WorldWideScience

Sample records for emergency healthcare policy

  1. Global perspectives on nursing and its contribution to healthcare and health policy: thoughts on an emerging policy model.

    Science.gov (United States)

    Shamian, Judith

    2014-12-01

    We know from rigorous evidence that nurses can exert an incredible impact on the everyday lives of people and their health. Nurses can also contribute in much wider spheres of influence by applying their knowledge and skills to address broader issues affecting population health across communities, nations and globally. Despite the prevalence of so many vexing health and social issues, nurses often fail to think globally, or even regionally, when they are lobbying for change. And while much political influence is local, some issues are simply too complex to rely on local influence alone. Importantly in all this, we must acknowledge the ways these complex health issues are shaped by economic and political agendas and not necessarily by healthcare agendas. As such, the nursing community has to act globally and locally, both within and outside of the nursing arena. This paper explores early thinking about an evolving model of spheres--or "bubbles"--of policy influence in which nurses can and must operate to more effectively impact key global health and healthcare challenges.

  2. Visioning future emergency healthcare collaboration

    DEFF Research Database (Denmark)

    Söderholm, Hanna M.; Sonnenwald, Diane H.

    2010-01-01

    physicians, nurses, administrators, and information technology (IT) professionals working at large and small medical centers, and asked them to share their perspectives regarding 3DMC's potential benefits and disadvantages in emergency healthcare and its compatibility and/or lack thereof......New video technologies are emerging to facilitate collaboration in emergency healthcare. One such technology is 3D telepresence technology for medical consultation (3DMC) that may provide richer visual information to support collaboration between medical professionals to, ideally, enhance patient......, and resources. Both common and unique perceptions regarding 3DMC emerged,illustrating the need for 3DMC, and other collaboration technologies,to support interwoven situational awareness across different technological frames....

  3. Healthcare economics for the emergency physician.

    Science.gov (United States)

    Propp, Douglas A; Krubert, Christopher; Sasson, Andres

    2003-01-01

    Although the principles of healthcare economics are not usually part of the fundamental education of emergency physicians, an understanding of these elements will enhance our ability to contribute to improved health-care value. This article introduces the practical aspects of microeconomics, insurance, the supply-and-demand relationship, competition, and costs as they affect the practice of medicine on a daily basis. Being cognizant of how these elements create a dynamic interplay in the health-care industry will allow physicians to better understand the expanded role they need to assume in the ongoing cost and quality debate. Copyright 2003, Elsevier Science (USA). All rights reserved.)

  4. Healthcare Policy in Romania. Frameworks and Challenges

    Directory of Open Access Journals (Sweden)

    Buţiu Călina Ana

    2016-07-01

    Full Text Available The objective of the paper is to review some of the healthcare policy issues of Romania and identify those challenges which may be addressed through social intervention. Based on statistical data, documents, reports and applicable laws one will review the health condition of Romanian population and the state of the national health system, and will examine the broad strategies and policies currently under the scrutiny of appropriate ministries. The findings of the study suggest looking at health policies also through the lens of social inclusion.

  5. Reforming primary healthcare: from public policy to organizational change.

    Science.gov (United States)

    Gilbert, Frédéric; Denis, Jean-Louis; Lamothe, Lise; Beaulieu, Marie-Dominique; D'amour, Danielle; Goudreau, Johanne

    2015-01-01

    Governments everywhere are implementing reform to improve primary care. However, the existence of a high degree of professional autonomy makes large-scale change difficult to achieve. The purpose of this paper is to elucidate the change dynamics and the involvement of professionals in a primary healthcare reform initiative carried out in the Canadian province of Quebec. An empirical approach was used to investigate change processes from the inception of a public policy to the execution of changes in professional practices. The data were analysed from a multi-level, combined contextualist-processual perspective. Results are based on a longitudinal multiple-case study of five family medicine groups, which was informed by over 100 interviews, questionnaires, and documentary analysis. The results illustrate the multiple processes observed with the introduction of planned large-scale change in primary care services. The analysis of change content revealed that similar post-change states concealed variations between groups in the scale of their respective changes. The analysis also demonstrated more precisely how change evolved through the introduction of "intermediate change" and how cycles of prescribed and emergent mechanisms distinctively drove change process and change content, from the emergence of the public policy to the change in primary care service delivery. This research was conducted among a limited number of early policy adopters. However, given the international interest in turning to the medical profession to improve primary care, the results offer avenues for both policy development and implementation. The findings offer practical insights for those studying and managing large-scale transformations. They provide a better understanding of how deliberate reforms coexist with professional autonomy through an intertwining of change content and processes. This research is one of few studies to examine a primary care reform from emergence to implementation

  6. Barriers to knowledge sharing in Chinese healthcare referral services: an emergent theoretical model

    Science.gov (United States)

    Nunes, Miguel Baptista

    2016-01-01

    Background This paper reports on a research study that aims to identify and explain barriers to knowledge sharing (KS) in the provision of healthcare referral services in Chinese healthcare organisations. Design An inductive case study approach was employed, in which 24 healthcare professionals and workers from four healthcare organisations in the province of Hubei, Central China, were interviewed using semi-structured scripts. Results Through data analysis, 14 KS barriers emerged in four main themes: interpersonal trust barriers, communication barriers, management and leadership barriers, and inter-institutional barriers. A cause–consequence analysis of the identified barriers revealed that three of them are at the core of the majority of problems, namely, the absence of national and local policies for inter-hospital KS, lack of a specific hospital KS requirement, and lack of mutual acquaintance. Conclusions To resolve KS problems, it is of great importance that healthcare governance agencies, both at the national and regional levels, take leadership in the process of KS implementation by establishing specific and strong policies for inter-institutional KS in the referral process. This paper raises important issues that exceed academic interests and are important to healthcare professionals, hospital managers, and Information communication technology (ICT) managers in hospitals, as well as healthcare politicians and policy makers. PMID:26895146

  7. Emerging technologies in healthcare: navigating risks, evaluating rewards.

    Science.gov (United States)

    McGrady, Elizabeth; Conger, Sue; Blanke, Sandra; Landry, Brett J L

    2010-01-01

    The purpose of this prescriptive research is to help decision makers become better informed about three technologies emerging in the healthcare arena by providing a basic description of the technology and describing their current applications, future healthcare deployment, potential risks, and related managerial issues. Two of the technologies, radio frequency identification (RFID) and global positioning systems (GPS), are currently available to healthcare organizations and appear capable of decreasing cost but may require significant initial investment and have disruptive potential. The third technology, nanotechnology, has limited current use but may revolutionize both the delivery of medicine and hospital infrastructure management. With cautious attention to managerial issues and meticulous attention to implementation details, healthcare organizations that can successfully navigate the coming technologically driven paradigm shifts will emerge more resilient organizations.

  8. European healthcare policies for controlling drug expenditure.

    Science.gov (United States)

    Ess, Silvia M; Schneeweiss, Sebastian; Szucs, Thomas D

    2003-01-01

    In the last 20 years, expenditures on pharmaceuticals - as well as total health expenditures - have grown faster than the gross national product in all European countries. The aim of this paper was to review policies that European governments apply to reduce or at least slow down public expenditure on pharmaceutical products. Such policies can target the industry, the wholesalers and retailers, prescribers, and patients. The objectives of pharmaceutical policies are multidimensional and must take into account issues relating to public health, public expenditure and industrial incentives. Both price levels and consumption patterns determine the level of total drug expenditure in a particular country, and both factors vary greatly across countries. Licensing and pricing policies intend to influence the supply side. Three types of pricing policies can be recognised: product price control, reference pricing and profit control. Profit control is mainly used in the UK. Reference pricing systems were first used in Germany and The Netherlands and are being considered in other countries. Product price control is still the most common method for establishing the price of drugs. For the aim of fiscal consolidation, price-freeze and price-cut measures have been frequently used in the 1980s and 1990s. They have affected all types of schemes. For drug wholesalers and retailers, most governments have defined profit margins. The differences in price levels as well as the introduction of a Single European Pharmaceutical Market has led to the phenomenon of parallel imports among member countries of the European Union. This may be facilitated by larger and more powerful wholesalers and the vertical integration between wholesalers and retailers. To control costs, the use of generic drugs is encouraged in most countries, but only few countries allow pharmacists to substitute generic drugs for proprietary brands. Various interventions are used to reduce the patients' demand for drugs by

  9. Competition Policies in Emerging Economies: Lessons and ...

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

    30 juil. 2008 ... Do small developing economies, or SDEs, need a specific competition policy to ... to promote competition and business creation, yet the economic and ... in Emerging Economies features in-depth analysis of two strategic ...

  10. The Policy Argument for Healthcare Workforce Diversity.

    Science.gov (United States)

    Mensah, Michael O; Sommers, Benjamin D

    2016-11-01

    This perspectives article considers the potential implications an affirmative action ban would have on patient care in the US. A physician's race and ethnicity are among the strongest predictors of specialty choice and whether or not a physician cares for Medicaid and uninsured populations. Taking this into account, research suggests that an affirmative action ban in university admissions would sharply reduce the supply of primary care physicians to Medicaid and uninsured populations over the coming decade. Our article compares current conditions to the potential effect of an affirmative action ban by projecting how many future medical students will become primary care physicians for Medicaid and uninsured patients by 2025. Based on previous evidence and current medical student training patterns, we project that a ban could deny primary care access for 1.25 million of our nation's most vulnerable patients, considerably worsening existing healthcare disparities. More broadly, we argue that the effects of eliminating affirmative action would be fundamentally contrary to the Association of American Medical Colleges' stated goal of medical education-"to improve the health of all."

  11. Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms.

    Science.gov (United States)

    Exadaktylos, Aristomenis K; Evangelopoulos, Dimitrios S; Wullschleger, Marcel; Bürki, Leo; Zimmermann, Heinz

    2008-11-17

    Healthcare professionals and the public have increasing concerns about the ability of emergency departments to meet current demands. Increased demand for emergency services, mainly caused by a growing number of minor and moderate injuries has reached crisis proportions, especially in the United Kingdom. Numerous efforts have been made to explore the complex causes because it is becoming more and more important to provide adequate healthcare within tight budgets. Optimisation of patient pathways in the emergency department is therefore an important factor.This paper explores the possibilities offered by dynamic simulation tools to improve patient pathways using the emergency department of a busy university teaching hospital in Switzerland as an example.

  12. A review of the Australian healthcare system: A policy perspective

    Science.gov (United States)

    Sambasivan, Murali

    2018-01-01

    This article seeks to review the Australian healthcare system and compare it to similar systems in other countries to highlight the main issues and problems. A literature search for articles relating to the Australian and other developed countries’ healthcare systems was conducted by using Google and the library of Victoria University, Melbourne. Data from the websites of the Commonwealth of Australia, the Australian Institute of Health and Welfare, the Australian Productivity Commission, the Organisation for Economic Co-operation and Development and the World Bank have also been used. Although care within the Australian healthcare system is among the best in the world, there is a need to change the paradigm currently being used to measure the outcomes and allocate resources. The Australian healthcare system is potentially dealing with two main problems: (a) resource allocation, and (b) performance and patient outcomes improvements. An interdisciplinary research approach in the areas of performance measurement, quality and patient outcomes improvement could be adopted to discover new insights, by using the policy implementation error/efficiency and bureaucratic capacity. Hospital managers, executives and healthcare management practitioners could use an interdisciplinary approach to design new performance measurement models, in which financial performance, quality, healthcare and patient outcomes are blended in, for resource allocation and performance improvement. This article recommends that public policy implementation error and the bureaucratic capacity models be applied to healthcare to optimise the outcomes for the healthcare system in Australia. In addition, it highlights the need for evaluation of the current reimbursement method, freedom of choice to patients and a regular scrutiny of the appropriateness of care. PMID:29686869

  13. Emergency healthcare process automation using mobile computing and cloud services.

    Science.gov (United States)

    Poulymenopoulou, M; Malamateniou, F; Vassilacopoulos, G

    2012-10-01

    Emergency care is basically concerned with the provision of pre-hospital and in-hospital medical and/or paramedical services and it typically involves a wide variety of interdependent and distributed activities that can be interconnected to form emergency care processes within and between Emergency Medical Service (EMS) agencies and hospitals. Hence, in developing an information system for emergency care processes, it is essential to support individual process activities and to satisfy collaboration and coordination needs by providing readily access to patient and operational information regardless of location and time. Filling this information gap by enabling the provision of the right information, to the right people, at the right time fosters new challenges, including the specification of a common information format, the interoperability among heterogeneous institutional information systems or the development of new, ubiquitous trans-institutional systems. This paper is concerned with the development of an integrated computer support to emergency care processes by evolving and cross-linking institutional healthcare systems. To this end, an integrated EMS cloud-based architecture has been developed that allows authorized users to access emergency case information in standardized document form, as proposed by the Integrating the Healthcare Enterprise (IHE) profile, uses the Organization for the Advancement of Structured Information Standards (OASIS) standard Emergency Data Exchange Language (EDXL) Hospital Availability Exchange (HAVE) for exchanging operational data with hospitals and incorporates an intelligent module that supports triaging and selecting the most appropriate ambulances and hospitals for each case.

  14. [The five commandments for preparing the Israeli healthcare system for emergencies].

    Science.gov (United States)

    Adini, Bruria; Laor, Danny; Cohen, Robert; Lev, Boaz; Israeli, Avi

    2010-07-01

    In the last decade, the Israeli healthcare system dealt with many casualties that resulted from terrorist actions and at the same time maintained preparedness for other potential hazards such as natural disasters, toxicological, chemical, radiological and biological events. There are various models for emergency preparedness that are utilized in different countries. The aim of the article is to present the structure and the methodology of the Israeli healthcare system for emergencies. Assuring emergency preparedness for the different scenarios is based on 5 major components that include: comprehensive contingency planning; control and command of operations; central control of readiness; capacity building; coordination and collaboration among the numerous emergency agencies. CLose working relationships between the military and civilian systems characterize the operations of the emergency system. There is a mutual sharing of information, coordinated operations to achieve risk assessment and determine priorities, and consensual allocation of resources. The ability of the medical system to operate in optimal coordination with interface bodies, including the Israel Defense Forces, is derived from three main elements: the shortage of resources necessitate that all agencies work together to develop an effective response to emergencies; the Israeli society is characterized by transition of personnel from the military to the civilian system which promotes joint operations, whereas in most other countries these systems are completely separated; and also developing mechanisms for continuous and coordinated operation in routine and emergency times, such as the Supreme Health Authority. The Israeli healthcare system was put to the test several times in the Last decade, during the terror wave that occurred between 2001-2006, the 2nd Lebanon War and in operation "Cast Lead". An extensive process of learning lessons, conducted during and following each of these periods, and the

  15. Mapping healthcare systems: a policy relevant analytic tool.

    Science.gov (United States)

    Sekhri Feachem, Neelam; Afshar, Ariana; Pruett, Cristina; Avanceña, Anton L V

    2017-07-01

    In the past decade, an international consensus on the value of well-functioning systems has driven considerable health systems research. This research falls into two broad categories. The first provides conceptual frameworks that take complex healthcare systems and create simplified constructs of interactions and functions. The second focuses on granular inputs and outputs. This paper presents a novel translational mapping tool - the University of California, San Francisco mapping tool (the Tool) - which bridges the gap between these two areas of research, creating a platform for multi-country comparative analysis. Using the Murray-Frenk framework, we create a macro-level representation of a country's structure, focusing on how it finances and delivers healthcare. The map visually depicts the fundamental policy questions in healthcare system design: funding sources and amount spent through each source, purchasers, populations covered, provider categories; and the relationship between these entities. We use the Tool to provide a macro-level comparative analysis of the structure of India's and Thailand's healthcare systems. As part of the systems strengthening arsenal, the Tool can stimulate debate about the merits and consequences of different healthcare systems structural designs, using a common framework that fosters multi-country comparative analyses. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  16. Healthcare logistics in disaster planning and emergency management: A perspective.

    Science.gov (United States)

    VanVactor, Jerry D

    2017-12-01

    This paper discusses the role of healthcare supply chain management in disaster mitigation and management. While there is an abundance of literature examining emergency management and disaster preparedness efforts across an array of industries, little information has been directed specifically toward the emergency interface, interoperability and unconventional relationships among civilian institutions and the US Department of Defense (US DoD) or supply chain operations involved therein. To address this imbalance, this paper provides US DoD healthcare supply chain managers with concepts related to communicating and planning more effectively. It is worth remembering, however, that all disasters are local - under the auspice of tiered response involving federal agencies, the principal responsibility for responding to domestic disasters and emergencies rests with the lowest level of government equipped and able to deal with the incident effectively. As such, the findings are equally applicable to institutions outside the military. It also bears repeating that every crisis is unique: there is no such thing as a uniform response for every incident. The role of the US DoD in emergency preparedness and disaster planning is changing and will continue to do so as the need for roles in support of a larger effort also continues to change.

  17. Biochar: An emerging policy arrangement in Brazil?

    NARCIS (Netherlands)

    Francischinelli Rittl, T.; Arts, B.J.M.; Kuyper, T.W.

    2015-01-01

    Biochar, the solid product of pyrolysis, has emerged as a new technology and policy tool to address various environmental challenges (climate change, food production and Agricultural waste management). The concept of biochar drew its inspiration from Amazonian practices that had led to the creation

  18. Emerging environmental technologies and environmental technology policy

    Science.gov (United States)

    Clarke, Leon Edward

    This dissertation explores the role and design of environmental technology policy when environmental innovation is embodied in emerging environmental technologies such as photovoltaic cells or fuel cells. The dissertation consists of three individual studies, all of which use a simplified, general model industry between an emerging environmental technology and an entrenched, more-polluting technology. It clarifies the situations in which environmental technology policy can achieve high welfare and those in which it cannot; and it separates the possible situations an emerging environmental technology might face into four scenarios, each with its own technology policy recommendations. The second study attempts to clarify which of two factors is having a larger limiting effect on private investment in photovoltaics: the failure to internalize the environmental costs of fossil fuel electricity generation or a broad set of innovation market failures that apply to innovation irrespective of environmental concerns. The study indicates that innovation market failures are probably having a significantly larger impact than incomplete internalization. The third study explores the effectiveness of adoption subsidies at encouraging private-sector innovation. The conclusion is that adoption subsidies probably have only a limited effect on long-term, private-sector research. Two important general conclusions of the dissertation are (1) that optimal technology policy should begin with technology-push measures and end with demand-pull measures; and (2) that the technological response to internalization instruments, such as emissions taxes, may be highly nonlinear.

  19. Reinventing Emergency Department Flow via Healthcare Delivery Science.

    Science.gov (United States)

    DeFlitch, Christopher; Geeting, Glenn; Paz, Harold L

    2015-01-01

    Healthcare system flow resulting in emergency departments (EDs) crowding is a quality and access problem. This case study examines an overcrowded academic health center ED with increasing patient volumes and limited physical space for expansion. ED capacity and efficiency improved via engineering principles application, addressing patient and staffing flows, and reinventing the delivery model. Using operational data and staff input, patient and staff flow models were created, identifying bottlenecks (points of inefficiency). A new flow model of emergency care delivery, physician-directed queuing, was developed. Expanding upon physicians in triage, providers passively evaluate all patients upon arrival, actively manage patients requiring fewer resources, and direct patients requiring complex resources to further evaluation in ED areas. Sustained over time, ED efficiency improved as measured by near elimination of "left without being seen" patients and waiting times with improvement in door to doctor, patient satisfaction, and total length of stay. All improvements were in the setting on increased patient volume and no increase in physician staffing. Our experience suggests that practical application of healthcare delivery science can be used to improve ED efficiency. © The Author(s) 2015.

  20. Empowerment in healthcare policy making: three domains of substantive controversy.

    Science.gov (United States)

    Chiapperino, Luca; Tengland, Per-Anders

    2015-12-01

    This paper distinguishes between the uses of empowerment across different contexts in healthcare policy and health promotion, providing a model for the ethical and political scrutiny of those uses. We argue that the controversies currently engendered by empowerment are better understood by means of a historical distinction between two concepts of empowerment, namely, what we call the radical empowerment approach and the new wave of empowerment. Building on this distinction, we present a research agenda for ethicists and policy makers, highlighting three domains of controversy raised by the new wave of empowerment, namely: (1) the relationship between empowerment and paternalistic interferences on the part of professionals; (2) the evaluative commitment of empowerment strategies to the achievement of health-related goals; and (3) the problems arising from the emphasis on responsibility for health in recent uses of empowerment. Finally, we encourage the explicit theorisation of these moral controversies as a necessary step for the development and implementation of ethically legitimate empowerment processes.

  1. Sociology, systems and (patient) safety: knowledge translations in healthcare policy.

    Science.gov (United States)

    Jensen, Casper Bruun

    2008-03-01

    In 2000 the American Institute of Medicine, adviser to the federal government on policy matters relating to the health of the public, published the report To Err is Human: Building a Safer Health System, which was to become a call to arms for improving patient safety across the Western world. By re-conceiving healthcare as a system, it was argued that it was possible to transform the current culture of blame, which made individuals take defensive precautions against being assigned responsibility for error - notably by not reporting adverse events, into a culture of safety. The IOM report draws on several prominent social scientists in accomplishing this re-conceptualisation. But the analyses of these authors are not immediately relevant for health policy. It requires knowledge translation to make them so. This paper analyses the process of translation. The discussion is especially pertinent due to a certain looping effect between social science research and policy concerns. The case here presented is thus doubly illustrative: exemplifying first how social science is translated into health policy and secondly how the transformation required for this to function is taken as an analytical improvement that can in turn be redeployed in social research.

  2. [Emergency oral contraception policy: the Peruvian experience].

    Science.gov (United States)

    Pretell-Zárate, Eduardo A

    2013-07-01

    Emergency oral contraception is part of the sexual and reproductive rights of women. In 2001, this health policy was incorporated into the Rules of the National Family Planning Program of the Ministry of Health, primarily to prevent unwanted pregnancy and its serious consequences, induced abortion and the high associated maternal mortality rate, which are major public health problems. Scientific research has confirmed that the main mechanism of action of levonorgestrel, component of emergency oral contraception (EOC) is to inhibit or delay ovulation, preventing fertilization of the egg; additionally, it increases the thickening of the cervical mucus, making the sperm migration more difficult. No study has found endometrial abnormalities that may interfere with the implantation of the fertilized egg or embryo development of an implanted egg. However, despite the support of medical science and legal backing, the EOC is available only to users with economic resources, but its use has not been fully implemented in public sector services, due to obstacles created by groups opposed to contraception under claim of an alleged abortive effect that has already been ruled out scientifically. This article describes the administrative experience and legal confrontations between groups of power that prevent the proper implementation of an emergency contraception policy in Peru.

  3. MONETARY POLICY TRANSMISSION MECHANISM IN EMERGING COUNTRIES

    Directory of Open Access Journals (Sweden)

    Andreea ROŞOIU

    2013-06-01

    Full Text Available The transmission channels of monetary policy are used by central banks to accomplish the main objective of price stability in the context of sustainable economic growth. The importance of interest rate and exchange rate channels for the emerging countries Romania, Poland, Czech Republic and Hungary is analyzed by using Bayesian VAR approach with Diffuse priors over 1998Q1-2012Q3. Main result of the empirical study is that both channels are effective for the monetary policy transmission mechanism in Hungary and Czech Republic. In Romania and Poland they do not exhibit puzzles, but the impact of the macroeconomic variables is not very significant and shows very high volatility. In the context of monetary integration, exchange rate channel will become irrelevant when these countries adopt Euro currency. This change will lead instead to a powerful interest rate channel.

  4. The Imminent Healthcare and Emergency Care Crisis in Japan

    Directory of Open Access Journals (Sweden)

    Suzuki, Tetsuji

    2008-05-01

    Full Text Available Objectives: Japan has a universal healthcare system, and this paper describes the reality of the healthcare services provided, as well as current issues with the system.Methods: Academic, government, and press reports on Japanese healthcare systems and healthcare guidelines were reviewed.Results: The universal healthcare system of Japan is considered internationally to be both low-cost and effective because the Japanese population enjoys good health status with a long life expectancy, while healthcare spending in Japan is below the average given by the Organization for Economic Corporation and Development (OECD. However, in many regions of Japan the existing healthcare resources are seriously inadequate, especially with regard to the number of physicians and other health professionals. Because healthcare is traditionally viewed as “sacred” work in Japan, healthcare professionals are expected to make large personal sacrifices. Also, public attitudes toward medical malpractice have changed in recent decades, and medical professionals are facing legal issues without experienced support of the government or legal professionals. Administrative response to the lack of resources and collaboration among communities are beginning, and more efficient control and management of the healthcare system is under consideration.Conclusion: The Japanese healthcare system needs to adopt an efficient medical control organization to ease the strain on existing healthcare professionals and to increase the number of physicians and other healthcare resources. Rather than continuing to depend on healthcare professionals being able and willing to make personal sacrifices, the government, the public and medical societies must cooperate and support changes in the healthcare system.

  5. 76 FR 73595 - Healthcare Technology, Policy & Trade Mission: Mexico City, Mexico, May 13-16, 2012

    Science.gov (United States)

    2011-11-29

    ... DEPARTMENT OF COMMERCE International Trade Administration Healthcare Technology, Policy & Trade... Administration, U.S. and Foreign Commercial Service (CS) is organizing an executive-led healthcare technology... of U.S. suppliers of healthcare information technologies (IT), medical devices, and other medical...

  6. Emerging energy technologies impacts and policy implications

    International Nuclear Information System (INIS)

    Grubb, M.

    1992-01-01

    Technical change is a key factor in the energy world. Failure to recognize the potential for technical change, and the pace at which it may occur, has limited the accuracy and usefulness of past energy projections. conversely, programs to develop and deploy advanced energy technologies have often proved disappointing in the face of technical and commercial obstacles. This book examines important new and emerging energy technologies, and the mechanisms by which they may develop and enter the market. The project concentrates on the potential and probable role of selected energy technologies-which are in existence and likely to be of rapidly growing importance over the next decade-and the way in which market conditions and policy environment may affect their implementation

  7. Evaluation of Knowledge of Emergency Healthcare Workers Regarding Approach to Emergency Patients

    Directory of Open Access Journals (Sweden)

    Özgür Tanr›verdi

    2010-09-01

    Full Text Available Aim: Emergency units constitute the most important part of all hospitals. The aim of this study was to evaluate practitioners’ and healthcare providers’ knowledge and experience regarding emergency first aid in a hospital with insufficient facilities. Methods: 17 physicians and 25 assistant staff working at our hospital were evaluated in terms of their knowledge about and experience in “emergency medicine and trauma” by a questionnaire and by observations. Results: The results of observations and questionnaire indicated that knowledge and experience among physicians were inadequate in terms of basic life support and advanced cardiac life support. This lack of knowledge was not associated with age, time of employment, faculty graduated and training on “emergency medicine” in the group of physicians (r=0.301 p>0.05, r=0.317 p>0.06, r=0.228 p>0.05, r=0.284 p>0.05, respectively and in the group of assistant staff (r=0.341 p>0.05, r=0.287 p>0.06, r=0.234 p>0.05, r=0.227 p>0.05, respectively. Conclusion: Considering that the most of the physicians are gathered in certain regions of our country and that there is a lack of emergency medicine specialists in underdeveloped regions, it has been concluded that physicians specialized in other areas and practitioners must attend emergency medicine trainings under the concept of “emergency medicine rotation”. (The Medical Bulletin of Haseki 2010; 48:103-5

  8. From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis.

    Science.gov (United States)

    Burke, Sara Ann; Normand, Charles; Barry, Sarah; Thomas, Steve

    2016-03-01

    Ireland experienced one of the most severe economic crises of any OECD country. In 2011, a new government came to power amidst unprecedented health budget cuts. Despite a retrenchment in the ability of health resources to meet growing need, the government promised a universal, single-tiered health system, with access based solely on medical need. Key to this was introducing universal free GP care by 2015 and Universal Health Insurance from 2016 onwards. Delays in delivering universal access and a new health minister in 2014 resulted in a shift in language from 'universal health insurance' to 'universal healthcare'. During 2014 and 2015, there was an absence of clarity on what government meant by universal healthcare and divergence in policy measures from their initial intent of universalism. Despite the rhetoric of universal healthcare, years of austerity resulted in poorer access to essential healthcare and little extension of population coverage. The Irish health system is at a critical juncture in 2015, veering between a potential path to universal healthcare and a system, overwhelmed by years of austerity, which maintains the status quo. This papers assesses the gap between policy intent and practice and the difficulties in implementing major health system reform especially while emerging from an economic crisis. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  9. DEGREE OF BURNOUT AMONG EMERGENCY HEALTHCARE WORKERS AND FACTORS INFLUENCING LEVEL OF BURNOUT: A STUDY PROTOCOL

    OpenAIRE

    Shyamanta; Sashibha; Navoneela; Marami; Bornali; Sakhee; Anjana; Dipesh

    2015-01-01

    BACKGROUND Burnout is a feeling of failure and exhaustion. It is felt both at the physical and emotional level. Depletion of the person’s resources is a consequence and also has an impact on the organisation. Nature of the work itself makes emergency healthcare workers vulnerable to burnout. METHOD This study is designed to measure the degree of burnout among emergency healthcare workers in a hospital and to identify the factors that influence burnout. The study h...

  10. Identifying the science and technology dimensions of emerging public policy issues through horizon scanning.

    Science.gov (United States)

    Parker, Miles; Acland, Andrew; Armstrong, Harry J; Bellingham, Jim R; Bland, Jessica; Bodmer, Helen C; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D; Cope, David; Costanzo, Lucia; Dolan, James A; Doubleday, Robert; Feng, Wai Yi; Godfray, H Charles J; Good, David A; Grant, Jonathan; Green, Nick; Groen, Arnoud J; Guilliams, Tim T; Gupta, Sunjai; Hall, Amanda C; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A; Lueshi, Leila M; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P; Watkinson, Andrew R; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K A; Worts, Kim; Sutherland, William J

    2014-01-01

    Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

  11. Identifying the Science and Technology Dimensions of Emerging Public Policy Issues through Horizon Scanning

    Science.gov (United States)

    Parker, Miles; Acland, Andrew; Armstrong, Harry J.; Bellingham, Jim R.; Bland, Jessica; Bodmer, Helen C.; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D.; Cope, David; Costanzo, Lucia; Dolan, James A.; Doubleday, Robert; Feng, Wai Yi; Godfray, H. Charles J.; Good, David A.; Grant, Jonathan; Green, Nick; Groen, Arnoud J.; Guilliams, Tim T.; Gupta, Sunjai; Hall, Amanda C.; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A.; Lueshi, Leila M.; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J.; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A.; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P.; Watkinson, Andrew R.; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K. A.; Worts, Kim; Sutherland, William J.

    2014-01-01

    Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique [1]. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security. PMID:24879444

  12. Identifying the science and technology dimensions of emerging public policy issues through horizon scanning.

    Directory of Open Access Journals (Sweden)

    Miles Parker

    Full Text Available Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

  13. Translating Nursing Philosophy for Practice and Healthcare Policy.

    Science.gov (United States)

    Reed, Pamela G

    2017-07-01

    This article introduces the feature article on policy implications of integrative nursing. It describes unitary ontology in nursing, highlighting the Rogerian view of holism. The importance of linking philosophy to practice policy is emphasized.

  14. An Analysis of Emergency Healthcare Delivery in Ghana: Lessons ...

    African Journals Online (AJOL)

    Ghana medical emergencies usually result from road traffic accidents, during which ..... electrocardiography, intravenous therapy, administration of medications, drugs and solutions, use of adjunctive medical devices and trauma care.

  15. 3D medical collaboration technology to enhance emergency healthcare

    DEFF Research Database (Denmark)

    Welch, Gregory F; Sonnenwald, Diane H.; Fuchs, Henry

    2009-01-01

    Two-dimensional (2D) videoconferencing has been explored widely in the past 15-20 years to support collaboration in healthcare. Two issues that arise in most evaluations of 2D videoconferencing in telemedicine are the difficulty obtaining optimal camera views and poor depth perception. To address...... these problems, we are exploring the use of a small array of cameras to reconstruct dynamic three-dimensional (3D) views of a remote environment and of events taking place within. The 3D views could be sent across wired or wireless networks to remote healthcare professionals equipped with fixed displays...... or with mobile devices such as personal digital assistants (PDAs). The remote professionals' viewpoints could be specified manually or automatically (continuously) via user head or PDA tracking, giving the remote viewers head-slaved or hand-slaved virtual cameras for monoscopic or stereoscopic viewing...

  16. Innovation Policy Development and the Emergence of New Innovation Paradigms

    DEFF Research Database (Denmark)

    Tanev, Stoyan; Knudsen, Mette Præst; Bisgaard, Tanja

    2011-01-01

    The objective of the present article is to discuss innovation policy issues related to three emerging innovation paradigms: user-driven innovation, open innovation, and value cocreation. It provides a summary of insights based on innovation policy practices and challenges in Denmark. The choice...... of Danish innovation policy practices is not accidental. In 2008 Denmark implemented 40 different national innovation programs by allocating about 400 million euros. Since the three emerging paradigms have become globally relevant, the discussion of Danish policy development challenges and practices...... is expected to be insightful for innovation experts from other developed countries that are currently dealing with the adoption of these paradigms....

  17. Nutrition and sustainability: an emerging food policy discourse.

    Science.gov (United States)

    Lang, Tim; Barling, David

    2013-02-01

    It is well known that food has a considerable environmental impact. Less attention has been given to mapping and analysing the emergence of policy responses. This paper contributes to that process. It summarises emerging policy development on nutrition and sustainability, and explores difficulties in their integration. The paper describes some policy thinking at national, European and international levels of governance. It points to the existence of particular policy hotspots such as meat and dairy, sustainable diets and waste. Understanding the environmental impact of food systems challenges nutrition science to draw upon traditions of thinking which have recently been fragmented. These perspectives (life sciences, social and environmental) are all required if policy engagement and clarification is to occur. Sustainability issues offer opportunities for nutrition science and scientists to play a more central role in the policy analysis of future food systems. The task of revising current nutrition policy advice to become sustainable diet advice needs to begin at national and international levels.

  18. 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.

  19. Issues on Luck Egalitarianism, Responsibility, and Intercultural Healthcare Policies.

    Science.gov (United States)

    De Hoyos, Adalberto

    2016-04-01

    This article analyzes the criteria for the distribution of healthcare services through different justice theories such as utilitarianism and liberalism, pointing out the problems that arise when providing services to a culturally diverse population. The international epidemiological setting is a favorable one for discussing personal responsibility and luck egalitarianism; however, some provisions have to be made so that healthcare institutions do not treat ethnic, cultural, religious, and linguistic minorities unfairly. The article concludes by proposing that accommodations and culturally sensible attention should be provided when possible, without affecting the equal opportunity of others to access these services.

  20. Assessment of the Effects of Emerging Grazing Policies on Land ...

    African Journals Online (AJOL)

    ADOWIE PERE

    ABSTRACT: This study examines the effects of the emerging grazing policies on land degradation in Nigeria using soil, vegetation ... imposed land use controls divorced from economic and demographic ... may be either positive or negative.

  1. Person-centredness in healthcare policy, practice and research.

    NARCIS (Netherlands)

    McCormack, B.; Dulmen, S. van; Eide, H.; Skovdalh, K.; Eide, T.

    2017-01-01

    Twentieth century (western) societies are increasingly individualised. This is not only reflected in general politics, opinions and lifestyles but also in healthcare. Partly this is a result of an increased knowledge about the human genome, allowing for more individualised treatment plans

  2. Policy options to contain healthcare costs: a review and classification

    NARCIS (Netherlands)

    Stadhouders, N.W.; Koolman, X.; Tanke, M.A.C.; Maarse, H.; Jeurissen, P.P.T.

    2016-01-01

    Containing health care costs has been a challenge for most OECD member states. We classify 2250 cost containment policies in forty-one groups of policy options. This conceptual framework might act as a toolkit for policymakers that seek to develop strategies for cost control; and for researchers

  3. The influence of fiscal rules on healthcare policy in the United States and the Netherlands.

    Science.gov (United States)

    Schakel, H Christiaan; Jeurissen, Patrick; Glied, Sherry

    2017-10-01

    Governments use fiscal rules to put a framework and limits on how budgetary challenges are addressed, but the rules themselves are still an understudied area among health policy scholars. For a long time, healthcare held a somewhat separate status because of the reliance on entitlements and dedicated revenue streams. However, the combined forces of advocates for integral decision-making, central budget control and the increasing costs might shift healthcare towards budgetary frameworks that currently apply to other spending categories. In this paper, we study fiscal rules that the US and the Netherlands have adopted since 2010 and their impact on healthcare policy. Our analysis shows that fiscal rules can have an impact on the rationing of healthcare. In the studied timeframe, the rules seem to have more impact on budget outcomes than on the budget process itself. In addition, the convergence of fiscal and program policy objectives seems to be better accomplished in a budgetary system that applies enforceable budget ceilings. Budgeting for health entitlements requires a comprehensive and tailor-made approach and the composition of traditional rules might not fully answer to the complexities of healthcare policy. This paper aims to contribute to that debate and the way we think about healthcare budgeting. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Risk assessment of the emergency processes: Healthcare failure mode and effect analysis.

    Science.gov (United States)

    Taleghani, Yasamin Molavi; Rezaei, Fatemeh; Sheikhbardsiri, Hojat

    2016-01-01

    Ensuring about the patient's safety is the first vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conducted to evaluate the selected risk processes of emergency surgery department of a treatment-educational Qaem center in Mashhad by using analysis method of the conditions and failure effects in health care. In this study, in combination (qualitative action research and quantitative cross-sectional), failure modes and effects of 5 high-risk procedures of the emergency surgery department were identified and analyzed according to Healthcare Failure Mode and Effects Analysis (HFMEA). To classify the failure modes from the "nursing errors in clinical management model (NECM)", the classification of the effective causes of error from "Eindhoven model" and determination of the strategies to improve from the "theory of solving problem by an inventive method" were used. To analyze the quantitative data of descriptive statistics (total points) and to analyze the qualitative data, content analysis and agreement of comments of the members were used. In 5 selected processes by "voting method using rating", 23 steps, 61 sub-processes and 217 potential failure modes were identified by HFMEA. 25 (11.5%) failure modes as the high risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors (54.7%) and knowledge and skill (9.5%), respectively. Also, 29.4% of preventive measures were in the category of human resource management strategy. "Revision and re-engineering of processes", "continuous monitoring of the works", "preparation and revision of operating procedures and policies", "developing the criteria for evaluating the performance of the personnel", "designing a suitable educational content for needs of employee", "training patients", "reducing the workload and power shortage", "improving team

  5. Towards an oral healthcare framework and policy analysis for Swaziland

    OpenAIRE

    Mndzebele, Samuel

    2010-01-01

    Background and Rationale: A synopsis by the researcher suggested that caries was becoming a public health problem among the youth, hence there was a need for deeper investigations which would lead to possible oral health interventions. Purpose: The purpose of the study was to assess dental care practices and experiences among teenagers in the Northern region of Swaziland. Based on the outcomes and views from health professionals; develop a framework for oral healthcare delivery and ...

  6. Healthcare Service Auditing and Intervention in an Emergency ...

    African Journals Online (AJOL)

    A pre- and post-intevention randomized cross-sectional study was carried out from January to February and April to May 2001, respectively, to audit and intervene in the timeliness of health services delivery in an Emergency Paediatric Unit (EPU) of Jos University Teaching Hospital. A structured questionnaire was used to ...

  7. Healthcare information technology and medical-surgical nurses: the emergence of a new care partnership.

    Science.gov (United States)

    Moore, An'Nita; Fisher, Kathleen

    2012-03-01

    Healthcare information technology in US hospitals and ambulatory care centers continues to expand, and nurses are expected to effectively and efficiently utilize this technology. Researchers suggest that clinical information systems have expanded the realm of nursing to integrate technology as an element as important in nursing practice as the patient or population being served. This study sought to explore how medical surgical nurses make use of healthcare information technology in their current clinical practice and to examine the influence of healthcare information technology on nurses' clinical decision making. A total of eight medical surgical nurses participated in the study, four novice and four experienced. A conventional content analysis was utilized that allowed for a thematic interpretation of participant data. Five themes emerged: (1) healthcare information technology as a care coordination partner, (2) healthcare information technology as a change agent in the care delivery environment, (3) healthcare information technology-unable to meet all the needs, of all the people, all the time, (4) curiosity about healthcare information technology-what other bells and whistles exist, and (5) Big Brother is watching. The results of this study indicate that a new care partnership has emerged as the provision of nursing care is no longer supplied by a single practitioner but rather by a paired team, consisting of nurses and technology, working collaboratively in an interdependent relationship to achieve established goals.

  8. Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases.

    Science.gov (United States)

    Fu, Chuanxi; Wang, Shengyong

    2016-04-12

    The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respiratory syndrome (SARS) are diagnosed and treated, are often imperfect. When it comes to emerging or unknown infectious diseases, before the imported case was finally identified or community transmission was reported, cases have often occurred in clusters in healthcare settings. Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

  9. The emerging nuclear suppliers: some guidelines for policy (U)

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, Lewis A.

    1988-04-01

    Lewis A. Dunn, a former Assistant Director of the US Arms Control and Disarmament Agency and now a senior analyst with Science Applications International Corporation, looks to the future to offer "The Emerging Nuclear Suppliers: Some Guidelines for Policy ." Mr. Dunn notes that although most emerging suppliers are cautious, many are not party to existing nonproliferation treaties. He calls upon the nonproliferation community to continue the present policy of not supporting unsafeguarded nuclear activities. He suggests that the nonproliferation community work within existing standards and infrastructures of nuclear suppliers to convince emerging supplier nations of the merits of nuclear export control.

  10. Ethics, health policy, and Zika: From emergency to global epidemic?

    Science.gov (United States)

    Jamrozik, Euzebiusz; Selgelid, Michael J

    2018-05-01

    Zika virus was recognised in 2016 as an important vector-borne cause of congenital malformations and Guillain-Barré syndrome, during a major epidemic in Latin America, centred in Northeastern Brazil. The WHO and Pan American Health Organisation (PAHO), with partner agencies, initiated a coordinated global response including public health intervention and urgent scientific research, as well as ethical analysis as a vital element of policy design. In this paper, we summarise the major ethical issues raised during the Zika epidemic, highlighting the PAHO ethics guidance and the role of ethics in emergency responses, before turning to ethical issues that are yet to be resolved. Zika raises traditional bioethical issues related to reproduction, prenatal diagnosis of serious malformations and unjust disparities in health outcomes. But the epidemic has also highlighted important issues of growing interest in public health ethics, such as the international spread of infectious disease; the central importance of reproductive healthcare in preventing maternal and neonatal morbidity and mortality; diagnostic and reporting biases; vector control and the links between vectors, climate change, and disparities in the global burden of disease. Finally, there are controversies regarding Zika vaccine research and eventual deployment. Zika virus was a neglected disease for over 50 years before the outbreak in Brazil. As it continues to spread, public health agencies should promote gender equity and disease control efforts in Latin America, while preparing for the possibility of a global epidemic. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Emergent information technologies and enabling policies for counter-terrorism

    CERN Document Server

    Popp, R

    2006-01-01

    Explores both counter-terrorism and enabling policy dimensions of emerging information technologies in national security After the September 11th attacks, "connecting the dots" has become the watchword for using information and intelligence to protect the United States from future terrorist attacks. Advanced and emerging information technologies offer key assets in confronting a secretive, asymmetric, and networked enemy. Yet, in a free and open society, policies must ensure that these powerful technologies are used responsibly, and that privacy and civil liberties remain protected. Emergent Information Technologies and Enabling Policies for Counter-Terrorism provides a unique, integrated treatment of cutting-edge counter-terrorism technologies and their corresponding policy options. Featuring contributions from nationally recognized authorities and experts, this book brings together a diverse knowledge base for those charged with protecting our nation from terrorist attacks while preserving our civil liberti...

  12. The health of healthcare: Emergency department physician well-being

    Directory of Open Access Journals (Sweden)

    Martin Gagne

    2017-07-01

    Full Text Available Introduction: Physician health and well-being is an important issue that ultimately affects job performance. We compared the self-reported incidence of known medical issues, physical and mental health symptoms, and health behaviors of Emergency Physicians (EPs with the general public in the United States. Methods: Questions selected from a national survey conducted by the Center for Disease Control (CDC about public health trends were distributed to via Facebook to a private group of 12,917 EPs. Responses were compared between EPs and the general population using Chi-square tests of independence. Results: Our results demonstrated that EPs suffer less from chronic diseases, especially those related to the cardiopulmonary system; however, they suff er from a higher incidence of musculoskeletal pain and infectious disease complaints. EPs also exhibit higher rates of mental health symptoms, sleep-related complications, and alcohol consumption. Conclusions: Awareness, education, and advocacy may help improve physician health and ultimately job performance.

  13. A Judicialisation of Healthcare Policies in Denmark and Spain?

    DEFF Research Database (Denmark)

    Martinsen, Dorte Sindbjerg; Mayoral, Juan A.

    2017-01-01

    by the ex-post judicial, administrative and political responses, particularly the national courts’ activation of EU law. By using new data, a compilation of national court cases, quasi-judicial proceedings and research interviews with key respondents, we examine the process of judicialisation in the two......This paper examines the impact of judicialisation on the right to cross-border healthcare in Denmark and Spain, i.e., the national impact of legal integration as spurred by the Court of Justice of the European Union (CJEU). We expect the national impact of judicialisation to be conditioned...... member states. The findings demonstrate that the national courts hardly played a role in Denmark and that although the courts were more active in Spain, the rulings remained largely unobserved by the political and administrative elite and the courts were thus unable to push for change. The administrative...

  14. The emergence of personal growth amongst healthcare professionals who care for dying children.

    Science.gov (United States)

    Beaune, Laura; Muskat, Barbara; Anthony, Samantha J

    2018-06-01

    ABSTRACTObjective:Compassion fatigue, burnout, and vicarious traumatization are prominent topics in the current literature on the impact of the rewarding but challenging work of healthcare professionals who care for patients with life-limiting illnesses. The positive effects of caregiving constitute a newly emerging outcome that has been relatively unexplored in the pediatric literature, and yet they may play an important role in contributing to the satisfaction and well-being of the healthcare professionals who care for children who have a life-limiting illness. This paper reports the results of a secondary analysis of qualitative interview transcripts that explored the experiences of hospital-based pediatric healthcare providers caring for children with varied life-limiting illnesses. In-depth qualitative interviews were conducted with 25 healthcare professionals (9 social workers, 8 nurses, and 8 physicians). The majority of participants were women (80%), with an age range between 20 and 60 years, and most (84%) had the experience of caring for more than 15 dying children. Thematic analysis was conducted using interpretive description and constant comparison. Every healthcare professional interviewed experienced personal growth as a result of their providing care for dying children. Three dimensions of personal growth were most consistently reported: (1) new or altered life perspectives, (2) enhanced personal resources, and (3) benevolence. A deeper understanding of the phenomenon of personal growth could help healthcare organizations to implement innovative approaches that would counterbalance compassion fatigue, and thereby enhance both healthcare provider well-being and child and family outcomes.

  15. Transforming healthcare with information technology in Japan: a review of policy, people, and progress.

    Science.gov (United States)

    Abraham, Chon; Nishihara, Eitaro; Akiyama, Miki

    2011-03-01

    Healthcare reform as part of the economic recovery plan in Japan is placing emphasis on the use of healthcare information technology (HIT). This research mainly focuses on the HIT efforts in Japan with reference to the US for context. The purpose is to: (a) provide detail on governmental policy impacting promotion of HIT adoption to provide services to the people of Japan, (b) describe the outcomes of past and present policy impacting progress based on a case study of HIT use in the Kyoto Yamashina area, and (c) discuss issues for refinement of current policy. The method is case study, and data collection techniques include: (a) interviews of people involved in policy making for HIT in Japan (Japanese healthcare professionals, government officials, and academics involved in HIT research in Japan) and use in the medical community of HIT in the Kyoto Yamashina area, (b) archived document analysis of reports regarding government policy for HIT policy and user assessment for HIT mainly in the case study site, and (c) the literature review about HIT progression and effectiveness assessments to explore and describe issues concerning the transformation with HIT in Japan. This study reveals the aspects of governmental policy that have been effective in promoting successful HIT initiatives as well as some that have been detriments in Japan to help solve pressing social issues regarding healthcare delivery. For example, Japan has stipulated some standardized protocols and formats for HIT but does not mandate exactly how to engage in inter-organizational or intra-organizational health information exchange. This provides some desired autonomy for healthcare organizations and or governments in medical communities and allows for more advanced organizations to leverage current resources while providing a basis for lesser equipped organizations to use in planning the initiative. The insights gained from the Kyoto Yamashina area initiative reflect the success of past governmental

  16. Reflections on 'medical tourism' from the 2016 Global Healthcare Policy and Management Forum.

    Science.gov (United States)

    Crooks, Valorie A; Ormond, Meghann; Jin, Ki Nam

    2017-01-01

    In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this global health services practice that have appeared in multiple venues, including this very journal. Key questions for future research emerging from the forum include: who should be meaningfully involved in identifying and defining categories of those travelling across borders for health services and what risks exist if certain voices are underrepresented in such a process; who does and does not 'count' as a medical tourist and what are the implications of such quantitative assessments; why have researchers not been able to address pressing knowledge gaps regarding the health equity impacts of medical tourism; and how do national-level polices and initiatives shape the ways in which medical tourism is unfolding in specific local centres and clinics? This short report as an important time capsule that summarises the current state of medical tourism research knowledge as articulated by the thought leaders in attendance at the forum while also pushing for research growth.

  17. Healthcare

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This report, provides detailed analyses and projections of occupations in healthcare fields, and wages earned. In addition, the important skills and work values associated with workers in those fields of healthcare are discussed. Finally, the authors analyze the implications of research findings for the racial, ethnic, and class diversity of the…

  18. 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.

  19. Reflections on 'medical tourism' from the 2016 Global Healthcare Policy and Management Forum

    NARCIS (Netherlands)

    Crooks, V.A.; Ormond, M.E.; Jin, Ki Nam

    2017-01-01

    In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short

  20. Policies of access to healthcare services for accompanied asylum-seeking children in the Nordic countries.

    Science.gov (United States)

    Sandahl, Hinuga; Norredam, Marie; Hjern, Anders; Asher, Henry; Nielsen, Signe Smith

    2013-08-01

    Asylum-seeking children constitute a vulnerable group with high prevalence and risk for mental health problems. The aim of this study was to compare policies of access to healthcare services, including physical examination and screening for mental health problems on arrival, for accompanied asylum-seeking children in the Nordic countries. This study was based on the national reports "Reception of refugee children in the Nordic countries" written by independent national experts for the Nordic Network for Research on Refugee Children, supplemented by information from relevant authorities. In Sweden, Norway and Iceland, asylum-seeking children had access to healthcare services equal to children in the general population. On a policy level, Denmark imposed restrictions on non-acute hospitalisations and prolonged specialist treatments. Regarding health examinations, Sweden deviated from the Nordic pattern by not performing these systematically. In Denmark, Iceland, and some counties in Sweden, but not in Norway, screening for mental health problems was offered to asylum-seeking children. Access to healthcare services for asylum-seeking children differs in the Nordic countries; the consequences of these systematic differences for the individual asylum-seeking child are unknown. For asylum-seeking children, access to healthcare has to be considered in a wider context that includes the core conditions of being an asylum-seeker. A comparative study at policy level needs to be supplemented with empirical follow-up studies of the well-being of the study population to document potential consequences of policies in practice.

  1. 1995 Emerging Leaders in Healthcare. The new leaders: Gita Budd, Colene Daniel, Elizabeth Gallup, Scott Wordelman.

    Science.gov (United States)

    Southwick, K

    1995-01-01

    Fierce pressures for cost containment. Demands for quality improvements. The drive toward patient-centered care. The push for community involvement. Insistent voices of payers, patients, consumers, physicians. Accumulated tensions amid the chaos of change. Balancing all of these demands while inspiring and encouraging the professionals and other workers within the healthcare organization requires a high level of leadership ability. One that insists on the best from everyone involved in a healthcare system--from physicians to staff, nurses to social workers. And then strives for more. The four young executives who are this year's Emerging Leaders in Healthcare have all pushed their systems beyond traditional boundaries into new territory, helping their patients, their employees, their physicians, and their communities rise to new levels of achievement. At the same time, these leaders emphasize teamwork and consensus-style management, so that their co-workers feel like they're participating in the changes, not being victimized by them. Gita Budd, Colene Daniel, Elizabeth Gallup, and Scott Wordelman are winners of the 1995 award from The Healthcare Forum and Korn/Ferry International that honors ¿dynamic, decisive young leaders (under 40) with the proven ability to nurture the growth of the industry.¿ Korn/Ferry International and The Healthcare Forum are proud to present 1995's Emerging Leaders.

  2. A Study of Terrorism Emergency Preparedness Policies in School Districts

    Science.gov (United States)

    Umoh, Emmanuel

    2013-01-01

    The threat of terrorism is a concern in public facilities including schools. This study focused on school districts in a southwestern state. Terrorism emergency preparedness policies are well-documented as measures to protect students and staff in school districts from terrorism threats and vulnerabilities. However, those threats and…

  3. ICT Infrastructure in Emerging Asia: Policy and Regulatory Roadblocks

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

    2008-02-06

    Feb 6, 2008 ... This book brings together scholars, practitioners, former regulators, and policymakers to address the problem of expanding information and communication technology (ICT) connectivity in emerging Asia. It centrally engages the widespread claim that technology by itself — independent of policy and ...

  4. Student voice: An emerging discourse in Irish education policy

    Directory of Open Access Journals (Sweden)

    Domnall Fleming

    2015-09-01

    Full Text Available In positioning student voice within the Irish education policy discourse it is imperative that this emergent and complex concept is explored and theorized in the context of its definition and motivation. Student voice can then be positioned and critiqued as it emerged within Irish education policy primarily following Ireland’s ratification of the United Nations Charter on the Rights of the Child (UNCRC in 1992. Initially emerging in policy from a rights-based and democratic citizenship perspective, the student council became the principal construct for student voice in Irish post-primary schools. While central to the policy discourse, the student council construct has become tokenistic and redundant in practice. School evaluation policy, both external and internal, became a further catalyst for student voice in Ireland. Both processes further challenge and contest the motivation for student voice and point to the concept as an instrument for school improvement and performativity that lacks any centrality for a person-centered, rights-based, dialogic and consultative student voice within an inclusive classroom and school culture.

  5. Helping professionals and Border Force secrecy: effective asylum-seeker healthcare requires independence from callous policies.

    Science.gov (United States)

    Dudley, Michael

    2016-02-01

    To examine the Australian Border Force Act (BFA) and its context, its implications for asylum-seeker healthcare and professionals, and contemporary and historical parallels. Prolonged immigration detention and policies aiming to deter irregular migration cause maritime asylum-seekers undeniable, well-publicised harms and (notwithstanding claims about preventing drownings) show reckless indifference and calculated cruelty. Service personnel may be harmed. Such policies misuse helping professionals to underwrite state abuses and promote public numbing and indifference, resembling other state abuses in the 'war on terror' and (with qualification) historical counterparts, e.g. Nazi Germany. Human service practitioners and organisations recently denounced the BFA that forbids disclosure about these matters.Continuing asylum-seeker healthcare balances the likelihood of effective care and monitoring with lending credibility to abuses. Boycotting it might sacrifice scrutiny and care, fail to compel professionals and affect temporary overseas workers. Entirely transferring healthcare from immigration to Federal and/or State health departments, with resources augmented to adequate standard, would strengthen clinical independence and quality, minimise healthcare's being securitised and politicised, and uphold ethical codes. Such measures will not resolve detention's problems, but coupled with independent auditing, would expose and moderate detention's worst effects, promoting changes in national conversation and policy-making. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  6. The CRACK programme: a scientific alliance for bridging healthcare research and public health policies in Italy

    Directory of Open Access Journals (Sweden)

    Giovanni Corrao

    2013-09-01

    Full Text Available Healthcare utilisation databases, and other secondary data sources, have been used with growing frequency to assess health outcomes and healthcare interventions worldwide. Their increased popularity as a research tool is due to their timely availability, the large patient populations covered, low cost, and applicability for studying real-world clinical practice. Despite the need to measure Italian National Health Service performance both at regional and national levels, the wealth of good quality electronic data and the high standards of scientific research in this field, healthcare research and public health policies seem to progress along orthogonal dimensions in Italy. The main barriers to the development of evidence-based public health include the lack of understanding of evidence-based methodologies by policy makers, and of involvement of researchers in the policy process. The CRACK programme was launched by some academics from the Lombardy Region. By extensively using electronically stored data, epidemiologists, biostatisticians, pharmacologists and clinicians applied methods and evidence to several issues of healthcare research. The CRACK programme was based on their intention to remove barriers that thwart the process of bridging methods and findings from scientific journals to public health practice. This paper briefly describes aim, articulation and management of the CRACK programme, and discusses why it might find articulated application in Italy.

