and to investigate factors promoting, and hindering, success. Methods: A qualitative case study design was used involving a structured policy document review and semi-structured interviews with key informants, identified through stakeholder analysis and ‘cascading.’ Documents were abstracted into a standard form. Interviews were recorded, transcribed verbatim and underwent framework analysis, guided by the multiple streams framework (MSF). There were 25 key informants, from the Ministry of Health (MoH), other government Ministries, civil society organisations, and the private sector. Results: A significant policy window opened between 2005 and 2007 in which new posts to address NCDs were created in the MoH, and a government supported multi-sectoral national NCD commission was established. Factors contributing to this government commitment and funding included a high level of awareness, throughout society, of the NCD burden, including media coverage of local research findings; the availability of policy recommendations by international bodies that could be adopted locally, notably the framework convention on tobacco control (FCTC); and the activities of local highly respected policy entrepreneurs with access to senior politicians, who were able to bring together political concern for the problem with potential policy solutions. However, factors were also identified that hindered multi-sectoral policy development in several areas, including around nutrition, physical activity, and alcohol. These included a lack of consensus (valence) on the nature of the problem, often framed as being predominantly one of

  10. Alcohol consumption and burden of disease in the Americas in 2012: implications for alcohol policy.

    Science.gov (United States)

    Shield, Kevin D; Monteiro, Maristela; Roerecke, Michael; Smith, Blake; Rehm, Jürgen

    2015-12-01

    To describe the volume and patterns of alcohol consumption up to and including 2012, and to estimate the burden of disease attributable to alcohol consumption as measured in deaths and disability-adjusted life years (DALYs) lost in the Americas in 2012. Measures of alcohol consumption were obtained from the World Health Organization (WHO) Global Information System on Alcohol and Health (GISAH). The burden of alcohol consumption was estimated in both deaths and DALYs lost based on mortality data obtained from WHO, using alcohol-attributable fractions. Regional groupings for the Americas were based on the WHO classifications for 2004 (according to child and adult mortality). Regional variations were observed in the overall volume of alcohol consumed, the proportion of the alcohol market attributable to unrecorded alcohol consumption, drinking patterns, prevalence of drinking, and prevalence of heavy episodic drinking, with inhabitants of the Americas consuming more alcohol (8.4 L of pure alcohol per adult in 2012) compared to the world average. The Americas also experienced a high burden of disease attributable to alcohol consumption (4.7% of all deaths and 6.7% of all DALYs lost), especially in terms of injuries attributable to alcohol consumption. Alcohol is consumed in a harmful manner in the Americas, leading to a high burden of disease, especially in terms of injuries. New cost-effective alcohol policies, such as increasing alcohol taxation, increasing the minimum legal age to purchase alcohol, and decreasing the maximum legal blood alcohol content while driving, should be implemented to decrease the harmful consumption of alcohol and the resulting burden of disease.

  11. Alcohol consumption and burden of disease in the Americas in 2012: implications for alcohol policy

    Directory of Open Access Journals (Sweden)

    Kevin D. Shield

    Full Text Available OBJECTIVE:To describe the volume and patterns of alcohol consumption up to and including 2012, and to estimate the burden of disease attributable to alcohol consumption as measured in deaths and disability-adjusted life years (DALYs lost in the Americas in 2012. METHODS: Measures of alcohol consumption were obtained from the World Health Organization (WHO Global Information System on Alcohol and Health (GISAH. The burden of alcohol consumption was estimated in both deaths and DALYs lost based on mortality data obtained from WHO, using alcohol-attributable fractions. Regional groupings for the Americas were based on the WHO classifications for 2004 (according to child and adult mortality. RESULTS: Regional variations were observed in the overall volume of alcohol consumed, the proportion of the alcohol market attributable to unrecorded alcohol consumption, drinking patterns, prevalence of drinking, and prevalence of heavy episodic drinking, with inhabitants of the Americas consuming more alcohol (8.4 L of pure alcohol per adult in 2012 compared to the world average. The Americas also experienced a high burden of disease attributable to alcohol consumption (4.7% of all deaths and 6.7% of all DALYs lost, especially in terms of injuries attributable to alcohol consumption. CONCLUSIONS: Alcohol is consumed in a harmful manner in the Americas, leading to a high burden of disease, especially in terms of injuries. New cost-effective alcohol policies, such as increasing alcohol taxation, increasing the minimum legal age to purchase alcohol, and decreasing the maximum legal blood alcohol content while driving, should be implemented to decrease the harmful consumption of alcohol and the resulting burden of disease.

  12. Policy Guidelines for Effective Inclusion and Reintegration of People with Chronic Diseases in the Workplace: National and European Perspectives.

    Science.gov (United States)

    Vlachou, Anastasia; Stavroussi, Panayiota; Roka, Olga; Vasilou, Evdokia; Papadimitriou, Dimitra; Scaratti, Chiara; Kadyrbaeva, Asel; Fheodoroff, Klemens; Brecelj, Valentina; Svestkova, Olga; Tobiasz-Adamczyk, Beata; Finnvold, Jon Erik; Gruber, Sonja; Leonardi, Matilde

    2018-03-11

    The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers) from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets.

  13. Policy Guidelines for Effective Inclusion and Reintegration of People with Chronic Diseases in the Workplace: National and European Perspectives

    Directory of Open Access Journals (Sweden)

    Anastasia Vlachou

    2018-03-01

    Full Text Available The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets.

  14. Moving the Agenda on Noncommunicable Diseases: Policy Implications of Mobile Phone Surveys in Low and Middle-Income Countries.

    Science.gov (United States)

    Pariyo, George W; Wosu, Adaeze C; Gibson, Dustin G; Labrique, Alain B; Ali, Joseph; Hyder, Adnan A

    2017-05-05

    The growing burden of noncommunicable diseases (NCDs), for example, cardiovascular diseases and chronic respiratory diseases, in low- and middle-income countries (LMICs) presents special challenges for policy makers, due to resource constraints and lack of timely data for decision-making. Concurrently, the increasing ubiquity of mobile phones in LMICs presents possibilities for rapid collection of population-based data to inform the policy process. The objective of this paper is to highlight potential benefits of mobile phone surveys (MPS) for developing, implementing, and evaluating NCD prevention and control policies. To achieve this aim, we first provide a brief overview of major global commitments to NCD prevention and control, and subsequently explore how countries can translate these commitments into policy action at the national level. Using the policy cycle as our frame of reference, we highlight potential benefits of MPS which include (1) potential cost-effectiveness of using MPS to inform NCD policy actions compared with using traditional household surveys; (2) timeliness of assessments to feed into policy and planning cycles; (3) tracking progress of interventions, hence assessment of reach, coverage, and distribution; (4) better targeting of interventions, for example, to high-risk groups; (5) timely course correction for suboptimal or non-effective interventions; (6) assessing fairness in financial contribution and financial risk protection for those affected by NCDs in the spirit of universal health coverage (UHC); and (7) monitoring progress in reducing catastrophic medical expenditure due to chronic health conditions in general, and NCDs in particular. We conclude that MPS have potential to become a powerful data collection tool to inform policies that address public health challenges such as NCDs. Additional forthcoming assessments of MPS in LMICs will inform opportunities to maximize this technology. ©George W Pariyo, Adaeze C Wosu, Dustin G

  15. Respiratory syncytial virus (RSV disease – new data needed to guide future policy

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    Louis Bont

    2015-12-01

    Full Text Available RSV is the main cause of childhood lower respiratory infections, globally, an important cause of childhood wheeze and may be responsible for a substantial burden of disease in the very elderly and in adults with chronic medical problems, such as COPD. It is thus responsible for substantial healthcare and social costs. There are currently many companies and academic groups developing and testing candidate vaccines and there is an expectation that these will lead to effective and safe vaccines which will be available to health systems globally in the short- medium term. Despite this, there is an incomplete understanding of RSV disease, especially in adult groups, and large scale data are only available from a few countries and settings leading to low levels of awareness of the importance of this pathogen. We discuss the need for widespread national sentinel systems of RSV surveillance and some means by which this could be achieved. These data will be needed by national policy makers and immunisation advisory groups to guide future priority setting and decision making.

  16. Progress and policy implication of the Insurance Programs for Catastrophic Diseases in China.

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    Mao, Wenhui; Zhang, Luying; Chen, Wen

    2017-07-01

    The State Council encouraged the involvement of commercial insurance companies (CICs) in the development of the Insurance Program for Catastrophic Diseases (IPCD), yet its implementation has rarely been reported. We collected literature and policy documentation and conducted interviews in 10 cities with innovative IPCD policies to understand the details of the implementation of IPCD. IPCDs are operated at the prefectural level in 14 provinces, while in 4 municipalities and 6 provinces, unified IPCDs have been implemented at higher levels. The contribution level varied from 5% to 10% of total Basic Medical Insurance (BMI) funds or CNY10-35 per beneficiary in 2015. IPCD provides an additional 50% to 70% reimbursement rate for the expenses not covered by BMI with various settings in different locations. Two models of CIC operation of IPCD have been identified according to the financial risks shared by CICs. Either the local department of Human Resources and Social Security or a third party performs assessments of the IPCD operation, service quality, and patients' satisfaction. A number of IPCDs have been observed to use 1% to 5% of the funds as a performance-based payment to the CIC(s). CIC involvement in operating the IPCD raises concerns regarding the security of the information of beneficiaries. Developing appropriate data sharing mechanisms between the local department of Human Resources and Social Security and CICs is still in progress. In conclusion, the IPCD relieves the financial burden on patients by providing further reimbursement, but its benefit package remains limited to the BMI reimbursable list. CICs play an important role in monitoring and supervising health service provision, yet their capacity for actuarial services or risk control is underdeveloped. Copyright © 2017 John Wiley & Sons, Ltd.

  17. The impact of national policies on animal disease reporting within selected Pacific Island Countries and Territories (PICTs).

    Science.gov (United States)

    Tukana, Andrew; Hedlefs, Robert; Gummow, Bruce

    2018-04-20

    A semi-systematic literature review of national policies was carried out in relation to surveillance and disease reporting in Pacific Island Countries and Territories (PICTs). It also analysed the animal disease reporting structures in Fiji, Papua New Guinea (PNG), Vanuatu and the Solomon Islands. The strengths, weaknesses, opportunities and threats (SWOT) of those reporting structures were examined in relation to how they impacted the detection and management of animal diseases in PICTs. Field missions collected information on animal disease reporting structures and these were discussed in detail with country officials and documented. The findings from the literature review indicated that there is very little policy to support work in surveillance and disease reporting within national government structures of the countries studied. This increases the potential for disease transmission and the introduction of exotic diseases as the efficiency of disease reporting is low. The findings from the SWOT analysis of the reporting structures indicated that there were commonalities across the countries studied, i.e. reporting structures were long with multiple legs that were not functioning properly and this was worsened when positions were vacant in the reporting structure. The hierarchical nature of the reporting structure also reduced reporting efficiency as reports took a longer time to reach decision makers at the top of the structure. High officer turnover and the shortage of veterinarians in the countries studied also affected the efficiency of disease reporting as most in-county officials were inexperienced and could not recognise disease signs and there were no veterinarians to supervise them. Existing reporting structures need to be reviewed to remove duplication and shorten the chain. However, this could override existing command structures and would need to be documented and awareness created with the officers involved. There also needs to be more collaboration

  18. A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.

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    Helen Mason

    Full Text Available BACKGROUND: Coronary Heart Disease (CHD is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. METHODS AND FINDINGS: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy. All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30% resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey. CONCLUSION: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives.

  19. A Cost Effectiveness Analysis of Salt Reduction Policies to Reduce Coronary Heart Disease in Four Eastern Mediterranean Countries

    Science.gov (United States)

    Mason, Helen; Shoaibi, Azza; Ghandour, Rula; O'Flaherty, Martin; Capewell, Simon; Khatib, Rana; Jabr, Samer; Unal, Belgin; Sözmen, Kaan; Arfa, Chokri; Aissi, Wafa; Romdhane, Habiba Ben; Fouad, Fouad; Al-Ali, Radwan; Husseini, Abdullatif

    2014-01-01

    Background Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. Methods and Findings Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey. Conclusion Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives. PMID:24409297

  20. Tackling the chronic disease burden: are there co-benefits from climate policy measures?

    Science.gov (United States)

    Vandenberghe, Désirée; Albrecht, Johan

    2018-04-26

    Each year, non-communicable diseases (NCDs) kill 40 million people worldwide and impose an estimated economic burden of $600 billion. Without effective policymaking, NCDs will continue to undermine health and economic systems globally. We propose that climate policy measures-such as carbon pricing-can yield significant health-related co-benefits aside from their intended greenhouse gas emission reduction. We simulate three carbon tax scenarios in the energy and food sector in Belgium and assess the resulting health-related co-benefits. These benefits originate from decreased exposure to two leading NCD risk factors: fine particulate matter and dietary regimes excessive in animal products. The carbon tax could prevent 42,300-78,800 Disability-Adjusted Life Years in Belgium, or save 0.6-1.1% of total health care expenditure and an additional 0.06-0.12% of Belgian GDP. We conclude that these health-related co-benefits should be included in the cost-benefit analysis of carbon pricing.

  1. Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making

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    Gwenan M. Knight

    2016-01-01

    Full Text Available The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy, the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions.

  2. Association of US State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Early Infant Cardiac Deaths.

    Science.gov (United States)

    Abouk, Rahi; Grosse, Scott D; Ailes, Elizabeth C; Oster, Matthew E

    2017-12-05

    In 2011, critical congenital heart disease was added to the US Recommended Uniform Screening Panel for newborns, but whether state implementation of screening policies has been associated with infant death rates is unknown. To assess whether there was an association between implementation of state newborn screening policies for critical congenital heart disease and infant death rates. Observational study with group-level analyses. A difference-in-differences analysis was conducted using the National Center for Health Statistics' period linked birth/infant death data set files for 2007-2013 for 26 546 503 US births through June 30, 2013, aggregated by month and state of birth. State policies were classified as mandatory or nonmandatory (including voluntary policies and mandates that were not yet implemented). As of June 1, 2013, 8 states had implemented mandatory screening policies, 5 states had voluntary screening policies, and 9 states had adopted but not yet implemented mandates. Numbers of early infant deaths (between 24 hours and 6 months of age) coded for critical congenital heart disease or other/unspecified congenital cardiac causes for each state-month birth cohort. Between 2007 and 2013, there were 2734 deaths due to critical congenital heart disease and 3967 deaths due to other/unspecified causes. Critical congenital heart disease death rates in states with mandatory screening policies were 8.0 (95% CI, 5.4-10.6) per 100 000 births (n = 37) in 2007 and 6.4 (95% CI, 2.9-9.9) per 100 000 births (n = 13) in 2013 (for births by the end of July); for other/unspecified cardiac causes, death rates were 11.7 (95% CI, 8.6-14.8) per 100 000 births in 2007 (n = 54) and 10.3 (95% CI, 5.9-14.8) per 100 000 births (n = 21) in 2013. Early infant deaths from critical congenital heart disease through December 31, 2013, decreased by 33.4% (95% CI, 10.6%-50.3%), with an absolute decline of 3.9 (95% CI, 3.6-4.1) deaths per 100 000 births after

  3. Quantifying policy options for reducing future coronary heart disease mortality in England: a modelling study.

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    Shaun Scholes

    Full Text Available To estimate the number of coronary heart disease (CHD deaths potentially preventable in England in 2020 comparing four risk factor change scenarios.Using 2007 as baseline, the IMPACTSEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a assuming recent trends will continue; (b assuming optimal but feasible levels already achieved elsewhere; (c an intermediate point, halfway between current and optimal levels; and (d assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980. There would be some 39,720 (37,120-41,900 fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300 in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420 would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains.CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies.

  4. Quantifying policy options for reducing future coronary heart disease mortality in England: a modelling study.

    Science.gov (United States)

    Scholes, Shaun; Bajekal, Madhavi; Norman, Paul; O'Flaherty, Martin; Hawkins, Nathaniel; Kivimäki, Mika; Capewell, Simon; Raine, Rosalind

    2013-01-01

    To estimate the number of coronary heart disease (CHD) deaths potentially preventable in England in 2020 comparing four risk factor change scenarios. Using 2007 as baseline, the IMPACTSEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a) assuming recent trends will continue; (b) assuming optimal but feasible levels already achieved elsewhere; (c) an intermediate point, halfway between current and optimal levels; and (d) assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980). There would be some 39,720 (37,120-41,900) fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300) in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420) would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains. CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies.

  5. Policy initiatives, culture and the prevention and control of chronic non-communicable diseases (NCDs) in the Caribbean.

    Science.gov (United States)

    Samuels, T Alafia; Guell, Cornelia; Legetic, Branka; Unwin, Nigel

    2012-01-01

    To explore interactions between disease burden, culture and the policy response to non-communicable diseases (NCDs) within the Caribbean, a region with some of the highest prevalence rates, morbidity and mortality from NCDs in the Americas. We undertook a wide ranging narrative review, drawing on a variety of peer reviewed, government and intergovernmental literature. Although the Caribbean is highly diverse, linguistically and ethnically, it is possible to show how 'culture' at the macro-level has been shaped by shared historic, economic and political experiences and ties. We suggest four broad groupings of countries: the English-speaking Caribbean Community (CARICOM); the small island states that are still colonies or departments of colonial powers; three large-Spanish speaking countries; and Haiti, which although part of CARICOM is culturally distinct. We explore how NCD health policies in the region stem from and are influenced by the broad characteristics of these groupings, albeit played out in varied ways in individual countries. For example, the Port of Spain declaration (2007) on NCDs can be understood as the product of the co-operative and collaborative relationships with CARICOM, which are based on a shared broad culture. We note, however, that studies investigating the relationships between the formation of NCD policy and culture (at any level) are scarce. Within the Caribbean region it is possible to discern relationships between culture at the macro-level and the formation of NCD policy. However, there is little work that directly assesses the interactions between culture and NCD policy formation. The Caribbean with its cultural diversity and high burden of NCDs provides an ideal environment within which to undertake further studies to better understand the interactions between culture and health policy formation.

  6. Impact of NOx Emission Reduction Policy on Hospitalizations for Respiratory Disease in New York State

    Science.gov (United States)

    To date, only a limited number of studies have examined the impact of ambient pollutant policy on respiratory morbidities. This accountability study examined the effect of a regional pollution control policy, namely, the US Environmental Protection Agency’s (EPA) nitrogen oxides ...

  7. Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease (COPD) Using an Ontario Policy Model

    Science.gov (United States)

    Chandra, K; Blackhouse, G; McCurdy, BR; Bornstein, M; Campbell, K; Costa, V; Franek, J; Kaulback, K; Levin, L; Sehatzadeh, S; Sikich, N; Thabane, M; Goeree, R

    2012-01-01

    Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-Term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty_member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Background Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation throughout the airways, parenchyma, and pulmonary vasculature. The inflammation causes repeated cycles of injury and repair in the airway wall— inflammatory cells release a variety of chemicals and lead to cellular damage. The inflammation process also contributes to the loss of elastic recoil pressure

  8. Cost-effectiveness analysis of salt reduction policies to reduce coronary heart disease in Syria, 2010-2020.

    Science.gov (United States)

    Wilcox, Meredith L; Mason, Helen; Fouad, Fouad M; Rastam, Samer; al Ali, Radwan; Page, Timothy F; Capewell, Simon; O'Flaherty, Martin; Maziak, Wasim

    2015-01-01

    This study presents a cost-effectiveness analysis of salt reduction policies to lower coronary heart disease in Syria. Costs and benefits of a health promotion campaign about salt reduction (HP); labeling of salt content on packaged foods (L); reformulation of salt content within packaged foods (R); and combinations of the three were estimated over a 10-year time frame. Policies were deemed cost-effective if their cost-effectiveness ratios were below the region's established threshold of $38,997 purchasing power parity (PPP). Sensitivity analysis was conducted to account for the uncertainty in the reduction of salt intake. HP, L, and R+HP+L were cost-saving using the best estimates. The remaining policies were cost-effective (CERs: R=$5,453 PPP/LYG; R+HP=$2,201 PPP/LYG; R+L=$2,125 PPP/LYG). R+HP+L provided the largest benefit with net savings using the best and maximum estimates, while R+L was cost-effective with the lowest marginal cost using the minimum estimates. This study demonstrated that all policies were cost-saving or cost effective, with the combination of reformulation plus labeling and a comprehensive policy involving all three approaches being the most promising salt reduction strategies to reduce CHD mortality in Syria.

  9. Improved tools and strategies for the prevention and control of arboviral diseases: A research-to-policy forum.

    Directory of Open Access Journals (Sweden)

    Piero Olliaro

    2018-02-01

    Full Text Available Research has been conducted on interventions to control dengue transmission and respond to outbreaks. A summary of the available evidence will help inform disease control policy decisions and research directions, both for dengue and, more broadly, for all Aedes-borne arboviral diseases.A research-to-policy forum was convened by TDR, the Special Programme for Research and Training in Tropical Diseases, with researchers and representatives from ministries of health, in order to review research findings and discuss their implications for policy and research.The participants reviewed findings of research supported by TDR and others. Surveillance and early outbreak warning. Systematic reviews and country studies identify the critical characteristics that an alert system should have to document trends reliably and trigger timely responses (i.e., early enough to prevent the epidemic spread of the virus to dengue outbreaks. A range of variables that, according to the literature, either indicate risk of forthcoming dengue transmission or predict dengue outbreaks were tested and some of them could be successfully applied in an Early Warning and Response System (EWARS. Entomological surveillance and vector management. A summary of the published literature shows that controlling Aedes vectors requires complex interventions and points to the need for more rigorous, standardised study designs, with disease reduction as the primary outcome to be measured. House screening and targeted vector interventions are promising vector management approaches. Sampling vector populations, both for surveillance purposes and evaluation of control activities, is usually conducted in an unsystematic way, limiting the potentials of entomological surveillance for outbreak prediction. Combining outbreak alert and improved approaches of vector management will help to overcome the present uncertainties about major risk groups or areas where outbreak response should be initiated and

  10. Alcohol?attributed disease burden and alcohol policies in the BRICS?countries during the years 1990?2013

    OpenAIRE

    Rabiee, Rynaz; Agardh, Emilie; Coates, Matthew M; Allebeck, Peter; Danielsson, Anna?Karin

    2017-01-01

    Background We aimed to assess alcohol consumption and alcohol?attributed disease burden by DALYs (disability adjusted life years) in the BRICS countries (Brazil, Russia, India, China and South Africa) between 1990 and 2013, and explore to what extent these countries have implemented evidence?based alcohol policies during the same time period. Methods A comparative risk assessment approach and literature review, within a setting of the BRICS countries. Participants were the total populations (...

  11. Emerging and Reemerging Neglected Tropical Diseases: a Review of Key Characteristics, Risk Factors, and the Policy and Innovation Environment

    Science.gov (United States)

    Liang, Bryan A.; Cuomo, Raphael; Hafen, Ryan; Brouwer, Kimberly C.; Lee, Daniel E.

    2014-01-01

    SUMMARY In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern. PMID:25278579

  12. Engaging research with policy and action: what are the challenges of responding to zoonotic disease in Africa?

    Science.gov (United States)

    Bardosh, Kevin Louis; Scoones, Jake Cornwall; Grace, Delia; Kalema-Zikusoka, Gladys; Jones, Kate E; de Balogh, Katinka; Waltner-Toews, David; Bett, Bernard; Welburn, Susan C; Mumford, Elizabeth; Dzingirai, Vupenyu

    2017-07-19

    Zoonotic diseases will maintain a high level of public policy attention in the coming decades. From the spectre of a global pandemic to anxieties over agricultural change, urbanization, social inequality and threats to natural ecosystems, effectively preparing and responding to endemic and emerging diseases will require technological, institutional and social innovation. Much current discussion emphasizes the need for a 'One Health' approach: bridging disciplines and sectors to tackle these complex dynamics. However, as attention has increased, so too has an appreciation of the practical challenges in linking multi-disciplinary, multi-sectoral research with policy, action and impact. In this commentary paper, we reflect on these issues with particular reference to the African sub-continent. We structure the themes of our analysis on the existing literature, expert opinion and 11 interviews with leading One Health scholars and practitioners, conducted at an international symposium in 2016. We highlight a variety of challenges in research and knowledge production, in the difficult terrain of implementation and outreach, and in the politicized nature of decision-making and priority setting. We then turn our attention to a number of strategies that might help reconfigure current pathways and accepted norms of practice. These include: (i) challenging scientific expertise; (ii) strengthening national multi-sectoral coordination; (iii) building on what works; and (iv) re-framing policy narratives. We argue that bridging the research-policy-action interface in Africa, and better connecting zoonoses, ecosystems and well-being in the twenty-first century, will ultimately require greater attention to the democratization of science and public policy.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'. © 2017 The Authors.

  13. Alcohol–attributed disease burden and alcohol policies in the BRICS–countries during the years 1990–2013

    Science.gov (United States)

    Rabiee, Rynaz; Agardh, Emilie; Coates, Matthew M; Allebeck, Peter; Danielsson, Anna–Karin

    2017-01-01

    Background We aimed to assess alcohol consumption and alcohol–attributed disease burden by DALYs (disability adjusted life years) in the BRICS countries (Brazil, Russia, India, China and South Africa) between 1990 and 2013, and explore to what extent these countries have implemented evidence–based alcohol policies during the same time period. Methods A comparative risk assessment approach and literature review, within a setting of the BRICS countries. Participants were the total populations (males and females combined) of each country. Levels of alcohol consumption, age–standardized alcohol–attributable DALYs per 100 000 and alcohol policy documents were measured. Results The alcohol–attributed disease burden mirrors level of consumption in Brazil, Russia and India, to some extent in China, but not in South Africa. Between the years 1990–2013 DALYs per 100 000 decreased in Brazil (from 2124 to 1902), China (from 1719 to 1250) and South Africa (from 2926 to 2662). An increase was observed in Russia (from 4015 to 4719) and India (from 1574 to 1722). Policies were implemented in all of the BRICS countries and the most common were tax increases, drink–driving measures and restrictions on advertisement. Conclusions There was an overall decrease in alcohol–related DALYs in Brazil, China and South Africa, while an overall increase was observed in Russia and India. Most notably is the change in DALYs in Russia, where a distinct increase from 1990–2005 was followed by a steady decrease from 2005–2013. Even if assessment of causality cannot be done, policy changes were generally followed by changes in alcohol–attributed disease burden. This highlights the importance of more detailed research on this topic. PMID:28400952

  14. Alcohol-attributed disease burden and alcohol policies in the BRICS-countries during the years 1990-2013.

    Science.gov (United States)

    Rabiee, Rynaz; Agardh, Emilie; Coates, Matthew M; Allebeck, Peter; Danielsson, Anna-Karin

    2017-06-01

    We aimed to assess alcohol consumption and alcohol-attributed disease burden by DALYs (disability adjusted life years) in the BRICS countries (Brazil, Russia, India, China and South Africa) between 1990 and 2013, and explore to what extent these countries have implemented evidence-based alcohol policies during the same time period. A comparative risk assessment approach and literature review, within a setting of the BRICS countries. Participants were the total populations (males and females combined) of each country. Levels of alcohol consumption, age-standardized alcohol-attributable DALYs per 100 000 and alcohol policy documents were measured. The alcohol-attributed disease burden mirrors level of consumption in Brazil, Russia and India, to some extent in China, but not in South Africa. Between the years 1990-2013 DALYs per 100 000 decreased in Brazil (from 2124 to 1902), China (from 1719 to 1250) and South Africa (from 2926 to 2662). An increase was observed in Russia (from 4015 to 4719) and India (from 1574 to 1722). Policies were implemented in all of the BRICS countries and the most common were tax increases, drink-driving measures and restrictions on advertisement. There was an overall decrease in alcohol-related DALYs in Brazil, China and South Africa, while an overall increase was observed in Russia and India. Most notably is the change in DALYs in Russia, where a distinct increase from 1990-2005 was followed by a steady decrease from 2005-2013. Even if assessment of causality cannot be done, policy changes were generally followed by changes in alcohol-attributed disease burden. This highlights the importance of more detailed research on this topic.

  15. Evolving perception on the benefits of vaccination as a foot and mouth disease control policy: contributions of South America.

    Science.gov (United States)

    Bergmann, Ingrid E; Malirat, Viviana; Falczuk, Abraham J

    2005-12-01

    Within the past decade, changes in perceptions on the benefits of vaccination as an appropriate tool to achieve complete foot and mouth disease eradication have become evident. The former negative view was derived from misconceptions, resulting mainly from the belief that vaccines are not entirely effective and that vaccination masks asymptomatic viral circulation. The advent in the 1990s of vaccination policies implemented within a strategic eradication plan in South America, and during recurrence of the disease in disease-free regions contributed towards generating more reliable and visible outcomes of vaccination programs, paving the way towards a new perception. Particularly relevant was the development and application of novel serodiagnostic approaches to assess silent viral circulation, irrespective of vaccination. The use in South America of vaccination allied to serosurveys to accompany viral clarification during eradication campaigns and after emergencies clearly established the importance of this control tool to stop the spread of viral infection. This alliance gave input to break many myths associated with the use of vaccines, including the belief that immunized carrier animals pose an epidemiologic risk. This experience launched new concepts that supported the internationally recognized status of foot and mouth disease-free regions with vaccination and the 'vaccination to live' policy as an alternative to 'stamping out'.

  16. Policy and science of FMD control: the stakeholders' contribution to decision making. A call for integrated animal disease management.

    Science.gov (United States)

    Marshall, M; Roger, P

    Effective control of foot-and-mouth disease (FMD)--prevention, surveillance and response--requires integrated animal disease management as a cooperative effort between stakeholders, scientists and decision makers, at all levels: local, national, regional and international. This paper suggests a process and outlines specific critical issues that need to be addressed in order to best use the science and technology that is available now and to develop new technologies that will lead to significant improvements. The overall objective is not to allow the disease or the disease control measures to damage, violate or destroy public health, the environment, or the economy, or to allow politics to drive disease control policies at the expense of the ethical relationship between man and animals. Critical issues of prevention, surveillance and response policies are examined, and specific recommendations are made to reduce the risk or effect of natural and deliberate introductions. For prevention: a) rapid portable diagnostics and provision of vaccines to control and eradicate the reservoirs of disease. b) alerts, leading to increased controls at borders, animal movement restrictions and biosecurity on farms. For surveillance: a) reporting of unusual symptoms, rapid diagnostics and identification of patterns. b) enhanced role of geographic information systems (GIS) linked to an IT system. c) collection, storage and sharing of disease information. For response policies: a) the role and implementation of stamping out and of vaccination. b) simulation exercises with stakeholder participation. For all aspects of FMD control, consideration should be given to: a) the composition, responsibilities and role of the balanced, permanently operational Expert Group in EU member states as specified in the EU FMD Directive. b) establishment of a balanced, permanently operational European Expert Group. c) establishment of both a European and an International FMD Task Force. Stakeholders need

  17. Can the EVIDEM Framework Tackle Issues Raised by Evaluating Treatments for Rare Diseases: Analysis of Issues and Policies, and Context-Specific Adaptation.

    Science.gov (United States)

    Wagner, Monika; Khoury, Hanane; Willet, Jacob; Rindress, Donna; Goetghebeur, Mireille

    2016-03-01

    The multiplicity of issues, including uncertainty and ethical dilemmas, and policies involved in appraising interventions for rare diseases suggests that multicriteria decision analysis (MCDA) based on a holistic definition of value is uniquely suited for this purpose. The objective of this study was to analyze and further develop a comprehensive MCDA framework (EVIDEM) to address rare disease issues and policies, while maintaining its applicability across disease areas. Specific issues and policies for rare diseases were identified through literature review. Ethical and methodological foundations of the EVIDEM framework v3.0 were systematically analyzed from the perspective of these issues, and policies and modifications of the framework were performed accordingly to ensure their integration. Analysis showed that the framework integrates ethical dilemmas and issues inherent to appraising interventions for rare diseases but required further integration of specific aspects. Modification thus included the addition of subcriteria to further differentiate disease severity, disease-specific treatment outcomes, and economic consequences of interventions for rare diseases. Scoring scales were further developed to include negative scales for all comparative criteria. A methodology was established to incorporate context-specific population priorities and policies, such as those for rare diseases, into the quantitative part of the framework. This design allows making more explicit trade-offs between competing ethical positions of fairness (prioritization of those who are worst off), the goal of benefiting as many people as possible, the imperative to help, and wise use of knowledge and resources. It also allows addressing variability in institutional policies regarding prioritization of specific disease areas, in addition to existing uncertainty analysis available from EVIDEM. The adapted framework measures value in its widest sense, while being responsive to rare disease

  18. [Mass culling in the context of animal disease outbreaks--veterinarians caught between ethical issues and control policies].

    Science.gov (United States)

    Hartnack, Sonja; Doherr, Marcus G; Grimm, Herwig; Kunzmann, Peter

    2009-04-01

    In recent years controversial discussions arose during major animal disease outbreaks in the EU about the ethical soundness of mass culling. In contrast to numerous publications about ethical issues and laboratory animals/animal experiments, literature concerning ethical deliberations in the case of mass culling as a means of outbreak control remain scarce. Veterinarians in charge of decision about and implementation of mass culling actions find themselves in an area of conflict in between the officially required animal disease control policy and a public that is increasingly critical. Those veterinarians are faced with the challenge to defend the relevant decisions against all stakeholders and also themselves. In this context an interdisciplinary workshop was initiated in Switzerland in October 2007 with ethicians and (official) veterinarians from Germany, Switzerland and Austria. With the aim to identify ethical components of animal disease control for official veterinarians, talks and moderated group discussions took place. This article summarizes selected discussion points and conclusions.

  19. Health policy for sickle cell disease in Africa: experience from Tanzania on interventions to reduce under-five mortality.

    Science.gov (United States)

    Makani, Julie; Soka, Deogratias; Rwezaula, Stella; Krag, Marlene; Mghamba, Janneth; Ramaiya, Kaushik; Cox, Sharon E; Grosse, Scott D

    2015-02-01

    Tanzania has made considerable progress towards reducing childhood mortality, achieving a 57% decrease between 1980 and 2011. This epidemiological transition will cause a reduction in the contribution of infectious diseases to childhood mortality and increase in contribution from non-communicable diseases (NCDs). Haemoglobinopathies are amongst the most common childhood NCDs, with sickle cell disease (SCD) being the commonest haemoglobinopathy in Africa. In Tanzania, 10,313 children with SCD under 5 years of age (U5) are estimated to die every year, contributing an estimated 7% of overall deaths in U5 children. Key policies that governments in Africa are able to implement would reduce mortality in SCD, focusing on newborn screening and comprehensive SCD care programmes. Such programmes would ensure that interventions such as prevention of infections using penicillin plus prompt diagnosis and treatment of complications are provided to all individuals with SCD. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  20. Using economic policy to tackle chronic disease: options for the Australian Government.

    Science.gov (United States)

    Kaplin, Lauren; Thow, Anne Marie

    2013-03-01

    Australia suffers from one of the highest prevalences among developed countries of persons being overweight and obese, these conditions arising from the overconsumption of energy-dense, nutrient-poor foods that are generally less expensive than healthier options. One potential avenue for intervention is to influence the price of foods such that healthier options are less expensive and, therefore, are an easier choice to make. This article considers the potential for fiscal policies that would realign food prices with health incentives. Through a review of consumption taxes, consumer subsidies, trade policies, agricultural support policies, and other incentive programs as possible avenues for intervention, this article asks what the Commonwealth Government has already done to help improve Australian diets, and looks at where further improvements could be made.

  1. How do demographic transitions and public health policies affect patients with Parkinson’s disease in Brazil?

    Directory of Open Access Journals (Sweden)

    Bovolenta TM

    2017-01-01

    Full Text Available Tânia M Bovolenta, Andre C Felicio R. Neurology Program, Hospital Israelita Albert Einstein, São Paulo, Brazil Abstract: Brazil is currently experiencing a significant demographic transition characterized by a decrease in fertility rates and an exponential increase in the number of elderly citizens, which presents a special challenge for the health care professionals. More than other portions of the population, the elderly are most commonly affected by chronic diseases such as Parkinson’s disease. Policymakers contend that Brazil is reasonably well-prepared regarding elderly health care, with policies that aim to ensure the quality of life and the well-being of this portion of the population. However, what happens in practice falls short of what the Brazilian Constitution sets forth. Specifically, there is a clear contradiction between what the law recognizes as being a citizen’s rights and the implementation of guidelines. Because health financing in Brazil remains relatively low, the civil society tries to fill in the gaps as much as possible in the treatment of elderly patients suffering from chronic diseases such as Parkinson’s disease. In this review, we outline the current legislation in Brazil regarding the elderly and in particular, patients with Parkinson’s disease, in the context of a rapidly aging population. Keywords: Parkinson’s disease, demographic transition, public health, health assistance financing

  2. Control and management of congenital Chagas disease in Europe and other non-endemic countries: current policies and practices.

    Science.gov (United States)

    Soriano-Arandes, Antoni; Angheben, Andrea; Serre-Delcor, Nuria; Treviño-Maruri, Begoña; Gómez I Prat, Jordi; Jackson, Yves

    2016-05-01

    Identifying pregnant women infected with Trypanosoma cruzi is one of the major challenges for preventing and controlling Chagas disease (CD) in non-endemic countries. The aim of this paper was to perform a policy evaluation of the current practices of congenital Chagas disease (CCD) control in non-endemic countries and to propose specific targets for enhanced interventions to tackle this emerging health problem outside the endemic areas of Latin America. We conducted a mixed method review of CCD policy strategies by searching the literature in the PubMed, Google Scholar and the World Health Organization (WHO) databases using the key terms 'CCD', 'paediatric Chagas disease' and 'non-endemic countries'; as free text and combined as one phrase to increase the search sensitivity. Reviews, recommendations, guidelines and control/surveillance programme reports were included. Of 427 CCD papers identified in non-endemic countries, 44 matched the inclusion. Although local programmes were launched in different countries with large numbers of Latin American immigrants, there were considerable disparities in terms of the programmes' distribution, delivery, integration and appropriated CCD control strategies. Moreover, Catalonia, Spain is the only region/country with an established systematic monitoring of CCD in pregnant women from Latin American countries. Given the worldwide dissemination of CD, the nature of its vertical transmission, and the gaps of the current strategies in non-endemic countries, there is an urgent need to standardise, expand and reinforce the control measures against CCD transmission. © 2016 John Wiley & Sons Ltd.

  3. The Implications of the Developmental Origins of Health and Disease on Public Health Policy and Health Promotion in South Africa.

    Science.gov (United States)

    Reddy, Sasiragha Priscilla; Mbewu, Anthony David

    2016-11-09

    The developmental origins of health and disease (DOHaD) hypothesis states that environmental influences in utero and in early life can determine health and disease in later life through the programming of genes and/or altered gene expression. The DOHaD is likely to have had an effect in South Africa during the fifty years of apartheid; and during the twenty years since the dawn of democracy in 1994. This has profound implications for public health and health promotion policies in South Africa, a country experiencing increased prevalence of noncommunicable diseases (NCDs) and risk factors and behaviours for NCDs due to rapid social and economic transition, and because of the DOHaD. Public health policy and health promotion interventions, such as those introduced by the South African Government over the past 20 years, were designed to improve the health of pregnant women (and their unborn children). They could in addition, through the DOHaD mechanism, reduce NCDs and their risk factors in their offspring in later life. The quality of public health data over the past 40 years in South Africa precludes the possibility of proving the DOHaD hypothesis in that context. Nevertheless, public health and health promotion policies need to be strengthened, if South Africa and other low and middle income countries (LMICs) are to avoid the very high prevalence of NCDs seen in Europe and North America in the 50 years following the Second World War, as a result of socio economic transition and the DOHaD.

  4. Computer simulation to support policy-making in Aujeszky's disease control

    NARCIS (Netherlands)

    Buijtels, J.A.A.M.

    1997-01-01

    Aujeszky's disease is a contagious viral disease that affects the central nervous system of pigs. Several eradication programs or measures are available, each of them providing different results. Determining the preferred strategy is to a large extent a matter of economic

  5. Lyme disease in the Dutch policy context: patient consultation in government research agenda setting

    NARCIS (Netherlands)

    den Oudendammer, W.M.; Broerse, J.E.W.

    2017-01-01

    Prevalence of Lyme disease (LD) is increasing in the Netherlands. The Dutch Association for Lyme Disease Patients (NVLP) presented a petition to the Dutch Parliament for more LD research and political attention. The Parliament requested advice from the Health Council of the Netherlands, which among

  6. Foot and Mouth Disease. New values, innovative research agendas and policies

    NARCIS (Netherlands)

    Zijpp, van der A.J.; Braker, M.J.E.; Eilers, C.H.A.M.; Kieft, H.; Vogelzang, T.A.; Oosting, S.J.

    2004-01-01

    A Foot and Mouth Disease outbreak is not by definition similar to a Foot and Mouth Disease crisis. Why then did the 2001 outbreak result in a crisis situation in the Netherlands? It was not because nobody was prepared for it. The Ministry of Agriculture, Nature Management and Fisheries had a

  7. Disease spread models to estimate highly uncertain emerging diseases losses for animal agriculture insurance policies: an application to the U.S. farm-raised catfish industry.

    Science.gov (United States)

    Zagmutt, Francisco J; Sempier, Stephen H; Hanson, Terril R

    2013-10-01

    Emerging diseases (ED) can have devastating effects on agriculture. Consequently, agricultural insurance for ED can develop if basic insurability criteria are met, including the capability to estimate the severity of ED outbreaks with associated uncertainty. The U.S. farm-raised channel catfish (Ictalurus punctatus) industry was used to evaluate the feasibility of using a disease spread simulation modeling framework to estimate the potential losses from new ED for agricultural insurance purposes. Two stochastic models were used to simulate the spread of ED between and within channel catfish ponds in Mississippi (MS) under high, medium, and low disease impact scenarios. The mean (95% prediction interval (PI)) proportion of ponds infected within disease-impacted farms was 7.6% (3.8%, 22.8%), 24.5% (3.8%, 72.0%), and 45.6% (4.0%, 92.3%), and the mean (95% PI) proportion of fish mortalities in ponds affected by the disease was 9.8% (1.4%, 26.7%), 49.2% (4.7%, 60.7%), and 88.3% (85.9%, 90.5%) for the low, medium, and high impact scenarios, respectively. The farm-level mortality losses from an ED were up to 40.3% of the total farm inventory and can be used for insurance premium rate development. Disease spread modeling provides a systematic way to organize the current knowledge on the ED perils and, ultimately, use this information to help develop actuarially sound agricultural insurance policies and premiums. However, the estimates obtained will include a large amount of uncertainty driven by the stochastic nature of disease outbreaks, by the uncertainty in the frequency of future ED occurrences, and by the often sparse data available from past outbreaks. © 2013 Society for Risk Analysis.

  8. Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies.

