WorldWideScience

Sample records for health empirical evidence

  1. Early Child Disaster Mental Health Interventions: A Review of the Empirical Evidence

    Science.gov (United States)

    Pfefferbaum, Betty; Nitiéma, Pascal; Tucker, Phebe; Newman, Elana

    2017-01-01

    Background: The need to establish an evidence base for early child disaster interventions has been long recognized. Objective: This paper presents a descriptive analysis of the empirical research on early disaster mental health interventions delivered to children within the first 3 months post event. Methods: Characteristics and findings of the…

  2. How can the regulator show evidence of (no) risk selection in health insurance markets? Conceptual framework and empirical evidence.

    Science.gov (United States)

    van de Ven, Wynand P M M; van Vliet, René C J A; van Kleef, Richard C

    2017-03-01

    If consumers have a choice of health plan, risk selection is often a serious problem (e.g., as in Germany, Israel, the Netherlands, the United States of America, and Switzerland). Risk selection may threaten the quality of care for chronically ill people, and may reduce the affordability and efficiency of healthcare. Therefore, an important question is: how can the regulator show evidence of (no) risk selection? Although this seems easy, showing such evidence is not straightforward. The novelty of this paper is two-fold. First, we provide a conceptual framework for showing evidence of risk selection in competitive health insurance markets. It is not easy to disentangle risk selection and the insurers' efficiency. We suggest two methods to measure risk selection that are not biased by the insurers' efficiency. Because these measures underestimate the true risk selection, we also provide a list of signals of selection that can be measured and that, in particular in combination, can show evidence of risk selection. It is impossible to show the absence of risk selection. Second, we empirically measure risk selection among the switchers, taking into account the insurers' efficiency. Based on 2-year administrative data on healthcare expenses and risk characteristics of nearly all individuals with basic health insurance in the Netherlands (N > 16 million) we find significant risk selection for most health insurers. This is the first publication of hard empirical evidence of risk selection in the Dutch health insurance market.

  3. Endogenous Women's Autonomy and the Use of Reproductive Health Services: Empirical Evidence from Tajikistan

    OpenAIRE

    Yusuke Kamiya

    2010-01-01

    Though gender equity is widely considered to be a key to improving maternal health in developing countries, little empirical evidence has been presented to support this claim. This paper investigates whether or not and how female autonomy within the household affects women's use of reproductive health care in Tajikistan, where the situation of maternal health and gender equity is worse compared with neighbouring countries. Estimation is performed using bivariate probit models in which woman's...

  4. Women's autonomy and reproductive health care utilisation: empirical evidence from Tajikistan.

    Science.gov (United States)

    Kamiya, Yusuke

    2011-10-01

    Women's autonomy is widely considered to be a key to improving maternal health in developing countries, whereas there is no consistent empirical evidence to support this claim. This paper examines whether or not and how women's autonomy within the household affects the use of reproductive health care, using a household survey data from Tajikistan. Estimation is performed by the bivariate probit model whereby woman's use of health services and the level of women's autonomy are recursively and simultaneously determined. The data is from a sample of women aged 15-49 from the Tajikistan Living Standard Measurement Survey 2007. Women's autonomy as measured by women's decision-making on household financial matters increase the likelihood that a woman receives antenatal and delivery care, whilst it has a negative effect on the probability of attending to four or more antenatal consultations. The hypothesis that women's autonomy and reproductive health care utilisation are independently determined is rejected for most of the estimation specifications, indicating the importance of taking into account the endogenous nature of women's autonomy when assessing its effect on health care use. The empirical results reconfirm the assertion that women's status within the household is closely linked to reproductive health care utilisation in developing countries. Policymakers therefore need not only to implement not only direct health interventions but also to focus on broader social policies which address women's empowerment. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. The effect of economic development on population health: a review of the empirical evidence.

    Science.gov (United States)

    Lange, Simon; Vollmer, Sebastian

    2017-01-01

    Economic growth is considered an important determinant of population health. Relevant studies investigating the effect of economic growth on health outcomes were identified from Google Scholar and PubMed searches in economics and medical journals. Additional resources generated through economic growth are potentially useful for improving population health. The empirical evidence on the aggregate effect of economic growth on population health is rather mixed and inconclusive. The causal pathways from economic growth to population health are crucial and failure or success in completing the pathways explains differences in empirical findings. Future research should investigate how additional resources can more effectively reach those in need and how additional resources can be used more efficiently. It is particularly relevant to understand why preventive health care in developing countries is very price elastic whereas curative health care is very health inelastic and how this understanding can inform public health policy. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  6. How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011.

    Science.gov (United States)

    Kiil, Astrid; Houlberg, Kurt

    2014-11-01

    This article reviews the quantitative evidence on the behavioural effects of copayment within the health area across a wide range of countries. The review distinguishes itself from previous similar reviews by having a high degree of transparency for the search strategy used to identify the studies included in the review as well as the criteria for inclusion and by including the most recent literature. Empirical studies were identified by performing searches in EconLit. The literature search identified a total of 47 studies of the behavioural effects of copayment. Considering the demand effects, the majority of the reviewed studies found that copayment reduces the use of prescription medicine, consultations with general practitioners and specialists, and ambulatory care, respectively. The literature found no significant effects of copayment on the prevalence of hospitalisations. The empirical evidence on whether copayment for some services, but not for others, causes substitution from the services that are subject to copayment to the 'free' services rather than lower total use is sparse and mixed. Likewise, the health effects of copayment have only been analysed empirically in a limited number of studies, of which half did not find any significant effects in the short term. Finally, the empirical evidence on the distributional consequences of copayment indicates that individuals with low income and in particular need of care generally reduce their use relatively more than the remaining population in consequence of copayment. Hence, it is clear that copayment involves some important economic and political trade-offs.

  7. More Health Expenditure, Better Economic Performance? Empirical Evidence From OECD Countries

    Directory of Open Access Journals (Sweden)

    Fuhmei Wang PhD

    2015-08-01

    Full Text Available Recent economic downturns have led many countries to reduce health spending dramatically, with the World Health Organization raising concerns over the effects of this, in particular among the poor and vulnerable. With the provision of appropriate health care, the population of a country could have better health, thus strengthening the nation’s human capital, which could contribute to economic growth through improved productivity. How much should countries spend on health care? This study aims to estimate the optimal health care expenditure in a growing economy. Applying the experiences of countries from the Organization for Economic Co-Operation and Development (OECD over the period 1990 to 2009, this research introduces the method of system generalized method of moments (GMM to derive the design of the estimators of the focal variables. Empirical evidence indicates that when the ratio of health spending to gross domestic product (GDP is less than the optimal level of 7.55%, increases in health spending effectively lead to better economic performance. Above this, more spending does not equate to better care. The real level of health spending in OECD countries is 5.48% of GDP, with a 1.87% economic growth rate. The question which is posed by this study is a pertinent one, especially in the current context of financially constrained health systems around the world. The analytical results of this work will allow policymakers to better allocate scarce resources to achieve their macroeconomic goals.

  8. More Health Expenditure, Better Economic Performance? Empirical Evidence From OECD Countries

    Science.gov (United States)

    Wang, Fuhmei

    2015-01-01

    Recent economic downturns have led many countries to reduce health spending dramatically, with the World Health Organization raising concerns over the effects of this, in particular among the poor and vulnerable. With the provision of appropriate health care, the population of a country could have better health, thus strengthening the nation’s human capital, which could contribute to economic growth through improved productivity. How much should countries spend on health care? This study aims to estimate the optimal health care expenditure in a growing economy. Applying the experiences of countries from the Organization for Economic Co-Operation and Development (OECD) over the period 1990 to 2009, this research introduces the method of system generalized method of moments (GMM) to derive the design of the estimators of the focal variables. Empirical evidence indicates that when the ratio of health spending to gross domestic product (GDP) is less than the optimal level of 7.55%, increases in health spending effectively lead to better economic performance. Above this, more spending does not equate to better care. The real level of health spending in OECD countries is 5.48% of GDP, with a 1.87% economic growth rate. The question which is posed by this study is a pertinent one, especially in the current context of financially constrained health systems around the world. The analytical results of this work will allow policymakers to better allocate scarce resources to achieve their macroeconomic goals. PMID:26310501

  9. Health status of and health-care provision to asylum seekers in Germany: protocol for a systematic review and evidence mapping of empirical studies.

    Science.gov (United States)

    Schneider, Christine; Mohsenpour, Amir; Joos, Stefanie; Bozorgmehr, Kayvan

    2014-11-29

    There are more than 100,000 asylum seekers registered in Germany, who are granted limited access to health services. This study aims to provide a systematic overview of the empirical literature on the health status of and health-care provision to asylum seekers in Germany in order to consolidate knowledge, avoid scientific redundance, and identify research gaps. A systematic review and evidence mapping of empirical literature on the health status of and health-care provision to asylum seekers in Germany will be performed. We will apply a three-tiered search strategy: 1. search in databases (PubMed/MEDLINE, Web of Science, IBSS, Sociological Abstracts, Worldwide Political Science Abstracts, CINAHL, Sowiport, Social Sciences Citation Index, ASSIA, MedPilot, DNB), dissertation and theses databases, and the internet (Google); 2. screening references of included studies; 3. contacting authors and civil society organizations for grey literature. Included will be studies which report quantitative and/or qualitative data or review articles on asylum seekers in Germany, published in German or English language. Outcome measures will include physical, mental, or social well-being, and all aspects of health-care provision (access, availability, affordability, and quality). Search results will be screened for eligibility by screening titles, abstracts and full texts. Data extraction comprises information on study characteristics, research aims, and domains of health or health-care services analyzed. The quality of studies will be appraised and documented by appropriate assessment tools. A descriptive evidence map will be drawn by categorizing all included articles by research design and the health conditions and/or domains of health-care provision analyzed. The body of evidence will be evaluated, and a narrative evidence synthesis will be performed by means of a multi-level approach, whereby quantitative and qualitative evidence are analyzed as separate streams and the product

  10. Subjective social status, social network and health disparities: empirical evidence from Greece.

    Science.gov (United States)

    Charonis, Antonios; Kyriopoulos, Ilias-Ioannis; Spanakis, Manos; Zavras, Dimitris; Athanasakis, Kostas; Pavi, Elpida; Kyriopoulos, John

    2017-02-27

    Several studies suggest that socioeconomic status affects (SES) affects self-rated health (SRH), both in Greece and internationally. However, prior research mainly uses objective measures of SES, instead of subjective evaluations of individuals' social status. Based on this, this paper aims to examine (a) the impact of the economic dowturn on SRH in Greece and (b) the relationship between subjective social status (SSS), social network and SRH. The descriptive analysis is based on four cross-sectional surveys conducted by the National School of Public Health, Athens, Greece (2002, 2006, 2011, 2015), while the data for the empirical investigation were derived from the 2015 survey (Health + Welfare Survey GR). The empirical strategy is based on an ordinal logistic regression model, aiming to examine how several variables affect SRH. Size of social network and SSS are among the independent variables employed for the empirical analysis RESULTS: According to our findings, average SRH has deteriorated, and the percentage of the population that reports very good/good SRH has also decreased. Moreover, our empirical analysis suggests that age, existence of a chronic disease, size of social network and SSS affect SRH in Greece. Our findings are consistent with the existing literature and confirm a social gradient in health. According to our analysis, health disparities can be largely attributed to socioeconomic inequalities. The adverse economic climate has impact on socioeconomic differences which in turn affect health disparities. Based on these, policy initiatives are necessasy in order to mitigate the negative impact on health and the disparities caused by economic dowturn and the occuring socioeconomic inequalities.

  11. [Systematic review and evidence mapping of empirical studies on health status and medical care among refugees and asylum seekers in Germany (1990-2014)].

    Science.gov (United States)

    Bozorgmehr, Kayvan; Mohsenpour, Amir; Saure, Daniel; Stock, Christian; Loerbroks, Adrian; Joos, Stefanie; Schneider, Christine

    2016-05-01

    Owing to a lack of routine statistics on the health status and medical care of asylum seekers, empirical studies play a major role in the mapping of these aspects. The aim of this review is to provide a comprehensive overview of the research landscape in this area, synthesizing knowledge from empirical studies and identifying evidence gaps. A three-tiered search strategy included searching for empirical studies in national/international databases and on the internet, screening reference lists, and contacting experts. Studies meeting predefined inclusion criteria were thematically organized and described in a narrative synthesis. The searches generated 1,190 hits; 52 articles met the inclusion criteria. Of these, 41 were quantitative studies (78.9 %), 10 qualitative (19.2 %), and 1 was a review (1.9 %). A total of 30 primary articles (58.9 %) analyzed mental health aspects, followed by infectious diseases (n = 12, 23.5 %). Qualitative studies, mainly ethnographies and case studies, explored mental health and social determinants of health, providing evidence for the impact of living conditions on health and medical care. Few studies analyzed chronic diseases (n = 3) or childhood illnesses (n = 6). No studies analyzed the health needs or medical care of asylum-seeking women during pregnancy and child birth. In 62.7 % of the primary studies, a single sampling point was used to recruit asylum seekers. Nationwide external validity was given in two quantitative studies. The priority research areas identified are chronic diseases and childhood and maternal health. The divergency and heterogeneity of the studies hamper a comprehensive and comparable acquisition of knowledgeand emphasize the  need for collaborative research to close the existing evidence gaps.

  12. Expert opinion vs. empirical evidence

    OpenAIRE

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years sp...

  13. Expert opinion vs. empirical evidence

    Science.gov (United States)

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  14. Evidence Valued and Used by Health Promotion Practitioners

    Science.gov (United States)

    Li, V.; Carter, S. M.; Rychetnik, L.

    2015-01-01

    The use of evidence has become a foundational part of health promotion practice. Although there is a general consensus that adopting an evidence-based approach is necessary for practice, disagreement remains about what types of evidence practitioners should use to guide their work. An empirical understanding of how practitioners conceptualize and…

  15. Trends of Empirical Research in South Korean Mental Health Social Work

    Science.gov (United States)

    Song, In Han; Lee, Eun Jung

    2017-01-01

    Since the introduction of evidence-based practice in South Korea, it has gained significant attention for its potential to promote the efficacy of social work services and to integrate knowledge and practice in mental health social work. In order to see how empirical research in South Korean mental health social work has changed, we examined…

  16. Growth-corruption-health triaca and environmental degradation: empirical evidence from Indonesia, Malaysia, and Thailand.

    Science.gov (United States)

    Azam, Muhammad; Khan, Abdul Qayyum

    2017-07-01

    This study examines the impact of economic growth, corruption, health, and poverty on environmental degradation for three countries from ASEAN, namely Indonesia, Malaysia, and Thailand using annual data over the period of 1994-2014. The relationship between environmental degradation (pollution) by carbon dioxide (CO 2 ) emissions and economic growth is examined along with some other variables, namely health expenditure, poverty, agriculture value added growth, industrial value added growth, and corruption. The ordinary least squares (OLS) method is applied as an analytical technique for parameter estimation. The empirical results reveal that almost all variables are statistically significant at the 5% level of significance, whereby test rejects the null hypotheses of non-cointegration, indicating that all variables play an important role in affecting the environment across countries. Empirical results also indicate that economic growth has significant positive impact, while health expenditures show significantly negative impact on the environment. Corruption has significant positive effect on environment in the case of Malaysia; while in the case of Indonesia and Thailand, it has insignificant results. However, for the individual analysis across countries, the regression estimate suggests that economic growth has a significant positive relationship with environment for Indonesia, while it is found insignificantly negative and positive in the case of Malaysia and Thailand, respectively, during the period under the study. Empirical findings of the study suggest that policy-makers require to make technological-friendly environment sequentially to surmount unregulated pollution, steady population transfers from rural areas to urban areas are also important, and poverty alleviation and better health provision can also help to improve the environment.

  17. The role of sleep hygiene in promoting public health: A review of empirical evidence.

    Science.gov (United States)

    Irish, Leah A; Kline, Christopher E; Gunn, Heather E; Buysse, Daniel J; Hall, Martica H

    2015-08-01

    The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) improve sleep? Is there still a use for sleep hygiene? Global public health concern over sleep has increased demand for sleep promotion strategies accessible to the population. However, the extent to which sleep hygiene strategies apply outside clinical settings is not well known. The present review sought to evaluate the empirical evidence for sleep hygiene recommendations regarding exercise, stress management, noise, sleep timing, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Evidence-based decision making in health care settings: from theory to practice.

    Science.gov (United States)

    Kohn, Melanie Kazman; Berta, Whitney; Langley, Ann; Davis, David

    2011-01-01

    The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of evidence-based medicine. The result has been several comparisons in the literature between the use of evidence in health care management decisions and the use of evidence in medical decision making. Direct comparison, however, may be problematic, given the differences between medicine and management as they relate to (1) the nature of evidence that is brought to bear on decision making; (2) the maturity of empirical research in each field (in particular, studies that have substantiated whether or not and how evidence-based decision making is enacted); and (3) the context within which evidence-based decisions are made. By simultaneously reviewing evidence-based medicine and management, this chapter aims to inform future theorizing and empirical research on evidence-based decision making in health care settings.

  19. Contribution of health workforce to health outcomes: empirical evidence from Vietnam.

    Science.gov (United States)

    Nguyen, Mai Phuong; Mirzoev, Tolib; Le, Thi Minh

    2016-11-16

    In Vietnam, a lower-middle income country, while the overall skill- and knowledge-based quality of health workforce is improving, health workers are disproportionately distributed across different economic regions. A similar trend appears to be in relation to health outcomes between those regions. It is unclear, however, whether there is any relationship between the distribution of health workers and the achievement of health outcomes in the context of Vietnam. This study examines the statistical relationship between the availability of health workers and health outcomes across the different economic regions in Vietnam. We constructed a panel data of six economic regions covering 8 years (2006-2013) and used principal components analysis regressions to estimate the impact of health workforce on health outcomes. The dependent variables representing the outcomes included life expectancy at birth, infant mortality, and under-five mortality rates. Besides the health workforce as our target explanatory variable, we also controlled for key demographic factors including regional income per capita, poverty rate, illiteracy rate, and population density. The numbers of doctors, nurses, midwives, and pharmacists have been rising in the country over the last decade. However, there are notable differences across the different categories. For example, while the numbers of nurses increased considerably between 2006 and 2013, the number of pharmacists slightly decreased between 2011 and 2013. We found statistically significant evidence of the impact of density of doctors, nurses, midwives, and pharmacists on improvement to life expectancy and reduction of infant and under-five mortality rates. Availability of different categories of health workforce can positively contribute to improvements in health outcomes and ultimately extend the life expectancy of populations. Therefore, increasing investment into more equitable distribution of four main categories of health workforce

  20. Managerial Career Patterns: A Review of the Empirical Evidence

    NARCIS (Netherlands)

    Vinkenburg, C.J.; Weber, T.

    2012-01-01

    Despite the ubiquitous presence of the term "career patterns" in the discourse about careers, the existing empirical evidence on (managerial) career patterns is rather limited. From this literature review of 33 published empirical studies of managerial and similar professional career patterns found

  1. Mobile health technology evaluation: the mHealth evidence workshop.

    Science.gov (United States)

    Kumar, Santosh; Nilsen, Wendy J; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R Craig; Mohr, David C; Murphy, Susan A; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

    2013-08-01

    Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

  2. Managerial Career Patterns: A Review of the Empirical Evidence

    Science.gov (United States)

    Vinkenburg, Claartje J.; Weber, Torsten

    2012-01-01

    Despite the ubiquitous presence of the term "career patterns" in the discourse about careers, the existing empirical evidence on (managerial) career patterns is rather limited. From this literature review of 33 published empirical studies of managerial and similar professional career patterns found in electronic bibliographic databases, it is…

  3. The urban health transition hypothesis: empirical evidence of an avian influenza Kuznets curve in Vietnam?

    Science.gov (United States)

    Spencer, James Herbert

    2013-04-01

    The literature on development has focused on the concept of transition in understanding the emergent challenges facing poor but rapidly developing countries. Scholars have focused extensively on the health and urban transitions associated with this change and, in particular, its use for understanding emerging infectious diseases. However, few have developed explicit empirical measures to quantify the extent to which a transitions focus is useful for theory, policy, and practice. Using open source data on avian influenza in 2004 and 2005 and the Vietnam Census of Population and Housing, this paper introduces the Kuznets curve as a tool for empirically estimating transition and disease. Findings suggest that the Kuznets curve is a viable tool for empirically assessing the role of transitional dynamics in the emergence of new infectious diseases.

  4. Web 2.0 for health promotion: reviewing the current evidence.

    Science.gov (United States)

    Chou, Wen-ying Sylvia; Prestin, Abby; Lyons, Claire; Wen, Kuang-yi

    2013-01-01

    As Web 2.0 and social media make the communication landscape increasingly participatory, empirical evidence is needed regarding their impact on and utility for health promotion. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched 4 medical and social science databases for literature (2004-present) on the intersection of Web 2.0 and health. A total of 514 unique publications matched our criteria. We classified references as commentaries and reviews (n = 267), descriptive studies (n = 213), and pilot intervention studies (n = 34). The scarcity of empirical evidence points to the need for more interventions with participatory and user-generated features. Innovative study designs and measurement methods are needed to understand the communication landscape and to critically assess intervention effectiveness. To address health disparities, interventions must consider accessibility for vulnerable populations.

  5. When health policy and empirical evidence collide: the case of cigarette package warning labels and economic consumer surplus.

    Science.gov (United States)

    Song, Anna V; Brown, Paul; Glantz, Stanton A

    2014-02-01

    In its graphic warning label regulations on cigarette packages, the Food and Drug Administration severely discounts the benefits of reduced smoking because of the lost "pleasure" smokers experience when they stop smoking; this is quantified as lost "consumer surplus." Consumer surplus is grounded in rational choice theory. However, empirical evidence from psychological cognitive science and behavioral economics demonstrates that the assumptions of rational choice are inconsistent with complex multidimensional decisions, particularly smoking. Rational choice does not account for the roles of emotions, misperceptions, optimistic bias, regret, and cognitive inefficiency that are germane to smoking, particularly because most smokers begin smoking in their youth. Continued application of a consumer surplus discount will undermine sensible policies to reduce tobacco use and other policies to promote public health.

  6. Competition and quality indicators in the health care sector: empirical evidence from the Dutch hospital sector

    NARCIS (Netherlands)

    Croes, R.R.; Krabbe-Alkemade, Y.J.F.M.; Mikkers, M.C.

    2017-01-01

    textabstractThere is much debate about the effect of competition in healthcare and especially the effect of competition on the quality of healthcare, although empirical evidence on this subject is mixed. The Netherlands provides an interesting case in this debate. The Dutch system could be

  7. Competition and quality indicators in the health care sector : Empirical evidence from the Dutch hospital sector

    NARCIS (Netherlands)

    Croes, Ramsis; Krabbe, Yvonne; Mikkers, Misja

    There is much debate about the effect of competition in healthcare and especially the effect of competition on the quality of healthcare, although empirical evidence on this subject is mixed. The Netherlands provides an interesting case in this debate. The Dutch system could be characterized as a

  8. Practice management: observations, issues, and empirical evidence.

    Science.gov (United States)

    Wong, H M; Braithwaite, J

    2001-02-01

    The primary objective of this study is to provide objective, empirical, evidence-based practice management information. This is a hitherto under-researched area of considerable interest for both the practitioner and educator. A questionnaire eliciting a mix of structured and free text responses was administered to a random sample of 480 practitioners who are members of the American Academy of Periodontology. Potential respondents not in private practice were excluded and the next listed person substituted. The results provide demographic and descriptive information about some of the main issues and problems facing practice managers, central to which are information technology (IT), financial, people management, and marketing. Human resource and marketing management appear to represent the biggest challenges. Periodontists running practices would prefer more information, development, and support in dealing with IT, finance, marketing, and people management. The empirical evidence reported here suggests that although tailored educational programs on key management issues at both undergraduate and postgraduate levels have become ubiquitous, nevertheless some respondents seek further training opportunities. Evidence-based practice management information will be invaluable to the clinician considering strategic and marketing planning, and also for those responsible for the design and conduct of predoctoral and postdoctoral programs.

  9. On the Empirical Evidence of Mutual Fund Strategic Risk Taking

    NARCIS (Netherlands)

    Goriaev, A.P.; Nijman, T.E.; Werker, B.J.M.

    2001-01-01

    We reexamine empirical evidence on strategic risk-taking behavior by mutual fund managers.Several studies suggest that fund performance in the first semester of a year influences risk-taking in the second semester.However, we show that previous empirical studies implicitly assume that idiosyncratic

  10. When Health Policy and Empirical Evidence Collide: The Case of Cigarette Package Warning Labels and Economic Consumer Surplus

    Science.gov (United States)

    Song, Anna V.; Brown, Paul

    2014-01-01

    In its graphic warning label regulations on cigarette packages, the Food and Drug Administration severely discounts the benefits of reduced smoking because of the lost “pleasure” smokers experience when they stop smoking; this is quantified as lost “consumer surplus.” Consumer surplus is grounded in rational choice theory. However, empirical evidence from psychological cognitive science and behavioral economics demonstrates that the assumptions of rational choice are inconsistent with complex multidimensional decisions, particularly smoking. Rational choice does not account for the roles of emotions, misperceptions, optimistic bias, regret, and cognitive inefficiency that are germane to smoking, particularly because most smokers begin smoking in their youth. Continued application of a consumer surplus discount will undermine sensible policies to reduce tobacco use and other policies to promote public health. PMID:24328661

  11. Evidence-based care and the case for intuition and tacit knowledge in clinical assessment and decision making in mental health nursing practice: an empirical contribution to the debate.

    Science.gov (United States)

    Welsh, I; Lyons, C M

    2001-08-01

    This paper provides empirical evidence that challenges the view that methods of clinical assessment and decision making should not rely solely on logical positivist approaches. Whilst the National Health Service (NHS) Executive currently takes a hard positivist line on what constitutes evidence-based practice, data reveal that it is not always appropriate to disregard the tacit knowledge and intuition of experienced practitioners when making assessment decisions in mental health nursing practice. Data support the case for a holistic approach which may draw on intuition and tacit knowledge, as well as traditional approaches, to meet the requirements of clients with complex mental health problems. A model based on Schon's notion of reflection in and reflection on practice is proposed which demonstrates the value of intuition and tacit knowledge. This model allows the generation of insights which may ultimately be demonstrated to be acceptable and empirically testable. It is accepted that an element of risk taking is inevitable, but the inclusion of a formal analytical process into the model reduces the likelihood of inappropriate care interventions. The cognitive processes which experienced nurses use to make clinical decisions and their implications for practice will be explored.

  12. Eco-Health Linkages: evidence base and socio-economic considerations for linking ecosystem goods and services to human health

    Science.gov (United States)

    Ecosystem goods and services (EGS) are thought to play a role in protecting human health, but the empirical evidence directly linking EGS to human health outcomes is limited, and our ability to detect Eco-Health linkages is confounded by socio-economic factors. These limitations ...

  13. Evidence-based Nursing Education - a Systematic Review of Empirical Research

    Science.gov (United States)

    Reiber, Karin

    2011-01-01

    The project „Evidence-based Nursing Education – Preparatory Stage“, funded by the Landesstiftung Baden-Württemberg within the programme Impulsfinanzierung Forschung (Funding to Stimulate Research), aims to collect information on current research concerned with nursing education and to process existing data. The results of empirical research which has already been carried out were systematically evaluated with aim of identifying further topics, fields and matters of interest for empirical research in nursing education. In the course of the project, the available empirical studies on nursing education were scientifically analysed and systematised. The over-arching aim of the evidence-based training approach – which extends beyond the aims of this project - is the conception, organisation and evaluation of vocational training and educational processes in the caring professions on the basis of empirical data. The following contribution first provides a systematic, theoretical link to the over-arching reference framework, as the evidence-based approach is adapted from thematically related specialist fields. The research design of the project is oriented towards criteria introduced from a selection of studies and carries out a two-stage systematic review of the selected studies. As a result, the current status of research in nursing education, as well as its organisation and structure, and questions relating to specialist training and comparative education are introduced and discussed. Finally, the empirical research on nursing training is critically appraised as a complementary element in educational theory/psychology of learning and in the ethical tradition of research. This contribution aims, on the one hand, to derive and describe the methods used, and to introduce the steps followed in gathering and evaluating the data. On the other hand, it is intended to give a systematic overview of empirical research work in nursing education. In order to preserve a

  14. Whole-body cryotherapy: empirical evidence and theoretical perspectives

    Directory of Open Access Journals (Sweden)

    Bleakley CM

    2014-03-01

    Full Text Available Chris M Bleakley,1 François Bieuzen,2 Gareth W Davison,1 Joseph T Costello3 1Sport and Exercise Science Research Institute, Faculty of Life and Health Sciences, University of Ulster, Newtownabbey, Northern Ireland; 2Research Department, Laboratory of Sport, Expertise and Performance, French National Institute of Sport (INSEP, Paris, France; 3School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia Abstract: Whole-body cryotherapy (WBC involves short exposures to air temperatures below –100°C. WBC is increasingly accessible to athletes, and is purported to enhance recovery after exercise and facilitate rehabilitation postinjury. Our objective was to review the efficacy and effectiveness of WBC using empirical evidence from controlled trials. We found ten relevant reports; the majority were based on small numbers of active athletes aged less than 35 years. Although WBC produces a large temperature gradient for tissue cooling, the relatively poor thermal conductivity of air prevents significant subcutaneous and core body cooling. There is weak evidence from controlled studies that WBC enhances antioxidant capacity and parasympathetic reactivation, and alters inflammatory pathways relevant to sports recovery. A series of small randomized studies found WBC offers improvements in subjective recovery and muscle soreness following metabolic or mechanical overload, but little benefit towards functional recovery. There is evidence from one study only that WBC may assist rehabilitation for adhesive capsulitis of the shoulder. There were no adverse events associated with WBC; however, studies did not seem to undertake active surveillance of predefined adverse events. Until further research is available, athletes should remain cognizant that less expensive modes of cryotherapy, such as local ice-pack application or cold-water immersion, offer comparable

  15. Political and institutional influences on the use of evidence in public health policy. A systematic review.

    Science.gov (United States)

    Liverani, Marco; Hawkins, Benjamin; Parkhurst, Justin O

    2013-01-01

    There is increasing recognition that the development of evidence-informed health policy is not only a technical problem of knowledge exchange or translation, but also a political challenge. Yet, while political scientists have long considered the nature of political systems, the role of institutional structures, and the political contestation of policy issues as central to understanding policy decisions, these issues remain largely unexplored by scholars of evidence-informed policy making. We conducted a systematic review of empirical studies that examined the influence of key features of political systems and institutional mechanisms on evidence use, and contextual factors that may contribute to the politicisation of health evidence. Eligible studies were identified through searches of seven health and social sciences databases, websites of relevant organisations, the British Library database, and manual searches of academic journals. Relevant findings were extracted using a uniform data extraction tool and synthesised by narrative review. 56 studies were selected for inclusion. Relevant political and institutional aspects affecting the use of health evidence included the level of state centralisation and democratisation, the influence of external donors and organisations, the organisation and function of bureaucracies, and the framing of evidence in relation to social norms and values. However, our understanding of such influences remains piecemeal given the limited number of empirical analyses on this subject, the paucity of comparative works, and the limited consideration of political and institutional theory in these studies. This review highlights the need for a more explicit engagement with the political and institutional factors affecting the use of health evidence in decision-making. A more nuanced understanding of evidence use in health policy making requires both additional empirical studies of evidence use, and an engagement with theories and approaches

  16. Explaining foreign ownership by comparative and competitive advantage. Empirical evidence.

    OpenAIRE

    Bellak, Christian

    1999-01-01

    This paper provides empirical evidence on the determinants of foreign ownership in manufacturing industries. Foreign ownership, according to the theory of international production, is the result of the combination of comparative and competitive advantage. An adequate examination of the ownership structure of an industry requires the ability to establish empirically the extent to which international competitiveness of firms rests on comparative and competitive advantage. Analysis is based on a...

  17. Firm productivity, pollution, and output: theory and empirical evidence from China.

    Science.gov (United States)

    Tang, Erzi; Zhang, Jingjing; Haider, Zulfiqar

    2015-11-01

    Using a theoretical model, this paper argues that as firm productivity increases, there is a decrease in firm-level pollution intensity. However, as productivity increases, firms tend to increase their aggregate output, which requires the use of additional resources that increase pollution. Hence, an increase in productivity results in two opposing effects where increased productivity may in fact increase pollution created by a firm. We describe the joint effect of these two mechanisms on pollution emissions as the "productivity dilemma" of pollution emission. Based on firm-level data from China, we also empirically test this productivity dilemma hypothesis. Our empirical results suggest that, in general, firm productivity has a positive and statistically significant impact on pollution emission in China. However, the impact of productivity on pollution becomes negative when we control for increases in firm output. The empirical evidence also confirms the positive influence of productivity on output, which suggests that the main determinant of pollution is the firm's output. The empirical results provide evidence of the existence of, what we describe as, the productivity dilemma of pollution emission.

  18. ICT Pathways to Poverty Reduction: Empirical Evidence from East ...

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

    2014-01-14

    Jan 14, 2014 ... This book provides new empirical evidence on access to and use of ... English · Français ... Overall, the study concluded that ICTs make a difference to the ... staff of development agencies working on livelihoods for the poor.

  19. Exogenous empirical-evidence equilibria in perfect-monitoring repeated games yield correlated equilibria

    KAUST Repository

    Dudebout, Nicolas; Shamma, Jeff S.

    2014-01-01

    This paper proves that exogenous empirical-evidence equilibria (xEEEs) in perfect-monitoring repeated games induce correlated equilibria of the associated one-shot game. An empirical-evidence equilibrium (EEE) is a solution concept for stochastic games. At equilibrium, agents' strategies are optimal with respect to models of their opponents. These models satisfy a consistency condition with respect to the actual behavior of the opponents. As such, EEEs replace the full-rationality requirement of Nash equilibria by a consistency-based bounded-rationality one. In this paper, the framework of empirical evidence is summarized, with an emphasis on perfect-monitoring repeated games. A less constraining notion of consistency is introduced. The fact that an xEEE in a perfect-monitoring repeated game induces a correlated equilibrium on the underlying one-shot game is proven. This result and the new notion of consistency are illustrated on the hawk-dove game. Finally, a method to build specific correlated equilibria from xEEEs is derived.

  20. Exogenous empirical-evidence equilibria in perfect-monitoring repeated games yield correlated equilibria

    KAUST Repository

    Dudebout, Nicolas

    2014-12-15

    This paper proves that exogenous empirical-evidence equilibria (xEEEs) in perfect-monitoring repeated games induce correlated equilibria of the associated one-shot game. An empirical-evidence equilibrium (EEE) is a solution concept for stochastic games. At equilibrium, agents\\' strategies are optimal with respect to models of their opponents. These models satisfy a consistency condition with respect to the actual behavior of the opponents. As such, EEEs replace the full-rationality requirement of Nash equilibria by a consistency-based bounded-rationality one. In this paper, the framework of empirical evidence is summarized, with an emphasis on perfect-monitoring repeated games. A less constraining notion of consistency is introduced. The fact that an xEEE in a perfect-monitoring repeated game induces a correlated equilibrium on the underlying one-shot game is proven. This result and the new notion of consistency are illustrated on the hawk-dove game. Finally, a method to build specific correlated equilibria from xEEEs is derived.

  1. Empirical evidence on the demand for carve-outs in employment group mental health coverage.

    Science.gov (United States)

    Salkever, David S.; Shinogle, Judith A.

    2000-06-01

    BACKGROUND AND AIMS OF THE STUDY: The use of specialized behavioral health companies to manage mental/health benefits has become widespread in recent years. Recent studies have reported on the cost and utilization impacts of behavioral health carve-outs. Yet little previous research has examined the factors which lead employer-based health plans to adopt a carve-out strategy for mental health benefits. The examination of these factors is the main focus of our study. Our empirical analysis is also intended to explore several hypotheses (moral hazard, adverse selection, economies of scale and alternate utilization management strategies) that have recently been advanced to explain the popularity of carve-outs. METHODS: The data for this study are from a survey of employers who have long-term disability contracts with one large insurer. The analysis uses data from 248 employers who offer mental health benefits combined with local market information (e.g. health care price proxies, state tax rates etc), state regulations (mental health and substance abuse mandate and parity laws) and employee characteristics. Two different measures of carve-out use were used as dependent variables in the analysis: (1) the fraction of health plans offered by the employer that contained carve-out provisions and (2) a dichotomous indicator for those employers who included a carve-out arrangement in all the health plans they offered. RESULTS: Our results tended to support the general cost-control hypothesis that factors associated with higher use and/or costs of mental health services increase the demand for carve-outs. Our results gave less consistent support to the argument that carve-outs are demanded to control adverse selection, though only a few variables provided a direct test of this hypothesis. The role of economies of scale (i.e., group size) and the effectiveness of alternative strategies for managing moral hazard costs (i.e., HMOs) were confirmed by our results. DISCUSSION: We

  2. Health Status and Health Dynamics in an Empirical Model of Expected Longevity*

    Science.gov (United States)

    Benítez-Silva, Hugo; Ni, Huan

    2010-01-01

    Expected longevity is an important factor influencing older individuals’ decisions such as consumption, savings, purchase of life insurance and annuities, claiming of Social Security benefits, and labor supply. It has also been shown to be a good predictor of actual longevity, which in turn is highly correlated with health status. A relatively new literature on health investments under uncertainty, which builds upon the seminal work by Grossman (1972), has directly linked longevity with characteristics, behaviors, and decisions by utility maximizing agents. Our empirical model can be understood within that theoretical framework as estimating a production function of longevity. Using longitudinal data from the Health and Retirement Study, we directly incorporate health dynamics in explaining the variation in expected longevities, and compare two alternative measures of health dynamics: the self-reported health change, and the computed health change based on self-reports of health status. In 38% of the reports in our sample, computed health changes are inconsistent with the direct report on health changes over time. And another 15% of the sample can suffer from information losses if computed changes are used to assess changes in actual health. These potentially serious problems raise doubts regarding the use and interpretation of the computed health changes and even the lagged measures of self-reported health as controls for health dynamics in a variety of empirical settings. Our empirical results, controlling for both subjective and objective measures of health status and unobserved heterogeneity in reporting, suggest that self-reported health changes are a preferred measure of health dynamics. PMID:18187217

  3. Impact of climate change on human infectious diseases: Empirical evidence and human adaptation.

    Science.gov (United States)

    Wu, Xiaoxu; Lu, Yongmei; Zhou, Sen; Chen, Lifan; Xu, Bing

    2016-01-01

    Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events. It may lead to changes in health threat to human beings, multiplying existing health problems. This review examines the scientific evidences on the impact of climate change on human infectious diseases. It identifies research progress and gaps on how human society may respond to, adapt to, and prepare for the related changes. Based on a survey of related publications between 1990 and 2015, the terms used for literature selection reflect three aspects--the components of infectious diseases, climate variables, and selected infectious diseases. Humans' vulnerability to the potential health impacts by climate change is evident in literature. As an active agent, human beings may control the related health effects that may be effectively controlled through adopting proactive measures, including better understanding of the climate change patterns and of the compound disease-specific health effects, and effective allocation of technologies and resources to promote healthy lifestyles and public awareness. The following adaptation measures are recommended: 1) to go beyond empirical observations of the association between climate change and infectious diseases and develop more scientific explanations, 2) to improve the prediction of spatial-temporal process of climate change and the associated shifts in infectious diseases at various spatial and temporal scales, and 3) to establish locally effective early warning systems for the health effects of predicated climate change. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. The Role of Empirical Evidence for Transferring a New Technology to Industry

    Science.gov (United States)

    Baldassarre, Maria Teresa; Bruno, Giovanni; Caivano, Danilo; Visaggio, Giuseppe

    Technology transfer and innovation diffusion are key success factors for an enterprise. The shift to a new software technology involves, on one hand, inevitable changes to ingrained and familiar processes and, on the other, requires training, changes in practices and commitment on behalf of technical staff and management. Nevertheless, industry is often reluctant to innovation due to the changes it determines. The process of innovation diffusion is easier if the new technology is supported by empirical evidence. In this sense our conjecture is that Empirical Software Engineering (ESE) serves as means for validating and transferring a new technology within production processes. In this paper, the authors report their experience of a method, Multiview Framework, defined in the SERLAB research laboratory as support for designing and managing a goal oriented measurement program that has been validated through various empirical studies before being transferred to an Italian SME. Our discussion points out the important role of empirical evidence for obtaining management commitment and buy-in on behalf of technical staff, and for making technological transfer possible.

  5. What should we mean by empirical validation in hypnotherapy: evidence-based practice in clinical hypnosis.

    Science.gov (United States)

    Alladin, Assen; Sabatini, Linda; Amundson, Jon K

    2007-04-01

    This paper briefly surveys the trend of and controversy surrounding empirical validation in psychotherapy. Empirical validation of hypnotherapy has paralleled the practice of validation in psychotherapy and the professionalization of clinical psychology, in general. This evolution in determining what counts as evidence for bona fide clinical practice has gone from theory-driven clinical approaches in the 1960s and 1970s through critical attempts at categorization of empirically supported therapies in the 1990s on to the concept of evidence-based practice in 2006. Implications of this progression in professional psychology are discussed in the light of hypnosis's current quest for validation and empirical accreditation.