  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. Oil and Gas Emergency Policy: Poland 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  9. Oil and Gas Emergency Policy: Ireland 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  10. Oil and Gas Emergency Policy: Italy 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in Italy for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  11. Oil and Gas Emergency Policy: Slovak Republic 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  12. Oil and Gas Emergency Policy: Czech Republic 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in the Czech Republic for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  13. Oil and Gas Emergency Policy: Canada 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in Canada for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  14. Oil and Gas Emergency Policy: Spain 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  15. Oil and Gas Emergency Policy: Finland 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  16. Oil and Gas Emergency Policy: United Kingdom 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in the United Kingdom for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  17. Oil and Gas Emergency Policy: France 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  18. Oil and Gas Emergency Policy: Korea 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in the Republic of Korea for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  19. Oil and Gas Emergency Policy: Norway 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  20. Oil and Gas Emergency Policy: New Zealand 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in New Zealand for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  1. Oil and Gas Emergency Policy: Belgium 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  2. Oil and Gas Emergency Policy: Portugal 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  3. Oil and Gas Emergency Policy: Denmark 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  4. Oil and Gas Emergency Policy: Hungary 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-06

    This publication provides a detailed look at the specific systems in Hungary for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  5. Oil and Gas Emergency Policy: Greece 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in Greece for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  6. Oil and Gas Emergency Policy: Australia 2011 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  7. Oil and Gas Emergency Policy: France 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. This publication provides an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. This publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies. Rather than waiting for the completion of the current review cycle to renew this publication, the IEA will make available updates to the country chapters as these become available following the country's review.

  8. Oil and Gas Emergency Policy: Luxembourg 2010 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This publication provides a detailed look at the specific systems in Luxembourg for responding to an oil supply crisis. In 2007, the IEA published ''Oil Supply Security: Emergency Response of IEA Countries''. Rather than waiting for the completion of the current review cycle to renew this full publication, the IEA will provide updates to the country chapters as these become available following the specific country's review. The aim of series of publications is to provide an overview of the IEA oil emergency response system and a detailed look at the specific systems in each IEA country for responding to an oil supply crisis. The 2007 publication represented the findings of a five year review cycle of the emergency response mechanisms in IEA member countries. Since the 2007 publication, the IEA has started a new cycle of reviews which now includes reviewing gas emergency policies.

  9. Gas Emergency Policy: Where do IEA Countries Stand?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    Natural gas is of increasing importance in the energy mix of IEA Member countries. And yet this growing reliance on natural gas has been coupled with an increased risk of gas disruptions in recent years. Gas security is now an important policy concern for many IEA Member countries, and the IEA has sought to develop its expertise and analysis in this field. This Working Paper looks at the possible remedies that are available for dealing with gas security concerns, and takes stock of developments in gas emergency policy in IEA Member countries.

  10. Getting value today and incentivising for the future: Pharmaceutical development and healthcare policies

    Directory of Open Access Journals (Sweden)

    Kasper Munk Johannesen

    2015-05-01

    Full Text Available To manage the challenge of limited healthcare resources and unlimited demand for healthcare, decision makers utilise a variety of demand side policies, such as health technology appraisals and international reference pricing to regulate price and utilisation. By controlling price and utilisation demand side policies determine the earnings potential, and hence the incentives to invest in research and development (R&D of new technologies. However, the impact of demand side policies on R&D incentives is seldom formally assessed.Based on the key assumption that intellectual property rights, i.e. patents, and expected rent are key drivers of pharmaceutical R&D, this work outlines a framework illustrating the link between demand side policies and pharmaceutical R&D incentives. By analysing how policies impact expected rent and consumer surplus, the framework is used to understand how commonly used demand side policies (including timing and length of reimbursement process, international reference pricing, parallel trade, and sequential adoption into clinical practice may influence R&D incentives.The analysis demonstrates that delayed reimbursement decisions as well as sequential adoption into clinical practise may in fact reduce both expected rent and consumer surplus. It is also demonstrated how international reference pricing is likely to increase consumer surplus at the expense of lower rent and thus lower R&D incentives.Although this work illustrates the importance of considering how demand side policies may impact long-term R&D incentives, it is important to note that the purpose has not been to prescribe which demand side policies should be utilised or how. Rather, the main contribution is to illustrate the need for a structured approach to the analysis of the complex, and at times highly politicised question of how demand side policies ultimately influence population health, both in the short and in the long term. 

  11. Simulation of operational processes in hospital emergency units as lean healthcare tool

    Directory of Open Access Journals (Sweden)

    Andreia Macedo Gomes

    2017-07-01

    Full Text Available Recently, the Lean philosophy is gaining importance due to a competitive environment, which increases the need to reduce costs. Lean practices and tools have been applied to manufacturing, services, supply chain, startups and, the next frontier is healthcare. Most lean techniques can be easily adapted to health organizations. Therefore, this paper intends to summarize Lean practices and tools that are already being applied in health organizations. Among the numerous techniques and lean tools used, this research highlights the Simulation. Therefore, in order to understand the use of Simulation as a Lean Healthcare tool, this research aims to analyze, through the simulation technique, the operational dynamics of the service process of a fictitious hospital emergency unit. Initially a systematic review of the literature on the practices and tools of Lean Healthcare was carried out, in order to identify the main techniques practiced. The research highlighted Simulation as the sixth most cited tool in the literature. Subsequently, a simulation of a service model of an emergency unit was performed through the Arena software. As a main result, it can be highlighted that the attendants of the built model presented a degree of idleness, thus, they are able to atend a greater demand. As a last conclusion, it was verified that the emergency room is the process with longer service time and greater overload.

  12. Dental healthcare reforms in Germany and Japan: A comparison of statutory health insurance policy

    Directory of Open Access Journals (Sweden)

    Mayumi Nomura

    2008-10-01

    Full Text Available This article aims to compare statutory health insurance policy during the dental healthcare reforms in Germany and Japan. Germany and Japan have categorized their statutory health insurance systems. People in both countries have been provided with a wide coverage of dental treatment and prosthetics. To compare the trends of the indicators of oral healthcare systems over time, it has been suggested that the strategic allocation of dental expenditure is more important than the amount of expense. German dental healthcare policy has shifted under political and socio-economic pressures towards a cost-effective model. In contrast, Japanese healthcare reforms have focused on keeping the basic statutory health insurance scheme, whereby individuals share more of the cost of statutory health insurance. As a result, Germany has succeeded in dramatically decreasing the prevalence of dental caries among children. On comparing the dental conditions of both countries, the rate of decline in replacement of missing teeth among adults and the elderly in Germany and Japan has been interpreted as indicating the price-conscious demands of prosthetics. The difference in the decline of DMFT in 12-year-olds in Germany and Japan could be described as being due to the dental health insurance policy being shifted from treatment-oriented to preventive-oriented in Germany. These findings suggest that social health insurance provides people with equal opportunity for dental services, and healthcare reforms have improved people's oral health. A mixed coverage of social health insurance coverage for dental care should be reconsidered in Japan.

  13. Telemedicine and its transformation of emergency care: a case study of one of the largest US integrated healthcare delivery systems.

    Science.gov (United States)

    Sharma, Rahul; Fleischut, Peter; Barchi, Daniel

    2017-12-01

    Innovative methods for delivering healthcare via the use of technology are rapidly growing. Despite the passage of the Affordable Care Act, emergency department visits have continued to rise nationally. Healthcare systems must devise solutions to face these increasing volumes and also deliver high quality care. In response to the changing healthcare landscape, New York Presbyterian Hospital has implemented a comprehensive enterprise wide digital health portfolio which includes the first mobile stroke treatment unit on the east coast and the first emergency department-based digital emergency care program in New York City.

  14. Reflections on ?medical tourism? from the 2016 Global Healthcare Policy and Management Forum

    OpenAIRE

    Crooks, Valorie A.; Ormond, Meghann; Jin, Ki Nam

    2017-01-01

    In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this...

  15. An investigation of culturally competent terminology in healthcare policy finds ambiguity and lack of definition.

    Science.gov (United States)

    Grant, Julian; Parry, Yvonne; Guerin, Pauline

    2013-06-01

    This research explored how the concept of cultural competence was represented and expressed through health policies that were intended to improve the quality and efficacy of healthcare provided to families from culturally marginalised communities, particularly women and children with refugee backgrounds. A critical document analysis was conducted of policies that inform healthcare for families from culturally marginalised communities in two local government areas in South Australia. The analysis identified two major themes: lack of, or inconsistent, definitions of 'culture' and 'cultural competency' and related terms; and the paradoxical use of language to determine care. Cultural competence within health services has been identified as an important factor that can improve the health outcomes for families from marginalised communities. However, inconsistency in definitions, understanding and implementation of cultural competence in health practice makes it difficult to implement care using these frameworks. Clearly defined pathways are necessary from health policy to inform culturally competent service delivery. The capacity for policy directives to effectively circumvent the potential deleterious outcomes of culturally incompetent services is only possible when that policy provides clear definitions and instructions. Consultation and partnership are necessary to develop effective definitions and processes relating to cultural competence. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

  16. Travel demand policies for saving oil during a supply emergency

    International Nuclear Information System (INIS)

    Noland, Robert B.; Cowart, William A.; Fulton, Lewis M.

    2006-01-01

    An area of growing concern is the future stability of oil producing regions and the ability to maintain stability in international petroleum markets. The transport sector, in particular, is extremely vulnerable to short-term supply disruptions with consequent implications on economic activities in most countries. This paper analyses potential transport demand restraint strategies that could potentially mitigate the impact of short-term supply disruptions. Our analysis includes estimates of the potential fuel savings from several policies. Specifically, we examine various work-based policies (telecommuting, flexible work schedules), the potential of carpooling, speed limit reductions, driving bans and restrictions, increased public transport usage, and providing information on the effect of maintaining optimal tire pressures. The analysis uses various assumptions based on existing knowledge about how travelers may respond under emergency conditions to develop estimates of potential fuel savings. Results suggest that the most restrictive policies, such as driving bans and mandatory carpooling are the most effective. Other policies provide small reductions with some, such as telecommuting and flexible work schedules, having the potential to be easily implemented. Those policies, focussed on encouraging public transport use, are less effective and potentially more costly to implement

  17. Travel demand policies for saving oil during a supply emergency

    Energy Technology Data Exchange (ETDEWEB)

    Noland, Robert B. [Department of Civil and Environmental Engineering, Centre for Transport Studies, Imperial College London, London SW7 2AZ (United Kingdom)]. E-mail: r.noland@imperial.ac.uk; Cowart, William A. [ICF Consulting, Ltd., Egmont House, 25-31 Tavistock Place, Bloomsbury, London, WC1H 9SU (United Kingdom); Fulton, Lewis M. [International Energy Agency, 9 Rue de la Federation, Paris 75015 (France)

    2006-11-15

    An area of growing concern is the future stability of oil producing regions and the ability to maintain stability in international petroleum markets. The transport sector, in particular, is extremely vulnerable to short-term supply disruptions with consequent implications on economic activities in most countries. This paper analyses potential transport demand restraint strategies that could potentially mitigate the impact of short-term supply disruptions. Our analysis includes estimates of the potential fuel savings from several policies. Specifically, we examine various work-based policies (telecommuting, flexible work schedules), the potential of carpooling, speed limit reductions, driving bans and restrictions, increased public transport usage, and providing information on the effect of maintaining optimal tire pressures. The analysis uses various assumptions based on existing knowledge about how travelers may respond under emergency conditions to develop estimates of potential fuel savings. Results suggest that the most restrictive policies, such as driving bans and mandatory carpooling are the most effective. Other policies provide small reductions with some, such as telecommuting and flexible work schedules, having the potential to be easily implemented. Those policies, focussed on encouraging public transport use, are less effective and potentially more costly to implement.

  18. The role of information and communication policies in the governance of the healthcare sector

    Directory of Open Access Journals (Sweden)

    Barileé B. Baridam

    2016-07-01

    Full Text Available Information and communication technology (ICT is today an indispensable tool in the development of countries and economies, driving growth in many other sectors, including the health sector. The effective governance of the health sector demands enabling ICT policies. Healthcare is a key area in the development and growth of nations. A country that neglects this sector will definitely witness a decline in socio-economic development. Application of ICT in this sector is non-negotiable and an imperative. However, with diversities in policy ICT’s impact is not felt in many communities, and linking ICT and other business strategies is a big challenge. Availability of resources upon which ICT itself thrives is another factor limiting its impact upon the lives of the populations of most developing nations. Cultural diversity and technology problems seem to stand prominent among challenges impeding the impact of ICT on developing nations. Against this backdrop, this paper takes a critical look at the implementation and efficiency of ICT in healthcare delivery within the Nigerian context. The purpose is to assist those bodies responsible for ICT policy and implementation to enable the benefits of ICT to trickle through to the populace. We are also of the opinion that the adequate implementation of ICT policy in the health sector in the most populous black nation (Nigeria will go a long way to influence its implementation in neighbouring nations

  19. Private Sector in Indian Healthcare Delivery: Consumer Perspective and Government Policies to promote private Sector

    Directory of Open Access Journals (Sweden)

    Utkarsh Shah, Ragini Mohanty

    2011-01-01

    Full Text Available This research paper attempts to collate literature from various sources, in an attempt to answer three pertinent questions related to healthcare in India. Firstly, what is it meant by ‘private sector’ in healthcare delivery system of India, secondly how has the private sector evolved over the decades and what has been the role of the government in propelling the growth. Finally, the paper tries to highlight some of the factors that have promoted the growth of private sector in India with specific reference to quality of medical care. The paper explicitly indicates that the deficiencies in the public health delivery system of India, was the key to growth of private infrastructure in healthcare.The shift of hospital industry for ‘welfare orientation’ to ‘business orientation’ was marked by the advent of corporate hospitals, supported by various policy level initiatives made by the government. Today, there are over 20 international healthcare brands in India with several corporate hospitals.However, a large section of the ‘private healthcare delivery segment’ is scattered and quality of medical care continues to remain a matter of concern. This paper tracks the various government initiatives to promote private investment in healthcare and attempts to explore the reasons for preference of the private sector. Surprisingly, in contrast to contemporary belief, quality of medical care doesn’t seem to be the leading cause for preference of the private sector. Except for a few select corporate and trust hospitals, quality of medical care in private sector seems to be poor and at times compromised.

  20. Psycho-cognitive predictors of burnout in healthcare professionals working in emergency departments.

    Science.gov (United States)

    Masiero, Marianna; Cutica, Ilaria; Russo, Selena; Mazzocco, Ketti; Pravettoni, Gabriella

    2018-07-01

    Healthcare professionals working in emergency departments commonly experience high work pressure and stress due to witnessing human suffering and the unpredictable nature of the work. Several studies have identified variables that affect burnout syndrome, but poor data are available about the predictors of the different dimensions of burnout (depersonalisation, emotional exhaustion, professional inefficacy and disillusionment). Some research has suggested that alexithymia, coping style and decision-making style may predict burnout. We conducted a noninterventional study to investigate whether and how alexithymia, coping style and decision-making style are associated with the different dimensions of burnout. We recruited a convenience sample of 93 healthcare professionals working in an Italian emergency departments. Participants completed a questionnaire assessing their level of burnout (the Link Burnout Questionnaire), and possible burnout predictors: decision-making style, alexithymia and the coping style. Four bivariate linear regressions were performed to define the predictors that characterised the dimensions of burnout. We found that an avoidant decision-making style and a difficulty to identify and describe feelings (a difficulty close to alexithymia even though not as severe) are strong predictors of some burnout dimensions. Individuals who experience relational depersonalisation are more likely to turn to religion as a way to cope. Our research shows that, to some extent, difficulties in emotion regulation and the attitude to avoid or postpone decisions characterised burnout. These results might be used to develop tailored psycho-educational interventions. This might help healthcare professionals to develop personal skills to cope with the critical conditions that characterise their work and to enable them to recognise potential risk factors that favour burnout. This has pivotal implications for the maintenance of the patient-healthcare professional

  1. Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Fiona Cocker

    2016-06-01

    Full Text Available Compassion fatigue (CF is stress resulting from exposure to a traumatized individual. CF has been described as the convergence of secondary traumatic stress (STS and cumulative burnout (BO, a state of physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment. Professionals regularly exposed to the traumatic experiences of the people they service, such as healthcare, emergency and community service workers, are particularly susceptible to developing CF. This can impact standards of patient care, relationships with colleagues, or lead to more serious mental health conditions such as posttraumatic stress disorder (PTSD, anxiety or depression. A systematic review of the effectiveness of interventions to reduce CF in healthcare, emergency and community service workers was conducted. Thirteen relevant studies were identified, the majority of which were conducted on nurses (n = 10. Three included studies focused on community service workers (social workers, disability sector workers, while no studies targeting emergency service workers were identified. Seven studies reported a significant difference post-intervention in BO (n = 4 or STS (n = 3. This review revealed that evidence of the effectiveness of CF interventions in at-risk health and social care professions is relatively recent. Therefore, we recommend more research to determine how best to protect vulnerable workers at work to prevent not only CF, but also the health and economic consequences related to the ensuing, and more disabling, physical and mental health outcomes.

  2. 75 FR 49508 - Recovery Policy, RP9525.7, Labor Costs-Emergency Work

    Science.gov (United States)

    2010-08-13

    ...] Recovery Policy, RP9525.7, Labor Costs--Emergency Work AGENCY: Federal Emergency Management Agency, DHS... (FEMA) is accepting comments on RP9525.7, Labor Costs--Emergency Work. This is an existing policy that is scheduled for review to ensure that Recovery Directorate policies are up to date, incorporate...

  3. Making the CMS payment policy for healthcare-associated infections work: organizational factors that matter.

    Science.gov (United States)

    Hoff, Timothy; Hartmann, Christine W; Soerensen, Christina; Wroe, Peter; Dutta-Linn, Maya; Lee, Grace

    2011-01-01

    Healthcare-associated infections (HAIs) are among the most common adverse events in hospitals, and the morbidity and mortality associated with them are significant. In 2008, the Centers for Medicare and Medicaid Services (CMS) implemented a new financial policy that no longer provides payment to hospitals for services related to certain infections not present on admission and deemed preventable. At present, little is known about how this policy is being implemented in hospital settings. One key goal of the policy is for it to serve as a quality improvement driver within hospitals, providing the rationale and motivation for hospitals to engage in greater infection-related surveillance and prevention activities. This article examines the role organizational factors, such as leadership and culture, play in the effectiveness of the CMS policy as a quality improvement (QI) driver within hospital settings. Between late 2009 and early 2010, interviews were conducted with 36 infection preventionists working at a national sample of 36 hospitals. We found preliminary evidence that hospital executive behavior, a proactive infection control (IC) culture, and clinical staff engagement played a favorable role in enhancing the recognition, acceptance, and significance of the CMS policy as a QI driver within hospitals. We also found several other contextual factors that may impede the degree to which the above factors facilitate links between the CMS policy and hospital QI activities.

  4. A multicriteria decision making approach applied to improving maintenance policies in healthcare organizations.

    Science.gov (United States)

    Carnero, María Carmen; Gómez, Andrés

    2016-04-23

    Healthcare organizations have far greater maintenance needs for their medical equipment than other organization, as many are used directly with patients. However, the literature on asset management in healthcare organizations is very limited. The aim of this research is to provide more rational application of maintenance policies, leading to an increase in quality of care. This article describes a multicriteria decision-making approach which integrates Markov chains with the multicriteria Measuring Attractiveness by a Categorical Based Evaluation Technique (MACBETH), to facilitate the best choice of combination of maintenance policies by using the judgements of a multi-disciplinary decision group. The proposed approach takes into account the level of acceptance that a given alternative would have among professionals. It also takes into account criteria related to cost, quality of care and impact of care cover. This multicriteria approach is applied to four dialysis subsystems: patients infected with hepatitis C, infected with hepatitis B, acute and chronic; in all cases, the maintenance strategy obtained consists of applying corrective and preventive maintenance plus two reserve machines. The added value in decision-making practices from this research comes from: (i) integrating the use of Markov chains to obtain the alternatives to be assessed by a multicriteria methodology; (ii) proposing the use of MACBETH to make rational decisions on asset management in healthcare organizations; (iii) applying the multicriteria approach to select a set or combination of maintenance policies in four dialysis subsystems of a health care organization. In the multicriteria decision making approach proposed, economic criteria have been used, related to the quality of care which is desired for patients (availability), and the acceptance that each alternative would have considering the maintenance and healthcare resources which exist in the organization, with the inclusion of a

  5. Income, egalitarianism and attitudes towards healthcare policy: a study on public attitudes in 29 countries.

    Science.gov (United States)

    Azar, A; Maldonado, L; Castillo, J C; Atria, J

    2018-01-01

    To evaluate the relationship between income and egalitarian values and attitudes towards healthcare policy. Cross-sectional and cross-national study. Data for 29 countries from the International Social Survey Programme (ISSP) 2011 were used. The dependent variables are a general attitude towards government involvement in healthcare provision and two attitudes regarding specific policies (taxes and public funding). Income and egalitarianism were also measured by using ISSP. Data were analysed using regression models that account for individual and country-level characteristics, and country-fixed effects. The effect of income is small and non-significant for attitudes towards government involvement and public funding. For willingness to pay (WTP) taxes to improve healthcare services, we find a positive association with income. Results for egalitarianism suggest a positive association with government involvement in healthcare provision and significant interactions with WTP taxes. The distinction of dimensions and mechanisms underlying policy attitudes appears as relevant. Citizens across socioeconomic groups are motivated to support state-funded healthcare, favouring the design of non-selfish policies. These findings suggest that there is space for policymakers who seek to increase healthcare spending encouraging either policies for specific groups or broader institutional changes. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. No hospital left behind? Education policy lessons for value-based payment in healthcare.

    Science.gov (United States)

    Maurer, Kristin A; Ryan, Andrew M

    2016-01-01

    Value-based payment systems have been widely implemented in healthcare in an effort to improve the quality of care. However, these programs have not broadly improved quality, and some evidence suggests that they may increase inequities in care. No Child Left Behind is a parallel effort in education to address uneven achievement and inequalities. Yet, by penalizing the lowest performers, No Child Left Behind's approach to accountability has led to a number of unintended consequences. This article draws lessons from education policy, arguing that financial incentives should be designed to support the lowest performers to improve quality. © 2015 Society of Hospital Medicine.

  7. Requirements and Challenges of Location-Based Access Control in Healthcare Emergency Response

    DEFF Research Database (Denmark)

    Vicente, Carmen Ruiz; Kirkpatrick, Michael; Ghinita, Gabriel

    2009-01-01

    Recent advances in positioning and tracking technologies have led to the emergence of novel location-based applications that allow participants to access information relevant to their spatio-temporal context. Traditional access control models, such as role-based access control (RBAC), are not suf...... to such settings. We overview the main technical issues to be addressed, and we describe the architecture for policy decision and enforcement points....

  8. Prevalence and content of written ethics policies on euthanasia in Catholic healthcare institutions in Belgium (Flanders).

    Science.gov (United States)

    Gastmans, Chris; Lemiengre, Joke; van der Wal, Gerrit; Schotsmans, Paul; Dierckx de Casterlé, Bernadette

    2006-04-01

    Euthanasia is performed worldwide, regardless of the existence of laws governing it. Belgium became the second country in the world to enact a law on euthanasia in 2002. Healthcare institutions bear responsibility for guaranteeing the quality of care for patients at the end of life, and for ensuring support for caregivers involved. Therefore, institutional ethics policies on end-of-life decision-making, especially on euthanasia, may be useful. A cross-sectional mail survey of general directors of Catholic hospitals and nursing homes in Belgium was used to describe the prevalence and content of written ethics policies for competent terminally ill, incompetent terminally ill, and non-terminally ill patients. Of the 298 targeted institutions, 81% of hospitals and 62% of nursing homes returned complete questionnaires. Of these, 79% of hospitals and 30% of nursing homes had a written ethics policy on euthanasia. Of hospitals 83% and of nursing homes 85% permitted euthanasia for competent terminally ill patients only in exceptional cases in accordance with legal due care criteria and provisions outlined by the palliative filter procedure. Euthanasia for incompetent terminally ill patients was prohibited by 27% of the hospitals and by 60% of the nursing homes. For non-terminally ill patients, these figures were 43 and 64%, respectively. Catholic healthcare institutions in Belgium (Flanders) made great efforts to develop written ethics policies on euthanasia. Only a small group of institutions completely prohibited euthanasia. Most of the institutions considered euthanasia to be an option if all possible alternatives (e.g., palliative filter procedure, which contains more rigorous criteria than those in the Belgian Euthanasia Act), have been thoroughly investigated.

  9. Malaria healthcare policy change in Kenya: implications on sales and marketing of antimalarials.

    Science.gov (United States)

    Ngure, Peter K; Nyaoke, Lorraine; Minja, David

    2012-03-01

    Malaria healthcare policy change in Kenya aimed at improving the control of malaria but faced a number of challenges in implementation related to marketing of the drugs. This research investigated the effect of the change of the national malaria policy on drug sales and strategic marketing responses of antimalarial pharmaceutical companies in Kenya. A descriptive cross-sectional design was employed to describe the existing state of antimalarials market in Kenya after the change of the malaria healthcare policy. Policy change did result in an increase in the sales of Coartem®. Novartis Pharma recorded a 97% growth in sales of Coartem® between 2003 and 2004. However, this increase was not experienced by all the companies. Further, SPs (which had been replaced as first-line therapy for malaria) registered good sales. In most cases, these sales were higher than the sales of Coartem®. Generally, the sales contribution of SPs and generic antimalarial medicines exceeded that of Coartem® for most distributors. The most common change made to marketing strategies by distributors (62.5%) was to increase imports of antimalarials. A total of 40% of the manufacturers preferred to increase their budgetary allocation for marketing activities. In view of the fact that continued sale of SP drugs and limited availability of AL poses the risk of increasing the incidence of malaria in Kenya, it is therefore, recommended that pharmacy surveillance systems be strengthened to ensure drugs that have been rendered non-viable or that prescription-only medicines are not sold contrary to the national guidelines.

  10. Energy, emissions and emergency medical services: Policy matters

    International Nuclear Information System (INIS)

    Brown, Lawrence H.; Blanchard, Ian E.

    2012-01-01

    Understanding the energy consumption and emissions associated with health services is important for minimizing their environmental impact and guiding their adaptation to a low-carbon economy. In this post-hoc analysis, we characterize the energy burden of North American emergency medical services (EMS) agencies and estimate the potential marginal damage costs arising from their emissions as an example of how and why health services matter in environmental and energy policy, and how and why environmental and energy policy matter to health services. We demonstrate EMS systems are energy intensive, and that vehicle fuels represent 80% of their energy burden while electricity and natural gas represent 20%. We also demonstrate that emissions from EMS operations represent only a small fraction of estimated health sector emissions, but for EMS systems in the United States the associated marginal damage costs are likely between $2.7 million and $9.7 million annually. Significant changes in the supply or price of energy, including changes that arise from environmental and energy policy initiatives designed to constrain fossil fuel consumption, could potentially affect EMS agencies and other health services. We encourage cross disciplinary research to proactively facilitate the health system's adaptation to a low-carbon economy. - Highlights: ► Estimated EMS-related emissions less than 1% of health sector emissions. ► Damage costs of U.S. EMS-related emissions estimated at $2.7 to $9.7 million. ► EMS energy burden is approximately 442 MJ per ambulance response. ► Approximately 80% of EMS energy burden is vehicle fuels. ► Energy supply, price and policy could impact EMS (and other health) services. ► Research needed to facilitate health services’ adaptation to a low carbon economy.

  11. The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: a cross-sectional study in China.

    Science.gov (United States)

    Guo, Zhigang; Guan, Xiaodong; Shi, Luwen

    2017-11-13

    In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010. A questionnaire survey developed by the study team was distributed to all of the primary healthcare institutions. Nine indicators from three dimensions as the outcome variables were used and calculated to evaluate the impacts of implementation of policies. All of the outcome variables were tested using independent-samples T test between the treatment group (with the NEMPs implemented) and the control group (without the NEMPs implemented). The ratio of drug sales and institution revenues at primary healthcare institutions was 42.99% in the treatment group, which was significantly lower than the control group (53.90%, p financial subsidies of the treatment group was shown to be higher (30.78% VS 20.82%, p institutions, the improvement of the mechanisms for government investment, and the healthcare pricing system. Meanwhile, the gaps between urban and rural areas need to be addressed. In conclusion, the NEMPs of China are instrumental to the aim of providing basic healthcare services to every citizen.

  12. Retiree out-of-pocket healthcare spending: a study of consumer expectations and policy implications.

    Science.gov (United States)

    Hoffman, Allison K; Jackson, Howell E

    2013-01-01

    Even though most American retirees benefit from Medicare coverage, a mounting body of research predicts that many will face large and increasing out-of-pocket expenditures for healthcare costs in retirement and that many already struggle to finance these costs. It is unclear, however, whether the general population understands the likely magnitude of these out-of-pocket expenditures well enough to plan for them effectively. This study is the first comprehensive examination of Americans' expectations regarding their out-of-pocket spending on healthcare in retirement. We surveyed over 1700 near retirees and retirees to assess their expectations regarding their own spending and then compared their responses to experts' estimates. Our main findings are twofold. First, overall expectations of out-of-pocket spending are mixed. While a significant proportion of respondents estimated out-of-pocket costs in retirement at or above expert estimates of what the typical retiree will spend, a disproportionate number estimated their future spending substantially below what experts view as likely. Estimates by members of some demographic subgroups, including women and younger respondents, deviated relatively further from the experts' estimates. Second, respondents consistently misjudged spending uncertainty. In particular, respondents significantly underestimated how much individual health experience and changes in government policy can affect individual out-of-pocket spending. We discuss possible policy responses, including efforts to improve financial planning and ways to reduce unanticipated financial risk through reform of health insurance regulation.

  13. Healthcare service providers' and facility administrators' perspectives of the free maternal healthcare services policy in Malindi District, Kenya: a qualitative study.

    Science.gov (United States)

    Lang'at, Evaline; Mwanri, Lillian

    2015-06-27

    Globally, there are increasing efforts to improve maternal health outcomes including the reduction in maternal mortality rates. Improved access to skilled care utilisation during pregnancy and delivery has been one of the strategies employed to improve maternal health outcomes. In Kenya, more than half of the women deliver without the assistance of a skilled attendant and this has contributed to high maternal mortality rates. The free maternal healthcare services policy in all public facilities was initiated as a strategy to improve access to skilled care and reduce poor maternal health outcomes. This study aimed to explore the perspectives of the service providers and facility administrators of the free maternal health care service policy that was introduced in Kenya in 2013. A qualitative inquiry using semi-structured one-on-one interviews was conducted in Malindi District, Kenya. The participants included maternal health service providers and facility administrators recruited from five different healthcare facilities. Data were analysed using a thematic framework analysis. Free maternal healthcare service provision was perceived to boost skilled care utilisation during pregnancy and delivery. However, challenges including; delays in the reimbursement of funds by the government to the facilities, stock outs of essential commodities in the facilities to facilitate service provision, increased workload amidst staff shortage and lack of consultation and sensitisation of key stakeholders were perceived as barriers to effective implementation of this policy. Free maternal healthcare services can be one of the strategies to improve a range of maternal health outcomes. However, the implementation of this policy would be more effective if; the healthcare facilities were upgraded, equipped with adequate supplies, funds and staff; the community are continually sensitized on the importance of seeking skilled care during pregnancy and delivery; and inclusivity and

  14. Patient engagement as an emerging challenge for healthcare services: mapping the literature.

    Science.gov (United States)

    Barello, Serena; Graffigna, Guendalina; Vegni, Elena

    2012-01-01

    Patients' engagement in healthcare is at the forefront of policy and research practice and is now widely recognized as a critical ingredient for high-quality healthcare system. This study aims to analyze the current academic literature (from 2002 to 2012) about patient engagement by using bibliometric and qualitative content analyses. Extracting data from the electronic databases more likely to cover the core research publications in health issues, the number of yearly publications, the most productive countries, and the scientific discipline dealing with patient engagement were quantitatively described. Qualitative content analysis of the most cited articles was conducted to distinguish the core themes. Our data showed that patient engagement is gaining increasing attention by all the academic disciplines involved in health research with a predominance of medicine and nursing. Engaging patients is internationally recognized as a key factor in improving health service delivery and quality. Great attention is up to now paid to the clinical and organizational outcomes of engagement, whereas there is still a lack of an evidence-based theoretical foundation of the construct as well as of the organizational dimensions that foster it.

  15. Patient Engagement as an Emerging Challenge for Healthcare Services: Mapping the Literature

    Directory of Open Access Journals (Sweden)

    Serena Barello

    2012-01-01

    Full Text Available Patients’ engagement in healthcare is at the forefront of policy and research practice and is now widely recognized as a critical ingredient for high-quality healthcare system. This study aims to analyze the current academic literature (from 2002 to 2012 about patient engagement by using bibliometric and qualitative content analyses. Extracting data from the electronic databases more likely to cover the core research publications in health issues, the number of yearly publications, the most productive countries, and the scientific discipline dealing with patient engagement were quantitatively described. Qualitative content analysis of the most cited articles was conducted to distinguish the core themes. Our data showed that patient engagement is gaining increasing attention by all the academic disciplines involved in health research with a predominance of medicine and nursing. Engaging patients is internationally recognized as a key factor in improving health service delivery and quality. Great attention is up to now paid to the clinical and organizational outcomes of engagement, whereas there is still a lack of an evidence-based theoretical foundation of the construct as well as of the organizational dimensions that foster it.

  16. Convergent Innovation in Emerging Healthcare Technology Ecosystems: Addressing Complexity and Integration

    Directory of Open Access Journals (Sweden)

    Mark A. Phillips

    2017-09-01

    Full Text Available Precision Medicine and Digital Health are emerging areas in healthcare, and they are underpinned by convergent or cross-industry innovation. However, convergence results in greater uncertainty and complexity in terms of technologies, value networks, and organization. There has been limited empirical research on emerging and convergent ecosystems, especially in addressing the issue of integration. This research identifies how organizations innovate in emerging and convergent ecosystems, specifically, how they address the challenge of integration. We base our research on empirical analyses using a series of longitudinal case studies employing a combination of case interviews, field observations, and documents. Our findings identify a need to embrace the complexity by adopting a variety of approaches that balance “credibility-seeking” and “advantage-seeking” behaviours, to navigate, negotiate, and nurture both the innovation and ecosystem, in addition to a combination of “analysis” and “synthesis” actions to manage aspects of integration. We contribute to the convergent innovation agenda and provide practical approaches for innovators in this domain.

  17. A direct healthcare cost analysis of the cryopreserved versus fresh transfer policy at the blastocyst stage.

    Science.gov (United States)

    Papaleo, Enrico; Pagliardini, Luca; Vanni, Valeria Stella; Delprato, Diana; Rubino, Patrizia; Candiani, Massimo; Viganò, Paola

    2017-01-01

    A cost analysis covering direct healthcare costs relating to IVF freeze-all policy was conducted. Normal- and high- responder patients treated with a freeze-all policy (n = 63) compared with fresh transfer IVF (n = 189) matched by age, body mass index, duration and cause of infertility, predictive factors for IVF (number of oocytes used for fertilization) and study period, according to a 1:3 ratio were included. Total costs per patient (€6952 versus €6863) and mean costs per live birth were similar between the freeze-all strategy (€13,101, 95% CI 10,686 to 17,041) and fresh transfer IVF (€15,279, 95% CI 13,212 to 18,030). A mean per live birth cost-saving of €2178 (95% CI -1810 to 6165) resulted in a freeze-all strategy owing to fewer embryo transfer procedures (1.29 ± 0.5 versus 1.41 ± 0.7); differences were not significant. Sensitivity analysis revealed that the freeze-all strategy remained cost-effective until the live birth rate is either higher or only slightly lower (≥-0.59%) in the freeze-all group compared with fresh cycles. A freeze-all policy does not increase costs compared with fresh transfer, owing to negligible additional expenses, i.e. vitrification, endometrial priming and monitoring, against fewer embryo transfer procedures required to achieve pregnancy. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Emergency department visits of Syrian refugees and the cost of their healthcare.

    Science.gov (United States)

    Gulacti, Umut; Lok, Ugur; Polat, Haci

    2017-07-01

    The aim of this study was to evaluate the demographic and clinical characteristics of Emergency Department (ED) visits made by Syrian refugees and to assess the cost of their healthcare. This retrospective study was conducted in adult Syrians who visited the ED of Adiyaman University Training and Research Hospital, Adiyaman Province, Turkey, between 01 January and 31 December 2015. We evaluated 10,529 Syrian refugees who visited the ED, of whom 9,842 were included in the study. The number of ED visits significantly increased in 2015 compared with 2010; the increase in the proportion of total ED visits was 8% (n = 11,275, dif: 8%, CI 95%: 7.9- 8.2, p refugees and the remaining 1.5% accounted for the visits made by other individuals. Upper respiratory tract infections (URTI) were the diseases most frequently presented (n = 4,656; 47.3%), and 68.5% of ED visits were inappropriate (n = 6,749). The median ED length of stay (LOS) of the Syrian refugees was significantly longer than that of the other individuals visiting the ED (p refugees who visited the ED was calculated as US$ 773,374.63. This study showed that Syrian refugees have increased the proportion of ED visits and the financial healthcare burden. The majority of ED visits made by Syrian refugees were inappropriate. In addition, their ED LOS was longer than that of other individuals making ED visits.

  19. Preventing and managing workplace violence against healthcare workers in Emergency Departments.

    Science.gov (United States)

    D'Ettorre, Gabriele; Pellicani, Vincenza; Mazzotta, Mauro; Vullo, Annamaria

    2018-02-21

    Healthcare workers (HCWs) employed in Emergency Departments (EDs) frequently face with patients becoming violent because of long wait or diseases or under the influence of alcohol or drugs. Globally, workplace violence (WPV) in EDs is a major challenge to safety for HCWs, involving significant consequences to the victims, patients, and healthcare organizations. We reviewed the current literature with the aim to explore the topics focused on and to detect new evidences about approaching the issue of WPV toward HCWs in EDs. A search for articles regarding WPV toward HCWs employed in EDs and published from January 2007 through December 2017 was performed; using predetermined criteria for inclusion, selected articles were reviewed and qualitatively assessed for the aims of the review. We found 60 papers which matched our inclusion criteria; the topics, discussed in order of frequency from highest to lowest, were: "Risk Assessment", "Occurrence Rates", "Risk Management", and "Physical/non Physical Consequences". Dementia, schizophrenia, anxiety, acute stress reaction, suicidal ideation, and alcohol and drug intoxication were found as predictors of physical violence perpetrated by patients against HCWs. A strategic way to the effective management of WPV should prioritize training courses focused on: constructing HCW-patient relationship, improving the workers' communication skills, accurate reporting of each violent incident, and improving the labor context through management commitment and employee involvement in WPV prevention programs. A special effort is required in implementing workplace design effective in minimizing stressful conditions in waiting rooms which turned out to be the most frequent site of assaults.

  20. Crowding and delivery of healthcare in emergency departments: the European perspective.

    LENUS (Irish Health Repository)

    Jayaprakash, Namita

    2009-11-01

    Emergency department (ED) crowding is a multifactorial problem, resulting in increased ED waiting times, decreased patient satisfaction and deleterious domino effects on the entire hospital. Although difficult to define and once limited to anecdotal evidence, crowding is receiving more attention as attempts are made to quantify the problem objectively. It is a worldwide phenomenon with regional influences, as exemplified when analyzing the problem in Europe compared to that of the United States. In both regions, an aging population, limited hospital resources, staff shortages and delayed ancillary services are key contributors; however, because the structure of healthcare differs from country to country, varying influences affect the issue of crowding. The approach to healthcare delivery as a right of all people, as opposed to a free market commodity, depends on governmental organization and appropriation of funds. Thus, public funding directly influences potential crowding factors, such as number of hospital beds, community care facilities, and staffing. Ultimately ED crowding is a universal problem with distinctly regional root causes; thus, any approach to address the problem must be tailored to regional influences.

  1. Short-Range Noncontact Sensors for Healthcare and Other Emerging Applications: A Review

    Directory of Open Access Journals (Sweden)

    Changzhan Gu

    2016-07-01

    Full Text Available Short-range noncontact sensors are capable of remotely detecting the precise movements of the subjects or wirelessly estimating the distance from the sensor to the subject. They find wide applications in our day lives such as noncontact vital sign detection of heart beat and respiration, sleep monitoring, occupancy sensing, and gesture sensing. In recent years, short-range noncontact sensors are attracting more and more efforts from both academia and industry due to their vast applications. Compared to other radar architectures such as pulse radar and frequency-modulated continuous-wave (FMCW radar, Doppler radar is gaining more popularity in terms of system integration and low-power operation. This paper reviews the recent technical advances in Doppler radars for healthcare applications, including system hardware improvement, digital signal processing, and chip integration. This paper also discusses the hybrid FMCW-interferometry radars and the emerging applications and the future trends.

  2. Towards a stakeholders' consensus on patient payment policy: the views of health-care consumers, providers, insurers and policy makers in six Central and Eastern European countries.

    Science.gov (United States)

    Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

    2015-08-01

    Although patient charges for health-care services may contribute to a more sustainable health-care financing, they often raise public opposition, which impedes their introduction. Thus, a consensus among the main stakeholders on the presence and role of patient charges should be worked out to assure their successful implementation. To analyse the acceptability of formal patient charges for health-care services in a basic package among different health-care system stakeholders in six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). Qualitative data were collected in 2009 via focus group discussions and in-depth interviews with health-care consumers, providers, policy makers and insurers. The same participants were asked to fill in a self-administrative questionnaire. Qualitative and quantitative data are analysed separately to outline similarities and differences in the opinions between the stakeholder groups and across countries. There is a rather weak consensus on patient charges in the countries. Health policy makers and insurers strongly advocate patient charges. Health-care providers overall support charges but their financial profits from the system strongly affects their approval. Consumers are against paying for services, mostly due to poor quality and access to health-care services and inability to pay. To build consensus on patient charges, the payment policy should be responsive to consumers' needs with regard to quality and equity. Transparency and accountability in the health-care system should be improved to enhance public trust and acceptance of patient payments. © 2012 John Wiley & Sons Ltd.

  3. Healthcare Access for Iraqi Refugee Children in Texas: Persistent Barriers, Potential Solutions, and Policy Implications.

    Science.gov (United States)

    Vermette, David; Shetgiri, Rashmi; Al Zuheiri, Haidar; Flores, Glenn

    2015-10-01

    To identify access barriers to healthcare and potential interventions to improve access for Iraqi refugee children. Four focus groups were conducted using consecutive sampling of Iraqi refugee parents residing in the US for 8 months to 5 years. Eight key-informant interviews also were conducted with employees of organizations serving Iraqi refugee families, recruited using snowball sampling. Focus groups and interviews were audiotaped, transcribed, and analyzed using margin coding and grounded theory. Iraqi refugees identified provider availability, Medicaid maintenance and renewal, language issues, and inadequate recognition of post-traumatic stress disorder as barriers to care for their children. Interviewees cited loss of case-management services and difficulties in understanding the Medicaid renewal process as barriers. Potential interventions to improve access include community-oriented efforts to educate parents on Medicaid renewal, obtaining services, and accessing specialists. Given the enduring nature of language and Medicaid renewal barriers, policies addressing eligibility alone are insufficient.

  4. Work load and management in the delivery room: changing the direction of healthcare policy.

    Science.gov (United States)

    Sfregola, Gianfranco; Laganà, Antonio Simone; Granese, Roberta; Sfregola, Pamela; Lopinto, Angela; Triolo, Onofrio

    2017-02-01

    Nurse staffing, increased workload and unstable nursing unit environments are linked to negative patient outcomes including falls and medication errors on medical/surgical units. Considering this evidence, the aim of our study was to overview midwives' workload and work setting. We created a questionnaire and performed an online survey. We obtained information about the type and level of hospital, workload, the use of standardised procedures, reporting of sentinel and 'near-miss' events. We reported a severe understaffing in midwives' work settings and important underuse of standard protocols according to the international guidelines, especially in the South of Italy. Based on our results, we strongly suggest a change of direction of healthcare policy, oriented to increase the number of employed midwives, in order to let them fulfil their duties according to the international guidelines (especially one-to-one care). On the other hand, we encourage the adoption of standardised protocols in each work setting.

  5. US public policy and emerging technologies: the case of solar energy

    International Nuclear Information System (INIS)

    Rahm, Dianne

    1993-01-01

    Public policy is generally believed to have an effect on the emergence and rate of diffusion of technology. Solar energy technologies are no exception. This article explores the relationship between a variety of United States (US) public policies and the emergence and diffusion of solar energy technologies using data gathered as part of the National Solar Energy Policy Study. The article presents findings regarding the status and policy position of US renewable energy research and development (R and D) and manufacturing organizations. Specific policy options which could be adopted to speed emergence and diffusion of solar energy technology products are discussed. (Author)

  6. Meeting the healthcare needs of transgender people within the armed forces: putting UK military policy into practice.

    Science.gov (United States)

    Whybrow, Dean; New, Chris; Coetzee, Rik; Bickerstaffe, Paul

    2016-12-01

    To explain how the healthcare needs of transgender personnel are met within the United Kingdom Armed Forces. It may be that when transgender people disclose their gender preference that they are at increased risk of social exclusion. The United Kingdom Armed Forces has an inclusive organisational policy for the recruitment and management of transgender personnel. This is a position paper about how the healthcare needs of transgender military personnel are met by the United Kingdom Armed Forces. United Kingdom Armed Forces policy was placed into context by reviewing current research, discussing medical terminology and describing the policy. This was followed by an account of how UK AF policy is applied in practice. Where armed forces had an inclusive policy for the management of transgender personnel, there seemed to be little cause for secrecy and zero tolerance of discrimination when compared to nations where this was not the case. Medical terminology has changed to reflect a more inclusive, less stigmatising use of language. The United Kingdom Armed Forces policy has been described as progressive and inclusive. The application of this policy in practice may be dependent upon strong leadership and training. The wider United Kingdom Armed Forces seems capable of adopting a pragmatic and flexible approach to meeting the healthcare needs of transgender personnel. The United Kingdom Armed Forces value diversity within their workforce and have a progressive, inclusive policy for the recruitment and management of transgender personnel. When supporting a transgender military person, healthcare professionals, civilian organisations and military line managers should consider referring to United Kingdom Armed Forces policy as early as possible. Other military and uniformed services may wish to examine the United Kingdom Armed Forces exemplar in order to consider the applicability within their own organisational setting. © 2016 John Wiley & Sons Ltd.

  7. Exploring Context and the Factors Shaping Team-Based Primary Healthcare Policies in Three Canadian Provinces: A Comparative Analysis.

    Science.gov (United States)

    Misfeldt, Renée; Suter, Esther; Mallinson, Sara; Boakye, Omenaa; Wong, Sabrina; Nasmith, Louise

    2017-08-01

    This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis. We then wrote narrative summaries highlighting pivotal policy and local system events and the influence of actors and context. Our overall findings highlight the value of reviewing the context, relationships and power dynamics, which come together and create "policy windows" at different points in time. We observed physician-centric policy processes with some recent moves to rebalance power and be inclusive of other actors and perspectives. The context review also highlighted the significant influence of changes in political leadership and prioritization in driving policies on team-based care. While this existed in different degrees in the three provinces, the push and pull of political and professional power dynamics shaped Canadian provincial policies governing team-based care. If we are to move team-based primary healthcare forward in Canada, the provinces need to review the external factors and the complex set of relationships and trade-offs that underscore the policy process. Copyright © 2017 Longwoods Publishing.

  8. Burnout in emergency department healthcare professionals is associated with coping style: a cross-sectional survey.

    Science.gov (United States)

    Howlett, M; Doody, K; Murray, J; LeBlanc-Duchin, D; Fraser, J; Atkinson, P R

    2015-09-01

    Ineffective coping may lead to impaired job performance and burnout, with adverse consequences to staff well-being and patient outcomes. We examined the relationship between coping styles and burnout in emergency physicians, nurses and support staff at seven small, medium and large emergency departments (ED) in a Canadian health region (population 500,000). Linear regression with the Coping Inventory for Stressful Situations (CISS) and Maslach Burnout Inventory (MBI) was used to evaluate the effect of coping style on levels of burnout in a cross-sectional survey of 616 ED staff members. CISS measures coping style in three categories: task-oriented, emotion-oriented and avoidance-oriented coping; MBI, in use for 30 years, assesses the level of burnout in healthcare workers. Task-oriented coping was associated with decreased risk of burnout, while emotion-oriented coping was associated with increased risk of burnout. Specific coping styles are associated with varied risk of burnout in ED staff across several different types of hospitals in a regional network. Coping style intervention may reduce burnout, while leading to improvement in staff well-being and patient outcomes. Further studies should focus on building and sustaining task-oriented coping, along with alternatives to emotion-oriented coping. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Antimicrobial biocides in the healthcare environment: efficacy, usage, policies, and perceived problems.

    Science.gov (United States)

    Maillard, Jean-Yves

    2005-12-01

    Biocides are heavily used in the healthcare environment, mainly for the disinfection of surfaces, water, equipment, and antisepsis, but also for the sterilization of medical devices and preservation of pharmaceutical and medicinal products. The number of biocidal products for such usage continuously increases along with the number of applications, although some are prone to controversies. There are hundreds of products containing low concentrations of biocides, including various fabrics such as linen, curtains, mattresses, and mops that claim to help control infection, although evidence has not been evaluated in practice. Concurrently, the incidence of hospital-associated infections (HAIs) caused notably by bacterial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) remains high. The intensive use of biocides is the subject of current debate. Some professionals would like to see an increase in their use throughout hospitals, whereas others call for a restriction in their usage to where the risk of pathogen transmission to patients is high. In addition, the possible linkage between biocide and antibiotic resistance in bacteria and the role of biocides in the emergence of such resistance has provided more controversies in their extensive and indiscriminate usage. When used appropriately, biocidal products have a very important role to play in the control of HAIs. This paper discusses the benefits and problems associated with the use of biocides in the healthcare environment and provides a constructive view on their overall usefulness in the hospital setting.

  10. Implementing a province-wide mandatory vaccinate-or-mask policy at healthcare facilities in British Columbia, Canada.

    Science.gov (United States)

    Nunn, Alexandra; Campbell, Audrey C; Naus, Monika; Kwong, Jeffrey C; Puddicombe, David; Quach, Susan; Henry, Bonnie

    2018-01-08

    In 2012, British Columbia (BC) became the first Canadian province to implement an influenza prevention policy requiring healthcare workers (HCW) to either be vaccinated annually against influenza or wear a mask in patient care areas during the influenza season. This study describes an evaluation of influenza policy implementation processes and identifies supports and challenges related to successful policy implementation at the level of healthcare facilities, during the second policy year (2013/14). Implementation leaders from 262 long-term care (LTC) and acute care facilities, mostly in three of BC's five regional Health Authorities, were invited to participate in an online survey following the 2013/14 influenza season. Descriptive quantitative and qualitative analyses identified common and effective strategies for improving vaccination coverage and policy compliance. A total of 127 respondents completed the survey on behalf of 33 acute care and 99 LTC facilities, representing 36% of acute care and 27% of LTC facilities in BC. Respondents agreed that the policy was successfully implemented at 89% of facilities, and implementation was reported to be easy at 52% of facilities. The findings elaborate on communication and leadership strategies, campaign logistics and enforcement approaches involved in policy implementation. Implementation of a vaccinate-or-mask influenza policy is complex. This study provides insight for other jurisdictions considering implementing such a policy and offers practical recommendations for facilities and health authorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Demographic, Operational, and Healthcare Utilization Factors Associated with Emergency Department Patient Satisfaction

    Science.gov (United States)

    Morgan, Matthew W.; Salzman, Joshua G.; LeFevere, Robert C.; Thomas, Avis J.; Isenberger, Kurt M.

    2015-01-01

    Introduction The primary aim of this study was to determine which objectively-measured patient demographics, emergency department (ED) operational characteristics, and healthcare utilization frequencies (care factors) were associated with patient satisfaction ratings obtained from phone surveys conducted by a third-party vendor for patients discharged from our ED. Methods This is a retrospective, observational analysis of data obtained between September 2011 and August 2012 from all English- and Spanish-speaking patients discharged from our ED who were contacted by a third-party patient satisfaction vendor to complete a standardized nine-item telephone survey by a trained phone surveyor. We linked data from completed surveys to the patient’s electronic medical record to abstract additional demographic, ED operational, and healthcare utilization data. We used univariate ordinal logistic regression, followed by two multivariate models, to identify significant predictors of patient satisfaction. Results We included 20,940 patients for analysis. The overall patient satisfaction ratings were as follows: 1=471 (2%); 2=558 (3%); 3=2,014 (10%), 4=5,347 (26%); 5=12,550 (60%). Factors associated with higher satisfaction included race/ethnicity (Non-Hispanic Black; Hispanic patients), age (patients ≥65), insurance (Medicare), mode of arrival (arrived by bus or on foot), and having a medication ordered in the ED. Patients who felt their medical condition did not improve, those treated in our ED behavioral health area, and those experiencing longer wait times had reduced satisfaction. Conclusion These findings provide a basis for development and evaluation of targeted interventions that could be used to improve patient satisfaction in our ED. PMID:26265963

  12. EXPLORING HEALTHCARE-ASSOCIATED INFECTIONS: KNOWLEDGE, ATTITUDE, AND BEHAVIOR OF EMERGENCY NURSES WORKING IN BANDUNG, INDONESIA

    Directory of Open Access Journals (Sweden)

    Hudzaifah Al Fatih

    2016-10-01

    Full Text Available Background: Healthcare associated Infections (HAIs is considered being the most serious patient safety issue in health care settings and nurses in Emergency Department (ED face greater risk of exposure to infectious pathogens. Objective: The objectives of this study were to examine knowledge, attitude and behavior towards HAIs of Indonesian nurses working in ED and to examine the relationship among the above three variables. Method: A cross-sectional study with self-reported survey was conducted at four hospitals in Bandung, Indonesia. The Healthcare Associated Infections Survey consisting of four domains: demographic characteristics, knowledge, attitude and behavior related to HAIs was used. The participants of this study covered 115 nurses. Results: The mean of overall performance on the knowledge was good 21.23 ±5.173 (range 9-30 and 92.2% of them believed that guideline for HAIs control practice can reduced the risk of infections. The mean score for behavior when practicing infection control was 37.7±5.570 (26-50. Marital status and working hours per week, influenced nurses’ knowledge of HAIs (rs = 0.185, p = 0.048. Work experienced have negative correlation with attitude towards HAIs (rs = -0.196, p = 0.035. Furthermore, type of hospital and working hours per week have been associated with nurses’ behavior towards HAIs (r = 0.191, p = 0.04. There were no significant relationship between knowledge, attitude and behavior towards HAIs. Conclusion: Even though the majority of ED nurses in Indonesia believe that precautionary guidelines can reduce the risk of HAIs, this study has indicated that nurses’ behavior toward HAIs still insufficient.

  13. Migrants' access to healthcare services within the European Union: a content analysis of policy documents in Ireland, Portugal and Spain.

    Science.gov (United States)

    Ledoux, Céline; Pilot, Eva; Diaz, Esperanza; Krafft, Thomas

    2018-06-15

    The current migration flow into Europe is leading to a growing ethnically diverse population in many European countries. Now more than ever, those populations have different healthcare needs, languages, traditions, and previous level of care. This higher level of diversity is likely to increase health inequalities that might challenge healthcare systems if not addressed. In this context, this study aims at reviewing the policy framework for migrants' access to healthcare in Spain, Portugal and Ireland, countries with a long history of immigration, to identify lessons to be learned for policies on migrants' health. A content analysis of official policy documents was undertaken and the conceptual framework developed by Mladowsky was adapted to classify the actions indicated in the policies. The content analysis revealed that the policy aim for all three analysed countries is the improvement of the health status of the immigrant population based on equity and equality principles. The main strategies are the adaptation of services through actions targeting patients and providers, such as the implementation of cultural mediators and trainings for health professionals. The three countries propose a great range of policies aiming at improving access to healthcare services for immigrants that can inspire other European countries currently welcoming refugees. Developing inclusive policies, however does not necessarily mean they will be implemented or felt on the ground. Inclusive policies are indeed under threat due to the economic and social crises and due to the respective nationalistic attitudes towards integration. The European Union is challenged to take a more proactive leadership and ensure that countries effectively implement inclusive actions to improve migrant's access to health services.

  14. Knowledge of Good Blood Culture Sampling Practice among Healthcare Staffs in An Emergency Department - Are We Getting It Right?