    Science.gov (United States)

    Pimpin, Laura; Cortez-Pinto, Helena; Negro, Francesco; Corbould, Emily; Lazarus, Jeffrey V; Webber, Laura; Sheron, Nick

    2018-05-16

    The burden of liver disease in Europe continues to grow. We aimed to describe the epidemiology of liver diseases and their risk factors in European countries, and identify public health interventions that could impact on these risk factors to reduce the burden of liver disease. As part of the HEPAHEALTH project, commissioned by EASL, we extracted information on historical and current prevalence and mortality from national and international literature and databases on liver disease in 35 countries in the WHO European region, as well as historical and recent prevalence data on their main determinants; alcohol consumption, obesity and hepatitis B and C virus infections. We extracted information from peer-reviewed and grey literature to identify public health interventions targeting these risk factors. The epidemiology of liver disease is diverse and countries cluster with similar pictures, although the exact composition of diseases and the trends in risk factors which drive them is varied. Prevalence and mortality data indicate that increasing cirrhosis and liver cancer may be linked to dramatic increases in harmful alcohol consumption in Northern European countries, and viral hepatitis epidemics in Eastern and Southern European countries. Countries with historically low levels of liver disease may experience an increase in non-alcoholic fatty liver disease in the future, given the rise of obesity across the majority of European countries. Interventions exist for curbing harmful alcohol use, reducing obesity, preventing or treating viral hepatitis, and screening for liver disease at an early stage. Liver disease in Europe is a serious issue, with increasing cirrhosis and liver cancer. The public health and hepatology communities are uniquely placed to implement measures aimed at reducing their causes: harmful alcohol consumption, child and adult obesity prevalence and chronic infection with hepatitis viruses, which will in turn reduce the burden of liver disease. The

  9. The double burden of neoliberalism? Noncommunicable disease policies and the global political economy of risk.

    Science.gov (United States)

    Glasgow, Sara; Schrecker, Ted

    2016-05-01

    The growing prevalence of NCDs in low- and middle-income countries (LMICs) is now recognized as one of the major global health policy issues of the early 21st century. Current official approaches reflect ambivalence about how health policy should approach the social determinants of health identified by the WHO Commission on the topic that released its report in 2008, and in particular the role of macro-scale economic and social processes. Authoritative framing of options for NCD prevention in advance of the September, 2011 UN high-level meeting on NCDs arguably relied on a selective reading of the scientific (including social scientific) evidence, and foregrounded a limited number of risk factors defined in terms of individual behavior: tobacco use, unhealthy diet, alcohol (ab)use and physical inactivity. The effect was to reproduce at a transnational level the individualization of responsibility for health that characterizes most health promotion initiatives in high-income countries, ignoring both the limited control that many people have over their exposure to these risk factors and the contribution of macro-scale processes like trade liberalization and the marketing activities of transnational corporations to the global burden of NCDs. An alternative perspective focuses on "the inequitable distribution of power, money, and resources" described by the WHO Commission, and the ways in which policies that address those inequities can avoid unintentional incorporation of neoliberal constructions of risk and responsibility. Copyright © 2016. Published by Elsevier Ltd.

  10. An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

    Science.gov (United States)

    Karwalajtys, Tina; Kaczorowski, Janusz

    2010-01-01

    Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

  11. Vaccine delivery to disease control: a paradigm shift in health policy.

    Science.gov (United States)

    John, T Jacob; Jain, Yogesh; Nadimpally, Sarojini; Jesani, Amar

    2017-01-01

    India's Universal Immunisation Programme (UIP) has resulted in the creation of infrastructure, human resources and systems for the procurement and delivery of vaccines. Recently, new vaccines have been added and there are plans for the introduction of more. However, the outcomes in terms of reduction of the diseases for which the vaccines are being administered remain ambiguous. This is evident from the persistent health issues that children continue to experience, despite immunisation. This situation raises a fundamental ethical question for public health: vaccinations are one of the tools of disease control, but are they properly aligned to the control of disease so as to produce the expected public health utility or benefit?

  12. The health effects of US unemployment insurance policy: Does income from unemployment benefits prevent cardiovascular disease?

    NARCIS (Netherlands)

    S. Walter (Stefan); M.M. Glymour (Maria); M. Avendano Pabon (Mauricio)

    2014-01-01

    textabstractObjective: Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD) risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the

  13. European public health policies for managing contacts of invasive meningococcal disease cases better harmonised in 2013 than in 2007.

    Science.gov (United States)

    Vygen, Sabine; Hellenbrand, Wiebke; Stefanoff, Pawel; Hanquet, Germaine; Heuberger, Sigrid; Stuart, James

    2016-01-01

    In 2007, a European survey identified variation in country policies on public health management of invasive meningococcal disease (IMD). In 2009-10, the European Centre for Disease Prevention and Control (ECDC) published evidence-based guidance on IMD. We therefore surveyed again European countries to describe policies for managing IMD cases and contacts in 2013. We asked national IMD public health experts from 32 European countries to complete a questionnaire focusing on post-exposure prophylaxis (PEP) for IMD contacts and meningococcal vaccination. Proportions in 2007 and 2013 were compared using the chi-squared test. All 32 countries responded, with responses from two regions for Belgium and Italy; half stated having used ECDC guidance to update national recommendations. PEP was recommended to close contacts in 33 of 34 countries/regions, mainly ciprofloxacin for adults (29/32 countries) and rifampicin for children (29/32 countries). ECDC guidance for managing IMD contacts in airplanes was strictly followed by five countries/regions. Twenty-three countries/regions participated in both surveys. Compared with 2007, in 2013, more countries/regions recommended i) ceftriaxone for children (15/23 vs 6/20; p = 0.03), ii) PEP for all children in the same preschool group (8/23 vs 17/23; p = 0.02). More countries/regions recommended evidence-based measures for IMD public health management in 2013 than 2007. However, some discrepancies remain and they call for further harmonisation.

  14. Prioritization of Companion Animal Transmissible Diseases for Policy Intervention in Europe

    DEFF Research Database (Denmark)

    Cito, F.; Rijks, J.; Rantsios, A.T.

    2016-01-01

    A number of papers have been published on the prioritization of transmissible diseases in farm animals and wildlife, based either on semiquantitative or truly quantitative methods, but there is no published literature on the prioritization of transmissible diseases in companion animals. In this s...... reptiles. The methodology presented in this paper can be used to generate accurate priority lists according to narrower and more specific objectives....

  15. Non-communicable Chronic Diseases in the Americas: An Economic Perspective on Health Policie

    OpenAIRE

    David Mayer-Foulkes

    2010-01-01

    Non-communicable chronic diseases (NCDs) are amongst the principal burdens of disease in both developed and underdeveloped countries. The main causes of these illnesses are well known. They are tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol. The prevalence of these risk factors is directly related to the activities of transnational corporations. To begin with, just the budgets dedicated to advertising for risky consumption is larger than the budget of the Worl...

  16. Framing Tobacco Dependence as a "Brain Disease": Implications for Policy and Practice.

    Science.gov (United States)

    Morphett, Kylie; Carter, Adrian; Hall, Wayne; Gartner, Coral

    2017-07-01

    Like other forms of drug dependence, tobacco dependence is increasingly being described as a "chronic brain disease." The potential consequences of this medical labelling have been examined in relation to other addictions, but the implications for tobacco control have been neglected. Some have posited that biomedical conceptions of addiction will reduce stigma and increase uptake of efficacious treatments. Others have countered that it could increase stigma, reduce treatment seeking, and deter unassisted quitting. We explored how smokers respond to the labelling of smoking as a brain disease. Semi-structured interviews with 29 Australian smokers recruited using purposive sampling. Thematic analysis was used to analyze the results. Most participants questioned the accuracy of the brain disease label as applied to smoking. They believed that smoking was not a chronic disease because they perceived smoking to be an individual's choice. In addition, many believed that this label would increase the stigma that they already felt and, did not want to adopt a "sick role" in relation to their smoking. Describing smoking as a brain disease is more likely to alienate smokers than to engage them in quitting. The application of overly medical labels of smoking are inconsistent with smokers own conceptualizations of their smoking, and may have unintended consequences if they are widely disseminated in healthcare settings or antismoking campaigns. The participants in this project believed that biomedical labels of smoking as a "brain disease" or a "chronic disease" were discordant their existing understandings of their smoking. Explanations of addiction that downplay or ignore the role of choice and autonomy risk being perceived as irrelevant by smokers, and could lead to suspicion of health professionals or an unwillingness to seek treatment. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights

  17. Systems medicine approaches for the definition of complex phenotypes in chronic diseases and ageing. From concept to implementation and policies.

    Science.gov (United States)

    Bousquet, Jean; Jorgensen, Christian; Dauzat, Michel; Cesario, Alfredo; Camuzat, Thierry; Bourret, Rodolphe; Best, Nicolas; Anto, Josep M; Abecassis, Frederic; Aubas, Pierre; Avignon, Antoine; Badin, Melanie; Bedbrook, Anna; Blain, Hubert; Bourdin, Arnaud; Bringer, Jacques; Camu, William; Cayla, Guilhaume; Costa, David J; Courtet, Philippe; Cristol, Jean-Paul; Demoly, Pascal; de la Coussaye, Jean-Emmanuel; Fesler, Pierre; Gouzi, Fares; Gris, Jean-Christophe; Guillot, Bernard; Hayot, Maurice; Jeandel, Claude; Jonquet, Olivier; Journot, Laurent; Lehmann, Sylvain; Mathieu, Gwenaelle; Morel, Jacques; Ninot, Gregory; Pelissier, Jacques; Picot, Marie-Christine; Radier-Pontal, Francoise; Robine, Jean-Marie; Rodier, Michel; Roubille, Francois; Sultan, Ariane; Wojtusciszyn, Anne; Auffray, Charles; Balling, Rudi; Barbara, Cristina; Cambon-Thomsen, Anne; Chavannes, Niels H; Chuchalin, Alexander; Crooks, George; Dedeu, Antoni; Fabbri, Leonardo M; Garcia-Aymerich, Judith; Hajjam, Jawad; Melo Gomes, Elisabete; Palkonen, Susana; Piette, Francois; Pison, Christophe; Price, David; Samolinski, Boleslaw; Schunemann, Holger J; Sterk, Peter J; Yiallouros, Panayiotis; Roca, Josep; Van de Perre, Philippe; Mercier, Jacques

    2014-01-01

    Chronic diseases are diseases of long duration and slow progression. Major NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, rheumatologic diseases and mental health) represent the predominant health problem of the Century. The prevention and control of NCDs are the priority of the World Health Organization 2008 Action Plan, the United Nations 2010 Resolution and the European Union 2010 Council. The novel trend for the management of NCDs is evolving towards integrative, holistic approaches. NCDs are intertwined with ageing. The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has prioritised NCDs. To tackle them in their totality in order to reduce their burden and societal impact, it is proposed that NCDs should be considered as a single expression of disease with different risk factors and entities. An innovative integrated health system built around systems medicine and strategic partnerships is proposed to combat NCDs. It includes (i) understanding the social, economic, environmental, genetic determinants, as well as the molecular and cellular mechanisms underlying NCDs; (ii) primary care and practice-based interprofessional collaboration; (iii) carefully phenotyped patients; (iv) development of unbiased and accurate biomarkers for comorbidities, severity and follow up of patients; (v) socio-economic science; (vi) development of guidelines; (vii) training; and (viii) policy decisions. The results could be applicable to all countries and adapted to local needs, economy and health systems. This paper reviews the complexity of NCDs intertwined with ageing. It gives an overview of the problem and proposes two practical examples of systems medicine (MeDALL) applied to allergy and to NCD co-morbidities (MACVIA-LR, Reference Site of the European Innovation Partnership on Active and Healthy Ageing).

  18. Prioritization of Companion Animal Transmissible Diseases for Policy Intervention in Europe.

    Science.gov (United States)

    Cito, F; Rijks, J; Rantsios, A T; Cunningham, A A; Baneth, G; Guardabassi, L; Kuiken, T; Giovannini, A

    2016-07-01

    A number of papers have been published on the prioritization of transmissible diseases in farm animals and wildlife, based either on semiquantitative or truly quantitative methods, but there is no published literature on the prioritization of transmissible diseases in companion animals. In this study, available epidemiological data for diseases transmissible from companion animals to man were analysed with the aim of developing a procedure suitable for their prioritization within a European framework. A new method and its associated questionnaire and scoring system were designed based on methods described by the World Organisation for Animal Health (OIE). Modifications were applied to allow for the paucity of specific information on companion animal transmissible diseases. The OIE method was also adapted to the subject and to the regional scope of the interprofessional network addressing zoonotic diseases transmitted via companion animals in Europe: the Companion Animals multisectoriaL interprofessionaL Interdisciplinary Strategic Think tank On zoonoses (CALLISTO). Adaptations were made based on information collected from expert groups on viral, bacterial and parasitic diseases using a structured questionnaire, in which all questions were closed-ended. The expert groups were asked to select the most appropriate answer for each question taking into account the relevance and reliability of the data available in the scientific literature. Subsequently, the scoring of the answers obtained for each disease covered by the questionnaire was analysed to obtain two final overall scores, one for human health impact and one for agricultural economic impact. The adapted method was then applied to select the 15 most important pathogens (five for each pathogen group: viral, bacterial and parasitic) on the basis of their overall impact on public health and agriculture. The result of the prioritization exercise was a joint priority list (available at www.callistoproject.eu) of

  19. Childhood Obesity & Dental Disease: Common Causes, Common Solutions. Oral Health & Obesity Policy Brief

    Science.gov (United States)

    Children Now, 2011

    2011-01-01

    Too many California children suffer from high rates of preventable chronic conditions associated with childhood obesity and dental disease. The state is experiencing a crisis in both areas. Fortunately, common factors that contribute to both conditions--including the rates of breastfeeding, access to healthy food and the consumption of…

  20. Moving beyond too little, too late: managing emerging infectious diseases in wild populations requires international policy and partnerships

    Science.gov (United States)

    Voyles, Jamie; Kilpatrick, A. Marm; Collins, James P.; Fisher, Matthew C.; Frick, Winifred F.; McCallum, Hamish I.; Willis, Craig K.R.; Blehert, David S.; Murray, Kris A.; Puschendorf, Robert; Rosenblum, Erica Bree; Bolker, Benjamin M.; Cheng, Tina L.; Langwig, Kate E.; Linder, Daniel L.; Toothman, Mary; Wilber, Mark Q.; Briggs, Cheryl J.

    2015-01-01

    Emerging infectious diseases (EIDs) are on the rise due to multiple factors, including human facilitated movement of pathogens, broad-scale landscape changes, and perturbations to ecological systems (Jones et al. 2008; Fisher et al. 2012). Epidemics in wildlife are problematic because they can lead to pathogen spillover to new host organisms, erode biodiversity and threaten ecosystems that sustain human societies (Fisher et al. 2012; Kilpatrick 2011). There have been recent calls for large-scale research approaches to combat threats EIDs pose to wildlife (Sleeman 2013). While it is true that developing new analytical models, diagnostic assays and molecular tools will significantly avance outr abilities to respond to disease threats, we also propose that addressing difficult problems in EIDs will require considerable shofts in international health policy and infrastructure. While there are currently international organizations responsbile for rapidly initiating and coordinating preventative measures to control infectious diseases in human, livestock, and arable systems, there are few comparable instiutions that have the authority to implement transnational responses to EIDs in wildlife. This absence of well-developed infastructure hampers the rapid responses necessary to mitigate international spread of EIDs.

  1. Impacts of Climate Change on Vector Borne Diseases in the Mediterranean Basin - Implications for Preparedness and Adaptation Policy.

    Science.gov (United States)

    Negev, Maya; Paz, Shlomit; Clermont, Alexandra; Pri-Or, Noemie Groag; Shalom, Uri; Yeger, Tamar; Green, Manfred S

    2015-06-15

    The Mediterranean region is vulnerable to climatic changes. A warming trend exists in the basin with changes in rainfall patterns. It is expected that vector-borne diseases (VBD) in the region will be influenced by climate change since weather conditions influence their emergence. For some diseases (i.e., West Nile virus) the linkage between emergence andclimate change was recently proved; for others (such as dengue) the risk for local transmission is real. Consequently, adaptation and preparation for changing patterns of VBD distribution is crucial in the Mediterranean basin. We analyzed six representative Mediterranean countries and found that they have started to prepare for this threat, but the preparation levels among them differ, and policy mechanisms are limited and basic. Furthermore, cross-border cooperation is not stable and depends on international frameworks. The Mediterranean countries should improve their adaptation plans, and develop more cross-sectoral, multidisciplinary and participatory approaches. In addition, based on experience from existing local networks in advancing national legislation and trans-border cooperation, we outline recommendations for a regional cooperation framework. We suggest that a stable and neutral framework is required, and that it should address the characteristics and needs of African, Asian and European countries around the Mediterranean in order to ensure participation. Such a regional framework is essential to reduce the risk of VBD transmission, since the vectors of infectious diseases know no political borders.

  2. An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy

    Directory of Open Access Journals (Sweden)

    Tina Karwalajtys

    2010-09-01

    Full Text Available Tina Karwalajtys1, Janusz Kaczorowski2,31Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 2Primary Care & Community Research, Child & Family Research Institute, Vancouver, BC, Canada; 3Department of Family Practice, University of British Columbia, Vancouver, BC, CanadaAbstract: Cardiovascular disease (CVD is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.Keywords: risk factors, blood pressure determination, community health services, community health planning, public health practice

  3. Psychosocial stress and cardiovascular disease. Part 3: Clinical and policy implications of research on the transcendental meditation program.

    Science.gov (United States)

    Walton, Kenneth G; Schneider, Robert H; Salerno, John W; Nidich, Sanford I

    2005-01-01

    Cardiovascular disease (CVD) remains the leading cause of death in the United States today and a major contributor to total health care costs. Psychosocial stress has been implicated in CVD, and psychosocial approaches to primary and secondary prevention are gaining research support. This third article in the series on psychosocial stress and CVD continues the evaluation of one such approach, the Maharishi Transcendental Meditation program, a psychophysiological approach from the Vedic tradition that is systematically taught by qualified teachers throughout the world. Evidence suggests not only that this program can provide benefits in prevention but also that it may reduce CVD-related and other health care expenses. On the basis of data from the studies available to date, the Transcendental Meditation program may be responsible for reductions of 80% or greater in medical insurance claims and payments to physicians. This article evaluates the implications of research on the Transcendental Meditation program for health care policy and for large-scale clinical implementation of the program. The Transcendental Meditation program can be used by individuals of any ethnic or cultural background, and compliance with the practice regimen is generally high. The main steps necessary for wider adoption appear to be: (1) educating health care providers and patients about the nature and expected benefits of the program, and (2) adjustments in public policies at the state and national levels to allow this program to be included in private and public health insurance plans.

  4. Explaining differences in stakeholder take up of disease management programmes: A comparative analysis of policy implementation in Austria and Germany.

    Science.gov (United States)

    Schang, Laura; Thomson, Sarah; Czypionka, Thomas

    2016-03-01

    Understanding why policies to improve care for people with chronic conditions fail to be implemented is a pressing issue in health system reform. We explore reasons for the relatively high uptake of disease management programmes (DMPs) in Germany, in contrast to low uptake in Austria. We focus on the motivation, information and power of key stakeholder groups (payers, physician associations, individual physicians and patients). We conducted a comparative stakeholder analysis using qualitative data from interviews (n=15 in Austria and n=26 in Germany), legal documents and media reports. Stakeholders in Germany appeared to have systematically stronger motivation, exposure to more positive information about DMPs and better ability to implement DMPs than their counterparts in Austria. Policy in Austria focused on financial incentives to physicians only. In Germany, limited evidence about the quality improvement and cost savings potential of DMPs was mitigated by strong financial incentives to sickness funds but proved a fundamental obstacle in Austria. Efforts to promote DMPs should seek to ensure the cooperation of payers and patients, not just physicians, using a mix of financial and non-financial instruments suited to the context. A singular focus on financially incentivising providers is unlikely to stimulate uptake of DMPs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Urbanization and international trade and investment policies as determinants of noncommunicable diseases in Sub-Saharan Africa.

    Science.gov (United States)

    Schram, Ashley; Labonté, Ronald; Sanders, David

    2013-01-01

    There are three dominant globalization pathways affecting noncommunicable diseases in Sub-Saharan Africa (SSA): urbanization, trade liberalization, and investment liberalization. Urbanization carries potential health benefits due to improved access to an increased variety of food imports, although for the growing number of urban poor, this has often meant increased reliance on cheap, highly processed food commodities. Reduced barriers to trade have eased the importation of such commodities, while investment liberalization has increased corporate consolidation over global and domestic food chains. Higher profit margins on processed foods have promoted the creation of 'obesogenic' environments, which through progressively integrated global food systems have been increasingly 'exported' to developing nations. This article explores globalization processes, the food environment, and dietary health outcomes in SSA through the use of trend analyses and structural equation modelling. The findings are considered in the context of global barriers and facilitators for healthy public policy. © 2013.

  6. Cardiovascular disease risk factors among children of different socioeconomic status in Istanbul, Turkey: Directions for public health and nutrition policy

    Directory of Open Access Journals (Sweden)

    Keskin Yasar

    2004-06-01

    Full Text Available Abstract Objectives The aim of the current study was to examine the influence of socioeconomic status (SES on physiological (lipid profile, obesity indices and behavioral (dietary habits, physical activity cardiovascular disease (CVD risk factors among primary schoolchildren in Istanbul. Design Cross sectional study. Setting One private school and two public schools from different SES districts in Istanbul. Participants 510 randomly selected children aged 12 and 13 years old (257 boys, 253 girls. Results The prevalence of overweight (15.2% and the energy intake (p Conclusion The findings of the current study revealed a coexistence of both overweight and higher energy intake in middle/ high SES children, as well as a coexistence of underweight and lower physical activity levels in low SES children. These observations should guide the public health policy in developing appropriate intervention strategies to efficiently tackle these health and social issues early in life.

  7. From the American Academy of Pediatrics: Policy statement--Tobacco use: a pediatric disease.

    Science.gov (United States)

    2009-11-01

    Tobacco use and secondhand tobacco-smoke (SHS) exposure are major national and international health concerns. Pediatricians and other clinicians who care for children are uniquely positioned to assist patients and families with tobacco-use prevention and treatment. Understanding the nature and extent of tobacco use and SHS exposure is an essential first step toward the goal of eliminating tobacco use and its consequences in the pediatric population. The next steps include counseling patients and family members to avoid SHS exposures or cease tobacco use; advocacy for policies that protect children from SHS exposure; and elimination of tobacco use in the media, public places, and homes. Three overarching principles of this policy can be identified: (1) there is no safe way to use tobacco; (2) there is no safe level or duration of exposure to SHS; and (3) the financial and political power of individuals, organizations, and government should be used to support tobacco control. Pediatricians are advised not to smoke or use tobacco; to make their homes, cars, and workplaces tobacco free; to consider tobacco control when making personal and professional decisions; to support and advocate for comprehensive tobacco control; and to advise parents and patients not to start using tobacco or to quit if they are already using tobacco. Prohibiting both tobacco advertising and the use of tobacco products in the media is recommended. Recommendations for eliminating SHS exposure and reducing tobacco use include attaining universal (1) smoke-free home, car, school, work, and play environments, both inside and outside, (2) treatment of tobacco use and dependence through employer, insurance, state, and federal supports, (3) implementation and enforcement of evidence-based tobacco-control measures in local, state, national, and international jurisdictions, and (4) financial and systems support for training in and research of effective ways to prevent and treat tobacco use and SHS

  8. Disease burden of enterovirus infection in Taiwan: Implications for vaccination policy.

    Science.gov (United States)

    Liu, Ding-Ping; Wang, Ting-Ann; Huang, Wan-Ting; Chang, Luan-Yin; Wang, En-Tzu; Cheng, Shou-Hsia; Yang, Ming-Chin

    2016-02-10

    This study aimed to assess the disease burden and economic impacts of human nonpolio enteroviruses (NPEV) and enterovirus A71 (EV-A71) infection in Taiwan. We included children under five years old (n=983,127-1,118,649) with ICD-9-CM codes 0740 (herpangina) or 0743 (hand-foot-and-mouth disease) from the 2006 to 2010 National Health Insurance Database. Severity of enterovirus infection was assessed from outpatient/emergency visits, hospitalization (with/without intensive care unit [ICU] admission), infection with severe complications, and death. We estimated medical costs and indirect costs from the societal perspective. The annual rates of NPEV events for children under five years old ranged from 13.9% to 38.4%, of which 5.1-8.8% were hospitalized. EV-A71 accounted for 7.8% of all NPEV medical costs, but 79.1% of NPEV ICU costs. Travel costs and productivity loss of caregivers were $37.1 (range: $24.5-$64.7) million per year. These costs were not higher in the EV-A71 dominant year ($34.4 million) compared with those in the other years. Productivity losses resulting from premature mortality by NPEV infection were $0.8 (range: $0.0-$2.9) million per year, of which 96.3% were caused by EV-A71. Diseases associated with NPEV other than EV-A71 were responsible for most of the medical expenses. In addition, caregiver productivity loss by high rates of NPEV infection impacted the society much more than medical costs. A multi-valent vaccine that includes EV-A71 and other serotypes, for example coxsackievirus A16, may be beneficial to the health of children in Taiwan. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Group interventions for patients with cancer and HIV disease: part IV. Clinical and policy recommendations.

    Science.gov (United States)

    Leszcz, Molyn; Sherman, Allen; Mosier, Julie; Burlingame, Gary M; Cleary, Trish; Ulman, Kathleen Hubbs; Simonton, Stephanie; Latif, Umaira; Strauss, Bernhard; Hazelton, Lara

    2004-10-01

    Group interventions have assumed a growing role in primary prevention and supportive care for cancer and HIV disease. Earlier sections of this Special Report examined empirical findings for these interventions and provided recommendations for future research. The current section offers brief recommendations for service providers, policymakers, and stakeholders. Group services now occupy an increasingly prominent place in primary prevention programs and medical settings. In previous sections of this Special Report (Sherman, Leszcz et al., 2004; Sherman, Mosier et al., 2004a, 2004b) we examined the efficacy of different group interventions at different phases of cancer or HIV disease, considered characteristics of the intervention and the participants that might influence outcomes, and discussed mechanisms of action. Methodological challenges and priorities for future research were highlighted. In this, the final section, we offer brief recommendations for service providers, policymakers, and other stakeholders. We consider some of the barriers that constrain use of empirically-based group interventions and note how these programs might be implemented more widely and effectively.

  10. An Outbreak of Syphilis in Alabama Prisons: Correctional Health Policy and Communicable Disease Control

    Science.gov (United States)

    Wolfe, Mitchell I.; Xu, Fujie; Patel, Priti; O'Cain, Michael; Schillinger, Julia A.; St. Louis, Michael E.; Finelli, Lyn

    2001-01-01

    Objectives. After syphilis outbreaks were reported at 3 Alabama State men's prisons in early 1999, we conducted an investigation to evaluate risk factors for syphilis infection and describe patterns of syphilis transmission. Methods. We reviewed medical, patient interview, and prison transfer records and documented sexual networks. Presumptive source cases were identified. Odds of exposure to unscreened jail populations and transfer from other prisons were calculated for case patients at 1 prison. Results. Thirty-nine case patients with early syphilis were identified from 3 prisons. Recent jail exposure (odds ratio [OR] = 8.0, 95% confidence interval [CI] = 0.3, 158.7, P = .14) and prison transfer (OR = 32.0, 95% CI = 1.6, 1668.1, P prisons included mixing of prisoners with unscreened jail populations, transfer of infected inmates between prisons, and multiple concurrent sexual partnerships. Reducing sexual transmission of disease in correctional settings is a public health priority and will require innovative prevention strategies. PMID:11499107

  11. Supporting chronic disease self-management: translating policies and principles into clinical practice.

    Science.gov (United States)

    Higgins, Rosemary; Murphy, Barbara; Worcester, Marian; Daffey, Angela

    2012-01-01

    To support self-management, health professionals need to adopt a client-centred approach and learn to deliver evidence-based behaviour change interventions. This paper reports on the evaluation of 1- and 2-day training programs developed to improve health professionals' capacity to support chronic disease self-management (CDSM). The 321 participants attended one of eighteen supporting CDSM courses held in urban and rural settings. Participants included nurses, allied health professionals, Aboriginal health workers and general practitioners. Data were collected at three time points: before participation; immediately after the training; and, for a sub-sample of 37 participants, 2 months after the training. Results revealed a significant and sustained increase in CDSM self-efficacy following training regardless of participants' gender, age or qualifications. A thematic analysis of the responses concerning intended practice revealed four main areas of intended practice change, namely: use behavioural strategies; improve communication with clients; adopt a client-centred approach; and improve goal setting. The number of practice changes at 2 months reported by a sub-sample of participants ranged from 1 to 20 with a mean of 14 (s.d.=4). The three most common areas of practice change point to the adoption by health professionals of a collaborative approach with chronic disease patients. Lack of staff trained in CDSM was seen as a major barrier to practice change, with lack of support and finance also named as barriers to practice change. Participants identified that increased training, support and awareness of the principles of supporting CDSM would help to overcome barriers to practice change. These results indicate a readiness among health professionals to adopt a more collaborative approach given the skills and the tools to put this approach into practice.

  12. The effect of fiscal policy on diet, obesity and chronic disease: a systematic review

    Science.gov (United States)

    Jan, Stephen; Leeder, Stephen; Swinburn, Boyd

    2010-01-01

    Abstract Objective To assess the effect of food taxes and subsidies on diet, body weight and health through a systematic review of the literature. Methods We searched the English-language published and grey literature for empirical and modelling studies on the effects of monetary subsidies or taxes levied on specific food products on consumption habits, body weight and chronic conditions. Empirical studies were dealing with an actual tax, while modelling studies predicted outcomes based on a hypothetical tax or subsidy. Findings Twenty-four studies met the inclusion criteria: 13 were from the peer-reviewed literature and 11 were published on line. There were 8 empirical and 16 modelling studies. Nine studies assessed the impact of taxes on food consumption only, 5 on consumption and body weight, 4 on consumption and disease and 6 on body weight only. In general, taxes and subsidies influenced consumption in the desired direction, with larger taxes being associated with more significant changes in consumption, body weight and disease incidence. However, studies that focused on a single target food or nutrient may have overestimated the impact of taxes by failing to take into account shifts in consumption to other foods. The quality of the evidence was generally low. Almost all studies were conducted in high-income countries. Conclusion Food taxes and subsidies have the potential to contribute to healthy consumption patterns at the population level. However, current evidence is generally of low quality and the empirical evaluation of existing taxes is a research priority, along with research into the effectiveness and differential impact of food taxes in developing countries. PMID:20680126

  13. Currently important animal disease management issues in sub-Saharan Africa : policy and trade issues

    Directory of Open Access Journals (Sweden)

    G.R. Thomson

    2009-09-01

    Full Text Available The present international approach to management of transboundary animal diseases (TADs is based on the assumption that most can be eradicated ; consequently, that is the usual objective adopted by international organizations concerned with animal health. However, for sub-Saharan Africa and southern Africa more particularly, eradication of most TADs is impossible for the foreseeable future for a variety of technical, financial and logistical reasons. Compounding this, the present basis for access to international markets for products derived from animals requires that the area of origin (country or zone is free from trade-influencing TADs. The ongoing development of transfrontier conservation areas (TFCAs, extending across huge areas of southern Africa, therefore presents a development conundrum because it makes creation of geographic areas free from TADs more difficult and brings development based on wildlife conservation on the one hand and that based on livestock production on the other into sharp conflict. Sub-Saharan Africa is consequently confronted by a complex problem that contributes significantly to retarded rural development which, in turn, impedes poverty alleviation. In southern Africa specifically, foot-and-mouth disease (FMD presents the greatest problem in relation to access to international markets for animal products. However, it is argued that this problem could be overcome by a combination between (1 implementation of a commodity-based approach to trade in products derived from animals and (2 amendment of the international standards for FMD specifically (i.e. the FMD chapter in the Terrestrial Animal Health Code of the World Organisation for Animal Health [OIE] so that occurrence of SAT serotype viruses in free-living African buffalo need not necessarily mean exclusion of areas where buffalo occur from international markets for animal products. This would overcome a presently intractable constraint to market access for

  14. The effect of fiscal policy on diet, obesity and chronic disease: a systematic review.

    Science.gov (United States)

    Thow, Anne Marie; Jan, Stephen; Leeder, Stephen; Swinburn, Boyd

    2010-08-01

    To assess the effect of food taxes and subsidies on diet, body weight and health through a systematic review of the literature. We searched the English-language published and grey literature for empirical and modelling studies on the effects of monetary subsidies or taxes levied on specific food products on consumption habits, body weight and chronic conditions. Empirical studies were dealing with an actual tax, while modelling studies predicted outcomes based on a hypothetical tax or subsidy. Twenty-four studies met the inclusion criteria: 13 were from the peer-reviewed literature and 11 were published on line. There were 8 empirical and 16 modelling studies. Nine studies assessed the impact of taxes on food consumption only, 5 on consumption and body weight, 4 on consumption and disease and 6 on body weight only. In general, taxes and subsidies influenced consumption in the desired direction, with larger taxes being associated with more significant changes in consumption, body weight and disease incidence. However, studies that focused on a single target food or nutrient may have overestimated the impact of taxes by failing to take into account shifts in consumption to other foods. The quality of the evidence was generally low. Almost all studies were conducted in high-income countries. Food taxes and subsidies have the potential to contribute to healthy consumption patterns at the population level. However, current evidence is generally of low quality and the empirical evaluation of existing taxes is a research priority, along with research into the effectiveness and differential impact of food taxes in developing countries.

  15. The public production of medicines compared to the National Policy of Medicines and the burden of disease in Brazil

    Directory of Open Access Journals (Sweden)

    Tatiana Aragão Figueiredo

    2017-09-01

    Full Text Available Abstract: The public production of medicines in Brazil by Government Pharmaceutical Laboratories has once again become the object of incentives, and Industrial Development Partnerships are one of the mechanisms adopted for the production of strategic medicines for the Brazilian Unified National Health System (SUS. Considering that burden-of-disease studies have been used as a tool to define priority and essential medicines, the article compares the product portfolios of the country’s Official Pharmaceutical Laboratories (OPL and the list of strategic medicines for the SUS and burden of disease in Brazil in 2008. Of the 205 strategic medicines for the SUS and 111 from the portfolios, 73% and 89%, respectively, are on the National List of Essential Medicines (RENAME 2014. Some strategic medicines for the SUS are already produced by OPL and feature the selection of cancer drugs and biologicals. The current study contributes to the discussion on the public production of medicines in light of the country’s current industrial policy and highlights the need to define priority drugs and the role of OPL in guaranteeing access to them.

  16. Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association.

    Science.gov (United States)

    Dunbar, Sandra B; Khavjou, Olga A; Bakas, Tamilyn; Hunt, Gail; Kirch, Rebecca A; Leib, Alyssa R; Morrison, R Sean; Poehler, Diana C; Roger, Veronique L; Whitsel, Laurie P

    2018-05-08

    In a recent report, the American Heart Association estimated that medical costs and productivity losses of cardiovascular disease (CVD) are expected to grow from $555 billion in 2015 to $1.1 trillion in 2035. Although the burden is significant, the estimate does not include the costs of family, informal, or unpaid caregiving provided to patients with CVD. In this analysis, we estimated projections of costs of informal caregiving attributable to CVD for 2015 to 2035. We used data from the 2014 Health and Retirement Survey to estimate hours of informal caregiving for individuals with CVD by age/sex/race using a zero-inflated binomial model and controlling for sociodemographic factors and health conditions. Costs of informal caregiving were estimated separately for hypertension, coronary heart disease, heart failure, stroke, and other heart disease. We analyzed data from a nationally representative sample of 16 731 noninstitutionalized adults ≥54 years of age. The value of caregiving hours was monetized by the use of home health aide workers' wages. The per-person costs were multiplied by census population counts to estimate nation-level costs and to be consistent with other American Heart Association analyses of burden of CVD, and the costs were projected from 2015 through 2035, assuming that within each age/sex/racial group, CVD prevalence and caregiving hours remain constant. The costs of informal caregiving for patients with CVD were estimated to be $61 billion in 2015 and are projected to increase to $128 billion in 2035. Costs of informal caregiving of patients with stroke constitute more than half of the total costs of CVD informal caregiving ($31 billion in 2015 and $66 billion in 2035). By age, costs are the highest among those 65 to 79 years of age in 2015 but are expected to be surpassed by costs among those ≥80 years of age by 2035. Costs of informal caregiving for patients with CVD represent an additional 11% of medical and productivity costs

  17. Hand osteoarthritis: Differential diagnosis with inflammatory joint diseases and treatment policy

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    Yu. A. Olyunin

    2015-01-01

    Full Text Available Osteoarthritis (OA usually affects certain joint groups selectively and the hand joints (HJ are one of its classical locations. Hand OA is widespread in the population. In their practice rheumatologists encounter HJ injury in OA in 38% of cases. It is conventional to identify three main types of hand OA. These are 1 interphalangeal OA that may or may not be accompanied by nodulation; 2 first carpometacarpal OA; and 3 erosive OA. At the same time, the rate of clinical forms ranges from 2.0 to 6.2%; it is 4.7 to 20.4% in the elderly. Nonsteroidal antiinflammatory drugs (NSAIDs are most commonly used to relieve pain that is the main manifestation of the disease. The risk for NSAID-related adverse gastrointestinal (GI events is substantially reduced by the drugs that exert their effects mainly on cyclooxygenase 2. These include nimesulide in particular. Undesirable GI effects may be also considerably minimized by using NSAIDs that have both their gastroprotective and antiinflammatory activities. By suppressing pain and inflammatory changes, the recently designed NSAID amtolmetin guacil simultaneously exerts a protective effect on the GI mucosa, by elevating its nitric oxide levels.

  18. Community Health Policy Assessment of a Rural Northeast Missouri County using the Centers for Disease Control and Prevention’s CHANGE Tool

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    Mitch Stewart

    2013-06-01

    Full Text Available Background: In order to build a framework to address policy gaps and needs, community’s risk factors were identified and the extent to which current policies were in place to address the risk factors were compared. Methods: Face-to-face interviews, using the US Centers for Disease Con¬trol and Prevention’s CHANGE tool were conducted in a rural Northeast Missouri county possessing exceptionally high chronic disease rates to as¬sess the factor(s had the greatest influence on the rates in each sector of the community. Results: The Health Care Agency sector possessed the most factors cate¬gorized as environmental and policy assets, and the Community-at-Large and Business/Worksite sectors seemed to possess the least environmental and policy factors categorized as assets.Conclusions: Because organizational policies can strongly influence community health practices and behaviors, collaborative leadership from the Health Care Agency sector, comprehensive worksite health promotion programs in the Business/Worksite and Community In¬stitu¬tions/Organizations sectors, and tobacco-free school policies are recom¬mended. Multiple community sectors must work together to change not only behaviors but also environments in this county.

  19. The Health Effects of US Unemployment Insurance Policy: Does Income from Unemployment Benefits Prevent Cardiovascular Disease?

    Science.gov (United States)

    Walter, Stefan; Glymour, Maria; Avendano, Mauricio

    2014-01-01

    Objective Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD) risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the hypothesis that more generous benefits reduce CVD risk. Methods Cohort data came from 16,108 participants in the Health and Retirement Study (HRS) aged 50–65 at baseline interviewed from 1992 to 2010. Data on first and recurrent CVD diagnosis assessed through biennial interviews were linked to the generosity of unemployment benefit programmes in each state and year. Using state fixed-effect models, we assessed whether state changes in the generosity of unemployment benefits predicted CVD risk. Results States with higher unemployment benefits had lower incidence of CVD, so that a 1% increase in benefits was associated with 18% lower odds of CVD (OR:0.82, 95%-CI:0.71–0.94). This association remained after introducing US census regional division fixed effects, but disappeared after introducing state fixed effects (OR:1.02, 95%-CI:0.79–1.31).This was consistent with the fact that unemployment was not associated with CVD risk in state-fixed effect models. Conclusion Although states with more generous unemployment benefits had lower CVD incidence, this appeared to be due to confounding by state-level characteristics. Possible explanations are the lack of short-term effects of unemployment on CVD risk. Future studies should assess whether benefits at earlier stages of the life-course influence long-term risk of CVD. PMID:25025281

  20. Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases

    Directory of Open Access Journals (Sweden)

    Hawkes Corinna

    2006-03-01

    Full Text Available Abstract In a "nutrition transition", the consumption of foods high in fats and sweeteners is increasing throughout the developing world. The transition, implicated in the rapid rise of obesity and diet-related chronic diseases worldwide, is rooted in the processes of globalization. Globalization affects the nature of agri-food systems, thereby altering the quantity, type, cost and desirability of foods available for consumption. Understanding the links between globalization and the nutrition transition is therefore necessary to help policy makers develop policies, including food policies, for addressing the global burden of chronic disease. While the subject has been much discussed, tracing the specific pathways between globalization and dietary change remains a challenge. To help address this challenge, this paper explores how one of the central mechanisms of globalization, the integration of the global marketplace, is affecting the specific diet patterns. Focusing on middle-income countries, it highlights the importance of three major processes of market integration: (I production and trade of agricultural goods; (II foreign direct investment in food processing and retailing; and (III global food advertising and promotion. The paper reveals how specific policies implemented to advance the globalization agenda account in part for some recent trends in the global diet. Agricultural production and trade policies have enabled more vegetable oil consumption; policies on foreign direct investment have facilitated higher consumption of highly-processed foods, as has global food marketing. These dietary outcomes also reflect the socioeconomic and cultural context in which these policies are operating. An important finding is that the dynamic, competitive forces unleashed as a result of global market integration facilitates not only convergence in consumption habits (as is commonly assumed in the "Coca-Colonization" hypothesis, but adaptation to

  1. Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases

    Science.gov (United States)

    Hawkes, Corinna

    2006-01-01

    In a "nutrition transition", the consumption of foods high in fats and sweeteners is increasing throughout the developing world. The transition, implicated in the rapid rise of obesity and diet-related chronic diseases worldwide, is rooted in the processes of globalization. Globalization affects the nature of agri-food systems, thereby altering the quantity, type, cost and desirability of foods available for consumption. Understanding the links between globalization and the nutrition transition is therefore necessary to help policy makers develop policies, including food policies, for addressing the global burden of chronic disease. While the subject has been much discussed, tracing the specific pathways between globalization and dietary change remains a challenge. To help address this challenge, this paper explores how one of the central mechanisms of globalization, the integration of the global marketplace, is affecting the specific diet patterns. Focusing on middle-income countries, it highlights the importance of three major processes of market integration: (I) production and trade of agricultural goods; (II) foreign direct investment in food processing and retailing; and (III) global food advertising and promotion. The paper reveals how specific policies implemented to advance the globalization agenda account in part for some recent trends in the global diet. Agricultural production and trade policies have enabled more vegetable oil consumption; policies on foreign direct investment have facilitated higher consumption of highly-processed foods, as has global food marketing. These dietary outcomes also reflect the socioeconomic and cultural context in which these policies are operating. An important finding is that the dynamic, competitive forces unleashed as a result of global market integration facilitates not only convergence in consumption habits (as is commonly assumed in the "Coca-Colonization" hypothesis), but adaptation to products targeted at different

  2. Will the next generation of preferential trade and investment agreements undermine prevention of noncommunicable diseases? A prospective policy analysis of the Trans Pacific Partnership Agreement.

    Science.gov (United States)

    Thow, Anne Marie; Snowdon, Wendy; Labonté, Ronald; Gleeson, Deborah; Stuckler, David; Hattersley, Libby; Schram, Ashley; Kay, Adrian; Friel, Sharon

    2015-01-01

    The Trans Pacific Partnership Agreement (TPPA) is one of a new generation of 'deep' preferential trade and investment agreements that will extend many of the provisions seen in previous agreements. This paper presents a prospective policy analysis of the likely text of the TPPA, with reference to nutrition policy space. Specifically, we analyse how the TPPA may constrain governments' policy space to implement the 'policy options for promoting a healthy diet' in the World Health Organization's Global Action Plan for Prevention and Control of Noncommunicable Diseases (NCDs) 2013-2020. This policy analysis suggests that if certain binding commitments are made under the TPPA, they could constrain the ability of governments to protect nutrition policy from the influence of vested interests, reduce the range of interventions available to actively discourage consumption of less healthy food (and to promote healthy food) and limit governments' capacity to implement these interventions, and reduce resources available for nutrition education initiatives. There is scope to protect policy space by including specific exclusions and/or exceptions during negotiation of trade and investment agreements like the TPPA, and by strengthening global health frameworks for nutrition to enable them to be used as reference during disputes in trade fora. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Reaching Agreement in Uncertain Circumstances: The Practice of Evidence-Based Policy in the Case of the Swedish National Guidelines for Heart Diseases

    Science.gov (United States)

    Eckard, Nathalie; Nedlund, Ann-Charlotte; Janzon, Magnus; Levin, Lars-Åke

    2017-01-01

    This paper explores the practice of evidence-based policy in a Swedish healthcare context. The study focused on how policymakers in the specific working group, the Priority-Setting Group (PSG), handled the various forms of evidence and values and their competing rationalities, when producing the Swedish National Guidelines for heart diseases that…

  4. Higher Mortality in registrants with sudden model for end-stage liver disease increase: Disadvantaged by the current allocation policy.