  6. Modeling the Dynamics and Spillovers of the Health Labor Market: Evidence from China’s Provincial Panel Data

    Directory of Open Access Journals (Sweden)

    Bin Zhu

    2018-01-01

    Full Text Available Health workforce misdistribution is a major challenge faced by almost all countries. A more profound understanding of the dynamics of the health labor market provides evidence for policy makers to balance health workforce distribution with solid evidence. However, one major deficit of existing theoretical and empirical studies is that they often ignore the intra-regional spillovers of the health labor market. This study builds a theoretical “supply–demand–spillover” model that considers both intra-regional supply and demand-side factors, and inter-regional spillovers, hence providing a theoretical reference point for further in-depth studies. Using spatial econometric panel models, the effect of all determinants and spillovers were empirically measured based on a Chinese panel data set, shedding light on health workforce policies in China.

  7. Health risk perception and betel chewing behavior--the evidence from Taiwan.

    Science.gov (United States)

    Chen, Chiang-Ming; Chang, Kuo-Liang; Lin, Lin; Lee, Jwo-Leun

    2013-11-01

    In this study, we provided an empirical examination of the interaction between people's health risk perception and betel chewing. We hypothesized that a better knowledge of possible health risks would reduce both the number of individuals who currently chew betel and the likelihood of those who do not yet chew betel to begin the habit. We constructed a simultaneous equation model with Bayesian two-stage approach to control the endogeneity between betel chewing and risk perception. Using a national survey of 26,684 observations in Taiwan, our study results indicated that better health knowledge reduced the possibility that people would become betel chewers. We also found that, in general, betel chewers have a poorer health risk perception than other population. Overall, the empirical evidence suggested that health authorities could reduce the odds of people becoming betel chewers by improving their knowledge of betel-chewing's harmful effects. © 2013 Elsevier Ltd. All rights reserved.

  8. An empirically based model for knowledge management in health care organizations.

    Science.gov (United States)

    Sibbald, Shannon L; Wathen, C Nadine; Kothari, Anita

    2016-01-01

    Knowledge management (KM) encompasses strategies, processes, and practices that allow an organization to capture, share, store, access, and use knowledge. Ideal KM combines different sources of knowledge to support innovation and improve performance. Despite the importance of KM in health care organizations (HCOs), there has been very little empirical research to describe KM in this context. This study explores KM in HCOs, focusing on the status of current intraorganizational KM. The intention is to provide insight for future studies and model development for effective KM implementation in HCOs. A qualitative methods approach was used to create an empirically based model of KM in HCOs. Methods included (a) qualitative interviews (n = 24) with senior leadership to identify types of knowledge important in these roles plus current information-seeking behaviors/needs and (b) in-depth case study with leaders in new executive positions (n = 2). The data were collected from 10 HCOs. Our empirically based model for KM was assessed for face and content validity. The findings highlight the paucity of formal KM in our sample HCOs. Organizational culture, leadership, and resources are instrumental in supporting KM processes. An executive's knowledge needs are extensive, but knowledge assets are often limited or difficult to acquire as much of the available information is not in a usable format. We propose an empirically based model for KM to highlight the importance of context (internal and external), and knowledge seeking, synthesis, sharing, and organization. Participants who reviewed the model supported its basic components and processes, and potential for incorporating KM into organizational processes. Our results articulate ways to improve KM, increase organizational learning, and support evidence-informed decision-making. This research has implications for how to better integrate evidence and knowledge into organizations while considering context and the role of

  9. Factors Affecting Quality of Audit; Empirical Evidence from Iran ...

    African Journals Online (AJOL)

    This study examines factors affecting quality of audit using empirical evidence from Iran Quality of audit was seen as the degree to which an audit report is free from deficiencies and distortions which show up later on. The quality of an audit was measured in terms of an auditor's ability to report financial distortions willingly ...

  10. The Role of Students’ Emotional Intelligence: Empirical Evidence

    Directory of Open Access Journals (Sweden)

    Natalio Extremera Pacheco

    2004-11-01

    Full Text Available Emotional intelligence (EI has attracted great interest in the field of education as a vehicle to improve the socioemotional development of students. The first publications that appeared made a great number of claims about the positive influence of emotional intelligence in the classroom. The only problem was that not all these claims were coupled with empirical research to show, on the one hand, the predictive level of EI, and on the other hand, the actual role of EI in different areas of life. It has been only recently that the effect of a high level of EI exercises on people has been investigated. The object of this article is to examine the most relevant empirical research done within the educational setting, in order to collect the existing evidence for the influence of EI, evaluated by different instruments, in the personal, social and scholastic functioning of students.

  11. Falling Standards of Education in Nigeria: An Empirical Evidence in ...

    African Journals Online (AJOL)

    Falling Standards of Education in Nigeria: An Empirical Evidence in Delta State of Nigeria. ... Open Access DOWNLOAD FULL TEXT ... the results are often devastating leading especially to poor quality output and wastage which in ... annual budget, inculcation of the tenets of traditional education, and utilization of research ...

  12. Empirical Evidence or Intuition? An Activity Involving the Scientific Method

    Science.gov (United States)

    Overway, Ken

    2007-01-01

    Students need to have basic understanding of scientific method during their introductory science classes and for this purpose an activity was devised which involved a game based on famous Monty Hall game problem. This particular activity allowed students to banish or confirm their intuition based on empirical evidence.

  13. Health status convergence at the local level: empirical evidence from Austria

    Directory of Open Access Journals (Sweden)

    Gächter Martin

    2011-08-01

    Full Text Available Abstract Introduction Health is an important dimension of welfare comparisons across individuals, regions and states. Particularly from a long-term perspective, within-country convergence of the health status has rarely been investigated by applying methods well established in other scientific fields. In the following paper we study the relation between initial levels of the health status and its improvement at the local community level in Austria in the time period 1969-2004. Methods We use age standardized mortality rates from 2381 Austrian communities as an indicator for the health status and analyze the convergence/divergence of overall mortality for (i the whole population, (ii females, (iii males and (iv the gender mortality gap. Convergence/Divergence is studied by applying different concepts of cross-regional inequality (weighted standard deviation, coefficient of variation, Theil-Coefficient of inequality. Various econometric techniques (weighted OLS, Quantile Regression, Kendall's Rank Concordance are used to test for absolute and conditional beta-convergence in mortality. Results Regarding sigma-convergence, we find rather mixed results. While the weighted standard deviation indicates an increase in equality for all four variables, the picture appears less clear when correcting for the decreasing mean in the distribution. However, we find highly significant coefficients for absolute and conditional beta-convergence between the periods. While these results are confirmed by several robustness tests, we also find evidence for the existence of convergence clubs. Conclusions The highly significant beta-convergence across communities might be caused by (i the efforts to harmonize and centralize the health policy at the federal level in Austria since the 1970s, (ii the diminishing returns of the input factors in the health production function, which might lead to convergence, as the general conditions (e.g. income, education etc. improve

  14. Dynamic analysis of interhospital collaboration and competition: empirical evidence from an Italian regional health system.

    Science.gov (United States)

    Mascia, Daniele; Di Vincenzo, Fausto; Cicchetti, Americo

    2012-05-01

    Policymakers stimulate competition in universalistic health-care systems while encouraging the formation of service provision networks among hospital organizations. This article addresses a gap in the extant literature by empirically analyzing simultaneous collaboration and competition between hospitals within the Italian National Health Service, where important procompetition reforms have been implemented. To explore how rising competition between hospitals relates to their propensity to collaborate with other local providers. Longitudinal data on interhospital collaboration and competition collected in an Italian region from 2003 to 2007 are analyzed. Social network analysis techniques are applied to study the structure and dynamics of interhospital collaboration. Negative binomial regressions are employed to explore how interhospital competition relates to the collaborative network over time. Competition among providers does not hinder interhospital collaboration. Collaboration is primarily local, with resource complementarity and differentials in the volume of activity and hospital performance explaining the propensity to collaborate. Formation of collaborative networks among hospitals is not hampered by reforms aimed at fostering market forces. Because procompetition reforms elicit peculiar forms of managed competition in universalistic health systems, studies are needed to clarify whether the positive association between interhospital competition and collaboration can be generalized to other health-care settings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Empirical evidence in consumer law cases: what are 'up to' claims up to?

    NARCIS (Netherlands)

    Luzak, J.; Heiderhoff, B.; Schulze, R.

    2016-01-01

    In this contribution I argue that in certain consumer law cases providing empirical evidence is necessary and that specific standards of proof should then apply. Only through analysing evidence of actual consumer behaviour as well as of trader’s commercial practices courts and enforcement

  16. Risk aversion, time preference and health production: theory and empirical evidence from Cambodia.

    Science.gov (United States)

    Rieger, Matthias

    2015-04-01

    This paper quantifies the relationship between risk aversion and discount rates on the one hand and height and weight on the other. It studies this link in the context of poor households in Cambodia. Evidence is based on an original dataset that contains both experimental measures of risk taking and impatience along with anthropometric measurements of children and adults. The aim of the paper is to (i) explore the importance of risk and time preferences in explaining undernutrition and (ii) compare the evidence stemming from poor households to strikingly similar findings from industrialized countries. It uses an inter-generational approach to explain observed correlations in adults and children that is inspired by the height premium on labor markets. Parents can invest in the health capital of their child to increase future earnings and their consumption when old: better nutrition during infancy translates into better human capital and better wages, and ultimately better financial means to take care of elderly parents. However this investment is subject to considerable uncertainty, since parents neither perfectly foresee economic conditions when the child starts earning nor fully observe the ability to transform nutritional investments into long-term health capital. As a result, risk taking households have taller and heavier children. Conversely, impatience does not affect child health. In the case of adults, only weight and the body mass index (BMI), but not height, are positively and moderately correlated with risk taking and impatience. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Demand Response in U.S. Electricity Markets: Empirical Evidence

    OpenAIRE

    Cappers, Peter

    2009-01-01

    Empirical evidence concerning demand response (DR) resources is needed in order to establish baseline conditions, develop standardized methods to assess DR availability and performance, and to build confidence among policymakers, utilities, system operators, and stakeholders that DR resources do offer a viable, cost-effective alternative to supply-side investments. This paper summarizes the existing contribution of DR resources in U.S. electric power markets. In 2008, customers enrolled in ...

  18. Does Missing Classes Decelerate Student Exam Performance Progress? Empirical Evidence and Policy Implications

    Science.gov (United States)

    Lin, Tin-Chun

    2014-01-01

    A total of 389 business students in undergraduate introductory microeconomics classes in spring 2007, 2009, and 2011, and fall 2012 participated in an exam performance progress study. Empirical evidence suggested that missing classes decelerates and hampers high-performing students' exam performance progress. Nevertheless, the evidence does…

  19. A Survey on Agricultural Trade Policies in Bangladesh: theoretical Insights and empirical Evidence

    Directory of Open Access Journals (Sweden)

    Dayal Talukder

    2014-01-01

    Full Text Available The purpose of this paper is to review the theoretical insights and empirical evidence on agricultural trade policies and their impacts on the Bangladesh‟s economy, with a view to presenting both, the positive and negative effects of trade liberalization. Theoretically, while advocates of trade liberalization argue that free trade is an engine of growth and protection leads to wasteful use of resources, critics argue that openness has its costs and sometimes it could be detrimental to the economic development. The empirical evidence in Bangladesh was consistent with the ongoing debate on the effects of trade liberalization on economic development. The evidence remained mixed and loaded with criticisms on the grounds of choice of liberalization determinants, model specifications and methodology, as well as other measurement shortcomings. The review suggests that the literature is inconclusive and outcomes are largely case-specific.

  20. A Survey on Agricultural Trade Policies in Bangladesh: theoretical Insights and empirical Evidence

    Directory of Open Access Journals (Sweden)

    D. Talukder

    2014-06-01

    Full Text Available The purpose of this paper is to review the theoretical insights and empirical evidence on agricultural trade policies and their impacts on the Bangladesh’s economy, with a view to presenting both, the positive and negative effects of trade liberalization. Theoretically, while advocates of trade liberalization argue that free trade is an engine of growth and protection leads to wasteful use of resources, critics argue that openness has its costs and sometimes it could be detrimental to the economic development. The empirical evidence in Bangladesh was consistent with the ongoing debate on the effects of trade liberalization on economic development. The evidence remained mixed and loaded with criticisms on the grounds of choice of liberalization determinants, model specifications and methodology, as well as other measurement shortcomings. The review suggests that the literature is inconclusive and outcomes are largely case-specific

  1. Evidence-based medicine - an appropriate tool for evidence-based health policy? A case study from Norway.

    Science.gov (United States)

    Malterud, Kirsti; Bjelland, Anne Karen; Elvbakken, Kari Tove

    2016-03-05

    Evidence-based policy (EBP), a concept modelled on the principles of evidence-based medicine (EBM), is widely used in different areas of policymaking. Systematic reviews (SRs) with meta-analyses gradually became the methods of choice for synthesizing research evidence about interventions and judgements about quality of evidence and strength of recommendations. Critics have argued that the relation between research evidence and service policies is weak, and that the notion of EBP rests on a misunderstanding of policy processes. Having explored EBM standards and knowledge requirements for health policy decision-making, we present an empirical point of departure for discussing the relationship between EBM and EBP. In a case study exploring the Norwegian Knowledge Centre for the Health Services (NOKC), an independent government unit, we first searched for information about the background and development of the NOKC to establish a research context. We then identified, selected and organized official NOKC publications as an empirical sample of typical top-of-the-line knowledge delivery adhering to EBM standards. Finally, we explored conclusions in this type of publication, specifically addressing their potential as policy decision tools. From a total sample of 151 SRs published by the NOKC in the period 2004-2013, a purposive subsample from 2012 (14 publications) advised major caution about their conclusions because of the quality or relevance of the underlying documentation. Although the case study did not include a systematic investigation of uptake and policy consequences, SRs were found to be inappropriate as universal tools for health policy decision-making. The case study demonstrates that EBM is not necessarily suited to knowledge provision for every kind of policy decision-making. Our analysis raises the question of whether the evidence-based movement, represented here by an independent government organization, undertakes too broad a range of commissions using

  2. Emotional Competence in Children with Autism: Diagnostic Criteria and Empirical Evidence

    Science.gov (United States)

    Begeer, Sander; Koot, Hans M.; Rieffe, Carolien; Terwogt, Mark Meerum; Stegge, Hedy

    2008-01-01

    The diagnostic criteria of autism spectrum disorders (ASD) include emotional impairments. However, scientific evidence for these impairments is varied and subtle. In this contribution, recent empirical studies that examined the emotional competence in children and adolescents with ASD are reviewed. Four aspects of emotional competence that are…

  3. Abortion and mental health: Evaluating the evidence.

    Science.gov (United States)

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-12-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects and updates the report of the American Psychological Association Task Force on Mental Health and Abortion (2008). Major methodological problems pervaded most of the research reviewed. The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. Evidence did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se as opposed to other preexisting and co-occurring risk factors. Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however. It is important that women's varied experiences of abortion be recognized, validated, and understood. 2009 APA.

  4. Board diversity in the perspective of financial distress: Empirical evidence from the Netherlands

    Directory of Open Access Journals (Sweden)

    Bernard Santen

    2009-07-01

    Full Text Available This paper analyses the relationship between board diversity (in gender and in nationality and financial distress. A summary of the theory behind board diversity precedes an overview of the empirical evidence on the relationship between diversity and company performance. The paper presents empirical research on the relationship between a negative performance measure, financial distress, and diversity on the board. The results show a positive relationship between the presence of foreign non-executive directors and financial distress. It is suggested that this is caused by negative communication and misunderstandings. No relationship is found between the gender of a director and financial distress. On a micro-level, the data do not show evidence for the glass cliff hypothesis.

  5. Outcome (competency) based education: an exploration of its origins, theoretical basis, and empirical evidence

    DEFF Research Database (Denmark)

    Mørcke, Anne Mette; Dornan, Tim; Eika, Berit

    2013-01-01

    and professional attributes as ‘‘competencies’’. OBE has been adopted by consensus in the face of weak empirical evidence. OBE, which has been advocated for over 50 years, can contribute usefully to defining requisite knowledge and skills, and blueprinting assessments. Its applicability to more complex aspects...... greatest benefits. Our aim was to explore the underpinnings of OBE: its historical origins, theoretical basis, and empirical evidence of its effects in order to answer the question: How can predetermined learning outcomes influence undergraduate medical education? This literature review had three...... components: A review of historical landmarks in the evolution of OBE; a review of conceptual frameworks and theories; and a systematic review of empirical publications from 1999 to 2010 that reported data concerning the effects of learning outcomes on undergraduate medical education. OBE had its origins...

  6. Motives and chances of firm diversification: theory and empirical evidence

    International Nuclear Information System (INIS)

    Briglauer, W.

    2001-11-01

    It is beyond controversy that the majority of the largest companies in the industrialized countries perform to a certain extent product diversification strategies. Tying up to this finding the underlying work firstly deals with alternative theoretical and empirical definitions of corporate diversification. Subsequently the theoretical part mainly elaborates an industrial economic framework for categorizing motives of firm diversification. Despite of some inevitable degree of arbitrariness, a relatively widespread and sufficient categorization can be presented. With regards to the relevant economic literature most explanations of product diversification can be classified appropriately. Observing diversification activities one would prima facie infer a positive relationship between product diversification and firm performance, but both, theory and empirical evidence, yield ambiguous results. The empirical part provides a list of existing studies, classified according to the theoretical categorization. In an overview some stylised facts are filtered and discussed consecutively. Most notably, it was found that related diversification strategies significantly outperform strategies of unrelated diversification. At the end of the empirical section econometric methods are applied to agricultural and industrial economic (relating to telecommunication markets) data sets. For the agricultural studies a significantly positive relationship between product diversification and firm performance was found. In contrast no significant results were obtained for the telecommunication markets. (author)

  7. AN APPROACH TO THE EXTERNAL ASSESSMENT THROUGH EMPIRICAL EVIDENCE

    Directory of Open Access Journals (Sweden)

    Ismael Sanz Labrador

    2015-06-01

    Full Text Available This article presents the empiral evidences of standardized evaluations and explores the aspects of such evaluations more interesting to the educational community, and investigates the effects in implementing those exams on the performance of students. Furthermore, it is analyzed the relationship between external evaluations and teaching to the test , it is seen how it affects the introduction of these evaluations in student learning and their performance in international assessments of different characteristics, and the effect it produces in schools located in disadvantaged areas.

  8. The NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester: combining empirical, theoretical and experiential evidence to design and evaluate a large-scale implementation strategy.

    Science.gov (United States)

    Harvey, Gill; Fitzgerald, Louise; Fielden, Sandra; McBride, Anne; Waterman, Heather; Bamford, David; Kislov, Roman; Boaden, Ruth

    2011-08-23

    In response to policy recommendations, nine National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were established in England in 2008, aiming to create closer working between the health service and higher education and narrow the gap between research and its implementation in practice. The Greater Manchester (GM) CLAHRC is a partnership between the University of Manchester and twenty National Health Service (NHS) trusts, with a five-year mission to improve healthcare and reduce health inequalities for people with cardiovascular conditions. This paper outlines the GM CLAHRC approach to designing and evaluating a large-scale, evidence- and theory-informed, context-sensitive implementation programme. The paper makes a case for embedding evaluation within the design of the implementation strategy. Empirical, theoretical, and experiential evidence relating to implementation science and methods has been synthesised to formulate eight core principles of the GM CLAHRC implementation strategy, recognising the multi-faceted nature of evidence, the complexity of the implementation process, and the corresponding need to apply approaches that are situationally relevant, responsive, flexible, and collaborative. In turn, these core principles inform the selection of four interrelated building blocks upon which the GM CLAHRC approach to implementation is founded. These determine the organizational processes, structures, and roles utilised by specific GM CLAHRC implementation projects, as well as the approach to researching implementation, and comprise: the Promoting Action on Research Implementation in Health Services (PARIHS) framework; a modified version of the Model for Improvement; multiprofessional teams with designated roles to lead, facilitate, and support the implementation process; and embedded evaluation and learning. Designing and evaluating a large-scale implementation strategy that can cope with and

  9. Racism and Health I: Pathways and Scientific Evidence.

    Science.gov (United States)

    Williams, David R; Mohammed, Selina A

    2013-08-01

    This article reviews the scientific research that indicates that despite marked declines in public support for negative racial attitudes in the United States, racism, in its multiple forms, remains embedded in American society. The focus of the article is on the review of empirical research that suggests that racism adversely affects the health of non-dominant racial populations in multiple ways. First, institutional racism developed policies and procedures that have reduced access to housing, neighborhood and educational quality, employment opportunities and other desirable resources in society. Second, cultural racism, at the societal and individual level, negatively affects economic status and health by creating a policy environment hostile to egalitarian policies, triggering negative stereotypes and discrimination that are pathogenic and fostering health damaging psychological responses such as stereotype threat and internalized racism. Finally, a large and growing body of evidence indicates that experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioural patterns that increase health risks.

  10. Micro-Credit and Rural Poverty: An Analysis of Empirical Evidence

    OpenAIRE

    Chavan, P.; Ramakumar, R.

    2003-01-01

    This paper reviews empirical evidence on NGO-led micro-credit programmes in several developing countries, and compares them with state-led poverty alleviation schemes in India. It shows that micro-credit programmes have brought about a marginal improvement in the beneficiaries' income, though technological improvements are lacking due to its emphasis on ‘survival skills'. Also, in Bangladesh the practice of repayment of Grameen Bank loans by making fresh loans from moneylenders has resulted ...

  11. Expert opinion vs. empirical evidence: the precautionary principle applied to GM crops.

    Science.gov (United States)

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops.

  12. Empirical Evidence from Kenya

    African Journals Online (AJOL)

    FIRST LADY

    2011-01-18

    Jan 18, 2011 ... Empirical results reveal that consumption of sugar in. Kenya varies ... experiences in trade in different regions of the world. Some studies ... To assess the relationship between domestic sugar retail prices and sugar sales in ...

  13. A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care

    Directory of Open Access Journals (Sweden)

    Dipak Kalra

    2013-05-01

    Full Text Available Background The case has historically been presented that structured and/or coded electronic health records (EHRs benefit direct patient care, but the evidence base for this is not well documented.Methods We searched for evidence of direct patient care value from the use of structured and/or coded information within EHRs. We interrogated nine international databases from 1990 to 2011. Value was defined using the Institute of Medicine’s six areas for improvement for healthcare systems: effectiveness, safety, patient-centredness, timeliness, efficiency and equitability. We included studies satisfying the Cochrane Effective Practice and Organisation of Care (EPOC group criteria.Results Of 5016 potentially eligible papers, 13 studies satisfied our criteria: 10 focused on effectiveness, with eight demonstrating potential for improved proxy and actual clinical outcomes if a structured and/or coded EHR was combined with alerting or advisory systems in a focused clinical domain. Three studies demonstrated improvement in safety outcomes. No studies were found reporting value in relation to patient-centredness, timeliness, efficiency or equitability.Conclusions We conclude that, to date, there has been patchy effort to investigate empirically the value from structuring and coding EHRs for direct patient care. Future investments in structuring and coding of EHRs should be informed by robust evidence as to the clinical scenarios in which patient care benefits may be realised.

  14. Assessing the evidence of Six Sigma and Lean in the health care industry.

    Science.gov (United States)

    DelliFraine, Jami L; Langabeer, James R; Nembhard, Ingrid M

    2010-01-01

    Popular quality improvement tools such as Six Sigma and Lean Systems (SS/L) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether these 2 quality improvement tools actually improve health care quality. The authors conducted a comprehensive literature review to assess the empirical evidence relating SS/L to improved clinical outcomes, processes of care, and financial performance of health care organizations. The authors identified 177 articles on SS/L published in the last 10 years. However, only 34 of them reported any outcomes of the SS/L projects studied, and less than one-third of these articles included statistical analyses to test for significant changes in outcomes. This review demonstrates that there are significant gaps in the SS/L health care quality improvement literature and very weak evidence that SS/L improve health care quality.

  15. Educational Leaders and Emotions: An International Review of Empirical Evidence 1992-2012

    Science.gov (United States)

    Berkovich, Izhak; Eyal, Ori

    2015-01-01

    The aim of the present article is to review the international evidence about emotional aspects related to educational leaders. The review focuses on empirical studies published in peer-refereed educational journals between 1992 and 2012. First, we address the importance of researching emotions for understanding educational leaders. Next, we…

  16. What drives adult personality development? : A comparison of theoretical perspectives and empirical evidence

    NARCIS (Netherlands)

    Specht, J.; Bleidorn, W.; Denissen, J.J.A.; Hennecke, M.; Hutteman, R.; Luhmann, M.; Orth, U.; Reitz, A.K.; Zimmerman, J.

    2014-01-01

    Increasing numbers of empirical studies provide compelling evidence that personality traits change across the entire lifespan. What initiates this continuing personality development and how does this development proceed? In this paper, we compare six theoretical perspectives that offer testable

  17. Whole-body cryotherapy: empirical evidence and theoretical perspectives.

    Science.gov (United States)

    Bleakley, Chris M; Bieuzen, François; Davison, Gareth W; Costello, Joseph T

    2014-01-01

    Whole-body cryotherapy (WBC) involves short exposures to air temperatures below -100°C. WBC is increasingly accessible to athletes, and is purported to enhance recovery after exercise and facilitate rehabilitation postinjury. Our objective was to review the efficacy and effectiveness of WBC using empirical evidence from controlled trials. We found ten relevant reports; the majority were based on small numbers of active athletes aged less than 35 years. Although WBC produces a large temperature gradient for tissue cooling, the relatively poor thermal conductivity of air prevents significant subcutaneous and core body cooling. There is weak evidence from controlled studies that WBC enhances antioxidant capacity and parasympathetic reactivation, and alters inflammatory pathways relevant to sports recovery. A series of small randomized studies found WBC offers improvements in subjective recovery and muscle soreness following metabolic or mechanical overload, but little benefit towards functional recovery. There is evidence from one study only that WBC may assist rehabilitation for adhesive capsulitis of the shoulder. There were no adverse events associated with WBC; however, studies did not seem to undertake active surveillance of predefined adverse events. Until further research is available, athletes should remain cognizant that less expensive modes of cryotherapy, such as local ice-pack application or cold-water immersion, offer comparable physiological and clinical effects to WBC.

  18. Gathering Empirical Evidence Concerning Links between Computer Aided Design (CAD) and Creativity

    Science.gov (United States)

    Musta'amal, Aede Hatib; Norman, Eddie; Hodgson, Tony

    2009-01-01

    Discussion is often reported concerning potential links between computer-aided designing and creativity, but there is a lack of systematic enquiry to gather empirical evidence concerning such links. This paper reports an indication of findings from other research studies carried out in contexts beyond general education that have sought evidence…

  19. Judgments under competition and uncertainty : empirical evidence from online poker

    OpenAIRE

    Engelbergs, Jörg

    2010-01-01

    Playing poker has many aspects in common with the making of business decisions. Agents act in a strategically rich, dynamic environment, where they are repeatedly facing competition under uncertain prospects. Their main goal is to maximize their resources. However simple this goal is put down, it is difficult to fulfill. As vast and rich research has shown, heuristics and biases affect human decision-making. This work adds to these findings by providing empirical evidence for behavioral patte...

  20. Understanding the organization of public health delivery systems: an empirical typology.

    Science.gov (United States)

    Mays, Glen P; Scutchfield, F Douglas; Bhandari, Michelyn W; Smith, Sharla A

    2010-03-01

    Policy discussions about improving the U.S. health care system increasingly recognize the need to strengthen its capacities for delivering public health services. A better understanding of how public health delivery systems are organized across the United States is critical to improvement. To facilitate the development of such evidence, this article presents an empirical method of classifying and comparing public health delivery systems based on key elements of their organizational structure. This analysis uses data collected through a national longitudinal survey of local public health agencies serving communities with at least 100,000 residents. The survey measured the availability of twenty core public health activities in local communities and the types of organizations contributing to each activity. Cluster analysis differentiated local delivery systems based on the scope of activities delivered, the range of organizations contributing, and the distribution of effort within the system. Public health delivery systems varied widely in organizational structure, but the observed patterns of variation suggested that systems adhere to one of seven distinct configurations. Systems frequently migrated from one configuration to another over time, with an overall trend toward offering a broader scope of services and engaging a wider range of organizations. Public health delivery systems exhibit important structural differences that may influence their operations and outcomes. The typology developed through this analysis can facilitate comparative studies to identify which delivery system configurations perform best in which contexts.

  1. Policy lessons from health taxes: a systematic review of empirical studies

    Directory of Open Access Journals (Sweden)

    Alexandra Wright

    2017-06-01

    Full Text Available Abstract Background Taxes on alcohol and tobacco have long been an important means of raising revenues for public spending in many countries but there is increasing interest in using taxes on these, and other unhealthy products, to achieve public health goals. We present a systematic review of the research on health taxes, and aim to generate insights into how such taxes can: (i reduce consumption of targeted products and related harms; (ii generate revenues for health objectives and distribute the tax burden across income groups in an efficient and equitable manner; and (iii be made politically sustainable. Methods Six scientific and four grey-literature databases were searched for empirical studies of ‘health taxes’ – defined as those intended to increase the costs of manufacturing, distributing, retailing and/or consuming health-damaging products. Since reviews already exist of the evidence relating to traditional alcohol and tobacco excise taxes, we focus on other taxes such as taxes on retailers and manufacturers of unhealthy products, and consumer taxes targeting unhealthy foods, such as sugar-sweetened beverages. Results Ninety-one peer-reviewed and 11 grey-literature studies met our inclusion criteria. The review highlights a recent, rapid rise in research in this area, most of which focuses on high-income countries and on taxes on food products or nutrients. Findings demonstrate that high tax rates on sugar-sweetened beverages are likely to have a positive impact on health behaviours and outcomes, and, while taxes on products reduce demand, they add to fiscal revenues. Common concerns about health taxes are also discussed. Conclusions If the primary policy goal of a health tax is to reduce consumption of unhealthy products, then evidence supports the implementation of taxes that increase the price of products by 20% or more. However, where taxes are effective in changing health behaviours, the predictability of the revenue stream

  2. Policy lessons from health taxes: a systematic review of empirical studies.

    Science.gov (United States)

    Wright, Alexandra; Smith, Katherine E; Hellowell, Mark

    2017-06-19

    Taxes on alcohol and tobacco have long been an important means of raising revenues for public spending in many countries but there is increasing interest in using taxes on these, and other unhealthy products, to achieve public health goals. We present a systematic review of the research on health taxes, and aim to generate insights into how such taxes can: (i) reduce consumption of targeted products and related harms; (ii) generate revenues for health objectives and distribute the tax burden across income groups in an efficient and equitable manner; and (iii) be made politically sustainable. Six scientific and four grey-literature databases were searched for empirical studies of 'health taxes' - defined as those intended to increase the costs of manufacturing, distributing, retailing and/or consuming health-damaging products. Since reviews already exist of the evidence relating to traditional alcohol and tobacco excise taxes, we focus on other taxes such as taxes on retailers and manufacturers of unhealthy products, and consumer taxes targeting unhealthy foods, such as sugar-sweetened beverages. Ninety-one peer-reviewed and 11 grey-literature studies met our inclusion criteria. The review highlights a recent, rapid rise in research in this area, most of which focuses on high-income countries and on taxes on food products or nutrients. Findings demonstrate that high tax rates on sugar-sweetened beverages are likely to have a positive impact on health behaviours and outcomes, and, while taxes on products reduce demand, they add to fiscal revenues. Common concerns about health taxes are also discussed. If the primary policy goal of a health tax is to reduce consumption of unhealthy products, then evidence supports the implementation of taxes that increase the price of products by 20% or more. However, where taxes are effective in changing health behaviours, the predictability of the revenue stream is reduced. Hence, policy actors need to be clear about the primary

  3. Some empirical evidence on the relationship between inventory management and social responsibility

    Directory of Open Access Journals (Sweden)

    Khaled Elsayed

    2013-09-01

    Full Text Available Despite the crucial role that inventory plays in supply chain management (SCM, research that examines the relationship between inventory and corporate social responsibility (CSR is rare. This is surprising given the evidence that inventory represents a huge source of cost, a matter that is often reported as a major impediment in practicing social responsibility in SCM. As such, this paper fills this gape in literature by examining directly the effect of inventory management on CSR. Maximum-likelihood ordered logistic regression was performed on a sample of 38 Egyptian listed firms during the period from 2007 to 2010. The results demonstrate that inventory management exerts a positive and significant coefficient on CSR. Further analysis shows that inventory management cannot be safely dropped from model of analysis. Rather, inventory management does add something unique in explaining differences in CSR. For practitioners interested in optimizing their firms’ values, thinking in managing supply chain imperatives, and specially inventory, in terms of social responsibility may guide them to build up a stock of reputational capital that can be used, in turn, to increase the cost of their rivals. This study, to the best of knowledge, is the first one that offers empirical evidence regarding the effect of inventory management on CSR. Moreover, the paper adds to both SCM and CSR literature by providing empirical evidence from Egypt as an emerging market, where much of the existing evidence reflects experience from developed countries.

  4. Academic Advising Systems: A Systematic Literature Review of Empirical Evidence

    Directory of Open Access Journals (Sweden)

    Omiros Iatrellis

    2017-12-01

    Full Text Available This paper aims to provide the reader with a comprehensive background for understanding current knowledge on Academic Advising Systems (AAS and its impact on learning. It constitutes an overview of empirical evidence behind key objectives of the potential adoption of AAS in generic educational strategic planning. The researchers examined the literature on experimental case studies conducted in the domain during the past ten years (2008–2017. Search terms identified 98 mature pieces of research work, but inclusion criteria limited the key studies to 43. The authors analyzed the research questions, methodology, and findings of these published papers and categorized them accordingly. The results have highlighted three distinct major directions of the AAS empirical research. This paper discusses the emerged added value of AAS research and highlights the significance of further implications. Finally, the authors set their thoughts on possible uncharted key questions to investigate both from pedagogical and technical considerations.

  5. Assessing mental health clinicians' intentions to adopt evidence-based treatments: reliability and validity testing of the evidence-based treatment intentions scale.

    Science.gov (United States)

    Williams, Nathaniel J

    2016-05-05

    Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians' EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians' intentions to adopt EBTs. The study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed. Findings support the EBTI's factor structure (χ (2) = 3.96, df = 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians' observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p adoption at a 12-month follow-up (R (2) = .17, p adopt EBTs. Discussion focuses on research and practice applications.

  6. The health financing transition: a conceptual framework and empirical evidence.

    Science.gov (United States)

    Fan, Victoria Y; Savedoff, William D

    2014-03-01

    Almost every country exhibits two important health financing trends: health spending per person rises and the share of out-of-pocket spending on health services declines. We describe these trends as a "health financing transition" to provide a conceptual framework for understanding health markets and public policy. Using data over 1995-2009 from 126 countries, we examine the various explanations for changes in health spending and its composition with regressions in levels and first differences. We estimate that the income elasticity of health spending is about 0.7, consistent with recent comparable studies. Our analysis also shows a significant trend in health spending - rising about 1 per cent annually - which is associated with a combination of changing technology and medical practices, cost pressures and institutions that finance and manage healthcare. The out-of-pocket share of total health spending is not related to income, but is influenced by a country's capacity to raise general revenues. These results support the existence of a health financing transition and characterize how public policy influences these trends. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Putting mental health on the agenda for HIV+ women: a review of evidence from sub-Saharan Africa.

    Science.gov (United States)

    Brandt, René

    2009-01-01

    This article reviews the scientific literature regarding mental health services for poor HIV-infected women in sub-Saharan Africa and argues that they should constitute part of the healthcare agenda for these women. Key evidence points to the growing feminization of the HIV epidemic, as well as the differential social and economic impact of HIV on women. Further, HIV and poverty, both disproportionately affecting women, contribute independently and cumulatively to the risk for poor mental health. The limited empirical evidence regarding the mental health of this population is discussed. Multi-level psychosocial services, integrated within general health provision, are required to ensure long-term psychological benefits for HIV-infected women in the region.

  8. Law and Politics, an Emerging Epidemic: A Call for Evidence-Based Public Health Law.

    Science.gov (United States)

    Ulrich, Michael R

    2016-05-01

    As Jacobson v. Massachusetts recognized in 1905, the basis of public health law, and its ability to limit constitutional rights, is the use of scientific data and empirical evidence. Far too often, this important fact is lost. Fear, misinformation, and politics frequently take center stage and drive the implementation of public health law. In the recent Ebola scare, political leaders passed unnecessary and unconstitutional quarantine measures that defied scientific understanding of the disease and caused many to have their rights needlessly constrained. Looking at HIV criminalization and exemptions to childhood vaccine requirements, it becomes clear that the blame cannot be placed on the hysteria that accompanies emergencies. Indeed, these examples merely illustrate an unfortunate array of examples where empirical evidence is ignored in the hopes of quelling paranoia. These policy approaches are not only constitutionally questionable, they generate their own risk to public health. The ability of the law to jeopardize public health approaches to infectious disease control can, and should, be limited through a renewed emphasis on science as the foundation of public health, coordination through all levels and branches of government, and through a serious commitment by the judiciary to provide oversight. Infectious disease creates public anxiety, but this cannot justify unwarranted dogmatic approaches as a response. If we as a society hope to ensure efficient, constitutional control over the spread of disease, it is imperative that science take its rightful place at the forefront of governmental decision-making and judicial review. Otherwise, the law becomes its own public health threat.

  9. Mergers and Acquisitions in the Spanish Banking Industry: some Empirical Evidence.

    OpenAIRE

    Ignacio Fuentes; Teresa Sastre

    1999-01-01

    Since the late eighties, the Spanish banking system has been undergoing major changes that have affected both its structure and the nature of strategic interaction among banking institutions. Various different strategies have been adopted to tackle the demands of this new operating environment, one such strategy having been consolidation via mergers and acquisitions. This paper attempts to provide some empirical evidence on the impact of the consolidation process on the monetary transmission ...

  10. The ethical health lawyer: an empirical assessment of moral decision making.

    Science.gov (United States)

    Perry, Joshua E; Moore, Ilene N; Barry, Bruce; Clayton, Ellen Wright; Carrico, Amanda R

    2009-01-01

    Writing in 1999, legal ethics scholar Brad Wendel noted that "[v]ery little empirical work has been done on the moral decision making of lawyers." Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by the creation of a regular column "devoted to ethical issues arising in the practice of health law" in the Journal of Law, Medicine & Ethics, the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives.

  11. Collective animal navigation and migratory culture: from theoretical models to empirical evidence

    Science.gov (United States)

    Dell, Anthony I.

    2018-01-01

    Animals often travel in groups, and their navigational decisions can be influenced by social interactions. Both theory and empirical observations suggest that such collective navigation can result in individuals improving their ability to find their way and could be one of the key benefits of sociality for these species. Here, we provide an overview of the potential mechanisms underlying collective navigation, review the known, and supposed, empirical evidence for such behaviour and highlight interesting directions for future research. We further explore how both social and collective learning during group navigation could lead to the accumulation of knowledge at the population level, resulting in the emergence of migratory culture. This article is part of the theme issue ‘Collective movement ecology’. PMID:29581394

  12. Market power in the Nordic electricity wholesale market: A survey of the empirical evidence

    International Nuclear Information System (INIS)

    Fridolfsson, Sven-Olof; Tangeras, Thomas P.

    2009-01-01

    We review the recent empirical research assessing market power on the Nordic wholesale market for electricity, Nord Pool. The studies find no evidence of systematic exploitation of system level market power on Nord Pool. Local market power arising from transmission constraints seems to be more problematic in some price areas across the Nordic countries. Market power can manifest itself in a number of ways that have so far escaped empirical scrutiny. We discuss investment incentives, vertical integration and buyer power, as well as withholding of base-load (nuclear) capacity.

  13. Computational mate choice: theory and empirical evidence.

    Science.gov (United States)

    Castellano, Sergio; Cadeddu, Giorgia; Cermelli, Paolo

    2012-06-01

    The present review is based on the thesis that mate choice results from information-processing mechanisms governed by computational rules and that, to understand how females choose their mates, we should identify which are the sources of information and how they are used to make decisions. We describe mate choice as a three-step computational process and for each step we present theories and review empirical evidence. The first step is a perceptual process. It describes the acquisition of evidence, that is, how females use multiple cues and signals to assign an attractiveness value to prospective mates (the preference function hypothesis). The second step is a decisional process. It describes the construction of the decision variable (DV), which integrates evidence (private information by direct assessment), priors (public information), and value (perceived utility) of prospective mates into a quantity that is used by a decision rule (DR) to produce a choice. We make the assumption that females are optimal Bayesian decision makers and we derive a formal model of DV that can explain the effects of preference functions, mate copying, social context, and females' state and condition on the patterns of mate choice. The third step of mating decision is a deliberative process that depends on the DRs. We identify two main categories of DRs (absolute and comparative rules), and review the normative models of mate sampling tactics associated to them. We highlight the limits of the normative approach and present a class of computational models (sequential-sampling models) that are based on the assumption that DVs accumulate noisy evidence over time until a decision threshold is reached. These models force us to rethink the dichotomy between comparative and absolute decision rules, between discrimination and recognition, and even between rational and irrational choice. Since they have a robust biological basis, we think they may represent a useful theoretical tool for

  14. Mixed and Complex Mixed Migration during Armed Conflict: Multidimensional Empirical Evidence from Nepal.

    Science.gov (United States)

    Williams, Nathalie E

    Historically, legal, policy, and academic communities largely ascribed to a dichotomy between forced and voluntary migration, creating a black and white vision that was convenient for legal and policy purposes. More recently, discussions have begun addressing the possibility of mixed migration, acknowledging that there is likely a wide continuum between forced and voluntary, and most migrants likely move with some amount of compulsion and some volition, even during armed conflict. While the mixed migration hypothesis is well-received, empirical evidence is disparate and somewhat blunt at this point. In this article, I contribute a direct theoretical and causal pathway discussion of mixed migration. I also propose the complex mixed migration hypothesis, which argues that not only do non-conflict related factors influence migration during conflict, but they do so differently than during periods of relative peace. I empirically test both hypotheses in the context of the recent armed conflict in Nepal. Using detailed survey data and event history models, results provide strong evidence for both mixed migration and complex mixed migration during conflict hypotheses. These hypotheses and evidence suggest that armed conflict might have substantial impacts on long-term population growth and change, with significant relevance in both academic and policy spheres.