    Science.gov (United States)

    Chew, K S; Mohd Hashairi, F; Jusoh, A F; Aziz, A A; Nik Hisamuddin, N A R; Siti Asma, H

    2013-08-01

    Although a vital test, blood culture is often plagued with the problem of contamination and false results, especially in a chaotic emergency department setting. The objectives of this pilot study is to find out the level of understanding among healthcare staffs in emergency department, Hospital Universiti Sains Malaysia (HUSM) regarding good blood culture sampling practice. All healthcare staffs in emergency department, HUSM who consented to this study were given a set of selfadministered anonymous questionnaire to fill. More than half (53.1%) of the 64 participants are emergency medicine residents. Majority of them (75%) have been working in the emergency medicine, HUSM for more than 2 years. More than half of them were able to answer correctly the amount of blood volume needed for culture in adult and pediatric patients. When asked what are the factors required to improve the true yield as well as to reduce the risk of culture contamination, the four commonest answers given were observing proper aseptic technique during blood sampling, donning sterile glove, proper hand scrubbing as well as ensuring the sterility of the equipments. This study suggests that there is a lack of proper knowledge of good blood culture sampling practice among our healthcare staffs in emergency department.

  15. Healthcare for migrants, participatory health research and implementation science--better health policy and practice through inclusion. The RESTORE project.

    Science.gov (United States)

    MacFarlane, Anne; O'Reilly-de Brún, Mary; de Brún, Tomas; Dowrick, Christopher; O'Donnell, Catherine; Mair, Frances; Spiegel, Wolfgang; van den Muijsenbergh, Maria; van Weel Baumgarten, Evelyn; Lionis, Christos; Clissmann, Ciaran

    2014-06-01

    This is a time of unprecedented mobility across the globe. Healthcare systems need to adapt to ensure that primary care is culturally and linguistically appropriate for migrants. Evidence-based guidelines and training interventions for cultural competence and the use of professional interpreters are available across European healthcare settings. However, in real-world practice migrants and their healthcare providers 'get by' with a range of informal and inadequate strategies. RESTORE is an EU FP7 funded project, which is designed to address this translational gap. The objective of RESTORE is to investigate and support the implementation of guidelines and training initiatives to support communication in cross-cultural consultations in selected European primary care settings. RESTORE is a qualitative, participatory health project running from 2011-2015. It uses a novel combination of normalization process theory and participatory learning and action research to follow and shape the implementation journeys of relevant guidelines and training initiatives. Research teams in Ireland, England, the Netherlands, Austria and Greece are conducting similar parallel qualitative case study fieldwork, with a complementary health policy analysis led by Scotland. In each setting, key stakeholders, including migrants, are involved in participatory data generation and analysis. RESTORE will provide knowledge about the levers and barriers to the implementation of guidelines and training initiatives in European healthcare settings and about successful, transferrable strategies to overcome identified barriers. RESTORE will elucidate the role of policy in shaping these implementation journeys; generate recommendations for European policy driving the development of culturally and linguistically appropriate healthcare systems.

  16. Oil and Gas Emergency Policy: Sweden 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    , while households and other small consumers, numbering over 33 thousand, account for 2% of the total. The Swedish Energy Agency (SEA), under the Ministry of Enterprise, Energy and Communications, has the main responsibility for both oil and natural gas emergency response policy. Sweden fulfils its oil stockholding requirements to both the IEA and the European Union by placing minimum stockholding obligations on industry and major consumers. During a supply disruption and as a contribution to an IEA collective action, Swedish authorities would reduce the minimum obligation, thereby granting operators permission to draw stocks below the minimum level. In a natural gas crisis, supplies to protected customers (i.e. households) are safeguarded while the physical balance of the gas system would be maintained by restricting or discontinuing supplies to non-protected customers in a crisis. System operators are obliged to have in place crisis plans for dealing with emergency situations, including a strategy for reducing supplies to customers.

  17. Oil and Gas Emergency Policy: Japan 2013 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-01

    (before the March 2011 earthquake) to 22% in 2011, due to growing demand from the electricity generation sector. Japan’s demand for natural gas steadily increased from some 26 billion cubic meters (71 mcm/d) in 1980 to around 109 bcm (298.6 mcm/d) in 2010, to 124 bcm (340 mcm/d) in 2012. Japan’s domestic natural gas production is limited – with production of around 3.3 bcm in 2012. Natural gas supply sources to the country are well diversified. In 2011, Malaysia was the largest supplier, representing 18% of total imports. As Japan has no cross border pipelines, the country imported natural gas through 31 LNG terminals with around 10 bcm of natural gas storage capacity. Key elements of Japan’s overall gas security policy are diversifying its long-term supply contract portfolio, ensuring flexibility of increasing imports in times of an emergency in long term contracts, and using voluntary commercial LNG stocks in industry. Even though industry is not obliged to hold any emergency gas stocks, industry has commercial stocks equivalent to about 20 to 30 days of consumption. There is no single transmission operator in the country as the trunk line networks have developed separately around LNG terminals and they are not necessarily connected to each other. Each gas company is asked to ensure its natural gas supply to its distribution area.

  18. Globalisation, health and foreign policy: emerging linkages and interests

    Science.gov (United States)

    Owen, John Wyn; Roberts, Olivia

    2005-01-01

    A discussion of the growing links between the issues of globalisation, health and foreign policy. This article examines the effect this has on health, development and foreign policy communities in the UK and internationally and considers what steps the policy community must take to address the challenges and opportunities of this new relationship. PMID:16053520

  19. Oil and Gas Emergency Policy: Turkey 2013 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-01

    Oil has been one of the main energy sources in Turkey, accounting for some 28% of the country’s total primary energy supply (TPES) in 2011. Turkey’s oil demand slightly increased from 637 kb/d in 2003 to 670 kb/d in 2012, although it dropped down from 678 kb/d in 2009 to 650 kb/d in 2010. The transport sector accounted for half of total oil consumption in 2010. Domestic oil production is in decline in Turkey, amounting to 45 kb/d or about 6.7% of total consumption in 2012. In 2012, Turkey imported 712 kb/d, consisting of about 392 kb/d of crude oil and some 320 kb/d refined products. Around 39% of total crude oil imports came from Iran. Crude oil and petroleum products are mainly undertaken by tankers and two major international pipelines running through the country with a total annual handling capacity of 2.8 mb/d. In the country, there are four operational refineries with a total crude distillation capacity of around 610 kb/d. Turkey meets its 90-day stockholding obligation to the IEA by placing a minimum stockholding obligation on industry. Under the relevant acts, refineries and fuel distribution companies are obliged to hold at least 20 days of product stocks based on the average daily sales of previous year, while eligible consumers that use more than 20,000 tonnes annually are required to hold 15 days’ consumption of each type of liquid fuel. Turkey held some 61 million barrels of oil stocks at the end of January 2013, equating to 99 days of 2011 net-imports. Around 55% of total oil stocks are held in the form of crude oil. The use of emergency oil stocks is central to Turkey’s emergency response policy, which can be complemented by demand restraint measures. The share of natural gas in the country’s TPES significantly increased at 32% in 2011. Turkey’s gas demand significantly increased from 0.7 billion cubic meters (2 mcm/d) in 1987 to 45.3 bcm (124 mcm/d) in 2012, while indigenous natural gas production totalled some 0.63 bcm in the same year

  20. CBA and Precaution: Policy-Making about Emerging Technologies.

    Science.gov (United States)

    Kaebnick, Gregory E; Gusmano, Michael K

    2018-01-01

    In the technology assessment literature, the leading alternative to CBA-like methods is usually held to be precaution, which is understood in various ways but is always about making decisions under conditions of uncertainty. Under such conditions, proponents of precaution commonly hold, a straightforward tallying of potential outcomes does not seem possible. Since CBA aims to tally up outcomes to determine which outcome would produce the greatest public benefit, precaution begins to look like, not just an alternative to CBA, but an incompatible alternative. Nonetheless, some of the better-known formulations of a precautionary principle expressly call for combining precaution with assessment of costs and benefits. This essay examines the possible intersection of precaution and CBA. It argues that a moderate kind of CBA is a necessary part of a moderate kind of precaution. The existing proposals for integrating CBA and precaution start with an assumption that the integrative task consists in combining decision tools that generate (contrasting) substantive guidance. An alternative approach, explored here, starts with the idea that precaution is not a decision-generating tool. Rather, it is a way of organizing the thinking that leads eventually to substantive conclusions. The appropriate policy response is reached not by applying a principle but by studying the situation-the proposed action and the problem it is meant to address-and developing recommendations tailored to it. What makes the thinking precautionary is that it emphasizes certain questions-about risk, uncertainty, and values-that CBA tends to suppress. So understood, precaution may well slow the science but is not intrinsically opposed to science or innovation. It can be understood, in fact, as continuous with the science because the contextual understanding of the science and the problems it is meant to address would emerge-in part-from a close engagement with the science. © 2018 The Hastings Center.

  1. Elderly health and implementation of the Brazilian National Health Policy for Elderly Persons on the performed actions in basic healthcare

    Directory of Open Access Journals (Sweden)

    SCHMINSKI VIEIRA, Roseli

    2016-06-01

    Full Text Available The Brazilian National Health Policy for Elderly Persons (PNSPI – in Portuguese was formulated by the Ministry of Health through Ordinance No. 2.528/2006 in line with the 1988 Brazilian Constitution. The study investigated whether municipalities from the South region of the State of Santa Catarina had knowledge and applied the PNSPI, on the performed actions in basic healthcare, especially on the Units of Family Healthcare Services based on what the Constitution and the Statute of the Elderly comprise. A deductive method with a qualitative approach and a descriptive research were used. As a result, some difficulties experienced by the research subjects related to two important points of policies and strategies of PNSPI were identified: the lack of a planned policy and of a continuous health education for the elderly; and the lack of a stimulating exercise of social control, whether in the health sector, or in the Municipal Council of Elderly People.

  2. Rethinking Healthcare Transitions and Policies: Changing and Expanding Roles in Transitional Care

    Science.gov (United States)

    Moreño, Patricienn K.

    2014-01-01

    The breakdown of care transitions between various healthcare facilities, providers, and services is a major issue in healthcare, and accounts for over US$15 billion in healthcare expenditures annually. The transition between inpatient care and home care is a very delicate period where, too often, chronically ill patients get worse and wind up back…

  3. China’s Healthcare Reform And Resources Redistribution: Lessons For Emerging Nations

    OpenAIRE

    Jia CUI; Shaomin HUANG; Gerald RAMEY

    2009-01-01

    Following China’s recent economic growth and healthcare reform, medical services quickly merged into the market economy. The burden of healthcare expense on the Chinese people has become a serious political issue. This research project reviews the changes in health expenditures made during the last two decades. This paper explores the cause of this rapid change in the healthcare sector and analyzes the corresponding statistics during the entire economic reform period. In addition, the paper a...

  4. Oil and Gas Emergency Policy: China 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-06

    Although coal is the dominant energy source in China, accounting for some 70% of the country's Total Energy Consumption (TEC) in 2009, oil and gas are also essential energy sources. Despite strong growth in consumption of oil, its share of TEC fell from 22% in 2000 to 18% in 2009, as coal use rose even faster to meet burgeoning demand for electricity. A strong policy push boosted natural gas supplies, particularly to residential customers, so that the share of natural gas doubled from 2% in 2000 to 4% in 2009. China is one of the important oil and natural gas producing counties in the world. In 2010, China's crude oil production exceeded 4 million barrels per day (mb/d). However, with strong and sustained economic growth, its demand for oil has also increased, from 4.6 mb/d in 2000 to over 8 mb/d in 2009. In the New Policy Scenario (NPS) of the IEA World Energy Outlook (WEO) 2011, China's primary oil demand rises to 12.2 mb/d in 2020. Although China is now the world's fifth largest oil producer, the country has been a net oil importer since 1993. In 2011, China imported over 5 mb/d of crude oil, accounting for about 54% of its total demand. More than 50% of the total crude oil imports came from counties of the Middle East. To prevent a potential shock to the economy caused by an oil supply disruption, the Chinese government has been steadily pushing building an oil stock reserve system. China has completed four stockpiling facilities with a capacity of around 103 mb in the first phase of its Strategic Petroleum Reserve (SPR) plan, and has begun construction of its second phase, which comprises eight storage sites that will reportedly have a combined capacity of around 207 mb. Among them, two sites were completed in the second half of 2011 and the Tianjin site is reportedly set to be completed in 2012. According to unofficial reports, the remaining four SPR-II sites are expected to become operational by 2013. The third phase is expected to boost

  5. Building emerging leaders in communications policy in Africa and Asia

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

    Over the last ten years, the Communication for Policy Research South ... as well as policy contributions by CPRsouth scholars in their respective countries. ... conferences, development of a social media-based platform for practitioners, and ... IDRC congratulates first cohort of Women in Climate Change Science Fellows.

  6. Antimicrobial resistance, infection control and planning for pandemics: the importance of knowledge transfer in healthcare resilience and emergency planning.

    Science.gov (United States)

    Cole, Jennifer

    Over the last 70 years, the efficacy, ready availability and relatively low cost of antimicrobial drugs - medicines that kill microorganisms such as bacteria and viruses or inhibit their multiplication, growth and pathogenic action - has led to their considerable overuse. It is estimated that nearly 50 per cent of all antimicrobial use in hospitals is unnecessary or inappropriate1 while in neonatal care, the figure is even higher, with infection confirmed in only five per cent of neonates treated with antibiotics.2 The more antimicrobials are used, the faster the microorganisms they target evolve into new, resistant strains, a natural process of evolution that threatens to undermine the tremendous life-saving potential of these drugs. Antimicrobial resistance (AMR) is a growing concern not only for the healthcare sector3 but also, increasingly, for security and resilience. Pandemic influenza, comparable only to 'Catastrophic terrorist attacks' at the top of the UK's National Risk Register4 may well result from the emergence of a strain that cannot be treated effectively with currently available drugs or from one that quickly develops resistance to the stockpiled countermeasures. Multidrug-resistant tuberculosis impacts on immigration policy, methicillin-resistant Staphylococcus aureus (MRSA), a major cause of hospital-acquired infections is an ongoing challenge for the health sector and the increase in drug-resistant strains of malaria is problematic both in its own right and as an additional consequence of climate change. AMR places a significant burden on international governments and tackling it requires changes to thinking across a number of government departments. In 2011, the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) published Recommendations for future collaboration between the US and EU1 and both the EU and the UK's Department of Health have recently developed new AMR strategies and Action Plans. This paper will explore the cross

  7. Understanding frailty: a qualitative study of European healthcare policy-makers' approaches to frailty screening and management.

    Science.gov (United States)

    Gwyther, Holly; Shaw, Rachel; Jaime Dauden, Eva-Amparo; D'Avanzo, Barbara; Kurpas, Donata; Bujnowska-Fedak, Maria; Kujawa, Tomasz; Marcucci, Maura; Cano, Antonio; Holland, Carol

    2018-01-13

    To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views. Thematic analysis of semistructured qualitative interviews. European healthcare policy departments. Seven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role. Seven themes were identified. Our findings reveal a 'knowledge gap', around frailty and awareness of the malleability of frailty, which has resulted in restricted ownership of frailty by specialists. Policy-makers emphasised the need to recognise frailty as a clinical syndrome but stressed that it should be managed via an integrated and interdisciplinary response to chronicity and ageing. That is, through social co-production. This would require a culture shift in care with redeployment of existing resources to deliver frailty management and intervention services. Policy-makers proposed barriers to a culture shift, indicating a need to be innovative with solutions to empower older adults to optimise their health and well-being, while still fully engaging in the social environment. The cultural acceptance of an integrated care system theme described the complexities of institutional change management, as well as cultural issues relating to working democratically, while in signposting adult care , the need for a personal navigator to help older adults to access appropriate services was proposed. Policy-makers also believed that screening for frailty could be an effective tool for frailty management. There is potential for frailty to be managed in a more integrated and person-centred manner, overcoming the challenges associated with niche ownership within the

  8. National healthcare spending in the U.S. and Japan: national economic policy and implications for neurosurgery.

    Science.gov (United States)

    Bean, James R

    2005-01-01

    Growth of national healthcare spending is a problem confronting national governments of all industrially advanced countries. Healthcare spending in the U.S. reached 13.9% of the Gross Domestic Product (GDP) in 2003, compared to only 8% in Japan. In the U.S., health insurance is voluntary, with 15% of the population uninsured. In Japan, health insurance is mandatory and virtually universal, with growth in national health costs about half the rate of growth in the U.S. U.S. healthcare costs are projected to reach 18.4% of GDP 2013. The predicted growth in health care costs is expected to cause strain on the federal budget and a growing inability of employers and employees to pay for private insurance. Different national policies are the reason for different national health care costs in the U.S. and Japan. The U.S. has higher healthcare prices for salaries, equipment, supplies, and pharmaceuticals as compared to Japan. Higher prices, higher service intensity and volume during hospitalization create higher total cost in the U.S. Price controls in Japan kept medical inflation low at 0.46%/yr from 1980-2000. Market-pricing mechanisms in the U.S. have proven ineffective in controlling national healthcare costs, while Japan's national fee and price control policies have kept national costs among the lowest within the Organization for Economic Cooperation and Development. To guide insurance coverage policy, neurosurgery and other highly technical specialties should better define the comparative health benefit of high price technical services by prospective outcome studies.

  9. Policy Options for Radio Frequency Identification (RFID) Application in Healthcare; a Prospective View: Final Report (D5).

    Science.gov (United States)

    van Oranje-Nassau, Constantijn; Schindler, Helen Rebecca; Vilamovska, Anna-Marie; Botterman, Maarten

    2012-01-01

    This article reviews the state of play of European markets and applications of Radio Frequency Identification (RFID) technology in healthcare in Europe. Based on the current situation the study presents three scenarios for 2020, to describe futures in which the technology and health care sectors develop in different ways. The scenarios were discussed in expert workshops to derive issues that need to be addressed by future policies of the European Union and other stakeholders. The market assessment is based on a review of literature and an analysis of proprietary market data. The information on the state of RFID applications in Health in Europe summarises the results of a literature review, an online Delphi survey, expert interviews and seven cases studies in Europe and the US. The policy analysis is based on the outcomes of a scenario gaming workshop with experts from academia, industry, healthcare providers, policymakers and representatives of patient organisations.

  10. Incidence of emergency contacts (red responses to Norwegian emergency primary healthcare services in 2007 – a prospective observational study

    Directory of Open Access Journals (Sweden)

    Hansen Elisabeth

    2009-07-01

    Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics

  11. The Technology-Enabled Patient Advocate: A Valuable Emerging Healthcare Partner.

    Science.gov (United States)

    Kent, Susan M; Yellowlees, Peter

    2015-12-01

    The U.S. healthcare system is changing and is becoming more patient-centered and technology-supported, with greater emphasis on population health outcomes and team-based care. The roles of healthcare providers are changing, and new healthcare roles are developing such as that of the patient advocate. This article reviews the history of this type of role, the changes that have taken place over time, the technological innovations in service delivery that further enable the role, and how the role could increasingly be developed in the future. Logical future extensions of the current typical patient advocate are the appearance of a virtual or avatar-driven care navigator, using telemedicine and related information technologies, as healthcare provision moves increasingly in a hybrid direction, with care being given both in-person and online.

  12. Perceptions of Oncologists, Healthcare Policy Makers, Patients and the General Population on the Value of Pharmaceutical Treatments in Oncology.

    Science.gov (United States)

    Sacristán, José A; Lizan, Luís; Comellas, Marta; Garrido, Pilar; Avendaño, Cristina; Cruz-Hernández, Juan J; Espinosa, Javier; Dilla, Tatiana

    2016-11-01

    The purpose of this study was to explore the main factors explaining the relative weight of the different attributes that determine the value of oncologic treatments from the different perspectives of healthcare policy makers (HCPM), oncologists, patients and the general population in Spain. Structured interviews were conducted to assess: (1) the importance of the attributes on treatment choice when comparing a new cancer drug with a standard cancer treatment; (2) the importance of survival, quality of life (QoL), costs and innovation in cancer; and (3) the most worrying side effects related to cancer drugs. A total of 188 individuals participated in the study. For all participants, when choosing treatments, the best rated characteristics were greater efficacy, greater safety, treatment adaptation to patients' individual requirements and the rapid reincorporation of patients to their daily activities. There were important differences among participants in their opinion about survival, QoL and cost. In general, oncologists, patients, and the general population gave greater value to gains in QoL than healthcare policy makers. Compared to other participants healthcare policy makers gave greater importance to the economic impact related to oncology treatments. Gains in QoL, survival, safety, cost and innovation are perceived differently by different groups of stakeholders. It is recommended to consider the perspective of different stakeholders in the assessment of a new cancer drugs to obtain more informed decisions when deciding on the most appropriate treatment to use. Eli Lilly & Co, Madrid (Spain).

  13. Policy implications of emerging vehicle and infrastructure technology.

    Science.gov (United States)

    2014-08-01

    This report considers a broad range of emerging transportation technologies that have potential : for enhancing travel on and operations of the Texas transportation system. It provides an : overview of technology classifications and assesses the poli...

  14. Ontology-Driven Knowledge-Based Health-Care System, An Emerging Area - Challenges And Opportunities - Indian Scenario

    Science.gov (United States)

    Sunitha, A.; Babu, G. Suresh

    2014-11-01

    Recent studies in the decision making efforts in the area of public healthcare systems have been tremendously inspired and influenced by the entry of ontology. Ontology driven systems results in the effective implementation of healthcare strategies for the policy makers. The central source of knowledge is the ontology containing all the relevant domain concepts such as locations, diseases, environments and their domain sensitive inter-relationships which is the prime objective, concern and the motivation behind this paper. The paper further focuses on the development of a semantic knowledge-base for public healthcare system. This paper describes the approach and methodologies in bringing out a novel conceptual theme in establishing a firm linkage between three different ontologies related to diseases, places and environments in one integrated platform. This platform correlates the real-time mechanisms prevailing within the semantic knowledgebase and establishing their inter-relationships for the first time in India. This is hoped to formulate a strong foundation for establishing a much awaited basic need for a meaningful healthcare decision making system in the country. Introduction through a wide range of best practices facilitate the adoption of this approach for better appreciation, understanding and long term outcomes in the area. The methods and approach illustrated in the paper relate to health mapping methods, reusability of health applications, and interoperability issues based on mapping of the data attributes with ontology concepts in generating semantic integrated data driving an inference engine for user-interfaced semantic queries.

  15. Personalisation - An Emergent Institutional Logic in Healthcare? Comment on "(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare".

    Science.gov (United States)

    Ferlie, Ewan

    2017-06-20

    This commentary on the recent think piece by Mannion and Exworthy reviews their core arguments, highlighting their suggestion that recent forces for personalization have emerged which may counterbalance the strong standardization wave which has been evident in many healthcare settings and systems over the last two decades. These forces for personalization can take very different forms. The commentary explores the authors' suggestion that these themes can be fruitfully examined theoretically through an institutional logics (ILs) literature, which has recently been applied by some scholars to healthcare settings. This commentary outlines key premises of that theoretical tradition. Finally, the commentary makes suggestions for taking this IL influenced research agenda further, along with some issues to be addressed. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  16. Safety vs. reputation: risk controversies in emerging policy networks regarding school safety in the Netherlands

    NARCIS (Netherlands)

    Binkhorst, J.; Kingma, S.F.

    2012-01-01

    This article deals with risk controversies in emerging policy networks regarding school safety in the Netherlands. It offers a grounded account of the interpretations of school risks and safety measures by the various stakeholders of the policy network, in particular, schools, local government and

  17. Building emerging leaders in communications policy in Africa and Asia

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

    Among the activities supported will be tutorials, conferences, development of a social media-based platform for practitioners, and organization of a workshop on big data and development. The project is expected to build a new cohort of communications policy leaders and provide a nuanced understanding of how to ...

  18. Assessment of the Effects of Emerging Grazing Policies on Land ...

    African Journals Online (AJOL)

    Journal of Applied Sciences and Environmental Management ... policies on land degradation in Nigeria using soil, vegetation and sustainability as variables for the assessment. ... animals per kilometer square of land and 15,000 persons and 12,500 grazing animals per kilometer square of water. ... OTHER RESOURCES.

  19. Comparative Study on Rural Electrification Policies in Emerging Economies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    Brazil, China, India and South Africa have each worked to improve access to electricity services. While many of the challenges faced by these countries are similar, the means of addressing them varied in their application and effectiveness. This report analyses the four country profiles, determining the pre-requisites to successful rural electrification policies.

  20. Financial Policies and the Prevention of Financial Crises in Emerging Market Countries

    OpenAIRE

    Frederic S. Mishkin

    2001-01-01

    This paper outlines a set of financial policies that can help make financial crises less likely in emerging market countries. To justify these policies, the paper first explains what a financial crisis is, the factors that promote a financial crisis and the dynamics of a financial crisis. It then examines twelve basic areas of financial policies to prevent financial crises: 1) prudential supervision, 2) accounting and disclosure requirements, 3) legal and judicial systems, 4) market-based dis...

  1. Exchange rate policy and external debt in emerging economies: an empirical analysis

    OpenAIRE

    Cebir, Bilgen

    2012-01-01

    In this thesis, we empirically analyze the e ects of exchange rate policy on external debt accumulation in emerging market economies with a sample of 15 countries over the period 1998-2010. The exchange rate policy is captured by the de facto exchange rate classi cation of Ilzetzki, Reinhart, and Rogo (2008). This classification is based on the actual exchange rate behavior rather than the officially declared regimes. Therefore, it is expected to better reflect the exchange rate policies act...

  2. Enabling Healthcare IT Governance: Human Task Management Service for Administering Emergency Department's Resources for Efficient Patient Flow.

    Science.gov (United States)

    Rodriguez, Salvador; Aziz, Ayesha; Chatwin, Chris

    2014-01-01

    The use of Health Information Technology (HIT) to improve healthcare service delivery is constantly increasing due to research advances in medical science and information systems. Having a fully automated process solution for a Healthcare Organization (HCO) requires a combination of organizational strategies along with a selection of technologies that facilitate the goal of improving clinical outcomes. HCOs, requires dynamic management of care capability to realize the full potential of HIT. Business Process Management (BPM) is being increasingly adopted to streamline the healthcare service delivery and management processes. Emergency Departments (EDs) provide a case in point, which require multidisciplinary resources and services to deliver effective clinical outcomes. Managed care involves the coordination of a range of services in an ED. Although fully automated processes in emergency care provide a cutting edge example of service delivery, there are many situations that require human interactions with the computerized systems; e.g. Medication Approvals, care transfer, acute patient care. This requires a coordination mechanism for all the resources, computer and human, to work side by side to provide the best care. To ensure evidence-based medical practice in ED, we have designed a Human Task Management service to model the process of coordination of ED resources based on the UK's NICE Clinical guideline for managing the care of acutely ill patients. This functionality is implemented using Java Business process Management (jBPM).

  3. Healthcare Policy Statement on the Utility of Coronary Computed Tomography for Evaluation of Cardiovascular Conditions and Preventive Healthcare: From the Health Policy Working Group of the Society of Cardiovascular Computed Tomography.

    Science.gov (United States)

    Slim, Ahmad M; Jerome, Scott; Blankstein, Ron; Weigold, Wm Guy; Patel, Amit R; Kalra, Dinesh K; Miller, Ryan; Branch, Kelley; Rabbat, Mark G; Hecht, Harvey; Nicol, Edward D; Villines, Todd C; Shaw, Leslee J

    The rising cost of healthcare is prompting numerous policy and advocacy discussions regarding strategies for constraining growth and creating a more efficient and effective healthcare system. Cardiovascular imaging is central to the care of patients at risk of, and living with, heart disease. Estimates are that utilization of cardiovascular imaging exceeds 20 million studies per year. The Society of Cardiovascular CT (SCCT), alongside Rush University Medical Center, and in collaboration with government agencies, regional payers, and industry healthcare experts met in November 2016 in Chicago, IL to evaluate obstacles and hurdles facing the cardiovascular imaging community and how they can contribute to efficacy while maintaining or even improving outcomes and quality. The summit incorporated inputs from payers, providers, and patients' perspectives, providing a platform for all voices to be heard, allowing for a constructive dialogue with potential solutions moving forward. This article outlines the proceedings from the summit, with a detailed review of past hurdles, current status, and potential solutions as we move forward in an ever-changing healthcare landscape. Copyright © 2017 Society of Cardiovascular Computed Tomography. All rights reserved.

  4. Radiologic procedures, policies and protocols for pediatric emergency medicine

    International Nuclear Information System (INIS)

    Woodward, George A.

    2008-01-01

    Protocol development between radiology and pediatric emergency medicine requires a multidisciplinary approach to manage straightforward as well as complex and time-sensitive needs for emergency department patients. Imaging evaluation requires coordination of radiologic technologists, radiologists, transporters, nurses and coordinators, among others, and might require accelerated routines or occur at sub-optimal times. Standardized protocol development enables providers to design a best practice in all of these situations and should be predicated on evidence, mission, and service expectations. As in any new process, constructive feedback channels are imperative for evaluation and modification. (orig.)

  5. Economic and financial integration in emerging markets: A European policy

    Directory of Open Access Journals (Sweden)

    Theodoropoulos Theodore E.

    2005-01-01

    Full Text Available This paper extends to test if the same short-run increase in cyclical volatility arising from financial integration is observed in this specific sample of "emerging markets". This work finds signs that, contrary to other emerging markets, this does not happen: for the future member states financial integration, similarly to the outcome observed in mature market economies, reduces cyclical volatility both in the short and in the long run. Weak indications are found that this may happen partially due to the anchoring of expectations provided by the EU Accession, and to the more robust institutional framework imposed by this process onto the countries in question.

  6. Emerging Water Contaminants: Technical, Legal and Policy Challenges

    Science.gov (United States)

    Deeb, R. A.; Kresic, N.; Laugier, M. C.; Kavanaugh, M. C.

    2002-12-01

    Approximately 120 new chemicals are created each year due to ever-improving industry and technology markets. Releases of new contaminants into the environment can occur during production, use and disposal of these chemicals thereby leading to potential contamination of water supply sources. Very few emerging contaminants are regulated. In addition, knowledge gaps regarding emerging contaminants include lack health effects, occurrence (either because these compounds are not measured or because concentrations are below detection limits of readily available analytical techniques) and fate and transport in the environment especially with regards to mobility and persistence. The sources of these compounds are numerous. One source is treated wastewater, which is re-injected into groundwater aquifers for indirect potable reuse purposes. Emerging compounds of concern can be classified in various classes. This presentation will focus on contaminants, which have emerged in the last 10 years including pharmaceuticals (antibiotics/drugs), personal care products (polycyclic musks), pesticides/herbicides, industrial solvents (1,4-dioxane), gasoline additives (MTBE), disinfection byproducts such as NDMA (N-nitrosodimethylamine), and inorganic compounds such as perchlorate and arsenic. This presentation will present technical, legal and legislative challenges posed by the presence of these contaminants in water. Background information including chemical's history of use, sources in the environments, nationwide occurrence, physical and chemical properties, behavior in the environment and technologies for removal from soil and water will be presented. In addition, case studies on MTBE, pharmaceuticals and personal care products, 1,4-dioxane, arsenic and NDMA will be discussed.

  7. emergency psychiatry and mental health policy: an international ...

    African Journals Online (AJOL)

    psychiatric care such as clinical implications, care in large cities, the rights of the patients and deinstitutionalisation. Further chapters examine care on different continents. Emergency psychiatric services in the United States, Canada, the Netherlands, France, Italy, Denmark, Belgium, Germany,. Spain, Greece and South ...

  8. Healthcare technology innovation adoption electronic health records and other emerging health information technology innovations

    CERN Document Server

    Daim, Tugrul U; Basoglu, Nuri; Kök, Orhun M; Hogaboam, Liliya

    2016-01-01

    This book aims to study the factors affecting the adoption and diffusion of Health Information Technology (HIT) innovation. It analyzes the adoption processes of various tools and applications, particularly Electronic Health Records (EHR), highlighting the impact on various sectors of the healthcare system, such as physicians, administration,  and patient care, while also identifying the various pitfalls and gaps in the literature. With the various challenges currently facing the United States healthcare system, the study, adoption and diffusion of healthcare technology innovation, particularly HIT, is imperative to achieving national goals. This book is organized into three sections. Section one reviews theories and applications for the diffusion of Health Care Technologies. Section two evaluates EHR technology, including the barriers and enables in adoption and alternative technologies. Finally, section three examines the factors impacting the adoption of EHR systems. This book will be a key source for stu...

  9. Housing sector in emerging countries and international climate policy

    International Nuclear Information System (INIS)

    Barbier, C.

    2006-01-01

    After a first part on the relationship between housing and greenhouse effect in developing countries (assessment of the share of the housing-tertiary sector in CO 2 emissions in the world, housing stock growth and livelihood improvement, trend towards a sustainable city), this report proposes an overview of the Chinese situation in terms of greenhouse gas emissions, energy consumption in the housing sector, fossil energy production, energy prices, urban demographic dynamics and its impact on the housing stock. It describes the Chinese institutional frame (housing policy reform, energy mastering policy, actors of the housing sector), discusses some perspective aspects of housing energy consumption and CO 2 emissions: energy consumption by 2020, regional approach, usages of electricity, evolution of the housing stock by 2020, potential gains in CO 2 emissions, methodological framework for the assessment of the evolution of housing energy consumptions, simulation tool

  10. Policy statement--emergency information forms and emergency preparedness for children with special health care needs.

    Science.gov (United States)

    2010-04-01

    Children with chronic medical conditions rely on complex management plans for problems that cause them to be at increased risk for suboptimal outcomes in emergency situations. The emergency information form (EIF) is a medical summary that describes medical condition(s), medications, and special health care needs to inform health care providers of a child's special health conditions and needs so that optimal emergency medical care can be provided. This statement describes updates to EIFs, including computerization of the EIF, expanding the potential benefits of the EIF, quality-improvement programs using the EIF, the EIF as a central repository, and facilitating emergency preparedness in disaster management and drills by using the EIF.

  11. Prevention policies addressing packaging and packaging waste: Some emerging trends.

    Science.gov (United States)

    Tencati, Antonio; Pogutz, Stefano; Moda, Beatrice; Brambilla, Matteo; Cacia, Claudia

    2016-10-01

    Packaging waste is a major issue in several countries. Representing in industrialized countries around 30-35% of municipal solid waste yearly generated, this waste stream has steadily grown over the years even if, especially in Europe, specific recycling and recovery targets have been fixed. Therefore, an increasing attention starts to be devoted to prevention measures and interventions. Filling a gap in the current literature, this explorative paper is a first attempt to map the increasingly important phenomenon of prevention policies in the packaging sector. Through a theoretical sampling, 11 countries/states (7 in and 4 outside Europe) have been selected and analyzed by gathering and studying primary and secondary data. Results show evidence of three specific trends in packaging waste prevention policies: fostering the adoption of measures directed at improving packaging design and production through an extensive use of the life cycle assessment; raising the awareness of final consumers by increasing the accountability of firms; promoting collaborative efforts along the packaging supply chains. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Oil and Gas Emergency Policy: Chile 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-06

    Chile has experienced several serious energy supply incidents over the last decade, including major droughts, a sustained gas supply cut from Argentina (since 2004), and a major earthquake in early 2010 which affected electricity networks and refineries, and caused several black-outs. Due to Chile's unique and sinuous geography - it runs 4 300 kilometres from North to South and only 175 kms from East to West- the country's energy markets are regionally disjointed, particularly as the regional gas and electricity grids are not connected. In the arid North, energy demand is dominated by the mining industry, and operates based on a separate thermal-based Sistema Interconectado Norte Grande (SING) electricity grid. The more densely-populated central region (including Santiago) operates on the more hydro-dependent Sistema Interconectado Central (SIC) electricity grid. The southernmost, hydro-rich regions of the country are not connected to the rest of Chile in terms of electricity and gas. The following report is based on an IEA Emergency Response Assessment carried out in 2010 and 2011 which looked specifically at Chile's capacity to respond to short-term emergencies in oil, gas and electricity.

  13. Oil and Gas Emergency Policy: Chile 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-06

    Chile has experienced several serious energy supply incidents over the last decade, including major droughts, a sustained gas supply cut from Argentina (since 2004), and a major earthquake in early 2010 which affected electricity networks and refineries, and caused several black-outs. Due to Chile's unique and sinuous geography - it runs 4 300 kilometres from North to South and only 175 kms from East to West- the country's energy markets are regionally disjointed, particularly as the regional gas and electricity grids are not connected. In the arid North, energy demand is dominated by the mining industry, and operates based on a separate thermal-based Sistema Interconectado Norte Grande (SING) electricity grid. The more densely-populated central region (including Santiago) operates on the more hydro-dependent Sistema Interconectado Central (SIC) electricity grid. The southernmost, hydro-rich regions of the country are not connected to the rest of Chile in terms of electricity and gas. The following report is based on an IEA Emergency Response Assessment carried out in 2010 and 2011 which looked specifically at Chile's capacity to respond to short-term emergencies in oil, gas and electricity.

  14. Emergence of a new consumer health informatics framework: introducing the healthcare organization.

    Science.gov (United States)

    Reid, Paulette; Borycki, Elizabeth M

    2011-01-01

    Healthcare consumers are increasingly seeking reliable forms of health information on the Internet that can be used to support health related decision-making. Frameworks that have been developed and tested in the field of health informatics have attempted to describe the effects of the Internet upon the health care consumer and physician relationship. More recently, health care organizations are responding by providing information such as hospital wait lists or strategies for self-managing disease, and this information is being provided on organizational web-sites. The authors of this paper propose that current conceptualizations of the relationship between the Internet, physicians and patients are limited from a consumer informatics perspective and may need to be extended to include healthcare organizations.

  15. Simulation of operational processes in hospital emergency units as lean healthcare tool

    OpenAIRE

    Gomes, Andreia Macedo; Vieira, Pedro Senna; Reis, Augusto da Cunha

    2017-01-01

    Recently, the Lean philosophy is gaining importance due to a competitive environment, which increases the need to reduce costs. Lean practices and tools have been applied to manufacturing, services, supply chain, startups and, the next frontier is healthcare. Most lean techniques can be easily adapted to health organizations. Therefore, this paper intends to summarize Lean practices and tools that are already being applied in health organizations. Among the numerous techniques and lean tools ...

  16. How social policies can improve financial accessibility of healthcare: a multi-level analysis of unmet medical need in European countries.

    Science.gov (United States)

    Israel, Sabine

    2016-03-05

    The article explores in how far financial accessibility of healthcare (FAH) is restricted for low-income groups and identifies social protection policies that can supplement health policies in guaranteeing universal access to healthcare. The article is aimed to advance the literature on comparative European social epidemiology by focussing on income-related barriers of healthcare take-up. The research is carried out on the basis of multi-level cross-sectional analyses using 2012 EU-SILC data for 30 European countries. The social policy data stems from EU-SILC beneficiary information. It is argued that unmet medical needs are a reality for many individuals within Europe - not only due to direct user fees but also due to indirect costs such as waiting time, travel costs, time not spent working. Moreover, low FAH affects not only the lowest income quintile but also the lower middle income class. The study observes that social allowance increases the purchasing power of both household types, thereby helping them to overcome financial barriers to healthcare uptake. Alongside healthcare system reform aimed at improving the pro-poor availability of healthcare facilities and financing, policies directed at improving FAH should aim at providing a minimum income base to the low-income quintile. Moreover, categorical policies should address households exposed to debt which form the key vulnerable group within the low-income classes.

  17. Market policy as an innovative element of marketing in the Romanian healthcare services – an approach focused on the patient

    Science.gov (United States)

    Coculescu, BI; Coculescu, EC; Radu, A; Petrescu, L; Purcărea, VL

    2015-01-01

    The orientation towards one of the marketing policies with a major impact in organizations providing healthcare services, requires a careful analysis of the needs and aspirations of customers, targeting those patients whose needs the service organization can achieve through the existing resources at the respective health facility, finding the most effective way of achieving benefits associated with reduced costs to maximizing profits, placing the offers for medical services required by the patients on the market, as well as promptly reacting and acting to the changes of health services market which is constantly evolving through a flexible organizing and functioning structure, connected to the financial needs of the patients. PMID:26664466

  18. Market policy as an innovative element of marketing in the Romanian healthcare services - an approach focused on the patient.

    Science.gov (United States)

    Coculescu, B I; Coculescu, E C; Radu, A; Petrescu, L; Purcărea, V L

    2015-01-01

    The orientation towards one of the marketing policies with a major impact in organizations providing healthcare services, requires a careful analysis of the needs and aspirations of customers, targeting those patients whose needs the service organization can achieve through the existing resources at the respective health facility, finding the most effective way of achieving benefits associated with reduced costs to maximizing profits, placing the offers for medical services required by the patients on the market, as well as promptly reacting and acting to the changes of health services market which is constantly evolving through a flexible organizing and functioning structure, connected to the financial needs of the patients.

  19. Operationalising emergency care delivery in sub-Saharan Africa: consensus-based recommendations for healthcare facilities.

    Science.gov (United States)

    Calvello, Emilie J B; Tenner, Andrea G; Broccoli, Morgan C; Skog, Alexander P; Muck, Andrew E; Tupesis, Janis P; Brysiewicz, Petra; Teklu, Sisay; Wallis, Lee; Reynolds, Teri

    2016-08-01

    A major barrier to successful integration of acute care into health systems is the lack of consensus on the essential components of emergency care within resource-limited environments. The 2013 African Federation of Emergency Medicine Consensus Conference was convened to address the growing need for practical solutions to further implementation of emergency care in sub-Saharan Africa. Over 40 participants from 15 countries participated in the working group that focused on emergency care delivery at health facilities. Using the well-established approach developed in the WHO's Monitoring Emergency Obstetric Care, the workgroup identified the essential services delivered-signal functions-associated with each emergency care sentinel condition. Levels of emergency care were assigned based on the expected capacity of the facility to perform signal functions, and the necessary human, equipment and infrastructure resources identified. These consensus-based recommendations provide the foundation for objective facility capacity assessment in developing emergency health systems that can bolster strategic planning as well as facilitate monitoring and evaluation of service delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Private Sector in Indian Healthcare Delivery: Consumer Perspective and Government Policies to promote private Sector

    OpenAIRE

    Utkarsh Shah, Ragini Mohanty

    2011-01-01

    This research paper attempts to collate literature from various sources, in an attempt to answer three pertinent questions related to healthcare in India. Firstly, what is it meant by ‘private sector’ in healthcare delivery system of India, secondly how has the private sector evolved over the decades and what has been the role of the government in propelling the growth. Finally, the paper tries to highlight some of the factors that have promoted the growth of private sector in India with spec...

  1. Reliable in their failure: an analysis of healthcare reform policies in public systems.

    Science.gov (United States)

    Contandriopoulos, Damien; Brousselle, Astrid

    2010-05-01

    In this paper, we analyze recommendations of past governmental commissions and their implementation in Quebec as a case to discuss the obstacles that litter the road to healthcare system reform. Our analysis shows that the obstacles to tackling the healthcare system's main problems may have less to do with programmatic (what to do) than with political and governance (how to do it) questions. We then draw on neo-institutional theory to discuss the causes and effects of this situation. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  2. The public’s voice about healthcare quality regulation policies: a population-based survey.

    NARCIS (Netherlands)

    Bouwman, R.; Bomhoff, M.; Jong, J.D. de; Robben, P.; Friele, R.

    2015-01-01

    Background: In the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their ‘soft’ approach. In politics, concerns were expressed about public confidence. It was claimed that there are discrepancies between public opinions

  3. Healthcare staff attitudes towards the use of electronic cigarettes ('e-cigarettes') compared with a local trust policy.

    Science.gov (United States)

    Pippard, Benjamin J; Shipley, Mark D

    2017-07-01

    E-cigarette use has risen dramatically in recent years, despite uncertainty over long-term health effects and concerns regarding efficacy as a smoking cessation device. Currently, there is no legislation prohibiting use in public, though many trusts have extended the NHS Smokefree policy to include e-cigarettes. The successful implementation of such policy is, however, unclear. This study examined staff attitudes towards the use of e-cigarettes in a hospital environment with respect to enforcement of a local trust smoking policy. A total of 79 healthcare professionals working at South Tyneside District Hospital, South Shields, completed a written questionnaire regarding use of e-cigarettes, particularly views on use in public and on hospital premises. Factors influencing the likelihood of individuals to challenge the use of e-cigarettes were assessed. In all, 45% of respondents thought that e-cigarettes should be allowed in public places, though a majority (62%) favoured use on hospital grounds compared to within hospital buildings (18%). Over 50% of respondents were unaware of trust policy relating to e-cigarettes and only 25% had ever challenged someone using a device. Roughly, one-third reported that they would still not challenge someone in future, despite being informed of trust policy. Fear of abuse was the most cited reason for not challenging. Expressed concerns of e-cigarette use related to fire risk, 'normalising' smoking behaviour and uncertainty of long-term effects. Most staff do not enforce trust policy regarding e-cigarette use. This reflects variation in opinion over use, poor awareness of the policy itself and perceived barriers to implementation, including fear of abuse. Addressing these issues through staff education sessions may help successful future implementation.

  4. Oil and Gas Emergency Policy: India 2007 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    With almost 1.1 billion inhabitants, India is the second most populous country in the world and the seventh-largest country by geographical area. In 2005, India’s GDP was about USD 644 billion. In terms of purchasing power parity (PPP)21, GDP stood at USD 3 362 which makes it the fourth-largest economy in the world (after the United States, China and Japan). Per capita income in PPP terms is around USD 3 582, about one-tenth of the OECD average. GDP growth in 2005 was 9.2%. India has about 5.6 billion barrels of proven oil reserves (January 2007). The combination of rising oil consumption and fairly stable production levels leaves India increasingly dependent on imports to meet consumption needs; most of these imports are coming from the Middle East. In 2006, the country produced an average of 792 kb/d of total oil liquids, of which 87% (687 kb/d) was crude oil. During 2006, India’s demand for oil reached 2.64 mb/d. In 2004, India decided to build a strategic petroleum reserve (SPR) in a phased manner. The work on the first phase started in 2007, with invitations for tender for the construction of rock caverns with a capacity of some 37 mb (5 Mt), which equates to 20 days of net imports or 15 days of consumption in 2005. The work is planned to be fi nished in 2010, after which the rock caverns will begin to be filled. A second phase is projected (but not yet scheduled), which would expand the storage capacity to 45 days of consumption (roughly 110 mb or 15 Mt). The Integrated Energy Policy of 2006 states that the effectiveness of the reserves can be increased through co-operative operation with the reserves of other countries, such as IEA member countries.

  5. Influenza vaccination for healthcare workers in the UK: appraisal of systematic reviews and policy options

    Science.gov (United States)

    Kliner, Merav; Keenan, Alex; Sinclair, David; Ghebrehewet, Sam; Garner, Paul

    2016-01-01

    Background The UK Department of Health recommends annual influenza vaccination for healthcare workers, but uptake remains low. For staff, there is uncertainty about the rationale for vaccination and evidence underpinning the recommendation. Objectives To clarify the rationale, and evidence base, for influenza vaccination of healthcare workers from the occupational health, employer and patient safety perspectives. Design Systematic appraisal of published systematic reviews. Results The quality of the 11 included reviews was variable; some included exactly the same trials but made conflicting recommendations. 3 reviews assessed vaccine effects in healthcare workers and found 1 trial reporting a vaccine efficacy (VE) of 88%. 6 reviews assessed vaccine effects in healthy adults, and VE was consistent with a median of 62% (95% CI 56 to 67). 2 reviews assessed effects on working days lost in healthcare workers (3 trials), and 3 reported effects in healthy adults (4 trials). The meta-analyses presented by the most recent reviews do not reach standard levels of statistical significance, but may be misleading as individual trials suggest benefit with wide variation in size of effect. The 2013 Cochrane review reported absolute effects close to 0 for laboratory-confirmed influenza, and hospitalisation for patients, but excluded data on clinically suspected influenza and all-cause mortality, which had shown potentially important effects in previous editions. A more recent systematic review reports these effects as a 42% reduction in clinically suspected influenza (95% CI 27 to 54) and a 29% reduction in all-cause mortality (95% CI 15 to 41). Conclusions The evidence for employer and patient safety benefits of influenza vaccination is not straightforward and has been interpreted differently by different systematic review authors. Future uptake of influenza vaccination among healthcare workers may benefit from a fully transparent guideline process by a panel representing all

  6. Visitor restriction policies and practices in children's hospitals in North America: results of an Emerging Infections Network Survey.

    Science.gov (United States)

    Pong, Alice L; Beekmann, Susan E; Faltamo, Mekleet M; Polgreen, Philip M; Shane, Andi L

    2018-06-21

    To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities. An electronic survey to characterize VRPP in pediatric healthcare facilities. The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious disease consultants via an electronic link. Descriptive analyses were performed. A total of 170 eligible respondents completed a survey between 12 July and August 15, 2016, for a 51% response rate. Of the 104 respondents (61%) familiar with their VRPP, 92 (88%) had VRPP in all inpatient units. The respondents reported age-based VRPP (74%) symptom-based VRPP (97%), and outbreak-specific VRPP (75%). Symptom-based VRPP were reported to be seasonal by 24% of respondents and to be implemented year-round according to 70% of respondents. According to the respondents, communication of VRPP to families occurred at admission (87%) and through signage in care areas (64%), while communication of VRPP to staff occurred by email (77%), by meetings (55%), and by signage in staff-only areas (49%). Respondents reported that enforcement of VRPP was the responsibility of nursing (80%), registration clerks (58%), unit clerks (53%), the infection prevention team (31%), or clinicians 16 (16%). They also reported that the effectiveness of VRPP was assessed through active surveillance of hospital acquired respiratory infections (62%), through active surveillance of healthcare worker exposures (28%) and through patient/family satisfaction assessments (29%). Visitor restriction policies and practices vary in scope, implementation, enforcement, and physician awareness in pediatric facilities. A prospective multisite evaluation of outcomes would facilitate the adoption of uniform guidance.

  7. Oil and Gas Emergency Policy: Germany 2012 update

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    Germany has very little domestic oil and natural gas production and relies heavily on imports. It has well diversified and flexible oil and natural gas supply infrastructure, which consists of crude, product and gas pipelines and crude and oil product import terminals. Natural gas is imported into Germany exclusively by cross-border pipeline. The country has no LNG infrastructure, although some German companies have booked capacities in overseas LNG terminals. Oil continues to be the main source of energy in Germany although it has declined markedly since the early 1970s. It now represents approximately 32% of Germany’s total primary energy supply (TPES). Natural gas consumption in Germany has declined 10% since 2006. Demand was 90 bcm in 2010, down from 100 bcm in 2005. According to government commissioned analysis, the total consumption of natural gas in Germany is expected to continue to decline over the long term. The share of natural gas in Germany’s TPES is currently around 22%. German oil stock levels are generally well above the required 90-days. Total oil stock levels in Germany were equivalent to 140 days net imports in April 2012. Since 1998, the German oil stockholding agency (EBV) has been solely responsible for meeting Germany's 90-day stockholding obligation. The Oil Stockholding Act stipulates that the EBV shall constantly maintain stocks of oil and petroleum products at a level equivalent to or above 90 days of net imports. There is no minimum stockholding obligation on industry, so industry held commercial stocks are held in addition to the EBV stocks. There are several legal tools available to German authorities for natural gas emergency response. These include Ordinances that can be used to restrict the sale, purchase or use of goods, both in terms of quantity and time, or permit them only for certain priority purposes, to ensure that vital energy needs are met. There are no compulsory natural gas storage requirements in Germany, and no

  8. Debates of the Vista 2009 Colloquium 'A European emergency: energy policy'

    International Nuclear Information System (INIS)

    Fabius, Laurent; Ladoucette, Philippe de; Lederer, Pierre; Percebois, Jacques; Ristori, Dominique; ); ROSIER, Philippe; Tran Thiet, Jean-Paul; Chalmin, Philippe

    2009-05-01

    After an introduction speech by the chairman of Vista-Think tank energies, a first debate examined whether energy needs Europe. The interveners discussed the existence of other instruments than competition, the openness to all the market actors, the relationship between the regulatory policy and the possibility of development at a European level. The second debate examined whether Europe needs energy. The interveners describe the development of a European energy sector in a context without any actual European energy policy, how such a policy can emerge, how the various challenges and objectives are addressed

  9. Survey of patient and public perceptions of electronic health records for healthcare, policy and research: Study protocol

    Directory of Open Access Journals (Sweden)

    Luchenski Serena

    2012-05-01

    Full Text Available Abstract Background Immediate access to patients’ complete health records via electronic databases could improve healthcare and facilitate health research. However, the possible benefits of a national electronic health records (EHR system must be balanced against public concerns about data security and personal privacy. Successful development of EHR requires better understanding of the views of the public and those most affected by EHR: users of the National Health Service. This study aims to explore the correlation between personal healthcare experience (including number of healthcare contacts and number and type of longer term conditions and views relating to development of EHR for healthcare, health services planning and policy and health research. Methods/design A multi-site cross-sectional self-complete questionnaire designed and piloted for use in waiting rooms was administered to patients from randomly selected outpatients’ clinics at a university teaching hospital (431 beds and general practice surgeries from the four primary care trusts within the catchment area of the hospital. All patients entering the selected outpatients clinics and general practice surgeries were invited to take part in the survey during August-September 2011. Statistical analyses will be conducted using descriptive techniques to present respondents’ overall views about electronic health records and logistic regression to explore associations between these views and participants’ personal circumstances, experiences, sociodemographics and more specific views about electronic health records. Discussion The study design and implementation were successful, resulting in unusually high response rates and overall recruitment (85.5%, 5336 responses. Rates for face-to-face recruitment in previous work are variable, but typically lower (mean 76.7%, SD 20. We discuss details of how we collected the data to provide insight into how we obtained this unusually high

  10. Turning a Blind Eye: Public Support of Emergency Housing Policies for Sex Offenders.

    Science.gov (United States)

    Socia, Kelly M; Dum, Christopher P; Rydberg, Jason

    2017-07-01

    In this study, we examine the influences of citizen decision making in the context of four policy scenarios that would affect the living conditions of sex offenders (SOs) residing at an "emergency shelter" budget motel. We surveyed 773 citizens in an online survey about their support for four policy scenarios that would improve the living conditions of SOs: (a) at no cost to the respondent, (b) in exchange for a US$100 tax increase, and (c) by relocating SOs within the respondent's neighborhood (i.e., "in my backyard"/IMBY scenario). The fourth scenario involved moving nearby SOs into substandard housing located far away from the respondent (i.e., "not in my backyard"/NIMBY). While prior research finds that the public overwhelmingly supports punitive SO policies, we find that indifference is a mainstay of public opinion about improving SO housing conditions. That is, we find only modest levels of average support for any of the policy scenarios, and policy support decreased when increased taxes would be involved, compared with a "no cost" scenario. While no respondent characteristics significantly predicted policy support consistently across all four scenarios, some scenarios showed stark differences in support when considering specific respondent characteristics. Overall, these results suggest that what does affect support depends on the details of the policy being proposed, as well as who is considering the policy. We end by discussing the policy implications of our study for both policymakers and the public.

  11. The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review.

    Science.gov (United States)

    Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Lane, Haylee; Haines, Terry P

    2017-11-14

    It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors. An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data. After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1

  12. Influenza vaccination for healthcare workers in the UK: appraisal of systematic reviews and policy options.

    Science.gov (United States)

    Kliner, Merav; Keenan, Alex; Sinclair, David; Ghebrehewet, Sam; Garner, Paul

    2016-09-13

    The UK Department of Health recommends annual influenza vaccination for healthcare workers, but uptake remains low. For staff, there is uncertainty about the rationale for vaccination and evidence underpinning the recommendation. To clarify the rationale, and evidence base, for influenza vaccination of healthcare workers from the occupational health, employer and patient safety perspectives. Systematic appraisal of published systematic reviews. The quality of the 11 included reviews was variable; some included exactly the same trials but made conflicting recommendations. 3 reviews assessed vaccine effects in healthcare workers and found 1 trial reporting a vaccine efficacy (VE) of 88%. 6 reviews assessed vaccine effects in healthy adults, and VE was consistent with a median of 62% (95% CI 56 to 67). 2 reviews assessed effects on working days lost in healthcare workers (3 trials), and 3 reported effects in healthy adults (4 trials). The meta-analyses presented by the most recent reviews do not reach standard levels of statistical significance, but may be misleading as individual trials suggest benefit with wide variation in size of effect. The 2013 Cochrane review reported absolute effects close to 0 for laboratory-confirmed influenza, and hospitalisation for patients, but excluded data on clinically suspected influenza and all-cause mortality, which had shown potentially important effects in previous editions. A more recent systematic review reports these effects as a 42% reduction in clinically suspected influenza (95% CI 27 to 54) and a 29% reduction in all-cause mortality (95% CI 15 to 41). The evidence for employer and patient safety benefits of influenza vaccination is not straightforward and has been interpreted differently by different systematic review authors. Future uptake of influenza vaccination among healthcare workers may benefit from a fully transparent guideline process by a panel representing all relevant stakeholders, which clearly communicates

  13. Public-Private Collaboration in the Emergence of a National Electronic Identification Policy

    DEFF Research Database (Denmark)

    Medaglia, Rony; Hedman, Jonas; Eaton, Ben

    2017-01-01

    Governments envisioning large-scale national egovernment policies increasingly draw on collaboration with private actors, yet the relationship between dynamics and outcomes of public-private partnership (PPP) is still unclear. The involvement of the banking sector in the emergence of a national...... of governance models between government and the banking sector shaped the emergence of the Danish national e-ID. We propose a process model to conceptualize paths towards the emergence of public-private collaboration for digital information infrastructure – a common good....