    Science.gov (United States)

    Massie, Allan B; Luo, Xun; Alejo, Jennifer L; Poon, Anna K; Cameron, Andrew M; Segev, Dorry L

    2015-05-01

    Liver allocation is based on current Model for End-Stage Liver Disease (MELD) scores, with priority in the case of a tie being given to those waiting the longest with a given MELD score. We hypothesized that this priority might not reflect risk: registrants whose MELD score has recently increased receive lower priority but might have higher wait-list mortality. We studied wait-list and posttransplant mortality in 69,643 adult registrants from 2002 to 2013. By likelihood maximization, we empirically defined a MELD spike as a MELD increase ≥ 30% over the previous 7 days. At any given time, only 0.6% of wait-list patients experienced a spike; however, these patients accounted for 25% of all wait-list deaths. Registrants who reached a given MELD score after a spike had higher wait-list mortality in the ensuing 7 days than those with the same resulting MELD score who did not spike, but they had no difference in posttransplant mortality. The spike-associated wait-list mortality increase was highest for registrants with medium MELD scores: specifically, 2.3-fold higher (spike versus no spike) for a MELD score of 10, 4.0-fold higher for a MELD score of 20, and 2.5-fold higher for a MELD score of 30. A model incorporating the MELD score and spikes predicted wait-list mortality risk much better than a model incorporating only the MELD score. Registrants with a sudden MELD increase have a higher risk of short-term wait-list mortality than is indicated by their current MELD score but have no increased risk of posttransplant mortality; allocation policy should be adjusted accordingly. © 2015 American Association for the Study of Liver Diseases.

  5. Is gender policy related to the gender gap in external cause and circulatory disease mortality? A mixed effects model of 22 OECD countries 1973–2008

    Directory of Open Access Journals (Sweden)

    Backhans Mona

    2012-11-01

    Full Text Available Abstract Background Gender differences in mortality vary widely between countries and over time, but few studies have examined predictors of these variations, apart from smoking. The aim of this study is to investigate the link between gender policy and the gender gap in cause-specific mortality, adjusted for economic factors and health behaviours. Methods 22 OECD countries were followed 1973–2008 and the outcomes were gender gaps in external cause and circulatory disease mortality. A previously found country cluster solution was used, which includes indicators on taxes, parental leave, pensions, social insurances and social services in kind. Male breadwinner countries were made reference group and compared to earner-carer, compensatory breadwinner, and universal citizen countries. Specific policies were also analysed. Mixed effect models were used, where years were the level 1-units, and countries were the level 2-units. Results Both the earner-carer cluster (ns after adjustment for GDP and policies characteristic of that cluster are associated with smaller gender differences in external causes, particularly due to an association with increased female mortality. Cluster differences in the gender gap in circulatory disease mortality are the result of a larger relative decrease of male mortality in the compensatory breadwinner cluster and the earner-carer cluster. Policies characteristic of those clusters were however generally related to increased mortality. Conclusion Results for external cause mortality are in concordance with the hypothesis that women become more exposed to risks of accident and violence when they are economically more active. For circulatory disease mortality, results differ depending on approach – cluster or indicator. Whether cluster differences not explained by specific policies reflect other welfare policies or unrelated societal trends is an open question. Recommendations for further studies are made.

  6. GMDPtoolbox: A Matlab library for designing spatial management policies. Application to the long-term collective management of an airborne disease.

    Science.gov (United States)

    Cros, Marie-Josée; Aubertot, Jean-Noël; Peyrard, Nathalie; Sabbadin, Régis

    2017-01-01

    Designing management policies in ecology and agroecology is complex. Several components must be managed together while they strongly interact spatially. Decision choices must be made under uncertainty on the results of the actions and on the system dynamics. Furthermore, the objectives pursued when managing ecological systems or agroecosystems are usually long term objectives, such as biodiversity conservation or sustainable crop production. The framework of Graph-Based Markov Decision Processes (GMDP) is well adapted to the qualitative modeling of such problems of sequential decision under uncertainty. Spatial interactions are easily modeled and integrated control policies (combining several action levers) can be designed through optimization. The provided policies are adaptive, meaning that management actions are decided at each time step (for instance yearly) and the chosen actions depend on the current system state. This framework has already been successfully applied to forest management and invasive species management. However, up to now, no "easy-to-use" implementation of this framework was available. We present GMDPtoolbox, a Matlab toolbox which can be used both for the design of new management policies and for comparing policies by simulation. We provide an illustration of the use of the toolbox on a realistic crop disease management problem: the design of long term management policy of blackleg of canola using an optimal combination of three possible cultural levers. This example shows how GMDPtoolbox can be used as a tool to support expert thinking.

  7. Vaccination Policies

    NARCIS (Netherlands)

    Verweij, M.F.

    2013-01-01

    Vaccination involves priming the immune system with an antigenic agent that mimics a virus or bacterium, which results in immunity against the “real” microorganism. Collective vaccination policies have played an important role in the control of infectious disease worldwide. They can serve the

  8. Asymmetry in scientific method and limits to cross-disciplinary dialogue: toward a shared language and science policy in pharmacogenomics and human disease genetics.

    Science.gov (United States)

    Ozdemir, Vural; Williams-Jones, Bryn; Graham, Janice E; Preskorn, Sheldon H; Gripeos, Dimitrios; Glatt, Stephen J; Friis, Robert H; Reist, Christopher; Szabo, Sandor; Lohr, James B; Someya, Toshiyuki

    2007-04-01

    Pharmacogenomics is a hybrid field of experimental science at the intersection of human disease genetics and clinical pharmacology sharing applications of the new genomic technologies. But this hybrid field is not yet stable or fully integrated, nor is science policy in pharmacogenomics fully equipped to resolve the challenges of this emerging hybrid field. The disciplines of human disease genetics and clinical pharmacology contain significant differences in their scientific practices. Whereas clinical pharmacology originates as an experimental science, human disease genetics is primarily observational in nature. The result is a significant asymmetry in scientific method that can differentially impact the degree to which gene-environment interactions are discerned and, by extension, the study sample size required in each discipline. Because the number of subjects enrolled in observational genetic studies of diseases is characteristically viewed as an important criterion of scientific validity and reliability, failure to recognize discipline-specific requirements for sample size may lead to inappropriate dismissal or silencing of meritorious, although smaller-scale, craft-based pharmacogenomic investigations using an experimental study design. Importantly, the recognition that pharmacogenomics is an experimental science creates an avenue for systematic policy response to the ethical imperative to prospectively pursue genetically customized therapies before regulatory approval of pharmaceuticals. To this end, we discuss the critical role of interdisciplinary engagement between medical sciences, policy, and social science. We emphasize the need for development of shared standards across scientific, methodologic, and socioethical epistemologic divides in the hybrid field of pharmacogenomics to best serve the interests of public health.

  9. Projected Impact of Mexico’s Sugar-Sweetened Beverage Tax Policy on Diabetes and Cardiovascular Disease: A Modeling Study

    Science.gov (United States)

    Sánchez-Romero, Luz Maria; Penko, Joanne; Coxson, Pamela G.; Fernández, Alicia; Mason, Antoinette; Moran, Andrew E.; Ávila-Burgos, Leticia; Barquera, Simón; Bibbins-Domingo, Kirsten

    2016-01-01

    Background Rates of diabetes in Mexico are among the highest worldwide. In 2014, Mexico instituted a nationwide tax on sugar-sweetened beverages (SSBs) in order to reduce the high level of SSB consumption, a preventable cause of diabetes and cardiovascular disease (CVD). We used an established computer simulation model of CVD and country-specific data on demographics, epidemiology, SSB consumption, and short-term changes in consumption following the SSB tax in order to project potential long-range health and economic impacts of SSB taxation in Mexico. Methods and Findings We used the Cardiovascular Disease Policy Model–Mexico, a state transition model of Mexican adults aged 35–94 y, to project the potential future effects of reduced SSB intake on diabetes incidence, CVD events, direct diabetes healthcare costs, and mortality over 10 y. Model inputs included short-term changes in SSB consumption in response to taxation (price elasticity) and data from government and market research surveys and public healthcare institutions. Two main scenarios were modeled: a 10% reduction in SSB consumption (corresponding to the reduction observed after tax implementation) and a 20% reduction in SSB consumption (possible with increases in taxation levels and/or additional measures to curb consumption). Given uncertainty about the degree to which Mexicans will replace calories from SSBs with calories from other sources, we evaluated a range of values for calorie compensation. We projected that a 10% reduction in SSB consumption with 39% calorie compensation among Mexican adults would result in about 189,300 (95% uncertainty interval [UI] 155,400–218,100) fewer incident type 2 diabetes cases, 20,400 fewer incident strokes and myocardial infarctions, and 18,900 fewer deaths occurring from 2013 to 2022. This scenario predicts that the SSB tax could save Mexico 983 million international dollars (95% UI $769 million–$1,173 million). The largest relative and absolute reductions in

  10. Projected Impact of Mexico's Sugar-Sweetened Beverage Tax Policy on Diabetes and Cardiovascular Disease: A Modeling Study.

    Science.gov (United States)

    Sánchez-Romero, Luz Maria; Penko, Joanne; Coxson, Pamela G; Fernández, Alicia; Mason, Antoinette; Moran, Andrew E; Ávila-Burgos, Leticia; Odden, Michelle; Barquera, Simón; Bibbins-Domingo, Kirsten

    2016-11-01

    Rates of diabetes in Mexico are among the highest worldwide. In 2014, Mexico instituted a nationwide tax on sugar-sweetened beverages (SSBs) in order to reduce the high level of SSB consumption, a preventable cause of diabetes and cardiovascular disease (CVD). We used an established computer simulation model of CVD and country-specific data on demographics, epidemiology, SSB consumption, and short-term changes in consumption following the SSB tax in order to project potential long-range health and economic impacts of SSB taxation in Mexico. We used the Cardiovascular Disease Policy Model-Mexico, a state transition model of Mexican adults aged 35-94 y, to project the potential future effects of reduced SSB intake on diabetes incidence, CVD events, direct diabetes healthcare costs, and mortality over 10 y. Model inputs included short-term changes in SSB consumption in response to taxation (price elasticity) and data from government and market research surveys and public healthcare institutions. Two main scenarios were modeled: a 10% reduction in SSB consumption (corresponding to the reduction observed after tax implementation) and a 20% reduction in SSB consumption (possible with increases in taxation levels and/or additional measures to curb consumption). Given uncertainty about the degree to which Mexicans will replace calories from SSBs with calories from other sources, we evaluated a range of values for calorie compensation. We projected that a 10% reduction in SSB consumption with 39% calorie compensation among Mexican adults would result in about 189,300 (95% uncertainty interval [UI] 155,400-218,100) fewer incident type 2 diabetes cases, 20,400 fewer incident strokes and myocardial infarctions, and 18,900 fewer deaths occurring from 2013 to 2022. This scenario predicts that the SSB tax could save Mexico 983 million international dollars (95% UI $769 million-$1,173 million). The largest relative and absolute reductions in diabetes and CVD events occurred in the

  11. Projected Impact of Mexico's Sugar-Sweetened Beverage Tax Policy on Diabetes and Cardiovascular Disease: A Modeling Study.

    Directory of Open Access Journals (Sweden)

    Luz Maria Sánchez-Romero

    2016-11-01

    Full Text Available Rates of diabetes in Mexico are among the highest worldwide. In 2014, Mexico instituted a nationwide tax on sugar-sweetened beverages (SSBs in order to reduce the high level of SSB consumption, a preventable cause of diabetes and cardiovascular disease (CVD. We used an established computer simulation model of CVD and country-specific data on demographics, epidemiology, SSB consumption, and short-term changes in consumption following the SSB tax in order to project potential long-range health and economic impacts of SSB taxation in Mexico.We used the Cardiovascular Disease Policy Model-Mexico, a state transition model of Mexican adults aged 35-94 y, to project the potential future effects of reduced SSB intake on diabetes incidence, CVD events, direct diabetes healthcare costs, and mortality over 10 y. Model inputs included short-term changes in SSB consumption in response to taxation (price elasticity and data from government and market research surveys and public healthcare institutions. Two main scenarios were modeled: a 10% reduction in SSB consumption (corresponding to the reduction observed after tax implementation and a 20% reduction in SSB consumption (possible with increases in taxation levels and/or additional measures to curb consumption. Given uncertainty about the degree to which Mexicans will replace calories from SSBs with calories from other sources, we evaluated a range of values for calorie compensation. We projected that a 10% reduction in SSB consumption with 39% calorie compensation among Mexican adults would result in about 189,300 (95% uncertainty interval [UI] 155,400-218,100 fewer incident type 2 diabetes cases, 20,400 fewer incident strokes and myocardial infarctions, and 18,900 fewer deaths occurring from 2013 to 2022. This scenario predicts that the SSB tax could save Mexico 983 million international dollars (95% UI $769 million-$1,173 million. The largest relative and absolute reductions in diabetes and CVD events

  12. A Policy Analysis on the Proactive Prevention of Chronic Disease: Learnings from the Initial Implementation of Integrated Measurement for Early Detection (MIDO

    Directory of Open Access Journals (Sweden)

    Roberto Tapia-Conyer

    2017-06-01

    Full Text Available Mexico, like many low- and middle-income countries (LMICs, faces an epidemic of chronic non-communicable diseases (NCDs, specifically diabetes, hypertension, obesity, and lipid disorders. Many people with these NCDs may not be aware that they have a disease, pointing to the need for broader screening programs. The traditional prevention policy in Mexico was based on screening with a paper-based risk factor questionnaire. However, this was used to screen patients already seeking healthcare services at facilities, and screening goals were set as a function of the number of questionnaires applied, not number of individuals screened. Due to this, Fundación Carlos Slim developed Medición Integrada para la Detección Oportuna (MIDOTM, or Integrated Measurement for Early Detection, an NCD screening and proactive prevention policy. This document is a policy analysis based on early learnings from the initial implementation of MIDO in eight primary healthcare centers in two central Mexican states. MIDO was found to expand screening programs beyond clinic walls, systematize community screening strategies, emphasize the detection of pre-disease phases, incorporate lifestyle counseling, and propose screening goals based on population targets. In collaboration with the Mexican Ministry of Health, MIDO has successfully screened over 500 000 individuals—about 40% of whom would not have been screened under previous policies. Of these more than 500 000 screened individuals, 13.4% had pre-diabetes (fasting glucose between 100 and 125 mg/dL, and 5.8% had undiagnosed diabetes (defined as fasting glucose above 126 mg/dL or random glucose above 200 mg/dL. However, there is still room for improvement in linking positive results from screening with disease confirmation and with patient incorporation into disease management. The experience of implementing MIDO in Mexico suggests that primary and secondary prevention programs in other parts of the world should

  13. An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

    Directory of Open Access Journals (Sweden)

    Chan Brian T

    2011-10-01

    Full Text Available Abstract Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv effective strategies for HIV/AIDS care in other settings should be

  14. Bridging the gap between science and public health: taking advantage of tobacco control experience in Brazil to inform policies to counter risk factors for non-communicable diseases.

    Science.gov (United States)

    da Costa e Silva, Vera Luiza; Pantani, Daniela; Andreis, Mônica; Sparks, Robert; Pinsky, Ilana

    2013-08-01

    The historical and economic involvement of Brazil with tobacco, as a major producer and exporter, was considered an insurmountable obstacle to controlling the consumption of this product. Nevertheless, the country was able to achieve significant progress in implementing public policies and to take an international leadership position, meeting its constitutional commitment to protect public health. In this paper we provide a brief historical overview of tobacco control (TC) in Brazil, and analyse the factors that contributed to the major decline in tobacco consumption in the country over the last 20 years, as well as identify the challenges that had to be overcome and those still at play. The Brazilian case demonstrates how cross-sectorial collaborations among health-related groups that capitalize on their respective strengths and capacities can help to influence public policy and overcome industry and population resistance to change. Although Brazil still lags behind some leading TC nations, the country has an extensive collaborative TC network that was built over time and continues to focus upon this issue. The tobacco experience can serve as an example for other fields, such as alcoholic beverages, of how networks can be formed to influence the legislative process and the development of public policies. Brazilian statistics show that problems related to non-communicable diseases are a pressing public health issue, and advocacy groups, policy-makers and government departments can benefit from tobacco control history to fashion their own strategies. © 2013 Society for the Study of Addiction.

  15. Climate change and vector-borne diseases: what are the implications for public health research and policy?

    OpenAIRE

    Campbell-Lendrum, Diarmid; Manga, Lucien; Bagayoko, Magaran; Sommerfeld, Johannes

    2015-01-01

    Vector-borne diseases continue to contribute significantly to the global burden of disease, and cause epidemics that disrupt health security and cause wider socioeconomic impacts around the world. All are sensitive in different ways to weather and climate conditions, so that the ongoing trends of increasing temperature and more variable weather threaten to undermine recent global progress against these diseases. Here, we review the current state of the global public health effort to address t...

  16. Comparing different policy scenarios to reduce the consumption of ultra-processed foods in UK: impact on cardiovascular disease mortality using a modelling approach.

    Science.gov (United States)

    Moreira, Patricia V L; Baraldi, Larissa Galastri; Moubarac, Jean-Claude; Monteiro, Carlos Augusto; Newton, Alex; Capewell, Simon; O'Flaherty, Martin

    2015-01-01

    The global burden of non-communicable diseases partly reflects growing exposure to ultra-processed food products (UPPs). These heavily marketed UPPs are cheap and convenient for consumers and profitable for manufacturers, but contain high levels of salt, fat and sugars. This study aimed to explore the potential mortality reduction associated with future policies for substantially reducing ultra-processed food intake in the UK. We obtained data from the UK Living Cost and Food Survey and from the National Diet and Nutrition Survey. By the NOVA food typology, all food items were categorized into three groups according to the extent of food processing: Group 1 describes unprocessed/minimally processed foods. Group 2 comprises processed culinary ingredients. Group 3 includes all processed or ultra-processed products. Using UK nutrient conversion tables, we estimated the energy and nutrient profile of each food group. We then used the IMPACT Food Policy model to estimate reductions in cardiovascular mortality from improved nutrient intakes reflecting shifts from processed or ultra-processed to unprocessed/minimally processed foods. We then conducted probabilistic sensitivity analyses using Monte Carlo simulation. Approximately 175,000 cardiovascular disease (CVD) deaths might be expected in 2030 if current mortality patterns persist. However, halving the intake of Group 3 (processed) foods could result in approximately 22,055 fewer CVD related deaths in 2030 (minimum estimate 10,705, maximum estimate 34,625). An ideal scenario in which salt and fat intakes are reduced to the low levels observed in Group 1 and 2 could lead to approximately 14,235 (minimum estimate 6,680, maximum estimate 22,525) fewer coronary deaths and approximately 7,820 (minimum estimate 4,025, maximum estimate 12,100) fewer stroke deaths, comprising almost 13% mortality reduction. This study shows a substantial potential for reducing the cardiovascular disease burden through a healthier food system

  17. Collaborative Approaches and Policy Opportunities for Accelerated Progress toward Effective Disease Prevention, Care, and Control: Using the Case of Poverty Diseases to Explore Universal Access to Affordable Health Care

    Directory of Open Access Journals (Sweden)

    Samia Laokri

    2017-08-01

    Full Text Available BackgroundThere is a massive global momentum to progress toward the sustainable development and universal health coverage goals. However, effective policies to health-care coverage can only emerge through high-quality services delivered to empowered care users by means of strong local health systems and a translational standpoint. Health policies aimed at removing user fees for a defined health-care package may fail at reaching desired results if not applied with system thinking.MethodSecondary data analysis of two country-based cost-of-illness studies was performed to gain knowledge in informed decision-making toward enhanced access to care in the context of resource-constraint settings. A scoping review was performed to map relevant experiences and evidence underpinning the defined research area, the economic burden of illness.FindingsOriginal studies reflected on catastrophic costs to patients because of care services use and related policy gaps. Poverty diseases such as tuberculosis (TB may constitute prime examples to assess the extent of effective high-priority health-care coverage. Our findings suggest that a share of the economic burden of illness can be attributed to implementation failures of health programs and supply-side features, which may highly impair attainment of the global stated goals. We attempted to define and discuss a knowledge development framework for effective policy-making and foster system levers for integrated care.DiscussionBottlenecks to effective policy persist and rely on interrelated patterns of health-care coverage. Health system performance and policy responsiveness have to do with collaborative work among all health stakeholders. Public–private mix strategies may play a role in lowering the economic burden of disease and solving some policy gaps. We reviewed possible added value and pitfalls of collaborative approaches to enhance dynamic local knowledge development and realize integration with the various

  18. Collaborative Approaches and Policy Opportunities for Accelerated Progress toward Effective Disease Prevention, Care, and Control: Using the Case of Poverty Diseases to Explore Universal Access to Affordable Health Care.

    Science.gov (United States)

    Laokri, Samia

    2017-01-01

    There is a massive global momentum to progress toward the sustainable development and universal health coverage goals. However, effective policies to health-care coverage can only emerge through high-quality services delivered to empowered care users by means of strong local health systems and a translational standpoint. Health policies aimed at removing user fees for a defined health-care package may fail at reaching desired results if not applied with system thinking. Secondary data analysis of two country-based cost-of-illness studies was performed to gain knowledge in informed decision-making toward enhanced access to care in the context of resource-constraint settings. A scoping review was performed to map relevant experiences and evidence underpinning the defined research area, the economic burden of illness. Original studies reflected on catastrophic costs to patients because of care services use and related policy gaps. Poverty diseases such as tuberculosis (TB) may constitute prime examples to assess the extent of effective high-priority health-care coverage. Our findings suggest that a share of the economic burden of illness can be attributed to implementation failures of health programs and supply-side features, which may highly impair attainment of the global stated goals. We attempted to define and discuss a knowledge development framework for effective policy-making and foster system levers for integrated care. Bottlenecks to effective policy persist and rely on interrelated patterns of health-care coverage. Health system performance and policy responsiveness have to do with collaborative work among all health stakeholders. Public-private mix strategies may play a role in lowering the economic burden of disease and solving some policy gaps. We reviewed possible added value and pitfalls of collaborative approaches to enhance dynamic local knowledge development and realize integration with the various health-care silos. Despite a large political

  19. To notify or not to notify : Decision aid for policy makers on whether to make an infectious disease mandatorily notifiable

    NARCIS (Netherlands)

    Bijkerk, Paul; Fanoy, E. B.; Kardamanidis, K.; van der Plas, S. M.; te Wierik, M. J.; Kretzschmar, M. E.; Haringhuizen, G. B.; van Vliet, H. J.; van der Sande, M. A.

    2015-01-01

    Mandatory notification can be a useful tool to support infectious disease prevention and control. Guidelines are needed to help policymakers decide whether mandatory notification of an infectious disease is appropriate. We developed a decision aid, based on a range of criteria previously used in the

  20. How do high cost-sharing policies for physician care affect total care costs among people with chronic disease?

    Science.gov (United States)

    Xin, Haichang; Harman, Jeffrey S; Yang, Zhou

    2014-01-01

    This study examines whether high cost-sharing in physician care is associated with a differential impact on total care costs by health status. Total care includes physician care, emergency room (ER) visits and inpatient care. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies are a good strategy for controlling costs among chronically ill patients. This study used the 2007 Medical Expenditure Panel Survey data with a cross-sectional study design. Difference in difference (DID), instrumental variable technique, two-part model, and bootstrap technique were employed to analyze cost data. Chronically ill individuals' probability of reducing any overall care costs was significantly less than healthier individuals (beta = 2.18, p = 0.04), while the integrated DID estimator from split results indicated that going from low cost-sharing to high cost-sharing significantly reduced costs by $12,853.23 more for sick people than for healthy people (95% CI: -$17,582.86, -$8,123.60). This greater cost reduction in total care among sick people likely resulted from greater cost reduction in physician care, and may have come at the expense of jeopardizing health outcomes by depriving patients of needed care. Thus, these policies would be inappropriate in the short run, and unlikely in the long run to control health plans costs among chronically ill individuals. A generous benefit design with low cost-sharing policies in physician care or primary care is recommended for both health plans and chronically ill individuals, to save costs and protect these enrollees' health status.

  1. Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease.

    Science.gov (United States)

    Wolfenden, Luke; Nathan, Nicole K; Sutherland, Rachel; Yoong, Sze Lin; Hodder, Rebecca K; Wyse, Rebecca J; Delaney, Tessa; Grady, Alice; Fielding, Alison; Tzelepis, Flora; Clinton-McHarg, Tara; Parmenter, Benjamin; Butler, Peter; Wiggers, John; Bauman, Adrian; Milat, Andrew; Booth, Debbie; Williams, Christopher M

    2017-11-29

    A number of school-based policies or practices have been found to be effective in improving child diet and physical activity, and preventing excessive weight gain, tobacco or harmful alcohol use. Schools, however, frequently fail to implement such evidence-based interventions. The primary aims of the review are to examine the effectiveness of strategies aiming to improve the implementation of school-based policies, programs or practices to address child diet, physical activity, obesity, tobacco or alcohol use.Secondary objectives of the review are to: Examine the effectiveness of implementation strategies on health behaviour (e.g. fruit and vegetable consumption) and anthropometric outcomes (e.g. BMI, weight); describe the impact of such strategies on the knowledge, skills or attitudes of school staff involved in implementing health-promoting policies, programs or practices; describe the cost or cost-effectiveness of such strategies; and describe any unintended adverse effects of strategies on schools, school staff or children. All electronic databases were searched on 16 July 2017 for studies published up to 31 August 2016. We searched the following electronic databases: Cochrane Library including the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; Embase Classic and Embase; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); Dissertations and Theses; and SCOPUS. We screened reference lists of all included trials for citations of other potentially relevant trials. We handsearched all publications between 2011 and 2016 in two specialty journals (Implementation Science and Journal of Translational Behavioral Medicine) and conducted searches of the WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/) as well as the US National Institutes of Health registry (https://clinicaltrials.gov). We

  2. The effects of policy actions to improve population dietary patterns and prevent diet-related non-communicable diseases: scoping review.

    Science.gov (United States)

    Hyseni, L; Atkinson, M; Bromley, H; Orton, L; Lloyd-Williams, F; McGill, R; Capewell, S

    2017-06-01

    Poor diet generates a bigger non-communicable disease (NCD) burden than tobacco, alcohol and physical inactivity combined. We reviewed the potential effectiveness of policy actions to improve healthy food consumption and thus prevent NCDs. This scoping review focused on systematic and non-systematic reviews and categorised data using a seven-part framework: price, promotion, provision, composition, labelling, supply chain, trade/investment and multi-component interventions. We screened 1805 candidate publications and included 58 systematic and non-systematic reviews. Multi-component and price interventions appeared consistently powerful in improving healthy eating. Reformulation to reduce industrial trans fat intake also seemed very effective. Evidence on food supply chain, trade and investment studies was limited and merits further research. Food labelling and restrictions on provision or marketing of unhealthy foods were generally less effective with uncertain sustainability. Increasingly strong evidence is highlighting potentially powerful policies to improve diet and thus prevent NCDs, notably multi-component interventions, taxes, subsidies, elimination and perhaps trade agreements. The implications for policy makers are becoming clearer.

  3. A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention.

    Science.gov (United States)

    Sacks, G; Swinburn, B; Kraak, V; Downs, S; Walker, C; Barquera, S; Friel, S; Hawkes, C; Kelly, B; Kumanyika, S; L'Abbé, M; Lee, A; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Neal, B; Rayner, M; Sanders, D; Snowdon, W; Vandevijvere, S

    2013-10-01

    Private-sector organizations play a critical role in shaping the food environments of individuals and populations. However, there is currently very limited independent monitoring of private-sector actions related to food environments. This paper reviews previous efforts to monitor the private sector in this area, and outlines a proposed approach to monitor private-sector policies and practices related to food environments, and their influence on obesity and non-communicable disease (NCD) prevention. A step-wise approach to data collection is recommended, in which the first ('minimal') step is the collation of publicly available food and nutrition-related policies of selected private-sector organizations. The second ('expanded') step assesses the nutritional composition of each organization's products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products. The third ('optimal') step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy. The proposed approach will be further developed and piloted in countries of varying size and income levels. There is potential for this approach to enable national and international benchmarking of private-sector policies and practices, and to inform efforts to hold the private sector to account for their role in obesity and NCD prevention. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

  4. Use and effectiveness of behavioural economics in interventions for lifestyle risk factors of non-communicable diseases: a systematic review with policy implications.

    Science.gov (United States)

    Blaga, Oana M; Vasilescu, Livia; Chereches, Razvan M

    2018-03-01

    There is limited evidence on what behavioural economics strategies are effective and can be used to inform non-communicable diseases (NCDs) public health policies designed to reduce overeating, excessive drinking, smoking, and physical inactivity. The aim of the review is to examine the evidence on the use and effectiveness of behavioural economics insights on reducing NCDs lifestyle risk factors. Medline, Embase, PsycINFO, and EconLit were searched for studies published between January 2002 and July 2016 and reporting empirical, non-pharmacological, interventional research focusing on reducing at least one NCDs lifestyle risk factor by employing a behavioural economics perspective. We included 117 studies in the review; 67 studies had a low risk of bias and were classified as strong or very strong, 37 were moderate, and 13 were weak. We grouped studies by NCDs risk factors and conducted a narrative synthesis. The most frequent behavioural economics precepts used were incentives, framing, and choice architecture. We found inconclusive evidence regarding the success of behavioural economics strategies to reduce alcohol consumption, but we identified several strategies with policy-level implications which could be used to reduce smoking, improve nutrition, and increase physical activity. Most studies targeting tobacco consumption, physical activity levels, and eating behaviours from a behavioural economics perspective had promising results with potential impact on NCDs health policies. We recommend future studies to be implemented in real-life settings and on large samples from diverse populations.

  5. Climate change and vector-borne diseases: what are the implications for public health research and policy?

    Science.gov (United States)

    Campbell-Lendrum, Diarmid; Manga, Lucien; Bagayoko, Magaran; Sommerfeld, Johannes

    2015-01-01

    Vector-borne diseases continue to contribute significantly to the global burden of disease, and cause epidemics that disrupt health security and cause wider socioeconomic impacts around the world. All are sensitive in different ways to weather and climate conditions, so that the ongoing trends of increasing temperature and more variable weather threaten to undermine recent global progress against these diseases. Here, we review the current state of the global public health effort to address this challenge, and outline related initiatives by the World Health Organization (WHO) and its partners. Much of the debate to date has centred on attribution of past changes in disease rates to climate change, and the use of scenario-based models to project future changes in risk for specific diseases. While these can give useful indications, the unavoidable uncertainty in such analyses, and contingency on other socioeconomic and public health determinants in the past or future, limit their utility as decision-support tools. For operational health agencies, the most pressing need is the strengthening of current disease control efforts to bring down current disease rates and manage short-term climate risks, which will, in turn, increase resilience to long-term climate change. The WHO and partner agencies are working through a range of programmes to (i) ensure political support and financial investment in preventive and curative interventions to bring down current disease burdens; (ii) promote a comprehensive approach to climate risk management; (iii) support applied research, through definition of global and regional research agendas, and targeted research initiatives on priority diseases and population groups. PMID:25688013

  6. Climate change and vector-borne diseases: what are the implications for public health research and policy?

    Science.gov (United States)

    Campbell-Lendrum, Diarmid; Manga, Lucien; Bagayoko, Magaran; Sommerfeld, Johannes

    2015-04-05

    Vector-borne diseases continue to contribute significantly to the global burden of disease, and cause epidemics that disrupt health security and cause wider socioeconomic impacts around the world. All are sensitive in different ways to weather and climate conditions, so that the ongoing trends of increasing temperature and more variable weather threaten to undermine recent global progress against these diseases. Here, we review the current state of the global public health effort to address this challenge, and outline related initiatives by the World Health Organization (WHO) and its partners. Much of the debate to date has centred on attribution of past changes in disease rates to climate change, and the use of scenario-based models to project future changes in risk for specific diseases. While these can give useful indications, the unavoidable uncertainty in such analyses, and contingency on other socioeconomic and public health determinants in the past or future, limit their utility as decision-support tools. For operational health agencies, the most pressing need is the strengthening of current disease control efforts to bring down current disease rates and manage short-term climate risks, which will, in turn, increase resilience to long-term climate change. The WHO and partner agencies are working through a range of programmes to (i) ensure political support and financial investment in preventive and curative interventions to bring down current disease burdens; (ii) promote a comprehensive approach to climate risk management; (iii) support applied research, through definition of global and regional research agendas, and targeted research initiatives on priority diseases and population groups. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  7. Spatial Patterns of Ischemic Heart Disease in Shenzhen, China: A Bayesian Multi-Disease Modelling Approach to Inform Health Planning Policies

    Directory of Open Access Journals (Sweden)

    Qingyun Du

    2016-04-01

    Full Text Available Incorporating the information of hypertension, this paper applies Bayesian multi-disease analysis to model the spatial patterns of Ischemic Heart Disease (IHD risks. Patterns of harmful alcohol intake (HAI and overweight/obesity are also modelled as they are common risk factors contributing to both IHD and hypertension. The hospitalization data of IHD and hypertension in 2012 were analyzed with three Bayesian multi-disease models at the sub-district level of Shenzhen. Results revealed that the IHD high-risk cluster shifted slightly north-eastward compared with the IHD Standardized Hospitalization Ratio (SHR. Spatial variations of overweight/obesity and HAI were found to contribute most to the IHD patterns. Identified patterns of IHD risk would benefit IHD integrated prevention. Spatial patterns of overweight/obesity and HAI could supplement the current disease surveillance system by providing information about small-area level risk factors, and thus benefit integrated prevention of related chronic diseases. Middle southern Shenzhen, where high risk of IHD, overweight/obesity, and HAI are present, should be prioritized for interventions, including alcohol control, innovative healthy diet toolkit distribution, insurance system revision, and community-based chronic disease intervention. Related health resource planning is also suggested to focus on these areas first.

  8. Spatial Patterns of Ischemic Heart Disease in Shenzhen, China: A Bayesian Multi-Disease Modelling Approach to Inform Health Planning Policies.

    Science.gov (United States)

    Du, Qingyun; Zhang, Mingxiao; Li, Yayan; Luan, Hui; Liang, Shi; Ren, Fu

    2016-04-20

    Incorporating the information of hypertension, this paper applies Bayesian multi-disease analysis to model the spatial patterns of Ischemic Heart Disease (IHD) risks. Patterns of harmful alcohol intake (HAI) and overweight/obesity are also modelled as they are common risk factors contributing to both IHD and hypertension. The hospitalization data of IHD and hypertension in 2012 were analyzed with three Bayesian multi-disease models at the sub-district level of Shenzhen. Results revealed that the IHD high-risk cluster shifted slightly north-eastward compared with the IHD Standardized Hospitalization Ratio (SHR). Spatial variations of overweight/obesity and HAI were found to contribute most to the IHD patterns. Identified patterns of IHD risk would benefit IHD integrated prevention. Spatial patterns of overweight/obesity and HAI could supplement the current disease surveillance system by providing information about small-area level risk factors, and thus benefit integrated prevention of related chronic diseases. Middle southern Shenzhen, where high risk of IHD, overweight/obesity, and HAI are present, should be prioritized for interventions, including alcohol control, innovative healthy diet toolkit distribution, insurance system revision, and community-based chronic disease intervention. Related health resource planning is also suggested to focus on these areas first.

  9. Micronutrient malnutrition, obesity, and chronic disease in countries undergoing the nutrition transition: potential links and program/policy implications

    OpenAIRE

    Eckhardt, Cara L.

    2006-01-01

    This paper discusses the potential long-term effects of micronutrient malnutrition in early childhood on obesity and related disease outcomes. The links between early micronutrient malnutrition, stunting, and subsequent short adult stature — emerging risk factors for obesity and associated chronic diseases—are reviewed. This paper also explores recent literature linking micronutrient malnutrition in adults to increased risk and severity of chronic disease. Finally, this paper discusses the pr...

  10. Challenges Facing Successful Scaling Up of Effective Screening for Cardiovascular Disease by Community Health Workers in Mexico and South Africa: Policy Implications.

    Science.gov (United States)

    S, Abrahams-Gessel; Denman, C A; Ta, Gaziano; Ns, Levitt; T, Puoane

    The integration of community health workers (CHWs) into primary and secondary prevention functions in health programs and services delivery in Mexico and South Africa has been demonstrated to be effective. Task-sharing related to adherence and treatment, from nurses to CHWs, has also been effectively demonstrated in these areas. HIV/AIDS and TB programs in South Africa have seen similar successes in task-sharing with CHWs in the areas of screening for risk and adherence to treatment. In the area of non-communicable diseases (NCDs), there is a policy commitment to integrating CHWs into primary health care programs at public health facilities in both Mexico and South Africa in the areas of reproductive health and infant health. Yet current programs utilizing CHWs are not integrated into existing primary health care services in a comprehensive manner for primary and secondary prevention of NCDs. In a recently completed study, CHWs were trained to perform the basic diagnostic function of primary screening to assess the risk of suffering a CVD-related event in the community using a non-laboratory risk assessment tool and referring persons at moderate to high risk to local government clinics, for further assessment and management by a nurse or physician. In this paper we compare the experience with this CVD screening study to successful programs in vaccination, reproductive health, HIV/AIDS, and TB specifically to identify the barriers we identified as limitations to replicating these programs in the area of CVD diagnosis and management. We review barriers impacting the effective translation of policy into practice, including scale up issues; training and certification issues; integrating CHW to existing primary care teams and health system; funding and resource gaps. Finally, we suggest policy recommendations to replicate the demonstrated success of programs utilizing task-sharing with CHWs in infectious diseases and reproductive health, to integrated programs in NCD.

  11. Diversity and transboundary mobility of serotype O foot-and-mouth disease virus in East Africa: Implications for vaccination policies

    DEFF Research Database (Denmark)

    Balinda, Sheila; Sangula, Abraham; Heller, Rasmus

    2010-01-01

    Foot-and-mouth disease (FMD) virus serotype O has been responsible for most reported outbreaks of the disease in East Africa. A sustained campaign for the past 40 years to control FMD mainly by vaccination, combined with quarantine and zoosanitary measures has been undertaken with limited success....... We investigated the genetic relationships among serotype O strains in eastern Africa using complete VP1 coding region sequences obtained from 46 FMD virus isolates collected in Kenya in the years 1964–2008 and 8 Ugandan isolates collected between 1999 and 2006. In addition, 21 selected FMDV sequences...... the dominant evolutionary force. Cross-border disease transmission within the region has been suggested with probable incursions of topotypes EA-3 and EA-4 into Kenya and Uganda from neighboring Ethiopia and Sudan. We conclude that the vaccines have probably been effective in controlling EA-1, but less so...

  12. Moving Beyond Too Little, Too Late: Managing Emerging Infectious Diseases in Wild Populations Requires International Policy and Partnerships

    Science.gov (United States)

    Jamie Voyles; A. Marm Kilpatrick; James P. Collins; Matthew C. Fisher; Winifred F. Frick; Hamish McCallum; Craig K. R. Willis; David S. Blehert; Kris A. Murray; Robert Puschendorf; Erica Bree Rosenblum; Benjamin M. Bolker; Tina L. Cheng; Kate E. Langwig; Daniel L. Lindner; Mary Toothman; Mark Q. Wilber; Cheryl J. Briggs

    2015-01-01

    Emerging infectious diseases (EIDs) are on the rise due to multiple factors, including human facilitated movement of pathogens, broad-scale landscape changes, and perturbations to ecological systems (Jones et al. 2008; Fisher et al. 2012). Epidemics in wildlife are problematic because they can lead to pathogen spillover to new host organisms, erode biodiversity and...

  13. An Official American Thoracic Society Public Policy Statement : Novel Risk Factors and the Global Burden of Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Eisner, Mark D.; Anthonisen, Nicholas; Coultas, David; Kuenzli, Nino; Perez-Padilla, Rogelio; Postma, Dirkje; Romieu, Isabelle; Silverman, Edwin K.; Balmes, John R.

    2010-01-01

    Rationale: Although cigarette smoking is the most important cause of chronic obstructive pulmonary disease (COPD), a substantial proportion of COPD cases cannot be explained by smoking alone. Objectives: To evaluate the risk factors for COPD besides personal cigarette smoking. Methods: We

  14. Towards global benchmarking of food environments and policies to reduce obesity and diet-related non-communicable diseases: design and methods for nation-wide surveys.

    Science.gov (United States)

    Vandevijvere, Stefanie; Swinburn, Boyd

    2014-05-15

    Unhealthy diets are heavily driven by unhealthy food environments. The International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) has been established to reduce obesity, NCDs and their related inequalities globally. This paper describes the design and methods of the first-ever, comprehensive national survey on the healthiness of food environments and the public and private sector policies influencing them, as a first step towards global monitoring of food environments and policies. A package of 11 substudies has been identified: (1) food composition, labelling and promotion on food packages; (2) food prices, shelf space and placement of foods in different outlets (mainly supermarkets); (3) food provision in schools/early childhood education (ECE) services and outdoor food promotion around schools/ECE services; (4) density of and proximity to food outlets in communities; food promotion to children via (5) television, (6) magazines, (7) sport club sponsorships, and (8) internet and social media; (9) analysis of the impact of trade and investment agreements on food environments; (10) government policies and actions; and (11) private sector actions and practices. For the substudies on food prices, provision, promotion and retail, 'environmental equity' indicators have been developed to check progress towards reducing diet-related health inequalities. Indicators for these modules will be assessed by tertiles of area deprivation index or school deciles. International 'best practice benchmarks' will be identified, against which to compare progress of countries on improving the healthiness of their food environments and policies. This research is highly original due to the very 'upstream' approach being taken and its direct policy relevance. The detailed protocols will be offered to and adapted for countries of varying size and income in order to establish INFORMAS globally as a new monitoring initiative

  15. The impact of alcohol policies on alcohol-attributable diseases in Taiwan-A population-based study.

    Science.gov (United States)

    Ying, Yung-Hsiang; Weng, Yung-Ching; Chang, Koyin

    2017-11-01

    Taiwan has some of the strictest alcohol-related driving laws in the world. However, its laws continue to be toughened to reduce the ever-increasing social cost of alcohol-related harm. This study assumes that alcohol-related driving laws show a spillover effect such that behavioral changes originally meant to apply behind the wheel come to affect drinking behavior in other contexts. The effects of alcohol driving laws and taxes on alcohol-related morbidity are assessed; incidence rates of alcohol-attributable diseases (AAD) serve as our measure of morbidity. Monthly incidence rates of alcohol-attributable diseases were calculated with data from the National Health Insurance Research Database (NHIRD) from 1996 to 2011. These rates were then submitted to intervention analyses using Seasonal Autoregressive Integrated Moving Average models (ARIMA) with multivariate adaptive regression splines (MARS). ARIMA is well-suited to time series analysis while MARS helps fit the regression model to the cubic curvature form of the irregular AAD incidence rates of hospitalization (AIRH). Alcoholic liver disease, alcohol abuse and dependence syndrome, and alcohol psychoses were the most common AADs in Taiwan. Compared to women, men had a higher incidence of AADs and their AIRH were more responsive to changes in the laws governing permissible blood alcohol. The adoption of tougher blood alcohol content (BAC) laws had significant effects on AADs, controlling for overall consumption of alcoholic beverages. Blood alcohol level laws and alcohol taxation effectively reduced alcohol-attributable morbidities with the exception of alcohol dependence and abuse, a disease to which middle-aged, lower income people are particularly susceptible. Attention should be focused on this cohort to protect this vulnerable population. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Projected Impact of Mexico?s Sugar-Sweetened Beverage Tax Policy on Diabetes and Cardiovascular Disease: A Modeling Study

    OpenAIRE

    S?nchez-Romero, Luz Maria; Penko, Joanne; Coxson, Pamela G.; Fern?ndez, Alicia; Mason, Antoinette; Moran, Andrew E.; ?vila-Burgos, Leticia; Odden, Michelle; Barquera, Sim?n; Bibbins-Domingo, Kirsten

    2016-01-01

    Background Rates of diabetes in Mexico are among the highest worldwide. In 2014, Mexico instituted a nationwide tax on sugar-sweetened beverages (SSBs) in order to reduce the high level of SSB consumption, a preventable cause of diabetes and cardiovascular disease (CVD). We used an established computer simulation model of CVD and country-specific data on demographics, epidemiology, SSB consumption, and short-term changes in consumption following the SSB tax in order to project potential long-...