  15. A Systematic Literature Review of Empirical Evidence on Computer Games and Serious Games

    Science.gov (United States)

    Connolly, Thomas M.; Boyle, Elizabeth A.; MacArthur, Ewan; Hainey, Thomas; Boyle, James M.

    2012-01-01

    This paper examines the literature on computer games and serious games in regard to the potential positive impacts of gaming on users aged 14 years or above, especially with respect to learning, skill enhancement and engagement. Search terms identified 129 papers reporting empirical evidence about the impacts and outcomes of computer games and…

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

    Directory of Open Access Journals (Sweden)

    Gwenan M. Knight

    2016-01-01

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

  17. Do political or economic factors drive healthcare financing privatisations? Empirical evidence from OECD countries

    NARCIS (Netherlands)

    Wiese, Rasmus

    2013-01-01

    This paper adds new empirical evidence to the political economy literature of economic reform. One of the main contributions of this paper is the development of a novel methodology to identify privatisations. The methodology is a combination of the Bai & Perron structural break filter, and

  18. Does risk management contribute to IT project success? A meta-analysis of empirical evidence

    NARCIS (Netherlands)

    de Bakker, K.F.C.; Boonstra, A.; Wortmann, J.C.

    The question whether risk management contributes to IT project success is considered relevant by people from both academic and practitioners' communities already for a long time. This paper presents a meta-analysis of the empirical evidence that either supports or opposes the claim that risk

  19. Medicaid Crowd-Out of Private Long-Term Care Insurance Demand : Evidence from the Health and Retirement Survey

    NARCIS (Netherlands)

    Brown, J.R.; Coe, N.B.; Finkelstein, A.

    2006-01-01

    This paper provides empirical evidence of Medicaid crowd out of demand for private long-term care insurance. Using data on the near- and young-elderly in the Health and Retirement Survey, our central estimate suggests that a $10,000 decrease in the level of assets an individual can keep while

  20. Agro-ecology, household economics and malaria in Uganda: empirical correlations between agricultural and health outcomes.

    Science.gov (United States)

    Wielgosz, Benjamin; Kato, Edward; Ringler, Claudia

    2014-07-03

    This paper establishes empirical evidence relating the agriculture and health sectors in Uganda. The analysis explores linkages between agricultural management, malaria and implications for improving community health outcomes in rural Uganda. The goal of this exploratory work is to expand the evidence-base for collaboration between the agricultural and health sectors in Uganda. The paper presents an analysis of data from the 2006 Uganda National Household Survey using a parametric multivariate Two-Limit Tobit model to identify correlations between agro-ecological variables including geographically joined daily seasonal precipitation records and household level malaria risk. The analysis of agricultural and environmental factors as they affect household malaria rates, disaggregated by age-group, is inspired by a complimentary review of existing agricultural malaria literature indicating a gap in evidence with respect to agricultural management as a form of malaria vector management. Crop choices and agricultural management practices may contribute to vector control through the simultaneous effects of reducing malaria transmission, improving housing and nutrition through income gains, and reducing insecticide resistance in both malaria vectors and agricultural pests. The econometric results show the existence of statistically significant correlations between crops, such as sweet potatoes/yams, beans, millet and sorghum, with household malaria risk. Local environmental factors are also influential- daily maximum temperature is negatively correlated with malaria, while daily minimum temperature is positively correlated with malaria, confirming trends in the broader literature are applicable to the Ugandan context. Although not necessarily causative, the findings provide sufficient evidence to warrant purposefully designed work to test for agriculture health causation in vector management. A key constraint to modeling the agricultural basis of malaria transmission is

  1. The Political Economy of International Emission Trading Scheme Choice: Empirical Evidence

    DEFF Research Database (Denmark)

    Boom, J.T.; Svendsen, Gert Tinggaard

    2000-01-01

    The Kyoto Protocol allows emissions trading. It does however not specify how this is to take place and the discussion on the design of an emissions trading scheme is ongoing. In this paper, we give some empirical evidence on the preference of industry and environmental organizations for internati...... for international emissions trading scheme. Since they may have an influence on decision makers, their opinion is important. Our conclusion is that both industry and environmental organizations prefer credit trading, although for widely different reasons....

  2. Do political or economic factors drive healthcare financing privatisations? Empirical evidence from OECD countries

    OpenAIRE

    Wiese, Rasmus

    2013-01-01

    This paper adds new empirical evidence to the political economy literature of economic reform. One of the main contributions of this paper is the development of a novel methodology to identify privatisations. The methodology is a combination of the Bai & Perron structural break filter, and validation of the breaks identified by this filter using de jure evidence of reforms. 21 de facto healthcare financing privatisations are identified in a sample of 23 OECD countries. It is analysed which fa...

  3. Determinants of Financing Decisions in Innovative Firms: A Review on Theoretical Backgrounds and Empirical Evidence

    Directory of Open Access Journals (Sweden)

    Mihaela Diaconu

    2016-01-01

    Full Text Available We review some of the main aspects highlighted in the literature on financing innovation. Thetheoretical background related to the distinctive features of innovative firms impacting theirfinancing decisions and the empirical evidence is reviewed. The growing literature on the financingof innovation shows that the theoretical and empirical work are not always constant across thevarious samples and situations faced by firms as a result of generating new findings. We highlightthe interaction between financing choices for innovation and changing internal and externalcondition firms operate.

  4. Politics, welfare regimes, and population health: controversies and evidence.

    Science.gov (United States)

    Muntaner, Carles; Borrell, Carme; Ng, Edwin; Chung, Haejoo; Espelt, Albert; Rodriguez-Sanz, Maica; Benach, Joan; O'Campo, Patricia

    2011-09-01

    In recent years, a research area has emerged within social determinants of health that examines the role of politics, expressed as political traditions/parties and welfare state characteristics, on population health. To better understand and synthesise this growing body of evidence, the present literature review, informed by a political economy of health and welfare regimes framework, located 73 empirical and comparative studies on politics and health, meeting our inclusion criteria in three databases: PubMed (1948-), Sociological Abstracts (1953-), and ISI Web of Science (1900-). We identified two major research programmes, welfare regimes and democracy, and two emerging programmes, political tradition and globalisation. Primary findings include: (1) left and egalitarian political traditions on population health are the most salutary, consistent, and substantial; (2) the health impacts of advanced and liberal democracies are also positive and large; (3) welfare regime studies, primarily conducted among wealthy countries, find that social democratic regimes tend to fare best with absolute health outcomes yet consistently in terms of relative health inequalities; and (4) globalisation defined as dependency indicators such as trade, foreign investment, and national debt is negatively associated with population health. We end by discussing epistemological, theoretical, and methodological issues for consideration for future research. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  5. A knowledge management tool for public health: health-evidence.ca

    Directory of Open Access Journals (Sweden)

    Dobbins Maureen

    2010-08-01

    Full Text Available Abstract Background The ultimate goal of knowledge translation and exchange (KTE activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are

  6. Media and politics: Empirical data on their cross-influence in health policy.

    Science.gov (United States)

    2011-01-01

    OBJECTIVES: Despite the central influence of public policies on health and welfare, relatively little is known about actual health care policy-making processes. This presentation will offer preliminary results from a federally funded project aimed at gaining insights into the interrelations among interest-group strategies, media discourses and political debates in health care. The policy debate on health care privatization in Quebec is used as a case study. APPROACH: Two sources of data were used: media sources and political debates. Media sources were the six main provincial newspapers in Quebec, two national newspapers and The Canadian Press, as well as transcripts from specific news-related programs of three national television stations and two national radio stations. Political debates were obtained through transcripts of all question periods in the Parliament and debates in the standing committee on health. Sources were systematically searched to identify all relevant data. Multiple search syntaxes were developed and tested to maximize sensitivity and specificity. All data was entered and coded into qualitative analysis software. RESULTS: Data was analyzed longitudinally from June 2005 to January 1, 2010. Four levels of results will be presented: 1) Descriptive analysis of the interest groups involved, their policy preferences and the rhetoric they employed to support their views. 2) Descriptive analysis of the main policy proposals that structured the debate as well as of the coalition of groups behind those proposals. 3) Graphic longitudinal analysis of the intensity of the debate and of the relative importance and evolution of various policy proposals. 4) Preliminary results on the nature, direction and level of inter-influence between the policy and media agendas. CONCLUSION: This presentation provides empirical evidence on current policy-making processes in health care. It shows, unsurprisingly, that policy-making is a circumvoluted process of inter

  7. Status Concern and Relative Deprivation in China: Measures, Empirical Evidence and Economic and Policy Implications

    Science.gov (United States)

    Xi, CHEN

    2017-01-01

    Status concern and feelings of relative deprivation affect individual behaviour and well-being. Traditional norms and the alarming inequality in China have made relative deprivation increasingly intense for the Chinese population. This article reviews empirical literature on China that attempts to test the relative deprivation hypothesis, and also reviews the origins and pathways of relative deprivation, compares its economic measures in the literature and summarises the scientific findings. Drawing from solid empirical evidence, the author discusses the important policy implications on redistribution, official regulations and grassroots sanctions, and relative poverty alleviation. PMID:29033479

  8. Are stock market returns related to the weather effects? Empirical evidence from Taiwan

    Science.gov (United States)

    Chang, Tsangyao; Nieh, Chien-Chung; Yang, Ming Jing; Yang, Tse-Yu

    2006-05-01

    In this study, we employ a recently developed econometric technique of the threshold model with the GJR-GARCH process on error terms to investigate the relationships between weather factors and stock market returns in Taiwan using daily data for the period of 1 July 1997-22 October 2003. The major weather factors studied include temperature, humidity, and cloud cover. Our empirical evidence shows that temperature and cloud cover are two important weather factors that affect the stock returns in Taiwan. Our empirical findings further support the previous arguments that advocate the inclusion of economically neutral behavioral variables in asset pricing models. These results also have significant implications for individual investors and financial institutions planning to invest in the Taiwan stock market.

  9. Vertical Integration of Hospitals and Physicians: Economic Theory and Empirical Evidence on Spending and Quality.

    Science.gov (United States)

    Post, Brady; Buchmueller, Tom; Ryan, Andrew M

    2017-08-01

    Hospital-physician vertical integration is on the rise. While increased efficiencies may be possible, emerging research raises concerns about anticompetitive behavior, spending increases, and uncertain effects on quality. In this review, we bring together several of the key theories of vertical integration that exist in the neoclassical and institutional economics literatures and apply these theories to the hospital-physician relationship. We also conduct a literature review of the effects of vertical integration on prices, spending, and quality in the growing body of evidence ( n = 15) to evaluate which of these frameworks have the strongest empirical support. We find some support for vertical foreclosure as a framework for explaining the observed results. We suggest a conceptual model and identify directions for future research. Based on our analysis, we conclude that vertical integration poses a threat to the affordability of health services and merits special attention from policymakers and antitrust authorities.

  10. Effects of Monetary Shocks on Exchange Rate: Empirical Evidence from India

    Directory of Open Access Journals (Sweden)

    Sharma Chandan

    2017-08-01

    Full Text Available This paper examines the effect of monetary policy shocks on exchange rate in a Multiple Indicator Approach (MIA framework. This study has employed a monetary policy index of key monetary policy instruments in India (Bank rate, Cash Reserve Ratio, Repo and Reverse Repo rates. The study finds the empirical evidence for puzzling behavior of price level and exchange rate. Both price and exchange rate increase initially in response to a contractionary policy shock. Policy shocks affect output, inflation and exchange rate to an appreciable extent over a forecasting horizon of one year.

  11. Analysis of the distributional impact of out-of-pocket health payments: evidence from a public health insurance program for the poor in Mexico.

    Science.gov (United States)

    Garcia-Diaz, Rocio; Sosa-Rubi, Sandra G; Sosa-Rub, Sandra G

    2011-07-01

    Many governments have health programs focused on improving health among the poor and these have an impact on out-of-pocket health payments made by individuals. Therefore, one of the objectives of these programs is to reach the poorest and reduce their out-of-pocket expenditure. In this paper we propose the distributional poverty impact approach to measure the poverty impact of out-of-pocket health payments of different health financing policies. This approach is comparable to the impoverishment methodology proposed by Wagstaff and van Doorslaer (2003) that compares poverty indices before and after out-of-pocket health payments. In order to escape the specification of a particular poverty index, we use the marginal dominance approach that uses non-intersecting curves and can rank poverty reducing health financing policies. We present an empirical application of the out-of-pocket health payments for an innovative social financing policy implemented in Mexico named Seguro Popular. The paper finds evidence that Seguro Popular program has a better distributional poverty impact when families face illness when compared to other poverty reducing policies. The empirical dominance approach uses data from Mexico in 2006 and considers international poverty standards of $2 per person per day. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Evidence for the Effectiveness of Jungian Psychotherapy: A Review of Empirical Studies

    Directory of Open Access Journals (Sweden)

    Christian Roesler

    2013-10-01

    Full Text Available Since the 1990s several research projects and empirical studies (process and outcome on Jungian Psychotherapy have been conducted mainly in Germany and Switzerland. Prospective, naturalistic outcome studies and retrospective studies using standardized instruments and health insurance data as well as several qualitative studies of aspects of the psychotherapeutic process will be summarized. The studies are diligently designed and the results are well applicable to the conditions of outpatient practice. All the studies show significant improvements not only on the level of symptoms and interpersonal problems, but also on the level of personality structure and in every day life conduct. These improvements remain stable after completion of therapy over a period of up to six years. Several studies show further improvements after the end of therapy, an effect which psychoanalysis has always claimed. Health insurance data show that, after Jungian therapy, patients reduce health care utilization to a level even below the average of the total population. Results of several studies show that Jungian treatment moves patients from a level of severe symptoms to a level where one can speak of psychological health. These significant changes are reached by Jungian therapy with an average of 90 sessions, which makes Jungian psychotherapy an effective and cost-effective method. Process studies support Jungian theories on psychodynamics and elements of change in the therapeutic process. So finally, Jungian psychotherapy has reached the point where it can be called an empirically proven, effective method.

  13. Competition and quality indicators in the health care sector: empirical evidence from the Dutch hospital sector.

    Science.gov (United States)

    Croes, R R; Krabbe-Alkemade, Y J F M; Mikkers, M C

    2018-01-01

    There is much debate about the effect of competition in healthcare and especially the effect of competition on the quality of healthcare, although empirical evidence on this subject is mixed. The Netherlands provides an interesting case in this debate. The Dutch system could be characterized as a system involving managed competition and mandatory healthcare insurance. Information about the quality of care provided by hospitals has been publicly available since 2008. In this paper, we evaluate the relationship between quality scores for three diagnosis groups and the market power indicators of hospitals. We estimate the impact of competition on quality in an environment of liberalized pricing. For this research, we used unique price and production data relating to three diagnosis groups (cataract, adenoid and tonsils, bladder tumor) produced by Dutch hospitals in the period 2008-2011. We also used the quality indicators relating to these diagnosis groups. We reveal a negative relationship between market share and quality score for two of the three diagnosis groups studied, meaning that hospitals in competitive markets have better quality scores than those in concentrated markets. We therefore conclude that more competition is associated with higher quality scores.

  14. Empirical studies on usability of mHealth apps: a systematic literature review.

    Science.gov (United States)

    Zapata, Belén Cruz; Fernández-Alemán, José Luis; Idri, Ali; Toval, Ambrosio

    2015-02-01

    The release of smartphones and tablets, which offer more advanced communication and computing capabilities, has led to the strong emergence of mHealth on the market. mHealth systems are being used to improve patients' lives and their health, in addition to facilitating communication between doctors and patients. Researchers are now proposing mHealth applications for many health conditions such as dementia, autism, dysarthria, Parkinson's disease, and so on. Usability becomes a key factor in the adoption of these applications, which are often used by people who have problems when using mobile devices and who have a limited experience of technology. The aim of this paper is to investigate the empirical usability evaluation processes described in a total of 22 selected studies related to mHealth applications by means of a Systematic Literature Review. Our results show that the empirical evaluation methods employed as regards usability could be improved by the adoption of automated mechanisms. The evaluation processes should also be revised to combine more than one method. This paper will help researchers and developers to create more usable applications. Our study demonstrates the importance of adapting health applications to users' need.

  15. Bacterial clonal diagnostics as a tool for evidence-based empiric antibiotic selection.

    Science.gov (United States)

    Tchesnokova, Veronika; Avagyan, Hovhannes; Rechkina, Elena; Chan, Diana; Muradova, Mariya; Haile, Helen Ghirmai; Radey, Matthew; Weissman, Scott; Riddell, Kim; Scholes, Delia; Johnson, James R; Sokurenko, Evgeni V

    2017-01-01

    Despite the known clonal distribution of antibiotic resistance in many bacteria, empiric (pre-culture) antibiotic selection still relies heavily on species-level cumulative antibiograms, resulting in overuse of broad-spectrum agents and excessive antibiotic/pathogen mismatch. Urinary tract infections (UTIs), which account for a large share of antibiotic use, are caused predominantly by Escherichia coli, a highly clonal pathogen. In an observational clinical cohort study of urgent care patients with suspected UTI, we assessed the potential for E. coli clonal-level antibiograms to improve empiric antibiotic selection. A novel PCR-based clonotyping assay was applied to fresh urine samples to rapidly detect E. coli and the urine strain's clonotype. Based on a database of clonotype-specific antibiograms, the acceptability of various antibiotics for empiric therapy was inferred using a 20%, 10%, and 30% allowed resistance threshold. The test's performance characteristics and possible effects on prescribing were assessed. The rapid test identified E. coli clonotypes directly in patients' urine within 25-35 minutes, with high specificity and sensitivity compared to culture. Antibiotic selection based on a clonotype-specific antibiogram could reduce the relative likelihood of antibiotic/pathogen mismatch by ≥ 60%. Compared to observed prescribing patterns, clonal diagnostics-guided antibiotic selection could safely double the use of trimethoprim/sulfamethoxazole and minimize fluoroquinolone use. In summary, a rapid clonotyping test showed promise for improving empiric antibiotic prescribing for E. coli UTI, including reversing preferential use of fluoroquinolones over trimethoprim/sulfamethoxazole. The clonal diagnostics approach merges epidemiologic surveillance, antimicrobial stewardship, and molecular diagnostics to bring evidence-based medicine directly to the point of care.

  16. Mostly Heterosexual as a Distinct Sexual Orientation Group: A Systematic Review of the Empirical Evidence

    Science.gov (United States)

    Savin-Williams, Ritch C.; Vrangalova, Zhana

    2013-01-01

    We reviewed empirical evidence regarding whether mostly heterosexual exists as a sexual orientation distinct from two adjacent groups on a sexual continuum--exclusively heterosexual and substantially bisexual. We addressed the question: Do mostly heterosexuals show a unique profile of sexual and romantic characteristics that distinguishes them as…

  17. Evolution and early evidence of the impact of consumer-driven health plans: from e-commerce venture to health savings accounts.

    Science.gov (United States)

    Parente, Stephen T; Feldman, Roger

    2008-08-01

    Using results from peer-reviewed empirical analyses we describe the development and impact of the consumer-driven health plan market over the last 5 years. The results of these analyses show that consumers are responding to the financial incentives of these new health insurance benefits. Although the results may not always be what the consumer-driven health plan developers intended, there is clear evidence of 'consumerism', where individuals act in a way that generally increases their access to healthcare or investments, if the opportunity is present. Just as Medicare Part D enrollment demonstrated consumers could identify differences in prescription drug plans and make rational choices, so too are prospective patients able to function as consumers in the medical marketplace when give the opportunity.

  18. Education Improves Public Health and Promotes Health Equity.

    Science.gov (United States)

    Hahn, Robert A; Truman, Benedict I

    2015-01-01

    This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. © The Author(s) 2015.

  19. Efficiency indicators versus forntier methods: an empirical investigation of italian public hospitals

    Directory of Open Access Journals (Sweden)

    Lorenzo Clementi

    2013-05-01

    Full Text Available Efficiency has a key-role in the measurement of the impact of the National Health Service (NHS reforms. We investigate the issue of inefficiency in health sector and provide empirical evidence derived from Italian public hospitals. Despite the importance of efficiency measurement in health care services, only recently advanced econometric methods have been applied to hospital data. We provide a synoptic survey of few empirical analyses of efficiency measurement in health care services. An estimate of the cost efficiency level in Italian public hospitals during 2001-2003 is obtained through a sample. We propose an efficiency indicator and provide cost frontiers for such hospitals, using stochastic frontier analysis (SFA for longitudinal data.

  20. The Measurement of Central Bank Autonomy; Survey of Models, Indicators, and Empirical Evidence

    OpenAIRE

    Bernard J Laurens; Marco Arnone; Jean-François Segalotto

    2006-01-01

    This paper presents a survey of the literature on the measurement of central bank autonomy. We distinguish inputs that constitute the building blocks in the literature, and the literature that builds on them. Issues including sensitivity analysis, robustness, and endogeneity are discussed. The review shows that empirical evidence regarding the beneficial effects of central bank autonomy is substantial, although some technical issues still remain for further research. In particular, central ba...

  1. The Effect of Private Benefits of Control on Minority Shareholders: A Theoretical Model and Empirical Evidence from State Ownership

    Directory of Open Access Journals (Sweden)

    Kerry Liu

    2017-06-01

    Full Text Available Purpose: The purpose of this paper is to examine the effect of private benefits of control on minority shareholders. Design/methodology/approach: A theoretical model is established. The empirical analysis includes hand-collected data from a wide range of data sources. OLS and 2SLS regression analysis are applied with Huber-White standard errors. Findings: The theoretical model shows that, while private benefits are generally harmful to minority shareholders, the overall effect depends on the size of large shareholder ownership. The empirical evidence from government ownership is consistent with theoretical analysis. Research limitations/implications: The empirical evidence is based on a small number of hand-collected data sets of government ownership. Further studies can be expanded to other types of ownership, such as family ownership and financial institutional ownership. Originality/value: This study is the first to theoretically analyse and empirically test the effect of private benefits. In general, this study significantly contributes to the understanding of the effect of large shareholder and corporate governance.

  2. Altering micro-environments to change population health behaviour: towards an evidence base for choice architecture interventions

    Science.gov (United States)

    2013-01-01

    Background The idea that behaviour can be influenced at population level by altering the environments within which people make choices (choice architecture) has gained traction in policy circles. However, empirical evidence to support this idea is limited, especially its application to changing health behaviour. We propose an evidence-based definition and typology of choice architecture interventions that have been implemented within small-scale micro-environments and evaluated for their effects on four key sets of health behaviours: diet, physical activity, alcohol and tobacco use. Discussion We argue that the limitations of the evidence base are due not simply to an absence of evidence, but also to a prior lack of definitional and conceptual clarity concerning applications of choice architecture to public health intervention. This has hampered the potential for systematic assessment of existing evidence. By seeking to address this issue, we demonstrate how our definition and typology have enabled systematic identification and preliminary mapping of a large body of available evidence for the effects of choice architecture interventions. We discuss key implications for further primary research, evidence synthesis and conceptual development to support the design and evaluation of such interventions. Summary This conceptual groundwork provides a foundation for future research to investigate the effectiveness of choice architecture interventions within micro-environments for changing health behaviour. The approach we used may also serve as a template for mapping other under-explored fields of enquiry. PMID:24359583

  3. Does Access to Finance Lower Firms’ Cost of Capital? Empirical Evidence from International Manufacturing Data

    NARCIS (Netherlands)

    Lashitew, Addisu A.

    2011-01-01

    Lack of access to finance is argued to be one of the most binding constraints for firm growth. There is, however, limited empirical evidence on the relationship between access to finance and the cost of capital. This paper uses international manufacturing data to analyze the effect of access to

  4. Learning Analytics and Educational Data Mining in Practice: A Systematic Literature Review of Empirical Evidence

    Science.gov (United States)

    Papamitsiou, Zacharoula; Economides, Anastasios A.

    2014-01-01

    This paper aims to provide the reader with a comprehensive background for understanding current knowledge on Learning Analytics (LA) and Educational Data Mining (EDM) and its impact on adaptive learning. It constitutes an overview of empirical evidence behind key objectives of the potential adoption of LA/EDM in generic educational strategic…

  5. Price formation and intertemporal arbitrage within a low-liquidity framework. Empirical evidence from European natural gas markets

    Energy Technology Data Exchange (ETDEWEB)

    Nick, Sebastian

    2013-08-15

    In this study, the informational efficiency of the European natural gas market is analyzed by empirically investigating price formation and arbitrage efficiency between spot and futures markets. Econometric approaches are specified that explicitly account for nonlinearities and the low liquidity framework of the considered gas hubs. The empirical results reveal that price discovery takes place on the futures market, while the spot price subsequently follows the futures market price. Furthermore, there is empirical evidence of significant market frictions hampering intertemporal arbitrage. UK's NBP seems to be the hub at which arbitrage opportunities are exhausted most efficiently, although there is convergence in the degree of intertemporal arbitrage efficiency over time at the hubs investigated.

  6. Why borrowers pay premiums to larger lenders: Empirical evidence from sovereign syndicated loans

    OpenAIRE

    Hallak, Issam

    2002-01-01

    All other terms being equal (e.g. seniority), syndicated loan contracts provide larger lending compensations (in percentage points) to institutions funding larger amounts. This paper explores empirically the motivation for such a price design on a sample of sovereign syndicated loans in the period 1990-1997. I find strong evidence that a larger premium is associated with higher renegotiation probability and information asymmetries. It hardly has any impact on the number of lenders though. Thi...

  7. Measuring the health of the Indian elderly: evidence from National Sample Survey data

    Directory of Open Access Journals (Sweden)

    Mahal Ajay

    2010-11-01

    Full Text Available Abstract Background Comparable health measures across different sets of populations are essential for describing the distribution of health outcomes and assessing the impact of interventions on these outcomes. Self-reported health (SRH is a commonly used indicator of health in household surveys and has been shown to be predictive of future mortality. However, the susceptibility of SRH to influence by individuals' expectations complicates its interpretation and undermines its usefulness. Methods This paper applies the empirical methodology of Lindeboom and van Doorslaer (2004 to investigate elderly health in India using data from the 52nd round of the National Sample Survey conducted in 1995-96 that includes both an SRH variable as well as a range of objective indicators of disability and ill health. The empirical testing was conducted on stratified homogeneous groups, based on four factors: gender, education, rural-urban residence, and region. Results We find that region generally has a significant impact on how women perceive their health. Reporting heterogeneity can arise not only from cut-point shifts, but also from differences in health effects by objective health measures. In contrast, we find little evidence of reporting heterogeneity due to differences in gender or educational status within regions. Rural-urban residence does matter in some cases. The findings are robust with different specifications of objective health indicators. Conclusions Our exercise supports the thesis that the region of residence is associated with different cut-points and reporting behavior on health surveys. We believe this is the first paper that applies the Lindeboom-van Doorslaer methodology to data on the elderly in a developing country, showing the feasibility of applying this methodology to data from many existing cross-sectional health surveys.

  8. Bacterial clonal diagnostics as a tool for evidence-based empiric antibiotic selection.

    Directory of Open Access Journals (Sweden)

    Veronika Tchesnokova

    Full Text Available Despite the known clonal distribution of antibiotic resistance in many bacteria, empiric (pre-culture antibiotic selection still relies heavily on species-level cumulative antibiograms, resulting in overuse of broad-spectrum agents and excessive antibiotic/pathogen mismatch. Urinary tract infections (UTIs, which account for a large share of antibiotic use, are caused predominantly by Escherichia coli, a highly clonal pathogen. In an observational clinical cohort study of urgent care patients with suspected UTI, we assessed the potential for E. coli clonal-level antibiograms to improve empiric antibiotic selection. A novel PCR-based clonotyping assay was applied to fresh urine samples to rapidly detect E. coli and the urine strain's clonotype. Based on a database of clonotype-specific antibiograms, the acceptability of various antibiotics for empiric therapy was inferred using a 20%, 10%, and 30% allowed resistance threshold. The test's performance characteristics and possible effects on prescribing were assessed. The rapid test identified E. coli clonotypes directly in patients' urine within 25-35 minutes, with high specificity and sensitivity compared to culture. Antibiotic selection based on a clonotype-specific antibiogram could reduce the relative likelihood of antibiotic/pathogen mismatch by ≥ 60%. Compared to observed prescribing patterns, clonal diagnostics-guided antibiotic selection could safely double the use of trimethoprim/sulfamethoxazole and minimize fluoroquinolone use. In summary, a rapid clonotyping test showed promise for improving empiric antibiotic prescribing for E. coli UTI, including reversing preferential use of fluoroquinolones over trimethoprim/sulfamethoxazole. The clonal diagnostics approach merges epidemiologic surveillance, antimicrobial stewardship, and molecular diagnostics to bring evidence-based medicine directly to the point of care.

  9. EMPIRICAL EVIDENCE ON THE RELATIONSHIP BETWEEN MERGERS AND ACQUISITIONS AND THE ROMANIAN STOCK MARKET

    Directory of Open Access Journals (Sweden)

    Iamandi Irina Eugenia

    2010-12-01

    Full Text Available Based on empirical studies and theoretical evidence, the paper investigates the relationship between mergers and acquisitions in Romania and Romanian stock market, described by the BET and BET-C indexes. By using the Granger causality test for the number of mergers and acquisitions, the research results suggest that, for the market and period considered, one way and both ways relationships are present.

  10. Compliance costs caused by agency action? Empirical evidence and implications for tax compliance

    OpenAIRE

    Eichfelder, Sebastian; Kegels, Chantal

    2012-01-01

    The compliance costs of private taxpayers are not only affected by the tax law itself but also by its implementation through the tax authorities. In this paper we analyze the effect of the tax authorities on the burden of complying with tax regulations. Using survey data of Belgian businesses and controlling for potential endogeneity, we find empirical evidence that tax authority behavior is an important cost driver. According to our estimate, a customer-unfriendly tax administration increase...

  11. Ethics, equality and evidence in health promotion

    DEFF Research Database (Denmark)

    Vallgårda, Signild

    2014-01-01

    Abstract Aim: The Danish National Board of Health has expressed its commitment to social equality in health, evidence-informed health promotion and public health ethics, and has issued guidelines for municipalities on health promotion, in Danish named prevention packages.The aim of this article...... is to analyse whether the Board of Health adheres to ideals of equality, evidence and ethics in these guidelines. Methods: An analysis to detect statements about equity, evidence and ethics in 10 health promotion packages directed at municipalities with the aim of guiding the municipalities towards evidence......-informed disease prevention and health promotion. Results: Despite declared intentions of prioritizing social equality in health, these intentions are largely absent from most of the packages.When health inequalities are mentioned, focus is on the disadvantaged or the marginalized. Several interventions...

  12. Empirical investigation of purchasing power parity for Turkey: Evidence from recent nonlinear unit root tests

    Directory of Open Access Journals (Sweden)

    Dilem Yıldırım

    2017-06-01

    Full Text Available This study explores the empirical validity of the purchasing power parity (PPP hypothesis between Turkey and its four major trading partners, the European Union, Russia, China and the US. Accounting for the nonlinear nature of real exchange rates, we employ a battery of recently developed nonlinear unit root tests. Our empirical results reveal that nonlinear unit root tests deliver stronger evidence in favour of the PPP hypothesis when compared to the conventional unit root tests only if nonlinearities in real exchange rates are correctly specified. Furthermore, it emerges from our findings that the real exchange rates of the countries having a free trade agreement are more likely to behave as linear stationary processes.

  13. Switching benefits and costs in competitive health insurance markets: A conceptual framework and empirical evidence from the Netherlands.

    Science.gov (United States)

    Duijmelinck, Daniëlle M I D; Mosca, Ilaria; van de Ven, Wynand P M M

    2015-05-01

    Competitive health insurance markets will only enhance cost-containment, efficiency, quality, and consumer responsiveness if all consumers feel free to easily switch insurer. Consumers will switch insurer if their perceived switching benefits outweigh their perceived switching costs. We developed a conceptual framework with potential switching benefits and costs in competitive health insurance markets. Moreover, we used a questionnaire among Dutch consumers (1091 respondents) to empirically examine the relevance of the different switching benefits and costs in consumers' decision to (not) switch insurer. Price, insurers' service quality, insurers' contracted provider network, the benefits of supplementary insurance, and welcome gifts are potential switching benefits. Transaction costs, learning costs, 'benefit loss' costs, uncertainty costs, the costs of (not) switching provider, and sunk costs are potential switching costs. In 2013 most Dutch consumers switched insurer because of (1) price and (2) benefits of supplementary insurance. Nearly half of the non-switchers - and particularly unhealthy consumers - mentioned one of the switching costs as their main reason for not switching. Because unhealthy consumers feel not free to easily switch insurer, insurers have reduced incentives to invest in high-quality care for them. Therefore, policymakers should develop strategies to increase consumer choice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. THE DYNAMIC INTER-RELATIONSHIP BETWEEN OBESITY AND SCHOOL PERFORMANCE: NEW EMPIRICAL EVIDENCE FROM AUSTRALIA.

    Science.gov (United States)

    Nghiem, Son; Hoang, Viet-Ngu; Vu, Xuan-Binh; Wilson, Clevo

    2017-12-04

    This paper proposes a new empirical model for examining the relationship between obesity and school performance using the simultaneous equation modelling approach. The lagged effects of both learning and health outcomes were included to capture both the dynamic and inter-relational aspects of the relationship between obesity and school performance. The empirical application of this study used comprehensive data from the first five waves of the Longitudinal Study of Australian Children (LSAC), which commenced in 2004 (wave 1) and was repeated every two years until 2018. The study sample included 10,000 children, equally divided between two cohorts (infants and children) across Australia. The empirical results show that past learning and obesity status are strongly associated with most indicators of school outcomes, including reading, writing, spelling, grammar and numeracy national tests, and scores from the internationally standardized Peabody Picture Vocabulary Test and the Matrix Reasoning Test. The main findings of this study are robust due to the choice of obesity indicator and estimation methods.

  15. Priorities for action on the social determinants of health: Empirical evidence on the strongest associations with life expectancy in 54 low-income countries, 1990-2012.

    Science.gov (United States)

    Hauck, K; Martin, S; Smith, P C

    2016-10-01

    The WHO Commission on the Social Determinants of Health set out an impressive collection of policy proposals on the social determinants of health. However, a serious weakness for securing implementation is the difficulty for policymakers in identifying priorities for action. The objective of this study is to determine a small set of the most influential determinants using existing data and an empirical approach. 45 Indicators from the World Bank's World Development Indicators are selected to measure attainment for the determinants proposed by the Commission. Panel data models of life expectancy at birth for 54 low-income countries over the years 1990-2012 (1188 country-years) are estimated. Each determinant is subjected to a robustness test using Extreme Bound Analysis, to determine the stability of its estimated impact on life expectancy. For 20 robust and significant determinants the magnitude of association with life expectancy is determined. The largest average increases in life expectancy at 14.5 months per capita is associated with a one standard deviation reduction in HIV prevalence among children, followed by advances in gender equality at 9.4 months. Improvements in life expectancy between 6 and 9 months are associated with agricultural production, political stability, access to clean water and sanitation, good governance, and primary school enrolment. Improvements below 6 months are associated with increases in private health expenditure and overseas development assistance, and control of armed conflict and HIV prevalence among men. There is no evidence that national income, public spending on healthcare and education, secondary schooling, terms of international trade, employment, debt service and relief, out-of-pocket expenditures, agricultural ex- or imports, lifestock production, foreign investment, urbanization or environmental degradation are robustly associated with population health. Results provide support for the relevance of some proposed

  16. Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England.

    Science.gov (United States)

    Ovseiko, Pavel V; O'Sullivan, Catherine; Powell, Susan C; Davies, Stephen M; Buchan, Alastair M

    2014-11-08

    Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N = 17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the

  17. Trade liberalization, social policies and health: an empirical case study.

    Science.gov (United States)

    McNamara, Courtney

    2015-10-12

    This study investigates the health impacts of a major liberalization episode in the textile and clothing (T&C) sector. This episode triggered substantial shifts in employment across a wide range of countries. It is the first study to empirically link trade liberalization to health via changes in employment and offers some of the first empirical insights on how trade liberalization interacts with social policies to influence health. Data from 32 T&C reliant countries were analysed in reference to the pre- and post-liberalization periods of 2000-2004 and 2005-2009. Fuzzy-set qualitative comparative analysis (fsQCA) was used to examine the association between countries' a) level of development b) labour market and welfare state protections c) T&C employment changes and d) changes in adult female and infant mortality rates. Process tracing was used to further investigate these associations through twelve in-depth country studies. Results from the fsQCA relate changes in employment after the phase-out to both changing adult female and infant mortality rates. Findings from the in-depth country studies suggest that the worsening of adult female mortality rates is related to workers' lack of social protection, both in the context of T&C employment growth and loss. Overall, it is found that social protection is often inaccessible to the type of workers who may be the most vulnerable to processes of liberalization and that many workers are particularly vulnerable due to the structure of social protection policies. Social policies are therefore found to both moderate pathways to health and influence the type of health-related pathways resulting from trade liberalizing policies.

  18. E-shopping and its relationship with in-store shopping : empirical evidence from the Netherlands and the USA

    NARCIS (Netherlands)

    Farag, Sendy; Krizek, K.J.; Dijst, M.J.

    2006-01-01

    Despite considerable examination of the impact of telecommunications on travel, little empirical evidence sheds light on the impact of e-shopping on travel—a recent and increasingly popular form of telecommunications. This paper analyses determinants of online buying and their relationship with

  19. A study of the information seeking behaviour of hospital pharmacists: empirical evidence from Greece.

    Science.gov (United States)

    Kostagiolas, Petros A; Aggelopoulou, Vasiliki A; Niakas, Dimitris

    2011-12-01

    Hospital pharmacists need access to high-quality information in order to constantly update their knowledge and improve their skills. In their modern role, they are expected to address three types of challenges: scientific, organizational and administrative, thus having an increased need for adequate information and library services. This study investigates the information-seeking behaviour of public hospital pharmacists providing evidence from Greece that could be used to encourage the development of effective information hospital services and study the links between the information seeking behaviour of hospital pharmacists and their modern scientific and professional role. An empirical research was conducted between January and February 2010 with the development and distribution of a structured questionnaire. The questionnaire was filled in and returned by 88 public hospital pharmacists from a total of 286 working in all Greek public hospitals, providing a response rate of 31%. The hospital pharmacists in Greece are in search of scientific information and, more particularly, pharmaceutical information (e.g., drug indications, storage, dosage and prices). The Internet and the National Organization of Medicines are their main information sources, while the lack of time and organized information are the main obstacles they have to face when seeking information. The modern professional role of hospital pharmacists as invaluable contributors to efficient and safer healthcare services may be further supported through the development of specialized libraries and information services within Greek public hospitals. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  20. A comparison of usability methods for testing interactive health technologies: methodological aspects and empirical evidence.

    Science.gov (United States)

    Jaspers, Monique W M

    2009-05-01

    Usability evaluation is now widely recognized as critical to the success of interactive health care applications. However, the broad range of usability inspection and testing methods available may make it difficult to decide on a usability assessment plan. To guide novices in the human-computer interaction field, we provide an overview of the methodological and empirical research available on the three usability inspection and testing methods most often used. We describe two 'expert-based' and one 'user-based' usability method: (1) the heuristic evaluation, (2) the cognitive walkthrough, and (3) the think aloud. All three usability evaluation methods are applied in laboratory settings. Heuristic evaluation is a relatively efficient usability evaluation method with a high benefit-cost ratio, but requires high skills and usability experience of the evaluators to produce reliable results. The cognitive walkthrough is a more structured approach than the heuristic evaluation with a stronger focus on the learnability of a computer application. Major drawbacks of the cognitive walkthrough are the required level of detail of task and user background descriptions for an adequate application of the latest version of the technique. The think aloud is a very direct method to gain deep insight in the problems end users encounter in interaction with a system but data analyses is extensive and requires a high level of expertise both in the cognitive ergonomics and in computer system application domain. Each of the three usability evaluation methods has shown its usefulness, has its own advantages and disadvantages; no single method has revealed any significant results indicating that it is singularly effective in all circumstances. A combination of different techniques that compliment one another should preferably be used as their collective application will be more powerful than applied in isolation. Innovative mobile and automated solutions to support end-user testing have

  1. Empirical Evidence for the Outcomes of Therapeutic Video Games for Adolescents With Anxiety Disorders: Systematic Review

    Science.gov (United States)

    Barnes, Steven

    2018-01-01

    Background Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers. The growing discrepancy between demand for, and access to, clinical interventions for anxiety has led to the development of a range of eHealth (health care practice supported by electronic processes and communication) and mHealth (versions of eHealth using mobile devices) interventions. One such protocol is therapeutic games, which aim to provide clinical frameworks in dynamic, adaptable, and personalized virtual environments. Although some evidence exists to suggest therapeutic games are associated with reductions in subjective anxiety and observed stress reactivity, there is currently, to our knowledge, no systematic review of the adherence to, and effectiveness of, therapeutic games for adolescent anxiety. Objective The aim of this review was to establish the effectiveness of therapeutic games in making clinically measurable reductions in anxiety symptoms in adolescent samples. Methods A systematic search of the existing academic literature published between 1990 and July 2017 was conducted using the databases Journal of Medical Internet Research, Journal Storage, Psychology Articles, Psychology Info, ScienceDIRECT, and Scopus. Records linked to empirical papers on therapeutic games for anxiety using adolescent samples were evaluated. Results A total of 5 studies (N=410 participants) met the inclusion criteria, and 3 gamified anxiety interventions for adolescents were identified. The papers included a mixture of randomized controlled trials

  2. Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study.