  14. Developing Training Programs to Save Lives: Serving Students with Complex or Emergency Healthcare Needs

    Science.gov (United States)

    Urso, Annmarie; Rozalski, Michael

    2014-01-01

    The number of students with special health care needs (SHCN; McPherson, Arango & Fox, 1998) and the frequency of life-threatening health emergencies in schools (e.g., asthma, diabetes, severe allergic reactions, cardiac arrest, seizure disorders), continues to increase. It has become increasingly important for teachers to be trained in…

  15. Port economics, policy and management : review of an emerging research field

    NARCIS (Netherlands)

    Pallis, A.A.; Vitsounis, T.K.; Langen, de P.W.

    2010-01-01

    This paper reviews research in port economics, policy and management during the period 1997-2008. In an increasingly international economy, research interest in ports is gradually emerging. This paper examines the developments, themes and characteristics of this research, by reviewing a

  16. Emerging trends in diabetes care practice and policy in The Netherlands: a key informants study

    NARCIS (Netherlands)

    Wensing, M.; Koetsenruijter, J.; Rogers, A.; Portillo, M.C.; Lieshout, J. van

    2014-01-01

    BACKGROUND: Effective self-management is viewed as the cornerstone of diabetes care. Many interventions and policies are available to support self-management, but challenges remain regarding reaching specific subgroups and effectively changing lifestyles. Here, our aim was to identify emerging

  17. EmERGE project: Evaluating mHealth technology in HIV to improve Empowerment and healthcare utilisation

    Energy Technology Data Exchange (ETDEWEB)

    Chausa, P.; Gomez, A.J.; Apers, L.; Henwood, F.; Mandalia, S.; Wallitt, E.; Leon, A.; Begovac, J.; Borges, M.; Brown, A.; Block, K.; Glaysher, B.; Whetham, J.

    2016-07-01

    The EmERGE project (http://www.emergeproject.eu/) will develop a mHealth platform to enable self-management of HIV in patients with stable disease. The platform will build upon and integrate the existing mHealth solutions operated by pioneering healthcare providers in the UK and Spain and apply a rigorous co-design approach to ensure patient and clinician input to the solution. The platform will provide users with web based (clinicians) and mobile device applications (patients) which interface securely with relevant medical data and facilitate remote access to key healthcare providers. EATG, the leading European HIV patient organisation, will provide a direct and deep interaction with representative patients and clinicians from 5 EU countries. The platform and interfaces will be validated in a large study of 3900 patients using a tailored Health Technology Assessment process: the Model for Assessment of Telemedicine applications, specifically developed for the assessment of mHealth solutions including translatability as a key factor. (Author)

  18. Diffusion and use of health technology assessment in policy making: what lessons for decentralised healthcare systems?

    Science.gov (United States)

    Ciani, Oriana; Tarricone, Rosanna; Torbica, Aleksandra

    2012-12-01

    The Italian National Healthcare System (NHS) is one of the most decentralised systems since the devolution reform approved in 2001. HTA is spreading as an important tool for decision-making processes both at central and local levels. The aims of this study were to review the state of the health technology assessment (HTA) programmes in Italy - with a focus on regional and central initiatives - and to discuss consequences of a multi-level structure of HTA agencies in highly regionalised healthcare systems. Our method combined documentary review with interviews. We reviewed scientific literature about HTA's activities in decentralised systems, legislative and administrative documents from national as well as regional authorities. Semi-structured interviews were conducted with 18 key individuals associated with HTA both at the national and regional levels. Data on HTA programmes implemented or under development in nine regions were collected and analysed according to key principles for the improved conduct of health technology assessments for resource allocation decisions. HTA is in the early stage of development in Italy, although with great heterogeneity across regions. The National Agency for Health Services has certainly contributed to HTA diffusion through supporting and training activities. However, the multi-level structure of HTA in Italy has not yet provided full coordination and harmonisation of practices and outcomes across the country, with a consequent exacerbate inequality of access to services and technologies. There is probably need to rethink the multi-layer organizational framework of HTA in Italy by leveraging on current knowledge and efficient redistribution of activities across regions. We would advise for different jurisdictions playing different roles while achieving similar health outcomes for their patients, rather than jurisdictions aiming at doing exactly the same things resulting in unequal access to healthcare service provision. Copyright

  19. The global and domestic politics of health policy in emerging nations.

    Science.gov (United States)

    Gómez, Eduardo J; Ruger, Jennifer Prah

    2015-02-01

    In recent years, several emerging nations with burgeoning economies and in transition to democracy have pursued health policy innovations. As these nations have integrated into the world economy through bilateral trade and diplomacy, they have also become increasingly exposed to international pressures and norms and focused on more effective, equitable health care systems. There are several lessons learned from the case studies of Brazil, Ghana, India, China, Vietnam, and Thailand in this special issue on the global and domestic politics of health policy in emerging nations. For the countries examined, although sensitive to international preferences, domestic governments preferred to implement policy on their own and at their own pace. During the policy-making and implementation process, international and domestic actors played different roles in health policy making vis-à-vis other reform actors -- at times the state played an intermediary role. In several countries, civil society also played a central role in designing and implementing policy at all levels of government. International institutions also have a number of mechanisms and strategies in their tool box to influence a country's domestic health governance, and they use them, particularly in the context of an uncertain state or internal discordance within the state. Copyright © 2015 by Duke University Press.

  20. The Growth Challenge of Western SMES in Emerging Markets: An Exploratory Framework and Policy Implications

    Directory of Open Access Journals (Sweden)

    Mitja Ruzzier

    2017-09-01

    Full Text Available In this paper, we explore the main inhibiting factors associated with the process of entry and escalation of SMES in international markets, with a focus on Emerging Markets. We identify and propose seven main categories of Institutional Voids and three main types of resources that may critically determine SMES’ performances on EMS, namely, internationalization knowledge, social capital resources and marketing capabilities. Institutional Voids and resources are brought together within a conceptual framework suggesting that resource-scarce SMES will hold back in their attempts to commit further to Emerging Markets and will be further dissuaded the higher the Institutional Voids in the market. The paper contributes to the policy literature on SME internationalization by focusing on two areas of public policy action that could have a clear and manifest impact on SMES conduct in Emerging Markets, the first related to the resources available to and exploitable by SMES and the latter associated with Institutional Voids.

  1. Aligning emergency care with the triple aim: Opportunities and future directions after healthcare reform.

    Science.gov (United States)

    Agrawal, Shantanu; Conway, Patrick H

    2014-09-01

    The Triple Aim of better health, better care, and lower costs has become a fundamental framework for understanding the need for broad health care reform and describing health care value. While the framework is not specific to any clinical setting, this article focuses on the alignment between the framework and Emergency Department (ED) care. The paper explores where emergency care is naturally aligned with each Aim, as well as current barriers which must be addressed to meet the full vision of the Triple Aim. We propose a vision of EDs serving as a nexus for care coordination optimally consistent with the Triple Aim and the requirements for such a role. These requirements include: (1) substantial integration in coordinated care models; (2) development of reliable and actionable data on ED quality, population health, and cost outcomes; (3) specific initiatives to control and optimize ED utilization; and (4) payment models which preserve surge and disaster response capacity. Published by Elsevier Inc.

  2. The Enemy Within: The Emerging Threats to Healthcare from Malicious Mobile Devices

    OpenAIRE

    Zawoad, Shams; Hasan, Ragib

    2012-01-01

    With the proliferation of wireless networks, mobile devices and medical devices are increasingly being equipped with wireless interfaces, such as Bluetooth and WiFi to allow easy access to and control of the medical devices. Unfortunately, the very presence and usage of such interfaces also expose the medical devices to novel attacks from malicious parties. The emerging threat from malicious mobile devices is significant and severe, since attackers can steal confidential data from a patient's...

  3. [Medical short stay unit for geriatric patients in the emergency department: clinical and healthcare benefits].

    Science.gov (United States)

    Pareja, Teresa; Hornillos, Mercedes; Rodríguez, Miriam; Martínez, Javier; Madrigal, María; Mauleón, Coro; Alvarez, Bárbara

    2009-01-01

    To evaluate the impact of comprehensive geriatric assessment and management of high-risk elders in a medical short stay unit located in the emergency department of a general hospital. We performed a descriptive, prospective study of patients admitted to the medical short stay unit for geriatric patients of the emergency department in 2006. A total of 749 patients were evaluated, with a mean (standard deviation) stay in the unit of 37 (16) h. The mean age was 86 (7) years; 57% were women, and 50% had moderate-severe physical impairment and dementia. Thirty-five percent lived in a nursing home. The most frequent reason for admission was exacerbation of chronic cardiopulmonary disease. Multiple geriatric syndromes were identified. The most frequent were immobility, pressure sores and behavioral disorders related to dementia. Seventy percent of the patients were discharged to home after being stabilized and were followed-up by the geriatric clinic and day hospital (39%), the home care medical team (11%), or the nursing home or primary care physician (20%). During the month after discharge, 17% were readmitted and 7.7% died, especially patients with more advanced age or functional impairment. After the unit was opened, admissions to the acute geriatric unit fell by 18.2%. Medical short stay units for geriatric patients in emergency departments may be useful for geriatric assessment and treatment of exacerbations of chronic diseases. These units can help to reduce the number of admissions and optimize the care provided in other ambulatory and domiciliary geriatric settings.

  4. Electronic healthcare information security

    CERN Document Server

    Dube, Kudakwashe; Shoniregun, Charles A

    2010-01-01

    The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

  5. [Austerity policies and changes in healthcare use patterns. SESPAS report 2014].

    Science.gov (United States)

    Urbanos Garrido, Rosa; Puig-Junoy, Jaume

    2014-06-01

    This article analyzes the main changes in healthcare use patterns in Spain related to the economic recession and to the measures taken to address it. The impact of the reform of drug copayment is examined; the number of prescriptions has decreased, although the effects of this reform on adherence, access to necessary and effective treatments, and health, are still unknown. This article also describes how waiting times and waiting lists for surgery have increased in recent years, as has the population's dissatisfaction with the national health system. Analysis of microdata from the Spanish national health surveys for 2006 and 2011/12 show that the economic recession is deterring the use of uncovered dental visits among the lowest social class. We recommend clearer definition of the role played by copayments within the national health system, and focussing on those who most need healthcare in order to prevent the more socioeconomically advantaged collectives from consuming a larger share of available services after the cuts. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. Designing evaluation studies to optimally inform policy: what factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?

    Science.gov (United States)

    Wu, Shishi; Legido-Quigley, Helena; Spencer, Julia; Coker, Richard James; Khan, Mishal Sameer

    2018-02-23

    In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. Our qualitative study indicates that training programme evaluations that focus narrowly on direct training

  7. Implications of an emerging EHR monoculture for hospitals and healthcare systems.

    Science.gov (United States)

    Koppel, Ross; Lehmann, Christoph U

    2015-03-01

    In many hospitals and health systems, a 'new' electronic health record means a shift to one vendor: Epic, a vendor that dominates in large and medium hospital markets and continues its success with smaller institutions and ambulatory practices. Our paper examines the implications of this emerging monoculture: its advantages and disadvantages for physicians and hospitals and its role in innovation, professional autonomy, implementation difficulties, workflow, flexibility, cost, data standards, interoperability, and interactions with other information technology (IT) systems. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. An Overview of Turkish Healthcare System after Health Transformation Program: Main Successes, Performance Assessment, Further Challenges, and Policy Options

    Directory of Open Access Journals (Sweden)

    Kadir GÜRSOY

    2015-02-01

    Full Text Available Turkish healthcare system has been stated to show significant improvements regarding wider access to healthcare facilities, and the quality and efficiency through the introduction of Health Transformation Program launched in 2003. While the old system relied on differing provisions and financing and lacked behind many developed nations in terms of health outcomes, the new system achieved nearly universal coverage and many health outcomes enhanced significantly. Health expenditures rose to 5.4% of GDP in 2013 from 4.8% in 1998. Furthermore, Turkey provided both better financial protection for the poor against high health expenditures, and equity in access to health care across the population. However, Turkey still faces new challenges to catch other developed countries to have better health and further improve financial sustainability. To reach these targets, Turkey needs to further implement new policy options for reform such as combating informal economy, allocating more on health resources, designing incentive- based payment methods, adopting gate keeping system and referral chain, developing capacity to deploy health technology assessments in reimbursement decisions, and ensuring the hospital autonomy.

  9. Managing Law Enforcement Presence in the Emergency Department: Highlighting the Need for New Policy Recommendations.

    Science.gov (United States)

    Tahouni, Morsal R; Liscord, Emory; Mowafi, Hani

    2015-10-01

    The Emergency Department (ED) is the portal of entry to the health care system for a large percentage of patients. This is especially true for victims and perpetrators of interpersonal violence. Frequently, law enforcement personnel (LEP) accompany patients to the ED or seek access to patients during their ED stay or subsequent hospitalization. The time-sensitive nature of both emergency care and criminal investigation motivates both health care personnel and LEP, and can lead to potential conflicts of interest regarding access to patients in the ED. We hope to examine the relationship among patients, providers, and LEP in the ED, and the potential impact these interactions have on patient care. This article presents a review of the relevant literature and policy consideration as well as provides guidance on the development of such policies for EDs. Hospitals, EDs, and trauma resuscitation rooms are highly regulated environments, but LEP largely fall outside the ethical and institutional guidelines of health care institutions. Many potential areas of conflict exist when LEP are present in the ED that can have detrimental effects on patient care, provider liability, and LEP efficacy. Patients' perceptions of collaboration between ED personnel and LEP can compromise emergency patient care. There is a need for hospital policies to govern interactions among patients, emergency health care providers, and LEP in the ED. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Emerging contaminant uncertainties and policy: The chicken or the egg conundrum.

    Science.gov (United States)

    Naidu, Ravi; Jit, Joytishna; Kennedy, Bruce; Arias, Victor

    2016-07-01

    Best practice in regulating contaminants of emerging concern (CEC) must involve the integration of science and policy, be defensible and accepted by diverse stakeholders. Key elements of CEC frameworks include identification and prioritisation of emerging contaminants, evaluation of health and environmental impacts from key matrices such as soil, groundwater, surface waters and sediment, assessments of available data, methods and technologies (and limitations), and mechanisms to take cognisance of diverse interests. This paper discusses one of the few frameworks designed for emerging contaminants, the Minnesota Department of Health (MDH) Drinking Water Contaminants of Emerging Concern (CEC) program. Further review of mechanisms for CECs in other jurisdictions reveals that there is only a small number of regulatory and guidance regimes globally. There is also merit in a formal mechanism for the global exchange of knowledge and outcomes associated with CECs of global interest. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Major alternatives for government policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States

    International Nuclear Information System (INIS)

    1980-01-01

    The purpose of this report is to identify and assess major alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States. The National Academy of Public Administration agreed to identify and evaluate alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management. It agreed to review present policies and practices in civilian nuclear reactor emergency management, to review selected experiences and practices of governmental agencies other than the Nuclear Regulatory Commission, and industries other than the nuclear power industry, and to identify alternatives to the present nuclear emergency system

  12. The emergence and workings of a process view in public education policy

    DEFF Research Database (Denmark)

    Grønbæk Pors, Justine; Ratner, Helene Gad

    2017-01-01

    This article presents a study of Danish primary education policy with the purpose of exploring what is put at stake when contemporary management discourses describe the object of management as fluid and emergent processes rather than as entities, persons and things. The article examines how...... such a process view of organisation allows policy makers to imagine innovative change, but also how a process view interacts in particular ways with financial pressures and become entangled to increased performance measurements. We conclude that in this particular case, a conception of the object of management...

  13. Interactions: Trade Policy and Healthcare Reform After Chaoulli v. Quebec: Is it time for Canada to acknowledge the fragile boundary between health and trade policies and strengthen the separation between private and public health insurance?

    OpenAIRE

    Crawford, Mark

    2006-01-01

    The insulation of Canada’s healthcare system from trade treaty obligations is crucial to the legitimacy of Canada’s trade policy. Legal analysis has suggested, however, that competitive and for-profit delivery of the kind contemplated by the Kirby Report and some provinces may make healthcare more vulnerable to challenges under NAFTA and GATS. The Government of Canada has tried to counter this interpretation by stressing the importance of public financing as the principal criterion for exempt...

  14. Systems thinking perspectives applied to healthcare transition for youth with disabilities: a paradigm shift for practice, policy and research.

    Science.gov (United States)

    Hamdani, Y; Jetha, A; Norman, C

    2011-11-01

    Healthcare transition (HCT) for youth with disabilities is a complex phenomenon influenced by multiple interacting factors, including health, personal and environmental factors. Current research on the transition to adulthood for disabled youth has primarily focused on identifying these multilevel factors to guide the development of interventions to improve the HCT process. However, little is known about how this complex array of factors interacts and contributes to successful HCT. Systems thinking provides a theoretically informed perspective that accounts for complexity and can contribute to enhanced understanding of the interactions among HCT factors. The objective of this paper is to introduce general concepts of systems thinking as applied to HCT practice and research. Several systems thinking concepts and principles are introduced and a discussion of HCT as a complex system is provided. Systems dynamics methodology is described as one systems method for conceptualizing HCT. A preliminary systems dynamics model is presented to facilitate discourse on the application of systems thinking principles to HCT practice, policy and research. An understanding of the complex interactions and patterns of relationships in HCT can assist health policy makers and practitioners in determining key areas of intervention, the impact of these interventions on the system and the potential intended and unintended consequences of change. This paper provides initial examination of applying systems thinking to inform future research and practice on HCT. © 2011 Blackwell Publishing Ltd.

  15. Engaging the public in healthcare decision-making: results from a Citizens' Jury on emergency care services.

    Science.gov (United States)

    Scuffham, P A; Moretto, N; Krinks, R; Burton, P; Whitty, J A; Wilson, A; Fitzgerald, G; Littlejohns, P; Kendall, E

    2016-11-01

    Policies addressing ED crowding have failed to incorporate the public's perspectives; engaging the public in such policies is needed. This study aimed at determining the public's recommendations related to alternative models of care intended to reduce crowding, optimising access to and provision of emergency care. A Citizens' Jury was convened in Queensland, Australia, to consider priority setting and resource allocation to address ED crowding. Twenty-two jurors were recruited from the electoral roll, who were interested and available to attend the jury from 15 to 17 June 2012. Juror feedback was collected via a survey immediately following the end of the jury. The jury considered that all patients attending the ED should be assessed with a minority of cases diverted for assistance elsewhere. Jurors strongly supported enabling ambulance staff to treat patients in their homes without transporting them to the ED, and allowing non-medical staff to treat some patients without seeing a doctor. Jurors supported (in principle) patient choice over aspects of their treatment (when, where and type of health professional) with some support for patients paying towards treatment but unanimous opposition for patients paying to be prioritised. Most of the jurors were satisfied with their experience of the Citizens' Jury process, but some jurors perceived the time allocated for deliberations as insufficient. These findings suggest that the general public may be open to flexible models of emergency care. The jury provided clear recommendations for direct public input to guide health policy to tackle ED crowding. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Emergency diesel generating sets for the 900 MW PWR units operation and maintenance policy

    International Nuclear Information System (INIS)

    Guillon, A.; Lallier, M.

    1986-01-01

    In order to improve the reliability of the emergency diesel generating EDF has taken steps to ensure that: - sets are only started up when they are really needed, in order to reduce the thermal cycles and the mechanical stresses associated with start-up. - the maintenance policy is adapted to the conditions of use, by including the notion of a start-up being equivalent to a predetermined number of hours of operation. (authors)

  17. Emergency diesel generating sets for the 900 MW PWR units operation and maintenance policy

    Energy Technology Data Exchange (ETDEWEB)

    Guillon, A.; Lallier, M. [Electricite de France - EDF, Service de la Production Thermique, 3 rue de Messine, 75384 Paris Cedex 08 (France)

    1986-02-15

    In order to improve the reliability of the emergency diesel generating EDF has taken steps to ensure that: - sets are only started up when they are really needed, in order to reduce the thermal cycles and the mechanical stresses associated with start-up. - the maintenance policy is adapted to the conditions of use, by including the notion of a start-up being equivalent to a predetermined number of hours of operation. (authors)

  18. Nuclear regulatory policy concept on safety, security, safeguards and emergency preparedness (3S+EP)

    International Nuclear Information System (INIS)

    Ilyas, Zurias

    2009-01-01

    Regulatory Policy is formulated in regulations that stipulate the assurance of workers and public safety and environmental protection. Legislation and regulations on nuclear energy should consider nuclear safety, security and safeguards, as well as nuclear emergency preparedness (3S+EP) and liability for nuclear damage. Specific requirements stipulated in international conventions and agreements should also be taken into account. Regulatory Policy is formulated in regulations that stipulate the assurance of workers and public safety and environmental protection. Legislation and regulations on nuclear energy should consider nuclear safety, security and safeguards, as well as nuclear emergency preparedness (3S+EP) and liability for nuclear damage. Specific requirements stipulated in international conventions and agreements should also be taken into account. By undertaking proper regulatory oversight on Safety, Security and Emergency Preparedness (3S+EP) as an integrated and comprehensive system, safe and secure use of nuclear energy can be assured. Licence requirements and conditions should fulfil regulatory requirements pertaining to 3S+EP for nuclear installation as an integrated system. An effective emergency capacity that can be immediately mobilized is important. The capacity in protecting the personnel before, during and after the disaster should also be planned. Thus, proper emergency preparedness should be supported by adequate resources. The interface between safety, security, safeguards and emergency preparedness has to be set forth in nuclear regulations, such as regulatory requirements; 3S+EP; components, systems and structures of nuclear installations and human resources. Licensing regulations should stipulate, among others, DIQ, installations security system, safety analysis report, emergency preparedness requirements and necessary human resources that meet the 3S+EP requirements.

  19. Older adult perceptions of smart home technologies: implications for research, policy & market innovations in healthcare.

    Science.gov (United States)

    Coughlin, J; D'Ambrosio, L A; Reimer, B; Pratt, M R

    2007-01-01

    Advances in information communications technology and related computational power are providing a wide array of systems and related services that form the basis of smart home technologies to support the health, safety and independence of older adults. While these technologies offer significant benefits to older people and their families, they are also transforming older adults into lead adopters of a new 24/7 lifestyle of being monitored, managed, and, at times, motivated, to maintain their health and wellness. To better understand older adult perceptions of smart home technologies and to inform future research a workshop and focus group was conducted with 30 leaders in aging advocacy and aging services from 10 northeastern states. Participants expressed support of technological advance along with a variety of concerns that included usability, reliability, trust, privacy, stigma, accessibility and affordability. Participants also observed that there is a virtual absence of a comprehensive market and policy environment to support either the consumer or the diffusion of these technologies. Implications for research, policy and market innovation are discussed.

  20. Conscientious objection and refusal to provide reproductive healthcare: a White Paper examining prevalence, health consequences, and policy responses.

    Science.gov (United States)

    Chavkin, Wendy; Leitman, Liddy; Polin, Kate

    2013-12-01

    Global Doctors for Choice-a transnational network of physician advocates for reproductive health and rights-began exploring the phenomenon of conscience-based refusal of reproductive healthcare as a result of increasing reports of harms worldwide. The present White Paper examines the prevalence and impact of such refusal and reviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity. The White Paper draws on medical, public health, legal, ethical, and social science literature published between 1998 and 2013 in English, French, German, Italian, Portuguese, and Spanish. Estimates of prevalence are difficult to obtain, as there is no consensus about criteria for refuser status and no standardized definition of the practice, and the studies have sampling and other methodologic limitations. The White Paper reviews these data and offers logical frameworks to represent the possible health and health system consequences of conscience-based refusal to provide abortion; assisted reproductive technologies; contraception; treatment in cases of maternal health risk and inevitable pregnancy loss; and prenatal diagnosis. It concludes by categorizing legal, regulatory, and other policy responses to the practice. Empirical evidence is essential for varied political actors as they respond with policies or regulations to the competing concerns at stake. Further research and training in diverse geopolitical settings are required. With dual commitments toward their own conscience and their obligations to patients' health and rights, providers and professional medical/public health societies must lead attempts to respond to conscience-based refusal and to safeguard reproductive health, medical integrity, and women's lives. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Exploring technology diffusion in emerging markets – the role of public policy for wind energy

    International Nuclear Information System (INIS)

    Friebe, Christian A.; Flotow, Paschen von; Täube, Florian A.

    2014-01-01

    This study challenges the implicit assumption of homogeneity in national institutional contexts made in past studies of (renewable) energy policy. We propose that institutional differences matter by focusing on several technology-specific and generic policy factors that can foster technology diffusion through private sector activity. More specifically, we explore perceptions of early adopters in emerging economy contexts using wind park project developers as an example. By applying a parsimonious method for our questionnaire as well as qualitative data we make several contributions: Methodologically, we introduce Maximum Difference Scaling to the energy policy domain. Empirically, we identify several public influences on private investment, and assess their relative importance. This leads to new insights challenging findings from industrialized economies; we identified additional institutional barriers to diffusion, hence, the requirement of a combination of technology-specific and generic policy measures. - Highlights: • Explorative qualitative and quantitative study of project developers in emerging markets. • Identifies influencing factors for technology diffusion regarding wind farms. • Predictable public authorities and well-implemented public processes attract intern. project developers. • Feed-in-Tariffs and grid access guarantees are particularly appealing

  2. Older people's exclusion from healthcare services in Nepal: an analysis of the political economy of development aid, domestic policy and research.

    Science.gov (United States)

    Bhattarai, Lok P Sharma

    2013-04-01

    The objective of this review was to contribute to the discussion on older people's access to healthcare in developing countries. Relevant research findings, survey reports, policy papers and planning documents were critically reviewed, placing a particular focus on their relevance in understanding issues of access, equity and justice. A number of factors are identified for their roles on the issue; that is, place of residence, economic factors/poverty, cultural stigma, situation and impact of research, and the prevalent policy framework in health and the approach of development assistance adopted by donor communities. In order to make healthcare facilities equitable for older people, the identified factors need to be addressed at different levels - at local policy work, in the allocation of funding for health service research and in designing overseas development work. © 2012 Japan Geriatrics Society.

  3. Governing citizens and health professionals at a distance: A critical discourse analysis of policies of intersectorial collaboration in Danish health-care

    DEFF Research Database (Denmark)

    Andersen, Anne Bendix; Frederiksen, Kirsten; Kolbæk, Raymond

    2017-01-01

    of intersectorial collaboration. The premises of intersectorial collaboration are maintained through a specific presentation of actors leaving little room for discussion, where professionals are constructed as actors who are expected to develop ways of collaborating according to the Triple Aim approach in order...... policies as powerful actors and explores how effects of a concrete policy are adapted for intersectorial collaboration in Danish healthcare. The paper is based on a critical discourse analysis of a central policy document in Danish health-care known as the ‘Health Agreements’. Using Fairclough’s three......-dimensional model for discourse analysis, we explored the document to clarify the construction of actors participating in intersectorial collaboration. The analysis revealed the Health Agreement as a ‘negotiated text’, appearing as an overriding document legitimising one possible discourse regarding the premises...

  4. Implications of organizational ethics to healthcare.

    Science.gov (United States)

    Ells, Carolyn; MacDonald, Chris

    2002-01-01

    Organizational ethics is an emerging field concerned with the study and practice of the ethical behaviour of organizations. For effective application to healthcare settings, we argue that organizational ethics requires attention to organizations' special characteristics combined with tools borrowed from the fields of business ethics and bioethics. We identify and discuss several implications of this burgeoning field to healthcare organizations, showing how organizational ethics can facilitate policy making, accountability, self-evaluation, and patient and business perspectives. In our conclusion, we suggest an action plan for healthcare organizations to help them respond appropriately to their ethical responsibilities.

  5. Energy security, public policy, and the role of the DOE Office of Energy Emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Bjornstad, D.J.; Curlee, T.R. (Oak Ridge National Lab., TN (United States)); Bohi, D.R. (Resources for the Future, Inc., Washington, DC (United States))

    1991-11-01

    This paper addresses the concept of energy security, the costs and benefits of energy security, and policies which could potentially alter these costs and benefits. These issues are considered from the perspective of the DOE's Office of Energy Emergencies, with the goal of determining if alternative or additional roles should be open to this Office. The approach taken is limited to the economic costs and benefits of energy security, reflecting our view that the bulk of important energy security issues can at least be approached from this perspective. An energy emergency results from a sudden change in the quantity, market price, and/or social value of energy, in combination with a domestic and/or world wide energy system that cannot rapidly adjust to that change. We do not believe that mitigating the impacts of such events is always necessary, nor that it is uniquely a governmental responsibility. In fact, the first recourse in emergency preparedness should always be to the private sector. Government should deal with three different aspects of emergency energy activities. First, it should condition the decision making environment by seeing that adequate information about energy conditions is available and that its own policy position is clear. Next, it should evaluate the preparedness measures undertaken by the private sector. Finally, if it finds private sector preparation to be inadequate, government has a variety of direct and indirect means with which to intervene. One direct measure currently used is the buildup and drawdown of the strategic petroleum reserve (SPR). Others include contingency plans to override market allocations during wartime, as might be developed under the graduated mobilization response (GMR). Indirect means include a variety of tax and transfer schemes that alter existing private sector incentives to prepare. Well conceived monetary and fiscal policies complete the tools. 1 fig., 1 tab.

  6. Energy security, public policy, and the role of the DOE Office of Energy Emergencies

    International Nuclear Information System (INIS)

    Bjornstad, D.J.; Curlee, T.R.; Bohi, D.R.

    1991-11-01

    This paper addresses the concept of energy security, the costs and benefits of energy security, and policies which could potentially alter these costs and benefits. These issues are considered from the perspective of the DOE's Office of Energy Emergencies, with the goal of determining if alternative or additional roles should be open to this Office. The approach taken is limited to the economic costs and benefits of energy security, reflecting our view that the bulk of important energy security issues can at least be approached from this perspective. An energy emergency results from a sudden change in the quantity, market price, and/or social value of energy, in combination with a domestic and/or world wide energy system that cannot rapidly adjust to that change. We do not believe that mitigating the impacts of such events is always necessary, nor that it is uniquely a governmental responsibility. In fact, the first recourse in emergency preparedness should always be to the private sector. Government should deal with three different aspects of emergency energy activities. First, it should condition the decision making environment by seeing that adequate information about energy conditions is available and that its own policy position is clear. Next, it should evaluate the preparedness measures undertaken by the private sector. Finally, if it finds private sector preparation to be inadequate, government has a variety of direct and indirect means with which to intervene. One direct measure currently used is the buildup and drawdown of the strategic petroleum reserve (SPR). Others include contingency plans to override market allocations during wartime, as might be developed under the graduated mobilization response (GMR). Indirect means include a variety of tax and transfer schemes that alter existing private sector incentives to prepare. Well conceived monetary and fiscal policies complete the tools. 1 fig., 1 tab

  7. Service quality in healthcare institutions: establishing the gaps for policy action.

    Science.gov (United States)

    Abuosi, Aaron A; Atinga, Roger A

    2013-01-01

    The authors seek to examine two key issues: to assess patients' hospital service quality perceptions and expectation using SERVQUAL; and to outline the distinct concepts used to assess patient perceptions. Questionnaires were administered to 250 patients on admission and follow-up visits. The 22 paired SERVQUAL expectation and perception items were adopted. Repeated t-measures and factor analysis with Varimax rotation were used to analyse data. Results showed that patient expectations were not being met during medical treatment. Perceived service quality was rated lower than expectations for all variables. The mean difference between perceptions and expectations was statistically significant. Contrary to the SERVQUAL five-factor model, four service-quality factors were identified in the study. Findings have practical implications for hospital managers who should consider stepping up staffing levels backed by client-centred training programmes to help clinicians deliver care to patients' expectations. Limited studies are tailored towards patients' service-quality perception and expectation in Ghanaian hospitals. The findings therefore provide valuable information for policy and practice.

  8. The impact on healthcare, policy and practice from 36 multi-project research programmes: findings from two reviews.

    Science.gov (United States)

    Hanney, Steve; Greenhalgh, Trisha; Blatch-Jones, Amanda; Glover, Matthew; Raftery, James

    2017-03-28

    We sought to analyse the impacts found, and the methods used, in a series of assessments of programmes and portfolios of health research consisting of multiple projects. We analysed a sample of 36 impact studies of multi-project research programmes, selected from a wider sample of impact studies included in two narrative systematic reviews published in 2007 and 2016. We included impact studies in which the individual projects in a programme had been assessed for wider impact, especially on policy or practice, and where findings had been described in such a way that allowed them to be collated and compared. Included programmes were highly diverse in terms of location (11 different countries plus two multi-country ones), number of component projects (8 to 178), nature of the programme, research field, mode of funding, time between completion and impact assessment, methods used to assess impact, and level of impact identified. Thirty-one studies reported on policy impact, 17 on clinician behaviour or informing clinical practice, three on a combined category such as policy and clinician impact, and 12 on wider elements of impact (health gain, patient benefit, improved care or other benefits to the healthcare system). In those multi-programme projects that assessed the respective categories, the percentage of projects that reported some impact was policy 35% (range 5-100%), practice 32% (10-69%), combined category 64% (60-67%), and health gain/health services 27% (6-48%). Variations in levels of impact achieved partly reflected differences in the types of programme, levels of collaboration with users, and methods and timing of impact assessment. Most commonly, principal investigators were surveyed; some studies involved desk research and some interviews with investigators and/or stakeholders. Most studies used a conceptual framework such as the Payback Framework. One study attempted to assess the monetary value of a research programme's health gain. The widespread

  9. Implementation of a disability management policy in a large healthcare employer: a quasi-experimental, mixed-methods evaluation.

    Science.gov (United States)

    Mustard, Cameron A; Skivington, Kathryn; Lay, Morgan; Lifshen, Marni; Etches, Jacob; Chambers, Andrea

    2017-06-17

    This study describes the process and outcomes of the implementation of a strengthened disability management policy in a large Canadian healthcare employer. Key elements of the strengthened policy included an emphasis on early contact, the training of supervisors and the integration of union representatives in return-to-work (RTW) planning. The study applied mixed methods, combining a process evaluation within the employer and a quasi-experimental outcome evaluation between employers for a 3-year period prior to and following policy implementation in January 2012. Staff in the implementation organisation (n=4000) and staff in a peer group of 29 large hospitals (n=1 19 000). Work disability episode incidence and duration. Both qualitative and quantitative measures of the implementation process were predominantly positive. Over the 6-year observation period, there were 624 work disability episodes in the organisation and 8604 in the comparison group of 29 large hospitals. The annual per cent change in episode incidence in the organisation was -5.6 (95% CI -9.9 to -1.1) comparable to the annual per cent change in the comparison group: -6.2 (-7.2 to -5.3). Disability episode durations also declined in the organisation, from a mean of 19.4 days (16.5, 22.3) in the preintervention period to 10.9 days (8.7, 13.2) in the postintervention period. Reductions in disability durations were also observed in the comparison group: from a mean of 13.5 days (12.9, 14.1) in the 2009-2011 period to 10.5 days (9.9, 11.1) in the 2012-2014 period. The incidence of work disability episodes and the durations of work disability declined strongly in this hospital sector over the 6-year observation period. The implementation of the organisation's RTW policy was associated with larger reductions in disability durations than observed in the comparison group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

  10. The impact of fiscal policy on government bond spreads in emerging markets

    Directory of Open Access Journals (Sweden)

    Ante Žigman

    2011-12-01

    Full Text Available Spreads on government bonds are a collective expression of differences in the level of development, risk, expected returns and other essential characteristics of states or regions the bond yields of which we wish to compare. At issue here is a collective expression of factors that work on the bond supply and demand side. These are for example the political environment (or political risks, expected return, economic risks, expected inflation, expected change in the exchange rate, solvency, way in which the bonds of a given state fi t into the portfolios of the major investors and so on. The paper identifies the influence of fiscal and non-fiscal factors on movements in spreads on government bonds in emerging markets. The possibility of isolating fiscal from non-fiscal influences on spreads and the identification of the nature of fiscal impacts can be of great importance for the conduct of fiscal policy. The results obtained can be used for an optimisation of fiscal policy so as to avoid negative impacts on yields (i.e. a growth in yields, that is, a growth in the costs of government borrowing. This paper enlarges the line of research by querying whether the structure of deficit financing (domestic or foreign has an impact on bond yields in emerging markets, and how this impact is reflected on the other determinants of fiscal policy.

  11. Strategies for healthcare information systems

    NARCIS (Netherlands)

    Stegwee, R.A.; Spil, Antonius A.M.

    2001-01-01

    Information technologies of the past two decades have created significant fundamental changes in the delivery of healthcare services by healthcare provider organizations. Many healthcare organizations have been in search of ways and strategies to keep up with continuously emerging information

  12. Role of healthcare workers in early epidemic spread of Ebola: policy implications of prophylactic compared to reactive vaccination policy in outbreak prevention and control.

    Science.gov (United States)

    Coltart, Cordelia E M; Johnson, Anne M; Whitty, Christopher J M

    2015-10-19

    Ebola causes severe illness in humans and has epidemic potential. How to deploy vaccines most effectively is a central policy question since different strategies have implications for ideal vaccine profile. More than one vaccine may be needed. A vaccine optimised for prophylactic vaccination in high-risk areas but when the virus is not actively circulating should be safe, well tolerated, and provide long-lasting protection; a two- or three-dose strategy would be realistic. Conversely, a reactive vaccine deployed in an outbreak context for ring-vaccination strategies should have rapid onset of protection with one dose, but longevity of protection is less important. In initial cases, before an outbreak is recognised, healthcare workers (HCWs) are at particular risk of acquiring and transmitting infection, thus potentially augmenting early epidemics. We hypothesise that many early outbreak cases could be averted, or epidemics aborted, by prophylactic vaccination of HCWs. This paper explores the potential impact of prophylactic versus reactive vaccination strategies of HCWs in preventing early epidemic transmissions. To do this, we use the limited data available from Ebola epidemics (current and historic) to reconstruct transmission trees and illustrate the theoretical impact of these vaccination strategies. Our data suggest a substantial potential benefit of prophylactic versus reactive vaccination of HCWs in preventing early transmissions. We estimate that prophylactic vaccination with a coverage >99% and theoretical 100% efficacy could avert nearly two-thirds of cases studied; 75% coverage would still confer clear benefit (40% cases averted), but reactive vaccination would be of less value in the early epidemic. A prophylactic vaccination campaign for front-line HCWs is not a trivial undertaking; whether to prioritise long-lasting vaccines and provide prophylaxis to HCWs is a live policy question. Prophylactic vaccination is likely to have a greater impact on the

  13. Policies and Livestock Systems Driving Brucellosis Re-emergence in Kazakhstan.

    Science.gov (United States)

    Beauvais, Wendy; Coker, Richard; Nurtazina, Gulzhan; Guitian, Javier

    2017-06-01

    Brucellosis is a considerable public health and economic burden in many areas of the world including sub-Saharan Africa, the Middle East and former USSR countries. The collapse of the USSR has been cited as a driver for re-emergence of diseases including brucellosis, and human incidence rates in the former Soviet republics have been estimated as high as 88 per 100,000 per year. The aim of this paper is to examine the historical trends in brucellosis in Kazakhstan and to explore how livestock systems, veterinary services and control policies may have influenced them. In conclusion, a brucellosis epidemic most likely began before the collapse of the USSR and high livestock densities may have played an important role. Changes to the livestock systems in Kazakhstan, as well as other factors, are likely to have an impact on the success of brucellosis policies in the future. Incentives and practicalities of different policies in smallholder settings should be considered. However, the lack of reliable estimates of brucellosis prevalence and difficulties in understanding exactly how policy is being applied in Kazakhstan, which is a vast country with low population density, prevent firm conclusions from being drawn.

  14. Human resource for health reform in peri-urban areas: a cross-sectional study of the impact of policy interventions on healthcare workers in Epworth, Zimbabwe.

    Science.gov (United States)

    Taderera, Bernard Hope; Hendricks, Stephen James Heinrich; Pillay, Yogan

    2017-12-16

    The need to understand how healthcare worker reform policy interventions impact health personnel in peri-urban areas is important as it also contributes towards setting of priorities in pursuing the universal health coverage goal of health sector reform. This study explored the impact of post 2008 human resource for health reform policy interventions on healthcare workers in Epworth, a peri-urban community in Harare, Zimbabwe, and the implications towards health sector reform policy in peri-urban areas. The study design was exploratory and cross-sectional and involved the use of qualitative and quantitative methods in data collection, presentation, and analysis. A qualitative study in which data were collected through a documentary search, five key informant interviews, seven in-depth interviews, and five focus group discussions was carried out first. This was followed by a quantitative study in which data were collected through a documentary search and 87 semi-structured sample interviews with healthcare workers. Qualitative data were analyzed thematically whilst descriptive statistics were used to examine quantitative data. All data were integrated during analysis to ensure comprehensive, reliable, and valid analysis of the dataset. Three main factors were identified to help interpret findings. The first main factor consisted policy result areas that impacted most successfully on healthcare workers. These included the deployment of community health workers with the highest correlation of 0.83. Policy result areas in the second main factor included financial incentives with a correlation of 0.79, training and development (0.77), deployment (0.77), and non-financial incentives (0.75). The third factor consisted policy result areas that had the lowest satisfaction amongst healthcare workers in Epworth. These included safety (0.72), equipment and tools of trade (0.72), health welfare (0.65), and salaries (0.55). The deployment of community health volunteers impacted

  15. Interface between marketing, policy and development in emerging economies. An exploratory study and evaluation

    Directory of Open Access Journals (Sweden)

    Rodney Oudan

    2017-11-01

    Full Text Available This paper explores the role of marketing, policy, and development for emerging economies moving toward a market-driven economic environment. A historical review provides a foundation, then deductive analyses from theoretical reviews and transcripts reveal that such marketing is still in the developmental stages and has become necessary for the future direction of these economies. Following the findings, the paper provides managerial marketing implications and highlights how a market orientation and market-driven approach is necessary for the greater social good in a global economy.

  16. Knowledge and Skills of Healthcare Providers in Sub-Saharan Africa and Asia before and after Competency-Based Training in Emergency Obstetric and Early Newborn Care.

    Science.gov (United States)

    Ameh, Charles A; Kerr, Robert; Madaj, Barbara; Mdegela, Mselenge; Kana, Terry; Jones, Susan; Lambert, Jaki; Dickinson, Fiona; White, Sarah; van den Broek, Nynke

    2016-01-01

    Healthcare provider training in Emergency Obstetric and Newborn Care (EmOC&NC) is a component of 65% of intervention programs aimed at reducing maternal and newborn mortality and morbidity. It is important to evaluate the effectiveness of this. We evaluated knowledge and skills among 5,939 healthcare providers before and after 3-5 days 'skills and drills' training in emergency obstetric and newborn care (EmOC&NC) conducted in 7 sub-Saharan Africa countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Zimbabwe) and 2 Asian countries (Bangladesh, Pakistan). Standardised assessments using multiple choice questions and objective structured clinical examination (OSCE) were used to measure change in knowledge and skills and the Improvement Ratio (IR) by cadre and by country. Linear regression was performed to identify variables associated with pre-training score and IR. 99.7% of healthcare providers improved their overall score with a median (IQR) increase of 10.0% (5.0% - 15.0%) for knowledge and 28.8% (23.1% - 35.1%) for skill. There were significant improvements in knowledge and skills for each cadre of healthcare provider and for each country (phealthcare providers working in maternity wards in both sub-Saharan Africa and Asia. Additional support and training is needed for use of the partograph as a tool to monitor progress in labour. Further research is needed to assess if this is translated into improved service delivery.

  17. Coherence in the Danish Healthcare System

    DEFF Research Database (Denmark)

    Frederiksen, Jesper; Olivares Bøgeskov, Benjamin Miguel

    2017-01-01

    In this article, we investigate ‘coherence in healthcare’ as a strategy of welfare policy. We conduct our investigation within the theoretical and methodological framework of Scandinavian praxeology, and we construct our empirical data from Danish administrative documents. The tools and terms...... of this tradition are used to generate data from discourse as representations of institutional logics. The aim is to uncover how coherence in healthcare emerges as different strategies in healthcare governance in relation to different institutions seen as positions. Hence, our findings suggest that, although...... the stated aim in policy is to improve coherence in healthcare for the benefit of the patients, various ambiguities within the institutions producing policy tend to maintain a certain order rather than introducing changes. Furthermore, we discuss how this section of the welfare state, examined in relation...

  18. A Legal Analysis of Federal Disability Law as Related to Emerging Technology: Guidelines for Postsecondary Leadership, Policy, and Practice

    Science.gov (United States)

    Ford, Roderick Dwayne

    2014-01-01

    This dissertation identified and described the legal requirements imposed by federal disability mandates and case law related to emerging technology. Additionally, the researcher created a legal framework (guidelines) for higher education institutions to consider during policy development and implementation of emerging technology by providing an…

  19. A difficult balancing act: policy actors' perspectives on using economic evaluation to inform health-care coverage decisions under the Universal Health Insurance Coverage scheme in Thailand.

    Science.gov (United States)

    Teerawattananon, Yot; Russell, Steve

    2008-03-01

    In Thailand, policymakers have come under increasing pressure to use economic evaluation to inform health-care resource allocation decisions, especially after the introduction of the Universal Health Insurance Coverage (UC) scheme. This article presents qualitative findings from research that assessed a range of policymakers' perspectives on the acceptability of using economic evaluation for the development of health-care benefit packages in Thailand. The policy analysis examined their opinions about existing decision-making processes for including health interventions in the UC benefit package, their understanding of health economic evaluation, and their attitudes, acceptance, and values relating to the use of the method. Semistructured interviews were conducted with 36 policy actors who play a major role or have some input into health resource allocation decisions within the Thai health-care system. These included 14 senior policymakers at the national level, 5 hospital directors, 10 health professionals, and 7 academics. Policy actors thought that economic evaluation information was relevant for decision-making because of the increasing need for rationing and more transparent criteria for making UC coverage decisions. Nevertheless, they raised several difficulties with using economic evaluation that would pose barriers to its introduction, including distrust in the method, conflicting philosophical positions and priorities compared to that of "health maximization," organizational allegiances, existing decision-making procedures that would be hard to change, and concerns about political pressure and acceptability.

  20. Do elections matter for private-sector healthcare management in Brazil? An analysis of municipal health policy.

    Science.gov (United States)

    McGregor, Alecia J; Siqueira, Carlos Eduardo; Zaslavsky, Alan M; Blendon, Robert J

    2017-07-12

    This study analyzed several political determinants of increased private-sector management in Brazilian health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which remains severely underfunded. Given the overhead costs associated with privately contracted health services, increased private management is one driver of higher expenditures in the system. Although left parties campaign most vocally in support of greater public control of the SUS, the extent to which their stated positions translate into health care policy remains untested. Drawing on multiple publicly available data sources, we used linear regression to analyze how political party-in-power and existing private sector health care contracting affect the share of privately managed health care services and outsourcing in municipalities. Data from two election periods-2004 to 2008 and 2008 to 2012-were analyzed. Our findings showed that although private sector contracting varies greatly across municipalities, this variation is not systematically associated with political party in power. This suggests that electoral politics plays a relatively minor role in municipal-level health care administration. Existing levels of private sector management appear to have a greater effect on the public-private makeup of the Brazilian healthcare system, suggesting a strong role of path dependence in the evolution of Brazilian health care delivery. Despite campaign rhetoric asserting distinct positions on privatization in the SUS, factors other than political party in power have a greater effect on private-sector health system management at the municipal-level in Brazil. Given the limited effect of elections on this issue, strengthening participatory bodies such as municipal health councils may better enfranchise citizens in the fundamental debate over public and private roles in the health care sector.

  1. Devolution's policy impact on non-emergency medical transportation in State Children's Health Insurance Programs.

    Science.gov (United States)

    Borders, Stephen; Blakely, Craig; Ponder, Linda; Raphael, David

    2011-01-01

    Proponents of devolution often maintain that the transfer of power and authority of programs enables local officials to craft policy solutions that better align with the needs of their constituents. This article provides one of the first empirical evaluations of this assumption as it relates to non-emergency medical transportation (NEMT) in the State Children's Health Insurance Program (SCHIP). NEMT programs meet a critical need in the areas in which they serve, directly targeting this single key access barrier to care. Yet states have great latitude in making such services available. The authors utilize data from 32 states to provide a preliminary assessment of devolution's consequences and policy impact on transportation-related access to care. Their findings provide mixed evidence on devolution's impact on policy outcomes. Proponents of devolution can find solace in the fact that several states have gone beyond federally mandated minimum requirements to offer innovative programs to remove transportation barriers to care. Detractors of devolution will find continued pause on several key issues, as a number of states do not offer NEMT to their SCHIP populations while cutting services and leaving over $7 billion in federal matching funding unspent.

  2. An emerging interface between life science and nanotechnology: present status and prospects of reproductive healthcare aided by nano-biotechnology

    Directory of Open Access Journals (Sweden)

    Rakhi K. Jha

    2014-02-01

    Full Text Available Among the various applications of nano-biotechnology, healthcare is considered one of the most significant domains. For that possibility to synthesize various kind of nanoparticles (NPs and the ever-increasing ability to control their size as well as structure, to improve surface characteristics and binding NPs with other desired curing agents has played an important role. In this paper, a brief sketch of various kinds of nanomaterials and their biomedical applications is given. Despite claims of bio-nanotechnology about to touch all areas of medical science, information pertaining to the role of nanotechnology for the betterment of reproductive healthcare is indeed limited. Therefore, the various achievements of nano-biotechnology for healthcare in general have been illustrated while giving special insight into the role of nano-biotechnology for the future of reproductive healthcare betterment as well as current achievements of nanoscience and nanotechnology in this arena.

  3. An emerging interface between life science and nanotechnology: present status and prospects of reproductive healthcare aided by nano-biotechnology.

    Science.gov (United States)

    Jha, Rakhi K; Jha, Pradeep K; Chaudhury, Koel; Rana, Suresh V S; Guha, Sujoy K

    2014-01-01

    Among the various applications of nano-biotechnology, healthcare is considered one of the most significant domains. For that possibility to synthesize various kind of nanoparticles (NPs) and the ever-increasing ability to control their size as well as structure, to improve surface characteristics and binding NPs with other desired curing agents has played an important role. In this paper, a brief sketch of various kinds of nanomaterials and their biomedical applications is given. Despite claims of bio-nanotechnology about to touch all areas of medical science, information pertaining to the role of nanotechnology for the betterment of reproductive healthcare is indeed limited. Therefore, the various achievements of nano-biotechnology for healthcare in general have been illustrated while giving special insight into the role of nano-biotechnology for the future of reproductive healthcare betterment as well as current achievements of nanoscience and nanotechnology in this arena.

  4. Healthcare workers and health care-associated infections: knowledge, attitudes, and behavior in emergency departments in Italy

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    Marinelli Paolo

    2010-02-01

    Full Text Available Abstract Background This survey assessed knowledge, attitudes, and compliance regarding standard precautions about health care-associated infections (HAIs and the associated determinants among healthcare workers (HCWs in emergency departments in Italy. Methods An anonymous questionnaire, self-administered by all HCWs in eight randomly selected non-academic acute general public hospitals, comprised questions on demographic and occupational characteristics; knowledge about the risks of acquiring and/or transmitting HAIs from/to a patient and standard precautions; attitudes toward guidelines and risk perceived of acquiring a HAI; practice of standard precautions; and sources of information. Results HCWs who know the risk of acquiring Hepatitis C (HCV and Human Immunodeficiency Virus (HIV from a patient were in practice from less years, worked fewer hours per week, knew that a HCW can transmit HCV and HIV to a patient, knew that HCV and HIV infections can be serious, and have received information from educational courses and scientific journals. Those who know that gloves, mask, protective eyewear, and hands hygiene after removing gloves are control measures were nurses, provided care to fewer patients, knew that HCWs' hands are vehicle for transmission of nosocomial pathogens, did not know that a HCW can transmit HCV and HIV to a patient, and have received information from educational courses and scientific journals. Being a nurse, knowing that HCWs' hands are vehicle for transmission of nosocomial pathogens, obtaining information from educational courses and scientific journals, and needing information were associated with a higher perceived risk of acquiring a HAI. HCWs who often or always used gloves and performed hands hygiene measures after removing gloves were nurses, provided care to fewer patients, and knew that hands hygiene after removing gloves was a control measure. Conclusions HCWs have high knowledge, positive attitudes, but low

  5. Systematically reviewing and synthesizing evidence from conversation analytic and related discursive research to inform healthcare communication practice and policy: an illustrated guide.

    Science.gov (United States)

    Parry, Ruth H; Land, Victoria

    2013-05-30

    Healthcare delivery is largely accomplished in and through conversations between people, and healthcare quality and effectiveness depend enormously upon the communication practices employed within these conversations. An important body of evidence about these practices has been generated by conversation analysis and related discourse analytic approaches, but there has been very little systematic reviewing of this evidence. We developed an approach to reviewing evidence from conversation analytic and related discursive research through the following procedures: • reviewing existing systematic review methods and our own prior experience of applying these • clarifying distinctive features of conversation analytic and related discursive work which must be taken into account when reviewing • holding discussions within a review advisory team that included members with expertise in healthcare research, conversation analytic research, and systematic reviewing • attempting and then refining procedures through conducting an actual review which examined evidence about how people talk about difficult future issues including illness progression and dying We produced a step-by-step guide which we describe here in terms of eight stages, and which we illustrate from our 'Review of Future Talk'. The guide incorporates both established procedures for systematic reviewing, and new techniques designed for working with conversation analytic evidence. The guide is designed to inform systematic reviews of conversation analytic and related discursive evidence on specific domains and topics. Whilst we designed it for reviews that aim at informing healthcare practice and policy, it is flexible and could be used for reviews with other aims, for instance those aiming to underpin research programmes and projects. We advocate systematically reviewing conversation analytic and related discursive findings using this approach in order to translate them into a form that is credible and

  6. Demand for healthcare in India

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    Brijesh C. Purohit

    2013-03-01

    Full Text Available In a developing country like India, allocation of scarce fiscal resources has to be based on a clear understanding of how investments in the heath sector are going to affect demand. Three aspects like overall healthcare demand, consumer decisions to use public and/or private care and role of price/quality influencing poor/rich consumer’s decisions are critical to assessing the equity implications of alternative policies. Our paper addresses these aspects through examining the pattern of healthcare demand in India. Data from the National Family Health Survey are used to model the healthcare choices that individuals make. We consider what these behavioral characteristics imply for public policy. This analysis aims to study disparities between rural and urban areas from all throughout India to five Indian states representing three levels of per capita incomes (all-India average, rich and poor. Results evidence that healthcare demand both in rural and urban areas is a commodity emerging as an essential need. Choices between public or private provider are guided by income and quality variables mainly with regard to public healthcare denoting thus a situation of very limited alternatives in terms of availing private providers. These results emphasize that existing public healthcare facilities do not serve the objective of providing care to the poor in a satisfactory manner in rural areas. Thus, any financing strategy to improve health system and reduce disparities across rich-poor states and rural-urban areas should also take into account not only overcoming inadequacy but also inefficiency in allocation and utilization of healthcare inputs.

  7. Interactions: trade policy and healthcare reform after Chaoulli v. Quebec: is it time for Canada to acknowledge the fragile boundary between health and trade policies and strengthen the separation between private and public health insurance?

    Science.gov (United States)

    Crawford, Mark

    2006-01-01

    The insulation of Canada's healthcare system from trade treaty obligations is crucial to the legitimacy of Canada's trade policy. Legal analysis has suggested, however, that competitive and for-profit delivery of the kind contemplated by the Kirby Report and some provinces may make healthcare more vulnerable to challenges under NAFTA and GATS. The Government of Canada has tried to counter this interpretation by stressing the importance of public financing as the principal criterion for exemption of healthcare from trade treaties, but now the potential for private financing of essential medical services indicated by the Supreme Court's decision in Chaoulli v. Quebec has made that line of argument look risky as well. It is apparent that Canada failed to anticipate the possible interactions of domestic, international and constitutional law when it made commitments in the area of private health insurance at the WTO in 1997. Accordingly, the time has come to acknowledge the fragility of the boundary between health and trade policies, to take the risks and costs associated with trade treaty obligations fully into account when undertaking healthcare reform and to strengthen the separation between private and public health insurance.

  8. Crisis and Work: An Analysis of Emergency Labour Market Policies in Portugal, Spain and Greece

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    Margarida Martins Barroso

    2017-01-01

    Full Text Available In this article, we analyse the main reforms introduced in the Portuguese, Spanish and Greek labour-markets since the beginning of the crisis. Based in a documental and statistical analysis, the study takes in consideration the similar institutional, historical and geographic characteristics of these countries, but also their particularities. Results show that the emergency policies tend to resemble and to concentrate on dismissals, contracts, working time, salaries, collective bargaining and working conditions in the public sector. Nonetheless, the pre-crisis structural variations between these countries, together with the different effects that the crisis had in each one of them, help to understand possible differences in terms of results, giving a new contribution to the questioning of the internal homogeneity of the Mediterranean model.