  17. Managing marine mollusc diseases in the context of regional and international commerce: policy issues and emerging concerns

    Science.gov (United States)

    Carnegie, Ryan B.; Arzul, Isabelle; Bushek, David

    2016-01-01

    Marine mollusc production contributes to food and economic security worldwide and provides valuable ecological services, yet diseases threaten these industries and wild populations. Although the infrastructure for mollusc aquaculture health management is well characterized, its foundations are not without flaws. Use of notifiable pathogen lists can leave blind spots with regard to detection of unlisted and emerging pathogens. Increased reliance on molecular tools has come without similar attention to diagnostic validation, raising questions about assay performance, and has been accompanied by a reduced emphasis on microscopic diagnostic expertise that could weaken pathogen detection capabilities. Persistent questions concerning pathogen biology and ecology promote regulatory paralysis that impedes trade and which could weaken biosecurity by driving commerce to surreptitious channels. Solutions that might be pursued to improve shellfish aquaculture health management include the establishment of more broad-based surveillance programmes, wider training and use of general methods like histopathology to ensure alertness to emerging diseases, an increased focus on assay assessment and validation as fundamental to assay development, investment in basic research, and application of risk analyses to improve regulation. A continual sharpening of diagnostic tools and approaches and deepening of scientific knowledge is necessary to manage diseases and promote sustainable molluscan shellfish industries. PMID:26880834

  18. Promoting Policy, Systems, and Environment Change to Prevent Chronic Disease: Lessons Learned From the King County Communities Putting Prevention to Work Initiative.

    Science.gov (United States)

    Cheadle, Allen; Cromp, DeAnn; Krieger, James W; Chan, Nadine; McNees, Molly; Ross-Viles, Sarah; Kellogg, Ryan; Rahimian, Afsaneh; MacDougall, Erin

    2016-01-01

    Initiatives that convene community stakeholders to implement policy, systems, environment, and infrastructure (PSEI) change have become a standard approach for promoting community health. To assess the PSEI changes brought about by the King County, Washington, Communities Putting Prevention to Work initiative and describe how initiative structures and processes contributed to making changes. The impact evaluation used a logic model design, linking PSEI changes to longer-term behavioral impacts in healthy eating active living and tobacco use and exposure. Qualitative methods, including stakeholder interviews and surveys, were used to identify initiative success factors. Communities Putting Prevention to Work activities occurred throughout King County, with a focus on 7 low-income communities in South Seattle/King County. The focus communities had a combined population of 652 000, or 35% of the county total, with lower incomes and higher rates of physical inactivity, tobacco use, poor diet, and chronic disease. Twenty-four PSEI strategies were pursued by organizations in sectors including schools, local governments, and community organizations, supported by the public health department. There were 17 healthy eating active living strategies (eg, enhancements to school menus, city planning policies) and 7 tobacco strategies (eg, smoke-free policies in schools, housing, and hospitals). PSEI changes made and numbers of residents reached. Twenty-two of the 24 strategies achieved significant progress toward implementing PSEI changes. The most common success factor was a "dyad" consisting of a dedicated technical assistance provider-either an outside consultant or public health department staff-working closely with a champion from the participating organizations to bring about PSEI changes. An initiative structure that creates and supports external consultant/internal organizational champion dyads in key community sectors offers a promising approach that may be adopted by

  19. The role of urban food policy in preventing diet-related non-communicable diseases in Cape Town and New York.

    Science.gov (United States)

    Libman, K; Freudenberg, N; Sanders, D; Puoane, T; Tsolekile, L

    2015-04-01

    Cities are important settings for production and prevention of non-communicable diseases. This article proposes a conceptual framework for identification of opportunities to prevent diet-related non-communicable diseases in cities. It compares two cities, Cape Town in South Africa and New York City in the United States, to illustrate municipal, regional, national and global influences in three policy domains that influence NCDs: product formulation, shaping retail environments and institutional food practices, domains in which each city has taken action. Comparative case study. Critical analysis of selected published studies and government and non-governmental reports on food policies and systems in Cape Town and New York City. While Cape Town and New York City differ in governance, history and culture, both have food systems that make unhealthy food more available in low-income than higher income neighborhoods; cope with food environments in which unhealthy food is increasingly ubiquitous; and have political economies dominated by business and financial sectors. New York City has more authority and resources to take on local influences on food environments but neither city has made progress in addressing deeper social determinants of diet-related NCDs including income inequality, child poverty and the disproportionate political influence of wealthy elites. Through their intimate connections with the daily lives of their residents, municipal governments have the potential to shape environments that promote health. Identifying the specific opportunities to prevent diet-related NCDs in a particular city requires intersectoral and multilevel analyses of the full range of influences on food environments. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Advance price or purchase commitments to create markets for treatments for diseases of poverty: lessons from three policies.

    Science.gov (United States)

    Towse, Adrian; Kettler, Hannah

    2005-01-01

    New drugs and vaccines are needed for tackling diseases of poverty in low- and middle-income countries. The lack of effective demand or market for these products translates into insufficient investment being made in research and development to meet the need for them. Many have advocated cost-reducing (push) and market-enhancing (pull) incentives to tackle this problem. Advance price or purchase commitments (APPCs) funded by international agencies and governments offer one way forward. This paper looks at design issues for APPCs for drugs and vaccines for diseases of poverty drawing on experience and lessons from three case studies: the introduction of the meningitis C vaccine in the United Kingdom; the Orphan Drug Act (ODA) in the United States of America (US); and the newly legislated US Project BioShield for bioterrorist interventions. Our key conclusion is that that APPCs have the potential to be a powerful tool and should be tried. The correct structure and design may only be determined through the process of taking action to set one up. PMID:15868022

  1. Quality of care indicators in inflammatory bowel disease in a tertiary referral center with open access and objective assessment policies.

    Science.gov (United States)

    Gonczi, Lorant; Kurti, Zsuzsanna; Golovics, Petra Anna; Lovasz, Barbara Dorottya; Menyhart, Orsolya; Seres, Anna; Sumegi, Liza Dalma; Gal, Alexander; Ilias, Akos; Janos, Papp; Gecse, Krisztina Barbara; Bessisow, Talat; Afif, Waqqas; Bitton, Alain; Vegh, Zsuzsanna; Lakatos, Peter Laszlo

    2018-01-01

    In the management of inflammatory bowel diseases, there is considerable variation in quality of care. The aim of this study was to evaluate structural, access/process components and outcome quality indicators in our tertiary referral IBD center. In the first phase, structural/process components were assessed, followed by the second phase of formal evaluation of access and management on a set of consecutive IBD patients with and without active disease (248CD/125UC patients, median age 35/39 years). Structural/process components of our IBD center met the international recommendations. At or around the time of diagnosis usual procedures were full colonoscopy in all patients, with ileocolonoscopy/gastroscopy/CT/MRI in 81.8/45.5/66.1/49.6% of CD patients. A total of 86.7% of CD patients had any follow-up imaging evaluation or endoscopy. The median waiting time for non-emergency endoscopy/CT/MRI was 16/14/22 days. During the observational period patients with flares (CD/UC:50.6/54.6%) were seen by specialist at the IBD clinic within a median of 1day with same day laboratory assessment, abdominal US, CT scan/surgical consult and change in therapy if needed. Surgery and hospitalization rates were 20.1/1.4% and 17.3/3.2% of CD/UC patients. Our results highlight that structural components and processes applied in our center are in line with international recommendations, including an open clinic concept and fast track access to specialist consultation, endoscopy and imaging. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Bridging science and health policy in cardiovascular disease: focus on lipid management: A Report from a Session held during the 7th International Symposium on Multiple Risk Factors in Cardiovascular Diseases: Prevention and Intervention--Health Policy, in Venice, Italy, on 25 October, 2008.

    LENUS (Irish Health Repository)

    Atella, V

    2009-06-10

    In Europe, cardiovascular disease (CVD) represents the main cause of morbidity and mortality, costing countries euro 190 billion yearly (2006). CVD prevention remains unsatisfactory across Europe largely due to poor control of CVD risk factors (RFs), growing incidence of obesity and diabetes, and sedentary lifestyle\\/poor dietary habits. Hypercholesterolaemia is a proven CVD RF, and LDL-C lowering slows atherosclerotic progression and reduces major coronary events. Lipid-lowering therapy is cost-effective, and intensive treatment of high-risk patients further improves cost effectiveness. In Italy, models indicate that improved cholesterol management translates into potential yearly savings of euro 2.9-4 billion. Identifying and eliminating legislative and administrative barriers is essential to providing optimal lipid care to high-risk patients. Public health and government policy can influence clinical practice rapidly, and guideline endorsement via national health policy may reduce the CVD burden and change physician and patient behaviour. Action to reduce CVD burden should ideally include the integration of strategies to lower the incidence of major CV events, improvement in total CV risk estimation, database monitoring of CVD trends, and development of population educational initiatives on CVD prevention. Failure to bridge the gap between science and health policy, particularly in relation to lipid management, could result in missed opportunities to reverse the burgeoning epidemic of CVD in Europe.

  3. DISEASES

    DEFF Research Database (Denmark)

    Pletscher-Frankild, Sune; Pallejà, Albert; Tsafou, Kalliopi

    2015-01-01

    Text mining is a flexible technology that can be applied to numerous different tasks in biology and medicine. We present a system for extracting disease-gene associations from biomedical abstracts. The system consists of a highly efficient dictionary-based tagger for named entity recognition...... of human genes and diseases, which we combine with a scoring scheme that takes into account co-occurrences both within and between sentences. We show that this approach is able to extract half of all manually curated associations with a false positive rate of only 0.16%. Nonetheless, text mining should...... not stand alone, but be combined with other types of evidence. For this reason, we have developed the DISEASES resource, which integrates the results from text mining with manually curated disease-gene associations, cancer mutation data, and genome-wide association studies from existing databases...

  4. Geographic exposure risk of variant Creutzfeldt-Jakob disease in US blood donors: a risk-ranking model to evaluate alternative donor-deferral policies.

    Science.gov (United States)

    Yang, Hong; Huang, Yin; Gregori, Luisa; Asher, David M; Bui, Travis; Forshee, Richard A; Anderson, Steven A

    2017-04-01

    Variant Creutzfeldt-Jakob disease (vCJD) has been transmitted by blood transfusion (TTvCJD). The US Food and Drug Administration (FDA) recommends deferring blood donors who resided in or traveled to 30 European countries where they may have been exposed to bovine spongiform encephalopathy (BSE) through beef consumption. Those recommendations warrant re-evaluation, because new cases of BSE and vCJD have markedly abated. The FDA developed a risk-ranking model to calculate the geographic vCJD risk using country-specific case rates and person-years of exposure of US blood donors. We used the reported country vCJD case rates, when available, or imputed vCJD case rates from reported BSE and UK beef exports during the risk period. We estimated the risk reduction and donor loss should the deferral be restricted to a few high-risk countries. We also estimated additional risk reduction by leukocyte reduction (LR) of red blood cells (RBCs). The United Kingdom, Ireland, and France had the greatest vCJD risk, contributing approximately 95% of the total risk. The model estimated that deferring US donors who spent extended periods of time in these three countries, combined with currently voluntary LR (95% of RBC units), would reduce the vCJD risk by 89.3%, a reduction similar to that achieved under the current policy (89.8%). Limiting deferrals to exposure in these three countries would potentially allow donations from an additional 100,000 donors who are currently deferred. Our analysis suggests that a deferral option focusing on the three highest risk countries would achieve a level of blood safety similar to that achieved by the current policy. © 2016 AABB.

  5. Health benefits of reducing sugar-sweetened beverage intake in high risk populations of California: results from the cardiovascular disease (CVD policy model.

    Directory of Open Access Journals (Sweden)

    Tekeshe A Mekonnen

    Full Text Available Consumption of sugar-sweetened beverage (SSB has risen over the past two decades, with over 10 million Californians drinking one or more SSB per day. High SSB intake is associated with risk of type 2 diabetes, obesity, hypertension, and coronary heart disease (CHD. Reduction of SSB intake and the potential impact on health outcomes in California and among racial, ethnic, and low-income sub-groups has not been quantified.We projected the impact of reduced SSB consumption on health outcomes among all Californians and California subpopulations from 2013 to 2022. We used the CVD Policy Model - CA, an established computer simulation of diabetes and heart disease adapted to California. We modeled a reduction in SSB intake by 10-20% as has been projected to result from proposed penny-per-ounce excise tax on SSB and modeled varying effects of this reduction on health parameters including body mass index, blood pressure, and diabetes risk. We projected avoided cases of diabetes and CHD, and associated health care cost savings in 2012 US dollars.Over the next decade, a 10-20% SSB consumption reduction is projected to result in a 1.8-3.4% decline in the new cases of diabetes and an additional drop of 0.5-1% in incident CHD cases and 0.5-0.9% in total myocardial infarctions. The greatest reductions are expected in African Americans, Mexican Americans, and those with limited income regardless of race and ethnicity. This reduction in SSB consumption is projected to yield $320-620 million in medical cost savings associated with diabetes cases averted and an additional savings of $14-27 million in diabetes-related CHD costs avoided.A reduction of SSB consumption could yield substantial population health benefits and cost savings for California. In particular, racial, ethnic, and low-income subgroups of California could reap the greatest health benefits.

  6. Sustainability Policy and Environmental Policy

    OpenAIRE

    John C. V. Pezzey

    2001-01-01

    A theoretical, representative agent economy with a depletable resource stock, polluting emissions and productive capital is used to contrast environmental policy, which internalises externalised environmental values, with sustainability policy, which achieves some form of intergenerational equity. The obvious environmental policy comprises an emissions tax and a resource stock subsidy, each equal to the respective external cost or benefit. Sustainability policy comprises an incentive affectin...

  7. Privacy Policy

    Science.gov (United States)

    ... Home → NLM Privacy Policy URL of this page: https://medlineplus.gov/privacy.html NLM Privacy Policy To ... out of cookies in the most popular browsers, http://www.usa.gov/optout_instructions.shtml. Please note ...

  8. The policies

    International Nuclear Information System (INIS)

    Laruelle, Ph.; Snegaroff, Th.; Moreau, S.; Tellenne, C.; Brunel, S.

    2005-01-01

    Fourth chapter of the book on the geo-policy of the sustainable development, this chapter deal with the different and international policies concerned by the problem. The authors analyze the american energy attitude and policy, the economical equilibrium facing the environmental equilibrium for the european policy, the sanctified and sacrificed nature and the japanese attitude, India and China, the great fear of the 21 century and the sustainable development in Africa. (A.L.B.)

  9. Trade Policy

    OpenAIRE

    Murray Gibbs

    2007-01-01

    In an otherwise insightful and thoughtful article, Sebastian Pfotenhauer (Trade Policy Is Science Policy,” Issues, Fall 2013) might better have entitled his contribution “Trade Policy Needs to Be Reconciled with Science Policy.” The North American Free Trade Agreement (NAFTA) and the agreements administered by the World Trade Organization, particularly the General Agreement on Tariffs and Trade (GATT) and the Technical Barriers to Trade (TBT), were adopted to promote international trade and i...

  10. Parental educational level and cardiovascular disease risk factors in schoolchildren in large urban areas of Turkey: Directions for public health policy

    Directory of Open Access Journals (Sweden)

    Hayran Osman

    2005-02-01

    Full Text Available Abstract Background It is widely accepted that the development of atherosclerosis starts at an early age. However, there are very few studies evaluating the prevalence of the common clinical and behavioral cardiovascular disease (CVD risk factors among children, especially in developing countries. The aim of the present cross-sectional survey was to evaluate the distribution of blood lipid profile and various behavioral (i.e. dietary habits, physical activity status factors related to CVD risk and its relationships to paternal (PEL and maternal educational level (MEL among primary schoolchildren in Turkey. Methods In three major metropolises in Turkey (Istanbul, Ankara and Izmir, a random sample of 1044 children aged 12 and 13 years old was examined. ANOVA was applied to evaluate the tested hypothesis, after correcting for multiple comparisons (Tukey correction. Results After controlling for energy and fat intake, physical activity status and Body Mass Index (BMI, it was found that mostly PEL had a significant positive effect for most of the subgroups examined (Lower vs. Higher and Medium vs. Higher on TC and HDL-cholesterol and a negative effect on TC/HDL ratio for both genders. Furthermore, both boys and girls with higher PEL and MEL were found to have higher energy intake derived from fat and protein than their counterparts with Medium and Lower PEL and MEL, while the opposite was observed for the percentage of energy derived from carbohydrates. Conclusions Our study provides indications for a possible association between an adverse lipid profile, certain dietary patterns and Higher PEL and MEL among schoolchildren in Turkey. These findings underline the possible role of social status, indicated by the degree of education of both parents, in developing certain health behaviors and health indices among Turkish children and provide some guidance for Public Health Policy.

  11. Comparative Cost-Effectiveness of Conservative or Intensive Blood Pressure Treatment Guidelines in Adults Aged 35-74 Years: The Cardiovascular Disease Policy Model.

    Science.gov (United States)

    Moise, Nathalie; Huang, Chen; Rodgers, Anthony; Kohli-Lynch, Ciaran N; Tzong, Keane Y; Coxson, Pamela G; Bibbins-Domingo, Kirsten; Goldman, Lee; Moran, Andrew E

    2016-07-01

    The population health effect and cost-effectiveness of implementing intensive blood pressure goals in high-cardiovascular disease (CVD) risk adults have not been described. Using the CVD Policy Model, CVD events, treatment costs, quality-adjusted life years, and drug and monitoring costs were simulated over 2016 to 2026 for hypertensive patients aged 35 to 74 years. We projected the effectiveness and costs of hypertension treatment according to the 2003 Joint National Committee (JNC)-7 or 2014 JNC8 guidelines, and then for adults aged ≥50 years, we assessed the cost-effectiveness of adding an intensive goal of systolic blood pressure cost-effectiveness ratios cost-effective. JNC7 strategies treat more patients and are more costly to implement compared with JNC8 strategies. Adding intensive systolic blood pressure goals for high-risk patients prevents an estimated 43 000 and 35 000 annual CVD events incremental to JNC8 and JNC7, respectively. Intensive strategies save costs in men and are cost-effective in women compared with JNC8 alone. At a willingness-to-pay threshold of $50 000 per quality-adjusted life years gained, JNC8+intensive had the highest probability of cost-effectiveness in women (82%) and JNC7+intensive the highest probability of cost-effectiveness in men (100%). Assuming higher drug and monitoring costs, adding intensive goals for high-risk patients remained consistently cost-effective in men, but not always in women. Among patients aged 35 to 74 years, adding intensive blood pressure goals for high-risk groups to current national hypertension treatment guidelines prevents additional CVD deaths while saving costs provided that medication costs are controlled. © 2016 American Heart Association, Inc.

  12. Supporting the diffusion of healthy public policy in Canada: the Prevention Policies Directory.

    Science.gov (United States)

    Politis, Christopher E; Halligan, Michelle H; Keen, Deb; Kerner, Jon F

    2014-01-01

    Healthy public policy plays an essential role in a comprehensive public health approach to preventing cancer and chronic disease. Public policies spread through the 'policy diffusion' process, enabling governments to learn from another's enacted policy solutions. The Prevention Policies Directory (the Directory), an online database of municipal, provincial/territorial, and federal cancer and chronic disease prevention policies from across Canada, was developed to facilitate the diffusion of healthy public policies and support the work of prevention researchers, practitioners, and policy specialists. This information technology solution was implemented, through a participatory engagement approach, as a communication channel or policy knowledge transfer tool. It also addressed the intrinsic shortcomings of environmental scanning for policy surveillance and monitoring. A combination of quantitative web metrics and qualitative anecdotal evidence have illustrated that the Directory is becoming an important tool for healthy public policy surveillance and policy diffusion in Canada.

  13. Behcet's Disease

    Science.gov (United States)

    ... this research; and the dissemination of information on research progress in these diseases. Contact Us NIAMS Archive Viewers and Players Social Media Moderation Policy FOIA Privacy Statement Accessibility Disclaimer Digital Strategy ...

  14. Explaining the Decrease in Deaths from Cardiovascular Disease in Poland. The Top-Down Risk Assessment Approach, from Policy to Health Impact.

    Science.gov (United States)

    Kobza, Joanna; Geremek, Mariusz

    2016-04-13

    The purpose of this paper was to assess the relations between policy and health outcome The CVD mortality rate in Poland over the past two decades has decreased by about 40%. It was the highest decrease among Central and Eastern European countries and also exceptional on a global scale. Key determinants which can account for these phenomena include CVD-related life style factors, better environmental indicators, and better access to medical technologies and to pharmacological treatment. Health policy played a vital role. The study was based on an extensive literature review, documentation analysis and questionnaire survey research. The top-down risk assessment approach model was implemented, which followed the logical pathway between the policy, health determinants, risk factors and health outcome. Several national public health programs have been implemented since the beginning of the 1990s. The National Health Fund has constantly increased the expenditures on cardiology treatment. The number of invasive cardiology units has increased, as has the number of coronarography and angioplasty procedures in the same period. The significant mortality decrease can indicate to policy makers that it is necessary to prioritize policies to manage effective, innovative medical interventions. Topdown policy risk assessment is a useful methodological tool to present the full chain of interactions.

  15. ENERGY POLICY

    OpenAIRE

    Avrupa Topluluğu Enstitüsü, Marmara Üniversitesi

    2015-01-01

    John Mitchell considers EU policies on energy supply security; Tera Allas on energy security of supply in the UK: the way forward; Peter Odell assesses public/private partnerships on the UKCS; Olivier Appert provides an overview of French energy policy.

  16. Energy policy

    International Nuclear Information System (INIS)

    Forrester, J.W.

    1979-01-01

    The author places the energy problem in the context of world economy. The various obstacles encountered in the United States to spell out a viable national energy policy are cited. A certain number of practical proposals is given to lead to an 'effective policy' which would allow energy economy at the same time as energy development, that is, including nuclear energy [fr

  17. Data Policy

    Directory of Open Access Journals (Sweden)

    Mark A Parsons

    2013-07-01

    Full Text Available The first purpose of data policy should be to serve the objectives of the organization or project sponsoring the collection of the data. With research data, data policy should also serve the broader goals of advancing scientific and scholarly inquiry and society at large. This is especially true with government-funded data, which likely comprise the vast majority of research data. Data policy should address multiple issues, depending on the nature and objectives of the data. These issues include data access requirements, data preservation and stewardship requirements, standards and compliance mechanisms, data security issues, privacy and ethical concerns, and potentially even specific collection protocols and defined data flows. The specifics of different policies can vary dramatically, but all data policies need to address data access and preservation. Research data gain value with use and must therefore be accessible and preserved for future access. This article focuses on data access. While policy might address multiple issues, at a first level it must address where the data stand on what Lyon (2009 calls the continuum of openness. Making data as openly accessible as possible provides the greatest societal benefit, and a central purpose of data policy is to work toward ethically open data access. An open data regime not only maximizes the benefit of the data, it also simplifies most of the other issues around effective research data stewardship and infrastructure development.

  18. Policy Innovation in Innovation Policy

    DEFF Research Database (Denmark)

    Borras, Susana

    During the past two decades Europe has experienced important changes and transformations in the way in which governments approach the issue of science, technology and innovation, and their relation to economic growth and competitiveness. This has to do with the European Union level as well...... as with national and sub-national governments in Europe, all of them introducing interesting novelties in their innovation policy. These changes refer to different aspects of policy, mainly the content of policy initiatives towards science, technology and innovation; the instruments governments are using...... at the EU level, and mentions similar trends taking place at national and sub-national levels. The questions that guide the contents here are essentially three, namely, what are the main traits of innovation policies in Europe since the 1990s and how have the EU and different national governments approached...

  19. Networking to Improve Nutrition Policy Research.

    Science.gov (United States)

    Kim, Sonia A; Blanck, Heidi M; Cradock, Angie; Gortmaker, Steven

    2015-09-10

    Effective nutrition and obesity policies that improve the food environments in which Americans live, work, and play can have positive effects on the quality of human diets. The Centers for Disease Control and Prevention's (CDC's) Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) conducts transdisciplinary practice-based policy research and evaluation to foster understanding of the effectiveness of nutrition policies. The articles in this special collection bring to light a set of policies that are being used across the United States. They add to the larger picture of policies that can work together over time to improve diet and health.

  20. Policy stories

    DEFF Research Database (Denmark)

    Ren, Carina Bregnholm; Rasmussen, Rasmus Kjærgaard

    This article uses Arctic Winter 2016 as an exploration site of values and futures in Greenland. By taking a valuation approach where the creation and interpretation of event values are seen as an ongoing and taxing accomplishment, we firstly expand the understanding of events beyond their actual...... present three central policy stories from the field. The stories tell of how the event was first interested, then activated and finally evaluated. Besides adding a new understanding to policy-driven events as a locus of value creation, we also argue that the AWG 2016 offer speculative bets for new...... planning and execution and of event outcomes beyond the narrow confines of bed nights and legacies. Second, we introduce policies as an entry point to unlock discussions and manifestations of value and futures which connect to AWG. In order to exemplify the workings of the AWG event in these domains, we...

  1. Networking to Improve Nutrition Policy Research

    OpenAIRE

    Kim, Sonia A.; Blanck, Heidi M.; Cradock, Angie; Gortmaker, Steven

    2015-01-01

    Effective nutrition and obesity policies that improve the food environments in which Americans live, work, and play can have positive effects on the quality of human diets. The Centers for Disease Control and Prevention’s (CDC’s) Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) conducts transdisciplinary practice-based policy research and evaluation to foster understanding of the effectiveness of nutrition policies. The articles in this special collection bring to light a...

  2. Population policy.

    Science.gov (United States)

    1987-03-01

    Participants in the Seminar on Population Policies for Top-level Policy Makers and Program Managers, meeting in Thailand during January 1987, examined the challenges now facing them regarding the implementation of fertility regulation programs in their respective countries -- Bangladesh, China, India, Indonesia, Malaysia, Nepal, Pakistan, the Philippines, the Republic of Korea, and Thailand. This Seminar was organized to coincide with the completion of an Economic and Social Commission for Asia and the Pacific (ESCAP) study investigating the impact and efficiency of family planning programs in the region. Country studies were reviewed at the Seminar along with policy issues about the status of women, incentive and disincentive programs, and socioeconomic factors affecting fertility. In Bangladesh the government recognizes population growth as its top priority problem related to the socioeconomic development of the country and is working to promote a reorientation strategy from the previous clinic-oriented to a multidimensional family welfare program. China's family planning program seeks to postpone marraige, space the births of children between 3-5 years, and promote the 1-child family. Its goal is to reduce the rate of natural increase from 12/1000 in 1978 to 5/1000 by 1985 and 0 by 2000. India's 7th Five-Year-Plan (1986-90) calls for establishing a 2-child family norm by 2000. In Indonesia the government's population policy includes reducing the rate of population growth, achieving a redistribution of the population, adjusting economic factors, and creating prosperous families. The government of Indonesia reversed its policy to reduce the population growth rate in 1984 and announced its goal of achieving a population of 70 million by 2100 in order to support mass consumption industries. It has created an income tax deduction system favoring large families and maternity benefits for women who have up to 5 children as incentives. Nepal's official policy is to

  3. Policy Reader

    International Nuclear Information System (INIS)

    1985-09-01

    This policy reader comprises: Correspondence; Memorandum of Understanding between the US Department of Transportation and the US Department of Energy for the Transportation of Radioactive Materials under the Nuclear Waste Policy Act; Internal Guidelines for Interactions with Communities and Local Governments; Statement by Ben C. Rusche before the Committee on Interior and Insular Affairs, Subcommittee on Energy and the Environment, US House of Representatives, September 13, 1985; Speech presented by Ben C. Rusche before the ANS/CNS/AESJ/ENS Topical Meeting, Pasco, Washington, September 24, 1985 - ''Status of the United States' High-Level Nuclear Waste Disposal Program''; and ''DOE Seeks Comments on Nuclear Transportation Planning,'' DOE News, September 30, 1985

  4. Language Policy

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.

    2008-01-01

    Like any other text, instructive texts function within a given cultural and situational setting and may only be available in one language. However, the end users may not be familiar with that language and therefore unable to read and understand the instructions. This article therefore argues...... that instructive texts should always be available in a language that is understood by the end users, and that a corporate communication policy which includes a language policy should ensure that this is in fact the case for all instructive texts....

  5. CEP energy policy : Policy 917

    International Nuclear Information System (INIS)

    2002-10-01

    Some of the environmental challenges facing the world in the twenty-first century are energy and global warming. Vital human needs such as warmth, light and transportation require energy, which is also required in the production of goods. Absent from the debate concerning the energy industry and its efforts to stop climate change is the voice of energy workers. Previous policies from the Communications, Energy and Paperworkers Union of Canada (CEP) were replaced by this policy document. After providing a brief introduction, the document tackled global challenge: climate change. The following section dealt with global challenge: corporate rule. Canada's energy industries were examined from the workers' perspective, and the state of Canada's energy reserves was discussed. From national policies to national betrayal was the title of the following section of the document. Energy de-regulation and privatization was discussed, and an argument was made for a Canadian energy policy. The industrial policy was explored, as was the environment. A transition to sustainability was examined. refs

  6. Informed policies

    International Development Research Centre (IDRC) Digital Library (Canada)

    INTERNATIONAL DEVELOPMENT RESEARCH CENTRE. Informed ... more evidence-based policy on social ... Community involvement is key to the success of CBMS in reducing poverty. IDRC ... nationwide network of “telecentres” that ... and holidays for young people to use for ... National Conference on Youth led to the.

  7. Making health policy: networks in research and policy after 1945.

    Science.gov (United States)

    Berridge, Virginia

    2005-01-01

    Science and policy in health and medicine have interacted in new ways in Britain since 1945. The relationship between research and policy has a history. The changing role of social medicine, the rise of health services research and "customer contractor" policies in government have been important. The relationship between research and policy has been analysed by different schools of thought. This chapter categorises them as several groups: "evidence-based", "journalism", "sociology of scientific knowledge" and "science policy studies". The chapters in the book illuminate aspects of these changing relationships. The role of chronic disease epidemiology, of new networks in public health, of media-focussed activism, and of health technology and its advocates have been more important than political interest.

  8. STD Prevention Policies in the United States: Evidence and Opportunities

    OpenAIRE

    Leichliter, Jami S.; Seiler, Naomi; Wohlfeiler, Dan

    2016-01-01

    Policies are an important part of public health interventions, including in the area of STD prevention. Similar to other tools used in public health, policies are often evaluated to determine their usefulness. Therefore, we conducted a non-systematic review of policy evidence for sexually transmitted disease prevention. Our review considers assessments or evaluations of STD prevention-specific policies, health care system policies, and other, broader policies that have the potential to impact...

  9. Cost and Price Increases in Higher Education: Evidence of a Cost Disease on Higher Education Costs and Tuition Prices and the Implications for Higher Education Policy

    Science.gov (United States)

    Trombella, Jerry

    2011-01-01

    As concern over rapidly rising college costs and tuition sticker prices have increased, a variety of research has been conducted to determine potential causes. Most of this research has focused on factors unique to higher education. In contrast, cost disease theory attempts to create a comparative context to explain cost increases in higher…

  10. Energy policy

    International Nuclear Information System (INIS)

    1992-09-01

    Gasoline consumption by passenger cars and light trucks is a major source of air pollution. It also adds to the economy's dependence on petroleum and vulnerability to oil price shocks. Despite these environmental and other costs, called external cost, the price of gasoline, adjusted for inflation, has generally been declining since 1985, encouraging increased consumption. This paper reports that with these concerns in mind, the Chairman, Subcommittee on Environment, House Committee on Science, Space, and Technology, requested that GAO assess policy options for addressing the external costs of gasoline consumption. To do this, GAO identified six major policy options and evaluated whether they addressed several relevant objectives, including economic growth, environmental quality, equity, petroleum conservation, visibility of costs, energy security, traffic congestion, competitiveness, and administrative feasibility

  11. Internet Policy

    Science.gov (United States)

    Lehr, William H.; Pupillo, Lorenzo Maria

    The Internet is now widely regarded as essential infrastructure for our global economy and society. It is in our homes and businesses. We use it to communicate and socialize, for research, and as a platform for E-commerce. In the late 1990s, much was predicted about what the Internet has become at present; but now, we have actual experience living with the Internet as a critical component of our everyday lives. Although the Internet has already had profound effects, there is much we have yet to realize. The present volume represents a third installment in a collaborative effort to highlight the all-encompassing, multidisciplinary implications of the Internet for public policy. The first installment was conceived in 1998, when we initiated plans to organize an international conference among academic, industry, and government officials to discuss the growing policy agenda posed by the Internet. The conference was hosted by the European Commission in Brussels in 1999 and brought together a diverse mix of perspectives on what the pressing policy issues would be confronting the Internet. All of the concerns identified remain with us today, including how to address the Digital Divide, how to modify intellectual property laws to accommodate the new realities of the Internet, what to do about Internet governance and name-space management, and how to evolve broadcast and telecommunications regulatory frameworks for a converged world.

  12. POPULATION POLICY OR SOCIAL POLICY?

    Directory of Open Access Journals (Sweden)

    ANDREI STANOIU

    2011-04-01

    Full Text Available After 1989, the demographic situation of Romania population experienced a dramatic, very concerning and dangerous evolution trend. One of the first measures of the new political power was to abolish the very restrictive, anti-human and abusive legal regulation adopted in 1966 by the communist regime concerning abortion and the whole old demographic policy. As a result of this measure and of the worsening economic and social situation of the great majority of Romanian population, the birth rate declined sharply and, from 1992, the natural demographic growth rate became a negative one. The absolute number of Romanian population decreased more and more and, if nothing changes, in the next few decades it will be no bigger than 15 million people. At the same time, the process of demographic ageing of population will accentuate, generating serious problems from demographic and social-economic point of view, Taking into account the present demographic situation and, especially, the foreseen trend of evolution, it is more than clear that there should be taken some urgent, coherent and consistent measures in order to stop this dangerous demographic evolution, until it is not too late, and to avoid, as much as possible, a potential demographic disaster. The problem is: what kind of measures should be taken and what kind of policy should be adopted? Some social scientists believe that a new population policy should be adopted; some others believe that rather a social policy should be adopted. The purpose of my paper is to analyze this different opinions and to show that, behind the dispute on the terminology, should be taken consistent measures, at governmental level, in order to assure a substantial improvement of demographic situation, not only from a quantitative, but from a qualitative point of view as well, and to identify some of these kind of measures.

  13. Legitimizing policies

    DEFF Research Database (Denmark)

    Jørgensen, Martin Bak

    2012-01-01

    The focus of this article is on representations of irregular migration in a Scandinavian context and how irregular migrants are constructed as a target group. A common feature in many (Western-)European states is the difficult attempt to navigate between an urge for control and respecting......, upholding and promoting humanitarian aspects of migration management. Legitimizing policies therefore become extremely important as governments have to appease national voters to remain in power and have to respect European regulations and international conventions. Doing so raises questions of social...

  14. OWNERSHIP POLICY

    Directory of Open Access Journals (Sweden)

    V. Branovitskiy

    2018-01-01

    Full Text Available The article examines the ownership policy in Ukraine. It makes a survey of the following: the current situation at state-run enterprises and their efficiency; the key criteria of the classification of state-run enterprises for the privatization for the period of 2017-2020. The article evaluates the institutional changes coming from a new law on the privatization of state-owned property in Ukraine. It reveals the stages of making the ownership policy as a state strategy. It describes the measures meant to raise efficiency in the area of the public property management. The article assesses the state of play of the stock market in Ukraine as a mechanism to attract money to the real economy. It recommends attracting foreign investment to the public sector of economy following the restructuring process via IPO or sale to a strategic investor (Private equity. It considers the positive aspects in the completion of active privatization and the scope of the main privatization risks.

  15. Improving health through policies that promote active travel

    DEFF Research Database (Denmark)

    de Nazelle, Audrey; Nieuwenhuijsen, Mark J; Antó, Josep M

    2011-01-01

    Substantial policy changes to control obesity, limit chronic disease, and reduce air pollution emissions, including greenhouse gasses, have been recommended. Transportation and planning policies that promote active travel by walking and cycling can contribute to these goals, potentially yielding...

  16. Health policy model: long-term predictive results associated with the management of hepatitis C virus-induced diseases in Italy.

    Science.gov (United States)

    Mennini, Francesco Saverio; Marcellusi, Andrea; Andreoni, Massimo; Gasbarrini, Antonio; Salomone, Salvatore; Craxì, Antonio

    2014-01-01

    At present, there are no specific nationwide epidemiological studies representing the whole Italian population. This study is aimed at describing the epidemiological and economic burden that HCV will generate in the next few years in Italy. Furthermore, the impact that future anti-HCV treatments may have on the burden of disease was considered. This analysis was developed for the period 2012-2030 from the perspective of the Italian National Health Service (NHS). A published system dynamic model was adapted for Italy in order to quantify the HCV-infected population in terms of disease progression and the associated costs from 1950 to 2030. The model structure was based on transition probabilities reflecting the natural history of the disease. In order to estimate the efficacy of current anti-HCV treatment strategies for genotypes 1 and 4, the sustained virological response (SVR) rate in registration clinical trials for both boceprevir and telaprevir was estimated. It was assumed that the efficacy for patients treated with peginterferon + ribavirin was equal to the placebo arm of a randomized clinical trial (RCT) relating to boceprevir and telaprevir. For genotypes 2/3 patients it was assumed that treatment efficacy with dual therapy was equal to a SVR rate from the literature. According to the aim of this study, only direct health care costs (hospital admissions, drugs, treatment, and care of patients) incurred by the Italian NHS have been included in the model. Costs have been extrapolated using the published scientific literature available in Italy and actualized with the 2012 ISTAT (Istituto Nazionale di Statistica) Price Index system for monetary revaluation. Three different scenarios were assumed in order to evaluate the impact of future anti-HCV treatments on the burden of disease. Overall, in Italy, 1.2 million infected subjects were estimated in 2012. Of these, about 211,000 patients were diagnosed, while only about 11,800 subjects were actually being

  17. Policy implications of regional variations in eye disease detection and treatment on Prince Edward Island: a repeated cross-sectional analysis, 2010-2012.

    Science.gov (United States)

    Khan, A M; Trope, G E; Wedge, R; Buys, Y M; El-Defrawy, S; Chen, Q; Jin, Y P

    2018-04-10

    In Canada, government insurance covers eye care services provided by ophthalmologists and other physicians. However, government coverage for services provided by optometrists, non-medical school trained primary eye care providers, varies regionally. Little is known about the impact of a funding model in which ophthalmologist services are government-insured but services provided by optometrists are not, on eye care utilization and eye disease detection and treatment. We aimed to address this question by examining geographic variations in eye care service utilization on Prince Edward Island (PEI). PEI physician-billing data from 2010 to 2012 was analyzed across five distinct geographic regions (Charlottetown, Summerside, Prince, Queens & Kings and Stratford). The residential location of patients and practice locations of eye care providers were identified using the first three digits of their respective postal code. Age-standardized rates were computed for comparisons across different regions. There were six ophthalmologists practicing on PEI, five with offices in Charlottetown. Twenty optometrists practiced on the island with offices across the province. Stratford is closest and Prince farthest from Charlottetown. Age-standardized utilization rates of ophthalmologists per 100 populations were 10.44 in Charlottetown and 10.90 in Stratford, which was significantly higher than in other regions (7.74-8.92; p Prince and Summerside, the utilization of ophthalmologists by people with diabetes was almost twice as high in Charlottetown (6.49%) than in Prince (3.88%). The observed discrepancies in vision care utilization across geographic regions were likely attributed to barriers in accessing government-insured, geographically concentrated ophthalmologists, as opposed to a reflection of the true differences in eye disease occurrence. The lower prevalence of glaucoma visits in regions farther away from ophthalmologist offices may result in delayed detection and blindness in

  18. Policy Actors: Doing Policy Work in Schools

    Science.gov (United States)

    Ball, Stephen J.; Maguire, Meg; Braun, Annette; Hoskins, Kate

    2011-01-01

    This paper considers the "policy work" of teacher actors in schools. It focuses on the "problem of meaning" and offers a typology of roles and positions through which teachers engage with policy and with which policies get "enacted". It argues that "policy work" is made up of a set of complex and…

  19. Nuclear policy

    International Nuclear Information System (INIS)

    Ford, G.R.

    1976-01-01

    Then-President Gerald Ford outlines the potential benefits of nuclear power as opposed to the danger of proliferation. He points out that not all nations have the same interest or views toward nuclear energy; but also he says that if a choice must be made, nonproliferation objectives must take precedence over economic and energy benefits. It is pointed out that the management of nuclear energy can be only partial and temporary by technical measures, and that full management can result only if nations realistically face the task prepared to forego preconceived short-term advantages in favor of long-term gains. Coordination of the policies of all nations toward the common goal of nonproliferation is predicted to lead to success

  20. Health policy model: long-term predictive results associated with the management of hepatitis C virus-induced diseases in Italy

    Directory of Open Access Journals (Sweden)

    Mennini FS

    2014-06-01

    Full Text Available Francesco Saverio Mennini,1,2 Andrea Marcellusi,1,3 Massimo Andreoni,4 Antonio Gasbarrini,5 Salvatore Salomone,6 Antonio Craxì71Centre for Economic and International Studies (CEIS – Economic Evaluation and HTA (EEHTA Faculty of Economics, University of Rome Tor Vergata, Rome, Italy; 2Institute of Leadership and Management in Health, Kingston University, London, UK; 3Department of Demography, University of Rome La Sapienza, Rome, Italy; 4Department of Public Health and Cell Biology, School of Medicine, University of Rome Tor Vergata, Rome, Italy; 5Gastroenterology Division, Catholic University of the Sacred Heart of Rome, School of Medicine, Rome, Italy; 6Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy; 7Gastroenterology Division, University of Palermo, Palermo, ItalyBackground: At present, there are no specific nationwide epidemiological studies representing the whole Italian population. This study is aimed at describing the epidemiological and economic burden that HCV will generate in the next few years in Italy. Furthermore, the impact that future anti-HCV treatments may have on the burden of disease was considered. This analysis was developed for the period 2012–2030 from the perspective of the Italian National Health Service (NHS. Methods: A published system dynamic model was adapted for Italy in order to quantify the HCV-infected population in terms of disease progression and the associated costs from 1950 to 2030. The model structure was based on transition probabilities reflecting the natural history of the disease. In order to estimate the efficacy of current anti-HCV treatment strategies for genotypes 1 and 4, the sustained virological response (SVR rate in registration clinical trials for both boceprevir and telaprevir was estimated. It was assumed that the efficacy for patients treated with peginterferon + ribavirin was equal to the placebo arm of a

  1. Genetics in primary health care and the National Policy on Comprehensive Care for People with Rare Diseases in Brazil: opportunities and challenges for professional education.

    Science.gov (United States)

    Melo, Débora Gusmão; de Paula, Pamela Karen; de Araujo Rodrigues, Stephania; da Silva de Avó, Lucimar Retto; Germano, Carla Maria Ramos; Demarzo, Marcelo Marcos Piva

    2015-07-01

    As discoveries regarding the genetic contribution to disease have grown rapidly, health care professionals are expected to incorporate genetic and genomic perspectives into health education and practice. Genetic competencies common to all health professionals have been identified by the US National Coalition for Health Professional Education in Genetics (NCHPEG), which defined the knowledge, skills, and attitudes required to achieve these competencies. The aim of this study is to analyze genetic competencies of primary health care professionals in Brazil. It is a descriptive survey study, whereby doctors, nurses, and dentists were invited to participate by answering a questionnaire including 11 issues based on competencies established by the NCHPEG. Data were presented as percentages. Differences between groups of participants were assessed by the Fisher exact test, with the level of significance set at p < 0.05. Results showed that concerning knowledge, about 80 % of the participants recognized basic genetics terminology, but practitioners had difficulty in identifying patterns of inheritance. Regarding clinical skills, practitioners were able to recognize facial dysmorphias and identify situations where referral of patients to specialists was necessary. Nevertheless, there were challenges in the process of valuing and gathering information about family history. Regarding attitudes, 68.9 % of the participants thought about the comprehensiveness of care but faced challenges in counselling parents. The results of this study may contribute to developing an ongoing education program for primary health care professionals, leading to a strategy to overcome the challenges of including genetics in the Brazilian Unified Health System.

  2. Policy options

    International Nuclear Information System (INIS)

    Miller, A.