    Science.gov (United States)

    Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2014-11-29

    There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government

  3. Including values in evidence-based policy making for breast screening: An empirically grounded tool to assist expert decision makers.

    Science.gov (United States)

    Parker, Lisa

    2017-07-01

    Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions. The decision making tool provided here is intended to assist with this process. The tool is modified from more general frameworks that are intended to assist with ethical decision making in public health, and informed by data drawn from previous empirical studies on values amongst Australian breast screening experts. It provides a structured format for breast screening committees to consider and discuss the values of themselves and others, suggests relevant topics for further inquiry and highlights areas of need for future research into the values of the public. It enables committees to publicly explain and justify their decisions with reference to values, improving transparency and accountability. It is intended to act alongside practices that seek to accommodate the values of individual women in the informed decision making process for personal decision making about participation in breast screening. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Evidence-based commissioning in the English NHS: who uses which sources of evidence? A survey 2010/2011.

    Science.gov (United States)

    Clarke, Aileen; Taylor-Phillips, Sian; Swan, Jacky; Gkeredakis, Emmanouil; Mills, Penny; Powell, John; Nicolini, Davide; Roginski, Claudia; Scarbrough, Harry; Grove, Amy

    2013-05-28

    To investigate types of evidence used by healthcare commissioners when making decisions and whether decisions were influenced by commissioners' experience, personal characteristics or role at work. Cross-sectional survey of 345 National Health Service (NHS) staff members. The study was conducted across 11 English Primary Care Trusts between 2010 and 2011. A total of 440 staff involved in commissioning decisions and employed at NHS band 7 or above were invited to participate in the study. Of those, 345 (78%) completed all or a part of the survey. Participants were asked to rate how important different sources of evidence (empirical or practical) were in a recent decision that had been made. Backwards stepwise logistic regression analyses were undertaken to assess the contributions of age, gender and professional background, as well as the years of experience in NHS commissioning, pay grade and work role. The extent to which empirical evidence was used for commissioning decisions in the NHS varied according to the professional background. Only 50% of respondents stated that clinical guidelines and cost-effectiveness evidence were important for healthcare decisions. Respondents were more likely to report use of empirical evidence if they worked in Public Health in comparison to other departments (pfinance OR  0.19, 95%CI 0.05 to 0.78, other departments OR 0.35, 95%CI 0.17 to 0.71) or if they were female (OR 1.8 95% CI 1.01 to 3.1) rather than male. Respondents were more likely to report use of practical evidence if they were more senior within the organisation (pay grade 8b or higher OR 2.7, 95%CI 1.4 to 5.3, p=0.004 in comparison to lower pay grades). Those trained in Public Health appeared more likely to use external empirical evidence while those at higher pay scales were more likely to use practical evidence when making commissioning decisions. Clearly, National Institute for Clinical Excellence (NICE) guidance and government publications (eg, National Service

  5. Evidence-based commissioning in the English NHS: who uses which sources of evidence? A survey 2010/2011

    Science.gov (United States)

    Clarke, Aileen; Taylor-Phillips, Sian; Swan, Jacky; Gkeredakis, Emmanouil; Mills, Penny; Powell, John; Nicolini, Davide; Roginski, Claudia; Scarbrough, Harry; Grove, Amy

    2013-01-01

    Objectives To investigate types of evidence used by healthcare commissioners when making decisions and whether decisions were influenced by commissioners’ experience, personal characteristics or role at work. Design Cross-sectional survey of 345 National Health Service (NHS) staff members. Setting The study was conducted across 11 English Primary Care Trusts between 2010 and 2011. Participants A total of 440 staff involved in commissioning decisions and employed at NHS band 7 or above were invited to participate in the study. Of those, 345 (78%) completed all or a part of the survey. Main outcome measures Participants were asked to rate how important different sources of evidence (empirical or practical) were in a recent decision that had been made. Backwards stepwise logistic regression analyses were undertaken to assess the contributions of age, gender and professional background, as well as the years of experience in NHS commissioning, pay grade and work role. Results The extent to which empirical evidence was used for commissioning decisions in the NHS varied according to the professional background. Only 50% of respondents stated that clinical guidelines and cost-effectiveness evidence were important for healthcare decisions. Respondents were more likely to report use of empirical evidence if they worked in Public Health in comparison to other departments (pfinance OR  0.19, 95%CI 0.05 to 0.78, other departments OR 0.35, 95%CI 0.17 to 0.71) or if they were female (OR 1.8 95% CI 1.01 to 3.1) rather than male. Respondents were more likely to report use of practical evidence if they were more senior within the organisation (pay grade 8b or higher OR 2.7, 95%CI 1.4 to 5.3, p=0.004 in comparison to lower pay grades). Conclusions Those trained in Public Health appeared more likely to use external empirical evidence while those at higher pay scales were more likely to use practical evidence when making commissioning decisions. Clearly, National Institute for

  6. Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies.

    Science.gov (United States)

    Latulippe, Karine; Hamel, Christine; Giroux, Dominique

    2017-04-27

    eHealth is developing rapidly and brings with it a promise to reduce social health inequalities (SHIs). Yet, it appears that it also has the potential to increase them. The general objective of this review was to set out how to ensure that eHealth contributes to reducing SHIs rather than exacerbating them. This review has three objectives: (1) identifying characteristics of people at risk of experiencing social inequality in health; (2) determining the possibilities of developing eHealth tools that avoid increasing SHI; and (3) modeling the process of using an eHealth tool by people vulnerable to SHI. Following the EPPI approach (Evidence for Policy and Practice of Information of the Institute of Education at the University of London), two databases were searched for the terms SHIs and eHealth and their derivatives in titles and abstracts. Qualitative, quantitative, and mixed articles were included and evaluated. The software NVivo (QSR International) was employed to extract the data and allow for a metasynthesis of the data. Of the 73 articles retained, 10 were theoretical, 7 were from reviews, and 56 were based on empirical studies. Of the latter, 40 used a quantitative approach, 8 used a qualitative approach, 4 used mixed methods approach, and only 4 were based on participatory research-action approach. The digital divide in eHealth is a serious barrier and contributes greatly to SHI. Ethnicity and low income are the most commonly used characteristics to identify people at risk of SHI. The most promising actions for reducing SHI via eHealth are to aim for universal access to the tool of eHealth, become aware of users' literacy level, create eHealth tools that respect the cultural attributes of future users, and encourage the participation of people at risk of SHI. eHealth has the potential to widen the gulf between those at risk of SHI and the rest of the population. The widespread expansion of eHealth technologies calls for rigorous consideration of

  7. CSR Disclosures in the Mining Industry: Empirical Evidence from Listed Mining Firms in Indonesia

    OpenAIRE

    Rina Asmeri; Tika Alvionita; Ardi Gunardi

    2017-01-01

    Companies that are involved in CSR strive to meet the expectations of stakeholders. Therefore, CSR and CSR reporting are tools of legitimacy to demonstrate its obedience (legitimacy theory). This study aims to look at empirical evidence on the effect of profitability and environmental performance on CSR disclosure. This study examined the target population of mining companies listed on the Indonesian Stock Exchange that included the CSR reporting in the 2010-2014 annual report, obtained a sam...

  8. Rethinking School Safety in the Age of Empire: Militarization, Mental Health, and State Violence

    Directory of Open Access Journals (Sweden)

    Laura Jordan Jaffee

    2018-02-01

    Full Text Available Calls for stricter gun control and mental health screening often come on the heels of school shootings, which have raised national concerns about school safety. The implication is that people with psychiatric disabilities are dangerous or threatening, and that preventing them from owning guns will make schools safer. This paper challenges this assumption by considering dominant discourses about school safety and mental health alongside the increasing militarization of U.S. schools. Advocating reducing violence by identifying individuals with psychiatric disabilities—or those labelled with mental illnesses presumed to render them dangerous—erases the profound state violence schools engender in the service of empire while perpetuating ableist assumptions about people with psychiatric disabilities. In the age of empire and endless imperialist war, we need to challenge prevailing conceptions of both school safety and mental health.

  9. The Schumpeterian Entrepreneur: A Review of the Empirical Evidence on the Antecedents, Behavior, and Consequences of Innovative Entrepreneurship

    NARCIS (Netherlands)

    J.H. Block (Jörn); C.O. Fisch (Christian); M. van Praag (Mirjam)

    2016-01-01

    textabstractInnovative entrepreneurship is considered an important pillar for economic development and has sparked a lively discussion in academia and practice alike. Oftentimes, however, the debate is not sufficiently grounded on solid empirical evidence. The academic literature is growing but very

  10. The Schumpeterian entrepreneur: a review of the empirical evidence on the antecedents, behavior and consequences of innovative entrepreneurship

    NARCIS (Netherlands)

    Block, J.O.; Fisch, C.O.; van Praag, M.

    2017-01-01

    Innovative entrepreneurship is considered an important pillar for economic development and has sparked a lively discussion in academia and practice alike. Oftentimes, however, the debate is not sufficiently grounded on solid empirical evidence. The academic literature is growing but very scattered

  11. Social Media for the Dissemination of Cochrane Child Health Evidence: Evaluation Study.

    Science.gov (United States)

    Dyson, Michele P; Newton, Amanda S; Shave, Kassi; Featherstone, Robin M; Thomson, Denise; Wingert, Aireen; Fernandes, Ricardo M; Hartling, Lisa

    2017-09-01

    .com scores for 61 studies promoted during the study period and recorded an average increase of 11 points. Research staff (n=3) contributed approximately 433 hours to promotion activities and planning (6.5 hours each per week) to implement the social media strategy, and study investigators reviewed all content (blog posts and tweets). This study provides empirical evidence on the use of a coordinated social media strategy for the dissemination of evidence to professionals providing health services to children and youth. The results and lessons learned from our study provide guidance for future knowledge dissemination activities using social media tools. ©Michele P Dyson, Amanda S Newton, Kassi Shave, Robin M Featherstone, Denise Thomson, Aireen Wingert, Ricardo M Fernandes, Lisa Hartling. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.09.2017.

  12. Abortion and Mental Health: Evaluating the Evidence

    Science.gov (United States)

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-01-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…

  13. Empirical evidence for site coefficients in building code provisions

    Science.gov (United States)

    Borcherdt, R.D.

    2002-01-01

    Site-response coefficients, Fa and Fv, used in U.S. building code provisions are based on empirical data for motions up to 0.1 g. For larger motions they are based on theoretical and laboratory results. The Northridge earthquake of 17 January 1994 provided a significant new set of empirical data up to 0.5 g. These data together with recent site characterizations based on shear-wave velocity measurements provide empirical estimates of the site coefficients at base accelerations up to 0.5 g for Site Classes C and D. These empirical estimates of Fa and Fnu; as well as their decrease with increasing base acceleration level are consistent at the 95 percent confidence level with those in present building code provisions, with the exception of estimates for Fa at levels of 0.1 and 0.2 g, which are less than the lower confidence bound by amounts up to 13 percent. The site-coefficient estimates are consistent at the 95 percent confidence level with those of several other investigators for base accelerations greater than 0.3 g. These consistencies and present code procedures indicate that changes in the site coefficients are not warranted. Empirical results for base accelerations greater than 0.2 g confirm the need for both a short- and a mid- or long-period site coefficient to characterize site response for purposes of estimating site-specific design spectra.

  14. Computational and empirical simulations of selective memory impairments: Converging evidence for a single-system account of memory dissociations.

    Science.gov (United States)

    Curtis, Evan T; Jamieson, Randall K

    2018-04-01

    Current theory has divided memory into multiple systems, resulting in a fractionated account of human behaviour. By an alternative perspective, memory is a single system. However, debate over the details of different single-system theories has overshadowed the converging agreement among them, slowing the reunification of memory. Evidence in favour of dividing memory often takes the form of dissociations observed in amnesia, where amnesic patients are impaired on some memory tasks but not others. The dissociations are taken as evidence for separate explicit and implicit memory systems. We argue against this perspective. We simulate two key dissociations between classification and recognition in a computational model of memory, A Theory of Nonanalytic Association. We assume that amnesia reflects a quantitative difference in the quality of encoding. We also present empirical evidence that replicates the dissociations in healthy participants, simulating amnesic behaviour by reducing study time. In both analyses, we successfully reproduce the dissociations. We integrate our computational and empirical successes with the success of alternative models and manipulations and argue that our demonstrations, taken in concert with similar demonstrations with similar models, provide converging evidence for a more general set of single-system analyses that support the conclusion that a wide variety of memory phenomena can be explained by a unified and coherent set of principles.

  15. Evidence for Mental Health Occupational Therapy

    Directory of Open Access Journals (Sweden)

    Danielle Hitch

    2015-09-01

    Full Text Available This article reports on the evidence for mental health occupational therapy in peer-reviewed journals from 2000 to 2013. Descriptive and inductive methods were used to address this question, with evidence from CINAHL, OTDBase, PSYCInfo, SCOPUS, and Google Scholar® included. Many articles (n = 1,747 were found that met the inclusion and exclusion criteria. A total of 47 different methods were used to develop evidence for mental health occupational therapy, and evidence appeared in 300 separate peer-reviewed journals. It takes on average 7 months for an article to progress from submission to acceptance, and a further 7 months to progress from acceptance to publication. More than 95% of articles published between 2000 and 2002 were cited at least once in the following decade, and around 70% of these citations were recorded in non-occupational therapy journals. The current evidence base for mental health occupational therapy is both substantial and diverse.

  16. Developing a conceptual framework of urban health observatories toward integrating research and evidence into urban policy for health and health equity.

    Science.gov (United States)

    Caiaffa, W T; Friche, A A L; Dias, M A S; Meireles, A L; Ignacio, C F; Prasad, A; Kano, M

    2014-02-01

    Detailed information on health linked to geographic, sociodemographic, and environmental data are required by city governments to monitor health and the determinants of health. These data are critical for guiding local interventions, resource allocation, and planning decisions, yet they are too often non-existent or scattered. This study aimed to develop a conceptual framework of Urban Health Observatories (UHOs) as an institutional mechanism which can help synthesize evidence and incorporate it into urban policy-making for health and health equity. A survey of a select group of existent UHOs was conducted using an instrument based on an a priori conceptual framework of key structural and functional characteristics of UHOs. A purposive sample of seven UHOs was surveyed, including four governmental, two non-governmental, and one university-based observatory, each from a different country. Descriptive and framework analysis methods were used to analyze the data and to refine the conceptual framework in light of the empirical data. The UHOs were often a product of unique historical circumstances. They were relatively autonomous and capable of developing their own locally sensitive agenda. They often had strong networks for accessing data and were able to synthesize them at the urban level as well as disaggregate them into smaller units. Some UHOs were identified as not only assessing but also responding to local needs. The findings from this study were integrated into a conceptual framework which illustrates how UHOs can play a vital role in monitoring trends in health determinants, outcomes, and equity; optimizing an intersectoral urban information system; incorporating research on health into urban policies and systems; and providing technical guidance on research and evidence-based policy making. In order to be most effective, UHOs should be an integral part of the urban governance system, where multiple sectors of government, the civil society, and businesses can

  17. Empirical Evidence of Stakeholder Management in Sports Clubs: The Impact of the Board of Directors

    OpenAIRE

    Esteve, M.; Di Lorenzo, F.; Inglés, E.; Puig, N.

    2011-01-01

    A major challenge for non-profit sports organizations is how to raise resources from their stakeholders. The present article empirically assesses how the management of stakeholders can affect the resources raised by non-profit sports organizations. The moderating effect of particular characteristics of the Board of Directors is also considered. Evidence is obtained by surveying a large sample of sports clubs from Catalonia, Spain. Results indicate how the quality of relations between sports c...

  18. The Efficiency of the Chinese Commodity Futures Markets: Development and Empirical Evidence

    Institute of Scientific and Technical Information of China (English)

    Yu Xin; Gongmeng Chen; Michael Firth

    2006-01-01

    This study investigates the efficiency of the Chinese metal futures (i.e. copper and aluminum) traded on China's Shanghai Futures Exchange. First, we thoroughly analyze the development of China's commodity futures markets, which provides a fundamental background. Then we examine the random walk and unbiasedness hypotheses for two metal futures during 1999-2004. Based on the empirical evidence, we argue that China's copper and aluminum futures markets are efficient, and that they aid the process of price discovery because futures prices can be considered as unbiased predictors of future spot prices. We attribute this efficiency to the regulatory changes made in 1999 and the increased financial skills and acumen of the participants in the market.

  19. Innovation in clean coal technologies. Empirical evidence from firm-level patent data

    Energy Technology Data Exchange (ETDEWEB)

    Kruse, Juergen [Koeln Univ. (Germany). Dept. of Economics; Koeln Univ. (Germany). Energiewirtschaftliches Inst.; Wetzel, Heike [Kassel Univ. (Germany). Inst. of Economics

    2016-02-15

    This article empirically analyzes supply-side and demand-side factors expected to a.ect innovation in clean coal technologies. Patent data from 93 national and international patent offices is used to construct new firm-level panel data on 3,648 clean coal innovators over the time period 1978 to 2009. The results indicate that on the supply-side a firm¡¯s history in clean coal patenting and overall propensity to patent positively a.ects clean coal innovation. On the demand-side we find strong evidence that environmental regulation of emissions, that is CO{sub 2}, NO{sub X} and SO{sub 2}, induces innovation in both efficiency improving combustion and after pollution control technologies.

  20. [DGRW-update: neurology--from empirical strategies towards evidence based interventions].

    Science.gov (United States)

    Schupp, W

    2011-12-01

    Stroke, Multiple Sclerosis (MS), traumatic brain injuries (TBI) and neuropathies are the most important diseases in neurological rehabilitation financed by the German Pension Insurance. The primary goal is vocational (re)integration. Driven by multiple findings of neuroscience research the traditional holistic approach with mainly empirically derived strategies was developed further and improved by new evidence-based interventions. This process had been, and continues to be, necessary to meet the health-economic pressures for ever shorter and more efficient rehab measures. Evidence-based interventions refer to symptom-oriented measures, to team-management concepts, as well as to education and psychosocial interventions. Drug therapy and/or neurophysiological measures can be added to increase neuroregeneration and neuroplasticity. Evidence-based aftercare concepts support sustainability and steadiness of rehab results.Mirror therapy, robot-assisted training, mental training, task-specific training, and above all constraint-induced movement therapy (CIMT) can restore motor arm and hand functions. Treadmill training and robot-assisted training improve stance and gait. Botulinum toxine injections in combination with physical and redressing methods are superior in managing spasticity. Guideline-oriented management of associated pain syndromes (myofascial, neuropathic, complex-regional=dystrophic) improve primary outcome and quality of life. Drug therapy with so-called co-analgetics and physical therapy play an important role in pain management. Swallowing disorders lead to higher mortality and morbidity in the acute phase; stepwise diagnostics (screening, endoscopy, radiology) and specific swallowing therapy can reduce these risks and frequently can restore normal eating und drinking.In our modern industrial societies communicative and cognitive disturbances are more impairing than the above mentioned disorders. Speech and language therapy (SLT) is dominant in

  1. Empirical Evidence for the Outcomes of Therapeutic Video Games for Adolescents With Anxiety Disorders: Systematic Review.

    Science.gov (United States)

    Barnes, Steven; Prescott, Julie

    2018-02-28

    Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers. The growing discrepancy between demand for, and access to, clinical interventions for anxiety has led to the development of a range of eHealth (health care practice supported by electronic processes and communication) and mHealth (versions of eHealth using mobile devices) interventions. One such protocol is therapeutic games, which aim to provide clinical frameworks in dynamic, adaptable, and personalized virtual environments. Although some evidence exists to suggest therapeutic games are associated with reductions in subjective anxiety and observed stress reactivity, there is currently, to our knowledge, no systematic review of the adherence to, and effectiveness of, therapeutic games for adolescent anxiety. The aim of this review was to establish the effectiveness of therapeutic games in making clinically measurable reductions in anxiety symptoms in adolescent samples. A systematic search of the existing academic literature published between 1990 and July 2017 was conducted using the databases Journal of Medical Internet Research, Journal Storage, Psychology Articles, Psychology Info, ScienceDIRECT, and Scopus. Records linked to empirical papers on therapeutic games for anxiety using adolescent samples were evaluated. A total of 5 studies (N=410 participants) met the inclusion criteria, and 3 gamified anxiety interventions for adolescents were identified. The papers included a mixture of randomized controlled trials, quasi-experimental studies, and

  2. Commodity culture: tropical health and hygiene in the British Empire.

    Science.gov (United States)

    Johnson, Ryan

    2008-06-01

    Before heading to a 'tropical' region of the Empire, British men and women spent considerable time and effort gathering outfit believed essential for their impending trip. Ordinary items such as soap, clothing, foodstuffs and bedding became transformed into potentially life-saving items that required the fastidious attention of any would-be traveller. Everyone from scientists and physicians to missionaries and administrators was bombarded by relentless advertising and abundant advice about the outfit needed to preserve health in a tropical climate. A closer look at this marketing exercise reveals much about the way people thought about tropical people, places, health and hygiene and how scientific and commercial influences shaped this Imperial commodity culture.

  3. Persistent Educational Advantage Across Three Generations: Empirical Evidence for Germany

    Directory of Open Access Journals (Sweden)

    Andrea Ziefle

    2016-12-01

    Full Text Available This article uses survey data from the German Socio-Economic Panel (GSOEP to analyze the persistence of educational attainment across three generations in Germany. I obtain evidence of a robust effect of grandparents' education on respondents' own educational attainment in West Germany, net of parental class, education, occupational status, family income, parents' relationship history, and family size. I also test whether the grandparent effect results from resource compensation or cumulative advantage and find empirical support for both mechanisms. In comparison, the intergenerational association between grandparents' and respondents' education is considerably weaker in East Germany and is also mediated completely by parental education. There are hardly any gender differences in the role of grandparents for respondents’ educational attainment, except for the fact that resource compensation is found to be exclusively relevant for women’s attainment in both West Germany and in East Germany after German reunification and the associated transition to an open educational system.

  4. Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons.

    Science.gov (United States)

    Crivelli, Luca; Filippini, Massimo; Mosca, Ilaria

    2006-05-01

    Switzerland (7.2 million inhabitants) is a federal state composed of 26 cantons. The autonomy of cantons and a particular health insurance system create strong heterogeneity in terms of regulation and organisation of health care services. In this study we use a single-equation approach to model the per capita cantonal expenditures on health care services and postulate that per capita health expenditures depend on some economic, demographic and structural factors. The empirical analysis demonstrates that a larger share of old people tends to increase health costs and that physicians paid on a fee-for-service basis swell expenditures, thus highlighting a possible phenomenon of supply-induced demand.

  5. Governance and Human Development: Empirical Evidence from ...

    African Journals Online (AJOL)

    This study empirically investigates the effects of governance on human development in Nigeria. Using annual time series data covering the period 1998 to 2010, obtained from various sources, and employing the classical least squares estimation technique, the study finds that corruption, foreign aid and government ...

  6. Selection Bias in Educational Transition Models: Theory and Empirical Evidence

    DEFF Research Database (Denmark)

    Holm, Anders; Jæger, Mads

    variables. This paper, first, explains theoretically how selection on unobserved variables leads to waning coefficients and, second, illustrates empirically how selection leads to biased estimates of the effect of family background on educational transitions. Our empirical analysis using data from...

  7. Like grandparents, like parents: Empirical evidence and psychoanalytic thinking on the transmission of parenting styles.

    Science.gov (United States)

    De Carli, Pietro; Tagini, Angela; Sarracino, Diego; Santona, Alessandra; Bonalda, Valentina; Cesari, Paola Elena; Parolin, Laura

    2018-01-01

    The authors discuss the issue of intergenerational transmission of parenting from an empirical and psychoanalytic perspective. After presenting a framework to explain their conception of parenting, they describe intergenerational transmission of parenting as a key to interpreting and eventually changing parenting behaviors. Then they present (1) the empirical approach aimed at determining if there is actually a stability across generations that contributes to harsh parenting and eventually maltreatment and (2) the psyphoanalytic thinking that seeks to explain the continuity in terms of representations and clinical phenomena. The authors also discuss the relationship between the attachment and the caregiving systems and hypothesize a common base for the two systems in childhood experience. Finally, they propose the psychoanalytic perspective as a fruitful theoretical framework to integrate the evidence for the neurophysiological mediators and moderators of intergenerational transmission. Psychoanalytically informed research can provide clinically relevant insights and hypotheses to be tested.

  8. Does journal club membership improve research evidence uptake in different allied health disciplines: a pre-post study

    Directory of Open Access Journals (Sweden)

    Lizarondo Lucylynn M

    2012-10-01

    Full Text Available Abstract Background Although allied health is considered to be one 'unit' of healthcare providers, it comprises a range of disciplines which have different training and ways of thinking, and different tasks and methods of patient care. Very few empirical studies on evidence-based practice (EBP have directly compared allied health professionals. The objective of this study was to examine the impact of a structured model of journal club (JC, known as iCAHE (International Centre for Allied Health Evidence JC, on the EBP knowledge, skills and behaviour of the different allied health disciplines. Methods A pilot, pre-post study design using maximum variation sampling was undertaken. Recruitment was conducted in groups and practitioners such as physiotherapists, occupational therapists, speech pathologists, social workers, psychologists, nutritionists/dieticians and podiatrists were invited to participate. All participating groups received the iCAHE JC for six months. Quantitative data using the Adapted Fresno Test (McCluskey & Bishop and Evidence-based Practice Questionnaire (Upton & Upton were collected prior to the implementation of the JC, with follow-up measurements six months later. Mean percentage change and confidence intervals were calculated to compare baseline and post JC scores for all outcome measures. Results The results of this study demonstrate variability in EBP outcomes across disciplines after receiving the iCAHE JC. Only physiotherapists showed statistically significant improvements in all outcomes; speech pathologists and occupational therapists demonstrated a statistically significant increase in knowledge but not for attitude and evidence uptake; social workers and dieticians/nutritionists showed statistically significant positive changes in their knowledge, and evidence uptake but not for attitude. Conclusions There is evidence to suggest that a JC such as the iCAHE model is an effective method for improving the EBP knowledge

  9. Measuring health lifestyles in a comparative analysis: theoretical issues and empirical findings.

    Science.gov (United States)

    Abel, T

    1991-01-01

    The concept of lifestyle bears great potential for research in medical sociology. Yet, weaknesses in current methods have restrained lifestyle research from realizing its full potentials. The present focus is on the links between theoretical conceptions and their empirical application. The paper divides into two parts. The first part provides a discussion of basic theoretical and methodological issues. In particular selected lines of thought from Max Weber are presented and their usefulness in providing a theoretical frame of reference for health lifestyle research is outlined. Next, a theory guided definition of the subject matter is introduced and basic problems in empirical applications of theoretical lifestyle concepts are discussed. In its second part the paper presents findings from comparative lifestyle analyses. Data from the U.S. and West Germany are utilized to explore issues of measurement equivalence and theoretical validity. Factor analyses indicate high conceptual equivalence for new measures of health lifestyle dimensions in both the U.S. and West Germany. Divisive cluster analyses detect three distinct lifestyle groups in both nations. Implications for future lifestyle research are discussed.

  10. GENDER EQUALITY ON CORPORATE BOARDS: TOWARDS A MORE INCLUSIVE AND RESPONSIBLE SOCIETY EMPIRICAL EVIDENCE FROM CROATIA

    OpenAIRE

    Tipurić, Darko; Lovrinčević, Marina; Lovrinčević Šelamov, Ana

    2015-01-01

    Gender diversity issues are receiving great attention worldwide. Empirical evidence suggests that stronger women representation on boards is positively related to financial performance. Across Europe, initiatives for greater women representation on boards are undertaken. They vary from one country to another and include proposals in national codes, voluntary initiatives, demands for disclosure of nomination policies and legal quotas for women on company boards. Recent data show that women acc...

  11. A generalized preferential attachment model for business firms growth rates. I. Empirical evidence

    Science.gov (United States)

    Pammolli, F.; Fu, D.; Buldyrev, S. V.; Riccaboni, M.; Matia, K.; Yamasaki, K.; Stanley, H. E.

    2007-05-01

    We introduce a model of proportional growth to explain the distribution P(g) of business firm growth rates. The model predicts that P(g) is Laplace in the central part and depicts an asymptotic power-law behavior in the tails with an exponent ζ = 3. Because of data limitations, previous studies in this field have been focusing exclusively on the Laplace shape of the body of the distribution. We test the model at different levels of aggregation in the economy, from products, to firms, to countries, and we find that the predictions are in good agreement with empirical evidence on both growth distributions and size-variance relationships.

  12. Evidence-based clinical practice

    DEFF Research Database (Denmark)

    Gluud, Christian

    2002-01-01

    , and single clinics. Accordingly, there is an urgent need to improve this situation. Guidelines for Good Clinical (Research) Practice, conduct of more trials as multicentre trials, The Consort Statement, and The Cochrane Collaboration may all help in the application of the best research evidence in clinical......Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may...... practice. By investments in education, applied research, and The Cochrane Collaboration, evidence-based medicine may form a stronger basis for clinical practice....

  13. Agenda Setting and Evidence in Maternal Health: Connecting Research and Policy in Timor-Leste.

    Science.gov (United States)

    Wild, Kayli; Kelly, Paul; Barclay, Lesley; Martins, Nelson

    2015-01-01

    The evidence-based policy (EBP) movement has received significant attention in the scientific literature; however, there is still very little empirical research to provide insight into how policy decisions are made and how evidence is used. The lack of research on this topic in low- and middle-income countries is of particular note. We examine the maternity waiting home policy in Timor-Leste to understand the role of context, policy characteristics, individual actors, and how evidence is used to influence the policy agenda. The research tracked the maternity waiting home policy from 2005 to 2009 and is based on in-depth interviews with 31 senior policy-makers, department managers, non-government organization representatives, and United Nations advisors. It is also informed by direct observation, attendance at meetings and workshops, and analysis of policy documents. The findings from this ethnographic case study demonstrate that although the post-conflict context opened up space for new policy ideas senior Ministry of Health officials rather than donors had the most power in setting the policy agenda. Maternity waiting homes were appealing because they were a visible, non-controversial, and logical solution to the problem of accessing maternal health services. Evidence was used in a variety of ways, from supporting pre-determined agendas to informing new policy directions. In the pursuit of EBP, we conclude that the power of research to inform policy lies in its timeliness and relevance, and is facilitated by the connection between researchers and policy-makers.

  14. The use of evidence in maternal health: Connecting research and policy in Timor-Leste

    Directory of Open Access Journals (Sweden)

    Kayli Janine Wild

    2015-09-01

    Full Text Available The evidence-based policy (EBP movement has received significant attention in the scientific literature, however, there is still very little empirical research to provide insight into how policy decisions are made and how evidence is used. The lack of research on this topic in low and middle-income countries is of particular note. We examine the maternity waiting home policy in Timor-Leste to understand the role of context, policy characteristics, individual actors and how evidence is used to influence the policy agenda. The research tracked the maternity waiting home policy from 2005 to 2009 and is based on in-depth interviews with 31 senior policy-makers, department managers, non-government organisation (NGO representatives and United Nations (UN advisors. It is also informed by direct observation, attendance at meetings and workshops and analysis of policy documents. The findings from this case study demonstrate the importance of political context, policy characteristics and the power of senior Ministry of Health officials rather than donors in setting the policy agenda. Maternity waiting homes were appealing because they were a visible, non-controversial and logical solution to the problem of accessing maternal health services. Evidence was used in a variety of ways, from supporting pre-determined agendas to informing new policy directions. In the pursuit of EBP, we conclude that the power of research to inform policy lies in its timeliness and relevance, and is facilitated by the connection between researchers and policy-makers.

  15. Challenges of Empirical Antibiotic Therapy for Community-Acquired Pneumonia in Children

    Directory of Open Access Journals (Sweden)

    Charlene M.C. Rodrigues, MBChB, MRCPCH

    2017-01-01

    Conclusions: Effective and timely treatment is required for CAP and empirical antibiotics are evidence-based and appropriate in most settings. However, better diagnostics and education to target treatment may help to prevent antibiotic resistance. Ensuring the secure financing of clean food and water, sanitation, and public health infrastructure are also required to reduce the burden of disease in children in developing countries.

  16. Insuring against Health Shocks: Health Insurance and Household Choices

    OpenAIRE

    Liu, Kai

    2015-01-01

    This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investme...

  17. Do People Overestimate Their Information Literacy Skills? A Systematic Review of Empirical Evidence on the Dunning-Kruger Effect

    Science.gov (United States)

    Mahmood, Khalid

    2016-01-01

    This systematic review has analyzed 53 English language studies that assessed and compared peoples' self-reported and demonstrated information literacy (IL) skills. The objective was to collect empirical evidence on the existence of Dunning-Kruger Effect in the area of information literacy. The findings clearly show that this theory works in this…

  18. Objections to routine clinical outcomes measurement in mental health services: any evidence so far?

    Science.gov (United States)

    MacDonald, Alastair J D; Trauer, Tom

    2010-12-01

    Routine clinical outcomes measurement (RCOM) is gaining importance in mental health services. To examine whether criticisms published in advance of the development of RCOM have been borne out by data now available from such a programme. This was an observational study of routine ratings using HoNOS65+ at inception/admission and again at discharge in an old age psychiatry service from 1997 to 2008. Testable hypotheses were generated from each criticism amenable to empirical examination. Inter-rater reliability estimates were applied to observed differences between scores between community and ward patients using resampling. Five thousand one hundred eighty community inceptions and 862 admissions had HoNOS65+ ratings at referral/admission and discharge. We could find no evidence of gaming (artificially worse scores at inception and better at discharge), selection, attrition or detection bias, and ratings were consistent with diagnosis and level of service. Anticipated low levels of inter-rater reliability did not vitiate differences between levels of service. Although only hypotheses testable from within RCOM data were examined, and only 46% of eligible episodes had complete outcomes data, no evidence of the alleged biases were found. RCOM seems valid and practical in mental health services.

  19. Virtuous States and Virtuous Traits: How the Empirical Evidence Regarding the Existence of Broad Traits Saves Virtue Ethics from the Situationist Critique

    Science.gov (United States)

    Jayawickreme, Eranda; Meindl, Peter; Helzer, Erik G.; Furr, R. Michael; Fleeson, William

    2014-01-01

    A major objection to the study of virtue asserts that the empirical psychological evidence implies traits have little meaningful impact on behavior, as slight changes in situational characteristics appear to lead to large changes in virtuous behavior. We argue in response that the critical evidence is not these effects of situations observed in…

  20. A comparison of the health status and health care utilization patterns between foreigners and the national population in Spain: new evidence from the Spanish National Health Survey.

    Science.gov (United States)

    Hernández-Quevedo, Cristina; Jiménez-Rubio, Dolores

    2009-08-01

    The increasing proportion of immigrants in Spanish society is placing pressure on the National Health Care System to accommodate the needs of this population group while keeping costs under control. In the year 2000, a law was approved in Spain according to which all people, regardless of their nationality, are entitled to use health care services under the same conditions as Spanish citizens, provided that they are registered in the local population census. However, empirical evidence about differences in health status and health care utilization between the immigrant and the Spanish population is insufficient. This paper uses the 2003 and 2006 Spanish National Health Surveys to explore the existence of inequalities in health and in the access to health services for the immigrant population living in Spain, relative to that of Spaniards. Our results show that there are different patterns in the level of health and the medical care use between the national and the foreign population in Spain: while immigrants' self-reported health relative to that of the Spanish population depends upon individual nationality, all immigrants, regardless of their nationality, seem to face barriers of entry to specialized care. Further research is needed to understand the nature of these barriers in order to design more effective health policies.

  1. Physical activity and cognitive-health content in top-circulating magazines, 2006-2008.

    Science.gov (United States)

    Price, Anna E; Corwin, Sara J; Friedman, Daniela B; Laditka, Sarah B; Colabianchi, Natalie; Montgomery, Kara M

    2011-04-01

    Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90-300 min of physical activity per wk). Socioeconomic status and education level were not mentioned in the text. Results suggest an opportunity for greater coverage regarding the role of physical activity in promoting cognitive health in popular media. Magazine content would benefit from including more empirical evidence, culturally sensitive content, and physical activity recommendations that are consistent with U.S. guidelines.

  2. The potential and peril of health insurance tobacco surcharge programs: evidence from Georgia's State Employees' Health Benefit Plan.

    Science.gov (United States)

    Liber, Alex C; Hockenberry, Jason M; Gaydos, Laura M; Lipscomb, Joseph

    2014-06-01

    A rapidly growing number of U.S. employers are charging health insurance surcharges for tobacco use to their employees. Despite their potential to price-discriminate, little systematic empirical evidence of the impacts of these tobacco surcharges has been published. We attempted to assess the impact of a health insurance surcharge for tobacco use on cessation among enrollees in Georgia's State Health Benefit Plan (GSHBP). We identified a group of enrollees in GSHBP who began paying the tobacco surcharge at the program's inception in July 2005. We examined the proportion of these enrollees who certified themselves and their family members as tobacco-free and no longer paid the surcharge through April 2011, and we defined this as implied cessation. We compared this proportion to a national expected annual 2.6% cessation rate. We also compared our observation group to a comparison group to assess surcharge avoidance. By April 2011, 45% of enrollees who paid a tobacco surcharge starting in July 2005 had certified themselves as tobacco-free. This proportion exceeded the expected cessation based on 3 times the national rate (p health insurance surcharges in changing behavior, are tempered by the important limitation that enrollees' certification of quitting was self-reported and not subject to additional, clinical verification.

  3. Empirical Support for Perceptual Conceptualism

    Directory of Open Access Journals (Sweden)

    Nicolás Alejandro Serrano

    2018-03-01

    Full Text Available The main objective of this paper is to show that perceptual conceptualism can be understood as an empirically meaningful position and, furthermore, that there is some degree of empirical support for its main theses. In order to do this, I will start by offering an empirical reading of the conceptualist position, and making three predictions from it. Then, I will consider recent experimental results from cognitive sciences that seem to point towards those predictions. I will conclude that, while the evidence offered by those experiments is far from decisive, it is enough not only to show that conceptualism is an empirically meaningful position but also that there is empirical support for it.

  4. Empirical studies on informal patient payments for health care services: a systematic and critical review of research methods and instruments

    Directory of Open Access Journals (Sweden)

    Pavlova Milena

    2010-09-01

    Full Text Available Abstract Background Empirical evidence demonstrates that informal patient payments are an important feature of many health care systems. However, the study of these payments is a challenging task because of their potentially illegal and sensitive nature. The aim of this paper is to provide a systematic review and analysis of key methodological difficulties in measuring informal patient payments. Methods The systematic review was based on the following eligibility criteria: English language publications that reported on empirical studies measuring informal patient payments. There were no limitations with regard to the year of publication. The content of the publications was analysed qualitatively and the results were organised in the form of tables. Data sources were Econlit, Econpapers, Medline, PubMed, ScienceDirect, SocINDEX. Results Informal payments for health care services are most often investigated in studies involving patients or the general public, but providers and officials are also sample units in some studies. The majority of the studies apply a single mode of data collection that involves either face-to-face interviews or group discussions. One of the main methodological difficulties reported in the publication concerns the inability of some respondents to distinguish between official and unofficial payments. Another complication is associated with the refusal of some respondents to answer questions on informal patient payments. We do not exclude the possibility that we have missed studies that reported in non-English language journals as well as very recent studies that are not yet published. Conclusions Given the recent evidence from research on survey methods, a self-administrated questionnaire during a face-to-face interview could be a suitable mode of collecting sensitive data, such as data on informal patient payments.

  5. A narrative synthesis of illustrative evidence on effects of capitation ...

    African Journals Online (AJOL)

    search, Accra, Ghana 4University of Professional Studies, Centre for Universal Health Coverage, Accra,. Ghana 5Radboud University ..... cases, the perceived extra cost is shifted to the consumer through un-authorized co-payment. ..... adherence: empirical evidence in general practice. Scand J Prim Health Care. 2013 ...