  9. Personalisation - An Emergent Institutional Logic in Healthcare?; Comment on “(Re Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”

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    Ewan Ferlie

    2018-01-01

    Full Text Available This commentary on the recent think piece by Mannion and Exworthy reviews their core arguments, highlighting their suggestion that recent forces for personalization have emerged which may counterbalance the strong standardization wave which has been evident in many healthcare settings and systems over the last two decades. These forces for personalization can take very different forms. The commentary explores the authors’ suggestion that these themes can be fruitfully examined theoretically through an institutional logics (ILs literature, which has recently been applied by some scholars to healthcare settings. This commentary outlines key premises of that theoretical tradition. Finally, the commentary makes suggestions for taking this IL influenced research agenda further, along with some issues to be addressed.

  10. The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Laws.

    Science.gov (United States)

    Barraza, Leila; Schmit, Cason; Hoss, Aila

    2017-03-01

    This paper discusses recent changes to state legal frameworks for mandatory vaccination in the context of school and healthcare worker vaccination. It then discusses state laws that allow pharmacists the authority to vaccinate.

  11. Experience and policy implications of children presenting with dental emergencies to US pediatric dentistry training programs.

    Science.gov (United States)

    Edelstein, Burton; Vargas, Clemencia M; Candelaria, Devanie; Vemuri, Maryen

    2006-01-01

    The purpose of this study was to describe and substantiate the experience of children, their families, and their caregivers with children's dental pain and to explore implications of these experiences for public policy. Data for 301 children presenting to 35 pediatric dentistry training programs during a 1-week period in 2000 for pain relief were collected with a questionnaire asking for: (1) sociodemographic characteristics; (2) oral health status; (3) dental care history; (4) presenting problem; (5) clinical findings; and (6) clinical disposition. Descriptive statistics are presented. Among children presenting to training programs with oral pain, 28% were under age 6, 57% were on Medicaid, and 38% were regarded by their dentists to have "likely or obvious" functional impairment-with 22% reporting the highest pain level. Parents reported that 59% had "poor or fair oral health" and 29% had a prior dental emergency in the previous year. Pain, experienced for several days by 73% of children, was associated with difficulty: (1) eating; (2) sleeping; (3) attending school; and (4) playing. Parent-reported barriers to seeking dental care included: (1) missed work (24%); (2) transportation costs (12%); and (3) arranging child care (10%). In this study of children with dental pain, many suffered significant pain: (1) duration; (2) intensity; (3) recurrence; and (4) consequences. This study demonstrates the ongoing need for public policies that assure timely, comprehensive, and affordable dental care for vulnerable children.

  12. A Model for Good Governance of Healthcare Technology Management in the Public Sector: Learning from Evidence-Informed Policy Development and Implementation in Benin.

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    P Th Houngbo

    Full Text Available Good governance (GG is an important concept that has evolved as a set of normative principles for low- and middle-income countries (LMICs to strengthen the functional capacity of their public bodies, and as a conditional prerequisite to receive donor funding. Although much is written on good governance, very little is known on how to implement it. This paper documents the process of developing a strategy to implement a GG model for Health Technology Management (HTM in the public health sector, based on lessons learned from twenty years of experience in policy development and implementation in Benin. The model comprises six phases: (i preparatory analysis, assessing the effects of previous policies and characterizing the HTM system; (ii stakeholder identification and problem analysis, making explicit the perceptions of problems by a diverse range of actors, and assessing their ability to solve these problems; (iii shared analysis and visioning, delineating the root causes of problems and hypothesizing solutions; (iv development of policy instruments for pilot testing, based on quick-win solutions to understand the system's responses to change; (v policy development and validation, translating the consensus solutions identified by stakeholders into a policy; and (vi policy implementation and evaluation, implementing the policy through a cycle of planning, action, observation and reflection. The policy development process can be characterized as bottom-up, with a central focus on the participation of diverse stakeholders groups. Interactive and analytical tools of action research were used to integrate knowledge amongst actor groups, identify consensus solutions and develop the policy in a way that satisfies criteria of GG. This model could be useful for other LMICs where resources are constrained and the majority of healthcare technologies are imported.

  13. Follow-up after Involuntary Mental Healthcare: Who Cares? Emergency Compulsory Admission and Continuity of Care in Rotterdam, the Netherlands

    NARCIS (Netherlands)

    A.I. Wierdsma (André)

    2008-01-01

    textabstractIn 2000 Dutch television broadcasted a documentary, filmed by Hans Polak, about people who neglect themselves and their social environment. The film shows public mental health workers visiting people who fall outside of the regular healthcare system. These people live on the

  14. From Big Data to Smart Data for Pharmacovigilance: The Role of Healthcare Databases and Other Emerging Sources.

    Science.gov (United States)

    Trifirò, Gianluca; Sultana, Janet; Bate, Andrew

    2018-02-01

    In the last decade 'big data' has become a buzzword used in several industrial sectors, including but not limited to telephony, finance and healthcare. Despite its popularity, it is not always clear what big data refers to exactly. Big data has become a very popular topic in healthcare, where the term primarily refers to the vast and growing volumes of computerized medical information available in the form of electronic health records, administrative or health claims data, disease and drug monitoring registries and so on. This kind of data is generally collected routinely during administrative processes and clinical practice by different healthcare professionals: from doctors recording their patients' medical history, drug prescriptions or medical claims to pharmacists registering dispensed prescriptions. For a long time, this data accumulated without its value being fully recognized and leveraged. Today big data has an important place in healthcare, including in pharmacovigilance. The expanding role of big data in pharmacovigilance includes signal detection, substantiation and validation of drug or vaccine safety signals, and increasingly new sources of information such as social media are also being considered. The aim of the present paper is to discuss the uses of big data for drug safety post-marketing assessment.

  15. Policy strategies for an emergent technology: Lessons from the analysis of EV-policy in 8 North- European countries

    NARCIS (Netherlands)

    M. van der Steen (Martijn); R.M. Van Schelven; P. Van Deventer (Peter); M. van Twist (Mark); R. Kotter

    2015-01-01

    textabstractThis paper presents data from a comparative study of EV-policies in 8 different North-European countries, that maps out all of the policies of these countries (and a range of regions and cities) that target passenger vehicles (PHEV and BEV), chargers (home, private, public; level 1-3),

  16. Protecting Healthcare Personnel in Outpatient Settings: The Influence of Mandatory Versus Nonmandatory Influenza Vaccination Policies on Workplace Absenteeism During Multiple Respiratory Virus Seasons.

    Science.gov (United States)

    Frederick, John; Brown, Alexandria C; Cummings, Derek A; Gaydos, Charlotte A; Gibert, Cynthia L; Gorse, Geoffrey J; Los, Jenna G; Nyquist, Ann-Christine; Perl, Trish M; Price, Connie S; Radonovich, Lewis J; Reich, Nicholas G; Rodriguez-Barradas, Maria C; Bessesen, Mary T; Simberkoff, Michael S

    2018-04-01

    OBJECTIVE To determine the effect of mandatory and nonmandatory influenza vaccination policies on vaccination rates and symptomatic absenteeism among healthcare personnel (HCP). DESIGN Retrospective observational cohort study. SETTING This study took place at 3 university medical centers with mandatory influenza vaccination policies and 4 Veterans Affairs (VA) healthcare systems with nonmandatory influenza vaccination policies. PARTICIPANTS The study included 2,304 outpatient HCP at mandatory vaccination sites and 1,759 outpatient HCP at nonmandatory vaccination sites. METHODS To determine the incidence and duration of absenteeism in outpatient settings, HCP participating in the Respiratory Protection Effectiveness Clinical Trial at both mandatory and nonmandatory vaccination sites over 3 viral respiratory illness (VRI) seasons (2012-2015) reported their influenza vaccination status and symptomatic days absent from work weekly throughout a 12-week period during the peak VRI season each year. The adjusted effects of vaccination and other modulating factors on absenteeism rates were estimated using multivariable regression models. RESULTS The proportion of participants who received influenza vaccination was lower each year at nonmandatory than at mandatory vaccination sites (odds ratio [OR], 0.09; 95% confidence interval [CI], 0.07-0.11). Among HCP who reported at least 1 sick day, vaccinated HCP had lower symptomatic days absent compared to unvaccinated HCP (OR for 2012-2013 and 2013-2014, 0.82; 95% CI, 0.72-0.93; OR for 2014-2015, 0.81; 95% CI, 0.69-0.95). CONCLUSIONS These data suggest that mandatory HCP influenza vaccination policies increase influenza vaccination rates and that HCP symptomatic absenteeism diminishes as rates of influenza vaccination increase. These findings should be considered in formulating HCP influenza vaccination policies. Infect Control Hosp Epidemiol 2018;39:452-461.

  17. Policy maker and provider knowledge and attitudes regarding the provision of emergency contraceptive pills within Lao PDR

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    Hansana Visanou

    2010-07-01

    Full Text Available Abstract Background The Ministry of Health (MOH launched the National Reproductive Health Policy in 2005, which included recommendations regarding the use of emergency contraceptive pills (ECP. However, ECP have not yet been introduced officially in the public sector of the Lao PDR. Thus, their availability is limited. Understanding the knowledge of ECP and attitudes about their provision, barriers to use, and availability among health providers and policy makers is essential to successfully incorporate ECP into reproductive health services. Methods Qualitative research methods using in-depth interviews were employed to collect data from policy makers and health providers (auxiliary medical staff, nurses, and medical doctors. Altogether, 10 policy makers, 22 public providers, and 10 providers at private clinics were interviewed. Content analysis was applied to analyze the transcribed data. Results The majority of policy makers and health care providers had heard about ECP and supported their introduction in the public sector. However, their knowledge was poor, many expressed inconsistent attitudes, and their ability to meet the demand of potential users is limited. Conclusions There is a need to train health providers and policy makers on emergency contraception and improve their knowledge about ECP, especially regarding the correct timing of use and the availability of methods. In addition, the general public must be informed of the attributes, side effects, and availability of ECP, and policy makers must facilitate the approval of ECP by the Lao Food and Drug Administration. These interventions could lead to increased access to and demand for ECP.

  18. There Are Many Purposes for Conditional Incentives to Accessing Healthcare; Comment on “Denial of Treatment to Obese Patients—the Wrong Policy on Personal Responsibility for Health”

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    Sridhar Venkatapuram

    2013-01-01

    Full Text Available This commentary is a brief response to Nir Eyal’s argument that health policies should not make healthy behaviour a condition or prerequisite in order to access healthcare as it could result in the people who need healthcare the most not being able to access healthcare. While in general agreement due to the shared concern for equity, I argue that making health behaviour a condition to accessing healthcare can serve to develop commitment to lifestyle changes, make the health intervention more successful, help appreciate the value of the resources being spent, and help reflect on the possible risks of the intervention. I also argue that exporting or importing the carrot and stick policies to other countries without a solid understanding of the fiscal and political context of the rise of such policies in the US can lead to perverse consequences.

  19. Impact of new healthcare legislation and price policy on healthcare services provider at the time of financial crisis. A 10 years study

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    Ivona Malovecka

    2015-03-01

    Full Text Available Monitoring, calculation and assessment of healthcare services prosperity in the community pharmacy with the help of financial analysis indicators for the years 2003-2012, using financial statements was conducted, with respect to profitability, debt, liquidity, working capital, and efficiency parameters. These ratios reflect various changes that hold between years 2003 and 2012. Under the time of financial crisis, recession and serious socio-economic changes the profitability parameter Gross Profit ranged from 2003-2011 = 16.12-22.79% (average = 19.20%; mean = 19.78%; σ = 2.41, but in 2012 decreased on 14.35%. Net Profit ranged 2003-2011 = 10.96-18.3% (average = 14.62%; mean = 16.62%; σ = 4.92, while in 2012 reached only 2.29%. Debt ratio ranged from 2003-2012= 2.33-4.81 (average = 3.44; mean = 3.07; σ = 0.82. Liquidity parameters Current Ratio spread between 2003-2012 = 1.13-1.71 (average = 1.43; mean = 1.46; σ = 0.15 and Quick Ratio spread between 2003-2012 = 0.72-1.27 (average = 1.07; mean = 1.09; σ = 0.15. Working Capital Ratio ranged from 2003-2012 = 2.66-12.94 (average = 9.58; mean = 10.06; σ = 3.1 and efficiency ratios were measured either. All changes that have taken place in the society had an impact on community pharmacy finance by worsening its profitability, liquidity, working capital and some of efficiency parameters. Therefore the stability of community pharmacy may be threatened and may affect its future performance.http://dx.doi.org/10.7175/fe.v16i1.1040

  20. An emerging interface between life science and nanotechnology: present status and prospects of reproductive healthcare aided by nano-biotechnology

    OpenAIRE

    Jha, Rakhi K.; Jha, Pradeep K.; Chaudhury, Koel; Rana, Suresh V.S.; Guha, Sujoy K.

    2014-01-01

    Among the various applications of nano-biotechnology, healthcare is considered one of the most significant domains. For that possibility to synthesize various kind of nanoparticles (NPs) and the ever-increasing ability to control their size as well as structure, to improve surface characteristics and binding NPs with other desired curing agents has played an important role. In this paper, a brief sketch of various kinds of nanomaterials and their biomedical applications is given. Despite clai...

  1. Neoliberal policy impact: supply-side growth and emergence of duality in Turkish tobacco product market

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    Efza Evrengil

    2018-03-01

    Full Text Available Background In Turkey, adoption and implementation of MPOWER strategies were accompanied by a neoliberal tobacco policy framework aiming at supply-side growth, initiated in 1980's and culminating in Law No 4733 in 2002, which solidified liberalization, privatization, and market efficiency rules for tobacco manufacturing and trade, and guaranteed oligopoly conditions for transnational tobacco companies (TTCs. This study employs empirical market dynamics data to argue that demand reduction strategies cannot be pursued effectively in tandem with neoliberal policies. Methods Legal market dynamics are gauged with official data (2003-2016 on licenced tobacco products. The magnitude of illicit product market is assessed by employing prevalence data and estimations in secondary sources. Results During 2003-2016, (a Manufacturing and exports of licenced products have risen sharply (Cigarette manufacturing by 3 billion sticks/year; 2 new cigarette brands licenced per month. The declining trend in legal cigarette sales since 1999 was disrupted during last 5 years and was pushed upward. (b In addition to illicit cigarettes (market share 7.5%, the staggering growth in illicit RYO tobacco, estimated at 15,000 tonnes for 2016 by Tobacco Experts Association, represents 20.5 billion cigarette equivalents, which explains legal sales of 19 billion macarons (empty cigarette tubes in 2016. Estimated share of illicit products in total consumption has thus reached unprecedented level of 27%. Furthermore, using prevalence data, WPT market is estimated as 99% illicit. Conclusions Both legal and illicit tobacco product markets are growing in Turkey, indicating neoliberal framework has had far larger de facto impact than demand reduction efforts, and Law No 4733 is failing, given emergent duality between legal and illicit markets epitomised by TTCs and domestic outfits, respectively. This picture is in clear defiance of FCTC objectives, principles, and obligations, and

  2. Relationship between implementing interpersonal communication and mass education campaigns in emergency settings and use of reproductive healthcare services: evidence from Darfur, Sudan.

    Science.gov (United States)

    Adam, Izzeldin Fadl; Nakamura, Keiko; Kizuki, Masashi; Al Rifai, Rami; Vanching, Urnaa

    2015-09-15

    (1) To examine changes in women's awareness and utilisation of reproductive healthcare services in emergency settings following provision of interpersonal communication (IPC) and mass education campaigns, and (2) to describe factors associated with reproductive healthcare service use in internally displaced person (IDP) camps. Three camps containing 88 984 IDPs in Darfur, Sudan. 640 women aged 15-49 who had experienced pregnancy in the camp during the previous 2 years were enrolled in each of two independent cross-sectional surveys 26 months apart. IPC and mass education campaigns where community health workers disseminated information by home/shelter visits, clinic sessions, public meetings and other means to raise awareness and promote reproductive healthcare service use. Awareness of the existence of antenatal care (ANC) and tetanus toxoid (TT) vaccination services, reception of ANC and TT vaccination, place of delivery and use of postnatal care (PNC). The percentage of women who received home visits, and attended in-clinic sessions and public meetings increased from 61.6% to 86.7%, from 43.0% to 68.8%, and from 3.8% to 39.8%, respectively, between the initial and follow-up surveys. More women were aware of ANC (OR 18.6, 95% CI 13.1 to 26.5) and TT vaccination (OR 3.2, 95% CI 2.4 to 4.4) in the follow-up than the initial survey, after multivariable adjustment. More women received ≥3 ANC visits (OR 8.8, 95% CI 6.4 to 12.0) and ≥3 doses of TT (OR 2.5, 95% CI 1.9 to 3.3), delivered at a healthcare facility (OR 5.4, 95% CI 4.0 to 7.4) and received a PNC visit (OR 5.5, 95% CI 4.0 to 7.7) in the follow-up than in the initial survey, after multivariable adjustment. Awareness about and utilisation of reproductive healthcare services were higher in the follow-up survey. An integrated IPC and mass education campaign is effective for improving women's reproductive health in emergency settings. Published by the BMJ Publishing Group Limited. For permission to use

  3. Assessing the capacity of the healthcare system to use additional mechanical ventilators during a large-scale public health emergency (PHE)

    Science.gov (United States)

    Ajao, Adebola; Nystrom, Scott V.; Koonin, Lisa M.; Patel, Anita; Howell, David R.; Baccam, Prasith; Lant, Tim; Malatino, Eileen; Chamberlin, Margaret; Meltzer, Martin I.

    2015-01-01

    A large-scale Public Health Emergency (PHE), like a severe influenza pandemic can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use. We identified key components of the healthcare system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (i.e. conventional, contingency and crisis) and determined the constraining key component at each capacity level. Our study results showed that U.S. hospitals could absorb between 26,200 and 56,300 additional ventilators at the peak of a national influenza pandemic outbreak with robust pre-pandemic planning. This methodology could be adapted by emergency planners to determine stockpiling goals for critical resources or identify alternatives to manage overwhelming critical care need. PMID:26450633

  4. Policy, Practice, and Research Agenda for Emergency Medical Services Oversight: A Systematic Review and Environmental Scan.

    Science.gov (United States)

    Taymour, Rekar K; Abir, Mahshid; Chamberlin, Margaret; Dunne, Robert B; Lowell, Mark; Wahl, Kathy; Scott, Jacqueline

    2018-02-01

    criteria; 46 included process, 36 outcomes, and 18 structural measures. Most studies applied quality measures at the personnel level (40), followed by the agency (28) and system of care (28), and few at the oversight level (5). Numerous grey literature articles provided principles for high-quality EMS oversight. Limited quality measurement at the oversight level is an important gap in the peer-reviewed literature. The grey literature is ahead in this realm and can guide the policy and research agenda for EMS oversight quality measurement. Taymour RK , Abir M , Chamberlin M , Dunne RB , Lowell M , Wahl K , Scott J . Policy, practice, and research agenda for Emergency Medical Services oversight: a systematic review and environmental scan. Prehosp Disaster Med. 2018;33(1):89-97.

  5. Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

    Science.gov (United States)

    Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M

    2018-01-01

    In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

  6. Tweak, adapt, or transform: Policy scenarios in response to emerging bioenergy markets in the U.S

    Science.gov (United States)

    Ryan. C. Atwell; Lisa. A. Schulte; Lynne M. Westphal

    2011-01-01

    Emerging bioenergy markets portend both boon and bane for regions of intensive agricultural production worldwide. To understand and guide the effects of bioenergy markets on agricultural landscapes, communities, and economies, we engaged leaders in the Corn Belt state of Iowa in a participatory workshop and follow-up interviews to develop future policy scenarios....

  7. Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt

    NARCIS (Netherlands)

    Hoytema van Konijnenburg, Eva M. M.; Diderich, Hester M.; Teeuw, Arianne H.; Klein Velderman, Mariska; Oudesluys-Murphy, Anne Marie; van der Lee, Johanna H.; Biezeveld, Maarten H.; Brilleslijper-Kater, Sonja N.; Edelenbos, Esther; Flapper, Boudien C.; van Goudoever, Johannes B.; Lindauer, Ramón J. L.; Mahdi, Ulrike; Poldervaart, Jacoba D.; Sanders, Marian K.; Schoonenberg, N. Jolande; Sieswerda-Hoogendoorn, Tessa; van Sommeren, Pauwlina G. W.; Vogt, Anne; Wilms, Janneke F.; Baeten, Paul; Fekkes, Minne; Pannebakker, Fieke D.; Sorensen, Peggy J. G.; Verkerk, Paul H.

    2016-01-01

    To improve identification of child maltreatment, a new policy ('Hague protocol') was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care

  8. Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt

    NARCIS (Netherlands)

    Hoytema van Konijnenburg, E.M.; Diderich, H.M.; Teeuw, A.H.; Klein Velderman, M.; Oudesluys-Murphy, A.M.; Lee, J.H. van der

    2016-01-01

    To improve identification of child maltreatment, a new policy (‘Hague protocol’) was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care

  9. The role of cross-listing, foreign ownership and state ownership in dividend policy in an emerging market

    Directory of Open Access Journals (Sweden)

    Kevin C.K. Lam

    2012-09-01

    Full Text Available In this paper, we investigate if dividend policy is influenced by ownership type. Within the dividend literature, dividends have a signaling role regarding agency costs, such that dividends may diminish insider conflicts (reduce free cash flow or may be used to extract cash from firms (tunneling effect – which could be predominant in emerging markets. We expect firms with foreign ownership and those that are listed in overseas markets to have different dividend policies and practices than those that are not, and firms with more state ownership and less individual ownership to be more likely to pay cash dividends and less likely to pay stock dividends. Using firms from an emerging economy (China, we examine whether these effects exist in corporate dividend policy and practice. We find that both foreign ownership and cross-listing have significant negative effects on cash dividends, consistent with the signaling effect and the notion of reduced tunneling activities for firms with the ability to raise capital from outside of China. Consistent with the tunneling effect, we find that firms with higher state ownership tend to pay higher cash dividends and lower stock dividends, while the opposite is true for public (individual ownership. Further analysis shows that foreign ownership mediates the effect of state ownership on dividend policy. Our results have significant implications for researchers, investors, policy makers and regulators in emerging markets.

  10. Rationing hepatitis C treatment in the context of austerity policies in France and Cameroon: A transnational perspective on the pharmaceuticalization of healthcare systems.

    Science.gov (United States)

    Chabrol, Fanny; David, Pierre-Marie; Krikorian, Gaëlle

    2017-08-01

    New powerful drugs against hepatitis C can cure the disease, but they are not widely distributed because their exorbitant prices are destabilizing healthcare systems in both African and European countries. This article takes access to hepatitis C treatments since 2013 in France and in Cameroon as a lens to analyze the rationing of pharmaceutical treatments in relation to recent transformations of health systems. Access to these treatments is analyzed thanks to ethnographic observation and interviews lead in Paris and Yaoundé, with patients, associations, health professionals and public health experts. In Cameroon, rationing takes place through various layers of socio-economic restrictions, and no patient organization advocates for hepatitis treatment. In France, access to hepatitis C treatments has become politicized, and collective mobilizations have denounced rationing as a threat to the promise of universal social security. In this study, we examine Africa's long experience with rationing in the context of structural adjustment, and we bring together experiences in France and Cameroon. This article analyses the phenomenon of the pharmaceuticalization of healthcare systems, that is to say the growing use of pharmaceuticals in healthcare systems, by documenting the social and political construction of scarcity. Indeed, whereas pharmaceuticalization is a concept that has often been used in situations of drugs abundance, a parallel analysis of rationing highlights a political economy of pharmaceuticals that shapes public health debates and policies according to an economy of scarcity, especially in times of austerity. Copyright © 2017. Published by Elsevier Ltd.

  11. Emergence of a rehabilitation medicine model for low vision service delivery, policy, and funding.

    Science.gov (United States)

    Stelmack, Joan

    2005-05-01

    A rehabilitation medicine model for low vision rehabilitation is emerging. There have been many challenges to reaching consensus on the roles of each discipline (optometry, ophthalmology, occupational therapy, and vision rehabilitation professionals) in the service delivery model and finding a place in the reimbursement system for all the providers. The history of low vision, legislation associated with Centers for Medicare and Medicaid Services coverage for vision rehabilitation, and research on the effectiveness of low vision service delivery are reviewed. Vision rehabilitation is now covered by Medicare under Physical Medicine and Rehabilitation codes by some Medicare carriers, yet reimbursement is not available for low vision devices or refraction. Also, the role of vision rehabilitation professionals (rehabilitation teachers, orientation and mobility specialists, and low vision therapists) in the model needs to be determined. In a recent systematic review of the scientific literature on the effectiveness of low vision services contracted by the Agency for Health Care Quality Research, no clinical trials were found. The literature consists primarily of longitudinal case studies, which provide weak support for third-party funding for vision rehabilitative services. Providers need to reach consensus on medical necessity, treatment plans, and protocols. Research on low vision outcomes is needed to develop an evidence base to guide clinical practice, policy, and funding decisions.

  12. Implementation of new policy and principles of harmonisation of nuclear emergency preparedness in conditions of emergency Response Centre of the Nuclear Regulatory Authority of the Slovak Republic

    International Nuclear Information System (INIS)

    Janko, K.; Zatlkajova, H.; Sladek, V.

    2003-01-01

    With respect to Chernobyl accident the changes in understanding of nuclear emergency preparedness have initiated a developing process resulting in an effective enhancement of conditions ensuring adequate response to nuclear or radiological accidents of emergency situations in many countries. The Slovak Nuclear Regulatory Authority (UJD) in frame of co-operations with IAEA, EC, OECD/NEA and other international organisations has actively participated in this challenging work targeting implementation of international experience and best practices in the country. The new international policy (principles declared e.g. in 'Memorandum of Understanding', IAEA, Vienna, 1997) based on experiences propagating importance of regional co-operation, harmonised approach and clear strategy for protective measures implementation in case of a nuclear or radiological accident has influenced the development also in Slovakia. The implementation process in the country was supported by changes in legal conditions regulating peaceful use of nuclear energy [1,2] including basic rules for emergency preparedness published in the second half of 1990 years. The principles of emergency preparedness in Slovakia fully support regional harmonisation and co-operation. Effective implementation of international practice and sharing of experience substantially contributed to the level of emergency response in the country and to the harmonisation of emergency response preparedness creating also conditions for an efficient regional integration. (authors)

  13. 'The way things are around here': organisational culture is a concept missing from New Zealand healthcare policy, development, implementation, and research.

    Science.gov (United States)

    Scahill, Shane L

    2012-01-20

    Internationally, healthcare sectors are coming under increasing pressure to perform and to be accountable for the use of public funds. In order to deliver on stakeholder expectation, transformation will need to occur across all levels of the health system. Outside of health care it has been recognised for some time that organisational culture (OC) can have a significant influence on performance and that it is a mediator for change. The health sector has been slow to adopt organisational theory and specifically the benefits of understanding OC and impacts on performance. During a visit to health research units in the United Kingdom (UK) I realised the stark differences in the practice of health reform and its evaluation. OC is a firmly established concept within policy development, implementation and research in the UK. Unfortunately, the same cannot be said for New Zealand. There has been unrelenting reform and structural redesign, particularly of the primary healthcare sector under multiple governments over the past 20 to 30 years. However, there has been an underwhelming focus on the human aspects of organisational change. This seems set to continue and the aim of this viewpoint is to introduce the concept of OC and outline why New Zealand policy reformists and health services researchers should be thinking explicitly about OC. Culture is not solely the domain of the organisational scientist and current understandings of the influence of OC on performance are outlined in this commentary. Potential benefits of thinking about culture are argued and a proposed research agenda is presented.

  14. De innovatione: The concept of innovation for medical technologies and its implications for healthcare policy-making

    OpenAIRE

    Ciani, Oriana; Armeni, Patrizio; Boscolo, Paola Roberta; Cavazza, Marianna; Jommi, Claudio; Tarricone, Rosanna

    2016-01-01

    Innovation is constantly evoked as an imperative to drive growth, however identifying an actionable and agreed upon definition that applies to different settings and purposes is not trivial. In healthcare, innovation has often been described in relation to pharmaceuticals. Defining innovation allows for proper recognition and rewarding, thus fostering present and future innovativeness in the system. Current definitions adopted by payers are focused on therapeutic added value and more specific...

  15. Children, Families and Poverty: Definitions, Trends, Emerging Science and Implications for Policy. Social Policy Report. Volume 26, Number 3

    Science.gov (United States)

    Aber, Lawrence; Morris, Pamela; Raver, Cybele

    2012-01-01

    Now, more than ever, it is crucial to address the topic of children and poverty in the U.S., given current scientific knowledge about poverty's influence on children and effective strategies to mitigate its negative impact. In this report, we summarize the best available information on definitions and trends in child poverty, policy responses to…

  16. Mapping an Emergent Field of "Computational Education Policy": Policy Rationalities, Prediction and Data in the Age of Artificial Intelligence

    Science.gov (United States)

    Gulson, Kalervo N.; Webb, P. Taylor

    2017-01-01

    Contemporary education policy involves the integration of novel forms of data and the creation of new data platforms, in addition to the infusion of business principles into school governance networks, and intensification of socio-technical relations. In this paper, we examine how "computational rationality" may be understood as…

  17. The emergence of innovation policy as a field: The international context and the Danish experience

    DEFF Research Database (Denmark)

    Christensen, Jesper Lindgaard; Fagerberg, Jan

    2018-01-01

    This chapter traces the development of scholarly interest in innovation and innovation policy in the Western world in general and in Denmark in particular, ranging from the early post-war period to the early years of the new millennium. In the early post-war world, innovation was commonly identif...... of innovation and innovation policy instruments in Denmark gradually evolved under the influence of similar developments elsewhere, and as a response to policy needs and lessons from earlier (industrial) policies....

  18. Why healthcare providers merge.

    Science.gov (United States)

    Postma, Jeroen; Roos, Anne-Fleur

    2016-04-01

    In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities.

  19. Involuntary psychiatric attendances at an Australasian emergency department: A comparison of police and health-care worker initiated presentations.

    Science.gov (United States)

    Llewellin, Peter; Arendts, Glenn; Weeden, Jacqueline; Pethebridge, Andrew

    2011-10-01

    To identify any significant differences in the population of patients brought in to a hospital ED under involuntary mental health orders, based on whether the orders are initiated by police or health professionals. A retrospective analysis of consecutive presentations to a tertiary hospital ED with a co-located psychiatric emergency care centre over a 12 month period, with univariate and multivariate statistical comparisons. Two hundred and eighty-two patients (making 378 ED presentations) met the case definition and were analysed. Compared with patients on medical orders, patients on police orders had significantly more presentations related to violence, longer stays in ED and lower rates of admission to an inpatient bed, but were no more likely to require restraint or security intervention within the ED. Patients on police and medical orders differ considerably, but the impact of these differences on ED workload is small. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  20. Effectiveness of emergency nurses' use of the Ottawa Ankle Rules to initiate radiographic tests on improving healthcare outcomes for patients with ankle injuries: A systematic review.

    Science.gov (United States)

    Ho, Jonathan Ka-Ming; Chau, Janita Pak-Chun; Cheung, Nancy Man-Ching

    2016-11-01

    The Ottawa Ankle Rules provide guidelines for clinicians on the recommendation of radiographic tests to verify fractures in patients with ankle injuries. The use of the Ottawa Ankle Rules by emergency nurses has been suggested to minimise unnecessary radiographic-test requests and reduce patients' length of stay in emergency departments. However, the findings of studies in this area are inconsistent. A systematic review was conducted to synthesise the most accurate evidence available on the extent to which emergency nurses' use of the Ottawa Ankle Rules to initiate radiographic tests improves healthcare outcomes for patients with ankle injuries. The systematic review attempted to identify all relevant published and unpublished studies in English and Chinese from databases such as Ovid MEDLINE, EMBASE, ProQuest Health and Medical Complete, EBM Reviews, SPORTDiscus, CINAHL Plus, the British Nursing Index, Scopus, the Chinese Biomedical Literature Database, China Journal Net, WanFang Data, the National Central Library Periodical Literature System, HyRead, the Digital Dissertation Consortium, MedNar and Google Scholar. Two reviewers independently assessed the eligibility of all of the studies identified during the search, based on their titles and abstracts. If a study met the criteria for inclusion, or inconclusive information was available in its title and abstract, the full text was retrieved for further analysis. The methodological quality of all of the eligible studies was assessed independently by the two reviewers. The search of databases and other sources yielded 1603 records. The eligibility of 17 full-text articles was assessed, and nine studies met the inclusion criteria. All nine studies were subjected to narrative analysis, and five were meta-analysed. All of the studies investigated the use of the refined Ottawa Ankle Rules. The results indicated that emergency nurses' use of the refined Ottawa Ankle Rules minimised unnecessary radiographic-test requests

  1. Diplomatic strategies around FOCALAE: emerging platform for Latin American policy of China Popular

    Directory of Open Access Journals (Sweden)

    Roberto Ren-rang Chyou

    2008-10-01

    Full Text Available The People's Republic of China has always followed a policy of no alignment, even with its neighbors of the Southeast Asian region. But since every rule has an exception, the People's Republic of China changed its position in 1990, by joining the core of the Asian Region, in an action interpreted as remuneration for the support received in favor of its legal status, and for the political support to the principle of the "One China" In time, the financial Asian crisis has created a bi-polar development, with the Southern countries still under the influence of the financial sequels of the crisis, and the Northern ones, as the People's Republic of China, Japan, South Korea, Taiwan and Hong Kong attaining evident economic achievements. With the financial crisis, Beijing was invited to participate in the Asian Forum of BOAO, under the political clout of the "ASEAN+3" group. The People's Republic of China also actively cooperates in the Forum for East Asia-Latin America Cooperation (FEALAC, in order to project a "southern political sphere", able to act as a fence around the Capitalist World Axis, under the leadership of USA. The People's Republic of China, after gaining the desired success in the BOAO by projecting the image of "a China in peaceful emergence", has been able to come out as the leader of the Southeast Asian region, and also has managed to focus the international attention in the FEALAC. Nowadays, everybody tries to understand the real intentions of China in this forum. Does China look at it as a mere negotiation forum for South to South relations or it wants to turn it into a replica of the BOAO, to use it as a tool to influence Latin America?

  2. Is monetary policy really neutral in the long-run? Evidence for some emerging and developed economies

    OpenAIRE

    Reginaldo Pinto Nogueira

    2009-01-01

    The traditional economic theory suggests that changes in the money supply or in the interest rates can influence the business cycle, but not the long-run potential output. In other words, monetary policy is neutral over the long-run. In this paper we use some new developments in econometrics to test for the existence of a long-run relationship between the monetary policy instrument used by most Central Banks - short-term interest rates - and real output. Using annual data for 14 emerging and ...

  3. Antimicrobial resistance global emergence: healthcare facilities or environmental microbiota as the most important reservoir of antibiotic resistant microorganisms?

    Directory of Open Access Journals (Sweden)

    Roberta Migliavacca

    2016-06-01

    Full Text Available The ecosystems contamination caused by drugs and by their biologically active transformation products has become an emerging environmental issue: recently developed analytical and sensitive methods have allowed the detection of these pollutants in different matrices (like water, soil, sediment. [...

  4. Current and emerging occupational safety and health (OSH) issues in the healthcare sector, including home and community care

    NARCIS (Netherlands)

    Jong, T. de; Bos, E.; Pawlowska-Cyprysiak, K.; Hildt-Ciupinska, K.; Malinska, M.; Nicolescu, G.; Trifu, A.

    2014-01-01

    This report gives an overview of the current and emerging OSH issues for health- and social care workers and how these affect their safety and health at work and influence the quality of care they provide. It combines a literature review and the responses received to a questionnaire sent to OSH

  5. The effect of establishing a new, reorganized emergency department on quality of clinical healthcare and patient satisfaction

    DEFF Research Database (Denmark)

    Mattsson, Maria Søe

    2015-01-01

    in Denmark is seen. The quasi-experimental design of this study makes it difficult to conclude whether the observed improvement is directly related to the establishment of the new emergency department; however, significant results seems to be associated to the specific initiatives in the reorganization...

  6. Practical Aspects of the Use of Healthcare Failure Mode and Effects Analysis Tool in The Risk Management of Pediatric Emergency Department: The Scrutiny in Iran

    Directory of Open Access Journals (Sweden)

    Yasamin Molavi-Taleghani

    2018-03-01

    Full Text Available Aim: The Emergency Department is one of the most challenging wards of the hospital for studying patient safety and the prevention of treatment errors is the basic rule in the quality of health care. The present study was conducted to evaluate the selected risk processes of Pediatric Emergency of Qaem Educational Hospital in Mashhad by the Healthcare Failure Mode and Effects Analysis (HFMEA methodology. Materials and Methods: A mixed method was used to analyze failure modes and their effects with HFMEA. Five high-risk processes of the Pediatric Emergency were identified and analyzed. To classify failure modes, nursing errors in clinical management model; for classifying factors affecting error, the approved model by the United Kingdom National Health System; and for determining solutions for improvement, Theory of Inventive Problem Solving was used. Results: In 5 selected processes, 28 steps, 80 sub-processes and 254 potential failure modes were identified with HFMEA. Thirty-seven (14.5% failure modes as high-risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors as 62.3%, and knowledge and skill as 8.1% respectively. Also, 23.6% of preventive measures were in the category of human resource management strategy. Conclusion: Using the proactive method of HFMEA for identifying the possible failure of treatment procedures, determining the effective cause on each failure mode and proposing the improvement strategies, has high efficiency and effectiveness.

  7. The livelihoods of Haitian health-care providers after the january 2010 earthquake: a pilot study of the economic and quality-of-life impact of emergency relief.

    Science.gov (United States)

    Haar, Rohini J; Naderi, Sassan; Acerra, John R; Mathias, Maxwell; Alagappan, Kumar

    2012-03-02

    An effective international response to a disaster requires cooperation and coordination with the existing infrastructure. In some cases, however, international relief efforts can compete with the local work force and affect the balance of health-care systems already in place. This study seeks to evaluate the impact of the international humanitarian response to the 12 January 2010 earthquake on Haitian health-care providers (HHP). Fifty-nine HHPs were surveyed in August of 2010 using a modified World Health Organization Quality of Life-Brief questionnaire (WHOQoL-B) that included questions on respondents' workload before the earthquake, immediately after, and presently. The study population consisted of physicians, nurses, and technicians at public hospitals, non-governmental organization (NGO) clinics, and private offices in Port-au-Prince, Haiti. Following the earthquake, public hospital and NGO providers reported a significant increase in their workload (15 of 17 and 22 of 26 respondents, respectively). Conversely, 12 of 16 private providers reported a significant decrease in workload (p working a similar number of hours prior to the earthquake (average 40 h/week), they reported working significantly different amounts following the earthquake. Public hospital and NGO providers averaged more than 50 h/week, and private providers averaged just over 33 h/week of employment (p working at public hospitals and NGOs, however, had significantly lower scores on the WHOQoL-B when answering questions about their environment (p work among HHPs. To create a robust health-care system in the long term while meeting short-term needs, humanitarian responses should seek to better integrate existing systems and involve local providers in the design and implementation of an emergency program.

  8. The emergence of the vertical birth in Ecuador: an analysis of agenda setting and policy windows for intercultural health

    Science.gov (United States)

    Llamas, Ana; Mayhew, Susannah

    2016-01-01

    Maternal mortality continues to claim the lives of thousands of women in Latin America despite the availability of effective treatments to avert maternal death. In the past, efforts to acknowledge cultural diversity in birth practices had not been clearly integrated into policy. However, in Otavalo (Ecuador) a local hospital pioneered the implementation of the ‘Vertical Birth’—a practical manifestation of an intercultural health policy aimed at increasing indigenous women’s access to maternity care. Drawing on agenda-setting theory, this qualitative research explores how the vertical birth practice made it onto the local policy agenda and the processes that allowed actors to seize a window of opportunity allowing the vertical birth practice to emerge. Our results show that the processes that brought about the vertical birth practice took place over a prolonged period of time and resulted from the interplay between various factors. Firstly, a maternal health policy community involving indigenous actors played a key role in identifying maternal mortality as a policy problem, defining its causes and framing it as an indigenous rights issue. Secondly, previous initiatives to address maternal mortality provided a wealth of experience that gave these actors the knowledge and experience to formulate a feasible policy solution and consolidate support from powerful actors. Thirdly, the election of a new government that had incorporated the demands of the indigenous movement opened up a window of opportunity to push intercultural health policies such as the vertical birth. We conclude that the socioeconomic and political changes at both national and local level allowed the meaningful participation of indigenous actors that made a critical contribution to the emergence of the vertical birth practice. These findings can help us advance our knowledge of strategies to set the agenda for intercultural maternal health policy and inform future policy in similar settings

  9. Treating Dehydration at Home Avoids Healthcare Costs Associated With Emergency Department Visits and Hospital Readmissions for Adult Patients Receiving Home Parenteral Support.

    Science.gov (United States)

    Konrad, Denise; Roberts, Scott; Corrigan, Mandy L; Hamilton, Cindy; Steiger, Ezra; Kirby, Donald F

    2017-06-01

    Administration of home parenteral support (HPS) has proven to be cost-effective over hospital care. Avoiding hospital readmissions became more of a focus for healthcare institutions in 2012 with the implementation of the Affordable Care Act. In 2010, our service developed a protocol to treat dehydration at home for HPS patients by ordering additional intravenous fluids to be kept on hand and to focus patient education on the symptoms of dehydration. A retrospective analysis was completed through a clinical management database to identify HPS patients with dehydration. The hospital finance department and homecare pharmacy were utilized to determine potential cost avoidance. In 2009, 64 episodes (77%) of dehydration were successfully treated at home versus 6 emergency department (ED) visits (7.5%) and 13 readmissions (15.5%). In 2010, we successfully treated 170 episodes (84.5%) at home, with 9 episodes (4.5%) requiring ED visits and 22 hospital readmissions (11%). The number of dehydration episodes per patient was significantly higher in 2010 ( P dehydration identified and treated at home in 2010 versus 2009. Our protocol helped educate and provide the resources required to resolve dehydration at home when early signs were recognized. By reducing ED visits and hospital readmissions, healthcare costs were avoided by a factor of 29 when home treatment was successful.

  10. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    Science.gov (United States)

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.

  11. Essential equivalence: the objectives and requirements of a stategic nuclear policy: a perspective on the evolution of US strategic nuclear policy, and an assessment of present and emerging US strategic policy and force stucture options

    International Nuclear Information System (INIS)

    Hughes, P.C.

    1979-01-01

    This study provides a discussion of the origins and evolution of US strategic nuclear policy, the objectives an requirements of US nuclear forces, and an assessment of present and emerging US stategic nuclear policy and force structure options. It identifies the distinctive phases of US strategic nuclear policy, the conditions of the military environments in which those policies were developed, the interaction of US-Soviet strategic force and arms control processes during these phases, and the domestic debates which have accompanied US strategic nuclear policy developments. In particular, the study focuses on the major contending views which continue to characterize the debate concerning US strategic nuclear policy. The study assesses the implications of the contending views represented in what is commonly referred to as the counterforce-countervalue debate, particularly as they relate to the perception of what constitutes a credible US deterrent posture, and the corresponding alternatives that these views bring with them for making US strategic nuclear policy and force structure decisions. The arms control process, in general, and SALT I and SALT II in particular, is discussed as an integral and dynamic component of the strategic debate, fundamentally affecting the nation's security policies. The implications of modern weapons technology, and the problems inherent in preserving strategic stability between adversary nations with asymmetries in military force structures and doctrines, are also discussed. Further, the study focuses on the question of whether or not nuclear superiority can be considered relevant under the contemporary international conditions

  12. Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Hinkle, Janice L; Becker, Kyra J; Kim, Jong S; Choi-Kwon, Smi; Saban, Karen L; McNair, Norma; Mead, Gillian E

    2017-07-01

    At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers. © 2017 American Heart Association, Inc.

  13. The emergence of climate change adaptation as a new field of public policy in Europe

    OpenAIRE

    Massey, E.E.; Huitema, D.

    2016-01-01

    Over the past decade, climate change adaptation has become an integral item on the climate policy agendas of several European countries. As such, researchers have begun to question what concrete changes in polices are occurring at national levels and what dynamics can explain these changes. While new laws, policies and institutions have been created to deliver adaptation, supported through processes of cross-national policy innovation and learning, another interesting observation being made i...

  14. 3 CFR - Continuation of the National Emergency With Respect to the Actions and Policies of Certain...

    Science.gov (United States)

    2010-01-01

    ... processes or institutions; committed human rights abuses related to political repression, including..., including the release of internationally recognized political prisoners, the actions and policies of certain...

  15. How federal health-care policies interface with urban and rural areas: a comparison of three systems.

    Science.gov (United States)

    Baracskay, Daniel

    2012-01-01

    Global public health policies span national borders and affect multitudes of people. The spread of infectious disease has neither political nor economic boundaries, and when elevated to a status of pandemic proportions, immediate action is required. In federal systems of government, the national level leads the policy formation and implementation process, but also collaborates with supranational organisations as part of the global health network. Likewise, the national level of government cooperates with sub-national governments located in both urban and rural areas. Rural areas, particularly in less developed countries, tend to have higher poverty rates and lack the benefits of proper medical facilities, communication modes and technology to prevent the spread of disease. From the perspective of epidemiological surveillance and intervention, this article will examine federal health policies in three federal systems: Australia, Malaysia and the USA. Using the theoretical foundations of collaborative federalism, this article specifically examines how collaborative arrangements and interactions among governmental and non-governmental actors help to address the inherent discrepancies that exist between policy implementation and reactions to outbreaks in urban and rural areas. This is considered in the context of the recent H1N1 influenza pandemic, which spread significantly across the globe in 2009 and is now in what has been termed the 'post-pandemic era'.

  16. Translating for Linguistic Minorities in Northern Ireland: A Look at Translation Policy in the Judiciary, Healthcare, and Local Government

    Science.gov (United States)

    González Núñez, Gabriel

    2013-01-01

    Europe as a multilingual continent hosts three main types of languages: dominant languages, autochthonous minority languages, and new minority languages. From a policy standpoint, planning for speakers of these languages and their needs become a complex matter in which many actors with different interests are involved. Of the many issues which…

  17. Imagined in Policy, Inscribed on Bodies: Defending an Ethic of Compassion in a Political Context: Comment on "Why and How Is Compassion Necessary to Provide Good Quality Healthcare?".

    Science.gov (United States)

    Mercer, Dave

    2015-07-10

    In response to the International Journal of Health Policy and Management (IJHPM) editorial, this commentary adds to the debate about ethical dimensions of compassionate care in UK service provision. It acknowledges the importance of the original paper, and attempts to explore some of the issues that are raised in the context of nursing practice, research and education. It is argued that each of these fields of the profession are enacted in an escalating culture of corporatism, be that National Health Service (NHS) or university campus, and global neoliberalism. Post-structuralist ideas, notably those of Foucault, are borrowed to interrogate healthcare as discursive practice and disciplinary knowledge; where an understanding of the ways in which power and language operate is prominent. Historical and contemporary evidence of institutional and ideological degradation of sections of humanity, a 'history of the present,' serve as reminders of the import, and fragility, of ethical codes. © 2015 by Kerman University of Medical Sciences.

  18. Emerging School Sport Development Policy, Practice and Governance in England: Big Society, Autonomy and Decentralisation

    Science.gov (United States)

    Mackintosh, Chris; Liddle, Joyce

    2015-01-01

    International interest in developing mass sports participation through systems of school and community sports development has become a growing field of public leisure policy interest. This research paper considers the policy change from School Sport Partnerships to the new 2012 School Games model of networked partnerships to establish…

  19. Job satisfaction among mental healthcare professionals: The respective contributions of professional characteristics, team attributes, team processes, and team emergent states

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

    2017-01-01

    Objectives: The aim of this study was to determine the respective contribution of professional characteristics, team attributes, team processes, and team emergent states on the job satisfaction of 315 mental health professionals from Quebec (Canada). Methods: Job satisfaction was measured with the Job Satisfaction Survey. Independent variables were organized into four categories according to a conceptual framework inspired from the Input-Mediator-Outcomes-Input Model. The contribution of each category of variables was assessed using hierarchical regression analysis. Results: Variations in job satisfaction were mostly explained by team processes, with minimal contribution from the other three categories. Among the six variables significantly associated with job satisfaction in the final model, four were team processes: stronger team support, less team conflict, deeper involvement in the decision-making process, and more team collaboration. Job satisfaction was also associated with nursing and, marginally, male gender (professional characteristics) as well as with a stronger affective commitment toward the team (team emergent states). Discussion and Conclusion: Results confirm the importance for health managers of offering adequate support to mental health professionals, and creating an environment favorable to collaboration and decision-sharing, and likely to reduce conflicts between team members. PMID:29276591

  20. Job satisfaction among mental healthcare professionals: The respective contributions of professional characteristics, team attributes, team processes, and team emergent states.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

    2017-01-01

    The aim of this study was to determine the respective contribution of professional characteristics, team attributes, team processes, and team emergent states on the job satisfaction of 315 mental health professionals from Quebec (Canada). Job satisfaction was measured with the Job Satisfaction Survey. Independent variables were organized into four categories according to a conceptual framework inspired from the Input-Mediator-Outcomes-Input Model. The contribution of each category of variables was assessed using hierarchical regression analysis. Variations in job satisfaction were mostly explained by team processes, with minimal contribution from the other three categories. Among the six variables significantly associated with job satisfaction in the final model, four were team processes: stronger team support, less team conflict, deeper involvement in the decision-making process, and more team collaboration. Job satisfaction was also associated with nursing and, marginally, male gender (professional characteristics) as well as with a stronger affective commitment toward the team (team emergent states). Results confirm the importance for health managers of offering adequate support to mental health professionals, and creating an environment favorable to collaboration and decision-sharing, and likely to reduce conflicts between team members.

  1. The 2017 Academic College of Emergency Experts and Academy of Family Physicians of India position statement on preventing violence against health-care workers and vandalization of health-care facilities in India.

    Science.gov (United States)

    Chauhan, Vivek; Galwankar, Sagar; Kumar, Raman; Raina, Sunil Kumar; Aggarwal, Praveen; Agrawal, Naman; Krishnan, S Vimal; Bhoi, Sanjeev; Kalra, O P; Soans, Santosh T; Aggarwal, Vandana; Kubendra, Mohan; Bijayraj, R; Datta, Sumana; Srivastava, R P

    2017-01-01

    There have been multiple incidents where doctors have been assaulted by patient relatives and hospital facilities have been vandalized. This has led to mass agitations by Physicians across India. Violence and vandalism against health-care workers (HCWs) is one of the biggest public health and patient care challenge in India. The sheer intensity of emotional hijack and the stress levels in both practicing HCWs and patient relative's needs immediate and detail attention. The suffering of HCWs who are hurt, the damage to hospital facilities and the reactionary agitation which affects patients who need care are all together doing everything to damage the delivery of health care and relationship between a doctor and a patient. This is detrimental to India where illnesses and Injuries continue to be the biggest challenge to its growth curve. The expert group set by The Academic College of Emergency Experts and The Academy of Family Physicians of India makes an effort to study this Public Health and Patient Care Challenge and provide recommendations to solve it.

  2. Adoption and Design of Emerging Dietary Policies to Improve Cardiometabolic Health in the US.

    Science.gov (United States)

    Huang, Yue; Pomeranz, Jennifer; Wilde, Parke; Capewell, Simon; Gaziano, Tom; O'Flaherty, Martin; Kersh, Rogan; Whitsel, Laurie; Mozaffarian, Dariush; Micha, Renata

    2018-04-14

    Suboptimal diet is a leading cause of cardiometabolic disease and economic burdens. Evidence-based dietary policies within 5 domains-food prices, reformulation, marketing, labeling, and government food assistance programs-appear promising at improving cardiometabolic health. Yet, the extent of new dietary policy adoption in the US and key elements crucial to define in designing such policies are not well established. We created an inventory of recent US dietary policy cases aiming to improve cardiometabolic health and assessed the extent of their proposal and adoption at federal, state, local, and tribal levels; and categorized and characterized the key elements in their policy design. Recent federal dietary policies adopted to improve cardiometabolic health include reformulation (trans-fat elimination), marketing (mass-media campaigns to increase fruits and vegetables), labeling (Nutrition Facts Panel updates, menu calorie labeling), and food assistance programs (financial incentives for fruits and vegetables in the Supplemental Nutrition Assistance Program (SNAP) and Women, Infant and Children (WIC) program). Federal voluntary guidelines have been proposed for sodium reformulation and food marketing to children. Recent state proposals included sugar-sweetened beverage (SSB) taxes, marketing restrictions, and SNAP restrictions, but few were enacted. Local efforts varied significantly, with certain localities consistently leading in the proposal or adoption of relevant policies. Across all jurisdictions, most commonly selected dietary targets included fruits and vegetables, SSBs, trans-fat, added sugar, sodium, and calories; other healthy (e.g., nuts) or unhealthy (e.g., processed meats) factors were largely not addressed. Key policy elements to define in designing these policies included those common across domains (e.g., level of government, target population, dietary target, dietary definition, implementation mechanism), and domain-specific (e.g., media channels

  3. A Very General Overview of the Development Pediatric Emergency Medicine as a Specialty in the United States and Advocacy for Pediatric Healthcare; the Charge to Other Countries

    Directory of Open Access Journals (Sweden)

    Ron D. Waldrop

    2017-12-01

    and publications. In addition, as trauma specialties and general emergency medicine grew under the auspices of the American College of Emergency Physicians (ACEP and the American Heart Association (AHA so did the need for sub-specialization for pediatric emergency medicine (PEM. In the early 1980s as an outgrowth of the ACEP and AAP, plans to cooperate and create the subspecialty of PEM began. The goal of the specialty was to train specialists, procure resources funding for research, and standardize training.  The first subspecialty board for PEM was administered in 1992 and has continues to this date. Another outgrowth was federally funded agency called Emergency Medicine Services for Children (EMSC whose goal was to find and fund resources, research, and training for PEM specialists, particularly prehospital providers. As late as 2001 the Institute of Medicine in their periodic report regarding United States healthcare noted that most emergency departments were still largely deficient regarding preparedness for pediatric emergencies. Since that time there has been intense emphasis on preparedness for pediatric emergencies and now the United States has innumerable academic and community hospitals with full pediatric preparedness. Similarly, with the modern explosion of medical information it is now virtually impossible for any physician to know all of one field.  Most certainly no general emergency physician can possibly know everything regarding PEM thus obviating the need for PEM specialists to provide optimum care beyond the basics.  Numerous studies in the United States have also demonstrated seriously ill or injured children care receive superior care with better outcomes when cared for in pediatric specific facilities.  This does not imply that general emergency medicine and pediatric emergency medicine cannot co-exist and have economy of resources.  It simply seems to be true that the best possible pediatric care is delivered by pediatric subspecialists

  4. Reduction in hospitalisations and emergency department visits for frail patients with heart failure: Results of the UMIPIC healthcare programme.

    Science.gov (United States)

    Cerqueiro, J M; González-Franco, A; Montero-Pérez-Barquero, M; Llácer, P; Conde, A; Dávila, M F; Carrera, M; Serrado, A; Suárez, I; Pérez-Silvestre, J; Satué, J A; Arévalo-Lorido, J C; Rodríguez, A; Herrero, A; Jordana, R; Manzano, L

    2016-01-01

    Heart failure (HF) is a disease with high morbidity and mortality. We evaluated the usefulness of the Comprehensive Management Units for Patients with HF (Unidades de Manejo Integral para Pacientes con IC [UMIPIC]) programme. We analysed the patient data from the UMIPIC programme, which was recorded in the HF registry (RICA) of the Spanish Society of Internal Medicine. We compared emergency department visits and hospitalisations for any cause and for HF during the year prior to inclusion in the programme against those that occurred during the subsequent follow-up year, using the chi-squared test. A total of 258 patients (mean age, 80years; 51.9% women) were included in the study. During the previous year, there were 693 hospitalisations for all causes and 174 hospitalisations during the follow-up (75% reduction, Pde Medicina Interna (SEMI). All rights reserved.