    1990-01-01

    The obstacles to bringing about consumer response to environmental dangers are particularly challenging for global problems like ozone depletion and the greenhouse effect. In this situation, there is the danger of what is commonly termed the tragedy of the commons, the ecological destruction that can occur from uncontrolled use of shared resources like the atmosphere. There is probably no country for which reductions in global warming provide an adequate economic incentive to reduce greenhouse gas emissions unilaterally, even though such action could yield substantial global benefits. From any one country's viewpoint, the costs of controlling emissions may exceed the benefits since, without international agreement, reductions achieved by one nation may be offset by another. Therefore, even though the entire world may be better off as a result of efforts to lower emissions, new economic incentives are necessary to lead the market to a socially efficient outcome. This paper describes the range of domestic and international policies that could be adopted to reduce emissions of greenhouse gases, and also discusses the results of modeling analyses of government actions that could reduce or increase such emissions

  3. Management Matters. Selection Policies

    Science.gov (United States)

    Pappas, Marjorie L.

    2003-01-01

    One of the most important policy documents for a school library media center is the selection policy or the collection development policy. A well-developed selection policy provides a rationale for the selection decisions made by the school library media specialist. A selection policy represents the criteria against which a challenged book is…

  4. Research for health policy

    National Research Council Canada - National Science Library

    Bell, Erica

    2010-01-01

    ... Explicit, implicit, and pragmatic dimensions of policy-maker's needs and context 31 Constraints on policy-makers 32 Deciphering trade-offs 33 The policy-problem: deciphering uncertainty and the problem of innovation 34 A tool for deciphering policy problems 35 The different components of the policy problem 37 Recommended reading 38 Case studies in...

  5. Policy Feedback System (PFS)

    Data.gov (United States)

    Social Security Administration — The Policy Feedback System (PFS) is a web application developed by the Office of Disability Policy Management Information (ODPMI) team that gathers empirical data...

  6. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... 2018 Alzheimer's Disease Facts and Figures report contains data on the impact of this disease in every ... with third parties. Please read our security and privacy policy . Plan ahead Get help and support I ...

  7. The SPHERE Study. Secondary prevention of heart disease in general practice: protocol of a randomised controlled trial of tailored practice and patient care plans with parallel qualitative, economic and policy analyses. [ISRCTN24081411].

    LENUS (Irish Health Repository)

    Murphy, Andrew W

    2005-07-29

    BACKGROUND: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland. CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines. METHODS: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and two-year follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. The SPHERE intervention involves the implementation of a structured systematic programme of care for patients with CHD attending general practice. It is a multi-faceted intervention that has been developed to respond to barriers and solutions to

  8. Water Policies of Turkey

    Directory of Open Access Journals (Sweden)

    Hakan Istanbulluoglu

    2011-06-01

    Full Text Available Water is one of our most critical resources. Civilization has historically flourished around major waterways. The most important uses of water are; agricultural, industrial and domestic use. This critical resource is under threat around the world. In the next 20 years, the quantity of water available to everyone is predicted to decrease by 30%. 40% of the world\\\\\\\\\\\\\\'s inhabitants currently have insufficient fresh water for minimal hygiene. In 2000 more than 2.2 million people died from waterborne diseases. Water politics is politics affected by water and water resources. There are connections between water resources, water systems, and international security and conflict. Today, water is a strategic resource in the globe and an important element in many political conflicts. Turkey can be faced severe water-stress in the near future. Therefore Turkey has to develop realistic and feasible water policy for future generations. [TAF Prev Med Bull 2011; 10(3.000: 327-338

  9. Health Policy and Dementia.

    Science.gov (United States)

    Powell, Tia

    2018-02-01

    The anticipated number of persons with dementia continues to grow, and the US has insufficiently planned to provide and pay for care for this large population. A number of significant clinical trials aiming to prevent or cure dementia, including Alzheimer's disease, have not demonstrated success. Because of the lack of efficacious treatments, and the fact that brain changes associated with dementia may begin decades before symptoms, we can predict that efforts to cure or prevent dementia will not succeed in time for millions of people in the baby boomer generation. Because of the anticipated increase in people suffering with dementia in the coming years, US health policy must address major gaps in how to provide and pay for dementia care. Reliance on Medicaid and Medicare as currently structured will not sustain the necessary care, nor can families alone provide all necessary dementia care. Innovative forms of providing long-term care and paying for it are crucially needed.

  10. EU Industrial Policy

    DEFF Research Database (Denmark)

    Pellegrin, Julie; Giorgetti, Maria Letizia; Jensen, Camilla

    Following disregard in the 1980s, industrial policy has recently attracted policy attention at EU level. The objective of this study provided by Policy Department A at the request of the ITRE Committee, is to establish the state of the art of a coordinated and integrated EU industrial policy...

  11. Food policy an ethics

    DEFF Research Database (Denmark)

    Coff, Christian Eyde; Kemp, Peter

    2014-01-01

    This entry gives an overview of food policy and major ethical principles that in the last decades have been proposed and advocated for in debates on food policy. Food policies touch upon a vast area of interrelated policies (like health, transport, environment, poverty, animal welfare etc.) which...

  12. Education Policy Outlook: Austria

    Science.gov (United States)

    Figueroa, Diana Toledo; Golden, Gillian; Giovinazzo, Manon; Peterka, Judith; Ullmann, Marie

    2017-01-01

    This policy profile on education in Austria is part of the "Education Policy Outlook" series, which presents comparative analysis of education policies and reforms across OECD countries. Building on the OECD's substantial comparative and sectoral knowledge base, the series offers a comparative outlook on education policy by providing…

  13. Working for Policy

    NARCIS (Netherlands)

    Colebatch, H.K.; Hoppe, Robertus; Noordegraaf, Mirko

    2010-01-01

    Though democratic government calls for well-designed and implemented policy, there is surprisingly little expert guidance available for policy makers and politicians. Working for Policy fills that gap, addressing the nature of policy work and offering necessary guidance. The contributors bring

  14. Environmental policy in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Tsuru, Shigeto; Weidner, H. (eds.)

    1989-01-01

    This book deals in English with the most important features of Japanese environmental policy in a number of individual articles by different authors. The various sections report on: 1. History and organization of environmental policy; 2. The role of non-governmental actors in environmental policy (large industries); 3. Special features of environmental policies and problems; 4. Classical pollution control areas: Regulations and effects; 5. Environmental problems in a broader perspective (nature conservation); 6. Policy areas with influence on environmental quality; 7. Environmental monitoring and reporting; 8. Japanese environmental policy in an international perspective (preventive policies, developing countries). (HSCH).

  15. Environmental policy performance revisited

    DEFF Research Database (Denmark)

    Daugbjerg, Carsten; Sønderskov, Kim Mannemar

    2012-01-01

    . On the basis of the typology, a hypothesis on their ability to expand green markets is generated and tested in a comparative analysis of the performance of organic food policies in Denmark, Sweden, the UK and the US, focusing on their impact on organic consumption. Our analysis demonstrates that cross......Studies of environmental policy performance tend to concentrate on the impact of particular policy institutions or of single policy instruments. However, environmental policies most often consist of a package of policy instruments. Further, these studies pay no or very little attention to policy...... instruments directed at the demand side of the market. Therefore this article develops a policy typology for government intervention aimed at creating green markets. The typology distinguishes between four types of policy based on the balance between the supply-side and demand-side policy instruments...

  16. Deconstructing domestic violence policy

    OpenAIRE

    Branney, PE

    2006-01-01

    The primary objectives of this thesis are to, circularly, deconstruct contemporary domestic violence policy while developing and evaluating methods for deconstructing policy. Policy is theorised as a discursive practice, which allows a variety of policies to be compared and critiqued by how they position the people they affect. These are known as subject positions, or subjectivities, and throughout this thesis I attempt to critique policy by examining the (re)construction of subjectivity. In ...

  17. Corporate Language Policies

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum

    This paper offers a review of literature dealing with language policies in general and corporate language policies in particular. Based on a discussion of various definitions of these concepts within two research traditions, i.e. sociolinguistics and international management, a three......-level definition of corporate language policies is presented, emphasising that a corporate language policy is a context-specific policy about language use. The three-level definition is based on the argument that in order to acquire a complete understanding of what corporate language policies involve, one needs...... to consider three progressive questions; 1) what is a policy? 2) what is a language policy?, and ultimately, 3) what is a corporate language policy?...

  18. Corporate Language Policies

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum

    2015-01-01

    This paper offers a review of literature dealing with language policies in general and corporate language policies in particular. Based on a discussion of various definitions of these concepts within two research traditions, i.e. sociolinguistics and international management, a three......-level definition of corporate language policies is presented, emphasising that a corporate language policy is a context-specific policy about language use. The three-level definition is based on the argument that in order to acquire a complete understanding of what corporate language policies involve, one needs...... to consider three progressive questions; 1) what is a policy? 2) what is a language policy?, and ultimately, 3) what is a corporate language policy?...

  19. Single Policy Study

    DEFF Research Database (Denmark)

    Kronsell, Annica; Manners, Ian James

    2015-01-01

    Single policy studies are the most common form of European Union (EU) research. Single policy studies are widely used to understand the role of the EU in a wide variety of sectors, together with their development over time, and often offer public policy prescriptions. This chapter discusses...... the relevance of single policy studies in EU research and give examples of how such research can be designed and carried out. The chapter reviews three examples of single policy studies using different methods based on EU environmental policy, the EU biofuels directive, and the EU Common Security and Defence...... Policy (CSDP). The examples are illustrative of how single policy studies can be designed to use different approaches in the analysis: multiple streams approach to policy-making; a comparative hypothesis testing; and feminist institutional theory....

  20. Streamlining Policy Creation in Policy Frameworks

    NARCIS (Netherlands)

    M.A. Hills (Mark); N. Martí-Oliet; M. Palomino

    2012-01-01

    textabstract{\\it Policy frameworks} provide a technique for improving reuse in program analysis: the same language frontend, and a core analysis semantics, can be shared among multiple analysis policies for the same language, while analysis domains (such as units of measurement) can be shared among

  1. Innovation policies for tourism

    DEFF Research Database (Denmark)

    Hjalager, Anne-Mette

    2012-01-01

    The nature, extent, and implications of innovation in tourism are increasingly investigated in academic research, but the policies that affect these transformations in the industry and at tourism destinations are not equally well conceptualised theoretically or analysed empirically. The purpose...... of this article is, in an analysis of the literature, to interpret the rationale behind innovation policy, and to explain the persisting challenges related to acquisition of an informed foundation for policies based upon quantitative and qualitative inquiries. Observed in a historical perspective, innovation...... framework of policy instruments for innovation in tourism. New generations of policies instigate a mainstreaming of the innovation agenda in ways that proceed beyond the traditional policy concepts....

  2. Drug Policy in Bulgaria.

    Science.gov (United States)

    Dimova, Antoniya; Rohova, Maria; Atanasova, Elka; Kawalec, Paweł; Czok, Katarzyna

    2017-09-01

    Bulgaria has a mixed public-private health care financing system. Health care is financed mainly from compulsory health insurance contributions and out-of-pocket payments. Out-of-pocket payments constitute a large share of the total health care expenditure (44.14% in 2014). The share of drugs expenditure for outpatient treatment was 42.3% of the total health care expenditure in 2014, covered mainly by private payments (78.6% of the total pharmaceutical expenditure). The drug policy is run by the Ministry of Health (MoH), the National Council on Prices and Reimbursement of Medicinal Products, and the Health Technology Assessment Commission. The MoH defines diseases for which the National Health Insurance Fund (NHIF) pays for medicines. The National Council on Prices and Reimbursement of Medicinal Products maintains a positive drug list (PDL) and sets drug prices. Health technology assessment was introduced in 2015 for medicinal products belonging to a new international nonproprietary name group. The PDL defines prescription medicines that are paid for by the NHIF, the MoH, and the health care establishments; exact patient co-payments and reimbursement levels; as well as the ceiling prices for drugs not covered by the NHIF, including over-the-counter medicines. The reimbursement level can be 100%, 75%, or up to 50%. The PDL is revised monthly in all cases except for price increase. Physicians are not assigned with pharmaceutical budgets, there is a brand prescribing practice, and the substitution of prescribed medicines by pharmacists is prohibited. Policies toward cost containment and effectiveness increase include introduction of a reference pricing system, obligation to the NHIF to conduct mandatory centralized bargaining of discounts for medicinal products included in the PDL, public tendering for medicines for hospital treatment, reduction of markup margins of wholesalers and retailers, patient co-payment, and the introduction of health technology assessment

  3. IT Policy Archive

    Data.gov (United States)

    National Aeronautics and Space Administration — CIO defines IT processes and policies. The CIO defines the development processes, milestones, review gates, and the overall policies for all capital planning,...

  4. National Environmental Policy Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Environmental Policy Act (NEPA) was the first major environmental law in the United States and established national environmental policies for the...

  5. Nordic cultural policies

    DEFF Research Database (Denmark)

    Duelund, Peter

    2008-01-01

    A critical view on Nordic Cultural Policy 1961-2008 - Aims, measures, forms of organisation, state og national identity......A critical view on Nordic Cultural Policy 1961-2008 - Aims, measures, forms of organisation, state og national identity...

  6. Economics and obesity policy.

    Science.gov (United States)

    Lusk, J L

    2017-06-01

    This paper elucidates the challenges surrounding the economics of some popular obesity-related policy proposals. Solid economic justifications for anti-obesity policies are often lacking, and evidence suggests policies like fat and soda taxes or restrictions on food stamp spending are unlikely to substantively affect obesity prevalence. In short, many of the same factors that make obesity such a complicated and multifaceted issue extend to the economic analysis of public health policies.

  7. Innovation policies for tourism

    DEFF Research Database (Denmark)

    Hjalager, Anne-Mette

    2012-01-01

    The nature, extent, and implications of innovation in tourism are increasingly investigated in academic research, but the policies that affect these transformations in the industry and at tourism destinations are not equally well conceptualised theoretically or analysed empirically. The purpose...... framework of policy instruments for innovation in tourism. New generations of policies instigate a mainstreaming of the innovation agenda in ways that proceed beyond the traditional policy concepts....

  8. Hybrid Security Policies

    Directory of Open Access Journals (Sweden)

    Radu CONSTANTINESCU

    2006-01-01

    Full Text Available Policy is defined as the rules and regulations set by the organization. They are laid down by management in compliance with industry regulations, law and internal decisions. Policies are mandatory. Security policies rules how the information is protected against security vulnerabilities and they are the basis for security awareness, training and vital for security audits. Policies are focused on desired results. The means of achieving the goals are defined on controls, standards and procedures.

  9. Alcohol consumption and burden of disease in the Americas: implications for alcohol policy El consumo de alcohol y la carga de morbilidad en el continente americano: implicaciones para las políticas de control del consumo de alcohol

    Directory of Open Access Journals (Sweden)

    Jürgen Rehm

    2005-11-01

    Full Text Available OBJECTIVES: To describe patterns of alcohol consumption in the Americas, to estimate the burden of disease attributable to alcohol in the year 2000, and to suggest implications for policies to reduce alcohol-related disease burden. METHODS: Two dimensions of alcohol exposure were included in this secondary data analysis: average volume of alcohol consumption and patterns of drinking. There were two main outcome measures: mortality (number of deaths and disability-adjusted life years (DALYs lost (number of years of life lost due to premature mortality and disability. Separate estimates were obtained for different sexes, age groups and WHO regions. RESULTS: Despite regional variations, alcohol consumption in the Americas averaged more than 50% higher than worldwide consumption. Patterns of irregular heavy drinking prevailed. Alcohol consumption caused a considerable disease burden: 4.8% of all the deaths and 9.7% of all DALYs lost in the year 2000 were attributable to drinking, with most of the burden occurring outside North America. Intentional and unintentional injuries accounted for 59.8% of all alcohol-related deaths and 38.4% of the alcohol-related disease burden. Of all risk factors compared here, alcohol accounted for the greatest proportion of risk, followed by smoking. CONCLUSIONS: Interventions should be implemented to reduce the high burden of alcohol-related disease in the Americas. Given the epidemiological structure of this burden, injury prevention including, but not restricted to, prevention of traffic injuries, as well as appropriate treatment options, should play an important role in comprehensive plans to reduce the alcohol-related public health burden.OBJETIVOS: Describir las tendencias observadas en el consumo de alcohol en el continente americano, calcular la carga de morbilidad atribuible al alcohol en 2000 y examinar las consecuencias de políticas encaminadas a reducir la carga de enfermedad relacionada con el consumo de

  10. MACROPRUDENTIAL POLICY: CONCEPTUAL POSITIONS

    OpenAIRE

    Radu CUHAL; Ludmila STARIŢÎNA; Nicolae BASISTÎI

    2013-01-01

    The article explains the conceptual principles of macroprudential policy, its main objectives and instruments. The classification of macroprudential policy tools of the Committee on the Global Financial System is defined. The comparative characteristics of macro-prudential policy in the Western developed countries are also examined.

  11. Macroprudential policy: conceptual positions

    OpenAIRE

    Stariţîna Ludmila; Cuhal Radu

    2013-01-01

    The article explains the conceptual principles of macroprudential policy, its main objectives and instruments. The classification of macroprudential policy tools of the Committee on the Global Financial System is defined. The comparative characteristics of macro-prudential policy in the Western developed countries are also examined.

  12. Italian energy policy

    International Nuclear Information System (INIS)

    1988-01-01

    This document discusses problems associated with Italian energy policy; economic and industrial development as it relates to that policy is covered. Specific areas covered are: (1) the basis of Italy's new energy policy; (2) energy demand; (3) five objectives; (4) the electrical power system; (5) proposed action; and (6) energy resources

  13. Energy. Policy and Implementation

    International Nuclear Information System (INIS)

    Stroop, A.

    2006-01-01

    Why does the government have an energy policy? What form does it take? Who is involved in implementing that policy? These and similar questions are answered in the latest Energy Report. The Dutch Ministry of Economic Affairs (EZ) argues that the objectives are feasible as long as the energy policies are matched by suitable implementation measures [nl

  14. Quarterly fiscal policy

    NARCIS (Netherlands)

    Kendrick, D.A.; Amman, H.M.

    2014-01-01

    Monetary policy is altered once a month. Fiscal policy is altered once a year. As a potential improvement this article examines the use of feedback control rules for fiscal policy that is altered quarterly. Following the work of Blinder and Orszag, modifications are discussed in Congressional

  15. Economic and Policy Review: Editorial Policies

    African Journals Online (AJOL)

    The NESG Economic and Policy Review (EPR) is a quarterly publication of the ... of government and the Nigerian economy in the short, medium and long terms. ... must be of impeccable quality and must conform to world class standard.

  16. Designing collaborative policy innovation

    DEFF Research Database (Denmark)

    Agger, Annika; Sørensen, Eva

    2014-01-01

    Recent approaches to enhancing public innovation suffer from two shortcomings: They overemphasize competition as a driver of innovation and overlook the fact that public sector innovation involves policy innovation as well as service innovation. Drawing on governance research and innovation theory......, the chapter investigates the extent to which and how collaboration between politicians and relevant stakeholders can spur the formulation, implementation and diffusion of new innovative policies. A case study of a process of collaborative policy innovation in a Danish municipality shows that collaborative...... policy arenas do contribute to policy innovation but also that the degree to which they do so depends on the institutional design of these arenas....

  17. EUROPEAN MARITIME TRANSPORT POLICY

    Directory of Open Access Journals (Sweden)

    Jerzy Kujawa

    2014-03-01

    Full Text Available The article describes the common EU policy on maritime transport, which comprises almost 80% of the volume of external trade of the Union and about 40% of internal transport needs. The first part of the paper presents the origins of the common maritime transport policy and the difficulties encountered during its initial formation. Subsequently, the evolution of the concepts of the policy and its current shape is discussed. The final, substantial part of the article describes the main aims and directions of the EU maritime transport policy and includes an evaluation of the effects of the policy.

  18. Cyber security policy guidebook

    CERN Document Server

    Bayuk, nifer L; Rohmeyer, l; Sachs, cus; Schmidt, frey; Weiss, eph

    2012-01-01

    This book is a taxonomy and thesaurus of current cybersecurity policy issues, including a thorough description of each issue and a corresponding list of pros and cons with respect to identified stances on each issue. It documents policy alternatives for the sake of clarity with respect to policy alone, and dives into organizational implementation issues. Without using technical jargon, the book emphasizes the importance of critical and analytical thinking when making policy decisions.  It also equips the reader with descriptions of the impact of specific policy ch

  19. An Evaluation Framework for Obesity Prevention Policy Interventions

    Science.gov (United States)

    Sommers, Janice; Vu, Maihan; Jernigan, Jan; Payne, Gayle; Thompson, Diane; Heiser, Claire; Farris, Rosanne; Ammerman, Alice

    2012-01-01

    As the emphasis on preventing obesity has grown, so have calls for interventions that extend beyond individual behaviors and address changes in environments and policies. Despite the need for policy action, little is known about policy approaches that are most effective at preventing obesity. The Centers for Disease Control and Prevention (CDC) and others are funding the implementation and evaluation of new obesity prevention policies, presenting a distinct opportunity to learn from these practice-based initiatives and build the body of evidence-based approaches. However, contributions from this policy activity are limited by the incomplete and inconsistent evaluation data collected on policy processes and outcomes. We present a framework developed by the CDC-funded Center of Excellence for Training and Research Translation that public health practitioners can use to evaluate policy interventions and identify the practice-based evidence needed to fill the gaps in effective policy approaches to obesity prevention. PMID:22742594

  20. Energy policy and foreign policy in Italy

    International Nuclear Information System (INIS)

    Venanzi, F.

    2001-01-01

    Energy policy in Italy is principally a matter of foreign policy. As a result, extensive programmes for the exploration, development, transport and marketing of oil and natural gas have to be planned and carried out together with the producing countries. In this effort, the country shall need the support of its national energy companies. That is why ENI's controlling interest as well as its mission had better be on Italian hands [it

  1. Policies for Renewable Heat

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    This paper builds on IEA publications, Deploying Renewables, Principles for Effective Policies and Deploying Renewables, Best and Future Policy Practice, that discuss the 'integrated policy approach,' whereby renewable energy technologies require different support policies at different stages of their maturity pathways. The paper discusses how the integrated policy approach applies to renewable heat. It attempts to provide guidance for policy-makers on renewable heat throughout the different phases of the policy lifecycle, allowing for the specific challenges of renewable heat and needs of the many stakeholders involved. Stimulating a market for heat involves challenges that are different and, often, more difficult to overcome than in the electricity and transport sectors.

  2. Implementing public employment policy

    DEFF Research Database (Denmark)

    Larsen, Flemming; Bredgaard, Thomas

    disciplining of the unemployed (work first) (cf.Bredgaard & Larsen, 2005; Sol & Westerweld, 2005). It is, however, remarkable that in the research field there seems to be a division of labour so that changes in public administration and changes in the substance of employment policies are dealt with separately......Like most other areas within welfare policy, the employment and social policy areas are undergoing far-reaching changes in many countries. Partly in the shape of new forms of governance inspired by New Public Management (NPM), partly through new policies oriented towards activation and stronger....... But there is an interesting question to investigate here: whether and if so how, NPM-inspired reforms are related to changes in employment policy towards a work-first approach? Are changes in public management systems created as deliberate policy changes, or do they bring about more indirect and unintended policy changes...

  3. Policy for Sustainable Entrepreneurship

    DEFF Research Database (Denmark)

    Watson, Rosina; Nielsen, Kristian Roed; Wilson, Hugh N.

    open innovation with SME entrepreneurs, business execs, academics and policymakers via an online crowdsourcing event with 150 participants. Through inductive analysis of 1,696 text comments, five policy domains are identified: creating awareness/skills; building networks; funding/investing; measuring......Sustainable entrepreneurship—entrepreneurship with social and ecological gains as well as economic ones—can significantly address societal and environmental challenges, however, it is not clear how policy can support it. The authors develop a policy framework for sustainable entrepreneurship, using...... impact/performance; and innovating government. Contributions to entrepreneurship policy literature include measuring impact/performance and open policy innovation for entrepreneurship policy. Contributions to sustainability policy literature include empowering individuals as entrepreneurs and not just...

  4. Maternity Leave Policies

    Science.gov (United States)

    Strang, Lucy; Broeks, Miriam

    2017-01-01

    Abstract Over recent years many European Union countries have made changes to the design of the maternity leave provision. These policy developments reflect calls for greater gender equality in the workforce and more equal share of childcare responsibilities. However, while research shows that long period of leave can have negative effects on women's labour market attachment and career advancements, early return to work can be seen as a factor preventing exclusive breastfeeding, and therefore, potentially having negative health impacts for babies. Indeed, the World Health Organisation recommends exclusive breastfeeding up to 6 months of age to provide babies with the nutrition for healthy growth and brain development, protection from life-threatening ailments, obesity and non-communicable diseases such as asthma and diabetes. Therefore, labour market demands on women may be at odds with the health benefits for children gained by longer periods of maternity leave. The aim of this article is to examine the relationship between leave provision and health benefits for children. We examine maternity and parental leave provision across European countries and its potential impact on the breastfeeding of very young babies (up to 6-months of age). We also consider economic factors of potential extension of maternity leave provision to 6 months, such as costs to businesses, effects on the female labour market attachment, and wider consequences (benefits and costs) for individuals, families, employers and the wider society. PMID:28983432

  5. Reducing Environmental Allergic Triggers: Policy Issues.

    Science.gov (United States)

    Abramson, Stuart L

    The implementation of policies to reduce environmental allergic triggers can be an important adjunct to optimal patient care for allergic rhinitis and allergic asthma. Policies at the local level in schools and other public as well as private buildings can make an impact on disease morbidity. Occupational exposures for allergens have not yet been met with the same rigorous policy standards applied for exposures to toxicants by Occupational Safety and Health Administration. Further benefit may be obtained through policies by local, county, state, and national governments, and possibly through international cooperative agreements. The reduction of allergenic exposures can and should be affected by policies with strong scientific, evidence-based derivation. However, a judicious application of the precautionary principle may be needed in circumstances where the health effect of inaction could lead to more serious threats to vulnerable populations with allergic disease. This commentary covers the scientific basis, current implementation, knowledge gaps, and pro/con views on policy issues in reducing environmental allergic triggers. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  6. Energy policy in transport and transport policy

    International Nuclear Information System (INIS)

    Van Dender, Kurt

    2009-01-01

    Explanations for, and indirect evidence of, imperfections in the market for private passenger vehicle fuel economy suggest there is a reasonable case for combining fuel economy standards and fuel or carbon taxes to contribute to an energy policy that aims to reduce greenhouse gas emissions and improve energy security. Estimates of key elasticities, including the rebound effect, indicate that the positive and negative side-effects of fuel economy measures on transport activities and external costs are limited. However, an energy policy for transport does not replace a transport policy that aims to manage the main transport externalities including congestion and local pollution. Conventional marginal cost estimates and standard cost-benefit reasoning suggest that policies that address congestion and local pollution likely bring benefits at least as large as those from fuel economy measures. But the large uncertainty on the possible effects of greenhouse gas emissions constitutes a strong challenge for standard cost-benefit reasoning. Emerging results from methods to cope with this uncertainty suggest that policies to stimulate the widespread adoption of low-carbon technologies in transport are justified.

  7. Energy policy in transport and transport policy

    Energy Technology Data Exchange (ETDEWEB)

    Van Dender, Kurt [Joint Transport Research Centre of the International Transport Forum and the OECD, 2 rue Andre Pascale, F-75775 Paris Cedex 16 (France)

    2009-10-15

    Explanations for, and indirect evidence of, imperfections in the market for private passenger vehicle fuel economy suggest there is a reasonable case for combining fuel economy standards and fuel or carbon taxes to contribute to an energy policy that aims to reduce greenhouse gas emissions and improve energy security. Estimates of key elasticities, including the rebound effect, indicate that the positive and negative side-effects of fuel economy measures on transport activities and external costs are limited. However, an energy policy for transport does not replace a transport policy that aims to manage the main transport externalities including congestion and local pollution. Conventional marginal cost estimates and standard cost-benefit reasoning suggest that policies that address congestion and local pollution likely bring benefits at least as large as those from fuel economy measures. But the large uncertainty on the possible effects of greenhouse gas emissions constitutes a strong challenge for standard cost-benefit reasoning. Emerging results from methods to cope with this uncertainty suggest that policies to stimulate the widespread adoption of low-carbon technologies in transport are justified. (author)

  8. Management of science policy, sociology of science policy and economics of science policy

    CERN Document Server

    Ruivo, Beatriz

    2017-01-01

    'Management of science policy, sociology of science policy and economics of science policy' is a theoretical essay on the scientific foundation of science policy (formulation, implementation, instruments and procedures). It can be also used as a textbook.

  9. Language Policy and Communication Policy - Same Same but Different?

    DEFF Research Database (Denmark)

    Bergenholtz, Henning; Johnsen, Mia

    2006-01-01

    Surprisingly, no attempts have yet been made to relate language policy and communication policy. This is the case in theoretical contributions on language policy and theoretical contributions on communication policy alike, none of which mentions the other concept. It is also the case in existing...... language policies where the term communication policy is not mentioned at all. Likewise, the term language policy is not found in communication policies, even where a particular company or organisation has a language policy as well as a communication policy. This contribution aims to define both terms...

  10. Shaping Policy Curves

    DEFF Research Database (Denmark)

    Broome, André; Seabrooke, Leonard

    2015-01-01

    provide a conceptual framework for understanding how IOs seek to use their own cognitive authority to foster ‘diagnostic coordination’ across technocratic economic policy communities. This encourages officials to adapt to a common policy language and delimits the policy space within which they identify......International organizations (IOs) such as the International Monetary Fund and the World Bank are assumed to rely on ‘sympathetic interlocutors’ at the national level to drive through economic reforms that conform to global policy norms. In this article we answer the following question: How do...... sympathetic interlocutors for IOs emerge in the first place? We address this question by examining how IOs engage in teaching norms to national officials via transnational policy training in order to increase the number of domestic reformers who are sympathetic to their prescriptions for policy change. We...

  11. Counterterrorism policy in Colombia

    OpenAIRE

    Self, Kevin A.

    2007-01-01

    The purpose of this thesis is to suggest a coherent, credible, and long-term counterterrorism policy in Colombia. The events of September 11, 2001 heightened U.S. awareness of Colombian terrorist organizations, the most powerful being the Revolutionary Armed Forces of Colombia (FARC). The U.S. counterterror approach in Colombia appears fragmented, with only minor changes to its previous drug control policies. In contrast, the Colombian government has developed and implemented a policy to ...

  12. Macroprudential Policy: A Summary

    OpenAIRE

    Mahdi Ebrahimi Kahou; Alfred Lehar

    2016-01-01

    The 2007 global financial crisis brought sharply into focus the need for macroprudential policy as a means of controlling systemic financial stability. This has become a focal point for policy-makers and numerous central banks, including the Bank of Canada, but it has its drawbacks, particularly here in Canada. As a counterbalance to microprudential policy, the idea of a macroprudential outlook reaches beyond the notion that as long as every banking institution is healthy, financial stability...

  13. Environmental Policy Law

    International Nuclear Information System (INIS)

    Lee, Sang Don

    1985-03-01

    This book tell US environmental problems and environmental conservation, theory with present situation of the problems, influence of environmental aggravation, and cause of environmental problems, environmental policy influencing environment such as the national environmental policy act in America, and the role of court and environmental policy act, jurisdiction investigation about administrative action which influence on environment, and standard of jurisdiction investigation in environmental problems and legislation of environmental rights.

  14. Pension Fund Investment Policy

    OpenAIRE

    Zvi Bodie

    1988-01-01

    The purpose of this paper is to survey what is known about the investment policy of pension funds. Pension fund investment policy depends critically on the type of plan: defined contribution versus defined benefit. For defined contribution plans investment policy is not much different than it is for an individual deciding how to invest the money in an Individual Retirement Account (IRA). The guiding principle is efficient diversification, that is, achieving the maximum expected return for any...

  15. Popular Music Policy

    OpenAIRE

    Frith, Simon; Cloonan, Martin

    2008-01-01

    This special issue of Popular Music has its origins in a seminar organised at the University of Stirling in 2004. This meeting, one of a series on cultural policy, brought together researchers from a number of European countries who were asked to describe state music policy in their respective countries and to reflect on what differences, if any, such policies had made to recent national music history. As the seminar’s organisers, we were interested in a couple of issues: first, how policy ap...

  16. Federalism and health policy.

    Science.gov (United States)

    Nathan, Richard P

    2005-01-01

    This paper presents a cyclical theory of U.S. federalism and social policy: Many social policy initiatives are tested and refined at the state level, especially during conservative periods, and later morph into national policies. The paper describes such federalism cycles and offers an interpretation of why and how they occur, focusing on Medicaid. State activism has preserved and expanded Medicaid through policy innovation and resistance to retrenchment, especially in conservative periods, by taking advantage of the flexibility the program provides. I conclude that Medicaid's incremental/partnership approach is appropriate and feasible to build on for a future expansion of health care coverage.

  17. The Policy Design Effect

    DEFF Research Database (Denmark)

    Hedegaard, Troels Fage

    2014-01-01

    attitudes have argued that this ‘policy design effect’ can be explained by a combination of self-interest patterns, public perceptions of the recipient group and whether eligibility under the policy is perceived as fair or arbitrary.The explanations, however, lack micro-level theory and testing as to why...... the design of a policy affects individual and public support. This article seeks to explain this policy design effect by theoretically outlining and testing how being proximate to recipients of a social benefit affects attitudes towards the benefit. A survey of attitudes towards spending on five social...

  18. Australian uranium mining policy

    International Nuclear Information System (INIS)

    Fisk, B.

    1985-01-01

    Australian government policy is explained in terms of adherence to the Non-Proliferation Treaty. Two alleged uncertainties are discussed: the future of Australian mining industry as a whole -on which it is said that Australian uranium mines will continue to be developed; and detailed commercial policy of the Australian government - on which it is suggested that the three-mines policy of limited expansion of the industry would continue. Various aspects of policy, applying the principles of the NPT, are listed. (U.K.)

  19. Agricultural policy schemes

    DEFF Research Database (Denmark)

    Hansen, Henning Otte

    2016-01-01

    Agricultural support is a very important element in agricultural policy in many countries. Agricultural support is basically an instrument to meet the overall objectives of the agricultural policy – objectives set by society. There are a great number of instruments and ways of intervention...... in agricultural policy and they have different functions and impacts. Market price support and deficiency payments are two very important instruments in agricultural policy; however, they belong to two different support regimes or support systems. Market price support operates in the so-called high price system...

  20. Mapping public policy on genetics.

    Science.gov (United States)

    Weisfeld, N E

    2002-06-01

    The mapping of the human genome and related advances in genetics are stimulating the development of public policies on genetics. Certain notions that currently prevail in public policy development overall--including the importance of protecting privacy of information, an interest in cost-effectiveness, and the power of the anecdote--will help determine the future of public policy on genetics. Information areas affected include discrimination by insurers and employers, confidentiality, genetic databanks, genetic testing in law enforcement, and court-ordered genetic testing in civil cases. Service issues address clinical standards, insurance benefits, allocation of resources, and screening of populations at risk. Supply issues encompass funding of research and clinical positions. Likely government actions include, among others: (1) Requiring individual consent for the disclosure of personal information, except when such consent would impose inordinate costs; (2) licensing genetic databases; (3) allowing courts to use personal information in cases where a refusal to use such information would offend the public; (4) mandating health insurers to pay for cost-effective genetic services; (5) funding pharmaceutical research to develop tailored products to prevent or treat diseases; and (6) funding training programs.

  1. Non-communicable diseases in emergencies

    DEFF Research Database (Denmark)

    Demaio, Alessandro; Jamieson, Jennifer; Horn, Rebecca

    2013-01-01

    emergencies; • Raised awareness through greater advocacy for the issue and challenges of noncommunicable diseases during and following emergencies; • Incorporation of noncommunicable diseases into existing emergency-related policies, standards, and resources; • Development of technical guidelines...

  2. Childhood Diabesity: International Applications for Health Education and Health Policy

    Science.gov (United States)

    Pinzon-Perez, Helda; Kotkin-Jaszi, Suzanne; Perez, Miguel A.

    2010-01-01

    Health policy has a direct impact on health education initiatives, health care delivery, resource allocation, and quality of life. Increasing rates in the epidemics of obesity and obesity-dependent diabetes mellitus (aka diabesity) suggest that health policy changes should be included in health education and disease prevention strategies. Health…

  3. African Journal of Economic Policy: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. The primary aim of this journal, an offshoot of the Trade Policy Research and Training Programme in Economics Department, University of Ibadan, is to provide a forum for development and equity on the African continent. It, therefore, welcomes well researched papers on the implications of a specific ...

  4. Fact-Challenged Policy. Policy Memorandum #182

    Science.gov (United States)

    Rothstein, Richard

    2011-01-01

    This paper is a response on the topic of school reform efforts being promoted by Bill Gates and other prominent education policy advocates. Last week, Microsoft Chairman Bill Gates published an op-ed in the Washington Post, "How Teacher Development could Revolutionize our Schools," proposing that American public schools should do a…

  5. Economic and Policy Review

    African Journals Online (AJOL)

    The NESG Economic and Policy Review (EPR) is a quarterly publication of the Nigerian Economic Summit Group (NESG), established to serve as an avenue for constructive analysis of economic policies and their impacts on different aspects of the business and economic environment. The EPR aims to provide unbiased, ...

  6. Science and Technology Policy

    DEFF Research Database (Denmark)

    Baark, Erik

    1996-01-01

    This paper examines the status of science and technology in Mongolia, and discusses the policy issues which have emerged with the transition to market economy in recent years.......This paper examines the status of science and technology in Mongolia, and discusses the policy issues which have emerged with the transition to market economy in recent years....

  7. Policy and Practice

    DEFF Research Database (Denmark)

    Boje, Thomas P.; Ejrnæs, Anders

    2012-01-01

    Purpose – The purpose of this paper is to develop a typology of different family policy systems in Europe and evaluate their impact on the employment strategy of mothers with care responsibilities for dependent children. Design/methodology/approach – The paper outlines a typology of family policy...

  8. Language Policy in Slovenia

    Science.gov (United States)

    Novak-Lukanovic, Sonja; Limon, David

    2012-01-01

    The historical background, political changes, migration processes, EU membership and the current socio-linguistic situation have all influenced language policy and language planning in Slovenia. This article presents the most important aspects of language policy in Slovenia with a focus on the concept of linguistic diversity. The ethnic make-up of…

  9. Governing EU employment policy

    DEFF Research Database (Denmark)

    Sørensen, Eva; Triantafillou, Peter; Damgaard, Bodil

    2015-01-01

    In the European Union (EU), employment policy is a prerogative of the member states. Therefore the EU's ability to govern in this area depends on its capability to involve national governments and relevant stakeholders in a collaborative effort to formulate and implement shared policy objectives....... of collaboration, the implementation phase mainly consists in the less demanding forms of cooperation and coordination....

  10. Knowledge to Policy

    International Development Research Centre (IDRC) Digital Library (Canada)

    In development research, getting a new discovery into policy and practice is just as ... As a matter of principle, moreover, people have a right to participate in the ...... environmental practices, tax law, competition policy, and much else besides), ...... with 80 researchers in Indonesia, Malaysia, Thailand, and the Philippines.

  11. Science and technology policy

    DEFF Research Database (Denmark)

    Who is responsible for environmental and technological policy in Denmark? And how are those "policy-makers" made accountable to the public for their decisions?   This report attempts to answer these important questions by presenting the Danish contribution to the EU-funded project, Analysing Public...

  12. Radioactive waste management policy

    International Nuclear Information System (INIS)

    Morrison, R.W.

    1983-06-01

    The speaker discusses the development of government policy regarding radioactive waste disposal in Canada, indicates overall policy objectives, and surveys the actual situation with respect to radioactive wastes in Canada. He also looks at the public perceptions of the waste management situation and how they relate to the views of governmental decision makers

  13. Modern regional innovation policy

    NARCIS (Netherlands)

    McCann, Philip; Ortega-Argiles, Raquel

    This paper analyses the evolution of regional innovation policy into the mainstream of public policy. The paper examines the empirical and theoretical developments which have shifted much of the focus on innovation-related issues to matters of economic geography. As well as academic material we also

  14. Nuclear and uranium policies

    International Nuclear Information System (INIS)

    MacNabb, G.M.; Uranium Canada Ltd., Ottawa, Ontario)

    The background of the uranium industry in Canada is described. Government policies with respect to ownership of the uranium mining industry, price stabilization, and especially reservation of sufficient supplies of nuclear fuels for domestic utilities, are explained. Canadian policy re nuclear exports and safeguards is outlined. (E.C.B.)

  15. Intercultural Policies and Education

    Science.gov (United States)

    Goncalves, Susana, Ed.; Carpenter, Markus A., Ed.

    2012-01-01

    Intercultural Policies and Education is concerned with educational challenges in multicultural societies. Educational policies, practices and strategies for fruitful coexistence in the multicultural school and classroom are explored and analysed through a collection of chapters designed and selected to provide readers with international,…

  16. Local youth policy

    NARCIS (Netherlands)

    R. Gilsing

    1999-01-01

    Original title: Lokaal jeugdbeleid. Local authorities have been given an important role in youth policy in the Netherlands. They are expected to develop preventive youth policy to increase the opportunities of young people and prevent them dropping out from society. At the request of the

  17. Behavioral decisions and policy

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.

    2011-01-01

    We study the public policy implications of a model in which agents do not fully internalize all the conscequences of their actions. Such a model unifies seemingly disconected models with behavioral agents. We evaluate the scope of paternalistic and libertarian-parternalistic policies in light of our

  18. Behavioral Decisions and Policy

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.

    2010-01-01

    We study the public policy implications of a model in which agents do not fully internalize all the conscequences of their actions. Such a model uni es seemingly disconected models with behavioral agents. We evaluate the scope of paternalistic and libertarian-parternalistic policies in the light of

  19. A Web Policy Primer.

    Science.gov (United States)

    Levine, Elliott

    2001-01-01

    Sound technology policies can spell the difference between an effective website and an online nightmare. An effective web development policy addresses six key areas: roles and responsibilities, content/educational value, privacy and safety, adherence to copyright laws, technical standards, and use of commercial sites and services. (MLH)

  20. The policy trail methodology

    DEFF Research Database (Denmark)

    Holford, John; Larson, Anne; Melo, Susana

    of ‘policy trail’, arguing that it can overcome ‘methodological nationalism’ and link structure and agency in research on the ‘European educational space’. The ‘trail’ metaphor, she suggests, captures the intentionality and the erratic character of policy. The trail connects sites and brings about change......, but – although policy may be intended to be linear, with specific outcomes – policy often has to bend, and sometimes meets insurmountable obstacles. This symposium outlines and develops the methodology, but also reports on research undertaken within a major FP7 project (LLLIght’in’Europe, 2012-15) which made use......In recent years, the “policy trail” has been proposed as a methodology appropriate to the shifting and fluid governance of lifelong learning in the late modern world (Holford et al. 2013, Holford et al. 2013, Cort 2014). The contemporary environment is marked by multi-level governance (global...

  1. Energy crisis: policy response

    Energy Technology Data Exchange (ETDEWEB)

    Nemetz, P N [ed.

    1981-01-01

    Resource-management techniques must be applied to assess the risks, benefits, priorities, and potentials of the different energy options as prospective slowdowns in the flow of crude oil threaten recurring energy crises. The 23 contributors to this book use various managerial approaches in the formulation of energy policies. There is little agreement among the remedies put forth as to which policies will best achieve a balanced energy system. While some experts argue that Canadian energy policy should emphasize intensive development of coal, others claim that it ought to strive for greater reliance on electricity, and still others contend that the transition to soft energy paths is a preferable policy approach. The essays offer a broad range of policy responses, examining not only technical and economic possibilities, but political and institutional alternatives as well. 147 references, 18 figures, 30 tables.

  2. Good Tourism Policies

    DEFF Research Database (Denmark)

    Ooi, Can-Seng

    Tourism policy matters in cultural tourism. The starting point of this paper is the observation that many tourism policy studies draw three inter-related conclusions. One, tourism policy must be inclusive and require the support of different stakeholders (Baker 2009; Bernhard Jørgensen and Munar...... 2009). Two, a balanced approach to tourism policy is needed to harness the benefits of tourism while mitigating negative effects (Budeanu 2009; Chang 1997; Jenkins 1997; Leheny 1995, Newby 1994; Teo and Yeoh, 1997). Three, tourism policies should accentuate and maintain the cultural uniqueness...... and authenticity of the destination (Morgan et al. 2011). It seems that many tourism authorities are ignorant of local interests, unaware of the touristification of local cultures and uninterested in promoting local cultures. But local cultures and communities are what that constitute cultural tourism....