  6. Trends and structural shifts in health tourism: evidence from seasonal time-series data on health-related travel spending by Canada during 1970-2010.

    Science.gov (United States)

    Loh, Chung-Ping A

    2015-05-01

    There has been a growing interest in better understanding the trends and determinants of health tourism activities. While much of the expanding literature on health tourism offers theoretical or qualitative discussion, empirical evidences has been lacking. This study employs Canada's outbound health tourism activities as an example to examine the trends in health tourism and its association with changing domestic health care market characteristics. A time-series model that accounts for potential structural changes in the trend is employed to analyze the quarterly health-related travel spending series reported in the Balance of Payments Statistics (BOPS) during 1970-2010 (n = 156). We identified a structural shift point which marks the start of an accelerated growth of health tourism and a flattened seasonality in such activities. We found that the health tourism activities of Canadian consumers increase when the private investment in medical facilities declines or when the private MPI increases during the years following the structural-change. We discussed the possible linkage of the structural shift to the General Agreement on Trade in Services (GATS), which went into effect in January, 1995. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. HRM practices and knowledge processes outcomes: empirical evidence from a quasi-experiment on UK SMEs in the tourism hospitality and leisure sector

    OpenAIRE

    Andreas Georgiadis; Christos N. Pitelis

    2008-01-01

    This paper presents empirical evidence of the relationship between human resources practices and the effectiveness of a firm to capitalise on investment in knowledge as measured by the returns to innovation and business development expenditure. The empirical design is based on exploiting a natural experiment provided by a policy intervention that offers human resources-related support to small and medium sized enterprises in the UK Tourism Hospitality and Leisure sector. Our findings suggest ...

  8. Demand response in U.S. electricity markets: Empirical evidence

    International Nuclear Information System (INIS)

    Cappers, Peter; Goldman, Charles; Kathan, David

    2010-01-01

    Empirical evidence concerning demand response (DR) resources is needed in order to establish baseline conditions, develop standardized methods to assess DR availability and performance, and to build confidence among policymakers, utilities, system operators, and stakeholders that DR resources do offer a viable, cost-effective alternative to supply-side investments. This paper summarizes the existing contribution of DR resources in U.S. electric power markets. In 2008, customers enrolled in existing wholesale and retail DR programs were capable of providing ∝38,000 MW of potential peak load reductions in the United States. Participants in organized wholesale market DR programs, though, have historically overestimated their likely performance during declared curtailments events, but appear to be getting better as they and their agents gain experience. In places with less developed organized wholesale market DR programs, utilities are learning how to create more flexible DR resources by adapting legacy load management programs to fit into existing wholesale market constructs. Overall, the development of open and organized wholesale markets coupled with direct policy support by the Federal Energy Regulatory Commission has facilitated new entry by curtailment service providers, which has likely expanded the demand response industry and led to product and service innovation. (author)

  9. Employer-provided health insurance and the incidence of job lock: a literature review and empirical test.

    Science.gov (United States)

    Rashad, Inas; Sarpong, Eric

    2008-12-01

    The incidence of 'job lock' in the health insurance context has long been viewed as a potential problem with employer-provided health insurance, a concept that was instrumental in the passage of the United States Consolidated Omnibus Budget Reconciliation Act of 1986, and later, the Health Insurance Portability and Accountability Act in 1996. Several recent developments in healthcare in the USA include declining healthcare coverage and a noticeable shift in the burden of medical care costs to employees. If these developments cause employees with employer-provided health insurance to feel locked into their jobs, optimal job matches in the labor force may not take place. A summary of the seminal papers in the current literature on the topic of job lock is given, followed by an empirical exercise using single individuals from the National Health Interview Survey (1997-2003) and the 1979 cohort of the National Longitudinal Survey of Youth (1989-2000). Econometric methods used include difference in differences, ordinary least squares and individual fixed effects models, in gauging the potential effect that employer-provided health insurance may have on job tenure and voluntary job departure. Our findings are consistent with recent assertions that there is some evidence of job lock. Individuals with employer-provided health insurance stay on the job 16% longer and are 60% less likely to voluntarily leave their jobs than those with insurance that is not provided by their employers. Productivity may not be optimal if incentives are altered owing to the existence of fringe benefits, such as health insurance. Further research in this area should determine whether legislation beyond the Consolidated Omnibus Budget Reconciliation Act and Health Insurance Portability and Accountability Act laws is needed.

  10. Empirical evidence for multi-scaled controls on wildfire size distributions in California

    Science.gov (United States)

    Povak, N.; Hessburg, P. F., Sr.; Salter, R. B.

    2014-12-01

    Ecological theory asserts that regional wildfire size distributions are examples of self-organized critical (SOC) systems. Controls on SOC event-size distributions by virtue are purely endogenous to the system and include the (1) frequency and pattern of ignitions, (2) distribution and size of prior fires, and (3) lagged successional patterns after fires. However, recent work has shown that the largest wildfires often result from extreme climatic events, and that patterns of vegetation and topography may help constrain local fire spread, calling into question the SOC model's simplicity. Using an atlas of >12,000 California wildfires (1950-2012) and maximum likelihood estimation (MLE), we fit four different power-law models and broken-stick regressions to fire-size distributions across 16 Bailey's ecoregions. Comparisons among empirical fire size distributions across ecoregions indicated that most ecoregion's fire-size distributions were significantly different, suggesting that broad-scale top-down controls differed among ecoregions. One-parameter power-law models consistently fit a middle range of fire sizes (~100 to 10000 ha) across most ecoregions, but did not fit to larger and smaller fire sizes. We fit the same four power-law models to patch size distributions of aspect, slope, and curvature topographies and found that the power-law models fit to a similar middle range of topography patch sizes. These results suggested that empirical evidence may exist for topographic controls on fire sizes. To test this, we used neutral landscape modeling techniques to determine if observed fire edges corresponded with aspect breaks more often than expected by random. We found significant differences between the empirical and neutral models for some ecoregions, particularly within the middle range of fire sizes. Our results, combined with other recent work, suggest that controls on ecoregional fire size distributions are multi-scaled and likely are not purely SOC. California

  11. CSR Disclosures in the Mining Industry: Empirical Evidence from Listed Mining Firms in Indonesia

    Directory of Open Access Journals (Sweden)

    Rina Asmeri

    2017-06-01

    Full Text Available Companies that are involved in CSR strive to meet the expectations of stakeholders. Therefore, CSR and CSR reporting are tools of legitimacy to demonstrate its obedience (legitimacy theory. This study aims to look at empirical evidence on the effect of profitability and environmental performance on CSR disclosure. This study examined the target population of mining companies listed on the Indonesian Stock Exchange that included the CSR reporting in the 2010-2014 annual report, obtained a sample of 18 companies. By using multiple regression analysis test, there is no significant influence between profitability to CSR disclosure, whilst environmental performance has effect on CSR disclosure.

  12. Opportunities and challenges of Web 2.0 within the health care systems: an empirical exploration.

    Science.gov (United States)

    Lupiáñez-Villanueva, Francisco; Mayer, Miquel Angel; Torrent, Joan

    2009-09-01

    The Internet has become one of the main drivers of e-health. Whilst its impact and potential is being analysed, the Web 2.0 phenomenon has reached the health field and has emerged as a buzzword that people use to describe a wide range of online activities and applications. The aims of this article are: to explore the opportunities and challenges of the Web 2.0 within the health care system and to identify the gap between the potential of these online activities and applications and the empirical data. The analysis is based on: online surveys to physicians, nurses, pharmacist and patient support groups; static web shot analysis of 1240 web pages and exploration of the most popular Web 2.0 initiatives. The empirical results contrast with the Web 2.0 trends identified. Whereas the main characteristic of the Web 2.0 is the opportunity for social interaction, the health care system at large could currently be characterised by: a lack of interactive communication technologies available on the Internet; a lack of professional production of health care information on the Internet, and a lack of interaction between these professionals and patients on the Internet. These results reveal a scenario away from 2.0 trends.

  13. Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion.

    Science.gov (United States)

    Murrihy, Rachael C; Byrne, Mitchell K; Gonsalvez, Craig J

    2009-02-01

    Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training.

  14. Corruption in the health care system: the circumstantial evidence.

    Science.gov (United States)

    Ibrahim, Joseph; Majoor, Jennifer

    2002-01-01

    Health care systems are under intense scrutiny, and there is an increasing emphasis on patient safety and quality of care in general. Evidence continues to emerge demonstrating that health systems are performing at sub-optimal levels. The evidence includes the under-use, over-use and mis-use of health care services; new standards asking for respect, dignity, honesty and transparency; the corporatization of health; and the existing inequalities in power and health outcomes. Recommendations for improving health care often refer to increasing the level of collaboration and consultation. These strategies are unlikely to remedy the root causes of our ailing health systems if we accept the circumstantial evidence that suggests the system is rotten.

  15. Empirical Evidence for the Relation between Customer Satisfaction and Business Performance

    NARCIS (Netherlands)

    A. van der Wiele (Ton); J.P.P.E.F. Boselie (Paul); M. Hesselink

    2001-01-01

    textabstractThis paper focuses on the analysis of empirical data on customer satisfaction and the relationship with hard organisational performance data. The organisation is a Flexcompany with its headquarters in The Netherlands, but also operating in other countries in Europe. The empirical data on

  16. Building an evidence base for occupational health interventions

    NARCIS (Netherlands)

    Verbeek, Jos; Husman, Kaj; van Dijk, Frank; Jauhiainen, Merja; Pasternack, Iris; Vainio, Harri

    2004-01-01

    This article summarizes arguments for building an evidence base for occupational health. Evidence is needed on the most effective ways of eliminating health hazards in the workplace and at work, enhancing healthy behavior or the empowerment of workers, and preventing and treating occupational

  17. An empirical test of Maslow's theory of need hierarchy using hologeistic comparison by statistical sampling.

    Science.gov (United States)

    Davis-Sharts, J

    1986-10-01

    Maslow's hierarchy of basic human needs provides a major theoretical framework in nursing science. The purpose of this study was to empirically test Maslow's need theory, specifically at the levels of physiological and security needs, using a hologeistic comparative method. Thirty cultures taken from the 60 cultural units in the Health Relations Area Files (HRAF) Probability Sample were found to have data available for examining hypotheses about thermoregulatory (physiological) and protective (security) behaviors practiced prior to sleep onset. The findings demonstrate there is initial worldwide empirical evidence to support Maslow's need hierarchy.

  18. The Developing Role of Evidence-Based Environmental Health

    Directory of Open Access Journals (Sweden)

    Surindar Dhesi

    2015-10-01

    Full Text Available There has been renewed recognition that proactive strategies and interventions can address the social determinants of health, and the environmental health profession is well placed to effect positive change in many of these determinants. This qualitative research has revealed differences in the perceptions, experiences, and understandings of evidence-based practice among public health professionals from different backgrounds across different services in health care and local government in England. The absence of a strong tradition of evidence-based practice in environmental health appears to be a disadvantage in securing funding and playing a full role, as it has become the expectation in the new public health system. This has, at times, resulted in tensions between professionals with different backgrounds and frustration on the part of environmental health practitioners, who have a tradition of responding quickly to new challenges and “getting on with the job.” There is generally a willingness to develop evidence-based practice in environmental health; however, this will take time and investment.

  19. Developing an evidence-based approach to Public Health Nutrition: translating evidence into policy.

    Science.gov (United States)

    Margetts, B; Warm, D; Yngve, A; Sjöström, M

    2001-12-01

    The aim of this paper is to highlight the importance of an evidence-based approach to the development, implementation and evaluation of policies aimed at improving nutrition-related health in the population. Public Health Nutrition was established to realise a population-level approach to the prevention of the major nutrition-related health problems world-wide. The scope is broad and integrates activity from local, national, regional and international levels. The aim is to inform and develop coherent and effective policies that address the key rate-limiting steps critical to improving nutrition-related public health. This paper sets out the rationale for an evidence-based approach to Public Health Nutrition developed under the umbrella of the European Network for Public Health Nutrition.

  20. Is migration status a determinant of urban nutrition insecurity? Empirical evidence from Mumbai city, India.

    Science.gov (United States)

    Choudhary, Neetu; Parthasarathy, D

    2009-09-01

    From an economic perspective that understood it as a spillover of development, migration is now also the subject of socioeconomic investigation incorporating the problems of assimilation, relative deprivation and isolation. The corollary is an increased emphasis on economic and social understanding of migration and its consequences. This entails studying migration or migrants in terms of factors beyond income. Health outcome is important among these non-income factors but at the same time remains less studied. Although there have been a few influential studies on health issues as linked to migration status, the issue of malnutrition in this context continues to be under-researched. This paper explores, theoretically and empirically, migration status and malnutrition in Mumbai in India. An econometric analysis of Demographic and Health Survey data gives insight into the dynamics of child and maternal undernutrition as mediated by migration status in Mumbai.

  1. Goodness! The empirical turn in health care ethics

    NARCIS (Netherlands)

    Willems, D.; Pols, J.

    2010-01-01

    This paper is intended to encourage scholars to submit papers for a symposium and the next special issue of Medische Antropologie which will be on empirical studies of normative questions. We describe the ‘empirical turn’ in medical ethics. Medical ethics and bioethics in general have witnessed a

  2. Intermediation by Banks and Economic Growth: A Review of Empirical Evidence

    Directory of Open Access Journals (Sweden)

    Marijana Bađun

    2009-06-01

    Full Text Available This paper provides a review of empirical research on the link between financial intermediation by banks and economic growth. Special attention is paid to the issues of causality, non-linearity, time perspective, financial intermediation proxies, and interaction terms. The review shows that there are still quite a few unresolved issues in empirical research, which causes scepticism towards prioritizing financial sector policies in order to cause economic growth. Progress in the finance and growth literature is slow and researchers seem to go round in circles. A possibly fruitful direction for future empirical research is the relationship between government and banks, especially from the standpoint of political economy.

  3. Reduction of inequalities in health: assessing evidence-based tools

    Directory of Open Access Journals (Sweden)

    Shea Beverley

    2006-09-01

    Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

  4. Using Mental Health Consultation to Decrease Disruptive Behaviors in Preschoolers: Adapting an Empirically-Supported Intervention

    Science.gov (United States)

    Williford, Amanda P.; Shelton, Terri L.

    2008-01-01

    Background: This study examined the effectiveness of an adaptation of an empirically-supported intervention delivered using mental health consultation to preschoolers who displayed elevated disruptive behaviors. Method: Ninety-six preschoolers, their teachers, and their primary caregivers participated. Children in the intervention group received…

  5. Economic theory and evidence on smoking behavior of adults.

    Science.gov (United States)

    Sloan, Frank A; Wang, Yang

    2008-11-01

    To describe: (i) three alternative conceptual frameworks used by economists to study addictive behaviors: rational, imperfectly rational and irrational addiction; (ii) empirical economic evidence on each framework and specific channels to explain adult smoking matched to the frameworks; and (iii) policy implications for each framework. A systematic review and appraisal of important theoretical and empirical economic studies on smoking. There is some empirical support for each framework. For rational and imperfectly rational addiction there is some evidence that anticipated future cigarette prices influence current cigarette consumption, and quitting costs are high for smokers. Smokers are more risk-tolerant in the financial domain than are others and tend to attach a lower value to being in good health. Findings on differences in rates of time preference by smoking status are mixed; however, short-term rates are higher than long-term rates for both smokers and non-smokers, a stylized fact consistent with hyperbolic discounting. The economic literature lends no empirical support to the view that mature adults smoke because they underestimate the probability of harm to health from smoking. In support of the irrationality framework, smokers tend to be more impulsive than others in domains not related directly to smoking, implying that they may be sensitive to cues that trigger smoking. Much promising economic research uses the imperfectly rational addiction framework, but empirical research based on this framework is still in its infancy.

  6. Climate change and the collapse of the Akkadian empire: Evidence from the deep sea

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, H.M.; Menocal, P.B. de; Hemming, S.; Hemming, G.; Brown, F.H.; Guilderson, T.; Sirocko, F.

    2000-04-01

    The Akkadian empire ruled Mesopotamia from the headwaters of the Tigris-Euphrates Rivers to the Persian Gulf during the late third millennium B.C. Archeological evidence has shown that this highly developed civilization collapsed abruptly near 4,170 {+-} 150 calendar yr B.P., perhaps related to a shift to more arid conditions. Detailed paleoclimate records to test this assertion from Mesopotamia are rare, but changes in regional aridity are preserved in adjacent ocean basins. The authors document Holocene changes in regional aridity using mineralogic and geochemical analyses of a marine sediment core from the Gulf of Oman, which is directly downwind of Mesopotamian dust source areas and archeological sites. Results document a very abrupt increase in eolian dust and Mesopotamian aridity, accelerator mass spectrometer radiocarbon dates to 4,025 {+-} 125 calendar yr B.P., which persisted for {approximately} 300 yr. Radiogenic (Nd and Sr) isotope analyses confirm that the observed increase in mineral dust was derived from Mesopotamian source areas. Geochemical correlation of volcanic ash shards between the archeological site and marine sediment record establishes a direct temporal link between Mesopotamian aridification and social collapse, implicating a sudden shift to more arid conditions as a key factor contributing to the collapse of the Akkadian empire.

  7. Implanting inequality: empirical evidence of social and ethical risks of implantable radio-frequency identification (RFID) devices.

    Science.gov (United States)

    Monahan, Torin; Fisher, Jill A

    2010-10-01

    The aim of this study was to assess empirically the social and ethical risks associated with implantable radio-frequency identification (RFID) devices. Qualitative research included observational studies in twenty-three U.S. hospitals that have implemented new patient identification systems and eighty semi-structured interviews about the social and ethical implications of new patient identification systems, including RFID implants. The study identified three primary social and ethical risks associated with RFID implants: (i) unfair prioritization of patients based on their participation in the system, (ii) diminished trust of patients by care providers, and (iii) endangerment of patients who misunderstand the capabilities of the systems. RFID implants may aggravate inequalities in access to care without any clear health benefits. This research underscores the importance of critically evaluating new healthcare technologies from the perspective of both normative ethics and empirical ethics.

  8. Information overload, choice deferral, and moderating role of need for cognition: Empirical evidence

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Pilli

    2016-03-01

    Full Text Available ABSTRACT Choice deferral due to information overload is an undesirable result of competitive environments. The neoclassical maximization models predict that choice avoidance will not increase as more information is offered to consumers. The theories developed in the consumer behavior field predict that some properties of the environment may lead to behavioral effects and an increase in choice avoidance due to information overload. Based on stimuli generated experimentally and tested among 1,000 consumers, this empirical research provides evidence for the presence of behavioral effects due to information overload and reveals the different effects of increasing the number of options or the number of attributes. This study also finds that the need for cognition moderates these behavioral effects, and it proposes psychological processes that may trigger the effects observed.

  9. State ownership and firm performance: Empirical evidence from Chinese listed companies

    Directory of Open Access Journals (Sweden)

    Mei Yu

    2013-06-01

    Full Text Available While the relationship between state ownership and firm performance has been widely researched, the empirical evidence has provided mixed results. This study applies panel data regression techniques to 10,639 firm-year observations of non-financial Chinese listed firms during 2003–2010 to examine the relationship between state ownership and firm performance. The results show that state ownership has a U-shaped relationship with firm performance. The Split Share Structure Reform in 2005–2006 played a positive role in enhancing the relationship between state ownership and firm profitability ratios. Although state ownership decreased significantly after 2006, it remains high in strategically important industry sectors such as the oil, natural gas and mining sector and the publishing, broadcasting and media sector. The findings reveal that a higher level of state ownership is superior to a dispersed ownership structure due to the benefits of government support and political connections. The Split Share Structure Reform made previously non-tradable shares legally tradable, improving corporate governance and reducing the negative effect of non-tradable state shares.

  10. Evidence Translation in a Youth Mental Health Service

    Directory of Open Access Journals (Sweden)

    Alan P. Bailey

    2016-02-01

    Full Text Available An evidence–practice gap is well established in the mental health field, and knowledge translation is identified as a key strategy to bridge the gap. This study outlines a knowledge translation strategy, which aims to support clinicians in using evidence in their practice within a youth mental health service (headspace. We aim to evaluate the strategy by exploring clinicians’ experiences and preferences. The translation strategy includes the creation and dissemination of evidence translation resources that summarize the best available evidence and practice guidelines relating to the management of young people with mental disorders. Semi-structured interviews were conducted with 14 youth mental health clinicians covering three topics: experiences with evidence translation resources, preferences for evidence presentation, and suggestions regarding future translation efforts. Interviews were recorded, transcribed verbatim, coded, and analyzed using thematic analysis. Themes were both predetermined by interview topic and identified freely from the data. Clinicians described their experiences with the evidence translation resources as informing decision making, providing a knowledge base, and instilling clinical confidence. Clinicians expressed a preference for brief, plain language summaries and for involvement and consultation during the creation and dissemination of resources. Suggestions to improve the dissemination strategy and the development of new areas for evidence resources were identified. The knowledge translation efforts described support clinicians in the provision of mental health services for young people. The preferences and experiences described have valuable implications for services implementing knowledge translation strategies.

  11. Health decision making: lynchpin of evidence-based practice.

    Science.gov (United States)

    Spring, Bonnie

    2008-01-01

    Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.

  12. Redistribution through social health insurance: evidence on citizen preferences.

    Science.gov (United States)

    Pfarr, Christian; Schmid, Andreas

    2016-06-01

    The extent of social health insurance (SHI) and supplementary private insurance is frequently analyzed in public choice. Most of these analyses build on the model developed by Gouveia (1997), who defines the extent of SHI as consequence of a choice by self-interested voters. In this model, an indicator reflecting individuals' relative income position and relative risk of falling ill determines the voting decision. Up to now, no empirical evidence for this key assumption has been available. We test the effect of this indicator on individuals' preferences for the extent of SHI in a setting with mandatory SHI that can be supplemented by private insurance. The data is based on a DCE conducted in the field with a representative sample of 1538 German citizens in 2012. Conditional logit and latent class models are used to analyze preference heterogeneity. Our findings strongly support the assumptions of the models. Individuals likely to benefit from public coverage show a positive marginal willingness to pay (MWTP) for both a shift away from other beneficiary groups toward the sick and an expansion of publicly financed resources, and the expected net payers have a negative MWTP and prefer lower levels of public coverage.

  13. The impact of public employment on health and health inequalities: evidence from China.

    Science.gov (United States)

    Zhang, Wei

    2011-01-01

    Because the public and private sectors often operate with different goals, individuals employed by the two sectors may receive different levels of welfare. This can potentially lead to different health status. As such, employment sector offers an important perspective for understanding labor market outcomes. Using micro-level data from a recent Chinese household survey, this study empirically evaluated the impact of employment sector on health and within-sector health inequalities. It found that public sector employment generated better health outcomes than private sector employment, controlling for individual characteristics. The provision of more job security explained an important part of the association between public sector employment and better health. The study also found less health inequality by social class within the public sector. These findings suggest that policymakers should think critically about the "conventional wisdom" that private ownership is almost always superior, and should adjust their labor market policies accordingly.

  14. Advancing Empirical Approaches to the Concept of Resilience: A Critical Examination of Panarchy, Ecological Information, and Statistical Evidence

    Directory of Open Access Journals (Sweden)

    Ali Kharrazi

    2016-09-01

    Full Text Available Despite its ambiguities, the concept of resilience is of critical importance to researchers, practitioners, and policy-makers in dealing with dynamic socio-ecological systems. In this paper, we critically examine the three empirical approaches of (i panarchy; (ii ecological information-based network analysis; and (iii statistical evidence of resilience to three criteria determined for achieving a comprehensive understanding and application of this concept. These criteria are the ability: (1 to reflect a system’s adaptability to shocks; (2 to integrate social and environmental dimensions; and (3 to evaluate system-level trade-offs. Our findings show that none of the three currently applied approaches are strong in handling all three criteria. Panarchy is strong in the first two criteria but has difficulty with normative trade-offs. The ecological information-based approach is strongest in evaluating trade-offs but relies on common dimensions that lead to over-simplifications in integrating the social and environmental dimensions. Statistical evidence provides suggestions that are simplest and easiest to act upon but are generally weak in all three criteria. This analysis confirms the value of these approaches in specific instances but also the need for further research in advancing empirical approaches to the concept of resilience.

  15. Ethics, equality and evidence in health promotion Danish guidelines for municipalities.

    Science.gov (United States)

    Vallgårda, Signild

    2014-06-01

    The Danish National Board of Health has expressed its commitment to social equality in health, evidence-informed health promotion and public health ethics, and has issued guidelines for municipalities on health promotion, in Danish named prevention packages. The aim of this article is to analyse whether the Board of Health adheres to ideals of equality, evidence and ethics in these guidelines. An analysis to detect statements about equity, evidence and ethics in 10 health promotion packages directed at municipalities with the aim of guiding the municipalities towards evidence-informed disease prevention and health promotion. Despite declared intentions of prioritizing social equality in health, these intentions are largely absent from most of the packages. When health inequalities are mentioned, focus is on the disadvantaged or the marginalized. Several interventions are recommended, where there is no evidence to support them, notwithstanding the ambition of interventions being evidence-informed. Ethical considerations are scanty, scattered and unsystematically integrated. Further, although some packages mention the importance of avoiding stigmatization, there is little indicating how this could be done. Including reduction of health inequalities and evidence-informed and ethically defendable interventions in health promotion is a challenge, which is not yet fully met by the National Board of Health. When judged from liberal ethical principles, only few of the suggested interventions are acceptable, i.e., those concerning information, but from a paternalistic view, all interventions that may actually benefit the citizens are justified. © 2014 the Nordic Societies of Public Health.

  16. Working Capital Management and Firm Profitability. Empirical Evidence for the Romanian Industry

    Directory of Open Access Journals (Sweden)

    Miloş Marius Cristian

    2017-01-01

    Full Text Available The paper aims on empirically testing the connection between a firm's liquidity, or else a firm's ability to manage short-term liabilities, without undue stress and its profitability. We are using both a static and dynamic measure of firm liquidity: the traditional current liquidity ratio alongside one of the most frequent used working capital management indicator, the cash conversion cycle. An empirical analysis is performed based on 50 listed companies from Bucharest Stock Exchange, covering various industries. The empirical results are confirming the previous research that has confirmed the negative connection between the days sales outstanding (DSO, respectively the days inventory outstanding (DIO and the profitability of the firm, while cash conversion cycle seems to be positively connected with the firm profitability, in contradiction with some of the previous empirical literature.

  17. The global stock of research evidence relevant to health systems policymaking

    OpenAIRE

    Wilson, Michael G; Moat, Kaelan A; Lavis, John N

    2013-01-01

    Background: Policymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems. Methods: We examined all types of research evidence about governance, financial and delivery arrangements, and implementation strategies within health systems contained in Health Systems Evidence (HSE) (http://www.healthsystemsevidence.org). The research evidence types include evidence briefs fo...

  18. Strengthening health systems through linking research evidence to ...

    African Journals Online (AJOL)

    informed policies. Accordingly, a critical way of addressing these challenges facing health systems in the region is through the linking of health research findings to policy. Keywords: Evidence; Sub-Saharan Africa; Health Policy; Health Systems ...

  19. Employment Condition, Economic Deprivation and Self-Evaluated Health in Europe: Evidence from EU-SILC 2009-2012.

    Science.gov (United States)

    Bacci, Silvia; Pigini, Claudia; Seracini, Marco; Minelli, Liliana

    2017-02-03

    Background : The mixed empirical evidence about employment conditions (i.e., permanent vs. temporary job, full-time vs. part-time job) as well as unemployment has motivated the development of conceptual models with the aim of assessing the pathways leading to effects of employment status on health. Alongside physically and psychologically riskier working conditions, one channel stems in the possibly severe economic deprivation faced by temporary workers. We investigate whether economic deprivation is able to partly capture the effect of employment status on Self-evaluated Health Status (SHS). Methods : Our analysis is based on the European Union Statistics on Income and Living Conditions (EU-SILC) survey, for a balanced sample from 26 countries from 2009 to 2012. We estimate a correlated random-effects logit model for the SHS that accounts for the ordered nature of the dependent variable and the longitudinal structure of the data. Results and Discussion : Material deprivation and economic strain are able to partly account for the negative effects on SHS from precarious and part-time employment as well as from unemployment that, however, exhibits a significant independent negative association with SHS. Conclusions : Some of the indicators used to proxy economic deprivation are significant predictors of SHS and their correlation with the employment condition is such that it should not be neglected in empirical analysis, when available and further to the monetary income.

  20. Religious Europe, Russia and Serbia: Past and present (Arguments of empirical evidence: The case of Europe

    Directory of Open Access Journals (Sweden)

    Blagojević Mirko

    2008-01-01

    Full Text Available The author has envisaged to publish three articles in three issues of "Philosophy and Society" magazine in which, relying on the empirical scientific evidence, plans to reveal the scope and level of religiousness in some European countries, then to study the case of Russia in a separate text and finally to analyze religiousness of people in Serbia and their attachment to the church and religion. This sequence of publication has its own logics looking forward to the empirical research called "European Values Study" - a longitudinal and international comparative survey of human values - in almost all European countries including, for the first time, Serbia in 2008, the author first aims to present results of previous sociological research which are representative for the area of Europe, and then for the Orthodox area in the country with the highest number of Orthodox believers in the world. Therefore, in the last article the author will be able to compare the religious situation in Serbia not only with the (non-religious Europe but the (non-religious Orthodox Russia as well.

  1. Evidence-based approach for continuous improvement of occupational health.

    Science.gov (United States)

    Manzoli, Lamberto; Sotgiu, Giovanni; Magnavita, Nicola; Durando, Paolo

    2015-01-01

    It was recognized early on that an Evidence-Based Medicine (EBM) approach could be applied to Public Health (PH), including the area of Occupational Health (OH). The aim of Evidence-Based Occupational Health (EBOH) is to ensure safety, health, and well-being in the workplace. Currently, high-quality research is necessary in order to provide arguments and scientific evidence upon which effective, efficient, and sustainable preventive measures and policies are to be developed in the workplace in Western countries. Occupational physicians need to integrate available scientific evidence and existing recommendations with a framework of national employment laws and regulations. This paper addresses the state of the art of scientific evidence available in the field (i.e., efficacy of interventions, usefulness of education and training of workers, and need of a multidisciplinary strategy integrated within the national PH programs) and the main critical issues for their implementation. Promoting good health is a fundamental part of the smart, inclusive growth objectives of Europe 2020 - Europe's growth strategy: keeping people healthy and active for longer has a positive impact on productivity and competitiveness. It appears clear that health quality and safety in the workplace play a key role for smart, sustainable, and inclusive growth in Western countries.

  2. Intrahousehold Health Care Financing Strategy and the Gender Gap: Empirical Evidence from India

    OpenAIRE

    Abay Asfaw; Stephan Klasen; Francesca Lamanna

    2008-01-01

    The 'missing women' dilemma in India has sparked interest in investigating gender discrimination in the provision of health care in the country. No studies, however, have directly examined this discrimination in relation to household behavior in health care financing. We hypothesize that households who face tight budget constraints are more likely to spend their meager resources on hospitalization of boys rather than girls. We use the 60th Indian National Sample Survey and a multinomial logit...

  3. Psychological Models of Art Reception must be Empirically Grounded

    DEFF Research Database (Denmark)

    Nadal, Marcos; Vartanian, Oshin; Skov, Martin

    2017-01-01

    We commend Menninghaus et al. for tackling the role of negative emotions in art reception. However, their model suffers from shortcomings that reduce its applicability to empirical studies of the arts: poor use of evidence, lack of integration with other models, and limited derivation of testable...... hypotheses. We argue that theories about art experiences should be based on empirical evidence....

  4. A critique on efficient market hypothesis (EMH): Empirical evidence of return anomalies in 12 U.S. industry portfolios

    OpenAIRE

    Lee, Cheng Hsun George

    2006-01-01

    This paper focuses on two major arguments the momentum effect and market-learns hypothesis concerning the validity of the Efficient Market Hypothesis are summarized. Six empirical experiments with 12 U.S. Industry Portfolio are conducted. They not only provide the evidence against some of the EMH assumptions, but also aim to address the formation of return anomalies. Of them, three are designed to assess the validity of EMH with different approaches (White Noise, Effectiveness, Forecastibilit...

  5. Extending an evidence hierarchy to include topics other than treatment: revising the Australian 'levels of evidence'

    Science.gov (United States)

    2009-01-01

    Background In 1999 a four-level hierarchy of evidence was promoted by the National Health and Medical Research Council in Australia. The primary purpose of this hierarchy was to assist with clinical practice guideline development, although it was co-opted for use in systematic literature reviews and health technology assessments. In this hierarchy interventional study designs were ranked according to the likelihood that bias had been eliminated and thus it was not ideal to assess studies that addressed other types of clinical questions. This paper reports on the revision and extension of this evidence hierarchy to enable broader use within existing evidence assessment systems. Methods A working party identified and assessed empirical evidence, and used a commissioned review of existing evidence assessment schema, to support decision-making regarding revision of the hierarchy. The aim was to retain the existing evidence levels I-IV but increase their relevance for assessing the quality of individual diagnostic accuracy, prognostic, aetiologic and screening studies. Comprehensive public consultation was undertaken and the revised hierarchy was piloted by individual health technology assessment agencies and clinical practice guideline developers. After two and a half years, the hierarchy was again revised and commenced a further 18 month pilot period. Results A suitable framework was identified upon which to model the revision. Consistency was maintained in the hierarchy of "levels of evidence" across all types of clinical questions; empirical evidence was used to support the relationship between study design and ranking in the hierarchy wherever possible; and systematic reviews of lower level studies were themselves ascribed a ranking. The impact of ethics on the hierarchy of study designs was acknowledged in the framework, along with a consideration of how harms should be assessed. Conclusion The revised evidence hierarchy is now widely used and provides a common

  6. Extending an evidence hierarchy to include topics other than treatment: revising the Australian 'levels of evidence'

    Directory of Open Access Journals (Sweden)

    Merlin Tracy

    2009-06-01

    Full Text Available Abstract Background In 1999 a four-level hierarchy of evidence was promoted by the National Health and Medical Research Council in Australia. The primary purpose of this hierarchy was to assist with clinical practice guideline development, although it was co-opted for use in systematic literature reviews and health technology assessments. In this hierarchy interventional study designs were ranked according to the likelihood that bias had been eliminated and thus it was not ideal to assess studies that addressed other types of clinical questions. This paper reports on the revision and extension of this evidence hierarchy to enable broader use within existing evidence assessment systems. Methods A working party identified and assessed empirical evidence, and used a commissioned review of existing evidence assessment schema, to support decision-making regarding revision of the hierarchy. The aim was to retain the existing evidence levels I-IV but increase their relevance for assessing the quality of individual diagnostic accuracy, prognostic, aetiologic and screening studies. Comprehensive public consultation was undertaken and the revised hierarchy was piloted by individual health technology assessment agencies and clinical practice guideline developers. After two and a half years, the hierarchy was again revised and commenced a further 18 month pilot period. Results A suitable framework was identified upon which to model the revision. Consistency was maintained in the hierarchy of "levels of evidence" across all types of clinical questions; empirical evidence was used to support the relationship between study design and ranking in the hierarchy wherever possible; and systematic reviews of lower level studies were themselves ascribed a ranking. The impact of ethics on the hierarchy of study designs was acknowledged in the framework, along with a consideration of how harms should be assessed. Conclusion The revised evidence hierarchy is now widely

  7. Impact of GDP and tax revenue on health care financing: An empirical investigation from Indian states

    OpenAIRE

    Deepak Kumar BEHERA; Umakant DASH

    2017-01-01

    This paper investigates the long run impact of GDP and tax revenue on public health care expenditure using panel FMOLS and DOLS models for sixteen major states of India over the period 1980-2013. This study is more relevant in order to measure the progress in universal health care financing across the states of India because states are heterogeneous in terms of health care spending, associated with low tax bases and low level of GDP growth. The empirical result shows that healt...

  8. Health benefits of tai chi: What is the evidence?

    Science.gov (United States)

    Huston, Patricia; McFarlane, Bruce

    2016-11-01

    To summarize the evidence on the health benefits of tai chi. A literature review was conducted on the benefits of tai chi for 25 specific conditions, as well as for general health and fitness, to update a 2014 review of systematic reviews. Systematic reviews and recent clinical trials were assessed and organized into 5 different groups: evidence of benefit as excellent, good, fair, or preliminary, or evidence of no direct benefit. During the past 45 years more than 500 trials and 120 systematic reviews have been published on the health benefits of tai chi. Systematic reviews of tai chi for specific conditions indicate excellent evidence of benefit for preventing falls, osteoarthritis, Parkinson disease, rehabilitation for chronic obstructive pulmonary disease, and improving cognitive capacity in older adults. There is good evidence of benefit for depression, cardiac and stroke rehabilitation, and dementia. There is fair evidence of benefit for improving quality of life for cancer patients, fibromyalgia, hypertension, and osteoporosis. Current evidence indicates no direct benefit for diabetes, rheumatoid arthritis, or chronic heart failure. Systematic reviews of general health and fitness benefits show excellent evidence of benefit for improving balance and aerobic capacity in those with poor fitness. There is good evidence for increased strength in the lower limbs. There is fair evidence for increased well-being and improved sleep. There were no studies that found tai chi worsened a condition. A recent systematic review on the safety of tai chi found adverse events were typically minor and primarily musculoskeletal; no intervention-related serious adverse events have been reported. There is abundant evidence on the health and fitness effects of tai chi. Based on this, physicians can now offer evidence-based recommendations to their patients, noting that tai chi is still an area of active research, and patients should continue to receive medical follow-up for any

  9. Overweight and obesity: can we reconcile evidence about supermarkets and fast food retailers for public health policy?

    Science.gov (United States)

    Viola, Deborah; Arno, Peter S; Maroko, Andrew R; Schechter, Clyde B; Sohler, Nancy; Rundle, Andrew; Neckerman, Kathryn M; Maantay, Juliana

    2013-08-01

    The aim of this study is to determine whether access to fast food outlets and supermarkets is associated with overweight and obesity in New York City neighborhoods. We use a Bayesian ecologic approach for spatial prediction. Consistent with prior research, we find no association between fast food density and overweight or obesity. Consistent with prior research, we find that supermarket access has a salutary impact on overweight and obesity. Given the lack of empirical evidence linking fast food retailers with adverse health outcomes, policymakers should be encouraged to adopt policies that incentivize the establishment of supermarkets and the modification of existing food store markets and retailers to offer healthier choices. Reaching within neighborhoods and modifying the physical environment and public health prevention and intervention efforts based on the characteristics of those neighborhoods may play a key role in creating healthier communities.

  10. A Qualitative Methodological Framework to Assess Uptake of Evidence on Social Determinants of Health in Health Policy

    Science.gov (United States)

    Fisher, Matthew; Baum, Frances; MacDougall, Colin; Newman, Lareen; McDermott, Dennis

    2015-01-01

    Despite abundant evidence on social determinants of health (SDH) and health inequities, effective uptake of the evidence in health policies of high-income countries has been limited. Health policies might acknowledge evidence on SDH but still direct most strategies towards biomedical and behavioural interventions. This article reports on a…

  11. Women’s Empowerment through Self-help Groups and its Impact on Health Issues: Empirical Evidence

    Directory of Open Access Journals (Sweden)

    Assist. Prof. Sudipta De

    2011-01-01

    Full Text Available Based on an empirical study in West Bengal, this paper attempts toexamine whether women’s involvement in the microcredit programmethrough SHGs makes any positive change on women’s empowerment.From the assessment of various criteria of empowerment(power,autonomy and self-reliance, entitlement, participation and awarenessand capacity-building, the study suggests that if women participatingin the microcredit programme through SHGs sustain for some longerperiod (eight years or more, such programme might contribute tohigher level of women’s empowerment than women’s empowermentunder all types of control group. This paper also finds that women’searnings from saving and credit have positive and significant effect onnutritional status of the children of women members of SHGs and onthe protein-intake for their household compared with that of amongcontrol groups.

  12. The DSM revision process: needing to keep an eye on the empirical ball.

    Science.gov (United States)

    First, M B

    2017-01-01

    From DSM-III onward, successive DSM editions have strived to ground the diagnostic definitions in empirical evidence. DSM-IV established a three-stage process of empirical review, consisting of comprehensive and systematic literature reviews, secondary analyses of datasets, and field trials to provide reliability and validity data for the most substantial or controversial proposals. DSM-IV Work Group members were required to review the empirical literature to document explicitly the evidence supporting the text and criteria published in DSM-IV. As noted by Kendler and Solomon (2016), in contrast to the emphasis on systematic reviews in medicine which is a manifestation of the evidence-based medicine movement, such systematic evidence-based reviews have not been consistently integrated into the development of DSM-5, raising questions about empirical rigor underlying the DSM-5 revision. It is likely that this regression in terms of anchoring the revision process in a comprehensive review of empirical data stemmed from the emphasis during the DSM-5 revision process on trying to move DSM-5 from its categorical descriptive approach towards a more etiological dimensional approach. Although such a shift ultimately did not occur, the effort spent on trying to achieve a paradigm shift likely came at the expense of the hard work of conducting systematic empirical reviews. For the DSM to continue to remain credible in the current era of evidence-based medicine, it is essential that the developers of future editions of the DSM avoid taking their eye off the empirical ball and insure that the manual remains grounded in solid empirical evidence.