  5. The role of public policy in emerging green power markets: an analysis of marketer preferences

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, R.H. [Lawrence Berkeley National Laboratory, Berkeley, CA (United States)

    2000-06-01

    Green power marketing has been heralded by some as a means to create a private market for renewable energy that is driven by customer demand for green products. This article challenges the premise - sometimes proffered in debates over green markets - that profitable, sizable, credible markets for green products will evolve naturally without supportive public policies. Relying primarily on surveys and interviews of US green power marketers, the article examines the role of specific regulatory and legislative policies in 'enabling' the green market, and searches for those policies that are believed by marketers to be the most conducive or detrimental to the expansion of the green market. We find that marketers: (1) believe that profitable green power markets will only develop if a solid foundation of supportive policies exists; (2) believe that establishing overall price competition and encouraging customer switching are the top priorities; (3) are somewhat leery of government-sponsored or mandated public information programs; and (4) oppose three specific renewable energy policies that are frequently advocated by renewable energy enthusiasts, but that may have negative impacts on the green marketers' profitability. The stated preferences of green marketers shed light on ways to foster renewables by means of the green market. Because the interests of marketers do not coincide perfectly with those of society, however, this study also recognizes other normative perspectives and highlights policy tensions at the heart of current debates related to green markets. By examining these conflicts, we identify three key policy questions that should direct future research: To what extent should price competition and customer switching be encouraged at the expense of cost shifting? What requirements should be imposed to ensure credibility in green products and marketing? How should the green power market and broader renewable energy policies interact? (author)

  6. The Implementation of Monetary Policy in an Emerging Economy: The Case of Chile

    OpenAIRE

    Christian A Johnson; Rodrigo Vergara

    2005-01-01

    Central bank authorities base implementation of monetary policy on an analysis of multiple variables known as monetary policy indicators. In a small open economy such as Chile, these indicators may include in-flation misalignments, unemployment, GDP growth, money growth, the current account balance, exchange rate volatility and international re-serves. A neural network approach is used to establish the correspond-ing weights considered by the Board of the Central Bank of Chile dur-ing the per...

  7. Japan's healthcare policy for the elderly through the concepts of self-help (Ji-jo), mutual aid (Go-jo), social solidarity care (Kyo-jo), and governmental care (Ko-jo).

    Science.gov (United States)

    Sudo, Kyoko; Kobayashi, Jun; Noda, Shinichiro; Fukuda, Yoshiharu; Takahashi, Kenzo

    2018-03-18

    Elderly care is an emerging global issue threatening both developed and developing countries. The elderly in Japan increased to 26.7% of the population in 2015, and Japan is classified as a super-aged society. In this article, we introduce the financial aspects of the medical care and welfare services policy for the elderly in Japan. Japan's universal health insurance coverage system has been in place since 1961. Long-term care includes welfare services, which were separated from the medical care insurance scheme in 2000 when Japan was already recognized as an aging society. Since then, the percentage of the population over 65 has increased dramatically, with the productive-age population on the decrease. The Japanese government, therefore, is seeking to implement "The Community-based Integrated Care System" with the aim of building comprehensive up-to-the-end-of-life support services in each community. The system has four proposed elements: self-help (Ji-jo), mutual aid (Go-jo), social solidarity care (Kyo-jo), and government care (Ko-jo). From the financial perspective, as the government struggles against the financial burdens of an aging population, they are considering self-help and mutual aid. Based on Japan's present situation, both elements could lead to positive results. The Japanese government must also entrust the responsibility for implementing preventive support to municipalities through strongly required regional autonomy. As Japan has resolved this new challenge through several discussions over a long period of time, other aging countries could learn from the Japanese experience of solving barriers to healthcare policy for the elderly.

  8. Health promotion interventions and policies addressing excessive alcohol use: a systematic review of national and global evidence as a guide to health-care reform in China.

    Science.gov (United States)

    Li, Qing; Babor, Thomas F; Zeigler, Donald; Xuan, Ziming; Morisky, Donald; Hovell, Melbourne F; Nelson, Toben F; Shen, Weixing; Li, Bing

    2015-01-01

    Steady increases in alcohol consumption and related problems are likely to accompany China's rapid epidemiological transition and profit-based marketing activities. We reviewed research on health promotion interventions and policies to address excessive drinking and to guide health-care reform. We searched Chinese- and English-language databases and included 21 studies in China published between 1980 and 2013 that covered each policy area from the World Health Organization (WHO) Global Strategy to Reduce the Harmful Use of Alcohol. We evaluated and compared preventive interventions to the global alcohol literature for cross-national applicability. In contrast with hundreds of studies in the global literature, 11 of 12 studies from mainland China were published in Chinese; six of 10 in English were on taxation from Taiwan or Hong Kong. Most studies demonstrated effectiveness in reducing excessive drinking, and some reported the reduction of health problems. Seven were randomized controlled trials. Studies targeted schools, drink-driving, work-places, the health sector and taxation. China is the world's largest alcohol market, yet there has been little growth in alcohol policy research related to health promotion interventions over the past decade. Guided by a public health approach, the WHO Global Strategy and health reform experience in Russia, Australia, Mexico and the United States, China could improve its public health response through better coordination and implementation of surveillance and evidence-based research, and through programmatic and legal responses such as public health law research, screening and early intervention within health systems and the implementation of effective alcohol control strategies. © 2014 Society for the Study of Addiction.

  9. Green energy market development in Germany: effective public policy and emerging customer demand

    International Nuclear Information System (INIS)

    Wuestenhagen, Rolf; Bilharz, Michael

    2006-01-01

    This paper reviews the development of renewable energy in Germany from 1973 to 2003. It investigates the relative importance of energy policy and green power marketing in shaping the renewable energy market. More than a decade of consistent policy support for renewables under the feed-in law (StrEG) and its successor (EEG) has been an important driver for increasing renewable electricity generation to date, putting the country in a better position than most of its peers when it comes to achieving European Union targets for renewable energy. Green power marketing driven by customer demand, on the other hand, is growing, but has had limited measurable impact so far. We discuss potential intangible benefits of green power marketing and scenarios for future market development. The paper concludes with lessons that can be learned from the German case for policy design and market development in other countries

  10. Using tracking infrastructure to support public health programs, policies, and emergency response in New York City.

    Science.gov (United States)

    Jeffery, Nancy Loder; McKelvey, Wendy; Matte, Thomas

    2015-01-01

    To describe how the New York City (NYC) Tracking Program has used nationally mandated Secure Portal infrastructure and staff analytical expertise to support programs and inform policy. The NYC Health Department assesses, investigates, and acts on a wide range of environmental concerns to protect the health of New Yorkers. Specific examples of highly effective policies or initiatives that relied on the NYC Tracking Program are described, including restaurant sanitary grade posting, rat indexing, converting boilers to cleaner-burning fuels, reducing exposure to mercury from fish and contaminated products, and responding to Superstorm Sandy. The NYC Tracking Program supports the Health Department in using inspectional, administrative, and health data to guide operations. Tracking has also allowed internal and external partners to use these data to guide policy development.

  11. Implementation of pre-exposure prophylaxis for human immunodeficiency virus infection: progress and emerging issues in research and policy.

    Science.gov (United States)

    Cáceres, Carlos F; Borquez, Annick; Klausner, Jeffrey D; Baggaley, Rachel; Beyrer, Chris

    2016-01-01

    In this article, we present recent evidence from studies focused on the implementation, effectiveness and cost-effectiveness of pre-exposure prophylaxis (PrEP) for HIV infection; discuss PrEP scale-up to date, including the observed levels of access and policy development; and elaborate on key emerging policy and research issues to consider for further scale-up, with a special focus on lower-middle income countries. The 2015 WHO Early Release Guidelines for HIV Treatment and Prevention reflect both scientific evidence and new policy perspectives. Those guidelines present a timely challenge to health systems for the scaling up of not only treatment for every person living with HIV infection but also the offer of PrEP to those at substantial risk. Delivery and uptake of both universal antiretroviral therapy (ART) and PrEP will require nation-wide commitment and could reinvigorate health systems to develop more comprehensive "combination prevention" programmes and support wider testing linked to both treatments and other prevention options for populations at highest risk who are currently not accessing services. Various gaps in current health systems will need to be addressed to achieve strategic scale-up of PrEP, including developing prioritization strategies, strengthening drug regulations, determining cost and funding sources, training health providers, supporting user adherence and creating demand. The initial steps in the scale-up of PrEP globally suggest feasibility, acceptability and likely impact. However, to prevent setbacks in less well-resourced settings, countries will need to anticipate and address challenges such as operational and health systems barriers, drug cost and regulatory policies, health providers' openness to prescribing PrEP to populations at substantial risk, demand and legal and human rights issues. Emerging problems will require creative solutions and will continue to illustrate the complexity of PrEP implementation.

  12. Factors Influencing Healthcare Service Quality

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2014-07-01

    Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

  13. 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.

  14. The emergence of climate change adaptation as a new field of public policy in Europe

    NARCIS (Netherlands)

    Massey, E.E.; Huitema, D.

    2016-01-01

    Over the past decade, climate change adaptation has become an integral item on the climate policy agendas of several European countries. As such, researchers have begun to question what concrete changes in polices are occurring at national levels and what dynamics can explain these changes. While

  15. Digital Competence--An Emergent Boundary Concept for Policy and Educational Research

    Science.gov (United States)

    Ilomäki, Liisa; Paavola, Sami; Lakkala, Minna; Kantosalo, Anna

    2016-01-01

    Digital competence is an evolving concept related to the development of digital technology and the political aims and expectations of citizenship in a knowledge society. It is regarded as a core competence in policy papers; in educational research it is not yet a standardized concept. We suggest that it is a useful boundary concept, which can be…

  16. Perspectives of emergency department staff on the triage of mental health-related presentations: Implications for education, policy and practice.

    Science.gov (United States)

    Gerdtz, Marie F; Weiland, Tracey J; Jelinek, George A; Mackinlay, Claire; Hill, Nicole

    2012-10-01

    To explore ED staff perceptions of the factors that influence accuracy of triage for people with mental health problems. This qualitative learning needs analysis used a descriptive exploratory design. Participants were Australian emergency nurses and doctors. We used a criterion-based sampling approach. Recruitment was facilitated by the College of Emergency Nursing Australasia and the Australasian College for Emergency Medicine. A semi-structured interview schedule was developed. Telephone interviews were conducted, audio recorded and transcribed verbatim. Thematic analysis was used to identify factors perceived to affect triage outcomes and to explore strategies to optimise the accuracy of triage assessments. Thirty-six staff participated (16 nurses and 20 doctors). Four major factors were perceived to influence accuracy. These were: environmental factors (physical structure, time pressures, activity levels, and interruptions), policy and education (guidelines, training and resources), staff factors (knowledge, experience, attitudes) and patient factors (police presence, patient behaviour, clinical condition). Differences of opinion were expressed by emergency doctors about the validity of the time to treatment objectives included in the Australasian Triage Scale for mental health presentations, and the utility of the scale to differentiate urgency for psychiatric conditions. Clinical guidelines and training have been developed to support the use of the Australasian Triage Scale. Further evaluation of the application of this scale to assess mental health problems is indicated. Additional work is also required to reduce variance in urgency assignment based on staff knowledge and attitudes about the causes, assessment and early management of psychiatric disorders. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  17. 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

  18. Energy information needs for U. S. state-level policy making: Minimal data requirements during normal and emergency periods

    Energy Technology Data Exchange (ETDEWEB)

    Barkenbus, J.N.; Leff, H.S.

    1983-01-01

    Since the oil embargo of 1973, state governments have increased their efforts to track and understand energy flows within their boundaries. There is a commonly perceived need to comprehend the status of present and expected future energy availability, demand, and price and to be prepared to exercise responsible and effective management during energy emergencies. This responsibility has brought with it new needs for accurate and timely state-level information on energy transactions and the external parameters that effect energy availability and disposition. What energy data are needed by a state, regardless of its idiosyncracies, during both normal and energy emergency periods, and to what extent are these data available now. The authors find that needed ongoing (core) data are only partially available at present, and that emergency data can be obtained only with a carefully planned monitoring program that can be fitted to specific emergency conditions. Overall, this paper provides a realistic assessment of the state-level energy data needed to provide state policy makers with sufficient information to make considered judgments.

  19. Energy-information needs for US state-level policy making: minimal data requirements during normal and emergency periods

    Energy Technology Data Exchange (ETDEWEB)

    Barkenbus, J.N.; Leff, H.S.

    1983-01-01

    Since the oil embargo of 1973, state governments have increased their efforts to track and understand energy flows within their boundaries. There is a commonly perceived need to comprehend the status of present and expected future energy availability, demand, and price and to be prepared to exercise responsible and effective management during energy emergencies. This responsibility has brought with it new needs for accurate and timely state-level information on energy transactions and the external parameters that effect energy availability and disposition. Hence, we ask: what energy data are needed by a state, regardless of its idiosyncracies, during both normal and energy emergency periods, and to what extent are these data available now. We find that needed ongoing (core) data are only partially available at present, and that emergency data can be obtained only with a carefully planned monitoring program that can be fitted to specific emergency conditions. Overall, this paper provides a realistic assessment of the state-level energy data needed to provide state policy makers with sufficient information to make considered judgments. 7 references, 6 tables.

  20. Patient Safety and Healthcare Quality

    Directory of Open Access Journals (Sweden)

    Aikaterini Toska

    2012-01-01

    Full Text Available Introduction: Due to a variety of circumstances and world-wide research findings, patient safety andquality care during hospitalization have emerged as major issues. Patient safety deficits may burdenhealth systems as well as allocated resources. The international community has examined severalproposals covering general and systemic aspects in order to improve patient safety; several long-termprograms and strategies have also been implemented promoting the participation of health-relatedagents, and also government agencies and non-governmental organizations.Aim: Those factors that have negative correlations with patient safety and quality healthcare weredetermined; WHO and EU programs as well as the Greek health policy were also reviewed.Method: Local and international literature was reviewed, including EU and WHO official publications,by using the appropriate keywords.Conclusions: International cooperation on patient safety is necessary in order to improvehospitalization and healthcare quality standards. Such incentives depend heavily on establishing worldwideviable and effective health programs and planning. These improvements also require further stepson safe work procedures, environment safety, hazard management, infection control, safe use ofequipment and medication, and sufficient healthcare staff.

  1. Knowledge, Attitudes and Behaviours of Healthcare Workers in the Kingdom of Saudi Arabia to MERS Coronavirus and Other Emerging Infectious Diseases

    Directory of Open Access Journals (Sweden)

    Abdullah J. Alsahafi

    2016-12-01

    Full Text Available Background: The Kingdom of Saudi Arabia has experienced a prolonged outbreak of Middle East Respiratory Syndrome (MERS coronavirus since 2012. Healthcare workers (HCWs form a significant risk group for infection. Objectives: The aim of this survey was to assess the knowledge, attitudes, infection control practices and educational needs of HCWs in the Kingdom of Saudi Arabia to MERS coronavirus and other emerging infectious diseases. Methods: 1500 of HCWs from Saudi Ministry of Health were invited to fill a questionnaire developed to cover the survey objectives from 9 September 2015 to 8 November 2015. The response rate was about 81%. Descriptive statistics was used to summarise the responses. Results: 1216 HCWs were included in this survey. A total of 56.5% were nurses and 22% were physicians. The most common sources of MERS-coronavirus (MERS-CoV information were the Ministry of Health (MOH memo (74.3%. Only (47.6% of the physicians, (30.4% of the nurses and (29.9% of the other HCWs were aware that asymptomatic MERS-CoV was described. Around half of respondents who having been investigated for MERS-CoV reported that their work performance decreased while they have suspicion of having MERS-CoV and almost two thirds reported having psychological problems during this period. Almost two thirds of the HCWs (61.2% reported anxiety about contracting MERS-CoV from patients. Conclusions: The knowledge about emerging infectious diseases was poor and there is need for further education and training programs particularly in the use of personal protective equipment, isolation and infection control measures. The self-reported infection control practices were sub-optimal and seem to be overestimated.

  2. Assessing Healthcare Utilization for Influenza-like Illness at an Emergency Department and a Student Health Service during the 2009–2010 H1N1 Pandemic

    Directory of Open Access Journals (Sweden)

    Ruchi Bhandari

    2013-01-01

    Full Text Available Estimates of healthcare utilization during an influenza pandemic are needed in order to plan for the allocation of staff and resources. The aim of this study was to assess the number, age, and arrival time of patients with influenza-like-illness (ILI, and associations between their symptoms during the 2009–2010 H1N1 pandemic. We conducted a cross-sectional analysis of electronic health records from the student health service (SHS and an emergency department (ED in Morgantown, West Virginia, between January 2009 and December 2010. During the 2009–2010 H1N1 pandemic, patient arrivals at SHS and ED varied over the week. SHS patients arrived early in the week and primarily in the afternoon. ED patient arrivals were more evenly distributed, with busier evenings and weekends. Those with fever were more likely to experience cough, sore throat, vomiting/nausea, chills, congestion, headache, and body-ache. These results can assist health professionals in preparing for an influenza pandemic.

  3. An Attribute Based Access Control Framework for Healthcare System

    Science.gov (United States)

    Afshar, Majid; Samet, Saeed; Hu, Ting

    2018-01-01

    Nowadays, access control is an indispensable part of the Personal Health Record and supplies for its confidentiality by enforcing policies and rules to ensure that only authorized users gain access to requested resources in the system. In other words, the access control means protecting patient privacy in healthcare systems. Attribute-Based Access Control (ABAC) is a new access control model that can be used instead of other traditional types of access control such as Discretionary Access Control, Mandatory Access Control, and Role-Based Access Control. During last five years ABAC has shown some applications in both recent academic fields and industry purposes. ABAC by using user’s attributes and resources, makes a decision according to an access request. In this paper, we propose an ABAC framework for healthcare system. We use the engine of ABAC for rendering and enforcing healthcare policies. Moreover, we handle emergency situations in this framework.

  4. Information Technology in New Zealand: Review of Emerging Social Trends, Current Issues, and Policies

    OpenAIRE

    Erturk, Emre; Fail, Derwyn

    2015-01-01

    This paper discusses the general state of information technology in New Zealand society, current issues, and policies. It is a qualitative study that reviews recent scholarly articles, periodicals, and surveys in order to create an understanding of some of the information technology issues and trends in New Zealand. After reviewing previous research, it assesses the potential existence and nature of a 'digital divide' in New Zealand society whilst also evaluating possible strategic responses ...

  5. The emergence and workings of a process view in public education policy

    DEFF Research Database (Denmark)

    Grønbæk Pors, Justine; Ratner, Helene Gad

    2017-01-01

    such a process view of organisation allows policy makers to imagine innovative change, but also how a process view interacts in particular ways with financial pressures and become entangled to increased performance measurements. We conclude that in this particular case, a conception of the object of management...... as processes is utilised to stabilise a belief that undoing organisational structures and categories offer an almost limitless resource for a simultaneous improvement of performance and reduction of expenses....

  6. Delay Tolerant Networking with Data Triage Method based on Emergent User Policies for Disaster Information Network System

    Directory of Open Access Journals (Sweden)

    Noriki Uchida

    2014-01-01

    Full Text Available When Disaster Information Network System is considered in local areas that were heavy damaged by the East Japan Great Earthquake in 2011, the resiliency of the network system is one of significant subjects for the restoration of the areas. DTN (Delay Tolerant Network has been focused for the effective methods for such inoperable network circumstances. However, when DTN is applied for the local areas, there are some problems such as message delivery rate and latency because there are fewer roads, cars, and pedestrians than in urban areas. In this paper, we propose the Enhanced Media Coordinate System for its architecture, and Data Triage method by emergent user policies is introduced to improve the QoS in Disaster Information Network System in local areas. In the proposed method, every message is tagged with the priority levels by data types with considering emergent user policies, and the high priority messages are firstly duplicated to transmittable nodes. Then, the experimental results by the GIS map of a Japanese coastal town and the future studies are discussed.

  7. China's wind power industry: Policy support, technological achievements, and emerging challenges

    International Nuclear Information System (INIS)

    Wang, Zhongying; Qin, Haiyan; Lewis, Joanna I.

    2012-01-01

    Since 2005 the Chinese wind power technology industry has developed rapidly, with China becoming the largest installer of wind power capacity in the world in 2010. This paper reviews the policy system implemented in China to support the wind power industry, centered on China's 2005 Renewable Energy Law. It examines the industry's achievements over the past two decades, including the development of wind power technology and equipment, the utilization of China's wind power resources, and the cost reductions achieved. It then explores the obstacles affecting the ongoing sustainability of the Chinese wind industry, including regulatory barriers, grid integration challenges, and challenges to continued technological innovation. It recommends that integration challenges be addressed through policy reforms, establishing interconnection standards, and creating predictability with forecasting and storage; that market signals be established with long-term development goals and pricing reforms; and that industry limitations be addressed with targeted R and D, improved wind resource assessment and transparency, domestic and international collaborations, and the cultivation of a skilled workforce. - Highlights: ► Review the policy system and the achievements of Chinese wind industry. ► Analyze the obstacles affecting the sustainability of the industry. ► Provide recommendations for how China can address these obstacles.

  8. Correlates of Performance of Healthcare Workers in Emergency, Triage, Assessment and Treatment plus Admission Care (ETAT+) Course in Rwanda: Context Matters

    Science.gov (United States)

    Hategekimana, Celestin; Shoveller, Jeannie; Tuyisenge, Lisine; Kenyon, Cynthia; Cechetto, David F.; Lynd, Larry D.

    2016-01-01

    Background The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+) course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare workers (HCWs) knowledge and practical skills related to providing emergency care to severely ill newborns and children in Rwanda has not been studied. Objective To evaluate the impact of the ETAT+ course on HCWs knowledge and practical skills, and to identify factors associated with greater improvement in knowledge and skills. Methods We used a one group, pre-post test study using data collected during ETAT+ course implementation from 2010 to 2013. The paired t-test was used to assess the effect of ETAT+ course on knowledge improvement in participating HCWs. Mixed effects linear and logistic regression models were fitted to explore factors associated with HCWs performance in ETAT+ course knowledge and practical skills assessments, while accounting for clustering of HCWs in hospitals. Results 374 HCWs were included in the analysis. On average, knowledge scores improved by 22.8/100 (95% confidence interval (CI) 20.5, 25.1). In adjusted models, bilingual (French & English) participants had a greater improvement in knowledge 7.3 (95% CI 4.3, 10.2) and higher odds of passing the practical skills assessment (adjusted odds ratio (aOR) = 2.60; 95% CI 1.25, 5.40) than those who were solely proficient in French. Participants who attended a course outside of their health facility had higher odds of passing the skills assessment (aOR = 2.11; 95% CI 1.01, 4.44) than those who attended one within their health facility. Conclusions The current study shows a positive impact of ETAT+ course on improving participants’ knowledge and skills related to managing emergency pediatric and neonatal care conditions. The findings regarding key factors influencing ETAT+ course outcomes

  9. Correlates of Performance of Healthcare Workers in Emergency, Triage, Assessment and Treatment plus Admission Care (ETAT+ Course in Rwanda: Context Matters.

    Directory of Open Access Journals (Sweden)

    Celestin Hategekimana

    Full Text Available The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+ course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare workers (HCWs knowledge and practical skills related to providing emergency care to severely ill newborns and children in Rwanda has not been studied.To evaluate the impact of the ETAT+ course on HCWs knowledge and practical skills, and to identify factors associated with greater improvement in knowledge and skills.We used a one group, pre-post test study using data collected during ETAT+ course implementation from 2010 to 2013. The paired t-test was used to assess the effect of ETAT+ course on knowledge improvement in participating HCWs. Mixed effects linear and logistic regression models were fitted to explore factors associated with HCWs performance in ETAT+ course knowledge and practical skills assessments, while accounting for clustering of HCWs in hospitals.374 HCWs were included in the analysis. On average, knowledge scores improved by 22.8/100 (95% confidence interval (CI 20.5, 25.1. In adjusted models, bilingual (French & English participants had a greater improvement in knowledge 7.3 (95% CI 4.3, 10.2 and higher odds of passing the practical skills assessment (adjusted odds ratio (aOR = 2.60; 95% CI 1.25, 5.40 than those who were solely proficient in French. Participants who attended a course outside of their health facility had higher odds of passing the skills assessment (aOR = 2.11; 95% CI 1.01, 4.44 than those who attended one within their health facility.The current study shows a positive impact of ETAT+ course on improving participants' knowledge and skills related to managing emergency pediatric and neonatal care conditions. The findings regarding key factors influencing ETAT+ course outcomes demonstrate the importance of considering key

  10. Healthcare is primary

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2015-01-01

    Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

  11. Tweak, Adapt, or Transform: Policy Scenarios in Response to Emerging Bioenergy Markets in the U.S. Corn Belt

    Directory of Open Access Journals (Sweden)

    Ryan C. Atwell

    2011-03-01

    Full Text Available Emerging bioenergy markets portend both boon and bane for regions of intensive agricultural production worldwide. To understand and guide the effects of bioenergy markets on agricultural landscapes, communities, and economies, we engaged leaders in the Corn Belt state of Iowa in a participatory workshop and follow-up interviews to develop future policy scenarios. Analysis of workshop and interview data, in conjunction with the results of regional social and ecological research, was used to develop a heuristic model outlining interactions between key drivers and outcomes of regional landscape change. Three policy scenarios were built on this framework and included the following approaches: tweak, adapt, and transform. Our results suggest that if macroscale markets, technologies, and federal farm policies are allowed to be the overriding drivers of farm owner and operator decision making, Iowa's agricultural landscapes will likely become highly efficient at row crop production at the cost of other desired outcomes. However, the perspectives of Iowa leaders demonstrate how multifunctional agricultural landscapes can be achieved through a concerted portfolio of change coordinated across local, regional, and national scales.

  12. Emerging health isues in Asia and the Pacific: implications for public health policy

    OpenAIRE

    Amarakoon Bandara

    2005-01-01

    The Asia-Pacific region is confronted with several emerging healthrelated issues. The prevalence of diseases causing high rates of mortality and morbidity, and the lack of skilled health personnel, infrastructure, financial resources and health systems that are responsive to the needs of society, are among them. A pragmatic approach with a focus on issues of major health and socio-economic concern is vital for the development of successful public health services. Striking a balance between di...

  13. National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.

    Science.gov (United States)

    Kinsman, Jeremiah M; Robinson, Kathy

    2018-02-27

    Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR). State law and scopes of practice were systematically reviewed using a multi-tiered approach to determine each state's legally-defined EMS licensure levels and their authority to administer an opioid antagonist. State law, state EMS websites, and state EMS scope of practice documents were identified and searched using Google Advanced Search with Boolean Search Strings. Initial results of the review were sent to each state office of EMS for review and comment. As of September 1, 2017, 49 states and DC authorize EMTs to administer an opioid antagonist. Among the 40 US jurisdictions (39 states and DC) that define the EMR or a comparable first responder licensure level in state law, 37 states and DC authorize their EMRs to administer an opioid antagonist. Paramedics are authorized to administer opioid antagonists in all 50 states, DC, and PR. All 49 of the US jurisdictions (48 states and DC) that define the advanced emergency medical technician (AEMT) or a comparable intermediate EMS licensure level in state law authorize their AEMTs to administer an opioid antagonist. 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited

  14. Managing Acute Behavioural Disturbances in the Emergency Department Using the Environment, Policies and Practices: A Systematic Review.

    Science.gov (United States)

    Weiland, Tracey J; Ivory, Sean; Hutton, Jennie

    2017-06-01

    Effective strategies for managing acute behavioural disturbances (ABDs) within emergency departments (EDs) are needed given their rising occurrence and negative impact on safety, psychological wellbeing, and staff turnover. Non-pharmacological interventions for ABD management generally fall into four categories: environmental modifications; policies; practice changes; and education. Our objective was to systematically review the efficacy of strategies for ABD management within EDs that involved changes to environment, architecture, policy and practice. We performed systematic searches of CINAHL Plus with Full Text, PsycINFO, MEDLINE, and EMBASE, as well as reference lists of relevant review articles to identify relevant studies published between January 1985 - April 2016. We included studies written in English, which reported management of behavioural disturbances in adults associated with the ED through the use of environmental modifiers (including seclusion, restraint, specialised rooms, architectural changes), policy, and practice-based interventions excepting education-only interventions. Efficacy outcomes of interest included incidence, severity, and duration of ABD, incidence of injuries, staff absenteeism, restraint use, restraint duration, and staff and patient perceptions. Two reviewers independently screened titles and abstracts, and assessed the relevancy and eligibility of studies based on full-text articles. Two authors independently appraised included studies. A narrative synthesis of findings was undertaken. Studies reporting interventions for managing ABDs within the ED are limited in number and quality. The level of evidence for efficacy is low, requiring caution in conclusions. While there is preliminary evidence for environmental change in the form of specialised behavioural rooms, security upgrades and ED modifications, these are not supported by evidence from controlled studies. Many of these "common sense" environmental changes recommended in

  15. 75 FR 22816 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-04-30

    ... Infectious Diseases (NCEZID), regarding the practice of hospital infection control and strategies for surveillance, prevention, and control of healthcare-associated infections (e.g., nosocomial infections... policy statements regarding prevention of healthcare- associated infections and healthcare-related...

  16. The emergence and policy implications of converging new technologies integrated from the nanoscale

    International Nuclear Information System (INIS)

    Roco, M. C.

    2005-01-01

    Science based on the unified concepts on matter at the nanoscale provides a new foundation for knowledge creation, innovation, and technology integration. Convergent new technologies refers to the synergistic combination of nanotechnology, biotechnology, information technology and cognitive sciences (NBIC), each of which is currently progressing at a rapid rate, experiencing qualitative advancements, and interacting with the more established fields such as mathematics and environmental technologies (Roco and Bainbridge, 2002). It is expected that converging technologies will bring about tremendous improvements in transforming tools, new products and services, enable human personal abilities and social achievements, and reshape societal relationships.After a brief overview of the general implications of converging new technologies, this paper focuses on its effects on R and D policies and business models as part of changing societal relationships. These R and D policies will have implications on investments in research and industry, with the main goal of taking advantage of the transformative development of NBIC. Introduction of converging technologies must be done with respect of immediate concerns (privacy, toxicity of new materials, etc.) and longer-term concerns including human integrity, dignity and welfare. The efficient introduction and development of converging new technologies will require new organizations and business models, as well as solutions for preparing the economy, such as multifunctional research facilities, integrative technology platforms, and global risk governance

  17. The emergence and policy implications of converging new technologies integrated from the nanoscale

    Science.gov (United States)

    Roco, M. C.

    2005-06-01

    Science based on the unified concepts on matter at the nanoscale provides a new foundation for knowledge creation, innovation, and technology integration. Convergent new technologies refers to the synergistic combination of nanotechnology, biotechnology, information technology and cognitive sciences (NBIC), each of which is currently progressing at a rapid rate, experiencing qualitative advancements, and interacting with the more established fields such as mathematics and environmental technologies (Roco & Bainbridge, 2002). It is expected that converging technologies will bring about tremendous improvements in transforming tools, new products and services, enable human personal abilities and social achievements, and reshape societal relationships. After a brief overview of the general implications of converging new technologies, this paper focuses on its effects on R&D policies and business models as part of changing societal relationships. These R&D policies will have implications on investments in research and industry, with the main goal of taking advantage of the transformative development of NBIC. Introduction of converging technologies must be done with respect of immediate concerns (privacy, toxicity of new materials, etc.) and longer-term concerns including human integrity, dignity and welfare. The efficient introduction and development of converging new technologies will require new organizations and business models, as well as solutions for preparing the economy, such as multifunctional research facilities, integrative technology platforms, and global risk governance.

  18. The emergence and policy implications of converging new technologies integrated from the nanoscale

    Energy Technology Data Exchange (ETDEWEB)

    Roco, M. C. [National Science Foundation (United States)], E-mail: mroco@nsf.gov

    2005-06-15

    Science based on the unified concepts on matter at the nanoscale provides a new foundation for knowledge creation, innovation, and technology integration. Convergent new technologies refers to the synergistic combination of nanotechnology, biotechnology, information technology and cognitive sciences (NBIC), each of which is currently progressing at a rapid rate, experiencing qualitative advancements, and interacting with the more established fields such as mathematics and environmental technologies (Roco and Bainbridge, 2002). It is expected that converging technologies will bring about tremendous improvements in transforming tools, new products and services, enable human personal abilities and social achievements, and reshape societal relationships.After a brief overview of the general implications of converging new technologies, this paper focuses on its effects on R and D policies and business models as part of changing societal relationships. These R and D policies will have implications on investments in research and industry, with the main goal of taking advantage of the transformative development of NBIC. Introduction of converging technologies must be done with respect of immediate concerns (privacy, toxicity of new materials, etc.) and longer-term concerns including human integrity, dignity and welfare. The efficient introduction and development of converging new technologies will require new organizations and business models, as well as solutions for preparing the economy, such as multifunctional research facilities, integrative technology platforms, and global risk governance.

  19. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  20. Medical identity theft in the emergency department: awareness is crucial.

    Science.gov (United States)

    Mancini, Michelino

    2014-11-01

    Medical identity theft in the emergency department (ED) can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient's identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior.

  1. Medical Identity Theft in the Emergency Department: Awareness is Crucial

    Science.gov (United States)

    Mancini, Michelino

    2014-01-01

    Medical Identity theft in the emergency department (ED) can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient’s identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior. PMID:25493150

  2. De-risking concentrated solar power in emerging markets: The role of policies and international finance institutions

    International Nuclear Information System (INIS)

    Frisari, Gianleo; Stadelmann, Martin

    2015-01-01

    Concentrated solar power (CSP) is a promising technology for low-carbon energy systems, as combined with thermal storage it can store solar energy as heat, and deliver power more flexibly and when most needed by the grid. However, its high cost prevents its rapid deployment and affects its affordability in emerging economies. International financial institutions (IFIs) have emerged as key players to enable CSP in emerging economies, especially when cooperating with national policymakers. Through the analysis of two CSP plants in India and Morocco where IFIs provided the lion's share of finance, this paper aims to assess the effectiveness of their support and estimate the impact of IFIs financing on electricity production costs and mobilization of private investments. The two case studies show that public financial institutions can play a leading role in reducing the cost of CSP support on public budgets by providing concessional loans in countries where public and/or private finance would be too expensive, or extending maturities where commercial investors are present but poorly suited for project finance. Finally, we show that, combined with competitive tariff setting mechanism (tenders and auctions), public financial support can also be a cost-effective tool to engage private investors in CSP. -- Highlights: •We analyze the financial model of two large-scale concentrated solar power (CSP) plants in two emerging markets (India and Morocco). •We focus on the role of policies and public finance in reducing investment risks and generation costs. •Development banks' concessional loans can reduce the weight of CSP support on public budgets. •Even when non-concessional, development banks' loans can reduce investment costs by extending debt maturities. •Competitive tariff setting mechanisms can ensure cost-effectiveness of public financial support

  3. Lean healthcare.

    Science.gov (United States)

    Weinstock, Donna

    2008-01-01

    As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

  4. The emergence of two competing philosophies on climate policy: the implications for the application of technology solutions

    International Nuclear Information System (INIS)

    Jones, M.

    2001-01-01

    This paper discusses the two competing philosophies on Climate Policy the emerged as a result of the Rio Earth Summit and the Kyoto Protocol. The UN Framework Convention on Climate Change was signed by 154 nations at the Rio Earth Summit and was centred around its 'ultimate objective' - 'the stabilization of greenhouse gas (GHG) concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system'. Because the parties to the Convention would not be able to achieve the stabilization goal, negotiations that included binding emission reduction commitments were begun and culminated in the Kyoto Protocol. Taken together, the three primary objectives are to achieve maximum reductions at the least possible cost, while contributing to sustainable development. This has resulted in distinct positions being staked out by various parties. This paper details the two competing philosophies

  5. A successful strategy for increasing the influenza vaccination rate of healthcare workers without a mandatory policy outside of the United States: a multifaceted intervention in a Japanese tertiary care center.

    Science.gov (United States)

    Honda, Hitoshi; Sato, Yumiko; Yamazaki, Akinori; Padival, Simi; Kumagai, Akira; Babcock, Hilary

    2013-11-01

    Although mandatory vaccination programs have been effective in improving the vaccination rate among healthcare workers, implementing this type of program can be challenging because of varied reasons for vaccine refusal. The purpose of our study is to measure improvement in the influenza vaccination rate from a multifaceted intervention at a Japanese tertiary care center where implementing a mandatory vaccination program is difficult. Before-and-after trial. Healthcare workers at a 550-bed, tertiary care, academic medical center in Sapporo, Japan. We performed a multifaceted intervention including (1) use of a declination form, (2) free vaccination, (3) hospital-wide announcements during the vaccination period, (4) prospective audit and real-time telephone interview for healthcare workers who did not receive the vaccine, (5) medical interview with the hospital executive for noncompliant (no vaccine, no declination form) healthcare workers during the vaccination period, and (6) mandatory submission of a vaccination document if vaccinated outside of the study institution. With the new multifaceted intervention, the vaccination rate in the 2012-2013 season increased substantially, up to 97%. This rate is similar to that reported in studies with a mandatory vaccination program. Improved vaccination acceptance, particularly among physicians, likely contributed to the overall increase in the vaccination rate reported in the study. Implementation of comprehensive strategies with strong leadership can lead to substantial improvements in vaccine uptake among healthcare workers even without a mandatory vaccination policy. The concept is especially important for institutions where implementing mandatory vaccination programs is challenging.

  6. Ethanol Values During College Football Season: University Policy Change and Emergency Department Blood Ethanol Values From 2006 Through 2014.

    Science.gov (United States)

    Fierro-Fine, Amelia C; Harland, Karisa; House, Hans R; Krasowski, Matthew D

    2016-11-01

    Tailgating is popular at many college football games. However, it is known to contribute to binge drinking and alcohol intoxication, which are common public health challenges. To use laboratory data to measure changes in plasma ethanol levels observed in a large state university emergency department after a series of reforms were enacted to reduce binge drinking. We performed a retrospective chart review on all serum ethanol levels measured at the University of Iowa Hospitals and Clinics on weekends from 2006 through 2014. Data were analyzed by multivariable logistic regression after controlling for significant covariates. A total of 5437 patients had ethanol levels recorded on weekends. After the implementation of policy changes, there was a significant reduction in the adjusted odds ratio (AOR) of ethanol values reported in the severe intoxication range (≥240 mg/dL; AOR = 0.77; 95% confidence interval [CI], 0.64-0.92). The policy changes implemented in 2009 in an attempt to reduce binge drinking are associated with a decreased likelihood of an ethanol result being in the severe intoxication range. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Incentives and intrinsic motivation in healthcare

    Directory of Open Access Journals (Sweden)

    Mikel Berdud

    2016-11-01

    Conclusions: The conclusions could act as a guide to support the optimal design of incentive policies and schemes within health organisations when healthcare professionals are intrinsically motivated.

  8. 78 FR 62636 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2013-10-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Healthcare Quality Promotion, the Director, National Center for Emerging and Zoonotic Infectious Diseases... healthcare infection prevention and control; (2) strategies for surveillance, prevention, and control of...

  9. 78 FR 28221 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2013-05-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Healthcare Quality Promotion, the Director, National Center for Emerging and Zoonotic Infectious Diseases... healthcare infection prevention and control; (2) strategies for surveillance, prevention, and control of...

  10. 75 FR 29772 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)

    Science.gov (United States)

    2010-05-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Emerging and Zoonotic Infectious Diseases (NCEZID) regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

  11. Ethical issues in healthcare financing.

    Science.gov (United States)

    Maharaj, S R; Paul, T J

    2011-07-01

    The four goals of good healthcare are to relieve symptoms, cure disease, prolong life and improve quality of life. Access to healthcare has been a perpetual challenge to healthcare providers who must take into account important factors such as equity, efficiency and effectiveness in designing healthcare systems to meet the four goals of good healthcare. The underlying philosophy may designate health as being a basic human right, an investment, a commodity to be bought and sold, a political demand or an expenditure. The design, policies and operational arrangements will usually reflect which of the above philosophies underpin the healthcare system, and consequently, access. Mechanisms for funding include fee-for-service, cost sharing (insurance, either private or government sponsored) free-of-fee at point of delivery (payments being made through general taxes, health levies, etc) or cost-recovery. For each of these methods of financial access to healthcare services, there are ethical issues which can compromise the four principles of ethical practices in healthcare, viz beneficence, non-maleficence, autonomy and justice. In times of economic recession, providing adequate healthcare will require governments, with support from external agencies, to focus on poverty reduction strategies through provision of preventive services such as immunization and nutrition, delivered at primary care facilities. To maximize the effect of such policies, it will be necessary to integrate policies to fashion an intersectoral approach.

  12. INCUBATORS AND GOVERNMENT POLICY FOR DEVELOPING IT INDUSTRY AND REGION IN EMERGING ECONOMIES

    Directory of Open Access Journals (Sweden)

    Nur Atiqah Abdullah

    2012-01-01

    Full Text Available Incubation, a concept supported by a variety of economic cluster theories, is a vital element in economic development in developed countries. The entrepreneurial businesses that they house often improve the developed economies in terms of not only jobs but also wealth creation. The question that this article embraces is as follows: "Do incubators play the same vital role in economic development in developing regions of the world?" We use the case study methodology to develop this query in a focus area of regional development in an emerging economy. We examine the implementation of three incubators located in designated cybercities. The cybercity concept is one of the Malaysian government's initiatives to encourage the development of the IT industry within the Multimedia Super Corridor (MSC Program. This study takes advantage of the 10-year development of cybercities by performing a longitudinal study. We found that these incubators did well in achieving their initial performance objectives, but they need to catch up with developed countries' continued rapid progress.

  13. Global Perspectives on Children's Digital Opportunities: An Emerging Research and Policy Agenda.

    Science.gov (United States)

    Livingstone, Sonia; Lemish, Dafna; Lim, Sun Sun; Bulger, Monica; Cabello, Patricio; Claro, Magdalena; Cabello-Hutt, Tania; Khalil, Joe; Kumpulainen, Kristiina; Nayar, Usha S; Nayar, Priya; Park, Jonghwi; Tan, Maria Melizza; Prinsloo, Jeanne; Wei, Bu

    2017-11-01

    Diverse international perspectives show that children can benefit greatly from digital opportunities. Despite widespread optimism about the potential of digital technologies, especially for information and education, the research reveals an insufficient evidence base to guide policy and practice across all continents of the world, especially in middle- and low-income countries. Beyond revealing pressing and sizeable gaps in knowledge, this cross-national review also reveals the importance of understanding local values and practices regarding the use of technologies. This leads us to stress that future researchers must take into account local contexts and existing inequalities and must share best practices internationally so that children can navigate the balance between risks and opportunities. This article documents the particular irony that while the world's poorer countries look to research to find ways to increase access and accelerate the fair distribution of digital educational resources, the world's wealthier countries look to research for guidance in managing excessive screen time, heavily commercial content, and technologies that intrude on autonomy and privacy. We conclude by recommending that digital divides should be carefully bridged with contextual sensitivity to avoid exacerbating existing disparities; that the provision of technological resources is complemented by a focus on skills enhancement, for teachers as well as students; that a keen eye is needed to ensure the balance of children's protection and participation rights, with protection now including data abuses as well as safety considerations; and that we forge collaborations among all stakeholders in seeking to enhance children's digital opportunities worldwide. Copyright © 2017 by the American Academy of Pediatrics.

  14. Managing Acute Behavioural Disturbances in the Emergency Department Using the Environment, Policies and Practices: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tracey J. Weiland

    2017-05-01

    Full Text Available Introduction: Effective strategies for managing acute behavioural disturbances (ABDs within emergency departments (EDs are needed given their rising occurrence and negative impact on safety, psychological wellbeing, and staff turnover. Non-pharmacological interventions for ABD management generally fall into four categories: environmental modifications; policies; practice changes; and education. Our objective was to systematically review the efficacy of strategies for ABD management within EDs that involved changes to environment, architecture, policy and practice. Methods: We performed systematic searches of CINAHL Plus with Full Text, PsycINFO, MEDLINE, and EMBASE, as well as reference lists of relevant review articles to identify relevant studies published between January 1985 – April 2016. We included studies written in English, which reported management of behavioural disturbances in adults associated with the ED through the use of environmental modifiers (including seclusion, restraint, specialised rooms, architectural changes, policy, and practice-based interventions excepting education-only interventions. Efficacy outcomes of interest included incidence, severity, and duration of ABD, incidence of injuries, staff absenteeism, restraint use, restraint duration, and staff and patient perceptions. Two reviewers independently screened titles and abstracts, and assessed the relevancy and eligibility of studies based on full-text articles. Two authors independently appraised included studies. A narrative synthesis of findings was undertaken. Results: Studies reporting interventions for managing ABDs within the ED are limited in number and quality. The level of evidence for efficacy is low, requiring caution in conclusions. While there is preliminary evidence for environmental change in the form of specialised behavioural rooms, security upgrades and ED modifications, these are not supported by evidence from controlled studies. Many of these

  15. Policy analysis: palliative care in Ireland.

    LENUS (Irish Health Repository)

    Larkin, P

    2014-03-01

    Palliative care for patients with advanced illness is a subject of growing importance in health services, policy and research. In 2001 Ireland became one of the first nations to publish a dedicated national palliative care policy. This paper uses the \\'policy analysis triangle\\' as a framework to examine what the policy entailed, where the key ideas originated, why the policy process was activated, who were the key actors, and what were the main consequences. Although palliative care provision expanded following publication, priorities that were unaddressed or not fully embraced on the national policy agenda are identified. The factors underlying areas of non-fulfilment of policy are then discussed. In particular, the analysis highlights that policy initiatives in a relatively new field of healthcare face a trade-off between ambition and feasibility. Key policy goals could not be realised given the large resource commitments required; the competition for resources from other, better-established healthcare sectors; and challenges in expanding workforce and capacity. Additionally, the inherently cross-sectoral nature of palliative care complicated the co-ordination of support for the policy. Policy initiatives in emerging fields such as palliative care should address carefully feasibility and support in their conception and implementation.

  16. Healthcare Robotics

    OpenAIRE

    Riek, Laurel D.

    2017-01-01

    Robots have the potential to be a game changer in healthcare: improving health and well-being, filling care gaps, supporting care givers, and aiding health care workers. However, before robots are able to be widely deployed, it is crucial that both the research and industrial communities work together to establish a strong evidence-base for healthcare robotics, and surmount likely adoption barriers. This article presents a broad contextualization of robots in healthcare by identifying key sta...

  17. Comparative Characteristics of the Results of Evacuation to Healthcare Facilities and Treatment Outcomes of Children Who Applied for First Aid With Acute Abdominal Pains. The Case of an Emergency Medical Setting of an Average Municipal Entity

    Directory of Open Access Journals (Sweden)

    Ekaterina А. Romanova

    2017-01-01

    Full Text Available Background. Despite the active development of diagnostic capabilities, the problems of diagnosis at the pre-hospital stage with abdominal pain remain unresolved. Objective. Our aim was to analyze the results of evacuation to healthcare facilities as well as treatment outcomes (conservative and surgical of hospitalized children who applied for first aid with acute abdominal pain, in order to identify possible shortcomings in the existing diagnostic algorithm and its optimization. Methods. The results of treatment outcomes for children with acute abdominal pain at the pre-hospital stage and evacuation to healthcare facilities by visiting teams for the period 2014–2015. are presented by the example of the State Institution «Engels Emergency Medical Setting». Results. Difficulties in routing children to the necessary healthcare facilities (surgical or somatic are due to the complexities of differential diagnosis of the disease in children with acute abdominal pain at the pre-hospital stage. Conclusion. The main task of the primary care and emergency physician at the pre-hospital stage, whose decision determines the direction of the diagnostic search, timeliness and adequacy of the subsequent treatment measures, is to give a correct assessment of abdominal pain syndrome. 

  18. Reasons for accepting or declining Down syndrome screening in Dutch prospective mothers within the context of national policy and healthcare system characteristics : a qualitative study

    NARCIS (Netherlands)

    Crombag, Neeltje M T H; Boeije, Hennie; Iedema-Kuiper, Rita; Schielen, Peter C J I; Visser, Gerard H A; Bensing, Jozien M

    2016-01-01

    BACKGROUND: Uptake rates for Down syndrome screening in the Netherlands are low compared to other European countries. To investigate the low uptake, we explored women's reasons for participation and possible influences of national healthcare system characteristics. Dutch prenatal care is

  19. It Is Not That Simple nor Compelling!; Comment on “Translating Evidence Into Healthcare Policy and Practice: Single Versus Multi-faceted Implementation Strategies – Is There a Simple Answer to a Complex Question?”

    Directory of Open Access Journals (Sweden)

    Tracey Bucknall

    2015-11-01

    Full Text Available Healthcare decisions are often made under pressure, with varying levels of information in a changing clinical context. With limited resources and a focus on improving patient outcomes, healthcare managers and health professionals strive to implement both clinical and cost-effective care. However, the gap between research evidence and health policy/clinical practice persists despite our best efforts. In an attempt to close the gap through behaviour change interventions, there has been a strong held belief that ‘more is better,’ without understanding the mechanisms and circumstances of knowledge translation (KT. We argue that even a singleintervention or strategy in translating evidence into healthcare policy or practice is rarely simple to implement. Nor is the evidence compelling on the best approach. As Harvey and Kitson argued, designing and evaluating KT interventions requires flexibility and responsiveness. If we are to move forward in translation science then we need to use rigorous designs such as randomised controlled trials to test effectiveness of interventions or strategies with embedded process evaluations to understand the reason interventions do or do not work!

  20. The Intersection of Afterschool and Competency-Based Learning: Emerging Trends, Policy Considerations, and Questions for the Future. AYPF White Paper

    Science.gov (United States)

    Lerner, Jennifer Brown; Tomasello, Jenna; Brand, Betsy; Knowles, George

    2016-01-01

    Afterschool and competency-based learning are increasingly emerging as student-centered, supportive learning models to prepare students for college and career. This white paper explores the intersection and relationship between these two fields, recommends ideal policy environments for implementing successful programs, provides real-world…

  1. Redefining Health: Implication for Value-Based Healthcare Reform.

    Science.gov (United States)

    Putera, Ikhwanuliman

    2017-03-02

    Health definition consists of three domains namely, physical, mental, and social health that should be prioritized in delivering healthcare. The emergence of chronic diseases in aging populations has been a barrier to the realization of a healthier society. The value-based healthcare concept seems in line with the true health objective: increasing value. Value is created from health outcomes which matter to patients relative to the cost of achieving those outcomes. The health outcomes should include all domains of health in a full cycle of care. To implement value-based healthcare, transformations need to be done by both health providers and patients: establishing true health outcomes, strengthening primary care, building integrated health systems, implementing appropriate health payment schemes that promote value and reduce moral hazards, enabling health information technology, and creating a policy that fits well with a community.

  2. Emergency Diesel Generation System Surveillance Test Policy Optimization Through Genetic Algorithms Using Non-Periodic Intervention Frequencies and Seasonal Constraints

    International Nuclear Information System (INIS)

    Lapa, Celso M.F.; Pereira, Claudio M.N.A.; Frutuoso e Melo, P.F.

    2002-01-01

    Nuclear standby safety systems must frequently, be submitted to periodic surveillance tests. The main reason is to detect, as soon as possible, the occurrence of unrevealed failure states. Such interventions may, however, affect the overall system availability due to component outages. Besides, as the components are demanded, deterioration by aging may occur, penalizing again the system performance. By these reasons, planning a good surveillance test policy implies in a trade-off between gains and overheads due to the surveillance test interventions. In order maximize the systems average availability during a given period of time, it has recently been developed a non-periodic surveillance test optimization methodology based on genetic algorithms (GA). The fact of allowing non-periodic tests turns the solution space much more flexible and schedules can be better adjusted, providing gains in the overall system average availability, when compared to those obtained by an optimized periodic tests scheme. The optimization problem becomes, however, more complex. Hence, the use of a powerful optimization technique, such as GAs, is required. Some particular features of certain systems can turn it advisable to introduce other specific constraints in the optimization problem. The Emergency Diesel Generation System (EDGS) of a Nuclear Power Plant (N-PP) is a good example for demonstrating the introduction of seasonal constraints in the optimization problem. This system is responsible for power supply during an external blackout. Therefore, it is desirable during periods of high blackout probability to maintain the system availability as high as possible. Previous applications have demonstrated the robustness and effectiveness of the methodology. However, no seasonal constraints have ever been imposed. This work aims at investigating the application of such methodology in the Angra-II Brazilian NPP EDGS surveillance test policy optimization, considering the blackout probability

  3. Exercise physiologists emerge as allied healthcare professionals in the era of non-communicable disease pandemics: a report from Australia, 2006-2012.

    Science.gov (United States)

    Cheema, Birinder S; Robergs, Robert A; Askew, Christopher D

    2014-07-01

    Exercise can be prescribed to prevent, manage, and treat many leading non-communicable diseases (NCDs) and underlying risk factors. However, surprisingly, Australia is one of only a few countries where allied healthcare professionals with specialized university education and training in exercise prescription and delivery provide services within a government-run healthcare system (Medicare). This article presents data on Medicare-funded services provided by accredited exercise physiologists (AEPs) from the inclusion of the profession in the allied healthcare model (January, 2006) to the end of 2012. We conceptualize these data in relation to current NCD trends, and outline recommendations that can potentially help curtail the current chronic disease burden through the further integration of exercise professionals into the healthcare system in Australia, and internationally. From 2006 to 2012, the number of AEPs in Australia has increased 563 %. This rise in AEPs has been paralleled by increased delivery of services for eligible patients with a chronic medical condition (+614 %), type 2 diabetes mellitus (+211 to 230 %), and of Aboriginal and Torres Strait Islander descent (+343 %). These trends, which were developed through the "early years" of the profession, are encouraging and suggest that AEPs have taken up a vital position within the healthcare system. However, the total number of services provided by AEPs currently remains very low in relation to the prevalence of overweight-obesity and type 2 diabetes in Australia. Furthermore, services for Aboriginal Australians are very low considering the extreme burden of chronic diseases in these vulnerable populations. We provide some recommendations that may help the exercise physiology profession play a greater role in tackling the NCD burden and shift the healthcare model in a direction that is more proactive and focused on disease prevention and health, including the early identification and treatment of major

  4. Megatrend analaysis of the health policies of I.R.Iran

    Directory of Open Access Journals (Sweden)

    Iraj Nabipour

    2014-11-01

    Full Text Available Background: Megatrends are long-lasting global developments in society, technology, economy and political conditions that their effects are not restricted to a particular geographic area. In future studies, megatrends in social, technology, environment, politics, and values (STEEP-V should be considered. Material and Methods: The megatrends shaping healthcare in the new millennium were selected from the future studies. Trend analysis (macro to micro approach was used to emerge key fields of action or areas of innovation in healthcare and related technologies that might be reflected in the health policies of I.R.Iran. Results: Ten megatrends shaping healthcare in the new millennium were identified. High capacities for innovation in emerging health technologies, policies for health insurance, paradigm shift from volume to value in healthcare delivery, and infrastructure for participatory medicine were found in the health policies of I.R.Iran. Conclusions: The majority of the health policies of I.R.Iran are in line of healthcare megatrends and these policies provide a great potential for healthcare reform. However, more emphasis should be paid on mobile health (m-Health, medical tourism, community-based medicine, systems medicine, personalized medicine, transformation of big data to knowledge and geriatric health in the health policies of I.R.Iran.

  5. 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.

  6. From Data to Improved Decisions: Operations Research in Healthcare Delivery.

    Science.gov (United States)

    Capan, Muge; Khojandi, Anahita; Denton, Brian T; Williams, Kimberly D; Ayer, Turgay; Chhatwal, Jagpreet; Kurt, Murat; Lobo, Jennifer Mason; Roberts, Mark S; Zaric, Greg; Zhang, Shengfan; Schwartz, J Sanford

    2017-11-01

    The Operations Research Interest Group (ORIG) within the Society of Medical Decision Making (SMDM) is a multidisciplinary interest group of professionals that specializes in taking an analytical approach to medical decision making and healthcare delivery. ORIG is interested in leveraging mathematical methods associated with the field of Operations Research (OR) to obtain data-driven solutions to complex healthcare problems and encourage collaborations across disciplines. This paper introduces OR for the non-expert and draws attention to opportunities where OR can be utilized to facilitate solutions to healthcare problems. Decision making is the process of choosing between possible solutions to a problem with respect to certain metrics. OR concepts can help systematically improve decision making through efficient modeling techniques while accounting for relevant constraints. Depending on the problem, methods that are part of OR (e.g., linear programming, Markov Decision Processes) or methods that are derived from related fields (e.g., regression from statistics) can be incorporated into the solution approach. This paper highlights the characteristics of different OR methods that have been applied to healthcare decision making and provides examples of emerging research opportunities. We illustrate OR applications in healthcare using previous studies, including diagnosis and treatment of diseases, organ transplants, and patient flow decisions. Further, we provide a selection of emerging areas for utilizing OR. There is a timely need to inform practitioners and policy makers of the benefits of using OR techniques in solving healthcare problems. OR methods can support the development of sustainable long-term solutions across disease management, service delivery, and health policies by optimizing the performance of system elements and analyzing their interaction while considering relevant constraints.