  3. Collaborative Policy Innovation

    DEFF Research Database (Denmark)

    Sørensen, Eva; Boch Waldorff, Susanne

    2014-01-01

    Governments all over the Western world currently face wicked problems that call for policy innovation. A new strand of research in public innovation points to collaboration between public authorities and relevant and affected stakeholders as an important driver of public innovation. A case study...... of collaborative policy innovation in the area of mental health care in Denmark indicates that collaboration can contribute to qualify the politicians’ understanding of wicked policy problems, and to fostering new creative policy solutions. The study also shows, however, that the new problem understandings...... and policy ideas produced in collaborative governance arenas are not diffused to the formal political institutions of representative democracy because the participating politicians only to a limited extent function as boundary spanners between the collaborative governance arena and the decision making arenas...

  4. Random maintenance policies

    CERN Document Server

    Nakagawa, Toshio

    2014-01-01

    Exploring random maintenance models, this book provides an introduction to the implementation of random maintenance, and it is one of the first books to be written on this subject.  It aims to help readers learn new techniques for applying random policies to actual reliability models, and it provides new theoretical analyses of various models including classical replacement, preventive maintenance and inspection policies. These policies are applied to scheduling problems, backup policies of database systems, maintenance policies of cumulative damage models, and reliability of random redundant systems. Reliability theory is a major concern for engineers and managers, and in light of Japan’s recent earthquake, the reliability of large-scale systems has increased in importance. This also highlights the need for a new notion of maintenance and reliability theory, and how this can practically be applied to systems. Providing an essential guide for engineers and managers specializing in reliability maintenance a...

  5. The french energy policy

    International Nuclear Information System (INIS)

    1991-01-01

    This book describes french energy policy from 1973 oil crisis till 1992. In a first part, energy consumption, domestic primary energy production, trend of independence energy ratio and costs of petroleum imports in France are presented. In a second part, long-term energy prospects and new axis of energy policy are given: trends of french energy needs, progressive substitution of fossil fuels by nuclear energy and hydroelectric power, energy policy in Common Market and cooperation with eastern Europe. In a third part, energy demand and supply are studied: energy conservation policy in housing, transport and industrial sector is developed. Power generation policy is focused on two main stakes: the choice of investments and nuclear power plants programming, the quality of electric power and the development of efficient uses and exports. A diversification between coal petroleum and natural gas is led. After the fall of petroleum prices in 1986, renewable energies have lost their competitiveness, fire wood occupies a significant place

  6. Australian internet policy

    Directory of Open Access Journals (Sweden)

    Angela Daly

    2017-03-01

    Full Text Available This special issue focussing on internet policy in Australia provides a snapshot of developments on various topics (access, privacy, censorship as a means of understanding better the state of play in Australia, and also how this compares to internet policy in other parts of the world, especially Europe and North America. Given changing geopolitics, the influence of internet policy in the rest of the Asia Pacific through vehicles such as the Regional Comprehensive Economic Partnership (RCEP may become increasingly important in Australia in the coming years. This leaves Australia, and its internet policy, at a crossroads, which may reflect broader dynamics in internet policy internationally, and makes this an interesting time in which to explore what is happening in this particular country.

  7. Evidence-based policy: implications for nursing and policy involvement.

    Science.gov (United States)

    Hewison, Alistair

    2008-11-01

    Evidence-based policy making is espoused as a central feature of government in the United Kingdom. However, an expectation that this will improve the quality of policy produced and provide a path to increased involvement of nurses in the policy process is misplaced. The purpose of this article is to demonstrate that the emphasis on evidence-based policy is problematic and cannot be regarded as a "new model" of policy making. Also, it could deflect attention from more practical approaches to policy involvement on the part of nurses. Policy development activities, acquisition of skills in policy analysis, and other forms of involvement are needed if nurses are to move along the continuum from policy literacy, through policy acumen, to policy competence. This involves taking a critical stance on the notion of evidence-based policy.

  8. Modeling environmental policy

    International Nuclear Information System (INIS)

    Martin, W.E.; McDonald, L.A.

    1997-01-01

    The eight book chapters demonstrate the link between the physical models of the environment and the policy analysis in support of policy making. Each chapter addresses an environmental policy issue using a quantitative modeling approach. The volume addresses three general areas of environmental policy - non-point source pollution in the agricultural sector, pollution generated in the extractive industries, and transboundary pollutants from burning fossil fuels. The book concludes by discussing the modeling efforts and the use of mathematical models in general. Chapters are entitled: modeling environmental policy: an introduction; modeling nonpoint source pollution in an integrated system (agri-ecological); modeling environmental and trade policy linkages: the case of EU and US agriculture; modeling ecosystem constraints in the Clean Water Act: a case study in Clearwater National Forest (subject to discharge from metal mining waste); costs and benefits of coke oven emission controls; modeling equilibria and risk under global environmental constraints (discussing energy and environmental interrelations); relative contribution of the enhanced greenhouse effect on the coastal changes in Louisiana; and the use of mathematical models in policy evaluations: comments. The paper on coke area emission controls has been abstracted separately for the IEA Coal Research CD-ROM

  9. The agricultural policy of Serbia and common agricultural policy

    Directory of Open Access Journals (Sweden)

    Stanković Milica

    2012-01-01

    Full Text Available The agricultural sector has a relatively high importance in the economic structure of Serbia. The Common Agricultural Policy (CAP, Common Agricultural Policy is one of the main policies of the European Union. It is very important to point out the fundamental principles and objectives of the Common Agricultural Policy. Harmonization of the national agricultural policy of Serbia with the Common Agricultural Policy and acceptance of its mechanisms is crucial for the development of the agricultural sector as a whole.

  10. Virtual policy networks: navigating the policy web

    OpenAIRE

    McNutt, Kathleen

    2006-01-01

    Governing in an information-rich environment necessitates a redistribution of power and new approaches to policy learning. The key basis for this organizational repositioning is the accommodation of information. For the first time in human history mass amounts of information may be collected, stored, and searched using networked technologies. While informational assets are a critical commodity in the policymaking process, the extraordinary increase in the creation and dissemination of informa...

  11. Community energy policy

    International Nuclear Information System (INIS)

    Redondo Melchor, N.; Redondo Quintela, F.

    1994-01-01

    The twelve Member states of the European Union will attempt to make their national energy policies converge. Nevertheless the basis of the so called ''Community Energy Policy'' is not this convergence but rather the achievement of a new internal market, the Energy Market, where sources and forms of energy may circulate freely between countries. This aim derives from a change of orientation, dating back some years, when market integration was attempted instead of continuing with the mere unification of national policies. In this paper we summarize the most relevant aspects of the liberalization process and give some of its internal and external repercussions on the European Union. (Author)

  12. Cultural Policy in Iceland

    DEFF Research Database (Denmark)

    Gudmundsson, Gestur

    2003-01-01

    on the continuing emphasis on central cultural institution and the Icelandic language. Since the 1970s Cold War conflicts have been replaced by a consensus on growing support to artists and an armth's length policy, and furthermore the 1990s have seen a strong move towards NPM and international participation.......The article examines the history of cultural policy in Iceland from a Nordic comparative perspective. National cultural policy takes form in the 19th and early 20th century as a part of the nation-building, emphasising the Icelandic language as the core of national identity, building cultural...

  13. COMMON FISCAL POLICY

    Directory of Open Access Journals (Sweden)

    Gabriel Mursa

    2014-08-01

    Full Text Available The purpose of this article is to demonstrate that a common fiscal policy, designed to support the euro currency, has some significant drawbacks. The greatest danger is the possibility of leveling the tax burden in all countries. This leveling of the tax is to the disadvantage of countries in Eastern Europe, in principle, countries poorly endowed with capital, that use a lax fiscal policy (Romania, Bulgaria, etc. to attract foreign investment from rich countries of the European Union. In addition, common fiscal policy can lead to a higher degree of centralization of budgetary expenditures in the European Union.

  14. Bayesian policy reuse

    CSIR Research Space (South Africa)

    Rosman, Benjamin

    2016-02-01

    Full Text Available Keywords Policy Reuse · Reinforcement Learning · Online Learning · Online Bandits · Transfer Learning · Bayesian Optimisation · Bayesian Decision Theory. 1 Introduction As robots and software agents are becoming more ubiquitous in many applications.... The agent has access to a library of policies (pi1, pi2 and pi3), and has previously experienced a set of task instances (τ1, τ2, τ3, τ4), as well as samples of the utilities of the library policies on these instances (the black dots indicate the means...

  15. Tobacco control, global health policy and development: towards policy coherence in global governance

    Science.gov (United States)

    Collin, Jeff

    2015-01-01

    The WHO Framework Convention on Tobacco Control (FCTC) demonstrates the international political will invested in combating the tobacco pandemic and a newfound prominence for tobacco control within the global health agenda. However, major difficulties exist in managing conflicts with foreign and trade policy priorities, and significant obstacles confront efforts to create synergies with development policy and avoid tensions with other health priorities. This paper uses the concept of policy coherence to explore congruence and inconsistencies in objectives, policy, and practice between tobacco control and trade, development and global health priorities. Following the inability of the FCTC negotiations to satisfactorily address the relationship between trade and health, several disputes highlight the challenges posed to tobacco control policies by multilateral and bilateral agreements. While the work of the World Bank has demonstrated the potential contribution of tobacco control to development, the absence of non-communicable diseases from the Millennium Development Goals has limited scope to offer developing countries support for FCTC implementation. Even within international health, tobacco control priorities may be hard to reconcile with other agendas. The paper concludes by discussing the extent to which tobacco control has been pursued via a model of governance very deliberately different from those used in other health issues, in what can be termed ‘tobacco exceptionalism’. The analysis developed here suggests that non-communicable disease (NCD) policies, global health, development and tobacco control would have much to gain from re-examining this presumption of difference. PMID:22345267

  16. Rollout sampling approximate policy iteration

    NARCIS (Netherlands)

    Dimitrakakis, C.; Lagoudakis, M.G.

    2008-01-01

    Several researchers have recently investigated the connection between reinforcement learning and classification. We are motivated by proposals of approximate policy iteration schemes without value functions, which focus on policy representation using classifiers and address policy learning as a

  17. Realism in Foreign Policy Analysis

    DEFF Research Database (Denmark)

    Wivel, Anders

    2017-01-01

    'Realism in Foreign Policy Analysis' traces how realist thinking on foreign policy has developed over the years and discusses the challenges and opportunities faced by various strands of realism when applied to foreign policy analysis....

  18. The Politics of Industrial Policy

    DEFF Research Database (Denmark)

    Whitfield, Lindsay; Buur, Lars

    2014-01-01

    Economic transformation is driven by successfully implemented industrial policy, but industrial policy is inherently political. We cannot understand why some governments pursue and implement industrial policy better than others without understanding the politics. This article addresses...

  19. Advances in disease control of tick and tick-borne diseases

    African Journals Online (AJOL)

    J.nfection and treatment method ofimmunisation has been devised ... providing research and training and in extension work on. TBDs. ... systems, cattle types, level of disease risk, disease control policies ... This paper highlights tick .control,.

  20. Energy policy, strategies for uncertainty

    International Nuclear Information System (INIS)

    Cook, P.L.; Surrey, A.J.

    1977-01-01

    The subject is dealt with in chapters, entitled: energy policy-objectives, strategies and policies; the 1967 fuel policy; problems of the optimising approach; the uncertain outlook; oil; coal; gas; electricity; the interdependence of the four fuel industries; energy policy for the future - the need for a long-term strategy; medium-term strategies and short-term policies; the organisational decisions of energy policy. Nuclear power is included in the subject matter. (U.K.)

  1. Evaluation and Policy Learning

    DEFF Research Database (Denmark)

    Borrás, Susana; Højlund, Steven

    2015-01-01

    This article examines how evaluation induces policy learning – a question largely neglected by the scholarly literature on evaluation and policy learning. Following a learner's perspective, the article attempts to ascertain who the learners are, and what, and how, learners actually learn from...... evaluations. In so doing, it focuses on what different types of learners actually learn within the context of the evaluation framework (the set of administrative structures defining the evaluation goals and process). Taking the empirical case of three EU programme evaluations, the patterns of policy learning...... emanating from them are examined. The findings are that only two types of actors involved in the evaluation are actually learning (programme units and external evaluators), that learners learn different things (programme overview, small-scale programme adjustments, policy change and evaluation methods...

  2. Energy Policy Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Energy Policy Act (EPA) addresses energy production in the United States, including: (1) energy efficiency; (2) renewable energy; (3) oil and gas; (4) coal; (5)...

  3. Energy policy in Maghreb

    International Nuclear Information System (INIS)

    Rabah, S.

    1993-01-01

    This paper presents energy policy in Algeria, Morocco and Tunisia. Statistical data on fossil fuels reserves and renewable energy sources are given. This paper describes also energy consumption and energy conservation, power generation and interconnected power systems. 5 tabs

  4. Federal research policy 1988

    International Nuclear Information System (INIS)

    1988-01-01

    The report covers several separate parts dealing with the following: Orientation and perspectives of the Federal Government's research policy; resources available for science, research and development; fields of main interest in R and D work sponsored by the Government; research and technology policy of the Lands; international and national research and technology policy; organisations promoting and establishment doing research work in the FRG; statistics. The guidelines and principles of research policy are given: freedom of science and research; restraint from governmental influence within the meaning of the subsidiarity principle; positive attitude to scientific and technical progress; investigation of long-term perspectives and options; fostering joint responsibility of the Federal Government and the Lands; development of international cooperation. (orig./HSCH) [de

  5. Assessing sustainable freight policies.

    Science.gov (United States)

    2014-05-01

    The main aim of the study was to examine transportation demand management strategies related to long haul freight. It investigates freight : movements and truck vehicle miles traveled (TVMT) changes in response to certain transportation policies, inc...

  6. Identification and Authentication Policy

    National Research Council Canada - National Science Library

    Gimble, Thomas

    1999-01-01

    .... We will accomplish the audit objective in two phases. In this phase, we reviewed current DoD Component policies on the use of identification and authentication controls to access information systems...

  7. Omega report: energy policy

    International Nuclear Information System (INIS)

    1984-01-01

    The Adam Smith Institute's Omega Project was conceived to fill a significant gap in the field of public policy research. Administrations entering office in democratic societies are often aware of the problems which they face, but lack a well-developed range of policy options. The Omega Project was designed to create and develop new policy initiatives, to research and analyze these new ideas, and to bring them forward for public discussion in ways which overcame the conventional shortcomings. The organization of the Project is described. The results are presented in sections entitled: energy supplies and policy; the gas industry; North Sea oil; the coal industry; the electricity industry; nuclear energy; renewable and alternative fuel sources; energy conservation. (U.K.)

  8. Solar energy policy review

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-08-17

    A number of memoranda and reports are collected which deal with evaluations of solar energy policy options, including direct and indirect labor impacts and costs of different options and consumer protection. (LEW)

  9. New food policy

    DEFF Research Database (Denmark)

    Christensen, Tove; Andersen, Lill

    The urbanisation, technical changes, and the industrialisation of the food systems on one hand and increased income and changes in lifestyles on the other hand transform the way food is produced, marketed and consumed - those changes call for changes in the nature of food policy. Concerns over food...... safety have become an important driver of reform of food policy. In particular, the BSE crisis in 1996 had a significant impact on the formulation of a change in food safety policy in the EU. The White Paper on Food Safety was prepared by the EU commision as a response to the BSE scandal as the EU felt...... a need for restablishing public confidence in its food supply, its food science, its laws and its food control. In addition, the White Paper on Food Safety points towards a farm to fork policy in that 'as the food production chain is becoming increasingly complex, the health of consumers can ony...

  10. Exchange Risk Management Policy

    CERN Document Server

    2005-01-01

    At the Finance Committee of March 2005, following a comment by the CERN Audit Committee, the Chairman invited the Management to prepare a document on exchange risk management policy. The Finance Committee is invited to take note of this document.

  11. Policy in Focus

    International Development Research Centre (IDRC) Digital Library (Canada)

    Public Education in Mexico: Is all the. Spending for ... advantage of its demographic transition if proper educational and health policies are in place to .... traditional Generational Accounting, and ..... that, in modern societies, when individuals.

  12. Social Media Policies

    DEFF Research Database (Denmark)

    Stohl, Cynthia; Etter, Michael; Banghart, Scott

    2017-01-01

    of these trends is examined through a content analysis of 112 publicly available social media policies from the largest corporations in the world. The extent to which social media policies facilitate and/or constrain the communicative sensibilities and values associated with contemporary notions of CSR...... negotiation and participation in the social responsibilities of corporations. Moreover, policies generally enact organizational communication practices that are contrary to international CSR guidelines (e.g., the UN Global Compact and other international agreements). Findings suggest that social media...... policies represent a relatively unrecognized development in the institutionalization of CSR communicative norms and practices that call into question the promising affordances of social media for the inclusion of various voices in the public negotiation of what constitutes corporate social responsibility....

  13. PUBLIC POLICY AND TAXATION

    Directory of Open Access Journals (Sweden)

    IOSIF MOLDOVAN

    2014-10-01

    Full Text Available The state administration process and hence also the economy coordination effort requires the promotion of robust, consistent and transparent public policy, which must be accepted by all stakeholders of economic development. Public policy is a set of measures taken by the authorities legally constituted as public power. Under normal conditions these policy aims at improving living conditions of citizens by developing grounded strategies which are applied by measures implemented to stimulate economic development in all its complexity by harmonizing the efforts of the institutional and non-institutional bodies responsible for ensuring the overall public interest. In Romania, public policies, especially fiscal ones on which we dwell, not reached in many cases the expected effects primarily because of their superficial grounding, lack of transparency, unpredictability, poor communication and secondly as an effect of ineffective management of public financial resources.

  14. National Cyber Security Policy

    Indian Academy of Sciences (India)

    National Cyber Security Policy. Salient Features: Caters to ... Creating a secure cyber ecosystem. Creating an assurance framework. Encouraging Open Standards. Strengthening the Regulatory framework. Creating mechanisms for security threat early warning, vulnerability management and response to security threats.

  15. Assessing Screening Policies for Childhood Obesity

    Science.gov (United States)

    Wein, Lawrence M.; Yang, Yan; Goldhaber-Fiebert, Jeremy D.

    2014-01-01

    To address growing concerns over childhood obesity, the United States Preventive Services Task Force (USPSTF) recently recommended that children undergo obesity screening beginning at age 6 [1]. An Expert Committee recommends starting at age 2 [2]. Analysis is needed to assess these recommendations and investigate whether there are better alternatives. We model the age- and sex-specific population-wide distribution of body mass index (BMI) through age 18 using National Longitudinal Survey of Youth data [3]. The impact of treatment on BMI is estimated using the targeted systematic review performed to aid the USPSTF [4]. The prevalence of hypertension and diabetes at age 40 are estimated from the Panel Study of Income Dynamics [5]. We fix the screening interval at 2 years, and derive the age- and sex-dependent BMI thresholds that minimize adult disease prevalence, subject to referring a specified percentage of children for treatment yearly. We compare this optimal biennial policy to biennial versions of the USPSTF and Expert Committee recommendations. Compared to the USPSTF recommendation, the optimal policy reduces adult disease prevalence by 3% in relative terms (the absolute reductions are disease prevalence at a 28% reduction in treatment referral rate. If compared to the Expert Committee recommendation, the reductions change to 6% and 40%, respectively. The optimal policy treats mostly 16 year olds and few children under age 14. Our results suggest that adult disease is minimized by focusing childhood obesity screening and treatment on older adolescents. PMID:22240724

  16. Green industrial policy

    OpenAIRE

    Dani Rodrik

    2014-01-01

    Green growth requires green technologies: production techniques that economize on exhaustible resources and emit fewer greenhouse gases. The availability of green technologies both lowers social costs in the transition to a green growth path and helps achieve a satisfactory rate of material progress under that path. The theoretical case in favour of using industrial policy to facilitate green growth is quite strong. Economists’ traditional scepticism on industrial policy is grounded instead o...

  17. Swedish Disarmament Policy

    OpenAIRE

    2012-01-01

    NPIHP Partners Host Conference on Swedish Disarmament Policy Dec 05, 2012 The Nuclear Proliferation International History Project is pleased to announce a conference on Swedish nuclear disarmament policy, organized and hosted by Stockholm University on 26 november 2012. Organized by Stockholm University Professor Thomas Jonter, Emma Rosengren, Goran Rydeberg, and Stellan Andersson under the aegis of the Swedish Disarmament Resaerch Project, the conference featured keynote addresses by Hans Bl...

  18. Science and Policy

    Digital Repository Service at National Institute of Oceanography (India)

    Mukhopadhyay, R.

    that it is essential to reflect the thinking of senior-level scien- tists and technologists on the broader policies of scientific management in the country, a group of 22 senior scientists and heads of specialized divisions of major national institutes... health, cyber security, wildlife management, environment, renewable energy, foreign policy, and primary and higher education. For the ensuing century and even be- yond, S&T would be the leading element in spearheading the mental, psychologi- cal...

  19. Innovation Policies of Brazil

    Science.gov (United States)

    2013-09-01

    technology priorities and coordinates policies Ministry of Science, Technology and Innovation (Ministério da Ciência, Tecnologia e Inovação, MCTI... Tecnologia e Inovação, MCTI) initiated the Greater IT policy to build and enhance the country’s information, communications, and technology...Technology Institute) MCMM Ministry of Communications and Mass Media MCTI Ministério da Ciência, Tecnologia e Inovação (Ministry of Science, Technology

  20. Competition Policy in Malaysia

    OpenAIRE

    Lee, Cassey

    2004-01-01

    Malaysia does not have a national competition law. Competition is regulated at the sectoral level in the country. Two economic sectors have legal provisions for competition law but these have been relatively ineffectively enforced. The benefits of Malaysia's industrial policy as well as the policy reforms in regulation and trade have been compromised by the lack of a formal institution to address competition related issues. Hence, the future priority and direction of regulatory reform is obvi...

  1. Fertility and Population Policy

    OpenAIRE

    Ouedraogo, Abdoulaye; Tosun, Mehmet S.; Yang, Jingjing

    2018-01-01

    There have been significant changes in both the fertility rates and fertility perception since 1970s. In this paper, we examine the relationship between government policies towards fertility and the fertility trends. Total fertility rate, defined as the number of children per woman, is used as the main fertility trend variable. We use panel data from the United Nations World Population Policies database, and the World Bank World Development Indicators for the period 1976 through 2013. We find...

  2. Energy operations policy

    International Nuclear Information System (INIS)

    1993-01-01

    It is reported that energy policy was designed following the European Bank for Reconstruction and Development review of the most pressing energy issues confronting Central and Eastern Europe and the republics of the former Soviet Union. The main features of the policy described in the document set the general framework for the Bank's energy operations. Energy strategies for particular countries are designed as an integral part of the Bank's individual country strategies. Tabs

  3. Macroeconomics and Growth Policies

    OpenAIRE

    Jayati Ghosh

    2007-01-01

    This United Nations Background Note on Macroeconomics and Growth provides practical guidance on how to operationalize alternative equitable and employment-generating macroeconomic and growth policies in National Development Strategies. This Policy Note has been developed in cooperation with UN agencies, and has been officially reviewed by distinguished academics/ development specialists such as Jose Antonio Ocampo, Jomo K.S. and Nobel Laureate Joseph Stiglitz.

  4. Nuclear safeguards policy

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    Claims have been made that Australia's nuclear safeguards policy, announced in 1977, has changed. However, examination of the texts of nuclear safeguards agreements negotiated by Australia shows that the policy has been implemented and adhered to. The purpose of these agreements is to obtain assurance that uranium exported is used exclusively for peaceful purposes. The questions of reprocessing, transfer to third countries and the application of IAEA safeguards are discussed

  5. Nanotechnology: A Policy Primer

    Science.gov (United States)

    2013-06-24

    savings in the United States of 24 million barrels of oil.4 • Universal access to clean water. Nanotechnology water desalination and filtration...CRS Report for Congress Prepared for Members and Committees of Congress Nanotechnology : A Policy Primer John F. Sargent Jr. Specialist...COVERED 00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Nanotechnology : A Policy Primer 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

  6. Counterterrorism: Policy of Preemptive Action

    National Research Council Canada - National Science Library

    Westphal, Stephen

    2003-01-01

    ... our counterterrorism policy and it's ability to prevent future acts of terrorism. The specific focus during this counterterrorism policy review is the terrorism prevention concept of preemptive action...

  7. Urban photovoltaic electricity policies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-10-15

    This report for the International Energy Agency (IEA) made by Task 10 of the Photovoltaic Power Systems (PVPS) programme takes a look at urban photovoltaic electricity policies. The mission of the Photovoltaic Power Systems Programme is to enhance the international collaboration efforts which accelerate the development and deployment of photovoltaic solar energy as a significant and sustainable renewable energy option. The objective of Task 10 is stated as being to enhance the opportunities for wide-scale, solution-oriented application of photovoltaics in the urban environment. The goal of the study presented was to evaluate a standardised basis for urban policies regarding photovoltaic integration in a set of cities in the countries participating in the IEA's Task 10, Urban Scale PV. The investigation was focused on three topics: the present state of the policies, the prospects for future policies fostering photovoltaic deployment and the prospects for future policies to cope with large-scale photovoltaic integration. The first section analyses the state of the policies; this analysis is then confirmed in section 2, which deals with present obstacles to PV deployment and solutions to overcome them. The third section investigates future prospects for PV deployment with the question of mastering large scale integration. The report concludes that cities could formulate urban solutions by developing integrated, specific provisions for PV deployment in their urban infrastructure planning.

  8. Farber's Disease

    Science.gov (United States)

    ... management, and therapy of rare diseases, including the lipid storage diseases. Research on lipid storage diseases within the Network includes ... management, and therapy of rare diseases, including the lipid storage diseases. Research on lipid storage diseases within the Network includes ...

  9. Multisector Health Policy Networks in 15 Large US Cities

    Science.gov (United States)

    Leider, J. P.; Carothers, Bobbi J.; Castrucci, Brian C.; Hearne, Shelley

    2016-01-01

    Context: Local health departments (LHDs) have historically not prioritized policy development, although it is one of the 3 core areas they address. One strategy that may influence policy in LHD jurisdictions is the formation of partnerships across sectors to work together on local public health policy. Design: We used a network approach to examine LHD local health policy partnerships across 15 large cities from the Big Cities Health Coalition. Setting/Participants: We surveyed the health departments and their partners about their working relationships in 5 policy areas: core local funding, tobacco control, obesity and chronic disease, violence and injury prevention, and infant mortality. Outcome Measures: Drawing on prior literature linking network structures with performance, we examined network density, transitivity, centralization and centrality, member diversity, and assortativity of ties. Results: Networks included an average of 21.8 organizations. Nonprofits and government agencies made up the largest proportions of the networks, with 28.8% and 21.7% of network members, whereas for-profits and foundations made up the smallest proportions in all of the networks, with just 1.2% and 2.4% on average. Mean values of density, transitivity, diversity, assortativity, centralization, and centrality showed similarity across policy areas and most LHDs. The tobacco control and obesity/chronic disease networks were densest and most diverse, whereas the infant mortality policy networks were the most centralized and had the highest assortativity. Core local funding policy networks had lower scores than other policy area networks by most network measures. Conclusion: Urban LHDs partner with organizations from diverse sectors to conduct local public health policy work. Network structures are similar across policy areas jurisdictions. Obesity and chronic disease, tobacco control, and infant mortality networks had structures consistent with higher performing networks, whereas

  10. The Politics of Healthy Policies: Redesigning health impact assessment to integrate health in public policy

    NARCIS (Netherlands)

    M.P.M. Bekker (Marleen)

    2007-01-01

    textabstractPublic health issues, such as obesity, lung disease from air pollution or mental health complaints from living in an unsafe neighbourhood, are complex, intractable policy problems. The causes are dispersed at the individual and the collective level among different societal

  11. School Sun-Protection Policies: Measure Development and Assessments in 2 Regions of the United States

    Science.gov (United States)

    Reynolds, Kim D.; Buller, David B.; French, Simone A.; Buller, Mary K.; Ashley, Jeff L.

    2012-01-01

    Background: In 2002, the US Centers for Disease Control and Prevention recommended that schools adopt policies that reduce exposure of children to ultraviolet radiation to prevent skin cancer. We report here the development of a school sun-safety policy measure and baseline descriptive statistics from the assessment of written policies collected…

  12. Historical survey of nonproliferation policies

    International Nuclear Information System (INIS)

    Goldschmidt, B.

    1977-01-01

    This paper briefly surveys the successive nonproliferation policies and their influence on international commerce and the reaction of the countries where they were applied: the war policy, secrecy policy, liberal policy, safeguarded assistance policy, nonproliferation treaty policy, suppliers' policy, French policy, and the no weapon-usable material policy. It is emphasized that any new solution of the problem must not appear to delay or limit in any way a nation's access to nuclear energy, nor to make any countries dependent on others to meet their energy requirements. Therefore, in the choice of a future policy, political considerations are more important than technical or legal ones. The greatest catalyst of proliferation is the spread of national autarchic programs, and these can only be avoided within a general climate of international trust. The escalation of mistrust between the countries possessing the technological information and those desiring it must be dispelled. Such a policy will have to be clear and stable

  13. Reshaping skills policy in South Africa: structures, policies and ...

    African Journals Online (AJOL)

    Reshaping skills policy in South Africa: structures, policies and processes. ... New Agenda: South African Journal of Social and Economic Policy ... South African skills development policy since the promulgation of the Skills Development Act of 1998 has undergone a number of different iterations or attempts at accelerating ...

  14. Venue Shifts and Policy Change in EU Fisheries Policy

    NARCIS (Netherlands)

    Princen, S.B.M.

    2010-01-01

    Over the past two decades profound changes have taken place in the European Union's (EU) fisheries policy. Partly these changes have occurred within the EU's Common Fisheries Policy itself, but partly policy change has been effected by the application of environmental legislation and policy

  15. Improving health through policies that promote active travel: A review of evidence to support integrated health impact assessment

    NARCIS (Netherlands)

    Nazelle, A. de; Nieuwenhuijsen, M.J.; Antó, J.M.; Brauer, M.; Briggs, D.; Braun-Fahrlander, C.; Cavill, N.; Cooper, A.R.; Desqueyroux, H.; Fruin, S.; Hoek, G.; Panis, L.I.; Janssen, N.; Jerrett, M.; Joffe, M.; Andersen, Z.J.; Kempen, E. van; Kingham, S.; Kubesch, N.; Leyden, K.M.; Marshall, J.D.; Matamala, J.; Mellios, G.; Mendez, M.; Nassif, H.; Ogilvie, D.; Peiró, R.; Pérez, K.; Rabl, A.; Ragettli, M.; Rodríguez, D.; Rojas, D.; Ruiz, P.; Sallis, J.F.; Terwoert, J.; Toussaint, J.-F.; Tuomisto, J.; Zuurbier, M.; Lebret, E.

    2011-01-01

    Substantial policy changes to control obesity, limit chronic disease, and reduce air pollution emissions, including greenhouse gasses, have been recommended. Transportation and planning policies that promote active travel by walking and cycling can contribute to these goals, potentially yielding

  16. Moderation in Australia-Policy and Achievements

    Directory of Open Access Journals (Sweden)

    CREINA STOCKLEY

    2004-01-01

    Full Text Available Alcohol has been consumed in Australia since European settlement in 1788. In 1998, approximately 60 % of Australians consumed an alcoholic beverage at least once per week. The effects of alcohol on the human body are dose dependent, where the harmful effects of alcohol are generally observed only when alcohol consumption exceeds moderate consumption levels of 30 to 40 g of alcohol per day. The discovery that a J-shaped curve described the relationship between level of alcohol consumption and risk of cardiovascular disease was, however, only made in 1990_cardiovascular disease is the leading cause of death in the western world. Thus prior to 1990, Australian public health policy focused primarily on the harmful effects of alcohol consumption and the health benefits of a moderate level of alcohol consumption have only recently been recognized in public policy. This paper chronicles changes in Australian Federal government policy on alcohol since the initial draft National health policy on alcohol in Australia was presented to the Ministerial Council on Drug Strategy in 1987 to the National Drug Strategic plan for action 2001 to 2003-2004 which was launched in July last year

  17. Challenges for decommissioning policies

    International Nuclear Information System (INIS)

    Riotte, H.

    2007-01-01

    In the coming years, OECD member countries will be increasingly faced with the need to make appropriate provisions, in terms of policy, finance and management, for all aspects of decommissioning. Decommissioning requires regulatory approval and oversight, the directions of which are guided by national policy. In several instances, governments have only recently begun to address their approaches to decommissioning policy and regulation in national legislation, and international overviews of such approaches, which may eventually lead to international harmonization, are only now beginning to emerge. In parallel, policy and regulation have been evolving and a broadened competence has developed in relevant regulatory authorities. The challenge lying ahead is to establish a framework that will allow for the growth of nuclear industrial activities in competitive, globalized markets, while maintaining and assuring the safety of decommissioning for the public and for workers. Within this context, institutional arrangements, stakeholder issues, costs and funding, waste management and policies for release from regulatory control, as well as the availability of technologies and skills, need to be reviewed. (author)

  18. Energy policy of France

    International Nuclear Information System (INIS)

    Revol, H.

    2001-01-01

    In November 1997, the French senate decided the creation of an inquiry commission in order to start up a study about the future of the French energy policy. The commission has interviewed the overall actors of the energy policy: ministers, heads of energy companies, higher officials, syndicates, consumer and environment protection associations, scientists and economists. The inquiry has been extended to other countries of the European community, and also to China, Japan, the USA and Canada. Despite various economical contexts and resources, all these countries have developed energy policies which aim at ensuring an energy independence and at supplying energy at the best price for a better economic competitiveness. This report presents first the French experience and the evolution of the French energy policy during the last 50 years with respect to the economical and political constraints encountered. The second part is a reflection about the principles that will guide the French energy policy in the context of deregulation of the European energy market and of the environmental constraints imposed by the Kyoto summit. Detailed proposals for the increase of the French energy independence are presented in conclusion of the report. (J.S.)

  19. China's power policy

    International Nuclear Information System (INIS)

    Mayer, M.

    2006-01-01

    Whether the People's Republic of China may develop to an economical super-government in future depends on the amount of power and resources of this land. The security of power supply is in an extremely prominent position in the Agenda of the Chinese government. Under this aspect the author of the contribution under consideration reports on the power policy of China. The main aspects of this contribution are: (a) Trends of power consumption, productions and imports of power; (b) Power political targets, measures and instruments of China; (c) Characteristics, national and international impacts of the power policy of China. Due to the economical activities of the chinese oil industry worldwide as well as due to the increasing dependence from imports of petroleum and natural oil, China becomes a global player. Thus, one may expect an intensification of Beijing's economical activities with an increased military component. Nevertheless, the power policy of China is an important factor in the global competition according to fossil resources. In order to understand the future behaviour of China's power policy, one may have to take notice of the strategies relating the power policy and relating to foreign affairs. Furthermore, trends and problematic areas concerning the securitization of the power supply in the national area have to be observed

  20. Website Policies / Important Links | DOepatents

    Science.gov (United States)

    Links Website Policies / Important Links Javascript Not Enabled OSTI Security Website Policies and first) Publication Date (oldest first) Close Clear All Find DOepatents Website Policies / Important Important Links Some links on this page may take you to non-federal websites. Their policies may differ from

  1. Challenges in orphan drug development and regulatory policy in China.

    Science.gov (United States)

    Cheng, Alice; Xie, Zhi

    2017-01-18

    While regulatory policy is well defined for orphan drug development in the United States and Europe, rare disease policy in China is still evolving. Many Chinese patients currently pay out of pocket for international treatments that are not yet approved in China. The lack of a clear definition and therefore regulatory approval process for rare diseases has, until now, de-incentivized pharmaceutical companies to pursue rare disease drug development in China. In turn, many grassroots movements have begun to support rare disease patients and facilitate drug discovery through research. Recently, the Chinese FDA set new regulatory guidelines for drugs being developed in China, including an expedited review process for life-saving treatments. In this review, we discuss the effects of these new policy changes on and suggest potential solutions to innovate orphan drug development in China.

  2. Toward a comprehensive long term nicotine policy.

    Science.gov (United States)

    Gray, N; Henningfield, J E; Benowitz, N L; Connolly, G N; Dresler, C; Fagerstrom, K; Jarvis, M J; Boyle, P

    2005-06-01

    Global tobacco deaths are high and rising. Tobacco use is primarily driven by nicotine addiction. Overall tobacco control policy is relatively well agreed upon but a long term nicotine policy has been less well considered and requires further debate. Reaching consensus is important because a nicotine policy is integral to the target of reducing tobacco caused disease, and the contentious issues need to be resolved before the necessary political changes can be sought. A long term and comprehensive nicotine policy is proposed here. It envisages both reducing the attractiveness and addictiveness of existing tobacco based nicotine delivery systems as well as providing alternative sources of acceptable clean nicotine as competition for tobacco. Clean nicotine is defined as nicotine free enough of tobacco toxicants to pass regulatory approval. A three phase policy is proposed. The initial phase requires regulatory capture of cigarette and smoke constituents liberalising the market for clean nicotine; regulating all nicotine sources from the same agency; and research into nicotine absorption and the role of tobacco additives in this process. The second phase anticipates clean nicotine overtaking tobacco as the primary source of the drug (facilitated by use of regulatory and taxation measures); simplification of tobacco products by limitation of additives which make tobacco attractive and easier to smoke (but tobacco would still be able to provide a satisfying dose of nicotine). The third phase includes a progressive reduction in the nicotine content of cigarettes, with clean nicotine freely available to take the place of tobacco as society's main nicotine source.

  3. Japan's energy conservation policy

    International Nuclear Information System (INIS)

    Yoda, Kenichi

    1990-01-01

    This article reviews developments in Japanese energy conservation since the 1970s. The industrial sector has achieved the greatest success, due to industrial restructuring as well as improvements in energy efficiency. In the residential/commercial sector, the efficiency of appliances has been much improved. Although improvements have been made in the fuel efficiency of passenger cars, energy consumption in the transportation sector has risen slightly owing to increased transport of passengers and freight. The overall responsibility for energy conservation policy rests with the Ministry of International Trade and Industry. MITI is also responsible for implementing specific conservation policies in regard to the industrial and commercial sectors. In the residential sector, MITI works with the Ministry of Construction and in the transportation sector with the Ministry of Transport. To realize the goals of energy conservation policy through general research, dissemination of public information and other activities, MITI works with the Energy Conservation Center (ECC). (author). 2 figs, 3 tabs

  4. STS pricing policy

    Science.gov (United States)

    Lee, C. M.; Stone, B.

    1982-01-01

    In 1977 NASA published Shuttle Reimbursement Policies for Civil U.S. Government, DOD and Commercial and Foreign Users. These policies were based on the principle of total cost recovery over a period of time with a fixed flat price for initial period to time to enhance transition. This fixed period was to be followed with annual adjustments thereafter, NASA is establishing a new price for 1986 and beyond. In order to recover costs, that price must be higher than the initial fixed price through FY 1985. NASA intends to remain competitive. Competitive posture includes not only price, but other factors such as assured launch, reliability, and unique services. NASA's pricing policy considers all these factors.

  5. French nuclear energy policy

    International Nuclear Information System (INIS)

    Ferrari, A.; Bertel, E.

    1980-11-01

    The French energy policy is supported by a lucid view of the situation of our country and the constraints linked to the international context. This statement implies, the definition of a French policy or energy production essentially based on national resources, uranium, and especially for long term, technical know how which allows using plutonium in breeder reactors. This policy implies an effort in R and D, and industrial development of nuclear field, both in reactor construction and at all levels of fuel cycle. This coherent scientific and financial effort has been pursued since the beginning of years 60, and has placed France among the first nuclear countries in the world. Now this effort enables the mastership of a strong nuclear industry capable to assure the energy future of the country [fr

  6. Energy policy and externalities

    International Nuclear Information System (INIS)

    Bertel, E.; Fraser, P.

    2002-01-01

    External costs of energy have been assessed in a number of authoritative and reliable studies based upon widely accepted methodologies such as life cycle analysis (LCA). However, although those costs are recognised by most stakeholders and decision makers, results from analytical work on externalities and LCA studies are seldom used in policy making. The International Energy Agency (IEA) and the Nuclear Energy Agency (NEA) convened a joint workshop in November 2001 to offer experts and policy makers an opportunity to present state-of-the-art results from analytical work on externalities and debate issues related to the relevance of external costs and LCA for policy-making purposes. The findings from the workshop highlight the need for further work in the field and the potential rote of international organisations like the IEA and the NEA in this context. (authors)

  7. New staff contract policy

    CERN Document Server

    HR Department

    2006-01-01

    Following discussion at TREF and on the recommendation of the Finance Committee, Council approved a new staff contract policy, which became effective on 1 January 2006. Its application is covered by a new Administrative Circular No. 2 (Rev. 3) 'Recruitment, appointment and possible developments regarding the contractual position of staff members'. The revised circular replaces the previous Circulars No. 9 (Rev. 3) 'Staff contracts' and No. 2 (Rev. 2) 'Guidelines and procedures concerning recruitment and probation period for staff members'. The main features of the new contract policy are as follows: The new policy provides chances for long-term employment for all staff recruits staying for four years without distinguishing between those assigned to long-term or short-term activities when joining CERN. In addition, it presents a number of simplifications for the award of ICs. There are henceforth only 2 types of contract: Limited Duration (LD) contracts for all recruitment and Indefinite Contracts (IC) for...

  8. Europe's New Energy Policy

    International Nuclear Information System (INIS)

    Piebalgs, A.; Conn, I.; Dobbeni, D.; Josefsson, L.G.; Mogg, L.; Rifkin, J.; Scaroni, P.; Tanaka, N.

    2009-01-01

    Europe's energy policy has been completely transformed over the last few years, tackling the dual challenges of climate change and energy security. This has lead to major new laws on issues such as energy liberalisation, renewable energy and energy efficiency. In this volume the detailed reasons for these changes are outlined and the way in which the European Union has risen to these challenges is discussed. Views are given on where Europe's energy policy will go next, the challenges of 2050 and the development of a 'third industrial revolution'. This insight is complemented by the observations and comments of some of the leading figures concerning European and global energy issues, explaining how industry, energy regulators and global thinkers see Europe's energy policy and the challenges that it now faces

  9. Invalidating Policies using Structural Information

    DEFF Research Database (Denmark)

    Kammuller, Florian; Probst, Christian W.

    2013-01-01

    by invalidating policies using structural information of the organisational model. Based on this structural information and a description of the organisation's policies, our approach invalidates the policies and identifies exemplary sequences of actions that lead to a violation of the policy in question. Based...... on these examples, the organisation can identify real attack vectors that might result in an insider attack. This information can be used to refine access control system or policies....

  10. Water Economics and Policy

    Directory of Open Access Journals (Sweden)

    Julio Berbel

    2017-10-01

    Full Text Available Economics plays a double role in the field of water management, firstly as a powerful analytical tool supporting water allocation and policy decisions, and secondly in the form of policy instruments (water pricing, markets, etc.. This Special Issue presents a platform for sharing results connecting excellent interdisciplinary research applied to different regional and sectoral problems around the world. The 22 peer-reviewed papers collected in this Special Issue have been grouped into five broad categories: Water valuation and accounting; Economic instruments; Cost effectiveness and cost-benefit analysis; and Water productivity and Governance. They are briefly presented.

  11. Prostitution Policy Report

    DEFF Research Database (Denmark)

    Faber, Stine Thidemann; Emerek, Ruth

    2013-01-01

    The Child and Woman Abuse Studies Unit at London Metropolitan University is working with the European Commission and the European Network on Gender Equality (ENEGE) to produce a report on prostitution policy in member states. In this report the data from Denmark are presented.......The Child and Woman Abuse Studies Unit at London Metropolitan University is working with the European Commission and the European Network on Gender Equality (ENEGE) to produce a report on prostitution policy in member states. In this report the data from Denmark are presented....

  12. OPEC's production policies

    International Nuclear Information System (INIS)

    Mabro, R.