  13. Evidence-based architectural and space design supports Magnet® empirical outcomes.

    Science.gov (United States)

    Ecoff, Laurie; Brown, Caroline E

    2010-12-01

    This department expands nursing leaders' knowledge and competencies in health facility design. The editor of this department, Dr Jaynelle Stichler, asked guest authors, Drs Ecoff and Brown, to describe the process of using the conceptual models of a nursing evidence-based practice model and the Magnet Recognition Program® as a structured process to lead decision making in the planning and design processes and to achieve desired outcomes in hospital design.

  14. How much does it cost to get a dose of vaccine to the service delivery location? Empirical evidence from Vietnam's Expanded Program on Immunization.

    Science.gov (United States)

    Mvundura, Mercy; Kien, Vu Duy; Nga, Nguyen Tuyet; Robertson, Joanie; Cuong, Nguyen Van; Tung, Ho Thanh; Hong, Duong Thi; Levin, Carol

    2014-02-07

    Few studies document the costs of operating vaccine supply chains, but decision-makers need this information to inform cost projections for investments to accommodate new vaccine introduction. This paper presents empirical estimates of vaccine supply chain costs for Vietnam's Expanded Program on Immunization (EPI) for routine vaccines at each level of the supply chain, before and after the introduction of the pentavalent vaccine. We used micro-costing methods to collect resource-use data associated with storage and transportation of vaccines and immunization supplies at the national store, the four regional stores, and a sample of provinces, districts, and commune health centers. We collected stock ledger data on the total number of doses of vaccines handled by each facility during the assessment year. Total supply chain costs were estimated at approximately US$65,000 at the national store and an average of US$39,000 per region, US$5800 per province, US$2200 per district, and US$300 per commune health center. Across all levels, cold chain equipment capital costs and labor were the largest drivers of costs. The cost per dose delivered was estimated at US$0.19 before the introduction of pentavalent and US$0.24 cents after introduction. At commune health centers, supply chain costs were 104% of the value of vaccines before introduction of pentavalent vaccine and 24% after introduction, mainly due to the higher price per dose of the pentavalent vaccine. The aggregated costs at the last tier of the health system can be substantial because of the large number of facilities. Even in countries with high-functioning systems, empirical evidence on current costs from all levels of the system can help estimate resource requirements for expanding and strengthening resources to meet future immunization program needs. Other low- and middle-income countries can benefit from similar studies, in view of new vaccine introductions that will put strains on existing systems. Copyright

  15. Attitudes of mental health occupational therapists toward evidence-based practice.

    Science.gov (United States)

    Hitch, Danielle P

    2016-02-01

    Evidence-based practice is an important driver in modern health care and has become a priority in mental health occupational therapy in recent years. The aim of this study was to measure the attitudes of a cohort of mental health occupational therapists toward evidence-based practice. Forty-one mental health occupational therapists were surveyed using the Evidence-Based Practice Attitude Scale (EBPAS). Mann-Whitney U tests and Spearman's rho were used to analyze the data. The occupational therapy respondents had generally positive attitudes toward evidence-based practices comparable to established norms. Respondents with further qualifications beyond their professional degree were significantly more likely to try new interventions (p = .31). Significant negative correlations were found also for the subscales of Appeal and Openness in relation to years of occupational therapy practice (rho = -.354, p = .023; rho = -.344, p = 0.28) and mental health experience (rho = -.390, p = 0.12; rho = -.386, p = .013). Therapist factors can significantly impact attitudes toward evidence-based practice. © CAOT 2015.

  16. Results from a psychometric assessment of a new tool for measuring evidence-based decision making in public health organizations.

    Science.gov (United States)

    Stamatakis, Katherine A; Ferreira Hino, Adriano Akira; Allen, Peg; McQueen, Amy; Jacob, Rebekah R; Baker, Elizabeth A; Brownson, Ross C

    2017-02-01

    In order to better understand how to improve evidence-based decision making (EBDM) in state health departments, measurement tools are needed to evaluate changes in EBDM. The purpose of this study was to test the psychometric properties of a new measurement tool to assess EBDM in public health practice settings. A questionnaire was developed, pilot-tested and refined in an iterative process with the input of public health practitioners with the aim of identifying a set of specific measures representing different components of EBDM. Data were collected in a national survey of state health department chronic disease practitioners. The final dataset (n=879) for psychometric testing was comprised of 19 EBDM items that were first examined using exploratory factor analysis, and then confirmatory factor analysis. The final model from confirmatory factor analysis includes five latent factors representing components of EBDM: capacity for evaluation, expectations and incentives for EBDM, access to evidence and resources for EBDM, participatory decision making, and leadership support and commitment. This study addresses the need for empirically tested and theory-aligned measures that may be used to assess the extent to which EBDM is currently implemented, and further, to gauge the success of strategies to improve EBDM, in public health settings. This EBDM measurement tool may help identify needed supports for enhanced capacity and implementation of effective strategies. Copyright © 2016. Published by Elsevier Ltd.

  17. Factors affecting maternal health care services utilization in rural ...

    African Journals Online (AJOL)

    admin

    husband's level of ... countries, where women have access to basic health care, ... Democratic Republic of Congo, Ethiopia, India, ... existing information gap about maternal health care by providing empirical evidence-based on the data of the.

  18. Evidence-Based Psychological Assessment.

    Science.gov (United States)

    Bornstein, Robert F

    2017-01-01

    In recent years there has been increasing emphasis on evidence-based practice in psychology (EBPP), and as is true in most health care professions, the primary focus of EBPP has been on treatment. Comparatively little attention has been devoted to applying the principles of EBPP to psychological assessment, despite the fact that assessment plays a central role in myriad domains of empirical and applied psychology (e.g., research, forensics, behavioral health, risk management, diagnosis and classification in mental health settings, documentation of neuropsychological impairment and recovery, personnel selection and placement in organizational contexts). This article outlines the central elements of evidence-based psychological assessment (EBPA), using the American Psychological Association's tripartite definition of EBPP as integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences. After discussing strategies for conceptualizing and operationalizing evidence-based testing and evidence-based assessment, 6 core skills and 3 meta-skills that underlie proficiency in psychological assessment are described. The integration of patient characteristics, culture, and preferences is discussed in terms of the complex interaction of patient and assessor identities and values throughout the assessment process. A preliminary framework for implementing EBPA is offered, and avenues for continued refinement and growth are described.

  19. Access to data and material for research: Putting empirical evidence into perspective

    NARCIS (Netherlands)

    Rodriguez, V.

    2009-01-01

    The aim of this article is to put into critical perspective the empirical findings on secrecy and withholding in research. In other words, by taking existing empirical literature into account, it is intended that a crucial question is answered: Is secrecy and withholding in research harmful or

  20. Energy Innovations-GHG Emissions Nexus: Fresh Empirical Evidence from OECD Countries

    International Nuclear Information System (INIS)

    Álvarez-Herránz, Agustín; Balsalobre, Daniel; Cantos, José María; Shahbaz, Muhammad

    2017-01-01

    This study explores the impact of improvements in energy research development (ERD) on greenhouse gas (GHG) emissions using environmental Kuznets curve hypothesis for 28 OECD countries over the period of 1990–2014. In doing so, we have employed a panel data where public budget in energy research development and demonstration (ERD&D) has transformed into a finite inverted V-lag distribution model developed by De Leeuw (1962). This model considers that energy innovation accumulates in time and presents empirical evidence, how energy innovation contributes in reducing energy intensity and environmental pollution as well. Our results indicate that energy innovation measures require lapses of time to reach their full effect i.e. innovation applied to measures for environmental correction does not reach its whole effect immediately, requiring instead a certain amount of time to pass. Innovation policies have recommended for improving environmental quality. - Highlights: • This study analyses the impact of public budget in energy RD&D for 28 OECD countries on environmental quality. • Energy innovation contributes positively to reduce greenhouse gas emissions. • Advances in energy technology seem to be the key of improved environmental quality.

  1. An evidence-based public health approach to climate change adaptation.

    Science.gov (United States)

    Hess, Jeremy J; Eidson, Millicent; Tlumak, Jennifer E; Raab, Kristin K; Luber, George

    2014-11-01

    Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.

  2. Health policy--why research it and how: health political science.

    Science.gov (United States)

    de Leeuw, Evelyne; Clavier, Carole; Breton, Eric

    2014-09-23

    The establishment of policy is key to the implementation of actions for health. We review the nature of policy and the definition and directions of health policy. In doing so, we explicitly cast a health political science gaze on setting parameters for researching policy change for health. A brief overview of core theories of the policy process for health promotion is presented, and illustrated with empirical evidence. The key arguments are that (a) policy is not an intervention, but drives intervention development and implementation; (b) understanding policy processes and their pertinent theories is pivotal for the potential to influence policy change; (c) those theories and associated empirical work need to recognise the wicked, multi-level, and incremental nature of elements in the process; and, therefore, (d) the public health, health promotion, and education research toolbox should more explicitly embrace health political science insights. The rigorous application of insights from and theories of the policy process will enhance our understanding of not just how, but also why health policy is structured and implemented the way it is.

  3. Wealth and Health Behavior: Testing the Concept of a Health Cost.

    Science.gov (United States)

    van Kippersluis, Hans; Galama, Titus J

    2014-11-01

    Wealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of unhealthy consumption. The health cost increases with wealth and the degree of unhealthiness, leading wealthier individuals to consume more healthy and moderately unhealthy, but fewer severely unhealthy goods. The empirical evidence presented suggests that differences in health costs may indeed partially explain behavioral differences, and ultimately health outcomes, between wealth groups.

  4. Employment Condition, Economic Deprivation and Self-Evaluated Health in Europe: Evidence from EU-SILC 2009–2012

    Science.gov (United States)

    Bacci, Silvia; Pigini, Claudia; Seracini, Marco; Minelli, Liliana

    2017-01-01

    Background: The mixed empirical evidence about employment conditions (i.e., permanent vs. temporary job, full-time vs. part-time job) as well as unemployment has motivated the development of conceptual models with the aim of assessing the pathways leading to effects of employment status on health. Alongside physically and psychologically riskier working conditions, one channel stems in the possibly severe economic deprivation faced by temporary workers. We investigate whether economic deprivation is able to partly capture the effect of employment status on Self-evaluated Health Status (SHS). Methods: Our analysis is based on the European Union Statistics on Income and Living Conditions (EU-SILC) survey, for a balanced sample from 26 countries from 2009 to 2012. We estimate a correlated random-effects logit model for the SHS that accounts for the ordered nature of the dependent variable and the longitudinal structure of the data. Results and Discussion: Material deprivation and economic strain are able to partly account for the negative effects on SHS from precarious and part-time employment as well as from unemployment that, however, exhibits a significant independent negative association with SHS. Conclusions: Some of the indicators used to proxy economic deprivation are significant predictors of SHS and their correlation with the employment condition is such that it should not be neglected in empirical analysis, when available and further to the monetary income. PMID:28165375

  5. Insuring against health shocks: Health insurance and household choices.

    Science.gov (United States)

    Liu, Kai

    2016-03-01

    This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Innovation Forms and Firm Export Performance: Empirical Evidence from ECA Countries

    Directory of Open Access Journals (Sweden)

    Andrzej Cieślik

    2017-06-01

    Full Text Available Objective: The main objective of this paper is to verify empirically the relationship between various forms of innovation and export performance of firms from European and Central Asian (ECA countries. Research Design & Methods: In our empirical approach we refer to the self-selection hypothesis derived from the Melitz (2003 model which proposed the existence of a positive relationship between firm productivity and the probability of exporting. We argue that innovation activities should be regarded as a key element that can increase the level of firm productivity. We focus our analysis on four forms of innovation activities: product, process, marketing, organizational and managerial innovation. The empirical implementation of our analytical framework is based on the probit model, applied to the fifth edition of the BEEPS firm level dataset covering 2011-2014. Findings: Our empirical results indicate that the probability of exporting is positively related to both product and process innovations. The marketing and managerial innovations do not seem to affect positively export performance of firms from ECA countries. Implications & Recommendations: It is recommended to develop innovation supporting mechanisms that would target both product and process innovations rather than other forms of innovation in the ECA countries. Contribution & Value Added: The originality of this work lies in the use of the multi-country firm level dataset that allows distinguishing between various forms of innovations in the ECA countries.

  7. Towards Evidence Based Usability in Health Informatics?

    NARCIS (Netherlands)

    Marcilly, Romaric; Peute, Linda W.; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W.

    2015-01-01

    In a Health Information Technology (HIT) regulatory context in which the usability of this technology is more and more a critical issue, there is an increasing need for evidence based usability practice. However, a clear definition of evidence based usability practice and how to achieve it is still

  8. Are smokers rational addicts? Empirical evidence from the Indonesian Family Life Survey

    Directory of Open Access Journals (Sweden)

    Thabrany Hasbullah

    2011-02-01

    Full Text Available Abstract Background Indonesia is one of the largest consumers of tobacco in the world, however there has been little work done on the economics addiction of tobacco. This study provides an empirical test of a rational addiction (henceforth RA hypothesis of cigarette demand in Indonesia. Methods Four estimators (OLS, 2SLS, GMM, and System-GMM were explored to test the RA hypothesis. The author adopted several diagnostics tests to select the best estimator to overcome econometric problems faced in presence of the past and future cigarette consumption (suspected endogenous variables. A short-run and long-run price elasticities of cigarettes demand was then calculated. The model was applied to individuals pooled data derived from three-waves a panel of the Indonesian Family Life Survey spanning the period 1993-2000. Results The past cigarette consumption coefficients turned out to be a positive with a p-value Conclusions Health policymakers should redesign current public health campaign against cigarette smoking in the country. Given the demand for cigarettes to be more prices sensitive for the long run (and female than the short run (and male, an increase in the price of cigarettes could lead to a significant fall in cigarette consumption in the long run rather than as a constant source of government revenue.

  9. Who supported the Deutsche Bundesbank? An empirical investigation

    NARCIS (Netherlands)

    Maier, P; Knaap, T

    2002-01-01

    The relevance of public support for monetary policy has largely been over-looked in the empirical Central Bank literature. We have constructed a new indicator for the support of the German Bundesbank and present descriptive and empirical evidence. We find that major German interest groups were quite

  10. Traditional Arabic & Islamic medicine: validation and empirical assessment of a conceptual model in Qatar.

    Science.gov (United States)

    AlRawi, Sara N; Khidir, Amal; Elnashar, Maha S; Abdelrahim, Huda A; Killawi, Amal K; Hammoud, Maya M; Fetters, Michael D

    2017-03-14

    Evidence indicates traditional medicine is no longer only used for the healthcare of the poor, its prevalence is also increasing in countries where allopathic medicine is predominant in the healthcare system. While these healing practices have been utilized for thousands of years in the Arabian Gulf, only recently has a theoretical model been developed illustrating the linkages and components of such practices articulated as Traditional Arabic & Islamic Medicine (TAIM). Despite previous theoretical work presenting development of the TAIM model, empirical support has been lacking. The objective of this research is to provide empirical support for the TAIM model and illustrate real world applicability. Using an ethnographic approach, we recruited 84 individuals (43 women and 41 men) who were speakers of one of four common languages in Qatar; Arabic, English, Hindi, and Urdu, Through in-depth interviews, we sought confirming and disconfirming evidence of the model components, namely, health practices, beliefs and philosophy to treat, diagnose, and prevent illnesses and/or maintain well-being, as well as patterns of communication about their TAIM practices with their allopathic providers. Based on our analysis, we find empirical support for all elements of the TAIM model. Participants in this research, visitors to major healthcare centers, mentioned using all elements of the TAIM model: herbal medicines, spiritual therapies, dietary practices, mind-body methods, and manual techniques, applied singularly or in combination. Participants had varying levels of comfort sharing information about TAIM practices with allopathic practitioners. These findings confirm an empirical basis for the elements of the TAIM model. Three elements, namely, spiritual healing, herbal medicine, and dietary practices, were most commonly found. Future research should examine the prevalence of TAIM element use, how it differs among various populations, and its impact on health.

  11. Psychosocial Clusters and their Associations with Well-Being and Health: An Empirical Strategy for Identifying Psychosocial Predictors Most Relevant to Racially/Ethnically Diverse Women’s Health

    Science.gov (United States)

    Jabson, Jennifer M.; Bowen, Deborah; Weinberg, Janice; Kroenke, Candyce; Luo, Juhua; Messina, Catherine; Shumaker, Sally; Tindle, Hilary A.

    2016-01-01

    BACKGROUND Strategies for identifying the most relevant psychosocial predictors in studies of racial/ethnic minority women’s health are limited because they largely exclude cultural influences and they assume that psychosocial predictors are independent. This paper proposes and tests an empirical solution. METHODS Hierarchical cluster analysis, conducted with data from 140,652 Women’s Health Initiative participants, identified clusters among individual psychosocial predictors. Multivariable analyses tested associations between clusters and health outcomes. RESULTS A Social Cluster and a Stress Cluster were identified. The Social Cluster was positively associated with well-being and inversely associated with chronic disease index, and the Stress Cluster was inversely associated with well-being and positively associated with chronic disease index. As hypothesized, the magnitude of association between clusters and outcomes differed by race/ethnicity. CONCLUSIONS By identifying psychosocial clusters and their associations with health, we have taken an important step toward understanding how individual psychosocial predictors interrelate and how empirically formed Stress and Social clusters relate to health outcomes. This study has also demonstrated important insight about differences in associations between these psychosocial clusters and health among racial/ethnic minorities. These differences could signal the best pathways for intervention modification and tailoring. PMID:27279761

  12. Does better information about hospital quality affect patients’ choice? Empirical findings from Germany

    OpenAIRE

    Wübker, Ansgar; Sauerland, Dirk; Wübker, Achim

    2008-01-01

    Background: Economic theory strongly suggests that better information about the quality of care affects patients’ choice of health service providers. However, we have little empirical evidence about the impact of information provided on provider’s choice in Germany. Problem: In Germany, we recently find publicly available information about hospital quality. For example, 50 percent of the hospitals in the Rhine-Ruhr area do now publish their quality data voluntarily in a comprehensive, underst...

  13. Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence.

    Science.gov (United States)

    Edmunds, Laurel D; Ovseiko, Pavel V; Shepperd, Sasha; Greenhalgh, Trisha; Frith, Peggy; Roberts, Nia W; Pololi, Linda H; Buchan, Alastair M

    2016-12-10

    Women are under-represented in academic medicine. We reviewed the empirical evidence focusing on the reasons for women's choice or rejection of careers in academic medicine. Using a systematic search, we identified 52 studies published between 1985, and 2015. More than half had methodological limitations and most were from North America. Eight main themes were explored in these studies. There was consistent evidence for four of these themes: women are interested in teaching more than in research; participation in research can encourage women into academic medicine; women lack adequate mentors and role models; and women experience gender discrimination and bias. The evidence was conflicting on four themes: women are less interested in research than men; women lose commitment to research as their education and training progress; women are deterred from academic careers by financial considerations; and women are deterred by concerns about work-life balance. Inconsistency of findings across studies suggests significant opportunities to overcome barriers by providing a more enabling environment. We identified substantial gaps in the scientific literature that could form the focus of future research, including shifting the focus from individuals' career choices to the societal and organisational contexts and cultures within which those choices are made; extending the evidence base to include a wider range of countries and settings; and testing the efficacy of interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. INTERNAL AND EXTERNAL DETERMINANTS OF COMMERCIAL BANKS PROFITABILITY: EMPIRICAL EVIDENCE FROM BULGARIA AND ROMANIA

    Directory of Open Access Journals (Sweden)

    FIRTESCU BOGDAN

    2015-07-01

    Full Text Available Our study focuses on commercial banks which are operating in Bulgaria and Romania, two countries whose banking sectors have registered major structural changes in the transition to a market economy and which are showing some similarities. Similar to other EU countries, the financial system from Bulgaria and Romania is dominated by the banking sector, which holds the largest share of total assets. Thus, we can say that health, strength and performance of the banking sector are of major importance for the sustainable economic development of states, but also for efficient transmission of monetary policy decisions on the real economy. The paper aims to identify the key factors that affect bank profitability and to evaluate empirically their contribution to a sample of 29 commercial banks in Bulgaria and Romania, for the period 2003-2012. Our research is based on data from the Bureau Van Dijk database, the World Bank and the European Central Bank and uses panel data estimation techniques. The dependent variable used in our study is the bank profitability, which is measured by two representative indicators the Return on Average Assets (ROAA and Return on Average Equity (ROAE. Regarding the independent variables, our analysis includes capital adequacy, the loan loss reserve rate, cost to income ratio, the ratio of liquid assets to total assets, the interest expenses to deposits ratio, the non-interest income over total gross revenues, bank size, the GDP per capita growth, inflation rate, domestic bank credit to private sector and banking industry concentration. The results of our empirical study shows that among the variables considered, the loan loss reserve rate, the ratio of cost to income, GDP per capita growth and domestic bank credit to the private sector, have a significant impact on bank profitability, results in line with our expectations, but also with the results of other empirical studies.

  15. How do medical device manufacturers' websites frame the value of health innovation? An empirical ethics analysis of five Canadian innovations.

    Science.gov (United States)

    Lehoux, P; Hivon, M; Williams-Jones, B; Miller, F A; Urbach, D R

    2012-02-01

    While every health care system stakeholder would seem to be concerned with obtaining the greatest value from a given technology, there is often a disconnect in the perception of value between a technology's promoters and those responsible for the ultimate decision as to whether or not to pay for it. Adopting an empirical ethics approach, this paper examines how five Canadian medical device manufacturers, via their websites, frame the corporate "value proposition" of their innovation and seek to respond to what they consider the key expectations of their customers. Our analysis shows that the manufacturers' framing strategies combine claims that relate to valuable socio-technical goals and features such as prevention, efficiency, sense of security, real-time feedback, ease of use and flexibility, all elements that likely resonate with a large spectrum of health care system stakeholders. The websites do not describe, however, how the innovations may impact health care delivery and tend to obfuscate the decisional trade-offs these innovations represent from a health care system perspective. Such framing strategies, we argue, tend to bolster physicians' and patients' expectations and provide a large set of stakeholders with powerful rhetorical tools that may influence the health policy arena. Because these strategies are difficult to counter given the paucity of evidence and its limited use in policymaking, establishing sound collective health care priorities will require solid critiques of how certain kinds of medical devices may provide a better (i.e., more valuable) response to health care needs when compared to others.

  16. Empirical evidence of direct rebound effect in Catalonia

    International Nuclear Information System (INIS)

    Freire Gonzalez, Jaume

    2010-01-01

    This paper reviews the empirical literature concerning the direct rebound effect in households; it briefly analyzes the main theoretical and methodological aspects, and finally estimates the magnitude of direct rebound effect for all energy services using electricity in households of Catalonia (Spain) using econometric techniques. The main results show an estimated direct rebound effect of 35% in the short term and 49% in the long term. The existence of a rebound effect reduces the effectiveness of energy efficiency policies.

  17. Gaps in studies of global health education: an empirical literature review

    Directory of Open Access Journals (Sweden)

    Yan Liu

    2015-04-01

    Full Text Available Background: Global health has stimulated a lot of students and has attracted the interest of many faculties, thereby initiating the establishment of many academic programs on global health research and education. global health education reflects the increasing attention toward social accountability in medical education. Objective: This study aims to identify gaps in the studies on global health education. Design: A critical literature review of empirical studies was conducted using Boolean search techniques. Results: A total of 238 articles, including 16 reviews, were identified. There had been a boom in the numbers of studies on global health education since 2010. Four gaps were summarized. First, 94.6% of all studies on global health education were conducted in North American and European countries, of which 65.6% were carried out in the United States, followed by Canada (14.3% and the United Kingdom (9.2%. Only seven studies (2.9% were conducted in Asian countries, five (2.1% in Oceania, and two (0.8% in South American/Caribbean countries. A total of 154 studies (64.4% were qualitative studies and 64 studies (26.8% were quantitative studies. Second, elective courses and training or programs were the most frequently used approach for global health education. Third, there was a gap in the standardization of global health education. Finally, it was mainly targeted at medical students, residents, and doctors. It had not granted the demands for global health education of all students majoring in medicine-related studies. Conclusions: Global health education would be a potentially influential tool for achieving health equity, reducing health disparities, and also for future professional careers. It is the time to build and expand education in global health, especially among developing countries. Global health education should be integrated into primary medical education. Interdisciplinary approaches and interprofessional collaboration were

  18. Evidence, ethics, and values: a framework for health promotion.

    Science.gov (United States)

    Carter, Stacy M; Rychetnik, Lucie; Lloyd, Beverley; Kerridge, Ian H; Baur, Louise; Bauman, Adrian; Hooker, Claire; Zask, Avigdor

    2011-03-01

    We propose a new approach to guide health promotion practice. Health promotion should draw on 2 related systems of reasoning: an evidential system and an ethical system. Further, there are concepts, values, and procedures inherent in both health promotion evidence and ethics, and these should be made explicit. We illustrate our approach with the exemplar of intervention in weight, and use a specific mass-media campaign to show the real-world dangers of intervening with insufficient attention to ethics and evidence. Both researchers and health promotion practitioners should work to build the capacities required for evidential and ethical deliberation in the health promotion profession.

  19. Adapting health promotion interventions to meet the needs of ethnic minority groups: mixed-methods evidence synthesis.

    Science.gov (United States)

    Liu, Jj; Davidson, E; Bhopal, Rs; White, M; Johnson, Mrd; Netto, G; Deverill, M; Sheikh, A

    2012-01-01

    of adapted interventions and summarised data to assess feasibility, acceptability, equity, clinical effectiveness and cost-effectiveness. Interviews were transcribed, coded and thematically analysed. The quantitative and qualitative data were then synthesised using a realist framework to understand better how adapted interventions work and to assess implementation considerations and prioritise future research. Our preliminary findings were refined through discussion and debate at an end-of-study national user engagement conference. Initial user engagement emphasised the importance of extending this work beyond individual-centred behavioural interventions to also include examination of community- and ecological-level interventions; however, individual-centred behavioural approaches dominated the 15 relevant guidelines and 111 systematic reviews we identified. The most consistent evidence of effectiveness was for pharmacological interventions for smoking cessation. This body of work, however, provided scant evidence on the effectiveness of these interventions for ethnic minority groups. We identified 173 reports of adapted health promotion interventions, the majority of which focused on US-based African Americans. This body of evidence was used to develop a 46-item Typology of Adaptation and a Programme Theory of Adapted Health Promotion Interventions. Only nine empirical studies directly compared the effectiveness of culturally adapted interventions with standard health promotion interventions, these failing to yield any consistent evidence; no studies reported on cost-effectiveness. The 26 qualitative interviews highlighted the need to extend thinking on ethnicity from conventional dimensions to more contextual considerations. The realist synthesis enabled the production of a decision-making tool (RESET) to support future research. The lack of robust evidence of effectiveness for physical activity and healthy-eating interventions in the general population identified

  20. Understanding the roles of faith-based health-care providers in Africa: review of the evidence with a focus on magnitude, reach, cost, and satisfaction.

    Science.gov (United States)

    Olivier, Jill; Tsimpo, Clarence; Gemignani, Regina; Shojo, Mari; Coulombe, Harold; Dimmock, Frank; Nguyen, Minh Cong; Hines, Harrison; Mills, Edward J; Dieleman, Joseph L; Haakenstad, Annie; Wodon, Quentin

    2015-10-31

    At a time when many countries might not achieve the health targets of the Millennium Development Goals and the post-2015 agenda for sustainable development is being negotiated, the contribution of faith-based health-care providers is potentially crucial. For better partnership to be achieved and for health systems to be strengthened by the alignment of faith-based health-providers with national systems and priorities, improved information is needed at all levels. Comparisons of basic factors (such as magnitude, reach to poor people, cost to patients, modes of financing, and satisfaction of patients with the services received) within faith-based health-providers and national systems show some differences. As the first report in the Series on faith-based health care, we review a broad body of published work and introduce some empirical evidence on the role of faith-based health-care providers, with a focus on Christian faith-based health providers in sub-Saharan Africa (on which the most detailed documentation has been gathered). The restricted and diverse evidence reported supports the idea that faith-based health providers continue to play a part in health provision, especially in fragile health systems, and the subsequent reports in this Series review controversies in faith-based health care and recommendations for how public and faith sectors might collaborate more effectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Toward a bioethical framework for antibiotic use, antimicrobial resistance and for empirically designing ethically robust strategies to protect human health: a research protocol.

    Science.gov (United States)

    Hernández-Marrero, Pablo; Martins Pereira, Sandra; de Sá Brandão, Patrícia Joana; Araújo, Joana; Carvalho, Ana Sofia

    2017-12-01

    Introduction Antimicrobial resistance (AMR) is a challenging global and public health issue, raising bioethical challenges, considerations and strategies. Objectives This research protocol presents a conceptual model leading to formulating an empirically based bioethics framework for antibiotic use, AMR and designing ethically robust strategies to protect human health. Methods Mixed methods research will be used and operationalized into five substudies. The bioethical framework will encompass and integrate two theoretical models: global bioethics and ethical decision-making. Results Being a study protocol, this article reports on planned and ongoing research. Conclusions Based on data collection, future findings and using a comprehensive, integrative, evidence-based approach, a step-by-step bioethical framework will be developed for (i) responsible use of antibiotics in healthcare and (ii) design of strategies to decrease AMR. This will entail the analysis and interpretation of approaches from several bioethical theories, including deontological and consequentialist approaches, and the implications of uncertainty to these approaches.

  2. Financial development and economic growth: literature survey and empirical evidence from sub-Saharan African countries

    Directory of Open Access Journals (Sweden)

    Songul Kakilli Acaravci

    2011-08-01

    Full Text Available In this paper we review the literature on the finance-growth nexus and investigate the causality between financial development and economic growth in Sub-Saharan Africa for the period 1975-2005. Using panel co-integration and panel GMM estimation for causality, the results of the panel co-integration analysis provide evidence of no long-run relationship between financial development and economic growth. The empirical findings in the paper show a bi-directional causal relationship between the growth of real GDP per capita and the domestic credit provided by the banking sector for the panels of 24 Sub-Saharan African countries. The findings imply that African countries can accelerate their economic growth by improving their financial systems and vice versa.

  3. Determinants of evidence use in Public Health Policy making

    DEFF Research Database (Denmark)

    van de Goor, Ien; Hämäläinen, Riitta-Maija; Syed, Ahmed

    2017-01-01

    The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized. Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities...... evidence, evidence on costs, and a lack of joint understanding were specific hindrances. Also users' characteristics and the role media play were identified as factors of influence. Attention for individual and social factors within the policy context might provide the key to enhance more sustainable...

  4. Using social media to monitor mental health discussions - evidence from Twitter.

    Science.gov (United States)

    McClellan, Chandler; Ali, Mir M; Mutter, Ryan; Kroutil, Larry; Landwehr, Justin

    2017-05-01

    Given the public health importance of communicating about mental illness and the growing use of social media to convey information, our goal was to develop an empirical model to identify periods of heightened interest in mental health topics on Twitter. We collected data on 176 million tweets from 2011 to 2014 with content related to depression or suicide. Using an autoregressive integrated moving average (ARIMA) data analysis, we identified deviations from predicted trends in communication about depression and suicide. Two types of heightened Twitter activity regarding depression or suicide were identified in 2014: expected increases in response to planned behavioral health events, and unexpected increases in response to unanticipated events. Tweet volume following expected increases went back to the predicted level more rapidly than the volume following unexpected events. Although ARIMA models have been used extensively in other fields, they have not been used widely in public health. Our findings indicate that our ARIMA model is valid for identifying periods of heightened activity on Twitter related to behavioral health. The model offers an objective and empirically based measure to identify periods of greater interest for timing the dissemination of credible information related to mental health. Spikes in tweet volume following a behavioral health event often last for less than 2 days. Individuals and organizations that want to disseminate behavioral health messages on Twitter in response to heightened periods of interest need to take this limited time frame into account. Published by Oxford University Press on behalf of the American Medical Informatics Association 2016. This work is written by US Government employees and is in the public domain in the United States.

  5. The determinants of domestic water demand. Empirical evidence from Emilia-Romagna municipal data

    International Nuclear Information System (INIS)

    Mazzanti, Massimiliano; Montini, Anna

    2004-01-01

    This paper presents empirical evidence on the determinants of water demand for domestic use in one Italian region, the Emilia Romagna, by using municipal data. Two main stems in urban/domestic demand analysis cab be found in the empirical literature. The first deals with the estimation of price or income demand elasticities in the short and the long run. The price demand elasticities can be used for water demand managements purpose while the income price elasticities can be useful in the forecasting process of the water requirements. The second one deals with the estimate of customer willingness to pay increasing in water service quality in holistic sense or concerning single characteristics of the service: safety, flavour, continuity, appearance, pollution rate and cost. The aim of the analysis in this case the elicitation of the direct use, indirect use and non-use values associated to the water resource consumption, by means of direct or indirect techniques. In this paper we focused the analysis in the first stem of the empirical literature in which a cross section data set is required. The paper explores the topic problems of the estimating process whit the analysis of the empirical literature (with particular regard to investigations that use municipal data) and with the analysis of the econometric problems related to the demand estimate. The theoretical model for the water demand analysis is also presented and discussed. Two datasets have been implemented: one with 125 municipalities and four years, the other with 40 municipalities and eleven years. Both the databases bring together municipal water consumption and tariffs data provided by local water utilities and other municipal data (inhabitants, surface, household, income, etc.) stemming from official sources. The econometric analysis is based on both fixed effects, performing better than random effects models, and dynamic panel models. The estimated coefficient of the tariff variable arises always

  6. [Glocalization: the outlook for Taiwan evidence based health care].

    Science.gov (United States)

    Chen, Chiehfeng

    2014-12-01

    Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality.

  7. Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.

    Science.gov (United States)

    Armstrong, Rebecca; Waters, Elizabeth; Moore, Laurence; Dobbins, Maureen; Pettman, Tahna; Burns, Cate; Swinburn, Boyd; Anderson, Laurie; Petticrew, Mark

    2014-12-14

    The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions. The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health. In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision

  8. Supporting Evidence-Informed Teaching in Biomedical and Health Professions Education Through Knowledge Translation: An Interdisciplinary Literature Review.

    Science.gov (United States)

    Tractenberg, Rochelle E; Gordon, Morris

    2017-01-01

    Phenomenon: The purpose of "systematic" reviews/reviewers of medical and health professions educational research is to identify best practices. This qualitative article explores the question of whether systematic reviews can support "evidence informed" teaching and contrasts traditional systematic reviewing with a knowledge translation (KT) approach to this objective. Degrees of freedom analysis (DOFA) is used to examine the alignment of systematic review methods with educational research and the pedagogical strategies and approaches that might be considered with a decision-making framework developed to support valid assessment. This method is also used to explore how KT can be used to inform teaching and learning. The nature of educational research is not compatible with most (11/14) methods for systematic review. The inconsistency of systematic reviewing with the nature of educational research impedes both the identification and implementation of "best-evidence" pedagogy and teaching. This is primarily because research questions that do support the purposes of review do not support educational decision making. By contrast to systematic reviews of the literature, both a DOFA and KT are fully compatible with informing teaching using evidence. A DOFA supports the translation of theory to a specific teaching or learning case, so could be considered a type of KT. The DOFA results in a test of alignment of decision options with relevant educational theory, and KT leads to interventions in teaching or learning that can be evaluated. Examples of how to structure evaluable interventions are derived from a KT approach that are simply not available from a systematic review. Insights: Systematic reviewing of current empirical educational research is not suitable for deriving or supporting best practices in education. However, both "evidence-informed" and scholarly approaches to teaching can be supported as KT projects, which are inherently evaluable and can generate

  9. Business models of micro businesses: Empirical evidence from creative industries

    Directory of Open Access Journals (Sweden)

    Pfeifer Sanja

    2017-01-01

    Full Text Available Business model describes how a business identifies and creates value for customers and how it organizes itself to capture some of this value in a profitable manner. Previous studies of business models in creative industries have only recently identified the unresolved issues in this field of research. The main objective of this article is to analyse the structure and diversity of business models and to deduce how these components interact or change in the context of micro and small businesses in creative services such as advertising, architecture and design. The article uses a qualitative approach. Case studies and semi-structured, in-depth interviews with six owners/managers of micro businesses in Croatia provide rich data. Structural coding in data analysis has been performed manually. The qualitative analysis has indicative relevance for the assessment and comparison of business models, however, it provides insights into which components of business models seem to be consolidated and which seem to contribute to the diversity of business models in creative industries. The article contributes to the advancement of empirical evidence and conceptual constructs that might lead to more advanced methodological approaches and proposition of the core typologies or classifications of business models in creative industries. In addition, a more detailed mapping of different choices available in managing value creation, value capturing or value networking might be a valuable help for owners/managers who want to change or cross-fertilize their business models.

  10. Appropriability, Technological Opportunity, Market Demand, and Technical Change - Empirical Evidence from Switzerland

    OpenAIRE

    Harabi, Najib

    1992-01-01

    The purpose of this paper is to analyze both theoretically and empirically those factors which underlay the - empirically observable - inter-industry differences in technical progress. At the theoretical level economists agree more and more that technical progress can be explained at the industry level by the following three factors: (1) the technological opportunities, (2) the appropriability conditions, meaning the ability to capture and protect the results of technical innovations and (3) ...

  11. Health care for irregular migrants: pragmatism across Europe: a qualitative study

    NARCIS (Netherlands)

    Dauvrin, M.; Lorant, V.; Sandhu, S.; Devillé, W.; Dia, H.; Dias, S.; Gaddini, A.; Ioannidis, E.; Jensen, N.K.; Kluge, U.; Mertaniemi, R.; Puigpinós i Riera, R.; Sárváry, A.; Straßmayr, C.; Stankunas, M.; Soares, J.J.F.; Welbel, M.; Priebe, S.

    2012-01-01

    Background Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in

  12. Assessing the Potential and Limitations of Leveraging Food Sovereignty to Improve Human Health.

    Science.gov (United States)

    Jones, Andrew D; Fink Shapiro, Lilly; Wilson, Mark L

    2015-01-01

    Food sovereignty has been defined as "the right of peoples to healthy and culturally appropriate food produced through ecologically sound and sustainable methods, and their right to define their own food and agriculture systems." Human health is an implied component of this definition through the principle of healthy food. In fact, improved human health is commonly cited as a benefit of transforming food production away from the dominant practices of industrial agriculture. Yet, does the use of "ecologically sound and sustainable methods" of food production necessarily translate into better human health outcomes? Does greater choice in defining an agricultural or food system create gains in health and well-being? We elucidate the conceptual linkages between food sovereignty and human health, critically examine the empirical evidence supporting or refuting these linkages, and identify research gaps and key priorities for the food sovereignty-human health research agenda. Five domains of food sovereignty are discussed including: (1) use of agroecological management practices for food production, (2) the localization of food production and consumption, (3) promotion of social justice and equity, (4) valuation of traditional knowledge, and (5) the transformation of economic and political institutions and structures to support self-determination. We find that although there are many plausible linkages between food sovereignty and human health, the empirical evidence in support of the hypothesis that increasing food sovereignty yields improvements to human health is weak. We propose that a concerted effort to generate new empirical evidence on the health implications of these domains of food sovereignty is urgently needed, and suggest areas of research that may be crucial for addressing the gaps in the evidence base.

  13. Political instability and economic growth: an empirical evidence from the Baltic states

    OpenAIRE

    Ladislava Grochová; Luděk Kouba

    2011-01-01

    For more than last 20 decades, new political economics has been dealing with theories of economic growth (for example influential contributions by Mancur Olson, Dani Rodrik). However, less attention has been paid to their empirical verification. The new political economics growth theory defines some factors that are necessary for economic growth among which political stability. Our aim is to test the theory focused on political stability empirically in order to enrich the studies with recent ...

  14. GRADE: Assessing the quality of evidence in environmental and occupational health.

    Science.gov (United States)

    Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary S; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C; Santesso, Nancy; Schünemann, Holger J

    2016-01-01

    There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are

  15. The effectiveness of health care cost management strategies: a review of the evidence.

    Science.gov (United States)

    Fronstin, P

    1994-10-01

    This Issue Brief discusses the evolution of the health care delivery and financing systems and its effects on health care cost management and describes the changes in the health care delivery system as they pertain to managed care. It presents empirical evidence on the effectiveness of managed care and concludes with an analysis of the potential of future health care reform to influence the evolution of the health care delivery system and affect health care costs. Between 1987 and 1993, total enrollment in health maintenance organizations (HMOs) increased from 28.6 million to 39.8 million, representing an additional 11.2 million individuals, or 4 percent of the U.S. population. At the same time, new forms of managed care organizations emerged. Enrollment in preferred provider organizations increased from 12.2 million individuals in 1987 to 58 million in 1992, and enrollment in point-of-service plans increased from virtually none in 1987 to 2.3 million individuals in 1992. In addition, the percentage of traditional fee-for-service plans with some form of utilization review increased to 95 percent in 1990 from 41 percent in 1987. Measuring the effects of the changing delivery system on the costs and quality of health care services has been a difficult task, resulting in considerable disagreement as to whether or not costs have been affected. In a recent report, the Congressional Budget Office recognizes two new major findings. First, managed care can provide cost-effective health care at a level of quality comparable with the care typically provided by a fee-for-service plan. Second, independent practice associations can be as effective as group- or staff-model HMOs under certain conditions. In the future, we are likely to see a continued movement of Americans into managed care arrangements, an increase in the number of physicians forming networks, a reduction in the number of insurers, an increase in the number of employers joining coalitions to purchase health care

  16. A New Statistical Method to Determine the Degree of Validity of Health Economic Model Outcomes against Empirical Data.