  7. Emerging role of human factors and ergonomics in healthcare delivery – A new field of application and influence for the IEA

    Science.gov (United States)

    Carayon, Pascale

    2014-01-01

    Recent developments of research and application of Human Factors and Ergonomics (HFE) are described, in particular the domain of healthcare delivery. HFE activities in this domain are highlighted and challenges for the discipline and the International Ergonomics Association are presented. PMID:22317500

  8. Responsible healthcare innovation: anticipatory governance of nanodiagnostics for theranostics medicine.

    Science.gov (United States)

    Fisher, Erik; Boenink, Marianne; van der Burg, Simone; Woodbury, Neal

    2012-11-01

    Theranostics signals the integrated application of molecular diagnostics, therapeutic treatment and patient response monitoring. Such integration has hitherto neglected another crucial dimension: coproduction of theranostic scientific knowledge, novel technological development and broader sociopolitical systems whose boundaries are highly porous. Nanodiagnostics applications to theranostics are one of the most contested and potentially volatile postgenomics innovation trajectories as they build on past and current tensions and promises surrounding both nanotechnology and personalized medicine. Recent science policy research suggests that beneficial outcomes of innovations do not simply flow from the generation of scientific knowledge and technological capability in a linear or automatic fashion. Thus, attempts to offset public concerns about controversial emerging technologies by expert risk assurances can be unproductive. Anticipation provides a more robust basis for governance that supports genuine healthcare progress. This article presents a synthesis of novel policy approaches that directly inform theranostics medicine and the future(s) of postgenomics healthcare.

  9. Medical Identity Theft in the Emergency Department: Awareness is Crucial

    Directory of Open Access Journals (Sweden)

    Michelino Mancini

    2014-11-01

    Full Text Available Medical Identity theft in the emergency department (ED can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient’s identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior. [West J Emerg Med. 2014;15(7:–0.

  10. Competing Logics and Healthcare

    Science.gov (United States)

    Saks, Mike

    2018-01-01

    This paper offers a short commentary on the editorial by Mannion and Exworthy. The paper highlights the positive insights offered by their analysis into the tensions between the competing institutional logics of standardization and customization in healthcare, in part manifested in the conflict between managers and professionals, and endorses the plea of the authors for further research in this field. However, the editorial is criticized for its lack of a strong societal reference point, the comparative absence of focus on hybridization, and its failure to highlight structural factors impinging on the opposing logics in a broader neo-institutional framework. With reference to the Procrustean metaphor, it is argued that greater stress should be placed on the healthcare user in future health policy. Finally, the case of complementary and alternative medicine is set out which – while not explicitly mentioned in the editorial – most effectively concretizes the tensions at the heart of this analysis of healthcare. PMID:29626406

  11. Emerging communities of child-healthcare practice in the management of long-term conditions such as chronic kidney disease: qualitative study of parents' accounts.

    Science.gov (United States)

    Carolan, Ian; Smith, Trish; Hall, Andy; Swallow, Veronica M

    2014-07-07

    Parents of children and young people with long-term conditions who need to deliver clinical care to their child at home with remote support from hospital-based professionals, often search the internet for care-giving information. However, there is little evidence that the information available online was developed and evaluated with parents or that it acknowledges the communities of practice that exist as parents and healthcare professionals share responsibility for condition management. The data reported here are part of a wider study that developed and tested a condition-specific, online parent information and support application with children and young people with chronic-kidney disease, parents and professionals. Semi-structured interviews were conducted with 19 fathers and 24 mothers who had recently tested the novel application. Data were analysed using Framework Analysis and the Communities of Practice concept. Evolving communities of child-healthcare practice were identified comprising three components and several sub components: (1) Experiencing (parents making sense of clinical tasks) through Normalising care, Normalising illness, Acceptance & action, Gaining strength from the affected child and Building relationships to formalise a routine; (2) Doing (Parents executing tasks according to their individual skills) illustrated by Developing coping strategies, Importance of parents' efficacy of care and Fear of the child's health failing; and (3) Belonging/Becoming (Parents defining task and group members' worth and creating a personal identity within the community) consisting of Information sharing, Negotiation with health professionals and Achieving expertise in care. Parents also recalled factors affecting the development of their respective communities of healthcare practice; these included Service transition, Poor parent social life, Psycho-social affects, Family chronic illness, Difficulty in learning new procedures, Shielding and avoidance, and

  12. The Role of Higher Education within Broader Skills Policies, a Comparison of Emerging Scottish and English Approaches

    Science.gov (United States)

    Keep, Ewart

    2014-01-01

    This article explores the important role played by higher education in broader skills and economic development policies in England and Scotland. It places the often divergent policy experiments and structural developments in these two countries' higher education systems within an international policy context and explains why England and Scotland…

  13. Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt.

    Science.gov (United States)

    Hoytema van Konijnenburg, Eva M M; Diderich, Hester M; Teeuw, Arianne H; Klein Velderman, Mariska; Oudesluys-Murphy, Anne Marie; van der Lee, Johanna H

    2016-03-01

    To improve identification of child maltreatment, a new policy ('Hague protocol') was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care for children. If so, these children are referred to the Reporting Center for Child Abuse and Neglect (RCCAN), for assessment and referrals to support services. An adapted, hospital-based version of this protocol ('Amsterdam protocol') was implemented in another region. Children are identified in the same manner, but, instead of a RCCAN referral, they are referred to the pediatric outpatient department for an assessment, including a physical examination, and referrals to services. We compared results of both protocols to assess how differences between the protocols affect the outcomes on implementation, detection of child maltreatment and referrals to services. Furthermore, we assessed social validity and results of a screening physical examination. We included 212 families from the Amsterdam protocol (cohort study with reports by pediatric staff and parents) and 565 families from the Hague protocol (study of RCCAN records and telephone interviews with parents). We found that the RCCAN identified more maltreatment than pediatric staff (98% versus at least 51%), but referrals to services were similar (82% versus 80% of the total sample) and parents were positive about both interventions. Physical examination revealed signs of maltreatment in 5%. We conclude that, despite the differences, both procedures can serve as suitable methods to identify and refer children at risk for maltreatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Science education policy for emergency, conflict, and post-conflict: An analysis of trends and implications for the science education program in Uganda

    Science.gov (United States)

    Udongo, Betty Pacutho

    admission in higher institutions of learning, (b) curriculum reform, (c) professional development of teachers, (d) school security and safety, (e) science and technology education, and (f) increased funding for emergency education. The study proposes a model of "Schools as Islands of Peace and Hope" with science education as the tool for post-conflict economic recovery, as a blue print for emergency education policy framework.

  15. Big Data, Big Problems: A Healthcare Perspective.

    Science.gov (United States)

    Househ, Mowafa S; Aldosari, Bakheet; Alanazi, Abdullah; Kushniruk, Andre W; Borycki, Elizabeth M

    2017-01-01

    Much has been written on the benefits of big data for healthcare such as improving patient outcomes, public health surveillance, and healthcare policy decisions. Over the past five years, Big Data, and the data sciences field in general, has been hyped as the "Holy Grail" for the healthcare industry promising a more efficient healthcare system with the promise of improved healthcare outcomes. However, more recently, healthcare researchers are exposing the potential and harmful effects Big Data can have on patient care associating it with increased medical costs, patient mortality, and misguided decision making by clinicians and healthcare policy makers. In this paper, we review the current Big Data trends with a specific focus on the inadvertent negative impacts that Big Data could have on healthcare, in general, and specifically, as it relates to patient and clinical care. Our study results show that although Big Data is built up to be as a the "Holy Grail" for healthcare, small data techniques using traditional statistical methods are, in many cases, more accurate and can lead to more improved healthcare outcomes than Big Data methods. In sum, Big Data for healthcare may cause more problems for the healthcare industry than solutions, and in short, when it comes to the use of data in healthcare, "size isn't everything."

  16. Defining the role of University of Kentucky HealthCare in its medical market--how strategic planning creates the intersection of good public policy and good business practices.

    Science.gov (United States)

    Karpf, Michael; Lofgren, Richard; Bricker, Timothy; Claypool, Joseph O; Zembrodt, Jim; Perman, Jay; Higdon, Courtney M

    2009-02-01

    In response both to national pressures to reduce costs and improve health care access and outcomes and to local pressures to become a top-20 public research university, the University of Kentucky moved toward an integrated clinical enterprise, UK HealthCare, to create a common vision, shared goals, and an effective decision-making process. The leadership formed the vision and then embarked on a comprehensive and coordinated planning process that addressed financial, clinical, academic, and operational issues. The authors describe in depth the strategic planning process and specifically the definition of UK HealthCare's role in its medical marketplace. They began a rigorous process to assess and develop goals for the clinical programs and followed the progress of these programs through meetings driven by data and attended by the organization's senior leadership. They describe their approach to working with rural and community hospitals throughout central, eastern, and southern Kentucky to support the health care infrastructure of the state. They review the early successes of their strategic approach and describe the lessons they learned. The clinical successes have led to academic gains. The experience of UK HealthCare suggests that good business practices and good public policy are synergistic.

  17. Healthcare leadership's diversity paradox.

    Science.gov (United States)

    Silver, Reginald

    2017-02-06

    color in leadership roles that guide healthcare policy and access. This study connects contemporary literature to perspectives of executives in the field and offers practical solutions to improving the representation of people of color in executive healthcare leadership roles. Social implications The recommendations offered as a result of this research effort serve to create awareness of the challenges that people of color face in career attainment. Although the process of increasing the representation of people of color in executive healthcare leadership will be a complex task that will involve a number of players over the course of several years, this study serves to provide a practical roadmap with actionable tactics that can be deployed. Originality/value This paper is an extension of the work that was done by the author during the course of completing the program requirements for the author's doctoral program. The findings were previously discussed in the author's dissertation. The value of these findings is significant because they validate some of the topics in contemporary literature with the perspectives of practicing healthcare executives. This study is also unique from other studies in that it offers a long-term plan to increase the representation of people of color in executive roles by creating an early disposition toward executive level roles and identifies a number of practical steps toward that end.

  18. The emergency Policies in Decisions of the Communist Central Committee Politburo between «Revolution from Above» and the Great Terror, 1930-1936

    Directory of Open Access Journals (Sweden)

    Геннадий Аркадьевич Бордюгов

    2011-06-01

    Full Text Available The article emphasizes the «critical points» of the policy and ideology behind the emergency measures applied as a special means of administering the country. On the basis of «special files» of the minutes of the Politburo, it studies the limits and the causes of the transformation of the emergency measures into «chrezvychaishchina». This change in the measures applied weakened the social bases of Stalin's regime and undermined the foundations of the productive forces of the country. The author shows how the policy of taking drastic action, which was first applied to production (grain supply, etc., was progressively extended to the problems of security and political control, and how those in power tried to find ways of preventing a shift towards «chrezvychaishchina».

  19. Improvement attributes in healthcare: implications for integrated care.

    Science.gov (United States)

    Harnett, Patrick John

    2018-04-16

    Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care. Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare. Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics. Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process. Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches.

  20. Emerging organisational models of primary healthcare and unmet needs for care: insights from a population-based survey in Quebec province

    Directory of Open Access Journals (Sweden)

    Levesque Jean-Frédéric

    2012-07-01

    Full Text Available Abstract Background Reform of primary healthcare (PHC organisations is underway in Canada. The capacity of various types of PHC organizations to respond to populations’ needs remains to be assessed. The main objective of this study was to evaluate the association of PHC affiliation with unmet needs for care. Methods Population-based survey of 9205 randomly selected adults in two regions of Quebec, Canada. Outcomes Self-reported unmet needs for care and identification of the usual source of PHC. Results Among eligible adults, 18 % reported unmet needs for care in the last six months. Reasons reported for unmet needs were: waiting times (59 % of cases; unavailability of usual doctor (42 %; impossibility to obtain an appointment (36 %; doctors not accepting new patients (31 %. Regression models showed that unmet needs were decreasing with age and was lower among males, the least educated, and unemployed or retired. Controlling for other factors, unmet needs were higher among the poor and those with worse health status. Having a family doctor was associated with fewer unmet needs. People reporting a usual source of care in the last two-years were more likely to report unmet need for care. There were no differences in unmet needs for care across types of PHC organisations when controlling for affiliation with a family physician. Conclusion Reform models of primary healthcare consistent with the medical home concept did not differ from other types of organisations in our study. Further research looking at primary healthcare reform models at other levels of implementation should be done.

  1. Do reviews of healthcare interventions teach us how to improve healthcare systems?

    Science.gov (United States)

    Pawson, Ray; Greenhalgh, Joanne; Brennan, Cathy; Glidewell, Elizabeth

    2014-08-01

    Planners, managers and policy makers in modern health services are not without ingenuity - they will always try, try and try again. They face deep-seated or 'wicked' problems, which have complex roots in the labyrinthine structures though which healthcare is delivered. Accordingly, the interventions devised to deal with such stubborn problems usually come in the plural. Many different reforms are devised to deal with a particular stumbling block, which may be implemented sequentially, simultaneously or whenever policy fashion or funding dictates. This paper examines this predicament from the perspective of evidence based policy. How might researchers go about reviewing the evidence when they are faced with multiple or indeed competing interventions addressing the same problem? In the face of this plight a rather unheralded form of research synthesis has emerged, namely the 'typological review'. We critically review the fortunes of this strategy. Separating the putative reforms into series of subtypes and producing a scorecard of their outcomes has the unintended effect of divorcing them all from an understanding of how organisations change. A more fruitful approach may lie in a 'theory-driven review' underpinned by an understanding of dynamics of social change in complex organisations. We test this thesis by examining the primary and secondary research on the many interventions designed to tackle a particularly wicked problem, namely the inexorable rise in demand for healthcare. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Governance mechanisms for healthcare apps

    DEFF Research Database (Denmark)

    Manikas, Konstantinos; Hansen, Klaus Marius; Kyng, Morten

    2014-01-01

    The introduction of the `app store' concept has challenged the way software is distributed and marketed: developers have easier access to customers, while customers have easy access to innovative applications. Apps today are increasingly focusing on more "mission-critical" areas like healthcare...... with the Apple AppStore counting more than 40,000 apps under the category "health & fitness". This rapid development of healthcare apps increases the necessity of governance as, currently, healthcare apps are not thoroughly governed. The U.S. Food and Drug Administration and the European Commission only have...... policies for apps that are medical devices.In this paper, we approach the problem of how to govern healthcare and medical apps by addressing the risks the use of these apps pose, while at the same time inviting for development of new apps. To do so we (i) analyze four cases of healthcare app governance...

  3. An effective strategy for influenza vaccination of healthcare workers in Australia: experience at a large health service without a mandatory policy.

    Science.gov (United States)

    Heinrich-Morrison, Kristina; McLellan, Sue; McGinnes, Ursula; Carroll, Brendan; Watson, Kerrie; Bass, Pauline; Worth, Leon J; Cheng, Allen C

    2015-02-06

    Annual influenza vaccination of healthcare workers (HCWs) is recommended in Australia, but uptake in healthcare facilities has historically been low (approximately 50%). The objective of this study was to develop and implement a dedicated campaign to improve uptake of staff influenza annual vaccination at a large Australian health service. A quality improvement program was developed at Alfred Health, a tertiary metropolitan health service spanning 3 campuses. Pre-campaign evaluation was performed by questionnaire in 2013 to plan a multimodal vaccination strategy. Reasons for and against vaccination were captured. A campaign targeting clinical and non-clinical healthcare workers was then implemented between March 31 and July 31 2014. Proportional uptake of influenza vaccination was determined by campus and staff category. Pre-campaign questionnaire responses were received from 1328/6879 HCWs (response rate 20.4%), of which 76% were vaccinated. Common beliefs held by unvaccinated staff included vaccine ineffectiveness (37.1%), that vaccination makes staff unwell (21.0%), or that vaccination is not required because staff are at low risk for acquiring influenza (20.2%). In 2014, 6009/7480 (80.3%) staff were vaccinated, with significant improvement in uptake across all campuses and amongst nursing, medical and allied health staff categories from 2013 to 2014 (p strategy utilising social marketing and a customised staff database was successful in increasing influenza vaccination uptake by all staff categories. The sustainability of dedicated campaigns must be evaluated.

  4. Harnessing the privatisation of China's fragmented health-care delivery.

    Science.gov (United States)

    Yip, Winnie; Hsiao, William

    2014-08-30

    Although China's 2009 health-care reform has made impressive progress in expansion of insurance coverage, much work remains to improve its wasteful health-care delivery. Particularly, the Chinese health-care system faces substantial challenges in its transformation from a profit-driven public hospital-centred system to an integrated primary care-based delivery system that is cost effective and of better quality to respond to the changing population needs. An additional challenge is the government's latest strategy to promote private investment for hospitals. In this Review, we discuss how China's health-care system would perform if hospital privatisation combined with hospital-centred fragmented delivery were to prevail--population health outcomes would suffer; health-care expenditures would escalate, with patients bearing increasing costs; and a two-tiered system would emerge in which access and quality of care are decided by ability to pay. We then propose an alternative pathway that includes the reform of public hospitals to pursue the public interest and be more accountable, with public hospitals as the benchmarks against which private hospitals would have to compete, with performance-based purchasing, and with population-based capitation payment to catalyse coordinated care. Any decision to further expand the for-profit private hospital market should not be made without objective assessment of its effect on China's health-policy goals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. From 'knowledge use' to 'boundary work': sketch of an emerging new research programme for science/policy interactions

    NARCIS (Netherlands)

    Hoppe, Robertus; in 't Veld, Roeland J.

    2010-01-01

    This chapter is about a new agenda for inquiry into the relationships between science and public policy. So far, most research has conceptualised this relationship in terms of knowledge utilisation and downstream impact on the policy process. However, this leads to over-instrumentalisation and

  6. The proportion of work-related emergency department visits not expected to be paid by workers' compensation: implications for occupational health surveillance, research, policy, and health equity.

    Science.gov (United States)

    Groenewold, Matthew R; Baron, Sherry L

    2013-12-01

    To examine trends in the proportion of work-related emergency department visits not expected to be paid by workers' compensation during 2003-2006, and to identify demographic and clinical correlates of such visits. A total of 3,881 work-related emergency department visit records drawn from the 2003-2006 National Hospital Ambulatory Medical Care Surveys. Secondary, cross-sectional analyses of work-related emergency department visit data were performed. Odds ratios and 95 percent confidence intervals were modeled using logistic regression. A substantial and increasing proportion of work-related emergency department visits in the United States were not expected to be paid by workers' compensation. Private insurance, Medicaid, Medicare, and workers themselves were expected to pay for 40 percent of the work-related emergency department visits with this percentage increasing annually. Work-related visits by blacks, in the South, to for-profit hospitals and for work-related illnesses were all more likely not to be paid by workers' compensation. Emergency department-based surveillance and research that determine work-relatedness on the basis of expected payment by workers' compensation systematically underestimate the occurrence of occupational illness and injury. This has important methodological and policy implications. © Health Research and Educational Trust.

  7. Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

    Science.gov (United States)

    Rockwell, Kimberly Lovett; Gilroy, Alexis

    2018-03-12

    Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

  8. [Fostering LGBT-friendly healthcare services].

    Science.gov (United States)

    Wei, Han-Ting; Chen, Mu-Hong; Ku, Wen-Wei

    2015-02-01

    LGBT (lesbian, gay, bisexual, transgender) patients suffer from stigma and discrimination when seeking healthcare. A large LGBT healthcare survey revealed that 56% of gay patients and 70% of transgender patients suffered some type of discrimination while seeking healthcare in 2014. The fostering of LGBT-friendly healthcare services is not just an advanced step of gender mainstreaming but also a fulfillment of health equality and equity. Additionally, LGBT-friendly healthcare services are expected to provide new opportunities for healthcare workers. Therefore, proactive government policies, education, research, and clinical practice should all encourage the development of these healthcare services. We look forward to a well-developed LGBT-friendly healthcare system in Taiwan.

  9. Primary Healthcare Spending: Striving for Equity under Fiscal ...

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

    2010-04-01

    Apr 1, 2010 ... Book cover Primary Healthcare Spending: Striving for Equity under Fiscal Federalism ... Primary Healthcare Spending is an important reference for ... field of health policy and health economics, agencies involved in providing ...

  10. 75 FR 50770 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Science.gov (United States)

    2010-08-17

    ... Infectious Diseases (NCEZID), regarding: (1) The practice of hospital infection control; strategies for surveillance, prevention, and control of infections (e.g., nosocomial infections), antimicrobial resistance... and other policy statements regarding prevention of healthcare- associated infections and healthcare...

  11. Machine learning in healthcare informatics

    CERN Document Server

    Acharya, U; Dua, Prerna

    2014-01-01

    The book is a unique effort to represent a variety of techniques designed to represent, enhance, and empower multi-disciplinary and multi-institutional machine learning research in healthcare informatics. The book provides a unique compendium of current and emerging machine learning paradigms for healthcare informatics and reflects the diversity, complexity and the depth and breath of this multi-disciplinary area. The integrated, panoramic view of data and machine learning techniques can provide an opportunity for novel clinical insights and discoveries.

  12. Healthcare Lean.

    Science.gov (United States)

    Long, John C

    2003-01-01

    Lean Thinking is an integrated approach to designing, doing and improving the work of people that have come together to produce and deliver goods, services and information. Healthcare Lean is based on the Toyota production system and applies concepts and techniques of Lean Thinking to hospitals and physician practices.

  13. Instruments to increase climate policy ambition before 2020. Economic and political implications in selected industry and emerging countries. Pre2020 climate policy ambition. Draft version

    Energy Technology Data Exchange (ETDEWEB)

    Braun, Nadine; Hoehne, Niklas; Hagemann, Markus; Day, Thomas [Ecofys Germany GmbH, Berlin (Germany); Healy, Sean; Schumacher, Katja [Oeko-Institut e.V. - Institut fuer Angewandte Oekologie, Berlin (Germany); Duscha, Vicki [Fraunhofer-Institut fuer System- und Innovationsforschung (ISI), Karlsruhe (Germany)

    2014-06-06

    The objective of this research paper is to analyse the current efforts of country activities towards the 2020 2 C target, in order to identify best practices and their possible impact on emission reduction in 2020. A first scan of policies in countries with high greenhouse gas emissions and countries with remarkably ambitious climate change mitigation strategies (see Table 1) revealed that thematic areas with notable coverage in domestic climate policy are: general strategies and targets, renewable energy support schemes for electricity, product standards and codes for energy efficiency in buildings, and direct subsidies and fuel quotas for renewables in Transport. From this, along with initial indications of mitigation potential, we identified four areas where ambition could be significantly enhanced by 2020.

  14. Lean in healthcare: A comprehensive review.

    Science.gov (United States)

    D'Andreamatteo, Antonio; Ianni, Luca; Lega, Federico; Sargiacomo, Massimo

    2015-09-01

    Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of "system wide approach" are still low in number. Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Are undocumented migrants’ entitlements and barriers to healthcare a public health challenge for the European Union?

    OpenAIRE

    De Vito, Elisabetta; de Waure, Chiara; Specchia, Maria Lucia; Parente, Paolo; Azzolini, Elena; Frisicale, Emanuela Maria; Favale, Marcella; Teleman, Adele Anna; Ricciardi, Walter

    2016-01-01

    Undocumented migrants (UMs) are at higher risk for health problems because of their irregular status and the consequences of economic and social marginalization. Moreover, the emergent reality of undocumented migration in Europe calls for action in the field of management of UM’s health demands as their access to health services has become a sensitive political and social issue. In this light, this paper aims to address UMs’ entitlement and barriers to healthcare and related policies citing e...

  16. Healthcare service quality: towards a broad definition.

    Science.gov (United States)

    Mosadeghrad, Ali Mohammad

    2013-01-01

    The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

  17. Stakeholders' Perceptions on Shortage of Healthcare Workers in Primary Healthcare in Botswana: Focus Group Discussions.

    Directory of Open Access Journals (Sweden)

    Oathokwa Nkomazana

    Full Text Available An adequate health workforce force is central to universal health coverage and positive public health outcomes. However many African countries have critical shortages of healthcare workers, which are worse in primary healthcare. The aim of this study was to explore the perceptions of healthcare workers, policy makers and the community on the shortage of healthcare workers in Botswana.Fifteen focus group discussions were conducted with three groups of policy makers, six groups of healthcare workers and six groups of community members in rural, urban and remote rural health districts of Botswana. All the participants were 18 years and older. Recruitment was purposive and the framework method was used to inductively analyse the data.There was a perceived shortage of healthcare workers in primary healthcare, which was believed to result from an increased need for health services, inequitable distribution of healthcare workers, migration and too few such workers being trained. Migration was mainly the result of unfavourable personal and family factors, weak and ineffective healthcare and human resources management, low salaries and inadequate incentives for rural and remote area service.Botswana has a perceived shortage of healthcare workers, which is worse in primary healthcare and rural areas, as a result of multiple complex factors. To address the scarcity the country should train adequate numbers of healthcare workers and distribute them equitably to sufficiently resourced healthcare facilities. They should be competently managed and adequately remunerated and the living conditions and rural infrastructure should also be improved.

  18. The making of a European healthcare union

    DEFF Research Database (Denmark)

    Vollaard, Hans; van de Bovenkamp, Hester M.; Martinsen, Dorte Sindbjerg

    2016-01-01

    that federalism offers the most fruitful way to do so because of its sensitivity to the EU’s institutional settings and to the territorial dimension of politics. The division of competences and national diversity of healthcare systems have been major obstacles for the formation of a healthcare union. However......, the EU obtained a role in healthcare through the impact of non-healthcare legislation, voluntary co-operation, court rulings, governments’ joint-decision traps, and fiscal stress of member states. The emerging European healthcare union is a system of cooperative federalism without much cost-sharing...

  19. A software platform to analyse the ethical issues of electronic patient privacy policy: the S3P example.

    Science.gov (United States)

    Mizani, M A; Baykal, N

    2007-12-01

    Paper-based privacy policies fail to resolve the new changes posed by electronic healthcare. Protecting patient privacy through electronic systems has become a serious concern and is the subject of several recent studies. The shift towards an electronic privacy policy introduces new ethical challenges that cannot be solved merely by technical measures. Structured Patient Privacy Policy (S3P) is a software tool assuming an automated electronic privacy policy in an electronic healthcare setting. It is designed to simulate different access levels and rights of various professionals involved in healthcare in order to assess the emerging ethical problems. The authors discuss ethical issues concerning electronic patient privacy policies that have become apparent during the development and application of S3P.

  20. 76 FR 35091 - Continuation of the National Emergency With Respect to the Actions and Policies of Certain...

    Science.gov (United States)

    2011-06-15

    ... engage in public corruption, including by diverting or misusing Belarusian public assets or by misusing... measures adopted on that date to deal with that emergency, must continue in effect beyond June 16, 2011...

  1. Imagined in Policy, Inscribed on Bodies: Defending an Ethic of Compassion in a Political Context; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

    Directory of Open Access Journals (Sweden)

    Dave Mercer

    2015-10-01

    Full Text Available In response to the International Journal of Health Policy and Management (IJHPMeditorial, this commentary adds to the debate about ethical dimensions of compassionate care in UK service provision. It acknowledges the importance of the original paper, and attempts to explore some of the issues that are raised in the context of nursing practice, research and education. It is argued that each of these fields of the profession are enacted in an escalating culture of corporatism, be that National Health Service (NHS or university campus, and global neoliberalism. Post-structuralist ideas, notably those of Foucault, are borrowed to interrogate healthcare as discursive practice and disciplinary knowledge; where an understanding of the ways in which power and language operate is prominent. Historical and contemporary evidence of institutional and ideological degradation of sections of humanity, a ‘history of the present,’ serve as reminders of the import, and fragility, of ethical codes.

  2. The crisis in United States hospital emergency services.

    Science.gov (United States)

    Harrison, Jeffrey P; Ferguson, Emily D

    2011-01-01

    Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.

  3. Museums as brokers of participation: how visitors view the emerging role of European science centres and museums in policy

    Directory of Open Access Journals (Sweden)

    Andrea Bandelli

    2016-05-01

    Full Text Available Science centres and museums in Europe traditionally offer opportunities for public participation, such as dialogues, debates and workshops. In recent years, starting with the support of grants from the European Commission, the purpose of these initiatives is increasingly more connected with the policy making processes where science centres play a role as brokers between the public and other stakeholders. This article begins an investigation on how these two levels of participation – the participation of museums in policy, and the participation of visitors in museums – are related in seven European science centres and museums. The results suggest that science centres and museums are regarded by their visitors as potential platforms to facilitate public participation in policy, especially in countries where the general infrastructure for public participation in science is weak.

  4. The Hazards of Data Mining in Healthcare.

    Science.gov (United States)

    Househ, Mowafa; Aldosari, Bakheet

    2017-01-01

    From the mid-1990s, data mining methods have been used to explore and find patterns and relationships in healthcare data. During the 1990s and early 2000's, data mining was a topic of great interest to healthcare researchers, as data mining showed some promise in the use of its predictive techniques to help model the healthcare system and improve the delivery of healthcare services. However, it was soon discovered that mining healthcare data had many challenges relating to the veracity of healthcare data and limitations around predictive modelling leading to failures of data mining projects. As the Big Data movement has gained momentum over the past few years, there has been a reemergence of interest in the use of data mining techniques and methods to analyze healthcare generated Big Data. Much has been written on the positive impacts of data mining on healthcare practice relating to issues of best practice, fraud detection, chronic disease management, and general healthcare decision making. Little has been written about the limitations and challenges of data mining use in healthcare. In this review paper, we explore some of the limitations and challenges in the use of data mining techniques in healthcare. Our results show that the limitations of data mining in healthcare include reliability of medical data, data sharing between healthcare organizations, inappropriate modelling leading to inaccurate predictions. We conclude that there are many pitfalls in the use of data mining in healthcare and more work is needed to show evidence of its utility in facilitating healthcare decision-making for healthcare providers, managers, and policy makers and more evidence is needed on data mining's overall impact on healthcare services and patient care.

  5. EVALUATION OF THE “MAIS MÉDICOS” (“MORE DOCTORS” PROGRAM AS A STRENGTHENING POLICY OF PRIMARY HEALTHCARE

    Directory of Open Access Journals (Sweden)

    Silvania Moraes Costa

    2017-07-01

    Full Text Available The “Mais Médicos” (“More Doctors” Program in Brazil aims to solve the shortage of doctors by providing Brazilian and foreign professionals to work in cities with difficult access and marked socioeconomic vulnerability. This study aims to describe existing researches on the implementation of the “Mais Médicos” (More Doctors Program on Primary Healthcare. This is a descriptive research, in the form of an integrative review of literature according to data collection in the online databases: BVS and Scielo, with interrelations of Boolean operators and and or. The studies analyzed are: opinion articles, editorials, open space technology and debates, denoting the scarcity of original research carried out in this area. It is perceived that SUS (“Brazilian Unified Health System” needs to develop much more to guarantee the universal right to health, since the population, besides the necessity of more doctors, also needs better perspectives of health and social justice.

  6. Society of Behavioral Medicine's (SBM) position on emerging policy issues regarding electronic nicotine delivery systems (ENDS): A need for regulation.

    Science.gov (United States)

    Rojewski, Alana M; Coleman, Nortorious; Toll, Benjamin A

    2016-09-01

    Electronic nicotine delivery systems (ENDS), commonly known as electronic cigarettes (or e-cigarettes), are widely available in the USA, yet almost entirely unregulated on a national level. Researchers are currently gathering data to understand the individual and public health effects of ENDS, as well as the role that ENDS may play in tobacco treatment. Given these uncertainties, regulatory efforts should be aimed at understanding and minimizing any potential harms of ENDS. The Society of Behavioral Medicine (SBM) supports stronger regulation of ENDS, incorporation of ENDS into clean air policies, and special consideration of safety standards to protect vulnerable populations. SBM also supports research on ENDS to guide policy decisions.

  7. Bridging the gaps among research, policy and practice in ten low- and middle-income countries: Development and testing of questionnaire for health-care providers

    Directory of Open Access Journals (Sweden)

    Boupha Boungnong

    2010-01-01

    Full Text Available Abstract Background The reliability and validity of instruments used to survey health-care providers' views about and experiences with research evidence have seldom been examined. Methods Country teams from ten low- and middle-income countries (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania participated in the development, translation, pilot-testing and administration of a questionnaire designed to measure health-care providers' views and activities related to improving their clinical practice and their awareness of, access to and use of research evidence, as well as changes in their clinical practice that they attribute to particular sources of research evidence that they have used. We use internal consistency as a measure of the questionnaire's reliability and, whenever possible, we use explanatory factor analyses to assess the degree to which questions that pertain to a single domain actually address common themes. We assess the questionnaire's face validity and content validity and, to a lesser extent, we also explore its criterion validity. Results The questionnaire has high internal consistency, with Cronbach's alphas between 0.7 and 0.9 for 16 of 20 domains and sub-domains (identified by factor analyses. Cronbach's alphas are greater than 0.9 for two domains, suggesting some item redundancy. Pre- and post-field work assessments indicate the questionnaire has good face validity and content validity. Our limited assessment of criterion validity shows weak but statistically significant associations between the general influence of research evidence among providers and more specific measures of providers' change in approach to preventing or treating a clinical condition. Conclusion Our analysis points to a number of strengths of the questionnaire - high internal consistency (reliability and good face and content validity - but also to areas where it can be shortened without losing important conceptual

  8. Your Heart Failure Healthcare Team

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Your Heart Failure Healthcare Team Updated:May 9,2017 Patients with ... to the Terms and Conditions and Privacy Policy Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  9. Healthcare costs for new technologies

    International Nuclear Information System (INIS)

    Goyen, Mathias; Debatin, Joerg F.

    2009-01-01

    Continuous ageing of the population coupled with growing health consciousness and continuous technological advances have fueled the rapid rise in healthcare costs in the United States and Europe for the past several decades. The exact impact of new medical technology on long-term spending growth remains the subject of controversy. By all measures it is apparent that new medical technology is the dominant driver of increases in health-care costs and hence insurance premiums. This paper addresses the impact of medical technology on healthcare delivery systems with regard to medical practice and costs. We first explore factors affecting the growth of medical technology and then attempt to provide a means for assessing the effectiveness of medical technology. Avoidable healthcare cost drivers are identified and related policy issues are discussed. (orig.)

  10. Healthcare costs for new technologies

    Energy Technology Data Exchange (ETDEWEB)

    Goyen, Mathias; Debatin, Joerg F. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany)

    2009-03-15

    Continuous ageing of the population coupled with growing health consciousness and continuous technological advances have fueled the rapid rise in healthcare costs in the United States and Europe for the past several decades. The exact impact of new medical technology on long-term spending growth remains the subject of controversy. By all measures it is apparent that new medical technology is the dominant driver of increases in health-care costs and hence insurance premiums. This paper addresses the impact of medical technology on healthcare delivery systems with regard to medical practice and costs. We first explore factors affecting the growth of medical technology and then attempt to provide a means for assessing the effectiveness of medical technology. Avoidable healthcare cost drivers are identified and related policy issues are discussed. (orig.)

  11. Evaluating Alcohol Control Policies in Peru and St. Kitts and Nevis ...

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

    Alcohol is the world's third largest risk factor for disease burden. It has had a dramatic impact on morbidity, mortality, and healthcare costs in South America and the Caribbean. This project aims to inform policymakers in two countries with emerging alcohol policies: Peru and St. Kitts and Nevis. It is designed to help guide ...

  12. Accounting practice diversity in the healthcare industry.

    Science.gov (United States)

    Robbins, W A; Turpin, R

    1993-05-01

    A recent study examining accounting practices currently being used to prepare annual hospital financial statements indicates relatively little diversity, regardless of organizational type or size. The study's findings should interest those concerned with healthcare accounting and financial reporting issues, especially healthcare administrators and members of standards setting boards who participate in accounting policy deliberations.

  13. Like an extended family: Relationships that emerge when older caregivers use written messages to communicate in an ICT-based healthcare service.

    Science.gov (United States)

    Solli, Hilde; Bjørk, Ida Torunn; Hvalvik, Sigrun; Hellesø, Ragnhild

    2018-03-01

    To explore the relationships that emerge amongst caregivers of persons with dementia and stroke when caregivers use written messages as their communication tool in a closed information and communication technology (ICT)-based support group. An explorative design with a qualitative approach was used that applied systematic text condensation (STC) to analyse 173 written messages extracted from a web forum. Empathetic, empowering and familiar relationships emerged amongst peers of older caregivers when the caregivers used written messages as their communication tool. The empathetic relationship was characterised by sincerity and openness when the caregivers shared emotions related to caregiving. The empowering relationship reflected a fellowship based on solidarity influenced by a sense of optimism and a willingness to share knowledge to support one another in overcoming challenges. In the familiar relationship, the caregivers were thoughtful and good-humoured with one another and displayed an attitude of consideration towards one another, as in an extended family. The use of computer-mediated communication in health care service will change the context of establishing and maintaining interpersonal relationships. Therefore, greater knowledge regarding how the peers of caregivers interact with one another is vital so nurses may better support and educate ICT-based support groups.

  14. Emergency river storage in the Ooij polder - A bridge too far? Forms of participation in flood preparedness policy

    NARCIS (Netherlands)

    Warner, J.F.

    2008-01-01

    Disaster policy tends to be in the domain of top-down security governance. However, international organizations are calling for more 'horizontal', participatory forms of planning for flood preparedness together with local stakeholders. But what modality of public involvement do they mean? A case

  15. The Long-Term Impact of Admission Policies: A Comparative Study of Two Emergent Research Institutions in Texas

    Science.gov (United States)

    Crisp, Gloria; Horn, Catherine; Dizinno, Gerry; Barlow, Libby

    2013-01-01

    The present study explored the long-term impact of admission policies at two aspiring research institutions in Texas. Six years of longitudinal institutional data were analyzed for all full-time first time in college undergraduate students at both universities. Descriptive and inferential statistics were used to identify relationships and…

  16. Emerging Voices: "Speak White": Language Policy, Immigration Discourse, and Tactical Authenticity in a French Enclave in New England

    Science.gov (United States)

    Peters, Jason

    2013-01-01

    This article provides a historical case study of the Sentinelle Affair, a conflict between French language rights and the English Only educational policies of the Catholic Church in New England in the 1920s. An analysis of this conflict reveals a correspondence between programs of language centralization and the production of language differences…

  17. 75 FR 32841 - Continuation of the National Emergency With Respect to the Actions and Policies of Certain...

    Science.gov (United States)

    2010-06-10

    ... or institutions, to commit human rights abuses related to political repression, including detentions... political prisoners in the fall of 2008 and our continuing efforts to press for further reforms related to democracy, human rights, and the rule of law in Belarus, serious challenges remain. The actions and policies...

  18. Emerging Economic Entity Crises in Post Financial Crisis Era – The impact and countermeasures against the escape of America from quantitative easing policy

    Directory of Open Access Journals (Sweden)

    Yu Hua

    2015-01-01

    Full Text Available Five years from the eruption of financial crisis in 2008, the global economy is also on its way to the restoration, among which the emerging economic entities, typically China, India, Brazil, South Africa, Indonesia, etc., have rapidly run away from the crisis and led the recovery of global economy, which may be considered as the engine of global economy growth in the post financial crisis. While, with the America declaring that it would gradually reduce the quantitative easing (QE scale and escaped from the quantitative easing policy in the mid 2014, the fluctuation of global financial market was rapidly intensified, and the risk assets were largely sold off, with the emerging economic entities suffering serious impact. Furthermore, the anxiety about the “third round of financial crisis will burst out due to the emerging economic entities” is increasingly intensified. This article will first analyze the current economic situation of main global economic entities, discuss about the impact of America’s escape from QE on the emerging economic entity and its mechanism, and finally propose the countermeasures for China.

  19. Views of senior health personnel about quality of emergency obstetric care: A qualitative study in Nigeria.

    Science.gov (United States)

    Okonofua, Friday; Randawa, Abdullahi; Ogu, Rosemary; Agholor, Kingsley; Okike, Ola; Abdus-Salam, Rukayat Adeola; Gana, Mohammed; Abe, Eghe; Durodola, Adetoye; Galadanci, Hadiza

    2017-01-01

    Late arrival in hospital by women experiencing pregnancy complications is an important background factor leading to maternal mortality in Nigeria. The use of effective and timely emergency obstetric care determines whether women survive or die, or become near-miss cases. Healthcare managers have the responsibility to deploy resources for implementing emergency obstetric care. To determine the nature of institutional policies and frameworks for managing obstetric complications and reducing maternal deaths in Nigeria. Thirty-six hospital managers, heads of obstetrics department and senior midwives were interviewed about hospital infrastructure, resources, policies and processes relating to emergency obstetric care, whilst allowing informants to discuss their thoughts and feelings. The interviews were audiotaped, transcribed and analyzed using Atlas ti 6.2software. Hospital managers are aware of the seriousness of maternal mortality and the steps to improve maternal healthcare. Many reported the lack of policies and specific action-plans for maternal mortality prevention, and many did not purposely disburse budgets or resources to address the problem. Although some reported that maternal/perinatal audit take place in their hospitals, there was no substantive evidence and no records of maternal/perinatal audits were made available. Respondents decried the lack of appropriate data collection system in the hospitals for accurate monitoring of maternal mortality and identification of appropriate remediating actions. Healthcare managers are handicapped to properly manage the healthcare system for maternal mortality prevention. Relevant training of healthcare managers would be crucial to enable the development of strategic implementation plans for the prevention of maternal mortality.

  20. Social media disruptive change in healthcare : Responses of healthcare providers?

    NARCIS (Netherlands)

    Smailhodzic, E.; Boonstra, A.; Langley, D.J.

    2016-01-01

    Social media represent specific types of technologies that are end-user driven and end-users are able to drive disruptive change giving little time to organizations to react. With rapid and powerful emergence of social media communities in healthcare, this sector is faced with new and alternative

  1. Social media disruptive change in healthcare : responses of healthcare providers

    NARCIS (Netherlands)

    Smailhodzic, Edin; Boonstra, Albert; Langley, David

    Social media represent specific types of technologies that are end-user driven and end-users are able to drive disruptive change giving little time to organizations to react. With rapid and powerful emergence of social media communities in healthcare, this sector is faced with new and alternative

  2. [Interdisciplinary healthcare centres--a way of organising healthcare in the future from a health insurer's perspective].

    Science.gov (United States)

    Hecke, Torsten L; Hoyer, Jens Martin

    2009-01-01

    The German healthcare system modernization act enables healthcare providers to fund interdisciplinary healthcare centres. The Techniker Krankenkasse (TK) is a statutory health sickness fund that has contracted with some of the interdisciplinary healthcare centres named ATRIO-MED to achieve high-quality medical care and healthcare management. A range of patient-centred services is described in the cooperation agreement; in addition to central medical patient records one of the core competencies includes integrated pathways for defined diagnosis. The concept of the interdisciplinary healthcare centre is highly accepted among patients. It will serve as a platform for future TK healthcare policies.

  3. Reasons for accepting or declining Down syndrome screening in Dutch prospective mothers within the context of national policy and healthcare system characteristics: a qualitative study.

    Science.gov (United States)

    Crombag, Neeltje M T H; Boeije, Hennie; Iedema-Kuiper, Rita; Schielen, Peter C J I; Visser, Gerard H A; Bensing, Jozien M

    2016-05-26

    Uptake rates for Down syndrome screening in the Netherlands are low compared to other European countries. To investigate the low uptake, we explored women's reasons for participation and possible influences of national healthcare system characteristics. Dutch prenatal care is characterised by an approach aimed at a low degree of medicalisation, with pregnant women initially considered to be at low risk. Prenatal screening for Down syndrome is offered to all women, with a 'right not to know' for women who do not want to be informed on this screening. At the time this study was performed, the test was not reimbursed for women aged 35 and younger. We conducted a qualitative study to explore reasons for participation and possible influences of healthcare system characteristics. Data were collected via ten semi-structured focus groups with women declining or accepting the offer of Down syndrome screening (n = 46). All focus groups were audio- and videotaped, transcribed verbatim, coded and content analysed. Women declining Down syndrome screening did not consider Down syndrome a condition severe enough to justify termination of pregnancy. Young women declining felt supported in their decision by perceived confirmation of their obstetric caregiver and reassured by system characteristics (costs and age restriction). Women accepting Down syndrome screening mainly wanted to be reassured or be prepared to care for a child with Down syndrome. By weighing up the pros and cons of testing, obstetric caregivers supported young women who accepted in the decision-making process. This was helpful, although some felt the need to defend their decision to accept the test offer due to their young age. For some young women accepting testing, costs were considered a disincentive to participate. Presentation of prenatal screening affects how the offer is attended to, perceived and utilised. By offering screening with age restriction and additional costs, declining is considered the

  4. Complexity science and leadership in healthcare.

    Science.gov (United States)

    Burns, J P

    2001-10-01

    The emerging field of complexity science offers an alternative leadership strategy for the chaotic, complex healthcare environment. A survey revealed that healthcare leaders intuitively support principles of complexity science. Leadership that uses complexity principles offers opportunities in the chaotic healthcare environment to focus less on prediction and control and more on fostering relationships and creating conditions in which complex adaptive systems can evolve to produce creative outcomes.

  5. Customer privacy on UK healthcare websites.

    Science.gov (United States)

    Mundy, Darren P

    2006-09-01

    Privacy has been and continues to be one of the key challenges of an age devoted to the accumulation, processing, and mining of electronic information. In particular, privacy of healthcare-related information is seen as a key issue as health organizations move towards the electronic provision of services. The aim of the research detailed in this paper has been to analyse privacy policies on popular UK healthcare-related websites to determine the extent to which consumer privacy is protected. The author has combined approaches (such as approaches focused on usability, policy content, and policy quality) used in studies by other researchers on e-commerce and US healthcare websites to provide a comprehensive analysis of UK healthcare privacy policies. The author identifies a wide range of issues related to the protection of consumer privacy through his research analysis using quantitative results. The main outcomes from the author's research are that only 61% of healthcare-related websites in their sample group posted privacy policies. In addition, most of the posted privacy policies had poor readability standards and included a variety of privacy vulnerability statements. Overall, the author's findings represent significant current issues in relation to healthcare information protection on the Internet. The hope is that raising awareness of these results will drive forward changes in the industry, similar to those experienced with information quality.

  6. 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...

  7. Ética, direitos dos usuários e políticas de humanização da atenção à saúde Ethics, users' rights and policies of humanization of healthcare

    Directory of Open Access Journals (Sweden)

    Paulo Antonio de Carvalho Fortes

    2004-12-01

    Full Text Available O artigo trata da evolução das políticas públicas de humanização dos serviços de saúde no Brasil. No campo da atenção em saúde, o termo humanização tem sido utilizado com diferentes significados e entendimentos, relacionando-o com os direitos dos pacientes e a ética voltada ao respeito ao outro. A partir dos anos 90, a humanização da atenção à saúde vem sendo tratada como política pública, iniciando-se no ambiente hospitalar, e , atualmente, sendo dirigida para todos os níveis de atenção de saúde.The article shows the evolution of public policies of humanization of healthcare in Brazil. Humanization was first related to patients' rights and ethics regarding respect for the others. In the nineties humanization is vieved as a public policies. Nowadays it is oriented to all services of health care.

  8. Emergence of a Policy, closure of a sector: regarding the management of penitentiary health care in Brazil.

    Science.gov (United States)

    Batista E Silva, Martinho Braga

    2016-06-01

    The aim of this study is to understand recent transformations in penitentiary health care management in Brazil, during the implementation of the National Policy for Comprehensive Health Care for People Deprived of Liberty in the Prison System, and the closure of the National Sector for Penitentiary Health Care. The scientific problem investigated is the language of penitentiary health care policy. The theoretical-methodological framework adopted is Pierre Bourdieu's genetic structuralism. In this manner, we carry out an analysis of documents and public statements in search of State categories and classifications. We note the consolidation of a state classification that separates the 'penitentiary' domain from the 'prison' domain, as well as the creation of the State category of 'person deprived of liberty in the prison system'. Penitentiary health care management constitutes itself as a question of primary care.

  9. Massively parallel sequencing and the emergence of forensic genomics: Defining the policy and legal issues for law enforcement.

    Science.gov (United States)

    Scudder, Nathan; McNevin, Dennis; Kelty, Sally F; Walsh, Simon J; Robertson, James

    2018-03-01

    Use of DNA in forensic science will be significantly influenced by new technology in coming years. Massively parallel sequencing and forensic genomics will hasten the broadening of forensic DNA analysis beyond short tandem repeats for identity towards a wider array of genetic markers, in applications as diverse as predictive phenotyping, ancestry assignment, and full mitochondrial genome analysis. With these new applications come a range of legal and policy implications, as forensic science touches on areas as diverse as 'big data', privacy and protected health information. Although these applications have the potential to make a more immediate and decisive forensic intelligence contribution to criminal investigations, they raise policy issues that will require detailed consideration if this potential is to be realised. The purpose of this paper is to identify the scope of the issues that will confront forensic and user communities. Copyright © 2017 The Chartered Society of Forensic Sciences. All rights reserved.

  10. Oil price shocks and policy implications the emergence of U.S. tight oil production: a case study

    OpenAIRE

    Voth, Jeffrey Michael

    2015-01-01

    How have shocks to supply and demand affected global oil prices; and what are key policy implications following the resurgence of oil production in the United States? Highlights: − The recent collapse in global oil prices was dominated by oversupply. − The future of tight oil in the United States is vulnerable to obstacles beyond oil prices. − Opinions on tight oil from the Top 25 think tank organizations are considered. Global oil prices have fallen more than fifty percent since ...

  11. U.S.-China Economic and Security Review Commission: Emerging Factor in Western Pacific Strategic Policy Analysis

    OpenAIRE

    Chapman, Bert

    2017-01-01

    Those studying and analyzing Western Pacific strategic trends and develop- ments have access to multiple unclassified analyses of security trends in this region covering these waters and adjacent countries. These information resources are produced by military and government agencies from multiple countries, multinational public policy research institutions, popular and scholarly journals, and Internet resources featuring text, data, webcasts, and imagery. One of these resources is the U.S.–Ch...

  12. Landscapes in transition: an analysis of sustainable policy initiatives and emerging corporate commitments in the palm oil industry

    OpenAIRE

    Padfield, Rory; Drew, Simon; Syayuti, Khadijah; Page, Susan; Evers, Stephanie; Campos-Arceiz, Ahimsa; Kangayatkarasu, Nagulendran; Sayok, Alex; Hansen, Sune; Schouten, Greetje; Maulidia, Martha; Papargyropoulou, Effie; Hou Tham, Mun

    2016-01-01

    markdownabstractThe recent Southeast Asian haze crisis has generated intense public scrutiny over the rate, methods and types of landscape change in the tropics. Debate has centred on the environmental impacts of large-scale agricultural expansion, particularly the associated loss of high carbon stock forest and forests of high conservation value. Focusing on palm oil—a versatile food crop and source of bioenergy—this paper analyses national, international and corporate policy initiatives in ...

  13. Rural emergency care 360°: mobilising healthcare professionals, decision-makers, patients and citizens to improve rural emergency care in the province of Quebec, Canada: a qualitative study protocol.

    Science.gov (United States)

    Fleet, Richard; Dupuis, Gilles; Fortin, Jean-Paul; Gravel, Jocelyn; Ouimet, Mathieu; Poitras, Julien; Légaré, France

    2017-08-17

    Emergency departments (EDs) are an important safety net for rural populations. Results of our earlier studies suggest that rural Canadian hospitals have limited access to advanced imaging services and intensive care units and that patients are transferred over large distances. They also revealed significant geographical variations in rural services. In the absence of national standards, our studies raise questions about inequities in rural access to emergency services and the risks for citizens. Our goal is to build recommendations for improving services by mobilising stakeholders interested in rural emergency care. With help and full engagement of stakeholders, we will (1) identify solutions for improving quality and performance in rural EDs; (2) formulate and prioritise recommendations; (3) transfer knowledge of the recommendations to rural EDs and support operationalisation and (4) assess knowledge transfer and explore further impacts of this participatory action research project. We will use a participatory action research approach. We will plan for a governance structure that includes all stakeholders’ representatives, so throughout this project, stakeholders are fully engaged at every step. Our sample will be 26 EDs in rural Quebec. We will conduct semistructured individual and focus group interviews with relevant and representative participants, including patients and citizens (estimated n=200). Interviews will be thematically analysed to extract potential solutions and other qualitative information.An expert panel (±15) will use an analysis grid to develop consensus recommendations from solutions suggested and will evaluate feasibility, impacts, costs, conditions for implementation and establish monitoring indicators. Recommendations will be transferred to stakeholders using tailored knowledge translation strategies (web platform, meetings and so on). This study will result in a comprehensive consensus list of feasible and high

  14. Recruiting and consenting into a peripartum trial in an emergency setting: a qualitative study of the experiences and views of women and healthcare professionals.

    Science.gov (United States)

    Lawton, Julia; Snowdon, Claire; Morrow, Susan; Norman, Jane E; Denison, Fiona C; Hallowell, Nina

    2016-04-11

    Recruiting and consenting women to peripartum trials can be challenging as the women concerned may be anxious, in pain, and exhausted; there may also be limited time for discussion and decision-making to occur. To address these potential difficulties, we undertook a qualitative evaluation of the internal pilot of a trial (Got-it) involving women who had a retained placenta (RP). We explored the experiences and views of women and staff about the information and consent pathway used within the pilot, in order to provide recommendations for use in future peripartum trials involving recruitment in emergency situations. In-depth interviews were undertaken with staff (n = 27) and participating women (n = 22). Interviews were analysed thematically. The accounts of women and staff were compared to identify differences and similarities in their views about recruitment and consent procedures. Women and staff regarded recruitment as having been straightforward and facilitated by the use of simplified (verbal and written) summaries of trial information. Both parties, however, conveyed discordant views about whether fully informed consent had been obtained. These differences in perspectives appeared to arise from the different factors and considerations impinging on women and staff at the time of recruitment. While staff placed emphasis on promoting understanding in the emergency situation of RP by imparting information in clear and succinct ways, women highlighted the experiential realities of their pre- and post-birthing situations, and how these had led to quick decisions being made without full engagement with the potential risks of trial participation. To facilitate informed consent, women suggested that trial information should be given during the antenatal period, and, in doing so, articulated a rights-based discourse. Staff, however, voiced opposition to this approach by emphasising a duty of care to all pregnant women, and raising concerns about causing undue

  15. Data reliability in home healthcare services

    NARCIS (Netherlands)

    Vavilis, S.; Zannone, N.; Petkovic, M.

    2013-01-01

    Home healthcare services are emerging as a new frontier in healthcare practices. Data reliability, however, is crucial for the acceptance of these new services. This work presents a semi-automated system to evaluate the quality of medical measurements taken by patients. The system relies on data

  16. Healthcare worker influenza immunization vaccinate or mask policy: strategies for cost effective implementation and subsequent reductions in staff absenteeism due to illness.

    Science.gov (United States)

    Van Buynder, P G; Konrad, S; Kersteins, F; Preston, E; Brown, P D; Keen, D; Murray, N J

    2015-03-24

    A new policy requiring staff in clinical areas to vaccinate or wear a mask was implemented in British Columbia (BC) in the 2012/13 winter. This review assessed the impact of the policy on absenteeism in health care workers. A retrospective cohort study of full-time HCW that worked prior to and during the 2012/13 influenza season in a health authority in BC. The rate of absenteeism due to all cause illness was compared between vaccinated and unvaccinated staff controlling for behaviors outside influenza season. Of the 10079 HCW, 77% were vaccinated. By comparison to absenteeism rates in the pre-influenza season, unvaccinated staff in winter had twice the increase in absenteeism due to all-cause illness than vaccinated staff. After controlling for baseline differences between those vaccinated and unvaccinated, influenza vaccination was associated with reduced absenteeism, saving the Health Authority substantial money. Having regular staff in attendance increases the quality of care. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Designing interprofessional modules for undergraduate healthcare learners

    Directory of Open Access Journals (Sweden)

    C Maree

    2017-12-01

    Full Text Available Background. Interprofessional education aims to prepare learners to collaborate across specialties to provide high-quality healthcare. Internationally and nationally, the emerging need for integrated healthcare and education has been emphasised. The current education programme at the School of Health Care Sciences, University of Pretoria, South Africa primarily follows a uniprofessional approach.Objectives. To describe the development of interprofessional modules over 4 years between the departments of Human Nutrition, Nursing Science, Occupational Therapy, Physiotherapy and Radiography.Methods. The Knowledge-to-Action model guided the module development process. The planning phase comprised three steps: (i problem identification (e.g. national and international policy focus on interprofessional education; (ii review of existing knowledge (e.g. common learning outcomes; and (iii adaptation of knowledge to the local context (e.g. syllabi and logistics.Results. The development of interprofessional modules can be guided by the above-mentioned model to meet the needs of the faculty, departments, students and community and to contribute to interprofessional education, while overcoming the associated challenges.Conclusion. Challenges included clashes in timetable schedules, financial constraints, administrative support, logistical issues and resistance to change. The designing and implementing of new modules were intense and time consuming, and required commitment. The development of the modules was an excellent example of interprofessional teamwork that needs to be transferred to the implementation and role modelling of interprofessional education.

  18. Healthcare waste management in Asia

    International Nuclear Information System (INIS)

    Prem Ananth, A.; Prashanthini, V.; Visvanathan, C.