    1989-01-01

    An enlightening study on the workings of OPEC its policies and practices, agreements and disagreements, and how each affects the world petroleum market. The book explores OPEC's production patterns and quota agreements and the relationship between production and pricing policies. Political compromises that have hindered OPEC production agreements and their successful implementation are covered - compromises such as concessions made to the U.A.E. and those resulting from the Gulf war. Notable historical events are cited, and a look into the future at what we can expect of OPEC in coming years concludes the study

  13. Canada's nuclear export policy

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, R W; Wonder, E F [Carleton Univ., Ottawa, Ontario (Canada)

    1978-01-01

    The factors influencing the evolution of Canada's nuclear export policy are examined. Initially, nuclear technology was exported to establish an industry in Canada and to share the technology with other countries. After 1974 an increasingly broad range of political and social factors were taken into account and safeguards became the dominant factor. The indirect impacts of the new policy fall into two groups. One consists of the effects of Canada's leadership in taking a tough stand on safeguards. The second group of effects involve the concern of other countries about access to secure energy supplies and advanced technology.

  14. SMART HERITAGE POLICY

    Directory of Open Access Journals (Sweden)

    Bojan Radej

    2018-01-01

    Full Text Available European Cultural Heritage Strategy for the 21st Century (Council of Europe, 2017 has importantly contributed to emphasizing integrative intervention logic of heritage policy by shifting from vertical, sector based to cross-sector based horizontal thinking. Paper develops and explain integral logic that combines vertical and horizontal approach. Three integration measures are proposed: weak and strong balance and cohesion. It is illustrated by a hypothetical example showing how integral heritage policy can be programmed (and evaluated in relatively simple and transparent way, despite its essential complexity.

  15. Wind farm policy 1995

    International Nuclear Information System (INIS)

    Anon.

    1995-03-01

    Argyll and Bute District Council, having received a number of planning applications for the erection of wind farms, seeks, in this document, to set out its environmental policy on these installations in line with national government guidelines and those from Strathclyde Regional Council. District Council policy on thirteen environmental issues connected with wind farm construction is set out, covering issues such as environmental impacts on wild-life, noise pollution, access for construction, maintenance and decommissioning vehicles as well as planning consent issues. Recommendations are made to four interested bodies, Strathclyde Regional Council, the Forestry Authority and Scottish Natural Heritage and the Royal Society for the Protection of Birds. (UK)

  16. Decommissioning policy in Sweden

    International Nuclear Information System (INIS)

    Bergman, C.; Boge, R.; Snihs, J.O.

    1987-01-01

    In Sweden the nuclear power program is, according to a parliamentary decision, limited to twelve power producing reactors. The last reactor shall be taken out of service no later than the year 2010. As a result of the Chernobyl accident the program for taking the reactors out of service will be accelerated. This report is the first approach by the Swedish authorities to formulate a decommissioning policy. It is not the final policy document but it discusses the principal questions from the special Swedish viewpoint. (orig.)

  17. Reagan outlines nonproliferation policy

    International Nuclear Information System (INIS)

    Walsh, J.

    1981-01-01

    The Reagan Administration wants to shift from efforts to impose direct control over the fuel cycle and nuclear technology to a framework based on cooperation and initiatives for greater political stability. A nuclear-free zone for the Middle East is one area to explore. Congress responded to this announced plan with a counter move to tighten non-proliferation strategies. Reagan's policy will be to restore the US as an aggressive, but reliable nuclear trading partner operating under adequate safeguards. Critics find this approach dangerous and contradictory. The policy is still too general to answer specific questions about bilateral arrangements, generic permits, plutonium recycling, and other matters

  18. Canada's nuclear export policy

    International Nuclear Information System (INIS)

    Morrison, R.W.; Wonder, E.F.

    1978-01-01

    The factors influencing the evolution of Canada's nuclear export policy are examined. Initially, nuclear technology was exported to establish an industry in Canada and to share the technology with other countries. After 1974 an increasingly broad range of political and social factors were taken into account and safeguards became the dominant factor. The indirect impacts of the new policy fall into two groups. One consists of the effects of Canada's leadership in taking a tough stand on safeguards. The second group of effects involve the concern of other countries about access to secure energy supplies and advanced technology. (O.T.)

  19. Nordic Energy Policy Cooperation

    DEFF Research Database (Denmark)

    Jørgensen, Birte Holst

    2016-01-01

    Brundtland Commission Report, and climate change became a common concern. Energy technology cooperation was an integral part of Nordic energy policy cooperation from the very beginning. The Nordic Energy Research Programme was established with funding from each of the Nordic countries, and was earmarked...... by a committee of senior officials and a secretariat. This was characterised by an incremental development of the cooperation based on consensus, mutual understanding and trust facilitated through exchange of experiences, work groups, seminars, educational activities and mobility schemes for energy policy...

  20. Macroprudential Policy: A Review

    Directory of Open Access Journals (Sweden)

    Mahdi Ebrahimi Kahou

    2015-10-01

    Full Text Available The severity and longevity of the recession caused by the 2007 financial crisis has highlighted the lack of a reliable macro-based financial regulation framework. As a consequence, addressing the link between the stability of the financial system as a whole and the performance of the overall economy has become a mandate for policymakers and scholars. Many countries have adopted macroprudential tools as policy responses for safeguarding the financial system. This paper provides a literature review of macroprudential policies, its objectives and the challenges that a macro-based framework needs to overcome, such as financial stability, procyclicality, and systemic risk.

  1. Decommissioning policy in Sweden

    International Nuclear Information System (INIS)

    Bergman, C.; Boge, R.; Snihs, J.O.

    1987-01-01

    In Sweden the nuclear power program is, according to a parliamentary decision, limited to twelve power producing reactors. The last reactor shall be taken out of service no later than the year 2010. As a result of the Chernobyl accident the program for taking the reactors out of service will be accelerated. The first approach by the Swedish authorities to formulate a decommissioning policy is discussed. It is not the final policy document but it discusses the principal questions from the special Swedish viewpoint

  2. Endocrine Diseases

    Science.gov (United States)

    ... Syndrome (PCOS) Pregnancy and Thyroid Disease Primary Hyperparathyroidism Prolactinoma Thyroid Tests Turner Syndrome Contact Us The National ... Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información de la ...

  3. Education Policies and Policy Making in Arizona: Report on a Survey of Education Policy Actors

    Science.gov (United States)

    Lawton, Stephen B.

    2011-01-01

    This study provides an objective look at the education policies adopted by the State of Arizona since 2000, describes participants in the policy-making process, and identifies policy options for the future. The framework of the study uses a typology of educational policies with seven categories: school building and facilities, curriculum…

  4. Advertisement Policy - 2016

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    Full Text Available ADVERTISEMENT POLICY - 2016Indian Journal of Community Health (IJCH, the official publication of Indian Association of Preventive and Social Medicine (IAPSM published from Uttar Pradesh and Uttarakhand, India is an indexed journal published quarterly. The open access policy of the journals ensure good visibility of the online content of the journals. The journal with high circulation and visibility, thus offer excellent media for promotion of your products, services or conferences of academic or research interest through advertisement. The journal has the potential to deliver the message to the targeted audience regularly with each issue. The cost of investment per view is substantially low for our print as well as electronic journals.Your advertisements in our journal will keep your products getting boost every quarter in the nook and corner of the country through our journal which is the forefront of community health. The journal is indexed and abstracted in more than 70 databases worldwide including SCOPUS, Index Medicus SEAR, Bioline International, DOAJ, WHO HINARI, Indian Science Abstract, etc. Apart from the print advertisement, we also consider advertisement on web, bulk subscriptions, gift subscriptions or reprint purchases for distribution.Note: Indian Journal of Community Health does not give medical advice and will not be able to respond to inquiries about specific diseases, medical or surgical conditions, diagnosis, treatments or contact of another person. Advertisement Rate – 2016Category INRInside Full Back Cover (color15,000Inside Full Back Cover (B & W10,000Full Page (Color10,000Half Page (Color5,000Full Page (B & W5,000Half Page (B & W2,000 Sponsorship Rate - Supplementary IssueThe cost towards publishing a single special issue of IJCH is Rs. 75,000/- per issue. The above mentioned cost is based on the following specifications i.e.  Page size 8.5" X 11", Printing Offset printing, Pages - 90 b/w + 10 full color pages + 4

  5. 75 FR 60485 - NRC Enforcement Policy Revision

    Science.gov (United States)

    2010-09-30

    ... NUCLEAR REGULATORY COMMISSION [NRC-2008-0497] NRC Enforcement Policy Revision AGENCY: Nuclear Regulatory Commission. ACTION: Policy statement. SUMMARY: The Nuclear Regulatory Commission (NRC or Commission) is publishing a major revision to its Enforcement Policy (Enforcement Policy or Policy) to...

  6. The new health policy

    National Research Council Canada - National Science Library

    Gauld, Robin

    2009-01-01

    ... Gauld brings together in one volume a comprehensive picture of the health policy challenges facing contemporary developed world health systems, as well as the strategies for tackling these. Individual chapters analyze: Challenges in health care funding and organization Quality and patient safety The application of information te...

  7. Talking Policy into Being

    DEFF Research Database (Denmark)

    Caswell, Dorte

    2018-01-01

    Active labour market policy is talked into being in meetings between street-level bureaucrats and hard-to-place unemployed. The analytical perspective is informed by conversation analysis and data consists of naturally occurring interactions. The patterns of talk consist of both general and concr...... outcomes in ways that are responsive to the needs and wishes of the individual client...

  8. Environment stakes and policies

    International Nuclear Information System (INIS)

    Tronquoy, Ph.

    2002-01-01

    This document devoted to the environment discusses on the following topics: the environmental policies, the threats for the environment (climatic change, water management and risks), the deforestation, the sustainable development of cities, the safety first principle, the energy challenge, the international cooperation, the North-South relations. (A.L.B.)

  9. Assessment and Educational Policy.

    Science.gov (United States)

    Smith, Virginia B.

    1975-01-01

    Because of increased access of postsecondary education in the 1950's and 1960's, higher education cost analysis gained importance. Attempts have been made to develop a standard unit cost, but it is hard to see unit cost accounting by itself as a valuable tool for public accountability or policy making. For these purposes a cost-effectiveness ratio…

  10. Big ideas: innovation policy

    OpenAIRE

    John Van Reenen

    2011-01-01

    In the last CentrePiece, John Van Reenen stressed the importance of competition and labour market flexibility for productivity growth. His latest in CEP's 'big ideas' series describes the impact of research on how policy-makers can influence innovation more directly - through tax credits for business spending on research and development.

  11. Road pricing policy implementation

    NARCIS (Netherlands)

    Vonk Noordegraaf, D.M.

    2016-01-01

    Urban areas suffer from the negative externalities of road transport like congested road networks, air pollution and road traffic accidents. A measure to reduce these negative externalities is road pricing, meaning policies that impose direct charges on road use (Jones and Hervik, 1992). Since the

  12. Deep Learning Policy Quantization

    NARCIS (Netherlands)

    van de Wolfshaar, Jos; Wiering, Marco; Schomaker, Lambertus

    2018-01-01

    We introduce a novel type of actor-critic approach for deep reinforcement learning which is based on learning vector quantization. We replace the softmax operator of the policy with a more general and more flexible operator that is similar to the robust soft learning vector quantization algorithm.

  13. Parenting, Pressures and Policies.

    Science.gov (United States)

    Chance, Graham W.

    2000-01-01

    In the 1990s, parenting became a difficult effort to balance work demands with children's needs. However, Canadian and U.S. government policies have not met changing family needs for child care, other services, paid parental leave, and work flexibility. Canada's long-awaited National Children's Agenda has the potential to modernize family policy…

  14. The Policy Context

    DEFF Research Database (Denmark)

    Panagakos, George

    2016-01-01

    Green project. The term ‘green’ is used in the sustainability context, meaning that it features economic and social dimensions in addition to the usual environmental one. The most important EU transport policy documents are reviewed and briefly presented by transportation mode. Horizontal documents covering all...

  15. Sustainability Statement and Policy

    Science.gov (United States)

    Journal of Education for Sustainable Development, 2009

    2009-01-01

    This article presents nine resources that focus on environmental education and sustainability. These include: (1) "Sustainability Statement and Policy," Dalhousie University, Nova Scotia, Canada, 2009, which is available at http://office.sustainability.dal.ca/Governance; (2) "Climate Literacy: The Essential Principles of Climate…

  16. Environmental education policy research

    DEFF Research Database (Denmark)

    Læssøe, Jeppe; Feinstein, Noah Weeth; Blum, Nicole

    2013-01-01

    in the areas of Environmental Education (EE), Education for Sustainable Development and Climate Change Education. It especially makes a case for two kinds of research on EE policy: (1) a multi-sited approach to empirical documentation and theory development which explores the relationships between...

  17. Petroleum and international policy

    International Nuclear Information System (INIS)

    Pertuzio, A.

    2002-01-01

    To illustrate the relation between the petroleum and the international policy, the author presents the place of the petroleum industry in the international relations by an analysis of the historical aspects, the states and international organizations interventions and the prices evolution. (A.L.B.)

  18. User Centric Policy Management

    Science.gov (United States)

    Cheek, Gorrell P.

    2013-01-01

    Internet use, in general, and online social networking sites, in particular, are experiencing tremendous growth with hundreds of millions of active users. As a result, there is a tremendous amount of privacy information and content online. Protecting this information is a challenge. Access control policy composition is complex, laborious and…

  19. Child Poverty & Public Policy.

    Science.gov (United States)

    Chafel, Judith A., Ed.

    This collection documents how far we still are in the United States from putting our knowledge about child well being and policy into practice. It provides an overview of the changing nature of child poverty in the United States through the contributions of authors who use a number of qualitative and quantitative approaches to look at children in…

  20. Technology Policy and Employment.

    Science.gov (United States)

    Williams, Bruce

    1983-01-01

    Current social and economic problems in the United Kingdom are placed in the context of long-term trends in labor economics and the impact of new technology. The relationship of technological change and economic recovery is analyzed. Policy implications and the university's role are discussed. (MSE)

  1. Environmental policy analysis

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    The Environmental Policy Analysis Program was established to improve the formation of energy development and environmental policies with due mutual regard for national environmental and energy development needs. As a separate office under the Assistant Secretary for Environment, the program is implemented by the Director and by Offices of Environmental Policy Analysis in the eight DOE multiprogram laboratories. The program provides the Assistant Secretary with information on alternatives for decision making and early warning of environmental problems and considerations that may affect energy policy decisions. The program is intended to be a continuing activity, with its scope determined progressively as issues are defined. During FY-1977 the program focused on information compilation on levels of Pu and other transuranic elements in soils that would render the area unsafe for unlimited use; the impact of water pollution control laws on energy technologies; an analysis of the comparative health risks associated with various energy technologies; and the cost and related impacts on the nuclear industry arising from changes in radiation standards during the past 15 years

  2. US energy policy

    International Nuclear Information System (INIS)

    Katz, J.E.

    1984-01-01

    After three years in power, the Reagan Administration has been able to reverse much of the US federal government's energy policy measures that had occurred since 1973, particularly the build-up that took place during the Carter presidency. Another change is a repudiation of social equity concerns, which were an important part of the energy policies of the Nixon, Ford and Carter presidencies. Instead of using government to direct energy policy, the Reagan Administration has stressed the pre-eminence of the private sector. One exception is nuclear energy, which the Administration strongly supports. While the Reagan policies implemented have increased economic efficiency and reduced federal-related budgets and staffs, they have caused environmental degradation and hardship on the poor. Yet their greatest implication is that of a nation less well prepared to handle a severe energy shortage. The Administration believes this is not a problem, based on its optimistic expectations of the extent of untapped resources worldwide and the resilience of the free market. (author)

  3. Parliaments and Foreign Policy

    NARCIS (Netherlands)

    Wagner, W.M.; Haney, Patrick; Harnisch, Sebastian; Kaarbo, Juliet; Oppermann, Kai; Tago, Atsushi

    Parliaments differ enormously in their foreign policy competences. This is best documented in the area of “war powers,” understood as decision-making on the use of force. In other issue areas, such as treaty-making, defense budgets, sanctions, or arms exports, differences across countries are far

  4. Against all policies

    DEFF Research Database (Denmark)

    Sungusia, Eliezeri; Lund, Jens Friis

    2016-01-01

    landscapes are unknown. This case illustrates how existing forest and land policies and practices of implementation discourage landscape level forest conservation and how a current rush for ‘unused’ village land areas for conservation, agribusiness or forest plantations implies an incentive for villages...

  5. Personnel Policy and Profit

    DEFF Research Database (Denmark)

    Bingley, Paul; Westergård-Nielsen, Niels Chr.

    2004-01-01

    personnel structure variation. It is found that personnel policy is strongly related to economic performance. At the margin, more hires are associated with lower profit, and more separations with higher profit. For the average firm, one new job, all else equal, is associated with ?2680 (2000 prices) lower...

  6. English obesity policies

    DEFF Research Database (Denmark)

    Vallgårda, Signild

    2015-01-01

    Problem definitions constitute a crucial part of the policy process. In 2008 the Labour Government presented a plan to reduce the obesity prevalence in England. Only three years later the Conservative-Liberal Government introduced a plan on the same topic, which it presented as new and innovative...

  7. Immigration policy index

    Czech Academy of Sciences Publication Activity Database

    Vikhrov, Dmytro

    2017-01-01

    Roč. 25, č. 1 (2017), s. 3-46 ISSN 0967-0750 Institutional support: Progres-Q24 Keywords : immigration policy * visa * differences-in-differences estimation Subject RIV: AH - Economics OBOR OECD: Applied Economics , Econometrics Impact factor: 0.479, year: 2016

  8. Policies built upon pathways

    NARCIS (Netherlands)

    Musterd, S.; Kovács, Z.; Musterd, S.; Kovács, Z.

    2013-01-01

    After the general introductions, the first substantive part of this volume (Part II) provides concise research-based discussions of policies developed in recognition of the important role played by the pathways along which city-regions have travelled. Our research has shown that it is highly

  9. The French energy policy

    International Nuclear Information System (INIS)

    Maillard, D.; Baulinet, Ch.; Lajoinie, A.

    2001-01-01

    France has to face strong energy challenges: a heavy energy bill, increasing supplies risk, no decreasing CO 2 emissions, deregulation of energy markets, nuclear controversy etc.. In consequence, the French government has defined a voluntaristic energy policy with a better balance between the development of renewable energies and the mastery of energy and without renouncing the advantages of nuclear energy. In parallel, the electric power and natural gas industries have to cope with the deregulation of energy markets and the resulting competition. This issue of 'Energies et Matieres Premieres' newsletter comprises 3 articles. The first one gives a general presentation of the French energy policy ('mobilizing our margins of manoeuvre without renouncing our stakes'): challenges of the energy policy (greenhouse effect, security of supplies, long-term worldwide energy context, European integration, nuclear contestation), stakes for France (evolution of production structure, advantages of the French energy status), renewable energies and energy saving, long-term view of the nuclear industry, managing together the dynamism of competition and the advantages of public utilities. The second article entitled 'energy for everybody: a challenge for the 21. century' is a reprint of the introduction of the information report registered on January 31, 2001 by the commission of production and exchanges of the French national assembly. The third article is a reprint of the summary of conclusions and recommendations of the IEA about the French energy policy. (J.S.)

  10. Energy policy and federalism

    Energy Technology Data Exchange (ETDEWEB)

    Thur, L M [ed.

    1981-04-01

    Separate abstracts are prepared for six papers presented as the product of an international seminar on Energy Policy and Federalism in North America. Specially commissioned papers for the seminar are presented along with a summary of the discussions. The summary appears in English, French, and Spanish; the other papers are in English. (MCW)

  11. Canada's uranium policies

    International Nuclear Information System (INIS)

    Smith, K.L.; Williams, R.M.

    1991-01-01

    The purpose of this paper is to provide an update on the Canadian Government policies which affect the uranium industry and, where appropriate, to provide some background on the development of these policies. This review is timely because of two recent announcements by the Minister of Energy, Mines and Resources - one concerning the Canadian Government's renewed commitment to maintain the nuclear power option for Canada, and the other concerning some adjustments to Canada's uranium export policy. The future of Canada's nuclear industry was subject to a thorough review by the Canadian Government during 1989. This review occurred at a time when environmental issues were attracting increasing attention around the world, and the environmental advantages of nuclear power were becoming increasingly recognised. The strong support for the nuclear industry in Canada is consistent with the government's long-standing efforts to maintain Canada's position as a reliable and competitive supplier of uranium. This paper is particularly devoted to an outline of the results of the uranium export policy review. (author)

  12. Privacy Policy | FNLCR Staging

    Science.gov (United States)

    The privacy of our users is of utmost importance to Frederick National Lab. The policy outlined below establishes how Frederick National Lab will use the information we gather about you from your visit to our website. We may collect and store

  13. Essays on fiscal policy

    NARCIS (Netherlands)

    van Oudheusden, P.

    2013-01-01

    This thesis deals with selected topics in fiscal policy. The first part examines the relationship between fiscal decentralization and certain outcomes, one being the amount of trust citizens have in their government, the other being economic efficiency. The second part looks into the challenge of

  14. Measuring agricultural policy bias

    DEFF Research Database (Denmark)

    Jensen, Henning Tarp; Robinson, Sherman; Tarp, Finn

    2010-01-01

    Measurement is a key issue in the literature on price incentive bias induced by trade policy. We introduce a general equilibrium measure of the relative effective rate of protection, which generalizes earlier protection measures. For our fifteen sample countries, results indicate that the agricul...

  15. Refinement for administrative policies

    NARCIS (Netherlands)

    Dekker, M.A.C.; Etalle, S.; Jonker, W.; Petkovic, M.

    2007-01-01

    Flexibility of management is an important requisite for access control systems as it allows users to adapt the access control system in accordance with practical requirements. This paper builds on earlier work where we defined administrative policies for a general class of RBAC models. We present a

  16. Innovation: Editorial Policies

    African Journals Online (AJOL)

    for Researchers · for Journals · for Authors · for Policy Makers · about Open Access · Journal Quality. 521 African Journals. Browse By Category · Browse Alphabetically · Browse By Country · List All Titles · Free To Read Titles This Journal is Open Access. Featuring journals from 32 Countries: Algeria (5); Benin (2); Botswana ...

  17. Bilingualism: Research and Policy

    Science.gov (United States)

    McCardle, Peggy

    2015-01-01

    Bilingualism, commonplace throughout the world, is not well accepted or supported in many parts of the United States. Education policies and practices regarding bilingualism are often based on myths and attitudes rather than facts, despite scientific evidence on both the disadvantages and advantages of bilingualism. Based on a brief overview of…

  18. Analyzing Screening Policies for Childhood Obesity

    Science.gov (United States)

    Yang, Yan; Goldhaber-Fiebert, Jeremy D.; Wein, Lawrence M.

    2013-01-01

    Due to the health and economic costs of childhood obesity, coupled with studies suggesting the benefits of comprehensive (dietary, physical activity and behavioral counseling) intervention, the United States Preventive Services Task Force recently recommended childhood screening and intervention for obesity beginning at age six. Using a longitudinal data set consisting of the body mass index of 3164 children up to age 18 and another longitudinal data set containing the body mass index at ages 18 and 40 and the presence or absence of disease (hypertension and diabetes) at age 40 for 747 people, we formulate and numerically solve – separately for boys and girls – a dynamic programming problem for the optimal biennial (i.e., at ages 2, 4, …, 16) obesity screening thresholds. Unlike most screening problem formulations, we take a societal viewpoint, where the state of the system at each age is the population-wide probability density function of the body mass index. Compared to the biennial version of the task force’s recommendation, the screening thresholds derived from the dynamic program achieve a relative reduction in disease prevalence of 3% at the same screening (and treatment) cost, or – due to the flatness of the disease vs. screening tradeoff curve – achieves the same disease prevalence at a 28% relative reduction in cost. Compared to the task force’s policy, which uses the 95th percentile of body mass index (from cross-sectional growth charts tabulated by the Centers for Disease Control and Prevention) as the screening threshold for each age, the dynamic programming policy treats mostly 16 year olds (including many who are not obese) and very few males under 14 years old. While our results suggest that adult hypertension and diabetes are minimized by focusing childhood obesity screening and treatment on older adolescents, the shortcomings in the available data and the narrowness of the medical outcomes considered prevent us from making a

  19. Bangladesh pharmaceutical policy and politics.

    Science.gov (United States)

    Reich, M R

    1994-06-01

    An analysis of the politics of Bangladesh pharmaceutical policy in the 1980s shows how significant health policy reforms in developing countries depend on political conditions both inside and outside the country. Bangladesh's drug policy of 1982 illustrates that governments can sometimes change public policy in ways unfavourable to multinational corporations, while the failed health policy reform of 1990 shows that reforms unfavourable to powerful domestic interest groups can be more difficult to achieve, even contributing to a government's downfall. The case provides evidence of basic changes in how the international agenda for health policy is set, especially the growing role of non-governmental organizations in international agencies and national policy debates. Understanding the political patterns of policy reform in Bangladesh has important implications for strategies to affect health policy in developing countries.

  20. Healthy lifestyle interventions to combat noncommunicable disease-a novel nonhierarchical connectivity model for key stakeholders: a policy statement from the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.

    Science.gov (United States)

    Arena, Ross; Guazzi, Marco; Lianov, Liana; Whitsel, Laurie; Berra, Kathy; Lavie, Carl J; Kaminsky, Leonard; Williams, Mark; Hivert, Marie-France; Cherie Franklin, Nina; Myers, Jonathan; Dengel, Donald; Lloyd-Jones, Donald M; Pinto, Fausto J; Cosentino, Francesco; Halle, Martin; Gielen, Stephan; Dendale, Paul; Niebauer, Josef; Pelliccia, Antonio; Giannuzzi, Pantaleo; Corra, Ugo; Piepoli, Massimo F; Guthrie, George; Shurney, Dexter; Arena, Ross; Berra, Kathy; Dengel, Donald; Franklin, Nina Cherie; Hivert, Marie-France; Kaminsky, Leonard; Lavie, Carl J; Lloyd-Jones, Donald M; Myers, Jonathan; Whitsel, Laurie; Williams, Mark; Corra, Ugo; Cosentino, Francesco; Dendale, Paul; Giannuzzi, Pantaleo; Gielen, Stephan; Guazzi, Marco; Halle, Martin; Niebauer, Josef; Pelliccia, Antonio; Piepoli, Massimo F; Pinto, Fausto J; Guthrie, George; Lianov, Liana; Shurney, Dexter

    2015-08-14

    Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale. © 2015 Mayo Foundation for Medical Education and Research, and the European Society of Cardiology. This article is being published concurrently in Mayo Clinic Proceedings [1]. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when

  1. EQUALIZATION OF RESULTS ACCOUNTING POLICIES

    Directory of Open Access Journals (Sweden)

    Florentina MOISESCU

    2014-06-01

    Full Text Available The purpose of this paper is to demonstrate the effect that different accounting policies have on the outcome of an enterprise, this effect being represented either earnings growth or diminishing it. Deprecation policy, the policy related to inventory, policy provisions and related policy borrowing costs are some of the many other possibilities which affect the content of financial statements. Because national and international accounting standards give businesses the flexibility to choose between different policies, managers take advantage of existing loopholes and draw on creative accounting , so that it answers to the needs of the management team.

  2. Policies as translation: situating the transnational social policies

    Directory of Open Access Journals (Sweden)

    Paul Stubbs

    2012-06-01

    Full Text Available This article explores some of the implications of the development of an anthropology or ethnography of the transnational dimensions of policies. The fi rst part explains the basic conceptual apparatus, in terms of policies as a generator of meanings. The second part examines policies as translation and explores its implications in terms of the transnationalization of the policies and, in particular, it seeks to contrast the translation of policies with more orthodox knowledge of policies transference. The third part explores the translation of policies through a refl exive ethnographical approach, analyzing a number of cases based on the practical involvement of the authors in social policies reforms in regions of the Central Europe and the East. The fourth part presents some conclusions and indicates certain theoretical and ethical objections that can and must be raised with regard to the presented approach.

  3. A Proposal for a UK Ethics Council for Animal Policy: The Case for Putting Ethics Back into Policy Making.

    Science.gov (United States)

    McCulloch, Steven P; Reiss, Michael J

    2018-06-07

    Substantial controversy is a consistent feature of UK animal health and welfare policy. BSE, foot and mouth disease, bovine TB and badger culling, large indoor dairies, and wild animals in circuses are examples. Such policy issues are inherently normative; they include a substantial moral dimension. This paper reviews UK animal welfare advisory bodies such as the Animal Health and Welfare Board of England, the Farm Animal Welfare Council and the Animals in Science Committee. These bodies play a key advisory role, but do not have adequate expertise in ethics to inform the moral dimension of policy. We propose an "Ethics Council for Animal Policy" to inform the UK government on policy that significantly impacts sentient species. We review existing Councils (e.g., the Nuffield Council on Bioethics and The Netherlands Council on Animal Affairs) and examine some widely used ethical frameworks (e.g., Banner's principles and the ethical matrix). The Ethics Council for Animal Policy should be independent from government and members should have substantial expertise in ethics and related disciplines. A pluralistic six-stage ethical framework is proposed: (i) Problematisation of the policy issue, (ii) utilitarian analysis, (iii) animal rights analysis, (iv) virtue-based analysis, (v) animal welfare ethic analysis, and (vi) integrated ethical analysis. The paper concludes that an Ethics Council for Animal Policy is necessary for just and democratic policy making in all societies that use sentient nonhuman species.

  4. EU Policy. A Debate on EU Energy Policy

    International Nuclear Information System (INIS)

    Cohen, R.; Kjoelbye, L.; Aaslund, A.; Zwitserloot, R.

    2008-01-01

    Views from four experts in the field of energy on the EU's energy policy, as laid down in the Third Package, are presented. Kjoelbye and Cohen argue about the pros and cons of unbundling, Aaslund defends the policy of reciprocity towards Gazprom, and Zwitserloot warns that Europe's anti-Gazprom policy endangers security of supply

  5. Policy consistency and the achievement of Nigeria's foreign policy ...

    African Journals Online (AJOL)

    This study is an attempt to investigate the policy consistency of Nigeria‟s foreign policy and to understand the basis for this consistency; and also to see whether peacekeeping/peace-enforcement is key instrument in the achievement of Nigeria‟s foreign policy goals. The objective of the study was to examine whether the ...

  6. Science policy up close

    CERN Document Server

    Marburger, John H

    2015-01-01

    In a career that included tenures as president of Stony Brook University, director of Brookhaven National Laboratory, and science advisor to President George W. Bush, John Marburger (1941 2011) found himself on the front line of battles that pulled science ever deeper into the political arena. From nuclear power to global warming and stem cell research, science controversies, he discovered, are never just about science. Science Policy Up Close" presents Marburger s reflections on the challenges science administrators face in the twenty-first century. In each phase of public service Marburger came into contact with a new dimension of science policy. The Shoreham Commission exposed him to the problem of handling a volatile public controversy over nuclear power. The Superconducting Super Collider episode gave him insights into the collision between government requirements and scientists expectations and feelings of entitlement. The Directorship of Brookhaven taught him how to talk to the public about the risks ...

  7. Competition Policy and Innovation

    DEFF Research Database (Denmark)

    Møllgaard, Peter; Lorentzen, Jo

    2005-01-01

    We briefly review the rationale behind technological alliances and provide a snapshot oftheir role in global competition, especially insofar as it is based around intellectual capital.They nicely illustrate the increased importance of horizontal agreements and thusestablish the relevance of the t......We briefly review the rationale behind technological alliances and provide a snapshot oftheir role in global competition, especially insofar as it is based around intellectual capital.They nicely illustrate the increased importance of horizontal agreements and thusestablish the relevance...... of the topic. We move on to discuss the organisation of industriesin a dynamic context and draw out consequences for competition policy. We concludewith an outlook on the underlying tensions between technology alliances, competitionpolicy, and industrial policy.JEL codes: L4, L5, O31Keywords: Competition...

  8. Energy policy in Denmark

    Energy Technology Data Exchange (ETDEWEB)

    Lidegaard, M.

    2012-12-15

    Denmark has a long tradition of active energy policy, initiated by the first oil crisis in 1973. Over the years, numerous actions have been taken on the basis of a broad consensus in the Danish Parliament - both in order to reduce the energy consumption and in order to increase the share of renewable energy. Now, the cornerstones for the Danish energy future have also been laid. The Danish Government has set the long-term goal to abandon fossil fuels by 2050. An important milestone was reached in March 2012 with an Energy Agreement for the period 2012-2020 - again based on a broad consensus in the Danish Parliament. This Agreement contains a wide range of ambitious initiatives, bringing Denmark a good step closer to the target of 100% renewable energy. In the present publication, a selection of past and present Danish energy policies is presented, together with the results achieved in terms of energy savings, use of renewables etc. (LN)

  9. Globalisation and social policy.

    Science.gov (United States)

    Langmore, J

    2001-01-01

    This paper discusses six major themes: that economic and social issues are closely interdependent and that the appropriate stance is to work on both together, simultaneously; that though the threats from globalisation have been exaggerated, there can be substantial costs as well as considerable benefits; that constraints on national policy are significant but are less severe than is commonly considered; that the vitality-the vigour-of national and international political processes must be increased to cope effectively with the changes which are underway; that the private sector, unions and civil society have crucial roles in the provision of services and in advocating socially responsible values, standards and policies; and that one of the most effective means of addressing the erosion of national autonomy from globalisation is for countries to cooperate in setting and implementing shared objectives and international standards and establishing more global public goods.

  10. Danish Energy Efficiency Policy

    DEFF Research Database (Denmark)

    Togeby, Mikael; Larsen, Anders; Dyhr-Mikkelsen, Kirsten

    2009-01-01

    Ten groups of policy instruments for promoting energy efficiency are actively used in Denmark. Among these are the EU instruments such as the CO2 emissions trading scheme and labelling of appliances, labelling of all buildings, combined with national instruments such as high taxes especially...... of the entire Danish energy efficiency policy portfolio must be carried out before end 2008 and put forward for discussion among governing parties no later than February 2009. A consortium comprising Ea Energy Analyses, Niras, the Department of Society and Globalisation (Roskilde University) and 4-Fact...... on households and the public sector, obligations for energy companies (electricity, natural gas, district heating, and oil) to deliver documented savings, strict building codes, special instructions for the public sector, and an Electricity Saving Trust. A political agreement from 2005 states that an evaluation...

  11. Language policy from below:

    DEFF Research Database (Denmark)

    Mortensen, Janus

    2014-01-01

    . Not only is it at odds with the available empirical evidence, it also puts unnecessary constraints on the potential that transnational education holds for cultural and linguistic exchange and development. The article is based on a case study where the patterns of language choice of three student project......, to varying degrees, developed practice-based language policies ‘from below’ that allow for alternating and sometimes syncretic use of English and Danish....... internationalisation, and English is accordingly promoted as the ‘obvious’ language of instruction for international education in many university policies. This article argues that the idea that university internationalisation should equal the exclusive use of English as a lingua franca is essentially misguided...

  12. Higher Education Language Policy

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.

    2013-01-01

    Summary of recommendations HEIs are encouraged, within the framework of their own societal context, mission, vision and strategies, to develop the aims and objectives of a Higher Education Language Policy (HELP) that allows them to implement these strategies. In this process, they may want......: As the first step in a Higher Education Language Policy, HEIs should determine the relative status and use of the languages employed in the institution, taking into consideration the answers to the following questions:  What is/are the official language(s) of the HEI?  What is/are the language...... and the level of internationalisation the HEI has or wants to have, and as a direct implication of that, what are the language proficiency levels expected from the graduates of these programme?  Given the profile of the HEI and its educational strategies, which language components are to be offered within...

  13. Policy Analysis Reaches Midlife

    Directory of Open Access Journals (Sweden)

    Beryl A. Radin

    2013-07-01

    Full Text Available The field of policy analysis that exists in the 21st century is quite different from that found earlier phases. The world of the 1960s that gave rise to this field in the US often seems unrelated to the world we experience today. These shifts have occurred as a result of a range of developments – technological changes, changes in the structure and processes of government both internally and globally, new expectations about accountability and transparency, economic and fiscal problems, and increased political and ideological conflict.It is clear globalization has had a significant impact on the field. Shifts in the type of decisionmaking also have created challenges for policy analysts since analysts are now clearly in every nook and cranny in the decisionmaking world. Thus it is relevant to look at the work that they do, the skills that they require, and the background experience that is relevant to them.

  14. Review of energy policy

    International Nuclear Information System (INIS)

    1986-11-01

    Following the accident at the Chernobyl reactor in April 1986, the 1986 Annual Delegate Conference of the Institution of Professional Civil Servants set up a Working Party to review the Institution's energy policy, including safety and environmental factors. The review is presented in two volumes as the basis for discussion by the members. Volume I is the main report. Section A, the introduction, includes a summary of the detailed conclusions and recommendations of the Working Party. Section B (chapters 4-12) concerns all aspects of nuclear power including fuel reprocessing and waste management. Section C (chapters 13-16) considers the alternatives to nuclear power and Section D (chapters 17-24) looks at the economic and social aspects of energy policy. The appendices, which contain the detailed technical and source information used by the Working Party in reaching its conclusions, are printed separately in Volume II. (UK)

  15. Policy Making as Bricolage

    DEFF Research Database (Denmark)

    Cartel, Melodie; Boxenbaum, Eva; Aggeri, Franck

    The making of environmental policies is a multi-stakeholders process where actors often hold antagonistic interests. The paper explores how institutional compromises are reached by the mechanism of collective bricolage. Recent studies are developing a view on institutional innovation as bricolage......, but the conditions under which bricolage occurs and succeeds in relation to institutional innovation are still unknown. Drawing on the notion of platform developed in the context of economics performativity, we study their role in bricolage mechanisms. We hold an empirical case study of the GETS platform...... that was instrumental in developing the European carbon market as a corner-stone of European climate policy. Based on the GETS case study, we find three modalities in which platforms stimulate institutional bricolage: catalyzing combinations, managing learning, fostering compromise. These findings draw on, and extend...

  16. Macroprudential Policy: A Summary

    Directory of Open Access Journals (Sweden)

    Mahdi Ebrahimi Kahou

    2016-05-01

    Full Text Available The 2007 global financial crisis brought sharply into focus the need for macroprudential policy as a means of controlling systemic financial stability. This has become a focal point for policy-makers and numerous central banks, including the Bank of Canada, but it has its drawbacks, particularly here in Canada. As a counterbalance to microprudential policy, the idea of a macroprudential outlook reaches beyond the notion that as long as every banking institution is healthy, financial stability is assured. Macroprudential policy recognizes that all those financial institutions are linked, and that stability at the individual level may translate to fragility and uncertainty at the macro level. There are two approaches to macroprudential policy, and both come with downsides. One approach examines the network factor, in which banks are linked through their inter-connected financial transactions. A domino effect can thus be created; when one bank defaults, it causes a chain reaction down the line, creating instability in other banks in the network. The extent of this contagion of instability can be clearly observed through this model; unfortunately, it requires the use of detailed information typically available only to a limited circle of bank supervisors. The second approach gleans information from bank stock prices in a poorly performing market. This information is easily available and accessed, but the downside is the lack of clear understanding on how exactly these shocks travel through the complex links of the global banking system. Canada’s banking system is small and has only six major banks. However, it is important to understand how they are interconnected and how each individual bank can contribute to overall risk. Not only do banks need to be sufficiently capitalized in the normal business cycle, but it may be worthwhile for the sake of overall financial stability to create mechanisms, as regulators in some countries are doing

  17. Nuclear policy for India

    International Nuclear Information System (INIS)

    Kaushik, B.M.

    1977-01-01

    Changes in India's nuclear policy from time to time are discussed. Though firmly wedded to the principle of peaceful uses of nuclear energy, India did not sign in 1965 the NPT as it discriminated between nuclear weapons powers and non-nuclear weapon powers as regards the safeguards. India wanted to keep open the option of conducting peaceful nuclear explosions (PNEs). In May 1974, India did conduct a PNE which, however, resulted into the stoppage of Canadian aid for India's nuclear power programme and created difficulties in obtaining enriched uranium for the Tarapur Atomic Power Station from the U.S.. The new Indian Government formed after the March 1977 general electtions has endorsed the earlier government's policy of opposing manufacture of nuclear weapons and has gone a step further by declearing 'If it (PNE) not necessary it should never be done'. (M.G.B.)

  18. Energetic policy, society and environment

    International Nuclear Information System (INIS)

    Oliveira, George Gurgel de

    1999-01-01

    This paper sets out connections between emerging philosophies of economic development grouped together within the concept of sustainability, and future energy policies. The article discusses Brazilian energy policy recommendations formulated on the basis of present energy supply and demand levels

  19. PolicyNet Publication System

    Data.gov (United States)

    Social Security Administration — The PolicyNet Publication System project will merge the Oracle-based Policy Repository (POMS) and the SQL-Server CAMP system (MSOM) into a new system with an Oracle...

  20. Vital architecture, slow momentum policy

    DEFF Research Database (Denmark)

    Braae, Ellen Marie

    2010-01-01

    A reflection on the relation between Danish landscape architecture policy and the statements made through current landscape architectural project.......A reflection on the relation between Danish landscape architecture policy and the statements made through current landscape architectural project....

  1. Old-growth Policy

    Directory of Open Access Journals (Sweden)

    Diane Vosick

    2007-12-01

    Full Text Available Most federal legislation and policies (e.g., the Wilderness Act, Endangered Species Act, National Forest Management Act fail to speak directly to the need for old-growth protection, recruitment, and restoration on federal lands. Various policy and attitudinal barriers must be changed to move beyond the current situation. For example, in order to achieve the goal of healthy old growth in frequent-fire forests, the public must be educated regarding the evolutionary nature of these ecosystems and persuaded that collaborative action rather than preservation and litigation is the best course for the future of these forests. Land managers and policy makers must be encouraged to look beyond the single-species management paradigm toward managing natural processes, such as fire, so that ecosystems fall within the natural range of variability. They must also see that, given their recent evidence of catastrophic fires, management must take place outside the wildland-urban interface in order to protect old-growth forest attributes and human infrastructure. This means that, in some wilderness areas, management may be required. Land managers, researchers, and policy makers will also have to agree on a definition of old growth in frequent-fire landscapes; simply adopting a definition from the mesic Pacific Northwest will not work. Moreover, the culture within the federal agencies needs revamping to allow for more innovation, especially in terms of tree thinning and wildland fire use. Funding for comprehensive restoration treatments needs to be increased, and monitoring of the Healthy Forest Initiative and Healthy Forest Restoration Act must be undertaken.

  2. Energy control policy

    International Nuclear Information System (INIS)

    Moisan, F.; Bosseboeuf, D.

    1995-01-01

    The report 'energy efficiency policies' shows the evolution of energy efficiency for different countries since the first petroleum crisis. The countries concerned by this study are European countries, North America ones, Japan, Eastern Asia countries and some out of OECD such Brazil, Chile, Poland. The results are presented in a global way and then by industry sectors, transports and tertiary and residential sectors. 8 tabs

  3. Climate change policy position

    International Nuclear Information System (INIS)

    2002-11-01

    The Canadian Association of Petroleum Producers (CAPP) is a firm believer in the need to take action to mitigate the risks associated with climate change, and that clear government policy is called for. The principles of sustainable development must guide this policy development effort. The initiatives required to address greenhouse gas emissions over both the short and long term must be carefully considered, and it is up to industries to ensure their production efficiency and emission intensity. Promoting improved performance of industries in Canada and developing technology that can be deployed internationally for larger global effects represents Canada's best contribution to progress on greenhouse gas emissions. The increase in energy demand along with increases in population and economic growth have contributed to an increase in greenhouse gas emissions despite improved energy efficiency in industry. Significant damage to the economy will result if Canada is to meet its commitment under the Kyoto Protocol, forcing the country to buy large quantities of foreign credits instead of using those funds for increased research and development. CAPP indicated that an effective plan must be: balanced, equitable, responsible, competitive, focused on technology and innovation, and based on agreements on sectoral plans. Each of these principles were discussed, followed by the fundamentals of approach for upstream oil and gas. The framework for climate change policy was described as well as the elements of a sector plan. CAPP wants to work with all levels of government on an appropriate plan for Canada, that considers our unique circumstances. Canada can play a significant role on the international stage by properly implementing the policy position proposed by the CAPP without unnecessary risks to the economy. refs

  4. Science, Society and Policy

    Science.gov (United States)

    White, K. S.; Teich, A. H.