    NARCIS (Netherlands)

    Corro Ramos, Isaac; van Voorn, George A K; Vemer, Pepijn; Feenstra, Talitha L; Al, Maiwenn J

    2017-01-01

    The validation of health economic (HE) model outcomes against empirical data is of key importance. Although statistical testing seems applicable, guidelines for the validation of HE models lack guidance on statistical validation, and actual validation efforts often present subjective judgment of

  17. Electronic tools for health information exchange: an evidence-based analysis.

    Science.gov (United States)

    2013-01-01

    As patients experience transitions in care, there is a need to share information between care providers in an accurate and timely manner. With the push towards electronic medical records and other electronic tools (eTools) (and away from paper-based health records) for health information exchange, there remains uncertainty around the impact of eTools as a form of communication. To examine the impact of eTools for health information exchange in the context of care coordination for individuals with chronic disease in the community. A literature search was performed on April 26, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published until April 26, 2012 (no start date limit was applied). A systematic literature search was conducted, and meta-analysis conducted where appropriate. Outcomes of interest fell into 4 categories: health services utilization, disease-specific clinical outcomes, process-of-care indicators, and measures of efficiency. The quality of the evidence was assessed individually for each outcome. Expert panels were assembled for stakeholder engagement and contextualization. Eleven articles were identified (4 randomized controlled trials and 7 observational studies). There was moderate quality evidence of a reduction in hospitalizations, hospital length of stay, and emergency department visits following the implementation of an electronically generated laboratory report with recommendations based on clinical guidelines. The evidence showed no difference in disease-specific outcomes; there was no evidence of a positive impact on process-of-care indicators or measures of efficiency. A limited body of research specifically examined eTools for health information exchange in the population and setting of interest. This evidence included a

  18. The influence of system quality characteristics on health care providers' performance: Empirical evidence from Malaysia.

    Science.gov (United States)

    Mohd Salleh, Mohd Idzwan; Zakaria, Nasriah; Abdullah, Rosni

    The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  19. Monetary policy and bank behavior: Empirical evidence from India

    OpenAIRE

    Ghosh, Saibal

    2006-01-01

    The paper develops an empirical model to explore the role that bank characteristics play in influencing the monetary transmission process. Employing data on Indian commercial banks for the period 1992-2004, the findings indicate that for banks classified according to size and capitalization, a monetary contraction lowers bank lending, although large and well-capitalized banks are able to shield their loan portfolio from monetary shocks.

  20. Principles Involving Marketing Policies: An Empirical Assessment

    OpenAIRE

    JS Armstrong; Randall L. Schultz

    2005-01-01

    We examined nine marketing textbooks, published since 1927, to see if they contained useful marketing principles. Four doctoral students found 566 normative statements about pricing, product, place, or promotion in these texts. None of these stateinents were supported by empirical evidence. Four raters agreed on only twenty of these 566 statements as providing meaningful principles. Twenty marketing professors rated whether the twenty meaningful principles were correct, supported by empirical...

  1. Assessing communities of practice in health policy: a conceptual framework as a first step towards empirical research.

    Science.gov (United States)

    Bertone, Maria Paola; Meessen, Bruno; Clarysse, Guy; Hercot, David; Kelley, Allison; Kafando, Yamba; Lange, Isabelle; Pfaffmann, Jérôme; Ridde, Valéry; Sieleunou, Isidore; Witter, Sophie

    2013-10-20

    Communities of Practice (CoPs) are groups of people that interact regularly to deepen their knowledge on a specific topic. Thanks to information and communication technologies, CoPs can involve experts distributed across countries and adopt a 'transnational' membership. This has allowed the strategy to be applied to domains of knowledge such as health policy with a global perspective. CoPs represent a potentially valuable tool for producing and sharing explicit knowledge, as well as tacit knowledge and implementation practices. They may also be effective in creating links among the different 'knowledge holders' contributing to health policy (e.g., researchers, policymakers, technical assistants, practitioners, etc.). CoPs in global health are growing in number and activities. As a result, there is an increasing need to document their progress and evaluate their effectiveness. This paper represents a first step towards such empirical research as it aims to provide a conceptual framework for the analysis and assessment of transnational CoPs in health policy.The framework is developed based on the findings of a literature review as well as on our experience, and reflects the specific features and challenges of transnational CoPs in health policy. It organizes the key elements of CoPs into a logical flow that links available resources and the capacity to mobilize them, with knowledge management activities and the expansion of knowledge, with changes in policy and practice and, ultimately, with an improvement in health outcomes. Additionally, the paper addresses the challenges in the operationalization and empirical application of the framework.

  2. Assessing communities of practice in health policy: a conceptual framework as a first step towards empirical research

    Science.gov (United States)

    2013-01-01

    Communities of Practice (CoPs) are groups of people that interact regularly to deepen their knowledge on a specific topic. Thanks to information and communication technologies, CoPs can involve experts distributed across countries and adopt a ‘transnational’ membership. This has allowed the strategy to be applied to domains of knowledge such as health policy with a global perspective. CoPs represent a potentially valuable tool for producing and sharing explicit knowledge, as well as tacit knowledge and implementation practices. They may also be effective in creating links among the different ‘knowledge holders’ contributing to health policy (e.g., researchers, policymakers, technical assistants, practitioners, etc.). CoPs in global health are growing in number and activities. As a result, there is an increasing need to document their progress and evaluate their effectiveness. This paper represents a first step towards such empirical research as it aims to provide a conceptual framework for the analysis and assessment of transnational CoPs in health policy. The framework is developed based on the findings of a literature review as well as on our experience, and reflects the specific features and challenges of transnational CoPs in health policy. It organizes the key elements of CoPs into a logical flow that links available resources and the capacity to mobilize them, with knowledge management activities and the expansion of knowledge, with changes in policy and practice and, ultimately, with an improvement in health outcomes. Additionally, the paper addresses the challenges in the operationalization and empirical application of the framework. PMID:24139662

  3. The judgement process in evidence-based medicine and health technology assessment

    OpenAIRE

    Kelly, Michael P; Moore, Tessa A

    2011-01-01

    This article describes the judgements used to interpret evidence in evidence-based medicine (EBM) and health technology assessment (HTA). It outlines the methods and processes of EBM and HTA. Respectively, EBM and HTA are approaches to medical clinical decision making and efficient allocation of scarce health resources. At the heart of both is a concern to review and synthesise evidence, especially evidence derived from randomised controlled trials (RCTs) of clinical effectiveness. The driver...

  4. Does Eating Out Make Elderly People Depressed? Empirical Evidence from National Health and Nutrition Survey in Taiwan.

    Science.gov (United States)

    Chang, Hung-Hao; Saeliw, Kannika

    2017-06-01

    OBJECTIVES: This study investigates the association between eating out and depressive symptoms among elderly people. Potential mediators that may link to elderly eating out and depressive symptoms are also discussed. METHODS: A unique dataset of 1,184 individuals aged 65 and older was drawn from the National Health and Nutrition Survey in 2008 in Taiwan. A bivariate probit model and an instrumental variable probit model were estimated to account for correlated, unmeasured factors that may be associated with both the decision and frequency of eating out and depressive symptoms in the elderly. An additional analysis is conducted to check whether the nutrient intakes and body weights can be seen as mediators that link the association between eating out and depressive symptoms of the elderly. RESULTS: Elderly people who eat out are 38 percent points more likely to have depressive symptoms than their counterparts who do not eat out, after controlling for socio-demographic characteristics and other factors. A positive association between the frequency of eating out and the likelihood of having depressive symptoms of the elderly is also found. It is evident that one additional meal away from home is associated with an increase of the likelihood of being depressed by 3.8 percentage points. With respect to the mediations, we find that nutrient intakes and body weight are likely to serve as mediators for the positive relationship between eating out and depressive symptoms in the elderly. CONCLUSION: Our results show that elderly who eat out have a higher chance of having depressive symptoms. To prevent depressive symptoms in the elderly, policy makers should be aware of the relationship among psychological status, physical health and nutritional health when assisting the elderly to better manage their food consumption away from home. LIMITATONS AND IMPLICATIONS FOR FUTURE RESEARCH: Our study have some caveats. First, the interpretation of our results on the causality issue

  5. The influence of system quality characteristics on health care providers’ performance: Empirical evidence from Malaysia

    Directory of Open Access Journals (Sweden)

    Mohd Idzwan Mohd Salleh

    2016-11-01

    Full Text Available Summary: Background: The Ministry of Health Malaysia initiated the total hospital information system (THIS as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Methods: Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Results and conclusions: Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider’s performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers’ performance was expected when the system usage fits with patients’ needs that eventually increased their productivity. Keywords: Electronic health records system, System quality characteristics, Care providers’ performance, Evaluation, Partial least squares-structural equation modeling

  6. An empirical typology of social networks and its association with physical and mental health: a study with older Korean immigrants.

    Science.gov (United States)

    Park, Nan Sook; Jang, Yuri; Lee, Beom S; Ko, Jung Eun; Haley, William E; Chiriboga, David A

    2015-01-01

    In the context of social convoy theory, the purposes of the study were (a) to identify an empirical typology of the social networks evident in older Korean immigrants and (b) to examine its association with self-rated health and depressive symptoms. The sample consisted of 1,092 community-dwelling older Korean immigrants in Florida and New York. Latent class analyses were conducted to identify the optimal social network typology based on 8 indicators of interpersonal relationships and activities. Bivariate and multivariate analyses were conducted to examine how the identified social network typology was associated with self-rating of health and depressive symptoms. Results from the latent class analysis identified 6 clusters as being most optimal, and they were named diverse, unmarried/diverse, married/coresidence, family focused, unmarried/restricted, and restricted. Memberships in the clusters of diverse and married/coresidence were significantly associated with more favorable ratings of health and lower levels of depressive symptoms. Notably, no distinct network solely composed of friends was identified in the present sample of older immigrants; this may reflect the disruptions in social convoys caused by immigration. The findings of this study promote our understanding of the unique patterns of social connectedness in older immigrants. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Macroeconomic Conditions, Health and Mortality

    OpenAIRE

    Christopher J. Ruhm

    2004-01-01

    Although health is conventionally believed to deteriorate during macroeconomic downturns, the empirical evidence supporting this view is quite weak and comes from studies containing methodological shortcomings that are difficult to remedy. Recent research that better controls for many sources of omitted variables bias instead suggests that mortality decreases and physical health improves when the economy temporarily weakens. This partially reflects reductions in external sources of death, suc...

  8. Is economic growth good or bad for the environment? Empirical evidence from Korea

    International Nuclear Information System (INIS)

    Baek, Jungho; Kim, Hyun Seok

    2013-01-01

    The effects of economic growth on the environment in Korea, for a given level of energy consumption, and fossil fuels and nuclear energy in electricity production, are examined in a dynamic cointegration framework. To that end, the autoregressive distributed lag (ARDL) approach is used. We find empirical evidence supporting the existence of the environmental Kuznets curve (EKC) hypothesis for Korea; that is, economic growth indeed plays a favorable role in influencing environmental outcomes. It is also found that, in both the short- and long-run, nuclear energy has a beneficial effect on environmental quality, whereas fossil fuels in electricity production and energy consumption have a detrimental effect on the environment. - Highlights: ► We examine the validity of the environmental Kuznets curve hypothesis for Korea. ► The model includes the roles of energy consumption and electricity production. ► We find the existence of the EKC hypothesis for Korea. ► Nuclear energy is found to have a beneficial effect on the environment. ► Fossil fuels and energy consumption have a detrimental effect on the environment

  9. Do modified audit opinions have economic consequences? Empirical evidence based on financial constraints

    Directory of Open Access Journals (Sweden)

    Zhiwei Lin

    2011-09-01

    Full Text Available We present a framework and empirical evidence to explain why, on average, 11% of listed firms in China received modified audit opinions (MAOs between 1992 and 2009. We argue that there are two reasons for this phenomenon: strong earnings management incentives lower firms’ financial reporting quality and soft budget constraints weaken the information and governance roles of audit opinions. We find that firms’ financial constraints eased after receiving MAOs, which suggests that MAOs have limited economic consequences. Further analysis shows that this phenomenon predominantly exists in government-controlled firms and firms that receive MAOs for the first time. We also find that MAOs have not influenced financial constraints after 2006. Finally, we find that MAOs did not affect borrowing cash flows from banks until 2005, suggesting that MAOs did not start affecting bank financing until that year. We also find that firms receive more related-party financing after receiving MAOs. Our results indicate that a limited effect on bank financing and increased related-party financing reduce the effect of MAOs on financial constraints.

  10. Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

    Science.gov (United States)

    Guyon, Ak'ingabe; Perreault, Robert

    2016-10-20

    Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

  11. Entrepreneurship Education in Schools: Empirical Evidence on the Teacher's Role

    Science.gov (United States)

    Ruskovaara, Elena; Pihkala, Timo

    2015-01-01

    Different approaches and methodologies for entrepreneurship education have been introduced for schools. However, a better theoretical and empirical understanding of the antecedents of entrepreneurship education is needed. The authors analyze what entrepreneurship education practices are used in schools and what role the school and the teacher are…

  12. Are Health-Related Tweets Evidence Based? Review and Analysis of Health-Related Tweets on Twitter.

    Science.gov (United States)

    Alnemer, Khalid A; Alhuzaim, Waleed M; Alnemer, Ahmed A; Alharbi, Bader B; Bawazir, Abdulrahman S; Barayyan, Omar R; Balaraj, Faisal K

    2015-10-29

    Health care professionals are utilizing Twitter to communicate, develop disease surveillance systems, and mine health-related information. The immediate users of this health information is the general public, including patients. This necessitates the validation of health-related tweets by health care professionals to ensure they are evidence based and to avoid the use of noncredible information as a basis for critical decisions. The aim of this study was to evaluate health-related tweets on Twitter for validity (evidence based) and to create awareness in the community regarding the importance of evidence-based health-related tweets. All tweets containing health-related information in the Arabic language posted April 1-5, 2015, were mined from Twitter. The tweets were classified based on popularity, activity, interaction, and frequency to obtain 25 Twitter accounts (8 physician accounts, 10 nonofficial health institute accounts, 4 dietitian accounts, and 3 government institute accounts) and 625 tweets. These tweets were evaluated by 3 American Board-certified medical consultants and a score was generated (true/false) and interobserver agreement was calculated. A total of 625 health-related Arabic-language tweets were identified from 8 physician accounts, 10 nonofficial health institute accounts, 4 dietician accounts, and 3 government institute accounts. The reviewers labeled 320 (51.2%) tweets as false and 305 (48.8%) tweets as true. Comparative analysis of tweets by account type showed 60 of 75 (80%) tweets by government institutes, 124 of 201 (61.7%) tweets by physicians, and 42 of 101 (41.6%) tweets by dieticians were true. The interobserver agreement was moderate (range 0.78-0.22). More than half of the health-related tweets (169/248, 68.1%) from nonofficial health institutes and dietician accounts (59/101, 58.4%) were false. Tweets by the physicians were more likely to be rated "true" compared to other groups (PTwitter were found to be false based on expert

  13. Health Disparities in Veterans: A Map of the Evidence.

    Science.gov (United States)

    Kondo, Karli; Low, Allison; Everson, Teresa; Gordon, Christine D; Veazie, Stephanie; Lozier, Crystal C; Freeman, Michele; Motu'apuaka, Makalapua; Mendelson, Aaron; Friesen, Mark; Paynter, Robin; Friesen, Caroline; Anderson, Johanna; Boundy, Erin; Saha, Somnath; Quiñones, Ana; Kansagara, Devan

    2017-09-01

    Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood. To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence. We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources. We included studies of Veteran populations that examined disparities in 3 outcome categories: utilization, quality of health care, and patient health. We abstracted data on study design, setting, population, clinical area, outcomes, mediators, and presence of disparity for each outcome category. We grouped the data by population characteristics including race, disability status, mental illness, demographics (age, era of service, rural location, and distance from care), sex identity, socioeconomic status, and homelessness, and created maps illustrating the evidence. We reviewed 4249 citations and abstracted data from 351 studies which met inclusion criteria. Studies examining disparities by race/ethnicity comprised by far the vast majority of the literature, followed by studies examining disparities by sex, and mental health condition. Very few studies examined disparities related to lesbian, gay, bisexual, or transgender identity or homelessness. Disparities findings vary widely by population and outcome. Our evidence maps provide a "lay of the land" and identify important gaps in knowledge about health disparities experienced by different Veteran populations.

  14. Information demands of occupational health physicians and their attitude towards evidence-based medicine.

    Science.gov (United States)

    Schaafsma, Frederieke; Hulshof, Carel; van Dijk, Frank; Verbeek, Jos

    2004-08-01

    This study assessed the extent and nature of information demands among occupational health physicians and their attitude towards the application of evidence-based medicine in occupational health. A questionnaire survey was carried out among a random sample of 159 physicians practicing occupational medicine in The Netherlands. The questionnaire investigated the type and number of questions encountered in daily practice, the actions taken in response, the physicians' experience in using scientific databases on the Internet, and their attitude towards evidence-based medicine. The occupational health physicians' questions concerned medical, legal, and rehabilitation topics in particular. In pursuing answers to their questions, they generally chose to contact colleagues. Scientific databases were not consulted very often, although, in general, the attitude towards evidence-based medicine was positive. In addition to known barriers for practicing evidence-based medicine, occupational health physicians perceive a lack of scientific evidence in their field. The extensiveness of the field of knowledge in occupational health care was not regarded as an obstacle to their application of evidence-based medicine. Occupational health physicians have a demand for information on a broad range of topics, and, in most cases, their attitude towards evidence-based medicine is fairly positive. Besides education and training in evidence-based medicine, access to the Internet and the presence of a good knowledge infrastructure would help occupational health physicians use evidence-based medicine.

  15. Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project).

    Science.gov (United States)

    Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb

    2018-04-01

    The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.

  16. On the reliability of self-reported health: Evidence from Albanian data

    Directory of Open Access Journals (Sweden)

    Nicolas Vaillant

    2012-06-01

    Full Text Available This paper investigates the reliability of self-assessed measures of health using panel data collected in Albania by the World Bank in 2002, 2003 and 2004 through the Living Standard Measurement Study project. As the survey includes questions on a self-assessed measure of health and on more objective health problems, both types of information are combined with a view to understanding how respondents change their answers to the self-reported measures over time. Estimates from random effects ordered Probit models show that differences in self-reported subjective health between individuals are much more marked than those over time, suggesting a strong state dependence in subjective health status. The empirical analysis also reveals respondent consistency, from both a subjective and an objective viewpoint. Self-reported health is much more influenced by permanent shocks than by more transitory illness or injury.

  17. Complex interventions required to comprehensively educate allied health practitioners on evidence-based practice

    Directory of Open Access Journals (Sweden)

    Dizon JM

    2011-05-01

    Full Text Available Janine Margarita Dizon1,2, Karen Grimmer-Somers11International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia; 2University of Santo Tomas, Manila, PhilippinesAbstract: There is currently no strong evidence regarding the most effective training approach for allied health professionals that will support them to consistently apply the best research evidence in daily practice. Current evidence-based practice training tends to be 'one size fits all', and is unlikely to be appropriate for all allied health disciplines because of the variability in their tasks and scope of practice. The scant body of evidence regarding the effectiveness of evidence-based practice training for allied health practitioners provides some support for improving knowledge and skills, but equivocal evidence about influencing behaviors and attitudes. We propose a new model of evidence-based practice training, based on the concept of complex interventions reported in the literature. We believe that by offering training in evidence-based practice based on complex interventions relevant to the needs of the attendees, using fixed and variable components, there may be greater success in significantly influencing knowledge skills, attitudes, and behaviors.Keywords: complex interventions, evidence-based practice training, allied health

  18. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

    DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. © The Author(s) 2016.

  19. Disparity and convergence: Chinese provincial government health expenditures.

    Science.gov (United States)

    Pan, Jay; Wang, Peng; Qin, Xuezheng; Zhang, Shufang

    2013-01-01

    The huge regional disparity in government health expenditures (GHE) is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.

  20. Disparity and convergence: Chinese provincial government health expenditures.

    Directory of Open Access Journals (Sweden)

    Jay Pan

    Full Text Available The huge regional disparity in government health expenditures (GHE is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.

  1. Internationalisation and technological innovation: empirical evidence on their relation

    OpenAIRE

    Filipescu, Diana-Andreea

    2010-01-01

    Descripció del recurs: el 25 d'octubre de 2011 Internationalisation and innovation of the firms have been considered two of the most important factors determining business success over the last decade (Buckler and Zien, 1996; Wind and Mahajan, 1997; Zahra and George, 2002; Vila and Kuster, 2007). The purpose of this dissertation is to understand better the relation which exists between these two factors. To do so, we undertake empirical investigation which consists of three studies (an ini...

  2. Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?

    Science.gov (United States)

    Cairney, Paul; Oliver, Kathryn

    2017-04-26

    There is extensive health and public health literature on the 'evidence-policy gap', exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems.We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking. The studies are drawn primarily from countries such as the United States, United Kingdom, Canada, Australia and New Zealand. We combine empirical and normative elements to identify the ways in which scientists can, do and could influence policy.We identify two important dilemmas, for scientists and researchers, that arise from our initial advice. First, effective actors combine evidence with manipulative emotional appeals to influence the policy agenda - should scientists do the same, or would the reputational costs outweigh the policy benefits? Second, when adapting to multi-level policymaking, should scientists prioritise 'evidence-based' policymaking above other factors? The latter includes governance principles such the 'co-production' of policy between local public bodies, interest groups and service users. This process may be based primarily on values and involve actors with no commitment to a hierarchy of evidence.We conclude that successful engagement in 'evidence-based policymaking' requires pragmatism, combining scientific evidence with governance principles, and persuasion to translate complex evidence into simple stories. To maximise the use of scientific evidence in health and public health policy, researchers should recognise the tendency of policymakers to base judgements on their beliefs, and shortcuts based on their emotions

  3. Supporting decision-making processes for evidence-based mental health promotion.

    Science.gov (United States)

    Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian

    2011-12-01

    The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.

  4. Benefiting from networks by occupying central positions: an empirical study of the Taiwan health care industry.

    Science.gov (United States)

    Peng, Tzu-Ju Ann; Lo, Fang-Yi; Lin, Chin-Shien; Yu, Chwo-Ming Joseph

    2006-01-01

    At issue is whether network resources imply some resources available to all members in networks or available only to those occupying structurally central positions in networks. In this article, two conceptual models, the additive and interaction models of the firm, are empirically tested regarding the impact of hospital resources, network resources, and centrality on hospital performance in the Taiwan health care industry. The results demonstrate that: (1) in the additive model, hospital resources and centrality independently affect performance, whereas network resources do not; and (2) no evidence supports the interaction effect of centrality and resources on performance. Based on our findings in Taiwanese practices, the extent to which the resources are acquired externally from networks, we suggest that while adopting interorganizational strategies, hospitals should clearly identify those important resources that reside in-house and those transferred from network partners. How hospitals access resources from central positions is more important than what network resources can hospitals acquire from networks. Hospitals should improve performance by exploiting its in-house resources rather than obtaining network resources externally. In addition, hospitals should not only invest in hospital resources for better performance but should also move to central positions in networks to benefit from collaborations.

  5. Empirical methods for systematic reviews and evidence-based medicine

    NARCIS (Netherlands)

    van Enst, W.A.

    2014-01-01

    Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. Systematic reviews have become the cornerstone of evidence-based medicine, which is reflected in the position systematic reviews have in the pyramid of evidence-based medicine. Systematic

  6. Innovation and productivity: empirical evidence for Brazilian industrial enterprises

    Directory of Open Access Journals (Sweden)

    Luciana Carvalho

    Full Text Available Abstract The aim of this paper is to carry out an empirical investigation into the relationship between innovation and the productive performance of Brazilian businesses measured by Work Productivity and Total Factor Productivity. Data taken from the Research of Innovation and estimated cross section models and panel data was used. The results suggest that innovation produces an incipient impact on competition in the national industry, reflected in the small magnitude of coefficients associated with the diverse indicators of innovation.

  7. Consumer trust in food safety--a multidisciplinary approach and empirical evidence from Taiwan.

    Science.gov (United States)

    Chen, Mei-Fang

    2008-12-01

    Food scandals that happened in recent years have increased consumers' risk perceptions of foods and decreased their trust in food safety. A better understanding of the consumer trust in food safety can improve the effectiveness of public policy and allow the development of the best practice in risk communication. This study proposes a research framework from a psychometric approach to investigate the relationships between the consumer's trust in food safety and the antecedents of risk perceptions of foods based on a reflexive modernization perspective and a cultural theory perspective in the hope of benefiting the future empirical study. The empirical results from a structural equation modeling analysis of Taiwan as a case in point reveal that this research framework based on a multidisciplinary perspective can be a valuable tool for a growing understanding of consumer trust in food safety. The antecedents in the psychometric research framework comprised reflexive modernization factors and cultural theory factors have all been supported in this study except the consumer's perception of pessimism toward food. Moreover, the empirical results of repeated measures analysis of variance give more detailed information to grasp empirical implications and to provide some suggestions to the actors and institutions involved in the food supply chain in Taiwan.

  8. Public mental health: the time is ripe for translation of evidence into practice.

    Science.gov (United States)

    Wahlbeck, Kristian

    2015-02-01

    Public mental health deals with mental health promotion, prevention of mental disorders and suicide, reducing mental health inequalities, and governance and organization of mental health service provision. The full impact of mental health is largely unrecognized within the public health sphere, despite the increasing burden of disease attributable to mental and behavioral disorders. Modern public mental health policies aim at improving psychosocial health by addressing determinants of mental health in all public policy areas. Stigmatization of mental disorders is a widespread phenomenon that constitutes a barrier for help-seeking and for the development of health care services, and is thus a core issue in public mental health actions. Lately, there has been heightened interest in the promotion of positive mental health and wellbeing. Effective programmes have been developed for promoting mental health in everyday settings such as families, schools and workplaces. New evidence indicates that many mental disorders and suicides are preventable by public mental health interventions. Available evidence favours the population approach over high-risk approaches. Public mental health emphasizes the role of primary care in the provision of mental health services to the population. The convincing evidence base for population-based mental health interventions asks for actions for putting evidence into practice. © 2015 World Psychiatric Association.

  9. Organizational dimensions of relationship-centered care. Theory, evidence, and practice.

    Science.gov (United States)

    Safran, Dana Gelb; Miller, William; Beckman, Howard

    2006-01-01

    Four domains of relationship have been highlighted as the cornerstones of relationship-centered health care. Of these, clinician-patient relationships have been most thoroughly studied, with a rich empirical literature illuminating significant linkages between clinician-patient relationship quality and a wide range of outcomes. This paper explores the realm of clinician-colleague relationships, which we define to include the full array of relationships among clinicians, staff, and administrators in health care organizations. Building on a stream of relevant theories and empirical literature that have emerged over the past decade, we synthesize available evidence on the role of organizational culture and relationships in shaping outcomes, and posit a model of relationship-centered organizations. We conclude that turning attention to relationship-centered theory and practice in health care holds promise for advancing care to a new level, with breakthroughs in quality of care, quality of life for those who provide it, and organizational performance.

  10. A MACROPRUDENTIAL SUPERVISION MODEL. EMPIRICAL EVIDENCE FROM THE CENTRAL AND EASTERN EUROPEAN BANKING SYSTEM

    Directory of Open Access Journals (Sweden)

    Trenca Ioan

    2013-07-01

    Full Text Available One of the positive effects of the financial crises is the increasing concern of the supervisors regarding the financial system’s stability. There is a need to strengthen the links between different financial components of the financial system and the macroeconomic environment. Banking systems that have an adequate capitalization and liquidity level may face easier economic and financial shocks. The purpose of this empirical study is to identify the main determinants of the banking system’s stability and soundness in the Central and Eastern Europe countries. We asses the impact of different macroeconomic variables on the quality of capital and liquidity conditions and examine the behaviour of these financial stability indicators, by analyzing a sample of 10 banking systems during 2000-2011. The availability of banking capital signals the banking system’s resiliency to shocks. Capital adequacy ratio is the main indicator used to assess the banking fragility. One of the causes of the 2008-2009 financial crisis was the lack of liquidity in the banking system which led to the collapse of several banking institutions and macroeconomic imbalances. Given the importance of liquidity for the banking system, we propose several models in order to determine the macroeconomic variables that have a significant influence on the liquid reserves to total assets ratio. We found evidence that GDP growth, inflation, domestic credit to private sector, as well as the money and quasi money aggregate indicator have significant impact on the banking stability. The empirical regression confirms the high level of interdependence of the real sector with the financial-banking sector. Also, they prove the necessity for an effective macro prudential supervision at country level which enables the supervisory authorities to have an adequate control over the macro prudential indicators and to take appropriate decisions at the right time.

  11. The scale-dependent market trend: Empirical evidences using the lagged DFA method

    Science.gov (United States)

    Li, Daye; Kou, Zhun; Sun, Qiankun

    2015-09-01

    In this paper we make an empirical research and test the efficiency of 44 important market indexes in multiple scales. A modified method based on the lagged detrended fluctuation analysis is utilized to maximize the information of long-term correlations from the non-zero lags and keep the margin of errors small when measuring the local Hurst exponent. Our empirical result illustrates that a common pattern can be found in the majority of the measured market indexes which tend to be persistent (with the local Hurst exponent > 0.5) in the small time scale, whereas it displays significant anti-persistent characteristics in large time scales. Moreover, not only the stock markets but also the foreign exchange markets share this pattern. Considering that the exchange markets are only weakly synchronized with the economic cycles, it can be concluded that the economic cycles can cause anti-persistence in the large time scale but there are also other factors at work. The empirical result supports the view that financial markets are multi-fractal and it indicates that deviations from efficiency and the type of model to describe the trend of market price are dependent on the forecasting horizon.

  12. Determinants of Economic Growth: Empirical Evidence from Russian Regions

    Directory of Open Access Journals (Sweden)

    Svetlana Ledyaeva

    2008-06-01

    Full Text Available A modification of Barro and Sala-i-Martin empirical framework of growth model is specified to examine determinants of per capita growth in 74 Russian regions during period of 1996-2005. We utilize both panel and cross-sectional data. Results imply that in general regional growth in 1996-2005 is explained by the initial level of region's economic development, the 1998 financial crisis, domestic investments, and exports. Growth convergence between poor and rich regions in Russia was not found for the period studied.

  13. Equity and Blindness: Closing Evidence Gaps to Support Universal Eye Health.

    Science.gov (United States)

    Ramke, Jacqueline; Zwi, Anthony B; Palagyi, Anna; Blignault, Ilse; Gilbert, Clare E

    2015-01-01

    The World Health Organization Program for the Prevention of Blindness adopted the principles of universal health coverage (UHC) in its latest plan, Universal Eye Health: A Global Action Plan, 2014-2019. This plan builds on the achievements of Vision 2020, which aimed to reduce the global prevalence of avoidable blindness, and its unequal distribution, by the year 2020. We reviewed the literature on health equity and the generation and use of evidence to promote equity, particularly in eye health. We describe the nature and extent of the equity-focused evidence to support and inform eye health programs on the path to universal eye health, and propose ways to improve the collection and reporting of this evidence. Blindness prevalence decreased in all regions of the world between 1990 and 2010, albeit not at the same rate or to the same extent. In 2010, the prevalence of blindness in West Africa (6.0%) remained 15 times higher than in high-income regions (0.4%); within all regions, women had a higher prevalence of blindness than men. Beyond inter-regional and sex differences, there is little comparable data on the distribution of blindness across social groups within regions and countries, or on whether this distribution has changed over time. Similarly, interventions known to address inequity in blindness are few, and equity-relevant goals, targets and indicators for eye health programs are scarce. Equity aims of eye health programs can benefit from the global momentum towards achieving UHC, and the progress being made on collecting, communicating and using equity-focused evidence.

  14. Human and animal evidence of potential transgenerational inheritance of health effects: An evidence map and state-of-the-science evaluation.

    Science.gov (United States)

    Walker, Vickie R; Boyles, Abee L; Pelch, Katherine E; Holmgren, Stephanie D; Shapiro, Andrew J; Blystone, Chad R; Devito, Michael J; Newbold, Retha R; Blain, Robyn; Hartman, Pamela; Thayer, Kristina A; Rooney, Andrew A

    2018-06-01

    An increasing number of reports suggest early life exposures result in adverse effects in offspring who were never directly exposed; this phenomenon is termed "transgenerational inheritance." Given concern for public health implications for potential effects of exposures transmitted to subsequent generations, it is critical to determine how widespread and robust this phenomenon is and to identify the range of exposures and possible outcomes. This scoping report examines the evidence for transgenerational inheritance associated with exposure to a wide range of stressors in humans and animals to identify areas of consistency, uncertainty, data gaps, and to evaluate general risk of bias issues for the transgenerational study design. A protocol was developed to collect and categorize the literature into a systematic evidence map for transgenerational inheritance by health effects, exposures, and evidence streams following the Office of Health Assessment and Translation (OHAT) approach for conducting literature-based health assessments. A PubMed search yielded 63,758 unique records from which 257 relevant studies were identified and categorized into a systematic evidence map by evidence streams (46 human and 211 animal), broad health effect categories, and exposures. Data extracted from the individual studies are available in the Health Assessment Workspace Collaborative (HAWC) program. There are relatively few bodies of evidence where multiple studies evaluated the same exposure and the same or similar outcomes. Studies evaluated for risk of bias generally had multiple issues in design or conduct. The evidence mapping illustrated that risk of bias, few studies, and heterogeneity in exposures and endpoints examined present serious limitations to available bodies of evidence for assessing transgenerational effects. Targeted research is suggested to addressed inconsistencies and risk of bias issues identified, and thereby establish more robust bodies of evidence to

  15. Empirical evidence of design-related bias in studies of diagnostic tests

    NARCIS (Netherlands)

    Lijmer, J. G.; Mol, B. W.; Heisterkamp, S.; Bonsel, G. J.; Prins, M. H.; van der Meulen, J. H.; Bossuyt, P. M.

    1999-01-01

    CONTEXT: The literature contains a large number of potential biases in the evaluation of diagnostic tests. Strict application of appropriate methodological criteria would invalidate the clinical application of most study results. OBJECTIVE: To empirically determine the quantitative effect of study

  16. Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

    Science.gov (United States)

    Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

    2017-09-01

    In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across segments of the population as well as evidence on specific

  17. IMPROVING THE EFFECTIVENESS AND EFFICIENCY OF EVIDENCE PRODUCTION FOR HEALTH TECHNOLOGY ASSESSMENT.

    Science.gov (United States)

    Facey, Karen; Henshall, Chris; Sampietro-Colom, Laura; Thomas, Sarah

    2015-01-01

    Health Technology Assessment (HTA) needs to address the challenges posed by high cost, effective technologies, expedited regulatory approaches, and the opportunities provided by collaborative real-world evaluation of technologies. The Health Technology Assessment International (HTAi) Policy Forum met to consider these issues and the implications for evidence production to inform HTA. This paper shares their discussion to stimulate further debate. A background paper, presentations, group discussions, and stakeholder role play at the 2015 HTAi Policy Forum meeting informed this paper. HTA has an important role to play in helping improve evidence production and ensuring that the health service is ready to adopt effective technologies. It needs to move from simply informing health system decisions to also working actively to align stakeholder expectations about realistic evidence requirements. Processes to support dialogue over the health technology life cycle need to be developed that are mindful of limited resources, operate across jurisdictions and learn from past processes. Collaborations between health technology developers and health systems in different countries should be encouraged to develop evidence that will inform decision making. New analytical techniques emerging for real-world data should be harnessed to support modeling for HTA. A paradigm shift (to "Health Innovation System 2.0") is suggested where HTA adopts a more central, proactive role to support alignment within and amongst stakeholders over the whole life cycle of the technology. This could help ensure that evidence production is better aligned with patient and health system needs and so is more effective and efficient.

  18. Health technology assessment of utilization, practice and ethical issues of self-pay services in the German ambulatory health care setting.

    Science.gov (United States)

    Hunger, Theresa; Schnell-Inderst, Petra; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin; Gothe, Holger; Wasem, Jürgen; Siebert, Uwe

    2014-02-01

    The provision of self-pay medical services is common across health care systems, but understudied. According to the German Medical Association, such services should be medically necessary, recommended or at least justifiable, and requested by the patient. We investigated the empirical evidence regarding frequency and practice of self-pay services as well as related ethical, social, and legal issues (ELSI). A systematic literature search in electronic databases and a structured internet search on stakeholder websites with qualitative and quantitative information synthesis. Of 1,345 references, we included 64 articles. Between 19 and 53 % of insured persons received self-pay service offers from their physician; 16-19 % actively requested such services. Intraocular pressure measurement was the most common service, followed by ultrasound investigations. There is a major discussion about ELSI in the context of individual health services. Self-pay services are common medical procedures in Germany. However, the empirical evidence is limited in quality and extent, even for the most frequently provided services. Transparency of their provision should be increased and independent evidence-based patient information should be supplied.

  19. The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Integration of Animal and Human Evidence for PFOA Effects on Fetal Growth

    Science.gov (United States)

    Koustas, Erica; Sutton, Patrice; Johnson, Paula I.; Atchley, Dylan S.; Sen, Saunak; Robinson, Karen A.; Axelrad, Daniel A.; Woodruff, Tracey J.

    2014-01-01

    Background: The Navigation Guide is a novel systematic review method to synthesize scientific evidence and reach strength of evidence conclusions for environmental health decision making. Objective: Our aim was to integrate scientific findings from human and nonhuman studies to determine the overall strength of evidence for the question “Does developmental exposure to perfluorooctanoic acid (PFOA) affect fetal growth in humans?” Methods: We developed and applied prespecified criteria to systematically and transparently a) rate the quality of the scientific evidence as “high,” “moderate,” or “low”; b) rate the strength of the human and nonhuman evidence separately as “sufficient,” “limited,” “moderate,” or “evidence of lack of toxicity”; and c) integrate the strength of the human and nonhuman evidence ratings into a strength of the evidence conclusion. Results: We identified 18 epidemiology studies and 21 animal toxicology studies relevant to our study question. We rated both the human and nonhuman mammalian evidence as “moderate” quality and “sufficient” strength. Integration of these evidence ratings produced a final strength of evidence rating in which review authors concluded that PFOA is “known to be toxic” to human reproduction and development based on sufficient evidence of decreased fetal growth in both human and nonhuman mammalian species. Conclusion: We concluded that developmental exposure to PFOA adversely affects human health based on sufficient evidence of decreased fetal growth in both human and nonhuman mammalian species. The results of this case study demonstrate the application of a systematic and transparent methodology, via the Navigation Guide, for reaching strength of evidence conclusions in environmental health. Citation: Lam J, Koustas E, Sutton P, Johnson PI, Atchley DS, Sen S, Robinson KA, Axelrad DA, Woodruff TJ. 2014. The Navigation Guide—evidence-based medicine meets environmental health

  20. Anomalies and Investor Sentiment: Empirical Evidences in the Brazilian Market

    Directory of Open Access Journals (Sweden)

    Gustavo Correia Xavier

    2017-10-01

    Full Text Available This study examined the relationship between investor sentiment and value anomalies in Brazil. In addition, it analyzed if pricing deviations caused by investors with optimistic views are different from those caused by pessimistic investors. The sample included all non-financial firms listed on the B3 (Brasil, Bolsa, Balcão stock exchange from July 1999 to June 2014. We used the Principal Component Analysis multivariate technique to capture the component common to four different proxies for investor sentiment. The study empirically tested the index series and its variation on the return series of Long-Short portfolios of 12 anomaly-based strategies. The study found that the measure of the sentiment index had a partial explanatory power for the anomalies only when included in the CAPM. Yet, when using the index sentiment changes as an explanatory variable, the study found a relationship with future returns, robust to all risk factors. Thus, it is possible to relate investor sentiment index to anomaly-based portfolio returns. When analyzing average returns after optimistic and pessimistic periods, the values we found in our empirical test were not statistically significant enough to infer the possible existence of short-sale constraints.

  1. Literary and Documentary Evidence for Lay Medical Practice in the Roman Republic and Empire.

    Science.gov (United States)

    Draycott, Jane

    2016-01-01

    The majority of surviving ancient medical literature was written by medical practitioners and produced for the purpose of ensuring the effective diagnosis and treatment of their patients, suggesting an audience of medical professionals ranging from instructors to students. This has led historians to concentrate on the professional medical practitioner and their theories, methods and practices, rather than on lay medical practitioners, or even patients themselves. This chapter seeks to redress this imbalance, and examine the ancient literary and documentary evidence for lay medical theories, methods and practices in the Roman Republic and Empire in an attempt to reconstruct the experiences of lay medical practitioners and their patients. The Roman agricultural treatises of Cato, Varro and Columella, papyri and ostraca from Egypt, and tablets from Britain are investigated, and it is established that the individual's personal acquisition of knowledge and expertise, not only from medical professionals and works of medical literature, but also from family members and friends, and through trial and error, was considered fundamental to domestic medical practice.