    2010-01-01

    The risks associated with healthcare waste and its management has gained attention across the world in various events, local and international forums and summits. However, the need for proper healthcare waste management has been gaining recognition slowly due to the substantial disease burdens associated with poor practices, including exposure to infectious agents and toxic substances. Despite the magnitude of the problem, practices, capacities and policies in many countries in dealing with healthcare waste disposal, especially developing nations, is inadequate and requires intensification. This paper looks upon aspects to drive improvements to the existing healthcare waste management situation. The paper places recommendation based on a 12 country study reflecting the current status. The paper does not advocate for any complex technology but calls for changes in mindset of all concerned stakeholders and identifies five important aspects for serious consideration. Understanding the role of governments and healthcare facilities, the paper also outlines three key areas for prioritized action for both parties - budget support, developing policies and legislation and technology and knowledge management.

  19. Healthcare waste management in Asia.

    Science.gov (United States)

    Ananth, A Prem; Prashanthini, V; Visvanathan, C

    2010-01-01

    The risks associated with healthcare waste and its management has gained attention across the world in various events, local and international forums and summits. However, the need for proper healthcare waste management has been gaining recognition slowly due to the substantial disease burdens associated with poor practices, including exposure to infectious agents and toxic substances. Despite the magnitude of the problem, practices, capacities and policies in many countries in dealing with healthcare waste disposal, especially developing nations, is inadequate and requires intensification. This paper looks upon aspects to drive improvements to the existing healthcare waste management situation. The paper places recommendation based on a 12 country study reflecting the current status. The paper does not advocate for any complex technology but calls for changes in mindset of all concerned stakeholders and identifies five important aspects for serious consideration. Understanding the role of governments and healthcare facilities, the paper also outlines three key areas for prioritized action for both parties - budget support, developing policies and legislation and technology and knowledge management.

  20. User-centered applications: Use of mobile information technologies to promote sustainable school healthcare services

    Directory of Open Access Journals (Sweden)

    Alida Veldsman

    2015-07-01

    Full Text Available The youth, especially school going children, are the future of any society. It is therefore important that children should receive adequate healthcare support at an early age in order to strive to preserve and ensure better education and welfare of the children and continuity in societal success. Despite the strategic initiatives that aim at improving the general health of school going children, such as South Africa’s Integrated School Health Policy, there still exist challenges in support programmes meant to alleviate the barriers to effective healthcare towards improved education for the school children. Advances in ICT enable a fundamental redesign of healthcare processes based on the use and integration of electronic communication at all levels. New communication technologies can support a transition from institution centric to user-centric applications. This paper defines key principles and challenges for designers, policy makers, and evaluators of user-centred technologies for healthcare in schools. The paper employs the User Experience Management Model (UXM2 to review the current and emerging trends, and highlights challenges related to the design of a typical m-ICT application that supports delivery of healthcare in schools. The paper reaches conclusions for next steps that will advance the domain.

  1. Strategies for navigating the healthcare credit market.

    Science.gov (United States)

    Wareham, T L

    2001-04-01

    Not-for-profit healthcare organizations are experiencing a tightened credit market due to financial stresses on the healthcare industry such as declining payments, effects of the Balanced Budget Act of 1997, and the shift to outpatient care. In the future, healthcare organizations wanting to access the capital market will be expected to preserve cash as an "insurance policy," offer greater security and stricter covenants, and report financial information on a quarterly basis. To meet these requirements and navigate today's tighter credit market, healthcare financial managers will need to focus on the organization's most reliably profitable areas of business, link strategic and financial issues, and carefully monitor the balance sheet.

  2. RTD and D to increase the share of renewables in emerging and developing countries with European technologies. Policy Assessment, Stakeholders opinions, Best-practices and Recommendations

    International Nuclear Information System (INIS)

    Hanekamp, E.

    2008-11-01

    The future energy demand worldwide will increase by 45% in 2030. To be able to meet this demand, respond to the threats of Climate Change and also improve access to energy for the very poor in emerging and developing countries (especially in rural areas) renewable energy technologies play a crucial role. The European Union envisions a thriving and sustainable future economy, with world leadership in a diverse portfolio of clean, efficient and low-carbon energy technologies as a motor for prosperity and a key contributor to growth and jobs. Strengthening of the international dimension in European Technology Platforms and in Joint Technology Initiatives is a priority in the EU. The demographic trends in Europe coupled with an ambitious strategy of growth based on the Lisbon agenda provide a new context for considering international co-operation in Science and Technology. No fortress Europe, but an open Europe - building open 'win-win' S and T relations with EDCs. The RTD4EDC project is focussed on the role of research, technological development and demonstration (RTD and D) in the implementation of renewable energy technologies in Emerging and Developing Countries (EDCs). The project is executed by a consortium of four partners based in Europe (Belgium/The Netherlands), and in Emerging and Developing Countries (Paraguay, South- Africa and India). The project consisted of desk research on relevant policies and developments, interviews with policymakers, representatives from EU RE industries and development cooperation agencies, a survey amongst EU RE industry representatives and analysis of 74 cases of RE implementations in EDCs. In this report the overall results are presented. Other deliverables are three reports with background material (policies, case studies and market potential for EU RE industry) and a website (www.developingrenewables.org) containing all information as reported and with a database containing the 74 cases of RE implementations in EDCs.

  3. Political, policy and social barriers to health system interoperability: emerging opportunities of Web 2.0 and 3.0.

    Science.gov (United States)

    Juzwishin, Donald W M

    2009-01-01

    Achieving effective health informatics interoperability in a fragmented and uncoordinated health system is by definition not possible. Interoperability requires the simultaneous integration of health care processes and information across different types and levels of care (systems thinking). The fundamental argument of this paper is that information system interoperability will remain an unfulfilled hope until health reforms effectively address the governance (accountability), structural and process barriers to interoperability of health care delivery. The ascendency of Web 2.0 and 3.0, although still unproven, signals the opportunity to accelerate patients' access to health information and their health record. Policy suggestions for simultaneously advancing health system delivery and information system interoperability are posited.

  4. The Rise of a European Healthcare Union

    DEFF Research Database (Denmark)

    Vollaard, Hans; Martinsen, Dorte Sindbjerg

    2017-01-01

    Healthcare has only slowly appeared on the European Union’s (EU) policy agenda. EU involvement in policies concerning the organization, financing and the provision of diagnosis, care and cures to ill people developed along three fragmented tracks: (a) EU public health policies concerning the well......-being of all people; (b) the application of the free movement principle to national healthcare systems in particular by the EU’s Court of Justice (CJEU); and (c) the austerity packages and the stricter EU surveillance of national budgets since the debt crises. The key questions of this special issue...... are whether this fragmented EU involvement has now developed into a distinct European healthcare union, and if so what its driving forces have been. Thus, it explores how European integration in healthcare has moved forward despite widespread reluctance. It also examines the underexplored political dynamics...

  5. The internet trade of counterfeit spirits in Russia – an emerging problem undermining alcohol, public health and youth protection policies?

    Science.gov (United States)

    Neufeld, Maria; Lachenmeier, Dirk W.; Walch, Stephan G.; Rehm, Jürgen

    2017-01-01

    Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits) over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia. PMID:28663784

  6. The internet trade of counterfeit spirits in Russia - an emerging problem undermining alcohol, public health and youth protection policies?

    Science.gov (United States)

    Neufeld, Maria; Lachenmeier, Dirk W; Walch, Stephan G; Rehm, Jürgen

    2017-01-01

    Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits) over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia.

  7. Strategy to Support Improvement of Healthcare Quality.

    Directory of Open Access Journals (Sweden)

    Ing. Andrea Zejdlova

    2013-01-01

    Full Text Available One of the latest market-based solutions to the rising costs and quality gaps in health care is pay for performance. Pay for performance is the use of financial incentives to promote the delivery of designated standards of care. It is an emerging movement in health insurance (initially in Britain and United States. Providers under this arrangement are rewarded for meeting pre-established targets for delivery of healthcare services. This is a fundamental change from fee for service payment.Also known as "P4P" or “value-based purchasing,” this payment model rewards physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures for quality and efficiency. Disincentives, such as eliminating payments for negative consequences of care (medical errors or increased costs, have also been proposed. In the developed nations, the rapidly aging population and rising health care costs have recently brought P4P to the forefront of health policy discussions. Pilot studies underway in several large healthcare systems have shown modest improvements in specific outcomes and increased efficiency, but no cost savings due to added administrative requirements. Statements by professional medical societies generally support incentive programs to increase the quality of health care, but express concern with the validity of quality indicators, patient and physician autonomy and privacy, and increased administrative burdens. This article serves as an introduction to pay for performance. We discuss the goals and structure of pay for performance plans and their limitations and potential consequences in the health care area.

  8. Big Data: transforming drug development and health policy decision making.

    Science.gov (United States)

    Alemayehu, Demissie; Berger, Marc L

    The explosion of data sources, accompanied by the evolution of technology and analytical techniques, has created considerable challenges and opportunities for drug development and healthcare resource utilization. We present a systematic overview these phenomena, and suggest measures to be taken for effective integration of the new developments in the traditional medical research paradigm and health policy decision making. Special attention is paid to pertinent issues in emerging areas, including rare disease drug development, personalized medicine, Comparative Effectiveness Research, and privacy and confidentiality concerns.

  9. 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

  10. Legitimising Emerging Power Diplomacy: an Analysis of Government and Media Discourses on Brazilian Foreign Policy under Lula

    Directory of Open Access Journals (Sweden)

    Rafael Mesquita

    2016-06-01

    Full Text Available Abstract This study analyses whether Brazilian foreign policy under Lula successfully legitimised the country's international identity as a rising power in the eyes of the domestic and international media. Based on a constructivist framework, we have applied French Discourse Analysis to a corpus of 36 official addresses by the President of the Republic and the Minister of Foreign Relations and 137 news articles from four news outlets, two Brazilian and two international, concerning two diplomatic episodes deemed representative of Brazil's quest for greater pre-eminence: the leadership of MINUSTAH (2004 and the Nuclear Deal signed with Iran and Turkey (2010. Results show that official discourse characterises Brazil's identity as a rising power chiefly by South-South diplomacy, while media discourse was more heterogeneous, being the discursive formation of each news outlet determinant in explaining their interpretation of Brazil's international identity.

  11. Evaluation of chloroquine as a potent anti-malarial drug: issues of public health policy and healthcare delivery in post-war Liberia.

    Science.gov (United States)

    Massaquoi, Moses B F; Kennedy, Stephen B

    2003-02-01

    Chloroquine-resistant plasmodium falciparum malaria is a serious public health threat that is spreading rapidly across Sub-Saharan Africa. It affects over three quarters (80%) of malarial endemic countries. Of the estimated 300-500 million cases of malaria reported annually, the vast majority of malarial-related morbidities occur among young children in Africa, especially those concentrated in the remote rural areas with inadequate access to appropriate health care services. In Liberia, in vivo studies conducted between 1993 and 2000 observed varying degrees of plasmodium falciparum malaria infections that were resistant to chloroquine, including sulfadiazine-pyrimethamine. As the country emerges from a prolonged civil war, the health care delivery system may not be adequately prepared to implement an effective nation-wide malarial control strategy. As a result, the management of uncomplicated malaria in Liberia poses a significant public health challenge for the government-financed health care delivery system. Therefore, based on extensive literature review, we report the failure of chloroquine as an effective first-line drug for the treatment of uncomplicated plasmodium falciparum malaria in Liberia and recommend that national health efforts be directed at identifying alternative drug(s) to replace it.

  12. A Bayesian Approach for the Analysis of Macroeconomic Dynamic in Case of Emerging Countries-Monetary and Fiscal Policy Model

    Directory of Open Access Journals (Sweden)

    Georgiana-Alina Ionita

    2016-10-01

    Full Text Available The paper proposes the analysis of the main drivers of the economic growth in Central and Eastern Europe, in three emerging countries: Czech Republic, Hungary and Poland, with a development stage similar with that of Romania. Given the vulnerabilities of the Central and Eastern Europe region at the beginning and during the recent global economic and financial crisis, there is an increased interest to identify the models that can describe the principalcharacteristics of the Central and Eastern Europe macroeconomic variables: gross domestic product, investment, wages and salaries, inflation, hours worked, consumption and themonetary variable- interest rate. Moreover, another scope is to analyze the frictions that describe the evolution of the seven data series, as the stochastic dynamic of the macroeconomic model is driven by orthogonal structural shocks.

  13. Perpetual transitions in Romanian healthcare.

    Science.gov (United States)

    Spiru, Luiza; Traşcu, Răzvan Ioan; Turcu, Ileana; Mărzan, Mircea

    2011-12-01

    Although Romania has a long-lasting tradition in organized medical healthcare, in the last two decades the Romanian healthcare system has been undergoing a perpetual transition with negative effects on all parties involved. The lack of long-term strategic vision, the implementation of initiatives without any impact studies, hence the constant short-term approach from the policy makers, combined with the "inherited" low allocation from GDP to the healthcare system have contributed significantly to its current evolution. Currently, most measures taken are of the "fire-fighting" type, rather than looking to the broader, long time perspective. There should be no wonder then, that predictive and preventive services do not get the proper attention and support. Patient and physicians should step in and take action in regulating a system that was originally designed for them. But until this happens, the organizations with leadership skills and vision need to take action-and this has already started.

  14. Romanian healthcare system at a glance

    Directory of Open Access Journals (Sweden)

    Christiana Balan

    2013-04-01

    Full Text Available The Romanian healthcare system is facing constant challenges to produce high quality care with low costs. Objectives The paper aims to analyze the efficiency of the Romanian healthcare system in terms of resources allocation. The evaluation and the dimension of healthcare system efficiency are important for identifying a balance between the resources required and the health outcomes. Prior Work Previous studies describe the Romanian healthcare system as a system in transition. This study focuses on the relationship between the inputs and outputs of the system. Approach In order to assess the efficiency of the Romanian healthcare system we use Data Envelopment Analysis approach. Both input and output healthcare indicators are observed for the period 1999-2010 and the years when healthcare inputs have been used efficiently are identified. Results The results show that human, financial, and technological resources have been used at maximum capacity in 1999, 2003, 2004, 2007 and 2010. Implications Though efficiency is defined differently by diverse stakeholders, healthcare policies should focus on rising the responsibility of communities and individuals for better treatments and services and better access to information on healthcare providers. Value The paper is an empirically based study of the healthcare resources allocation in Romania.

  15. Big Data for Public Health Policy-Making: Policy Empowerment.

    Science.gov (United States)

    Mählmann, Laura; Reumann, Matthias; Evangelatos, Nikolaos; Brand, Angela

    2018-04-04

    Digitization is considered to radically transform healthcare. As such, with seemingly unlimited opportunities to collect data, it will play an important role in the public health policy-making process. In this context, health data cooperatives (HDC) are a key component and core element for public health policy-making and for exploiting the potential of all the existing and rapidly emerging data sources. Being able to leverage all the data requires overcoming the computational, algorithmic, and technological challenges that characterize today's highly heterogeneous data landscape, as well as a host of diverse regulatory, normative, governance, and policy constraints. The full potential of big data can only be realized if data are being made accessible and shared. Treating research data as a public good, creating HDC to empower citizens through citizen-owned health data, and allowing data access for research and the development of new diagnostics, therapies, and public health policies will yield the transformative impact of digital health. The HDC model for data governance is an arrangement, based on moral codes, that encourages citizens to participate in the improvement of their own health. This then enables public health institutions and policymakers to monitor policy changes and evaluate their impact and risk on a population level. © 2018 S. Karger AG, Basel.

  16. Emerging Technologies: Web 2.0.

    Science.gov (United States)

    Holt, Claire

    2011-03-01

    Web 2.0 has brought a change to how we communicate and disseminate information with the use of Twitter, Facebook, YouTube, instant messaging and blogging. This technology is beginning to be used in the health field for public awareness campaigns, emergency health alerts, medical education and remote healthcare services. Australian Health Information Managers will be called upon to reconcile their organisations' policies and procedures regarding the use of Web 2.0 technologies within the existing legal framework of privacy, confidentiality and consent. This article explores various applications of Web 2.0, their benefits and some of their potential legal and ethical implications when implemented in Australia.

  17. Emerging methods and tools for environmental risk assessment, decision-making, and policy for nanomaterials: summary of NATO Advanced Research Workshop

    International Nuclear Information System (INIS)

    Linkov, Igor; Steevens, Jeffery; Adlakha-Hutcheon, Gitanjali; Bennett, Erin; Chappell, Mark; Colvin, Vicki; Davis, J. Michael; Davis, Thomas; Elder, Alison; Foss Hansen, Steffen; Hakkinen, Pertti Bert; Hussain, Saber M.; Karkan, Delara; Korenstein, Rafi; Lynch, Iseult; Metcalfe, Chris

    2009-01-01

    Nanomaterials and their associated technologies hold promising opportunities for the development of new materials and applications in a wide variety of disciplines, including medicine, environmental remediation, waste treatment, and energy conservation. However, current information regarding the environmental effects and health risks associated with nanomaterials is limited and sometimes contradictory. This article summarizes the conclusions of a 2008 NATO workshop designed to evaluate the wide-scale implications (e.g., benefits, risks, and costs) of the use of nanomaterials on human health and the environment. A unique feature of this workshop was its interdisciplinary nature and focus on the practical needs of policy decision makers. Workshop presentations and discussion panels were structured along four main themes: technology and benefits, human health risk, environmental risk, and policy implications. Four corresponding working groups (WGs) were formed to develop detailed summaries of the state-of-the-science in their respective areas and to discuss emerging gaps and research needs. The WGs identified gaps between the rapid advances in the types and applications of nanomaterials and the slower pace of human health and environmental risk science, along with strategies to reduce the uncertainties associated with calculating these risks.

  18. Technology Push / Market Pull Indicators in Healthcare

    Energy Technology Data Exchange (ETDEWEB)

    Nelhans, G.

    2016-07-01

    Healthcare and life sciences are among the most important drivers which form the present-day landscape of science and technology in general. A whole range of emerging areas of research and disruptive technologies are related to healthcare. The applied nature of such areas of research makes it important to specify indicators which describe these areas not only from R&D, but also from user need side. We analyze the content of domain-specific social media and online consulting services in healthcare with the help of semantic technologies in order to extract widespread and emerging user needs. We will map the corresponding topics on the agenda of scientific papers in healthcare. Understanding the intersection of these two agendas and the coverage of user needs by science and technology activities leads us to the development of the “market pull” indicators for emerging areas of research. (Author)

  19. Regional Healthcare Effectiveness

    Directory of Open Access Journals (Sweden)

    Olga Vladimirovna Kudelina

    2016-03-01

    Full Text Available An evaluation of healthcare systems effectiveness of the regions of the Russian Federation (federal districts was conducted using the Minmax method based on the data available at the United Interdepartmental Statistical Information System. Four groups of components (i.e. availability of resources; use of resources; access to resources and medical effectiveness decomposed into 17 items were analyzed. The resource availability was measured by four indicators, including the provision of doctors, nurses, hospital beds; agencies providing health care to the population. Use of resources was measured by seven indicators: the average hospital stay, days; the average bed occupancy, days; the number of operations per 1 physician surgical; the cost per unit volume of medical care: in outpatient clinics, day hospitals, inpatient and emergency care. Access to the resources was measured by three indicators: the satisfaction of the population by medical care; the capacity of outpatient clinics; the average number of visits to health facility. The medical effectiveness was also measured by three indicators: incidence with the "first-ever diagnosis of malignancy"; life expectancy at birth, years; the number of days of temporary disability. The study of the dynamics of the components and indexes for 2008–2012 allows to indicate a multidirectional influence on the regional healthcare system. In some federal districts (e.g. North Caucasian, the effectiveness decreases due to resource availability, in others (South, North Caucasian — due to the use of resources, in others (Far Eastern, Ural — due to access to resources. It is found that the effectiveness of the healthcare systems of the federal districts differs significantly. In addition, the built matrix proves the variability the of effectiveness (comparison of expenditures and results of healthcare systems of the federal districts of the Russian Federation: the high results can be obtained at high costs

  20. Licensed Healthcare Facilities

    Data.gov (United States)

    California Natural Resource Agency — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  1. A Global Perspective of Vaccination of Healthcare Personnel against Measles: Systematic Review

    Science.gov (United States)

    Fiebelkorn, Amy Parker; Seward, Jane F.; Orenstein, Walter

    2015-01-01

    Measles transmission has been well documented in healthcare facilities. Healthcare personnel who are unvaccinated and who lack other evidence of measles immunity put themselves and their patients at risk for measles. We conducted a systematic literature review of measles vaccination policies and their implementation in healthcare personnel, measles seroprevalence among healthcare personnel, measles transmission and disease burden in healthcare settings, and impact/costs incurred by healthcare facilities for healthcare-associated measles transmission. Five database searches yielded 135 relevant articles; 47 additional articles were found through cross-referencing. The risk of acquiring measles is estimated to be 2 to 19 times higher for susceptible healthcare personnel than for the general population. Fifty-three articles published worldwide during 1989–2013 reported measles transmission from patients to healthcare personnel; many of the healthcare personnel were unvaccinated or had unknown vaccination status. Eighteen articles published worldwide during 1982–2013 described examples of transmission from healthcare personnel to patients or to other healthcare personnel. Half of European countries have no measles vaccine policies for healthcare personnel. There is no global policy recommendation for the vaccination of healthcare personnel against measles. Even in countries such as the United States or Finland that have national policies, the recommendations are not uniformly implemented in healthcare facilities. Measles serosusceptibility in healthcare personnel varied widely across studies (median 6.5%, range 0%-46%) but was consistently higher among younger healthcare personnel. Deficiencies in documentation of two doses of measles vaccination or other evidence of immunity among healthcare personnel presents challenges in responding to measles exposures in healthcare settings. Evaluating and containing exposures and outbreaks in healthcare settings can be

  2. Gelişen Piyasa Ekonomilerinde Alternatif Para Politikası Stratejileri, Türkiye Ekonomisi Açısından Bir Değerlendirme(Alternative Monetary Policy Strategies in Emerging Countries, An Assessing For Turkish Economy

    Directory of Open Access Journals (Sweden)

    Şehnaz Bakır YİĞİTBAŞ

    2009-01-01

    Full Text Available This paper assesses the advantages and disadvantages of alternative monetary policy strategies involves for emerging market countries. Then it discusses two emerging market countries which illustrate what it takes to make inflation targeting work well, Chile and Brazil. The next topic that assessing inflation targeting as a monetary policy strategy for Turkey. The conclusion from this analysis is that inflation targeting is more complicated in Turkey. In order to improve inflation targeting’s performance in Turkey, the role of communication and transparency which is crutial for the process of building credibility, should be increased.

  3. Essentials for emergency care: Lessons from an inventory assessment of an emergency centre in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Kofi Marfo Osei

    2014-12-01

    Conclusion: Beyond pointing out specific material resource deficiencies at the Surgical Medical Emergency (SME centre, our inventory assessment indicated a need to develop better implementation strategies for infection control policies, to collaborate with other departments on coordination of patient care, and to set a research agenda to develop emergency and acute care protocols that are both effective and sustainable in our setting. Equipment and supplies are essential elements of emergency preparedness that must be both available and ‘ready-to-hand’. Consequently, key factors in determining readiness to provide quality emergency care include supply-chain, healthcare financing, functionality of systems, and a coordinated institutional vision. Lessons learnt may be useful for others facing similar challenges to emergency medicine development.

  4. Leading healthcare in complexity.

    Science.gov (United States)

    Cohn, Jeffrey

    2014-12-01

    Healthcare institutions and providers are in complexity. Networks of interconnections from relationships and technology create conditions in which interdependencies and non-linear dynamics lead to surprising, unpredictable outcomes. Previous effective approaches to leadership, focusing on top-down bureaucratic methods, are no longer effective. Leading in complexity requires leaders to accept the complexity, create an adaptive space in which innovation and creativity can flourish and then integrate the successful practices that emerge into the formal organizational structure. Several methods for doing adaptive space work will be discussed. Readers will be able to contrast traditional leadership approaches with leading in complexity. They will learn new behaviours that are required of complexity leaders, along with challenges they will face, often from other leaders within the organization.

  5. The Microbiome and Sustainable Healthcare

    Science.gov (United States)

    Dietert, Rodney R.; Dietert, Janice M.

    2015-01-01

    Increasing prevalences, morbidity, premature mortality and medical needs associated with non-communicable diseases and conditions (NCDs) have reached epidemic proportions and placed a major drain on healthcare systems and global economies. Added to this are the challenges presented by overuse of antibiotics and increased antibiotic resistance. Solutions are needed that can address the challenges of NCDs and increasing antibiotic resistance, maximize preventative measures, and balance healthcare needs with available services and economic realities. Microbiome management including microbiota seeding, feeding, and rebiosis appears likely to be a core component of a path toward sustainable healthcare. Recent findings indicate that: (1) humans are mostly microbial (in terms of numbers of cells and genes); (2) immune dysfunction and misregulated inflammation are pivotal in the majority of NCDs; (3) microbiome status affects early immune education and risk of NCDs, and (4) microbiome status affects the risk of certain infections. Management of the microbiome to reduce later-life health risk and/or to treat emerging NCDs, to spare antibiotic use and to reduce the risk of recurrent infections may provide a more effective healthcare strategy across the life course particularly when a personalized medicine approach is considered. This review will examine the potential for microbiome management to contribute to sustainable healthcare. PMID:27417751

  6. Principles for designing and delivering psychosocial and mental healthcare.

    Science.gov (United States)

    Williams, Richard; Kemp, V

    2018-03-08

    The development of the UK's military policy includes the potential for military organisations to deploy in support of humanitarian aid operations. This paper offers an overview of the risks to people's mental health of their exposure to emergencies, major incidents, disasters, terrorism, displacement, postconflict environments in which humanitarian aid is delivered, and deployments to conflict zones. It summarises the psychosocial approach recommended by many contemporary researchers and practitioners. It differentiates the extremely common experience of distress from the mental disorders that people who are affected may develop and introduces the construct of psychosocial resilience. The authors recognise the importance of trajectories of response in separating people who are distressed and require psychosocial care from those who require mental healthcare. Finally, this paper summarises a strategic approach to designing, planning and providing psychosocial and mental healthcare, provides a model of care and outlines the principles for early psychosocial interventions that do not require training in mental healthcare to deliver them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Patient charges for health services: the opinions of healthcare stakeholders in Bulgaria.

    Science.gov (United States)

    Atanasova, Elka; Pavlova, Milena; Moutafovа, Emanuela; Kostadinova, Todorka; Groot, Wim

    2015-01-01

    The reforms of the Bulgarian healthcare sector have been widely discussed, both nationally and internationally. In spite of the reforms, problems with the efficiency, equity and quality in healthcare provision continue to exist in Bulgaria. Among others, the reforms included the implementation of formal patient charges for the use of healthcare services. These were established in the country in 2000. Formal patient charges are applied to all levels of medical services with the exception of emergency care. The aim of this paper is to describe and analyze the attitudes of Bulgarian healthcare stakeholders toward patient charges. The analysis is based on data collected in focus group discussions and in-depth interviews carried out in Bulgaria in May-June 2009. The paper concludes by recommendations for policies related to patient payments. The social sensitivity of these payments requires broad discussion before policy decisions are implemented. There is also a need of a well-thought communication strategy on the issue of patient payments by the Ministry of Health. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Steering healthcare service delivery: a regulatory perspective.

    Science.gov (United States)

    Prakash, Gyan

    2015-01-01

    The purpose of this paper is to explore regulation in India's healthcare sector and makes recommendations needed for enhancing the healthcare service. The literature was reviewed to understand healthcare's regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS). Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges. This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach). Healthcare pitfalls across the world seem to follow similar follies. India's complexity and experience is useful for emerging and developed economies. The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient's perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

  9. EPPS: Efficient and Privacy-Preserving Personal Health Information Sharing in Mobile Healthcare Social Networks

    Directory of Open Access Journals (Sweden)

    Shunrong Jiang

    2015-09-01

    Full Text Available Mobile healthcare social networks (MHSNs have emerged as a promising next-generation healthcare system, which will significantly improve the quality of life. However, there are many security and privacy concerns before personal health information (PHI is shared with other parities. To ensure patients’ full control over their PHI, we propose a fine-grained and scalable data access control scheme based on attribute-based encryption (ABE. Besides, policies themselves for PHI sharing may be sensitive and may reveal information about underlying PHI or about data owners or recipients. In our scheme, we let each attribute contain an attribute name and its value and adopt the Bloom filter to efficiently check attributes before decryption. Thus, the data privacy and policy privacy can be preserved in our proposed scheme. Moreover, considering the fact that the computational cost grows with the complexity of the access policy and the limitation of the resource and energy in a smart phone, we outsource ABE decryption to the cloud while preventing the cloud from learning anything about the content and access policy. The security and performance analysis is carried out to demonstrate that our proposed scheme can achieve fine-grained access policies for PHI sharing in MHSNs.

  10. EPPS: Efficient and Privacy-Preserving Personal Health Information Sharing in Mobile Healthcare Social Networks

    Science.gov (United States)

    Jiang, Shunrong; Zhu, Xiaoyan; Wang, Liangmin

    2015-01-01

    Mobile healthcare social networks (MHSNs) have emerged as a promising next-generation healthcare system, which will significantly improve the quality of life. However, there are many security and privacy concerns before personal health information (PHI) is shared with other parities. To ensure patients’ full control over their PHI, we propose a fine-grained and scalable data access control scheme based on attribute-based encryption (ABE). Besides, policies themselves for PHI sharing may be sensitive and may reveal information about underlying PHI or about data owners or recipients. In our scheme, we let each attribute contain an attribute name and its value and adopt the Bloom filter to efficiently check attributes before decryption. Thus, the data privacy and policy privacy can be preserved in our proposed scheme. Moreover, considering the fact that the computational cost grows with the complexity of the access policy and the limitation of the resource and energy in a smart phone, we outsource ABE decryption to the cloud while preventing the cloud from learning anything about the content and access policy. The security and performance analysis is carried out to demonstrate that our proposed scheme can achieve fine-grained access policies for PHI sharing in MHSNs. PMID:26404300

  11. EPPS: Efficient and Privacy-Preserving Personal Health Information Sharing in Mobile Healthcare Social Networks.

    Science.gov (United States)

    Jiang, Shunrong; Zhu, Xiaoyan; Wang, Liangmin

    2015-09-03

    Mobile healthcare social networks (MHSNs) have emerged as a promising next-generation healthcare system, which will significantly improve the quality of life. However, there are many security and privacy concerns before personal health information (PHI) is shared with other parities. To ensure patients' full control over their PHI, we propose a fine-grained and scalable data access control scheme based on attribute-based encryption (ABE). Besides, policies themselves for PHI sharing may be sensitive and may reveal information about underlying PHI or about data owners or recipients. In our scheme, we let each attribute contain an attribute name and its value and adopt the Bloom filter to efficiently check attributes before decryption. Thus, the data privacy and policy privacy can be preserved in our proposed scheme. Moreover, considering the fact that the computational cost grows with the complexity of the access policy and the limitation of the resource and energy in a smart phone, we outsource ABE decryption to the cloud while preventing the cloud from learning anything about the content and access policy. The security and performance analysis is carried out to demonstrate that our proposed scheme can achieve fine-grained access policies for PHI sharing in MHSNs.

  12. Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals.

    Science.gov (United States)

    Smailhodzic, Edin; Hooijsma, Wyanda; Boonstra, Albert; Langley, David J

    2016-08-26

    Since the emergence of social media in 2004, a growing percentage of patients use this technology for health related reasons. To reflect on the alleged beneficial and potentially harmful effects of social media use by patients, the aim of this paper is to provide an overview of the extant literature on the effects of social media use for health related reasons on patients and their relationship with healthcare professionals. We conducted a systematic literature review on empirical research regarding the effects of social media use by patients for health related reasons. The papers we included met the following selection criteria: (1) published in a peer-reviewed journal, (2) written in English, (3) full text available to the researcher, (4) contain primary empirical data, (5) the users of social media are patients, (6) the effects of patients using social media are clearly stated, (7) satisfy established quality criteria. Initially, a total of 1,743 articles were identified from which 22 were included in the study. From these articles six categories of patients' use of social media were identified, namely: emotional, information, esteem, network support, social comparison and emotional expression. The types of use were found to lead to seven identified types of effects on patients, namely improved self-management and control, enhanced psychological well-being, and enhanced subjective well-being, diminished subjective well-being, addiction to social media, loss of privacy, and being targeted for promotion. Social media use by patients was found to affect the healthcare professional and patient relationship, by leading to more equal communication between the patient and healthcare professional, increased switching of doctors, harmonious relationships, and suboptimal interaction between the patient and healthcare professional. Our review provides insights into the emerging utilization of social media in healthcare. In particular, it identifies types of use by patients

  13. Politicidade do cuidado e avaliação em saúde: instrumentalizando o resgate da autonomia de sujeitos no âmbito de programas e políticas de saúde The political content of evaluation and healthcare: providing the tools to rescue the autonomy of subjects in the scope of programs and healthcare policies

    Directory of Open Access Journals (Sweden)

    Maria Raquel Gomes Maia Pires

    2005-12-01

    political nature of care, centered on subject autonomy. The intention is to indicate the possible application of the concept of the political nature of care in the scope of healthcare policies, programs and services, signaling towards the emancipation potential required to the implementation of the Universal Healthcare System (SUS - Sistema Universal de Saude. That is, assessment needs to become more democratic and viewed as a tool of citizenship change and empowerment.

  14. Involving traditional birth attendants in emergency obstetric care in Tanzania: policy implications of a study of their knowledge and practices in Kigoma Rural District.

    Science.gov (United States)

    Vyagusa, Dismas B; Mubyazi, Godfrey M; Masatu, Melchiory

    2013-10-14

    Access to quality maternal health services mainly depends on existing policies, regulations, skills, knowledge, perceptions, and economic power and motivation of service givers and target users. Critics question policy recommending involvement of traditional birth attendants (TBAs) in emergency obstetric care (EmoC) services in developing countries. This paper reports about knowledge and practices of TBAs on EmoC in Kigoma Rural District, Tanzania and discusses policy implications on involving TBAs in maternal health services. 157 TBAs were identified from several villages in 2005, interviewed and observed on their knowledge and practice in relation to EmoC. Quantitative and qualitative techniques were used for data collection and analysis depending on the nature of the information required. Among all 157 TBAs approached, 57.3% were aged 50+ years while 50% had no formal education. Assisting mothers to deliver without taking their full pregnancy history was confessed by 11% of all respondents. Having been attending pregnant women with complications was experienced by 71.2% of all respondents. Only 58% expressed adequate knowledge on symptoms and signs of pregnancy complications. Lack of knowledge on possible risk of HIV infections while assisting childbirth without taking protective gears was claimed by 5.7% of the respondents. Sharing the same pair of gloves between successful deliveries was reported to be a common practice by 21.1% of the respondents. Use of unsafe delivery materials including local herbs and pieces of cloth for protecting themselves against HIV infections was reported as being commonly practiced among 27.6% of the respondents. Vaginal examination before and during delivery was done by only a few respondents. TBAs in Tanzania are still consulted by people living in underserved areas. Unfortunately, TBAs' inadequate knowledge on EmOC issues seems to have contributed to the rising concerns about their competence to deliver the recommended maternal

  15. [The Marketing of Healthcare Services in ENT-Clinics].

    Science.gov (United States)

    Teschner, M; Lenarz, T

    2016-07-01

    The provision of healthcare services in Germany is based on fundamental principles of solidarity and is highly regulated. The question arises which conditions exist for marketing for healthcare services in ENT-clinics in Germany. The marketing options will be elicited using environmentally analytical considerations. The objectives can be achieved using measures derived from external instruments (service policy, pricing policy, distribution policy or communications policy) or from an internal instrument (human resources policy). The policy environment is particularly influenced by the regulatory framework, which particularly restricts the scope for both the pricing and communications policies. All measures must, however, reflect ethical frameworks, which are regarded as the fundamental premise underlying healthcare services and may be at odds with economic factors. Scope for flexibility in pricing exists only within the secondary healthcare market, and even there only to a limited extent. The significance of price in the marketing of healthcare services is thus very low. If marketing activities are to succeed, a market analysis must be carried out exploring the relevant factors for each individual provider. However, the essential precondition for the marketing of healthcare services is trust. The marketing of healthcare services differs from that of business management-oriented enterprises in other branches of economy. In the future the importance of marketing activities will increase. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Examining Perceptions about Mandatory Influenza Vaccination of Healthcare Workers through Online Comments on News Stories.

    Directory of Open Access Journals (Sweden)

    Yang Lei

    Full Text Available The aim of this study was to understand online public perceptions of the debate surrounding the choice of annual influenza vaccinations or wearing masks as a condition of employment for healthcare workers, such as the one enacted in British Columbia in August 2012.Four national and 82 local (British Columbia Canadian online news sites were searched for articles posted between August 2012 and May 2013 containing the words "healthcare workers" and "mandatory influenza vaccinations/immunizations" or "mandatory flu shots and healthcare workers." We included articles from sources that predominantly concerned our topic of interest and that generated reader comments. Two researchers coded the unedited comments using thematic analysis, categorizing codes to allow themes to emerge. In addition to themes, the comments were categorized by: 1 sentiment towards influenza vaccines; 2 support for mandatory vaccination policies; 3 citing of reference materials or statistics; 4 self-identified health-care worker status; and 5 sharing of a personal story.1163 comments made by 648 commenters responding to 36 articles were analyzed. Popular themes included concerns about freedom of choice, vaccine effectiveness, patient safety, and distrust in government, public health, and the pharmaceutical industry. Almost half (48% of commenters expressed a negative sentiment toward the influenza vaccine, 28% were positive, 20% were neutral, and 4% expressed mixed sentiment. Of those who commented on the policy, 75% did not support the condition to work policy, while 25% were in favour. Of the commenters, 11% self-identified as healthcare workers, 13% shared personal stories, and 18% cited a reference or statistic.The perception of the influenza vaccine in the comment sections of online news sites is fairly poor. Public health agencies should consider including online forums, comment sections, and social media sites as part of their communication channels to correct

  17. Role of Australian primary healthcare organisations (PHCOs) in primary healthcare (PHC) workforce planning: lessons from abroad.

    Science.gov (United States)

    Naccarella, Lucio; Buchan, James; Newton, Bill; Brooks, Peter

    2011-08-01

    To review international experience in order to inform Australian PHC workforce policy on the role of primary healthcare organisations (PHCOs/Medicare Locals) in PHC workforce planning. A NZ and UK study tour was conducted by the lead author, involving 29 key informant interviews with regard to PHCOs roles and the effect on PHC workforce planning. Interviews were audio-taped with consent, transcribed and analysed thematically. Emerging themes included: workforce planning is a complex, dynamic, iterative process and key criteria exist for doing workforce planning well; PHCOs lacked a PHC workforce policy framework to do workforce planning; PHCOs lacked authority, power and appropriate funding to do workforce planning; there is a need to align workforce planning with service planning; and a PHC Workforce Planning and Development Benchmarking Database is essential for local planning and evaluating workforce reforms. With the Australian government promoting the role of PHCOs in health system reform, reflections from abroad highlight the key action within PHC and PHCOs required to optimise PHC workforce planning.

  18. From healthcare assistant to student nurse

    OpenAIRE

    Adair, Fiona

    2017-01-01

    This article discusses research undertaken to investigate the journey that student nurses make who have previously worked as healthcare assistants (HCAs). It briefly identifies the research process, followed by in-depth discussion of one of the themes that emerged from the study: the difference between a student nurse and a healthcare assistant.\\ud \\ud The author chose to explore this theme in depth because more and more HCAs are undertaking the undergraduate degree programme to become a regi...

  19. Free versus subsidised healthcare: options for fee exemptions, access to care for vulnerable groups and effects on the health system in Burkina Faso.

    Science.gov (United States)

    Yaogo, Maurice

    2017-07-12

    The many forms of healthcare fee exemptions implemented in Burkina Faso since the 2000s have varied between total exemption (free) and cost subsidisation. This article examines both options, their contextual variations and the ways in which they affect access to healthcare for vulnerable people as well as the operation of the health system. This research is part of an interdisciplinary regional program on the elimination of user fees for health services in West Africa (Burkina Faso, Mali and Niger). A conceptual framework and a chronological review of policy interventions are used as references to summarise the results of the three qualitative studies presented. Historical reference points are used to describe the emergence of healthcare fee exemption policies in Burkina Faso and the events that influenced their adoption. The joint analysis of opinions on options for fee exemption focuses on the different types of repercussions on access to healthcare and the operation of the health system. In conjunction with the twists and turns of the gradual development of a national health policy and in response to international recommendations, healthcare fee exemptions have evolved since colonisation. The limitations of the changes introduced with cost recovery and the barriers to healthcare access for the poorest people led to the adoption of the current sectorial fee exemptions. The results provide information on the reasons for the changes that have occurred over time. The nuanced perspectives of different categories of people surveyed about fee exemption options show that, beyond the perceived effects on healthcare access and the health system, the issue is one of more equitable governance. In principle, the fee exemption measures are intended to provide improved healthcare access for vulnerable groups. In practice, the negative effects on the operation of the health system advocate for reforms to harmonise the changes to multifaceted fee exemptions and the actual needs

  20. Health equity monitoring for healthcare quality assurance.

    Science.gov (United States)

    Cookson, R; Asaria, M; Ali, S; Shaw, R; Doran, T; Goldblatt, P

    2018-02-01

    Population-wide health equity monitoring remains isolated from mainstream healthcare quality assurance. As a result, healthcare organizations remain ill-informed about the health equity impacts of their decisions - despite becoming increasingly well-informed about quality of care for the average patient. We present a new and improved analytical approach to integrating health equity into mainstream healthcare quality assurance, illustrate how this approach has been applied in the English National Health Service, and discuss how it could be applied in other countries. We illustrate the approach using a key quality indicator that is widely used to assess how well healthcare is co-ordinated between primary, community and acute settings: emergency inpatient hospital admissions for ambulatory care sensitive chronic conditions ("potentially avoidable emergency admissions", for short). Whole-population data for 2015 on potentially avoidable emergency admissions in England were linked with neighborhood deprivation indices. Inequality within the populations served by 209 clinical commissioning groups (CCGs: care purchasing organizations with mean population 272,000) was compared against two benchmarks - national inequality and inequality within ten similar populations - using neighborhood-level models to simulate the gap in indirectly standardized admissions between most and least deprived neighborhoods. The modelled inequality gap for England was 927 potentially avoidable emergency admissions per 100,000 people, implying 263,894 excess hospitalizations associated with inequality. Against this national benchmark, 17% of CCGs had significantly worse-than-benchmark equity, and 23% significantly better. The corresponding figures were 11% and 12% respectively against the similar populations benchmark. Deprivation-related inequality in potentially avoidable emergency admissions varies substantially between English CCGs serving similar populations, beyond expected statistical

  1. Healthcare providers' experiences screening for intimate partner violence among migrant and seasonal farmworking women: A phenomenological study.

    Science.gov (United States)

    Wilson, Jonathan B; Rappleyea, Damon L; Hodgson, Jennifer L; Brimhall, Andrew S; Hall, Tana L; Thompson, Alyssa P

    2016-12-01

    Migrant and seasonal farmworking (MSFW) women patients experience substantially more intimate partner violence (IPV) than the general population, but few health-care providers screen patients for IPV. While researchers have examined screening practices in health-care settings, none have exclusively focused on MSFW women. The aim of this phenomenological study was to explore the experiences of health-care providers who have screened for and/or addressed IPV with MSFW women patients. Researchers utilized descriptive phenomenology to capture the lived experiences of these health-care providers. Data were analysed using Colaizzi's seven-stage framework. Interviews were conducted with nine female participants - all of whom: (i) were clinically active health-care providers within the MSFW community, (ii) were bilingual in English and Spanish or had access to a translator, (iii) had treated MSFW patients who had experienced IPV and (iv) were at least 18 years of age. Participants' experiences were reflected in four emergent themes: (i) provider-centered factors, (ii) patient-centered factors, (iii) clinic-centered factors and (iv) community-centered factors. Participants described barriers to establish routine IPV assessment, decrease patient ambivalence and increase on-site support and community resources. This study aimed to generate a greater understanding of the experiences of health-care providers with screening for and addressing IPV with MSFW patients. Implications and recommendations for research, clinical practice and policy are provided. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  2. Emerging Politics of Educational Policy.

    Science.gov (United States)

    Guthrie, James W.

    1981-01-01

    Demography, economics, concentrated decision making, and politicization, will constitute the future policymaking environment for education. In addition, these conditions are likely to have a direct effect upon educators themselves; they will provoke higher levels of conflict within and among education organizations. (Author/BW)

  3. Competition Policies in Emerging Economies

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

    But important anti-competitive practices persist in this sector, and the ...... Each of these measures helped to establish the principles under which agents could ...... would be carried out by the Tax Administration System, which would be likely to ...... Malaysia. 166.07. 11. 0. 46. 18. 26. 41.26. 38. 2.2. 20. Mauritius. 96.15. 28. 0.

  4. Atomic energy in healthcare

    International Nuclear Information System (INIS)

    Gupta, Sudeep; Rangarajan, Venkatesh; Thakur, Meenakshi; Parmar, Vani; Jalali, Rakesh; Ashgar, Ali; Pramesh, C.S.; Shrivastava, Shyam; Badwe, Rajendra

    2013-01-01

    One of the socially important non-power programmes of the DAE is in the beneficial use of radiation and related techniques for healthcare. The diagnosis and therapy aspects of radiation based healthcare are discussed in this article. (author)

  5. Communicating with Healthcare Professionals

    Science.gov (United States)

    ... at follow-up appointments by talking with your healthcare team about your concerns, asking questions and getting ... from the time you spend with all your healthcare providers, not just your doctor. Use the skills ...

  6. Targeted Learning in Healthcare Research.

    Science.gov (United States)

    Gruber, Susan

    2015-12-01

    The increasing availability of Big Data in healthcare encourages investigators to seek answers to big questions. However, nonparametric approaches to analyzing these data can suffer from the curse of dimensionality, and traditional parametric modeling does not necessarily scale. Targeted learning (TL) combines semiparametric methodology with advanced machine learning techniques to provide a sound foundation for extracting information from data. Predictive models, variable importance measures, and treatment benefits and risks can all be addressed within this framework. TL has been applied in a broad range of healthcare settings, including genomics, precision medicine, health policy, and drug safety. This article provides an introduction to the two main components of TL, targeted minimum loss-based estimation and super learning, and gives examples of applications in predictive modeling, variable importance ranking, and comparative effectiveness research.

  7. Models of emergency departments for reducing patient waiting times.

    Directory of Open Access Journals (Sweden)

    Marek Laskowski

    Full Text Available In this paper, we apply both agent-based models and queuing models to investigate patient access and patient flow through emergency departments. The objective of this work is to gain insights into the comparative contributions and limitations of these complementary techniques, in their ability to contribute empirical input into healthcare policy and practice guidelines. The models were developed independently, with a view to compare their suitability to emergency department simulation. The current models implement relatively simple general scenarios, and rely on a combination of simulated and real data to simulate patient flow in a single emergency department or in multiple interacting emergency departments. In addition, several concepts from telecommunications engineering are translated into this modeling context. The framework of multiple-priority queue systems and the genetic programming paradigm of evolutionary machine learning are applied as a means of forecasting patient wait times and as a means of evolving healthcare policy, respectively. The models' utility lies in their ability to provide qualitative insights into the relative sensitivities and impacts of model input parameters, to illuminate scenarios worthy of more complex investigation, and to iteratively validate the models as they continue to be refined and extended. The paper discusses future efforts to refine, extend, and validate the models with more data and real data relative to physical (spatial-topographical and social inputs (staffing, patient care models, etc.. Real data obtained through proximity location and tracking system technologies is one example discussed.

  8. Traditional vs. Contemporary Management Control Practices for Developing Public Health Policies.

    Science.gov (United States)

    Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura

    2016-07-14

    Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way.

  9. Políticas de saúde mental e mudanças na demanda de serviços de emergência Mental health policies and changes in the emergency services profile

    Directory of Open Access Journals (Sweden)

    Cristina M Del-Ben

    1999-10-01

    Full Text Available OBJETIVO: Verificar as mudanças ocorridas em um serviço de emergências psiquiátricas de um hospital universitário de Ribeirão Preto-SP (EP-RP, em função de mudanças nas políticas de saúde mental da região. MÉTODOS: Os dados sobre os atendimentos foram colhidos em arquivos do EP-RP, período de 1988 a 1997. Foram estudadas as variáveis sexo, faixa etária, procedência e diagnóstico principal. Os dados sobre as mudanças nas políticas de saúde mental, na região, foram obtidos de documentos das secretarias de saúde do estado e do município. RESULTADOS: O aumento a cada ano do número de atendimentos realizados acompanhou o progressivo envolvimento do EP-RP na rede de serviços de saúde mental. Em 1995 a procura pelo serviço foi 2,3 vezes maior do que em 1988. Nesse período o atendimento no EP-RP deu apoio às mudanças nas políticas de saúde mental na região, que resultaram na redução de 654 leitos psiquiátricos. Em 1996 e 1997 houve uma diminuição do total de atendimentos em cerca de 20% com relação a 1995, acompanhando o aumento do número e da capacidade de atendimento dos serviços extra-hospitalares. A partir de 1990 o serviço passou a atender uma maior proporção de pacientes mais velhos, do sexo masculino, com diagnóstico de dependência de substâncias e transtornos psicóticos e uma proporção menor de quadros não psicóticos. CONCLUSÕES: As mudanças observadas no EP-RP correlacionam-se com as das políticas de saúde mental na região de Ribeirão Preto, como a instalação da Central de Vagas Psiquiátricas, em 1990, a redução de leitos psiquiátricos a partir de 1993 e a criação e/ou ampliação de serviços extra-hospitalares a partir de 1995.OBJECTIVE: To verify the modifications observed in a school hospital psychiatric emergency unit in Ribeirão Preto - SP, Brazil (EP-RP, due to alterations in the mental health policies implemented in this region. METHODS: Data about attendances was

  10. Medical doctors in healthcare leadership: theoretical and practical challenges.

    Science.gov (United States)

    Denis, Jean-Louis; van Gestel, Nicolette

    2016-05-24

    While healthcare systems vary in their structure and available resources, it is widely recognized that medical doctors play a key role in their adaptation and performance. In this article, we examine recent government and organizational policies in two different health systems that aim to develop clinical leadership among the medical profession. Clinical leadership refers to the engagement and guiding role of physicians in health system improvement. Three dimensions are defined to conduct our analysis of engaging medical doctors in healthcare leadership: the position and status of medical doctors within the system; the broader institutional context of governmental and organizational policies to engage medical doctors in clinical leadership roles; and the main factors that may facilitate or limit achievements. Our aim in this study is exploratory. We selected two contrasting cases according to their level of institutional pluralism: one national health insurance system, Canada, and one etatist social insurance system, the Netherlands. We documented the institutional dynamics of medical doctors' engagement and leadership through secondary sources, such as government websites, key policy reports, and scholarly literature on health policies in both countries. Initiatives across Canadian provinces signal that the medical profession and governments search for alternatives to involve doctors in health system improvement beyond the limitations imposed by their fundamental social contract and formal labour relations. These initiatives suggest an emerging trend toward more joint collaboration between governments and medical associations. In the Dutch system, organizational and legal attempts for integration over the past decades do not yet fit well with the ideas and interests of medical doctors. The engagement of medical doctors requires additional initiatives that are closer to their professional values and interests and that depart from an overly focus on top down

  11. Healthcare. Executive Summary

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This executive summary highlights several findings about healthcare. These are: (1) Healthcare is 18 percent of the U.S. economy, twice as high as in other countries; (2) There are two labor markets in healthcare: high-skill, high-wage professional and technical jobs and low-skill, low-wage support jobs; (3) Demand for postsecondary education in…

  12. 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.

  13. Google DeepMind and healthcare in an age of algorithms.

    Science.gov (United States)

    Powles, Julia; Hodson, Hal

    2017-01-01

    Data-driven tools and techniques, particularly machine learning methods that underpin artificial intelligence, offer promise in improving healthcare systems and services. One of the companies aspiring to pioneer these advances is DeepMind Technologies Limited, a wholly-owned subsidiary of the Google conglomerate, Alphabet Inc. In 2016, DeepMind announced its first major health project: a collaboration with the Royal Free London NHS Foundation Trust, to assist in the management of acute kidney injury. Initially received with great enthusiasm, the collaboration has suffered from a lack of clarity and openness, with issues of privacy and power emerging as potent challenges as the project has unfolded. Taking the DeepMind-Royal Free case study as its pivot, this article draws a number of lessons on the transfer of population-derived datasets to large private prospectors, identifying critical questions for policy-makers, industry and individuals as healthcare moves into an algorithmic age.

  14. [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.

  15. Fake news in healthcare

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2017-10-01

    Full Text Available No abstract available. Article truncated at 150 words. An article in the National Review by Pascal-Emmanuel Gobry points out that there is considerable waste in healthcare spending (1. He blames much of this on two entitlements-Medicare and employer-sponsored health insurance. He also lays much of the blame on doctors. “Doctors are the biggest villains in American health care. ... As with public-school teachers, we should be able to recognize that a profession as a whole can be pathological even as many individual members are perfectly good actors, and even if many of them are heroes. And just like public-school teachers, the medical profession as a whole puts its own interests ahead of those of the citizens it claims to be dedicated to serve.” Who is Pascal-Emmanuel Gobry and how could he say something so nasty about teachers and my profession? A quick internet search revealed that Mr. Gobry is a fellow at the Ethics & Public Policy Center …

  16. Situation Analysis of Healthcare Service Delivery using ...

    African Journals Online (AJOL)

    ISML5

    Geography plays an important role in planning and allocation of healthcare resources for an effective and efficient ... utilization and gaps in resource allocation, and to develop propositions to support the health policy. Facility survey and .... Figure 2. Location of health centres against population density in Sironko district ...

  17. Situation Analysis of Healthcare Service Delivery using ...

    African Journals Online (AJOL)

    ISML5

    7. No. 1, AARSE 2017 Special Edition, January 2017. 75. Situation Analysis of ... then becomes a major bottleneck to proper planning and policy formulation in healthcare delivery. ... Uganda Annual Health Sector Performance Report for Financial Year 2014/15 ... government's strategy of taking services closer to the people.

  18. Mutuality in the provision of Scottish healthcare.

    Science.gov (United States)

    Howieson, Brian

    2015-11-01

    The backdrop to this article is provided by the Better Health, Better Care Action Plan (Scottish Government, 2007), Section 1 of which is entitled 'Towards a Mutual NHS'. According to Better Health, Better Care (Scottish Government, 2007: 5): 'Mutual organisations are designed to serve their members. They are designed to gather people around a common sense of purpose. They are designed to bring the organisation together in what people often call "co-production."' The aim of this article is to précis the current knowledge of mutuality in the provision of Scottish healthcare. In detail, it will: introduce the 'mutual' organisation; offer a historical perspective of mutuality; suggest why healthcare mutuality is important; and briefly, detail the differences in mutual health-care policy in England and Scotland. It is hoped that this analysis will help researchers and practitioners alike appreciate further the philosophy of mutuality in the provision of Scottish healthcare. © The Author(s) 2015.

  19. Social Responsibility and Healthcare in Finland.

    Science.gov (United States)

    Ahola-Launonen, Johanna

    2016-07-01

    This article examines current trends and prospects in Finnish healthcare literature and discussion. The Finnish healthcare system was long considered to manifest an equal, universal, and solidaristic welfare scheme. However, recent data reveals structural inequalities in access to healthcare that result in health differences among socioeconomic groups. The political will aims at tackling these inequalities, but the ideological trend toward responsibilization of the individual taking place across political spheres elsewhere in Europe creates potential challenges to this goal. The applications of this trend have a theoretical background in the responsibility-sensitive egalitarian-or luck egalitarian-tradition. The theory, which is unfit for real-life policy applications, has explicit appeal in considerations aiming at the responsibilization of the individual within the healthcare sector. It remains to be seen in which direction the Finnish welfare schemes will continue to develop.

  20. Private healthcare quality: applying a SERVQUAL model.

    Science.gov (United States)

    Butt, Mohsin Muhammad; de Run, Ernest Cyril

    2010-01-01

    This paper seeks to develop and test the SERVQUAL model scale for measuring Malaysian private health service quality. The study consists of 340 randomly selected participants visiting a private healthcare facility during a three-month data collection period. Data were analyzed using means, correlations, principal component and confirmatory factor analysis to establish the modified SERVQUAL scale's reliability, underlying dimensionality and convergent, discriminant validity. Results indicate a moderate negative quality gap for overall Malaysian private healthcare service quality. Results also indicate a moderate negative quality gap on each service quality scale dimension. However, scale development analysis yielded excellent results, which can be used in wider healthcare policy and practice. Respondents were skewed towards a younger population, causing concern that the results might not represent all Malaysian age groups. The study's major contribution is that it offers a way to assess private healthcare service quality. Second, it successfully develops a scale that can be used to measure health service quality in Malaysian contexts.