    2010-12-01

    Apart from the journals they produce, scientific societies play an important role in communicating scientific findings and norms to the broader society. The American Association for the Advancement of Science (AAAS) includes among its goals to promote and defend the integrity of science and its use; provide a voice for science on societal issues; promote the responsible use of science in public policy; and increase public engagement with science and technology. AAAS websites and programs, including Communicating Science (www.aaas.org/communicatingscience), Working with Congress (http://www.aaas.org/spp/cstc/wwc/book.htm) and ScienceCareers.org (http://sciencecareers.sciencemag.org), provide tools for scientists to become more directly engaged in effectively communicating their findings and involved in the policy process. Education programs work to build the next generation of scientists and a science-literate public. To bridge the current communication gap between scientists, the public and policymakers, AAAS, like other scientific societies, maintains policy and outreach programs with limited budgets and staff. AAAS works to engage policymakers and provide scientific underpinning to key issues through congressional briefings, meetings, policy briefs, and media outreach. AAAS responds to challenges to accepted scientific findings and processes through op-eds, letters to government officials, resolutions, and Board statements. Some of these initiatives occur on a local level in partnership with local civic leaders, whose endorsement makes them more powerful. On a national scale, they assure that the voice of science is included in the debate. The changing media landscape presents opportunities and challenges for future AAAS endeavors.

  5. [French immigration policy].

    Science.gov (United States)

    Weil, P

    1994-01-01

    From the late nineteenth century through 1974, France permitted immigration to furnish workers and to compensate for the low level of fertility. Intense immigration from North Africa, the economic crisis of the 1970s, and other factors led to policy changes in 1974. French immigration policy since 1974 has fluctuated between guaranteeing foreigners equal rights regardless of their religion, race, culture, or national origin, and attempting to differentiate among immigrants depending on their degree of assimilability to French culture. From 1974 to 1988, France had five different policies regarding whether to permit new immigration and what to do about illegal immigrants. In July 1984, the four major political parties unanimously supported a measure in Parliament that definitively guaranteed the stay in France of legal immigrants, whose assimilation thus assumed priority. Aid for return to the homeland was no longer to be widely offered, and immigration of unskilled workers was to be terminated except for those originating in European Community countries. Major changes of government in 1988 and 1993 affected only the modalities of applying these principles. The number of immigrants has fluctuated since 1974. Unskilled workers, the only category whose entrance was specifically controlled by the 1984 measures, have declined from 174,000 in 1970 to 25,000 in the early 1990s. The number of requests for political asylum declined from 60,000 in 1989 to 27,000 in 1993, and in 1991, 15,467 persons were granted refugee status. The number of immigrants of all types permitted to remain in France declined from 250,000 or 3000 per year in the early 1970s to around 110,000 at present. Although the decline is significant, it appears insufficient to the government in power since 1993. Although migratory flows are often explained as the product of imbalance in the labor market or in demographic growth, the French experience suggests that government policies, both in the sending and

  6. Climate Change Policy

    OpenAIRE

    Toman, Michael; Shogren, Jason

    2000-01-01

    Having risen from relative obscurity as few as ten years ago, climate change now looms large among environmental policy issues. Its scope is global; the potential environmental and economic impacts are ubiquitous; the potential restrictions on human choices touch the most basic goals of people in all nations; and the sheer scope of the potential response—a significant shift away from using fossil fuels as the primary energy source in the modern economy—is daunting. In this paper, we explore t...

  7. Energy policy in Norway

    International Nuclear Information System (INIS)

    Lauen, Edvard; Bjoerndalen, Joergen

    2003-01-01

    The authors argue that the current energy policy in Norway will inevitably lead to higher and more varying electricity prices in the Nordic countries than in the rest of Europe. The Energy Act works well, but politicians have not realized that Norway is now an integral part of the power market in Europe. The EU Commission considers that the Nordic model with regional prices in order to utilize the capacity of international (market splitting) is the best

  8. SELinux policy administration

    CERN Document Server

    Vermeulen, Sven

    2013-01-01

    A step-by-step guide to learn how to set up security on Linux servers by taking SELinux policies into your own hands.Linux administrators will enjoy the various SELinux features that this book covers and the approach used to guide the admin into understanding how SELinux works. The book assumes that you have basic knowledge in Linux administration, especially Linux permission and user management.

  9. Economic and policy implications of pandemic influenza.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Braeton J.; Starks, Shirley J.; Loose, Verne W.; Brown, Theresa Jean; Warren, Drake E.; Vargas, Vanessa N.

    2010-03-01

    Pandemic influenza has become a serious global health concern; in response, governments around the world have allocated increasing funds to containment of public health threats from this disease. Pandemic influenza is also recognized to have serious economic implications, causing illness and absence that reduces worker productivity and economic output and, through mortality, robs nations of their most valuable assets - human resources. This paper reports two studies that investigate both the short- and long-term economic implications of a pandemic flu outbreak. Policy makers can use the growing number of economic impact estimates to decide how much to spend to combat the pandemic influenza outbreaks. Experts recognize that pandemic influenza has serious global economic implications. The illness causes absenteeism, reduced worker productivity, and therefore reduced economic output. This, combined with the associated mortality rate, robs nations of valuable human resources. Policy makers can use economic impact estimates to decide how much to spend to combat the pandemic influenza outbreaks. In this paper economists examine two studies which investigate both the short- and long-term economic implications of a pandemic influenza outbreak. Resulting policy implications are also discussed. The research uses the Regional Economic Modeling, Inc. (REMI) Policy Insight + Model. This model provides a dynamic, regional, North America Industrial Classification System (NAICS) industry-structured framework for forecasting. It is supported by a population dynamics model that is well-adapted to investigating macro-economic implications of pandemic influenza, including possible demand side effects. The studies reported in this paper exercise all of these capabilities.

  10. Insurance Coverage Policies for Personalized Medicine

    Directory of Open Access Journals (Sweden)

    Andrew Hresko

    2012-10-01

    Full Text Available Adoption of personalized medicine in practice has been slow, in part due to the lack of evidence of clinical benefit provided by these technologies. Coverage by insurers is a critical step in achieving widespread adoption of personalized medicine. Insurers consider a variety of factors when formulating medical coverage policies for personalized medicine, including the overall strength of evidence for a test, availability of clinical guidelines and health technology assessments by independent organizations. In this study, we reviewed coverage policies of the largest U.S. insurers for genomic (disease-related and pharmacogenetic (PGx tests to determine the extent that these tests were covered and the evidence basis for the coverage decisions. We identified 41 coverage policies for 49 unique testing: 22 tests for disease diagnosis, prognosis and risk and 27 PGx tests. Fifty percent (or less of the tests reviewed were covered by insurers. Lack of evidence of clinical utility appears to be a major factor in decisions of non-coverage. The inclusion of PGx information in drug package inserts appears to be a common theme of PGx tests that are covered. This analysis highlights the variability of coverage determinations and factors considered, suggesting that the adoption of personal medicine will affected by numerous factors, but will continue to be slowed due to lack of demonstrated clinical benefit.

  11. Drug Policy in Cyprus

    Directory of Open Access Journals (Sweden)

    George Charalambous

    2012-01-01

    Full Text Available Background: The provision of pharmaceutical drugs is of enormous significance in our lives. Notable progress made inthe domain of Public Health, combined with a general increase in the standard of living, has had a direct impact on thediscovery of new drugs and cures and has shifted pharmaceutical policies further in line with the current needs of boththe country’s health system and, its population.Aim: This research aims to both shed light on and analyse the current state of pharmaceutical policy in Cyprus, as well asto try to seek out its weaknesses, making suggestions, where possible, as to how to keep these to the minimum.Results, and Conclusions: The lack of both high level research and major industrial facilities relating to the discovery ofnew pharmaceutical drugs in Cyprus, has hindered the effectiveness of pharmaceutical policy in general domains such ascontrol over the circulation and production of pharmaceutical products in the country, their pricing and distribution andthe monitoring of our drug supplies. The lack of transparency in a number of pharmaceutical procedures, and ofinformation on drugs does not enhance the industry’s reliability, but rather exacerbates an underlying feeling of insecurityrelating to it among the population.

  12. Reflections on energy policy

    International Nuclear Information System (INIS)

    Lennings, M.

    1980-01-01

    The author first gives a general view of the present situation of the energy industry in the Federal Republic of Germany. Starting from the facts that we need further industrial growth in our country and the energy demand will increase, although not as fast as it did in the past, Mr. Lennings pleads for a long-range energy policy which should be accepted by the majority of the nation. The predominant goal of such a long-range energy policy, he states, should be a supply guarantee, i.e. sufficient supplies at relatively favourable prices must be guaranteed with regard to the industrial growth and the high export dependence of the German industry. Mr. Lenning's thoughts centre at the possible exchange potential to reduce the use of petroleum. A 'leave the petroleum' policy can only be realised by increased capital investiment, states he. In this connection he closely deals with district heating, heat pumps, conversion plants, and coal beneficiation processes and proves that with a capital investment of appr. 91 billion DM fuel oil and gasoline of appr. 28 million tons could be saved. To do this, however, additional quantities of hard coal would be necessary. Result: nuclear energy must be extended as fast as possible so it can replace coal in the sphere of power generation. (orig./UA) [de

  13. Peru: population and policy.

    Science.gov (United States)

    Sobrevilla, L A

    1987-06-01

    Peru's 1985 Population Policy Law states as its second objective that individuals and couples should be well informed and provided with the education and health services that will assist them in making responsible decisions about the number and spacing of their children. Thus, the law establishes a firm basis for IEC programs. With regard to population education, the purpose of the law is to create awareness through all educational channels of the reciprocal influence of population dynamics and socioeconomic development and to promote positive attitudes toward small family size. The law promotes the use of the communications media to educate and inform about population issues. The National Population Council, which coordinates and supervises the IEC activities of public sector agencies, has issued publications and audiovisual materials, conducted meetings with government officials and opinion leaders, and promoted awareness of population policy as a key part of development planning. In 1984, the Council organized the First National Seminar on Communication and Population to review activities, set the basis for intersectoral coordination, unify criteria, and review population policy concepts and language. The Ministry of Health carries out IEC activities as part of its family planning services program. In addition, the Ministry of Education has organized a national population education program that aims to revise school curricula to include a greater emphasis on population dynamics and family life education. The activities of a number of private institutions complement the IEC work public sector organizations.

  14. Danish Labour Market Activation Policies

    DEFF Research Database (Denmark)

    Kvist, Jon; Pedersen, Lisbeth

    2007-01-01

    Under the heading of flexicurity, Danish labour market activation policies are receiving international attention because of their perceived ability both to curb unemployment and to boost employment. Indeed, the objectives, target groups and design of activation policy have undergone a remarkable...... not only active labour market policies but also social and integration policies. Despite widespread popularity and belief in the positive effects of activation, little is actually known about its overall impact on the Danish economy....

  15. Equity Impacts of Environmental Policy

    OpenAIRE

    Antonio M. Bento

    2013-01-01

    This article surveys recent literature on the equity impacts of environmental policy. We focus on studies that look at the distribution of costs and benefits of alternative environmental policies. We also examine potentially important trade-offs between efficiency and equity that arise in the context of environmental policy, as well as transition effects. In many of the applications surveyed here, environmental policies can be regressive. Strategies are discussed to reduce this regressivity t...

  16. Monetary and Fiscal Policy Coordination

    OpenAIRE

    Hanif, Muhammad N.; Arby, Muhammad Farooq

    2003-01-01

    Macroeconomic policies are meant to achieve non-inflationary, stable growth. There are two major groups of policy instruments to achieve the purpose; one is related to monetary conditions and the other to fiscal conditions. Monetary instruments are employed by the central bank and fiscal instruments are employed by ministry of finance. The objectives and implications of policy measures taken by the two institutions often conflict with each other and thus call for policy coordination for effec...

  17. Changing closed agricultural policy communities

    NARCIS (Netherlands)

    Termeer, C.J.A.M.; Werkman, R.A.

    2011-01-01

    Agricultural policy networks have served as classic examples of closed policy communities facing pressure to open up. However, attempts to change them are slowly moving forward. The dialogues on Common Agricultural Policy reforms in which the Dutch Ministry of Agriculture is engaged with a range of

  18. Cartographic Communication and Information Policy.

    Science.gov (United States)

    van de Waal, E. Hans

    Trends in information policy are discussed as they impact on cartographic information, stressing particularly the relationships between cartographic communication, documentation, and policy making. Distinction is made between cartographic communication as a subject for information policy and cartographic communication as an expedient in public…

  19. EU Competition Policy Since 1990

    DEFF Research Database (Denmark)

    Bartalevich, Dzmitry

    2013-01-01

    in anticartel enforcement policies, antimonopoly regulation, and the regulation of mergers and acquisitions. The purpose of this article is to fill the gap by attempting to link EU competition policy with U.S. antitrust, provide a critical overview of the most important elements of European competition policy......, and merger control....

  20. Making Policy in the Classroom

    Science.gov (United States)

    Hohmann, Ulrike

    2016-01-01

    The concept of street-level bureaucracy (Lipsky, 1980, 2010) examines the form and extent discretion takes in teachers' and other public policy enactors' work and how they negotiate their way through sometimes contradictory policy imperatives. It provides a framework for straddling top-down and bottom-up perspectives on policy making. In this…

  1. Drug Policy: the "Dutch Model"

    NARCIS (Netherlands)

    van Ooijen-Houben, M.M.J.; Kleemans, E.R.

    2015-01-01

    Dutch drug policy, once considered pragmatic and lenient and rooted in a generally tolerant attitude toward drug use, has slowly but surely shifted from a primarily public health focus to an increasing focus on law enforcement. The "coffee shop" policy and the policy toward MDMA/ecstasy are

  2. Digital Citizenship Policy Development Guide

    Science.gov (United States)

    Alberta Education, 2012

    2012-01-01

    Education leaders are re-examining acceptable use policies in light of the increasing use of highly mobile information technologies. While acceptable use policies were developed to manage and control behaviour, a digital citizenship policy takes a more comprehensive approach by recognizing the important role of education in preparing digital…

  3. Methodology for Participatory Policy Analysis

    NARCIS (Netherlands)

    Geurts, J.L.A.; Joldersma, F.

    2001-01-01

    In the course of time it has become clear that policy analysts who use traditional formal modeling techniques have limited impact on policy making regarding complex policy problems. These kinds of problems require the analyst to combine scientific insights with subjective knowledge resources and to

  4. Cost of Policy Inaction

    International Nuclear Information System (INIS)

    Bakkes, J.A.; Brauer, I.; Ten Brink, P.; Gorlach, B.; Kuik, O.J.; Medhurst, J.

    2007-01-01

    The objective of this study is to lay out reasonable expectations of COPI as an assessment instrument. This includes aspects such as potential messages; important technical issues; limitations; issues of focus, direction and process; key information gaps; added value. The scope of this study is environment policy at the EU level, touching on policy areas that are not labelled 'environment' but are nevertheless relevant to the issue of cost of policy non-action regarding the environment. The study reflects on methods to assess COPI in money terms but also considers non-monetary endpoints, such as the number of premature deaths. The study aims to illuminate which stages of the policy making process the concept of COPI can best support. Our interpretation of what DG ENV seeks, in relation to COPI, is: economic thinking, but not too narrow, as an element of a communication strategy. This led us to consider inter alia the possibilities to apply the COPI concept to environmental-related policy as a whole - next to, or contrasted with, other EU priorities. Realism has been an important consideration: this study tries to provide ideas to DG ENV for pragmatic use of the COPI concept. That requires a balance between, or a proper combination and sequencing of, the quick-and-simple and the thorough-but-costly. The study reflects on both and eventually recommends a combination of mostly smaller studies in four distinct categories. In view of this we included in this scoping study elements of COPI methodology that can be of practical use in designing and committing follow-up work. This includes a two-page methodological summary, a section on important design choices, a framework for a COPI program, populated with some examples of good topics for COPI studies that seem double. Although the production of this scoping study has been a small project, it was nevertheless undertaken by five organizations in order to connect with as much practical experience as possible. GHK experience

  5. Transformation of Croatian Disabled Policy: Analysis of Policy Goals

    Directory of Open Access Journals (Sweden)

    Ana Petek

    2010-01-01

    Full Text Available The article is based on the idea of transformation of the policy-making mode of Croatian disabled policy, from the medical model, through the social model to the human rights model. The paper highlights 7 elements according to which these models differ, and which are structured into categories of problem-definition, goal-determination and then implementation of disabled policy. The analysis is focused on the goals of Croatian disabled policy, and is based on an interdisciplinary research project of political science, special education and social work. Empirical data were collected by document analysis, by interviewing relevant policy actors and by a survey with the members of representative bodies on all government levels. With the discourse analysis of documents, open coding of interviews and statistical analysis of data collected in the survey, the paper attempts, through the indicator of activity of persons with disability, to answer to what extent Croatian disabled policy is transformed into human rights policy.

  6. Ribbing disease

    International Nuclear Information System (INIS)

    Mukkada, Philson J; Franklin, Teenu; Rajeswaran, Rangasami; Joseph, Santhosh

    2010-01-01

    Ribbing disease is a rare sclerosing dysplasia that involves long tubular bones, especially the tibia and femur. It occurs after puberty and is reported to be more common in women. In this article we describe how Ribbing disease can be differentiated from diseases like Engelmann-Camurati disease, van Buchem disease, Erdheim-Chester disease, osteoid osteoma, chronic osteomyelitis, stress fracture, etc

  7. Historical account of venereal diseases in Mexico.

    OpenAIRE

    Conde-Glez, C J; Calderón, E; Juárez-Figueroa, L; Hernández-Avila, M

    1993-01-01

    This paper reviews the history of sexually acquired diseases in Mexico. It is divided into four major chronological sections which discuss social attitudes and values, the development of services and of official policy, and historical epidemiology.

  8. Policy Capacity for Health Reform: Necessary but Insufficient: Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Adams, Owen

    2015-09-04

    Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action. © 2016 by Kerman University of Medical Sciences.

  9. Health and Wellness Policy Ethics

    Directory of Open Access Journals (Sweden)

    Frank J. Cavico

    2013-01-01

    Full Text Available This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace.

  10. Invalidating Policies using Structural Information

    DEFF Research Database (Denmark)

    Kammuller, Florian; Probst, Christian W.

    2014-01-01

    by invalidating policies using structural information of the organisational model. Based on this structural information and a description of the organisation’s policies, our approach invalidates the policies and identifies exemplary sequences of actions that lead to a violation of the policy in question. Based...... on these examples, the organisation can identify real attack vectors that might result in an insider attack. This information can be used to refine access control systems or policies. We provide case studies showing how mechanical verification tools, i.e. modelchecking with MCMAS and interactive theorem proving...

  11. Health and Wellness Policy Ethics

    Science.gov (United States)

    Cavico, Frank J.; Mujtaba, Bahaudin G.

    2013-01-01

    This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace. PMID:24596847

  12. Policy Development Fosters Collaborative Practice

    DEFF Research Database (Denmark)

    Meyer, Daniel M; Kaste, Linda M; Lituri, Kathy M

    2016-01-01

    This article provides an example of interprofessional collaboration for policy development regarding environmental global health vis-à-vis the Minamata Convention on Mercury. It presents an overview of mercury and mercury-related environmental health issues; public policy processes and stakeholde...... requiring dental engagement for interprofessional policy development include education, disaster response, HPV vaccination, pain management, research priorities, and antibiotic resistance.......; and specifics including organized dentistry's efforts to create global policy to restrict environmental contamination by mercury. Dentistry must participate in interprofessional collaborations and build on such experiences to be optimally placed for ongoing interprofessional policy development. Current areas...

  13. Environmental and sustainability education policy

    DEFF Research Database (Denmark)

    The volume draws on a wide range of policy studies and syntheses to provide readers with insights into the international genealogy and priorities of ESE policy. Editors and contributors call for renewed attention to the possibilities for future directions in light of previously published work and......, ideological orthodoxy and critique, curriculum making and educational theory, globalisation and neoliberalism, climate change and environmental worldviews, and much more....... and innovations in scholarship. They also offer critical commentary on the evolution of research trends, approaches and findings. Including a wide range of examples of ESE policy and policy research, the book draws on studies of educational initiatives and legislation, policy making processes and rhetoric...

  14. Haemoglobinopathies in Europe: health & migration policy perspectives.

    Science.gov (United States)

    Aguilar Martinez, Patricia; Angastiniotis, Michael; Eleftheriou, Androulla; Gulbis, Beatrice; Mañú Pereira, Maria Del Mar; Petrova-Benedict, Roumyana; Corrons, Joan-Lluis Vives

    2014-07-01

    Major haemoglobinopathies (MH), such as thalassaemia syndromes (Thal) and sickle cell disorders (SCD), are genetic defects associated with chronic anaemia and other complications. In Europe, MH are rare diseases (RD) but their prevalence is significantly growing in many countries due to mobility and migration flows. This creates a growing health problem in the EU that has not yet been effectively addressed by Member States (MS) authorities. The present study has been conducted with the aim of: (i) providing an overview of policies for MH in 10 EU member states (MS) (ii) analysing the challenges linked to these RD due to growing requirements imposed by population, mobility and migration trends and (iii) identifying gaps, proposing improvements on existing policies, or developing new ones to fit the identified needs. The study has been undertaken by a group of members of the European Network for Rare and Congenital Anaemias (ENERCA) and the Thalassaemia International Federation (TIF), in collaboration with the public affairs firm Burson-Marsteller Brussels. Data from 10 EU countries have been gathered using targeted desk research and one-to-one interviews with local stakeholders, including healthcare professionals, patients and public health officers/providers. 1. MH are the most common RD in all the 10 countries, 2. Data on prevalence, overall burden, trends, and clinical follow up costs are lacking in most countries. 3. Neonatal screening practices show a wide variation across and within countries. 4. Awareness on MH and their related complications is very low, exception made of Italy, Greece, Cyprus and UK, 5. No disaggregated data is available to understand the impact of mobility and migration on the prevalence of haemoglobinopathies, and how healthcare delivery systems should adapt to respond to this situation. 6. Targeted policy measures and/or actions are generally lacking and/or delayed. Ten policy recommendations have been drawn from this study, building on

  15. Climate policy: Bucket or drainer?

    International Nuclear Information System (INIS)

    Oikonomou, Vlasis; Patel, Martin; Worrell, Ernst

    2006-01-01

    Worldwide, industry is responsible for about 40% of greenhouse gas (GHG) emissions, making it an important target for climate policy. Energy-intensive industries may be particularly vulnerable to higher energy costs caused by climate policy. If companies cannot offset rising energy costs and would face increased competition from countries without climate policy, they may decide to relocate their industrial production to the countries without climate policy. The resulting net effect of climate policy on GHG emissions in foreign countries is typically referred to as 'carbon leakage'. Carbon leakage may lead to higher global GHG emissions due to the use of less advanced technology in less developed countries. Based on a literature review of climate policy, earlier environmental policy and analyses of historical trends, this paper assesses the carbon leakage effects of climate policy for energy-intensive industries. Reviews of past trends in production location of energy-intensive industries show an increased global production share of Non-Annex 1 countries. However, from empirical analyses we conclude that the trend is primarily driven by regional demand growth. In contrast, climate policy models show a strong carbon leakage. Even though future climate policy may have a more profound impact than environmental policies in the past, the modelling results are doubtful. Leakage generally seems to be overestimated in current models, especially as potential positive spillovers are often not included in the models. The ambiguity of the empirical analyses and the modelling results warrants further research in the importance of production factors for relocation

  16. Solving the Policy Implementation Problem

    Directory of Open Access Journals (Sweden)

    Gregg A. Garn

    1999-08-01

    Full Text Available When Republican legislators in Arizona failed to approve educational vouchers in four consecutive legislative sessions, a charter school program was approved as a compromise. The charter school policy was written during a special summer session and within three years, over 30,000 students were enrolled in 260 charter schools across the state. Republican policy makers, who failed to enact voucher legislation, proclaimed the charter school program to be an overwhelming success and protected it from amendments by Democrats and potential actions of bureaucrats that could have altered the policy intent. Research on the implementation of policy indicates that state and local implementors frequently undermine or alter legislative intentions. However, when Arizona policy makers approved the charter school policy, they overcame this persistent implementation phenomenon and, in fact, succeeded in preserving the legislative intentions in the working program. This policy study analyzes how they were able to achieve this elusive result. Key policy makers attended to four significant features of policy implementation in creating the charter school policy: communication, financial resources, implementor attitudes, and bureaucratic structure. Manipulating these key variables allowed policy makers to reduce implementation slippage.

  17. Energy Policy. Highlights. 2013 Edition

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-07-01

    Energy Policy Highlights showcases recent developments in energy policies among all 28 IEA member countries. Each contribution underscores the changing nature of both global and domestic energy challenges, as well as the commonality of energy concerns among member countries. The policies highlighted in this publication identify an urgent need to reduce greenhouse gas (GHG) emissions as a clear policy objective. Electricity, enhancing energy efficiency and increasing the share of renewables in the energy mix in a cost effective manner are likewise areas of common focus. On the end-user side, increasing public awareness of domestic energy policies through improved transparency and engagement is an important facet of policy support among IEA member countries. The successful implementation of policies and other initiatives benefitted from efforts to inform the public.

  18. A Proposal for a UK Ethics Council for Animal Policy: The Case for Putting Ethics Back into Policy Making

    Directory of Open Access Journals (Sweden)

    Steven P. McCulloch

    2018-06-01

    Full Text Available Substantial controversy is a consistent feature of UK animal health and welfare policy. BSE,~foot and mouth disease, bovine TB and badger culling, large indoor dairies, and wild animals in circuses are examples. Such policy issues are inherently normative; they include a substantial moral dimension. This paper reviews UK animal welfare advisory bodies such as the Animal Health and Welfare Board of England, the Farm Animal Welfare Committee and the Animals in Science Committee. These bodies play a key advisory role, but do not have adequate expertise in ethics to inform the moral dimension of policy. We propose an “Ethics Council for Animal Policy” to inform the UK government on policy that significantly impacts sentient species. We review existing Councils (e.g., the Nuffield Council on Bioethics and The Netherlands Council on Animal Affairs and examine some widely used ethical frameworks (e.g., Banner’s principles and the ethical matrix. The Ethics Council for Animal Policy should be independent from government and members should have substantial expertise in ethics and related disciplines. A pluralistic six-stage ethical framework is proposed: (i Problematisation of the policy issue, (ii utilitarian analysis, (iii animal rights analysis, (iv virtue-based analysis, (v animal welfare ethic analysis, and (vi integrated ethical analysis. The~paper concludes that an Ethics Council for Animal Policy is necessary for just and democratic policy making in all societies that use sentient nonhuman species.

  19. Secrecy and misguided policy

    Energy Technology Data Exchange (ETDEWEB)

    Rossin, A D [Center for International Security and Cooperation, Stanford, California (United States)

    2001-07-01

    The atomic bomb was born in secrecy. After the war, scientists and statesmen committed themselves to develop the promise of nuclear energy without the proliferation of nuclear weapons. The most obvious tool available to them was secrecy. But secrecy was not the sword that could easily be beaten into the plowshare. It proved to be a double-edged sword. It could not stop the spread of basic scientific information, and it turned out to be a weapon for marketing information to promote political aims. It served that purpose in promoting President Carter policy to stop reprocessing of spent fuel. (author)

  20. Secrecy and misguided policy

    International Nuclear Information System (INIS)

    Rossin, A.D.

    2001-01-01

    The atomic bomb was born in secrecy. After the war, scientists and statesmen committed themselves to develop the promise of nuclear energy without the proliferation of nuclear weapons. The most obvious tool available to them was secrecy. But secrecy was not the sword that could easily be beaten into the plowshare. It proved to be a double-edged sword. It could not stop the spread of basic scientific information, and it turned out to be a weapon for marketing information to promote political aims. It served that purpose in promoting President Carter policy to stop reprocessing of spent fuel. (author)

  1. From policy to results

    International Nuclear Information System (INIS)

    Almassi, M.

    2004-01-01

    The Ontario Government's current policy on demand side management (DSM) and demand response (DR) represents the largest energy efficiency opportunity in Canada. The provincial government recently announced a proposal for an additional 300 MW of renewable generation, and 2,500 MW of conventional generation or demand side management. The 2007 conservation target is a 5 per cent reduction in Ontario's energy demand, equivalent to 1,200 MW. Eligible renewable projects include wind, solar, bio oil, bio gas, landfill gas and water. Past experiences and lessons learned in Ontario were outlined with reference to energy service companies (ESCO), old Ontario Hydro, and gas utilities. 2 figs

  2. Improving EU biofuels policy?

    DEFF Research Database (Denmark)

    Swinbank, Alan; Daugbjerg, Carsten

    2013-01-01

    to be 'like' a compliant biofuel. A more economically rational way to reduce GHG emissions, and one that might attract greater public support, would be for the RED to reward emission reductions along the lines of the FQD. Moreover, this modification would probably make the provisions more acceptable...... in the WTO, as there would be a clearer link between policy measures and the objective of reductions in GHG emissions; and the combination of the revised RED and the FQD would lessen the commercial incentive to import biofuels with modest GHG emission savings, and thus reduce the risk of trade tension....

  3. Discussion: European Commission policy

    International Nuclear Information System (INIS)

    Coldwell, R.

    1993-01-01

    This paper documents the debate which arose following two papers presented to a seminar run by the Centre for the Study of Regulated Industries, on 11th November 1992, on European Commission (EC) energy policies. The issues raised cover how an internal market for electricity and natural gas will be implemented under a proposed EC directive, bearing in mind the level of opposition from a number of Member States. How this Directive will apply to vertically integrated structures, such as Scottish Electricity Industry, is also considered. (UK)

  4. Children's media policy.

    Science.gov (United States)

    Jordan, Amy B

    2008-01-01

    Amy Jordan addresses the need to balance the media industry's potentially important contributions to the healthy development of America's children against the consequences of excessive and age-inappropriate media exposure. Much of the philosophical tension regarding how much say the government should have about media content and delivery stems from the U.S. Constitution's First Amendment protection against government interference in free speech, including commercial speech. Courts, Jordan says, have repeatedly had to weigh the rights of commercial entities to say what they please against the need to protect vulnerable citizens such as children. This balancing act is complicated even further, she says, because many government regulations apply only to broadcast television and not to non-broadcast media such as the Internet or cable television, though Congress has addressed the need to protect children's privacy online. The need to protect both free speech and children has given rise to a fluid media policy mix of federal mandates and industry self-regulation. Jordan describes the role of the three branches of the federal government in formulating and implementing media policy. She also notes the jockeying for influence in policymaking by industry lobbies, child advocacy groups, and academic researchers. The media industry itself, says Jordan, is spurred to self-regulation when public disapproval grows severe enough to raise the possibility of new government action. Jordan surveys a range of government and industry actions, from legislatively required parental monitoring tools, such as the V-Chip blocking device on television sets, to the voluntary industry ratings systems governing television, movies, and video games, to voluntary social website disclosures to outright government bans, such as indecency and child privacy information collection. She considers the success of these efforts in limiting children's exposure to damaging content and in improving parents

  5. From policy to reality

    DEFF Research Database (Denmark)

    Ditlevsen, Kia; Reventlow, Susanne; Nielsen, Annemette Ljungdalh

    2016-01-01

    This qualitative study explores the structural barriers to preventive interventions targeting childhood obesity in the Danish health care system. Based on interviews with relevant health care professionals, the paper reports on the problems which are experienced by general practitioners and health......, and lack of resources together make it difficult for health care professionals to initiate interventions and reach the children in need of support. By analyzing the policy implementation process in a theoretical framework that discloses the discursive allocation of responsibilities, the study is able...

  6. Personnel policy and management

    International Nuclear Information System (INIS)

    Dangelmaier, P.

    1986-01-01

    In the field of personnel policy and management two main points must be considered and fitted together: the aspects of the applicant and the aspects of the utility. The applicant wishes a position which suits to his abilities, education, training, experience and self-evaluation. The enterprise has beside these qualification criteria to look to some additional points: reliability - not only in the profession of the applicant but also in his daily life. In this examination licensing authorities are involved too; responsibility in a very broad sense and the ability to make correct decisions sometimes under stress situations. (orig.)

  7. An unsatisfactory contract policy

    CERN Multimedia

    Association du personnel

    2012-01-01

    For the last 15 years contract policy has been one of the top priorities of CERN staff, as expressed in successive surveys initiated by the Staff Association. In one’s professional life, having some forward vision of one’s career prospects is the key to loyalty and motivation. On the contrary, instability about the future is always at the root of anxiety, conflicts, or even health problems. A good employer must therefore balance the needs of the Company and those of its employees. CERN’s current contract policy, as described in the Administrative Circular No 2, states that staff members should first obtain a limited duration (LD) contract of up to five years. Then, if they want to stay in the Organization, staff members must apply, usually once a year, and before the end of their LD contract, for an indefinite contract (IC) post. All candidates for an IC post are considered by the Review Board for the award of indefinite contracts (Review Board) which will choose the most suita...

  8. Reassessing nuclear nonproliferation policy

    International Nuclear Information System (INIS)

    Smith, G.; Rathjens, G.

    1981-01-01

    Unresolved proliferation problems are as serious issues for the Reagan Administration as East-West relations and dependence on imported oil. The linkage of nuclear weapons to power reactors is debatable, but developing and industrialized countries alike feel that nuclear power is an important option. A review of Carter policies finds them flawed in several respects. Although they heightened worldwide concern about proliferation, they fell short because (1) most governments and the nuclear industry reacted negatively; (2) they offered no way to deal with countries which construct only weapons facilities; (3) they did not help the US image as a reliable supplier; (4) no realistic fuel-cycle alternatives emerged; and (5) little has been done about fuel assurances and international spent-fuel storage. Past policies need to be restructured under new premises to deal effectively with the motivation to acquire nuclear weapons. The effort should stress collective rather than unilateral action and a renewed effort for a comprehensive test ban treaty. 10 references

  9. Ademe's scientific policy

    International Nuclear Information System (INIS)

    Clement, D.

    2005-01-01

    The Ademe, the French agency of environment and energy mastery, is a public institution with industrial and commercial purposes. Its missions are multiple: fighting against climatic change (implementation of the French policy of energy efficiency, energy mastery and development of renewable energy sources); abatement of waste production and rehabilitation of polluted sites; monitoring of air quality and abatement of pollution sources (including noise); implementation of a sustainable development policy. The agency acts as a link between private and public research and follows a four steps strategy: contributing to the improvement of knowledge, technical progress and practices, valorizing the socio-economic aspects of the sustained researches, developing partnerships between public and private actors, and collaborating to the building up of a European research space. Today, in the energy domain, the Ademe is defending 5 technological priorities: hydrogen and fuel cells, CO 2 capture and sequestration, renewable energy sources (photovoltaic and biomass), clean and low energy transportation systems (PREDIT), and buildings without greenhouse effect (PREBAT). (J.S.)

  10. Generic policy in Bulgaria: a policy of failure or success?

    Directory of Open Access Journals (Sweden)

    Assena Stoimenova

    2016-09-01

    Full Text Available Generic medicines play a key role in managing the financial resources for pharmaceuticals in every country. This study analysed the generic policy legislative framework in Bulgaria with the aim to identify whether the policy implementation can be considered successful in the light of an international review of such policies introduced in other countries, or on the contrary, it has failed to deliver the main benefits. Legislative analysis, desktop study and macroeconomic overview of the Bulgarian pharmaceutical market were included. The study showed that only 3 out of 11 important policy elements are implemented in the country. Bulgaria has one of the highest shares of generics, an average of 81.39% (volume, for the studied period (2006–2014. However, further research is needed to evaluate the success of the existing generic policy in Bulgaria, as the market share of generic drugs is not the only measure of the policy efficiency.

  11. Policy Learning and Organizational Capacities in Innovation Policies

    DEFF Research Database (Denmark)

    Borrás, Susana

    2011-01-01

    Bengt-Åke Lundvall’s work has underlined the importance of policy learning for inducing innovation systems’ adaptability. In spite of his efforts and of the general interest in this topic, studies of policy learning in innovation policy continue to be scarce. Elaborating from recent theoretical...... advances, the paper identifies three levels of policy learning and argues that their effects on innovation systems are related to specific capacities of the relevant organizations implementing change. This analytical framework is used in the study of trans-national policy learning in Europe in the area...... of science–industry relations, showing the importance of capacities (or lack thereof). This calls for the practical need of addressing organizational capacity-building, in particular of analytical capacity, for truly strategic innovation policy-making....

  12. When Regional Innovation Policies Meet Policy Rationales and Evidence:

    DEFF Research Database (Denmark)

    Borrás, Susana; Jordana, Jacint

    regions, and to understand how rationales and evidence can be translated into policy-making. To this purpose, this paper develops a framework to study the extent to which regional innovation policies have changed during the past few years. Since the mid-2000s there has been an important development......In spite of recent advancements regarding regional innovation policy rationales and evidence, there are few analyses about the actual features of existing regional innovation policies. Nevertheless, a policy analysis perspective is important in order to recognise their distinctive patterns across...... of innovation policy rationales, advocating for more specialisation; likewise, greater data availability at the regional level has allowed more sophisticated assessment of innovation performance. Finally, the crisis since 2008 has had ravaging effects in some regions, with job losses and severe economic...

  13. When Regional Innovation Policies Meet Policy Rationales and Evidence

    DEFF Research Database (Denmark)

    Borrás, Susana; Jordana, Jacint

    2016-01-01

    regions, and to understand how rationales and evidence can be translated into policy-making. To this purpose, this paper develops a framework to study the extent to which regional innovation policies have changed during the past few years. Since the mid-2000s, there has been an important development......In spite of recent advancements regarding regional innovation policy rationales and evidence, there are few analyses about the actual features of existing regional innovation policies. Nevertheless, a policy analysis perspective is important in order to recognize their distinctive patterns across...... of innovation policy rationales, advocating for more specialization; likewise, greater data availability at the regional level has allowed more sophisticated assessment of innovation performance. Finally, the crisis since 2008 has had ravaging effects in some regions, with job losses and severe economic...

  14. How nutrition policy affects food and agricultural policy.

    Science.gov (United States)

    Johnson, S R

    1994-09-01

    The impact of the improved understanding of nutrition and the importance of the diet in nutrition status has had subtle but far-reaching consequences for food and agricultural policy. Many of the changes in the food supply are in response to increased consciousness of diet, nutrition and health status. The simple connection between nutrition policy and food and agricultural policy follows from the sovereignty of the consumer. Nutrition policy influences consumers' attitudes and choices. These impact the behavior of agents in the food and production system. And, if properly designed, food and agricultural policies can accelerate the process of adapting the production and distribution systems for agriculture and food to better meet the demands of the more informed consumer. Policies that reflect the behavior of consumers and supply better information to the agents in the food and agricultural system will be the most effective.

  15. An evaluation of public school district tobacco policies in St. Louis County, Missouri.

    Science.gov (United States)

    Barbero, Colleen; Moreland-Russell, Sarah; Bach, Laura E; Cyr, Julianne

    2013-08-01

    One way to address tobacco use by youth is for primary and secondary schools to adopt and implement comprehensive tobacco policies. The purpose of this study was to evaluate the comprehensiveness of tobacco policies in St. Louis County, Missouri public school districts. We evaluated the strength of tobacco policies from all 23 public school districts located in the county using the Center for Tobacco Policy Research's School Tobacco Policy Index, a standardized tool for rating school tobacco policies. The districts averaged a score of 24.4 of 40 possible points on the Index. Policies scored highest on the Tobacco-Free Environment domain and lowest on the Enforcement domain. Policies averaged about half of the total possible points for the Prevention and Treatment Services and Policy Organization domains. Despite more than a decade of efforts by the Centers for Disease Control and Prevention to improve school tobacco policies, this study shows that policies in St. Louis County districts have yet to meet the standard of comprehensiveness. It is recommended that schools adopt policies that are comprehensive and that address all domains of the School Tobacco Policy Index. © 2013, American School Health Association.

  16. The argument for pharmaceutical policy.

    Science.gov (United States)

    Traulsen, Janine Morgall; Almarsdóttir, Anna Birna

    2005-02-01

    Pharmaceutical policy is a global concern. It has become a hot political topic in most countries--developed as well as developing--and can be found on the agenda of international organizations such as WHO, OECD, EU, WTO and even the World Bank. Pharmaceutical policy affects everyone in the world of pharmacy and it is therefore imperative that it be understood, discussed and debated within the pharmacy profession and included in the curriculum of schools of pharmacy. This, the first article in a series, argues for the importance of the academic discipline of pharmaceutical policy analysis and the involvement of pharmacists in this endeavour. The aim of the authors is to stimulate an informed and critical appreciation of this field. The authors begin with an introduction to the field of pharmaceutical policy, introducing several important concepts and current trends including: medicines regulation; how pharmaceutical policy is made; pharmaceutical policy as a dynamic process; and the new public health as a global issue. The article ends with a short description of the remaining five articles in the series which will deal with important aspects of pharmaceutical policy. The topics include: economic pressures on health care systems; drug utilization from the clinical viewpoint (rational use of medicines); the impact of pharmaceutical policy on patients and the patient impact on pharmaceutical policy; the professional perspective; and finally the last article which deals with studying and evaluating pharmaceutical policy.

  17. Democratic cultural policy : democratic forms and policy consequences

    OpenAIRE

    Gray, Clive

    2012-01-01

    The forms that are adopted to give practical meaning to democracy are assessed to identify what their implications are for the production of public policies in general and cultural policies in particular. A comparison of direct, representative, democratic elitist and deliberative versions of democracy identifies clear differences between them in terms of policy form and democratic practice. Further elaboration of these differences and their consequences are identified as areas for further res...

  18. Tracing policy movements: methods for studying learning and policy circulation

    OpenAIRE

    Wood, Astrid

    2016-01-01

    Policy flows are not quantifiable and calculating processes but part of the uneven movement of ideas and experiences that involves power and personalities. Processes of learning and policy circulation have thus proven difficult to study especially as the exchanges taking place between actors and localities rarely lead directly to uptake. This paper outlines a conceptual and methodological framework for conducting policy mobilities research by attending to the plethora of ordinary practices – ...

  19. Antibiotic Policies in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Nese Saltoglu

    2003-08-01

    Full Text Available The antimicrobial management of patients in the Intensive Care Units are complex. Antimicrobial resistance is an increasing problem. Effective strategies for the prevention of antimicrobial resistance in ICUs have focused on limiting the unnecessary use of antibiotics and increasing compliance with infection control practices. Antibiotic policies have been implemented to modify antibiotic use, including national or regional formulary manipulations, antibiotic restriction forms, care plans, antibiotic cycling and computer assigned antimicrobial therapy. Moreover, infectious diseases consultation is a simple way to limit antibiotic use in ICU units. To improve rational antimicrobial using a multidisiplinary approach is suggested. [Archives Medical Review Journal 2003; 12(4.000: 299-309

  20. How Nutrition Sensitive Are the Nutrition Policies of New Zealand Food Manufacturers? A Benchmarking Study

    Science.gov (United States)

    Doonan, Rebecca

    2017-01-01

    Nutrition sensitive policy addresses the underlying determinants of nutrition-related disease and is a powerful tool in reducing the incidence of non-communicable disease. Some members of the food industry have long standing commitments to health-oriented nutrition policies. The aim of this study was to develop and apply a balanced scorecard of nutrition sensitive indicators to the policies of influential New Zealand food and beverage manufacturers and explore factors affecting policy processes. Results: The average nutrition sensitivity score of the twenty influential manufacturers policies was 42 against a benchmark of 75. Some manufacturers performed well whilst others had substantial scope for improvement, the largest variation was in policy development and implementation, whereas nutrition quality was relatively consistent. Manufacturers with written policy (n = 11) scored on average three times higher than their counterparts with verbal policy. The value a manufacturer placed on nutrition influenced whether formal nutrition policies were developed. The reputational risk of failing to deliver on publicly declared nutrition commitments acted as an informal accountability mechanism. We conclude the balanced scorecard offers a useful tool for assessing the nutrition sensitivity of influential food and beverage manufacturers’ policies. Our results provide a baseline for repeat assessments of the nutrition sensitivity of food manufacturers’ policies. PMID:29257049