  2. The effects of adolescent health-related behavior on academic performance : a systematic review of the longitudinal evidence

    NARCIS (Netherlands)

    Busch, Vincent; Loyen, Anne; Lodder, Mandy; Schrijvers, Augustinus J. P.; van Yperen, Tom A.; de Leeuw, Johannes R. J.

    Schools are increasingly involved in efforts to promote health and healthy behavior among their adolescent students, but are healthier students better learners? This synthesis of the empirical, longitudinal literature investigated the effects of the most predominant health-related behaviors-namely,

  3. Epistemonikos: a free, relational, collaborative, multilingual database of health evidence.

    Science.gov (United States)

    Rada, Gabriel; Pérez, Daniel; Capurro, Daniel

    2013-01-01

    Epistemonikos (www.epistemonikos.org) is a free, multilingual database of the best available health evidence. This paper describes the design, development and implementation of the Epistemonikos project. Using several web technologies to store systematic reviews, their included articles, overviews of reviews and structured summaries, Epistemonikos is able to provide a simple and powerful search tool to access health evidence for sound decision making. Currently, Epistemonikos stores more than 115,000 unique documents and more than 100,000 relationships between documents. In addition, since its database is translated into 9 different languages, Epistemonikos ensures that non-English speaking decision-makers can access the best available evidence without language barriers.

  4. Evidence for Busines Intelligence in Health Care: A Literature Review.

    Science.gov (United States)

    Loewen, Liz; Roudsari, Abdul

    2017-01-01

    This paper outlines a systematic literature review undertaken to establish current evidence regarding the impact of Business Intelligence (BI) on health system decision making and organizational performance. The review also examined BI implementation factors contributing to these constructs. Following the systematic review, inductive content analysis was used to categorize themes within the eight articles identified. This study demonstrated there is little evidence based literature focused on BI impact on organizational decision making and performance within health care. There was evidence found that BI does improve decision making. Implementation success was found to be dependent on several factors, many of which relate to broader organizational culture and readiness.

  5. Using knowledge and evidence in health care: multidisciplinary perspectives

    National Research Council Canada - National Science Library

    Champagne, François; Lemieux-Charles, Louise

    2004-01-01

    ... to the volume presents a conceptual framework that illustrates the factors critical to analysing and optimizing the use of knowledge and evidence in health care decision-making. The following essays, by distinguished scholars from a variety of disciplines, discuss the dominant paradigms and understanding of knowledge and evidence through different p...

  6. Why autobiographical memories for traumatic and emotional events might differ: theoretical arguments and empirical evidence.

    Science.gov (United States)

    Sotgiu, Igor; Rusconi, Maria Luisa

    2014-01-01

    The authors review five arguments supporting the hypothesis that memories for traumatic and nontraumatic emotional events should be considered as qualitatively different recollections. The first argument considers the objective features of traumatic and emotional events and their possible influence on the formation of memories for these events. The second argument assumes that traumatic memories distinguish from emotional ones as trauma exposure is often associated with the development of psychological disorders involving memory disturbances. The third argument is that traumatic experiences are more likely than emotional experiences to be forgotten and recovered. The fourth argument concerns the possibility that emotional memories are socially shared more frequently than traumatic memories. A fifth argument suggests that trauma exposure may impair selected brain systems implicated in memory functions. Theoretical and empirical evidence supporting these claims is reviewed. In the conclusions, the authors illustrate future research directions and discuss some conceptual issues related to the definitions of traumatic event currently employed by memory researchers.

  7. Applying a Health Network approach to translate evidence-informed policy into practice: a review and case study on musculoskeletal health.

    Science.gov (United States)

    Briggs, Andrew M; Bragge, Peter; Slater, Helen; Chan, Madelynn; Towler, Simon C B

    2012-11-14

    While translation of evidence into health policy and practice is recognised as critical to optimising health system performance and health-related outcomes for consumers, mechanisms to effectively achieve these goals are neither well understood, nor widely communicated. Health Networks represent a framework which offers a possible solution to this dilemma, particularly in light of emerging evidence regarding the importance of establishing relationships between stakeholders and identifying clinical leaders to drive evidence integration and translation into policy. This is particularly important for service delivery related to chronic diseases. In Western Australia (WA), disease and population-specific Health Networks are comprised of cross-discipline stakeholders who work collaboratively to develop evidence-informed policies and drive their implementation. Since establishment of the Health Networks in WA, over 50 evidence-informed Models of Care (MoCs) have been produced across 18 condition or population-focused Networks. The aim of this paper is to provide an overview of the Health Network framework in facilitating the translation of evidence into policy and practice with a particular focus on musculoskeletal health. A review of activities of the WA Musculoskeletal Health Network was undertaken, focussing on outcomes and the processes used to achieve them in the context of: development of policy, procurement of funding, stakeholder engagement, publications, and projects undertaken by the Network which aligned to implementation of MoCs.The Musculoskeletal Health Network has developed four MoCs which reflect Australian National Health Priority Areas. Establishment of community-based services for consumers with musculoskeletal health conditions is a key recommendation from these MoCs. Through mapping barriers and enablers to policy implementation, working groups, led by local clinical leaders and supported by the broader Network and government officers, have

  8. Applying a Health Network approach to translate evidence-informed policy into practice: A review and case study on musculoskeletal health

    Directory of Open Access Journals (Sweden)

    Briggs Andrew M

    2012-11-01

    Full Text Available Abstract Background While translation of evidence into health policy and practice is recognised as critical to optimising health system performance and health-related outcomes for consumers, mechanisms to effectively achieve these goals are neither well understood, nor widely communicated. Health Networks represent a framework which offers a possible solution to this dilemma, particularly in light of emerging evidence regarding the importance of establishing relationships between stakeholders and identifying clinical leaders to drive evidence integration and translation into policy. This is particularly important for service delivery related to chronic diseases. In Western Australia (WA, disease and population-specific Health Networks are comprised of cross-discipline stakeholders who work collaboratively to develop evidence-informed policies and drive their implementation. Since establishment of the Health Networks in WA, over 50 evidence-informed Models of Care (MoCs have been produced across 18 condition or population-focused Networks. The aim of this paper is to provide an overview of the Health Network framework in facilitating the translation of evidence into policy and practice with a particular focus on musculoskeletal health. Case presentation A review of activities of the WA Musculoskeletal Health Network was undertaken, focussing on outcomes and the processes used to achieve them in the context of: development of policy, procurement of funding, stakeholder engagement, publications, and projects undertaken by the Network which aligned to implementation of MoCs. The Musculoskeletal Health Network has developed four MoCs which reflect Australian National Health Priority Areas. Establishment of community-based services for consumers with musculoskeletal health conditions is a key recommendation from these MoCs. Through mapping barriers and enablers to policy implementation, working groups, led by local clinical leaders and supported by

  9. Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking

    Science.gov (United States)

    El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

    2015-01-01

    Background Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Methods Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Results Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts’ opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Conclusion Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can

  10. A rapid evidence review on the effectiveness of institutional health partnerships.

    Science.gov (United States)

    Kelly, Ema; Doyle, Vicki; Weakliam, David; Schönemann, Yvonne

    2015-12-14

    Institutional Health Partnerships are long-term, institution to institution partnerships between high income and low and middle income countries which seek to build capacity and strengthen health institutions in order to improve health service delivery and outcomes. Funding for Institutional Health Partnerships has increased in recent years. This paper outlines a rapid evidence review on the effectiveness of this modality. A rapid evidence review of published and grey literature was conducted. Content relating to the effectiveness of working in partnership and methods and frameworks used were extracted and analysed. The results of this analysis were used to structure a discussion regarding the next steps to strengthen the evidence base for the effectiveness of institutional health partnerships. The evidence review, including citation mapping, returned 27 published papers and 17 grey literature documents that met all of the inclusion criteria. Most of the literature did not meet the high standards of formal academic rigour and there was no original research amongst this literature that specifically addressed the effectiveness of institutional health partnerships. This was not surprising given institutional health partnerships do not lend themselves easily to case control studies and randomised control trials due to their high level of diversity and operation in complex social systems. There was, however, a body of practice based knowledge and experience. Evidence for the effectiveness of Institutional Health Partnerships is thin both in terms of quantity and academic rigour. There is a need to better define and differentiate Institutional Health Partnerships in order to measure and compare effectiveness across such a diverse group. Effectiveness needs to be measured at the level of individual partnerships, the bodies that facilitate partnership programmes and the level of health service delivery. There is a need to develop indicators and frameworks that specifically

  11. Family lifestyle dynamics and childhood obesity: evidence from the millennium cohort study

    OpenAIRE

    Gray, Laura A; Hernandez Alava, Monica; Kelly, Michael P; Campbell, Michael J

    2018-01-01

    Abstract Background The prevalence of childhood obesity has been increasing but the causes are not fully understood. Recent public health interventions and guidance aiming to reduce childhood obesity have focused on the whole family, as opposed to just the child but there remains a lack of empirical evidence examining this relationship. Methods Using data from the ...

  12. How can the regulator show evidence of (no) risk selection in health insurance markets? Conceptual framework and empirical evidence

    NARCIS (Netherlands)

    W.P.M.M. van de Ven (Wynand); R.C.J.A. van Vliet (René); R.C. van Kleef (Richard)

    2017-01-01

    textabstractIf consumers have a choice of health plan, risk selection is often a serious problem (e.g., as in Germany, Israel, the Netherlands, the United States of America, and Switzerland). Risk selection may threaten the quality of care for chronically ill people, and may reduce the affordability

  13. National systems of innovation: determinants and industrial policy measures, empirical evidence for OECD; Sistemas nacionales de innovacion: determinantes y acciones de politica industrial. Evidencia empirica para la OCDE

    Energy Technology Data Exchange (ETDEWEB)

    Hervas, J. L.; Rojas, R.; Sempere, F.; Albors, J.

    2012-11-01

    The paper presents an attempt to tackle the main gaps in the national innovation systems (NIS) literature: the problem specifying the boundaries of the NIS and the lack of connection between theory and empirics. For this purpose, the paper uses 55 countries as sample and constructs an NIS index based on a factor analysis of 28 variables. Empirical evidence shows that a firm's strategies, technology infrastructure, government governance, education and linkages are the main components of the NIS. The implications are important for policy-makers and the academia. (Author) 49 refs.

  14. The production and use of evidence in health care service innovation: a qualitative study.

    Science.gov (United States)

    Vasileiou, Konstantina; Barnett, Julie; Young, Terry

    2013-03-01

    The focus of this article is on a range of concepts of evidence employed by health care innovators in pursuing service innovations and in demonstrating their success. In-depth, semi-structured interviews were conducted with 18 key informants in the United Kingdom who had won Health Service Journal awards for successfully implementing 15 service innovations. Four concepts of evidence were identified: (a) evidence of effectiveness-both direct and indirect, (b) evidence of efficiency, (c) evidence of innovation acceptance, and (d) evidence of relevance. The results suggest that the innovators articulated evidential concepts from the main approaches prevailing in the British National Health Service, namely clinical trials and improvement cycles. Most aspired to "better" evidence than they were able to obtain, while the approach to evidence gathering was very pragmatic and was more aligned with the improvement-cycle framework. Developing supporting mechanisms for assisting innovation evaluation is an important challenge if service innovation is to be routinely attempted and achieved in health care.

  15. A Call to Digital Health Practitioners: New Guidelines Can Help Improve the Quality of Digital Health Evidence.

    Science.gov (United States)

    Agarwal, Smisha; Lefevre, Amnesty E; Labrique, Alain B

    2017-10-06

    Despite the rapid proliferation of health interventions that employ digital tools, the evidence on the effectiveness of such approaches remains insufficient and of variable quality. To address gaps in the comprehensiveness and quality of reporting on the effectiveness of digital programs, the mHealth Technical Evidence Review Group (mTERG), convened by the World Health Organization, proposed the mHealth Evidence Reporting and Assessment (mERA) checklist to address existing gaps in the comprehensiveness and quality of reporting on the effectiveness of digital health programs. We present an overview of the mERA checklist and encourage researchers working in the digital health space to use the mERA checklist for reporting their research. The development of the mERA checklist consisted of convening an expert group to recommend an appropriate approach, convening a global expert review panel for checklist development, and pilot-testing the checklist. The mERA checklist consists of 16 core mHealth items that define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features). Additionally, a 29-item methodology checklist guides authors on reporting critical aspects of the research methodology employed in the study. We recommend that the core mERA checklist is used in conjunction with an appropriate study-design specific checklist. The mERA checklist aims to assist authors in reporting on digital health research, guide reviewers and policymakers in synthesizing evidence, and guide journal editors in assessing the completeness in reporting on digital health studies. An increase in transparent and rigorous reporting can help identify gaps in the conduct of research and understand the effects of digital health interventions as a field of inquiry. ©Smisha Agarwal, Amnesty E Lefevre, Alain B Labrique. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 06.10.2017.

  16. Creating the document 'Promoting health in schools: from evidence to action'.

    Science.gov (United States)

    St Leger, Lawrence; Young, Ian M

    2009-12-01

    Schools across the world have been involved in health promotion and health education for nearly a century. Do school based initiatives make any difference to the education and health outcomes of young people? This article describes the process in developing the document Promoting health in schools: from evidence to action. The document was produced primarily for the Education sector. It develops an argument about why schools should be undertaking health related initiatives. It also highlights major findings from the literature about what is possible to achieve in school health and the circumstances under which the gains will occur. Attention is focused both on the evidence from the education sector, e.g. effective schools, learning and teaching approaches, and from the health sector, e.g. a whole of school or Health Promoting School (HPS) approach, as well as identifying outcomes from topic areas such as mental and emotional health, healthy eating and nutrition, physical activity, hygiene, sexual health and relationships, substance use and misuse.

  17. Sociopolitical Instability and Economic Growth Empirical Evidence from Sri Lanka

    OpenAIRE

    Changsheng Xu; Santhirasegaram Selvarathinam; Wen X. Li

    2007-01-01

    Sociopolitical instability severely affects economic growth in short and long run. This study analyzes that sociopolitical instability measured by proxy measure; annual growth rate of tourist arrivals in Sri Lanka during 1960-2005 adversely affects economic growth. Our empirical findings based on ordinary lease square econometric estimation, show that sociopolitical instability negatively and significantly affect economic growth. Reduction of economic growth rate (-0.032) due to the sociopoli...

  18. Does Income Inequality Harm Health? New Cross-National Evidence

    Science.gov (United States)

    Beckfield, Jason

    2004-01-01

    The provocative hypothesis that income inequality harms population health has sparked a large body of research, some of which has reported strong associations between income inequality and population health. Cross-national evidence is frequently cited in support of this important hypothesis, but the hypothesis remains controversial, and the…

  19. Social capital and health: evidence that ancestral trust promotes health among children of immigrants.

    Science.gov (United States)

    Ljunge, Martin

    2014-12-01

    This paper presents evidence that generalized trust promotes health. Children of immigrants in a broad set of European countries with ancestry from across the world are studied. Individuals are examined within country of residence using variation in trust across countries of ancestry. The approach addresses reverse causality and concerns that the trust measure picks up institutional factors in the individual's contextual setting. There is a significant positive estimate of ancestral trust in explaining self-assessed health. The finding is robust to accounting for individual, parental, and extensive ancestral country characteristics. Individuals with higher ancestral trust are also less likely to be hampered by health problems in their daily life, providing evidence of trust influencing real life outcomes. Individuals with high trust feel and act healthier, enabling a more productive life.

  20. Systematic review on the association between employee worktime control and work-non-work balance, health and well-being, and job-related outcomes.

    Science.gov (United States)

    Nijp, Hylco H; Beckers, Debby G J; Geurts, Sabine A E; Tucker, Philip; Kompier, Michiel A J

    2012-07-01

    The aim of this review was to assess systematically the empirical evidence for associations between employee worktime control (WTC) and work-non-work balance, health/well-being, and job-related outcomes (eg, job satisfaction, job performance). A systematic search of empirical studies published between 1995-2011 resulted in 63 relevant papers from 53 studies. Five different categories of WTC measurements were distinguished (global WTC, multidimensional WTC, flextime, leave control, and "other subdimensions of WTC"). For each WTC category, we examined the strength of evidence for an association with (i) work-non-work balance, (ii) health/well-being, and (iii) job-related outcomes. We distinguished between cross-sectional, longitudinal, and intervention studies. Evidence strength was assessed based on the number of studies and their convergence in terms of study findings. (Moderately) strong cross-sectional evidence was found for positive associations between global WTC and both work-non-work balance and job-related outcomes, whereas no consistent evidence was found regarding health/well-being. Intervention studies on global WTC found moderately strong evidence for a positive causal association with work-non-work balance and no or insufficient evidence for health/well-being and job-related outcomes. Limited to moderately strong cross-sectional evidence was found for positive associations between multidimensional WTC and our outcome categories. Moderately strong cross-sectional evidence was found for positive associations between flextime and all outcome categories. The lack of intervention or longitudinal studies restricts clear causal inferences. This review has shown that there are theoretical and empirical reasons to view WTC as a promising tool for the maintenance of employees' work-non-work balance, health and well-being, and job-related outcomes. At the same time, however, the current state of evidence allows only very limited causal inferences to be made

  1. The many meanings of evidence: a comparative analysis of the forms and roles of evidence within three health policy processes in Cambodia.

    Science.gov (United States)

    Walls, Helen; Liverani, Marco; Chheng, Kannarath; Parkhurst, Justin

    2017-11-10

    Discussions within the health community routinely emphasise the importance of evidence in informing policy formulation and implementation. Much of the support for the evidence-based policy movement draws from concern that policy decisions are often based on inadequate engagement with high-quality evidence. In many such discussions, evidence is treated as differing only in quality, and assumed to improve decisions if it can only be used more. In contrast, political science scholars have described this as an overly simplistic view of the policy-making process, noting that research 'use' can mean a variety of things and relies on nuanced aspects of political systems. An approach more in recognition of how policy-making systems operate in practice can be to consider how institutions and ideas influence which pieces of evidence appear to be relevant for, and are used within, different policy processes. Drawing on in-depth interviews undertaken in 2015-2016 with key health sector stakeholders in Cambodia, we investigate the evidence perceived to be relevant to policy decisions for three contrasting health policy examples, namely tobacco control, HIV/AIDS and performance-based salary incentives. These cases allow us to examine the ways that policy-relevant evidence may differ given the framing of the issue and the broader institutional context in which evidence is considered. The three health issues show few similarities in how pieces of evidence were used in various aspects of policy-making, despite all being discussed within a broad policy environment in which evidence-based policy-making is rhetorically championed. Instead, we find that evidence use can be better understood by mapping how these health policy issues differ in terms of the issue characteristics, and also in terms of the stakeholders structurally established as having a dominant influence for each issue. Both of these have important implications for evidence use. Contrasting concerns of key stakeholders

  2. Evidence-based information needs of public health workers: a systematized review.

    Science.gov (United States)

    Barr-Walker, Jill

    2017-01-01

    This study assessed public health workers' evidence-based information needs, based on a review of the literature using a systematic search strategy. This study is based on a thesis project conducted as part of the author's master's in public health coursework and is considered a systematized review. Four databases were searched for English-language articles published between 2005 and 2015: PubMed, Web of Science, Library Literature & Information Science Index, and Library, Information Science & Technology Abstracts (LISTA). Studies were excluded if there was no primary data collection, the population in the study was not identified as public health workers, "information" was not defined according to specific criteria, or evidence-based information and public health workers were not the major focus. Studies included in the final analysis underwent data extraction, critical appraisal using CASP and STROBE checklists, and thematic analysis. Thirty-three research studies were identified in the search, including twenty-one using quantitative methods and twelve using qualitative methods. Critical appraisal revealed many potential biases, particularly in the validity of research. Thematic analysis revealed five common themes: (1) definition of information needs, (2) current information-seeking behavior and use, (3) definition of evidence-based information, (4) barriers to information needs, and (5) public health-specific issues. Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers' information needs.

  3. Bridging evidence, policy, and practice to strengthen health systems for improved maternal and newborn health in Pakistan.

    Science.gov (United States)

    Hirose, Atsumi; Hall, Sarah; Memon, Zahid; Hussein, Julia

    2015-11-25

    Policy and decision making should be based on evidence, but translating evidence into policy and practice is often sporadic and slow. It is recognised that the relationship between research and policy uptake is complex and that dissemination of research findings is necessary, but insufficient, for policy uptake. Political, social, and economic context, use of (credible) data and dialogues between and across networks of researchers and policymakers play important roles in evidence uptake. Advocacy is the process of mobilising political and public opinions to achieve specific aims and its role is crucial in mobilising key actors to push for policy uptake. Advocacy and research groups (i.e. those who would like to see research evidence used by policymakers) may use different approaches and tools to stimulate the diffusion of research findings. The use of mass- and social media, communication with study participants, and the involvement of stakeholders at the early stages of research development are examples of the approaches that can be employed to stimulate diffusion of evidence and increase evidence uptake. The Research and Advocacy Fund (RAF) for Maternal and Newborn Health (MNH) worked within the health system context in Pakistan with the aim of espousing the principles of evidence, advocacy, and dissemination to improve MNH outcomes. The articles included in this special issue are outputs of RAF and highlight where RAF's approaches contributed to MNH policy reforms. The papers discuss critical health system issues facing Pakistan, including service delivery components, demand creation, equitable access, transportation interventions for improved referrals, availability of medicines and equipment, and health workforce needs. In addition to these tangible elements, the health system 'software', i.e. the power and the political and social contexts, is also represented in the collection. These articles highlight three considerations for the future: the growing

  4. Constraints and Dedication as Drivers for Relationship Commitment: An Empirical Study in a Health-Care Context

    OpenAIRE

    Gaby Odekerken-Schröder; Bloemer Josée

    2002-01-01

    The objective of this study is to empirically determine the role of constraints and dedication as drivers of relationship commitment as most of the existing work is of a conceptual nature only. We assess how and to which extent these two drivers fit into the established relationships between overall service quality, satisfaction, trust and commitment. Using LISREL, we estimate the conceptual model based on a sample of customers of health-care centers. The results indicate that both constraint...

  5. Mapping the contribution of Allied Health Professions to the wider public health workforce: a rapid review of evidence-based interventions.

    Science.gov (United States)

    Davis, S Fowler; Enderby, P; Harrop, D; Hindle, L

    2017-03-01

    The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Review of the Evidence for Oral Health Promotion Effectiveness

    Science.gov (United States)

    Satur, Julie G.; Gussy, Mark G.; Morgan, Michael V.; Calache, Hanny; Wright, Clive

    2010-01-01

    Dental caries, periodontal diseases, tooth loss and oral cancers have significant burden of disease effects, quality of life and cost implications for the Australian community. Oral health promotion is a key approach to addressing these conditions endorsed as part of the National Oral Health Plan. Understanding the evidence for effectiveness of…

  7. Labor market deregulation and globalization: empirical evidence from OECD countries

    OpenAIRE

    Potrafke , Niklas

    2010-01-01

    Abstract This paper empirically investigates the influence of globalization on various aspects of labor market deregulation. I employ the data set by Bassanini and Duval (2006) on labor market institutions in OECD countries and the KOF index of globalization. The data set covers 20 OECD countries in the 1982?2003 period. The results suggest that globalization did neither influence the unemployment replacement rate, the unemployment benefit length, public expenditures on ALMP, the t...

  8. Hydraulic fracturing and infant health: New evidence from Pennsylvania.

    Science.gov (United States)

    Currie, Janet; Greenstone, Michael; Meckel, Katherine

    2017-12-01

    The development of hydraulic fracturing ("fracking") is considered the biggest change to the global energy production system in the last half-century. However, several communities have banned fracking because of unresolved concerns about the impact of this process on human health. To evaluate the potential health impacts of fracking, we analyzed records of more than 1.1 million births in Pennsylvania from 2004 to 2013, comparing infants born to mothers living at different distances from active fracking sites and those born both before and after fracking was initiated at each site. We adjusted for fixed maternal determinants of infant health by comparing siblings who were and were not exposed to fracking sites in utero. We found evidence for negative health effects of in utero exposure to fracking sites within 3 km of a mother's residence, with the largest health impacts seen for in utero exposure within 1 km of fracking sites. Negative health impacts include a greater incidence of low-birth weight babies as well as significant declines in average birth weight and in several other measures of infant health. There is little evidence for health effects at distances beyond 3 km, suggesting that health impacts of fracking are highly local. Informal estimates suggest that about 29,000 of the nearly 4 million annual U.S. births occur within 1 km of an active fracking site and that these births therefore may be at higher risk of poor birth outcomes.

  9. Individual Breast Cancer risk assessment in Underserved Populations: Integrating empirical Bioethics and Health Disparities Research

    Science.gov (United States)

    Anderson, Emily E.; Hoskins, Kent

    2013-01-01

    Research suggests that individual breast cancer risk assessment may improve adherence to recommended screening and prevention guidelines, thereby decreasing morbidity and mortality. Further research on the use of risk assessment models in underserved minority populations is critical to informing national public health efforts to eliminate breast cancer disparities. However, implementing individual breast cancer risk assessment in underserved patient populations raises particular ethical issues that require further examination. After reviewing these issues, we will discuss how empirical bioethics research can be integrated with health disparities research to inform the translation of research findings. Our in-progress National Cancer Institute (NCI) funded study, How Do Underserved Minority Women Think About Breast Cancer?, conducted in the context of a larger study on individual breast cancer risk assessment, is presented as a model. PMID:23124498

  10. Does Worksite Culture of Health (CoH) Matter to Employees? Empirical Evidence Using Job-Related Metrics.

    Science.gov (United States)

    Kwon, Youngbum; Marzec, Mary L

    2016-05-01

    This study examines the relationships between the workplace culture of health (CoH), job satisfaction, and turnover intention. We also examined the moderating effect of job classification. Structural equation modeling analysis was performed on data from employees of a Korean life insurance company (N = 880). Workplace CoH directly influenced job satisfaction (β = 0.32; P Job satisfaction was directly associated with intention to leave (β = -0.42; P job satisfaction and intention to leave was stronger for managerial employees than for non-managerial employees. This study showed that a workplace CoH is related to job satisfaction and intention to leave. Supporting health at the workplace has implications beyond health that benefit both employees and the organization.

  11. The Effects of Adolescent Health-Related Behavior on Academic Performance: A Systematic Review of the Longitudinal Evidence

    Science.gov (United States)

    Busch, Vincent; Loyen, Anne; Lodder, Mandy; Schrijvers, Augustinus J. P.; van Yperen, Tom A.; de Leeuw, Johannes R. J.

    2014-01-01

    Schools are increasingly involved in efforts to promote health and healthy behavior among their adolescent students, but are healthier students better learners? This synthesis of the empirical, longitudinal literature investigated the effects of the most predominant health-related behaviors--namely, alcohol and marijuana use, smoking, nutrition,…

  12. Towards an empirical ethics in care: relations with technologies in health care.

    Science.gov (United States)

    Pols, Jeannette

    2015-02-01

    This paper describes the approach of empirical ethics, a form of ethics that integrates non-positivist ethnographic empirical research and philosophy. Empirical ethics as it is discussed here builds on the 'empirical turn' in epistemology. It radicalizes the relational approach that care ethics introduced to think about care between people by drawing in relations between people and technologies as things people relate to. Empirical ethics studies care practices by analysing their intra-normativity, or the ways of living together the actors within these practices strive for or bring about as good practices. Different from care ethics, what care is and if it is good is not defined beforehand. A care practice may be contested by comparing it to alternative practices with different notions of good care. By contrasting practices as different ways of living together that are normatively oriented, suggestions for the best possible care may be argued for. Whether these suggestions will actually be put to practice is, however, again a relational question; new actors need to re-localize suggestions, to make them work in new practices and fit them in with local intra-normativities with their particular routines, material infrastructures, know-how and strivings.

  13. Children's Sleep Needs: Is There Sufficient Evidence to Recommend Optimal Sleep for Children?

    OpenAIRE

    Matricciani, Lisa; Blunden, Sarah; Rigney, Gabrielle; Williams, Marie T.; Olds, Tim S.

    2013-01-01

    It is widely recognized that sleep is important for children's health and well-being and that short sleep duration is associated with a wide range of negative health outcomes. Recently, there has been much interest in whether or not there are sufficient data to support the specific recommendations made for how much sleep children need. In this article we explore concepts related to children's sleep need, discuss the theory, rationale, and empirical evidence for contemporary sleep recommendati...

  14. Linking research to practice: the rise of evidence-based health sciences librarianship.

    Science.gov (United States)

    Marshall, Joanne Gard

    2014-01-01

    The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.

  15. Linking research to practice: the rise of evidence-based health sciences librarianship*

    Science.gov (United States)

    Marshall, Joanne Gard

    2014-01-01

    Purpose: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. Methods: Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. Results: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Implications: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services. PMID:24415915

  16. A Formidable Task: Reflections on obtaining legal empirical evidence on human trafficking in Canada

    OpenAIRE

    Hayli Millar; Tamara O'Doherty; Katrin Roots

    2017-01-01

    This article explores the experiences, challenges and findings of two empirical research studies examining Canada’s legal efforts to combat human trafficking. The authors outline the methodologies of their respective studies and reflect on some of the difficulties they faced in obtaining empirical data on human trafficking court cases and legal proceedings. Ultimately, the authors found that Canadian trafficking case law developments are in their early stages with very few convictions, despit...

  17. Tangible Evidence, Trust and Power: Public Perceptions of Community Environmental Health Studies

    Science.gov (United States)

    Scammell, Madeleine Kangsen; Senier, Laura; Darrah-Okike, Jennifer; Brown, Phil; Santos, Susan

    2009-01-01

    Communities with environmental health concerns in the USA frequently request studies from their local or state departments of public health. This paper presents findings from three focus groups conducted in communities north of Boston that have been the subject of two different environmental health studies. The focus groups were designed to elicit residents’ perceptions of environmental health, and of the particular studies conducted in their communities. In all focus groups, participants had difficulty accepting the findings of health studies that contradicted their own experiences of environmental exposures and illness. Our results suggest that lay knowledge, informed in varying degrees by the experience of what we term “tangible evidence,” creates a lens through which communities interpret a health study’s findings. The differences in reliance on tangible evidence were related to participants’ sense of trust in public officials, and the institutions responsible for conducting health studies. Participants from the wealthier, predominantly white communities discussed trust in study design and methodologies used. In contrast, participants from the lower income, higher minority communities assessed health studies with reference to their trust (or lack thereof) in study sponsors and public health institutions. Participants’ experience of tangible evidence, trust or distrust in health agencies and research institutions, and a sense of relative community power, influence how they assess the findings of environmental health studies and may have implications for pubic health. PMID:18995942

  18. Quantitative analyses of empirical fitness landscapes

    International Nuclear Information System (INIS)

    Szendro, Ivan G; Franke, Jasper; Krug, Joachim; Schenk, Martijn F; De Visser, J Arjan G M

    2013-01-01

    The concept of a fitness landscape is a powerful metaphor that offers insight into various aspects of evolutionary processes and guidance for the study of evolution. Until recently, empirical evidence on the ruggedness of these landscapes was lacking, but since it became feasible to construct all possible genotypes containing combinations of a limited set of mutations, the number of studies has grown to a point where a classification of landscapes becomes possible. The aim of this review is to identify measures of epistasis that allow a meaningful comparison of fitness landscapes and then apply them to the empirical landscapes in order to discern factors that affect ruggedness. The various measures of epistasis that have been proposed in the literature appear to be equivalent. Our comparison shows that the ruggedness of the empirical landscape is affected by whether the included mutations are beneficial or deleterious and by whether intragenic or intergenic epistasis is involved. Finally, the empirical landscapes are compared to landscapes generated with the rough Mt Fuji model. Despite the simplicity of this model, it captures the features of the experimental landscapes remarkably well. (paper)

  19. Essays in the Economics of Corruption: Experimental and empirical evidence

    OpenAIRE

    Leszczynska, Nastassia

    2018-01-01

    The advent of experimental methodologies have led to decisive progress in the study of corrupt behaviour in the last two decades. Since they can complement survey data and perception indexes with controlled experimental data, scholars and policy makers have reached a better understanding of decision-making in bribery situations and are able to design innovative anticorruption policies.In this thesis, I use experimental and empirical data to contribute to the field of the economics of corrupti...

  20. Data-Driven and Expectation-Driven Discovery of Empirical Laws.

    Science.gov (United States)

    1982-10-10

    occurred in small integer proportions to each other. In 1809, Joseph Gay- Lussac found evidence for his law of combining volumes, which stated that a...of Empirical Laws Patrick W. Langley Gary L. Bradshaw Herbert A. Simon T1he Robotics Institute Carnegie-Mellon University Pittsburgh, Pennsylvania...Subtitle) S. TYPE OF REPORT & PERIOD COVERED Data-Driven and Expectation-Driven Discovery Interim Report 2/82-10/82 of Empirical Laws S. PERFORMING ORG

  1. Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.

    Science.gov (United States)

    Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

    2016-03-01

    The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

  2. Empirical evidence about inconsistency among studies in a pair‐wise meta‐analysis

    Science.gov (United States)

    Turner, Rebecca M.; Higgins, Julian P. T.

    2015-01-01

    This paper investigates how inconsistency (as measured by the I2 statistic) among studies in a meta‐analysis may differ, according to the type of outcome data and effect measure. We used hierarchical models to analyse data from 3873 binary, 5132 continuous and 880 mixed outcome meta‐analyses within the Cochrane Database of Systematic Reviews. Predictive distributions for inconsistency expected in future meta‐analyses were obtained, which can inform priors for between‐study variance. Inconsistency estimates were highest on average for binary outcome meta‐analyses of risk differences and continuous outcome meta‐analyses. For a planned binary outcome meta‐analysis in a general research setting, the predictive distribution for inconsistency among log odds ratios had median 22% and 95% CI: 12% to 39%. For a continuous outcome meta‐analysis, the predictive distribution for inconsistency among standardized mean differences had median 40% and 95% CI: 15% to 73%. Levels of inconsistency were similar for binary data measured by log odds ratios and log relative risks. Fitted distributions for inconsistency expected in continuous outcome meta‐analyses using mean differences were almost identical to those using standardized mean differences. The empirical evidence on inconsistency gives guidance on which outcome measures are most likely to be consistent in particular circumstances and facilitates Bayesian meta‐analysis with an informative prior for heterogeneity. © 2015 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd. © 2015 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd. PMID:26679486

  3. The Effect of Biogas Production on Farmland Rental Prices: Empirical Evidences from Northern Italy

    Directory of Open Access Journals (Sweden)

    Eugenio Demartini

    2016-11-01

    Full Text Available In the last decade, increased environmental awareness has prompted the adoption of incentives for exploiting renewable energy sources. Among these, biogas production has received a certain attention in developed countries. Nonetheless, the subsidies provided have posed the problem of an activity (the production of bioenergy that engages in direct competition with food and feed production for limited resources, like agricultural land. Even if this competition may be softened by allocating marginal land and/or using dedicated non-agricultural crops, empirical evidence shows that biogas plants have been developed in highly-productive agricultural areas, using increasing amounts of maize silage as feedstock. Thus, studies aimed at measuring the effect of biogas production on agricultural activities are needed in order to avoid this socially undesirable outcome. The paper presents an econometric estimation of the impact of biogas plants on farmland rental values of a Northern Italian rural area. Results show that biogas has a non-linear effect on rental prices, suggesting that incentive schemes specifically accounting for plants’ dimensions and technologies would improve the social sustainability of the bioenergy sector and its coexistence with agricultural activity.

  4. Health Technology Assessment: Global Advocacy and Local Realities; Comment on “Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness”

    Directory of Open Access Journals (Sweden)

    Kalipso Chalkidou

    2017-04-01

    Full Text Available Cost-effectiveness analysis (CEA can help countries attain and sustain universal health coverage (UHC, as long as it is context-specific and considered within deliberative processes at the country level. Institutionalising robust deliberative processes requires significant time and resources, however, and countries often begin by demanding evidence (including local CEA evidence as well as evidence about local values, whilst striving to strengthen the governance structures and technical capacities with which to generate, consider and act on such evidence. In low- and middle-income countries (LMICs, such capacities could be developed initially around a small technical unit in the health ministry or health insurer. The role of networks, development partners, and global norm setting organisations is crucial in supporting the necessary capacities.

  5. Rationality versus reality: the challenges of evidence-based decision making for health policy makers.

    Science.gov (United States)

    McCaughey, Deirdre; Bruning, Nealia S

    2010-05-26

    Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the EBDM/EBPM process can be

  6. Rationality versus reality: the challenges of evidence-based decision making for health policy makers

    Directory of Open Access Journals (Sweden)

    Bruning Nealia S

    2010-05-01

    Full Text Available Abstract Background Current healthcare systems have extended the evidence-based medicine (EBM approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM and evidence-based policy making (EBPM because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial

  7. Rationality versus reality: the challenges of evidence-based decision making for health policy makers

    Science.gov (United States)

    2010-01-01

    Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the

  8. Process health management using success tree and empirical model

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Gyunyoung [Kyung Hee Univ., Yongin (Korea, Republic of); Kim, Suyoung [BNF Technology, Daejeon (Korea, Republic of); Sung, Wounkyoung [Korea South-East Power Co. Ltd., Seoul (Korea, Republic of)

    2012-03-15

    Interests on predictive or condition-based maintenance are heightening in power industries. The ultimate goal of the condition-based maintenance is to prioritize and optimize the maintenance resources by taking a reasonable decision-making process depending op plant's conditions. Such decision-making process should be able to not only observe the deviation from a normal state but also determine the severity or impact of the deviation on different levels such as a component, a system, or a plant. In order to achieve this purpose, a Plant Health Index (PHI) monitoring system was developed, which is operational in more than 10 units of large steam turbine cycles in Korea as well as desalination plants in Saudi Arabia as a proto-type demonstration. The PHI monitoring system has capability to detect whether the deviation between a measured and an estimated parameter which is the result of kernel regression using the accumulated operation data and the current plant boundary conditions (referred as an empirical model) is statistically meaningful. This deviation is converted into a certain index considering the margin to set points which are associated with safety. This index is referred as a PHI and the PHIs can be monitored for an individual parameter as well as a component, system, or plant level. In order to organize the PHIs at the component, system, or plant level, a success tree was developed. At the top of the success tree, the PHIs nodes in the middle of the success tree, the PHIs represent the health status of a component or a system. The concept and definition of the PHI, the key methodologies, the architecture of the developed system, and a practical case of using the PHI monitoring system are described in this article.

  9. Process health management using success tree and empirical model

    International Nuclear Information System (INIS)

    Heo, Gyunyoung; Kim, Suyoung; Sung, Wounkyoung

    2012-01-01

    Interests on predictive or condition-based maintenance are heightening in power industries. The ultimate goal of the condition-based maintenance is to prioritize and optimize the maintenance resources by taking a reasonable decision-making process depending op plant's conditions. Such decision-making process should be able to not only observe the deviation from a normal state but also determine the severity or impact of the deviation on different levels such as a component, a system, or a plant. In order to achieve this purpose, a Plant Health Index (PHI) monitoring system was developed, which is operational in more than 10 units of large steam turbine cycles in Korea as well as desalination plants in Saudi Arabia as a proto-type demonstration. The PHI monitoring system has capability to detect whether the deviation between a measured and an estimated parameter which is the result of kernel regression using the accumulated operation data and the current plant boundary conditions (referred as an empirical model) is statistically meaningful. This deviation is converted into a certain index considering the margin to set points which are associated with safety. This index is referred as a PHI and the PHIs can be monitored for an individual parameter as well as a component, system, or plant level. In order to organize the PHIs at the component, system, or plant level, a success tree was developed. At the top of the success tree, the PHIs nodes in the middle of the success tree, the PHIs represent the health status of a component or a system. The concept and definition of the PHI, the key methodologies, the architecture of the developed system, and a practical case of using the PHI monitoring system are described in this article

  10. A Formidable Task: Reflections on obtaining legal empirical evidence on human trafficking in Canada

    Directory of Open Access Journals (Sweden)

    Hayli Millar

    2017-04-01

    Full Text Available This article explores the experiences, challenges and findings of two empirical research studies examining Canada’s legal efforts to combat human trafficking. The authors outline the methodologies of their respective studies and reflect on some of the difficulties they faced in obtaining empirical data on human trafficking court cases and legal proceedings. Ultimately, the authors found that Canadian trafficking case law developments are in their early stages with very few convictions, despite a growing number of police-reported charges. The authors assert it is difficult to assess the efficacy and effects of Canadian anti-trafficking laws and policies due to the institutional and political limitations to collecting legal data in this highly politicised subject area. They conclude with five recommendations to increase the transparency of Canada’s public claims about its anti-trafficking enforcement efforts and call for more empirically-based law reform.

  11. Evidence-based practice curriculum in allied health professions for teaching-research-practice nexus.

    Science.gov (United States)

    Asokan, G V

    2012-11-01

    Allied healthcare workers are from diverse professions and the key skill required is providing evidence-based care but this concept has not permeated enough for using it skillfully in their professions. A well structured curriculum in allied health professions is needed to strengthen concerted teaching, research, and practice to empower their professionals and make considerable differences in the lives of people by adopting evidence-based practice. Information sources for allied health professionals have relied on advice of their supervisors and colleagues, personal experiences, authoritative theory and texts for practice. Because of "research-practice" gap, often the use of evidence is not reflected in an individual day to day professional practice. Although allied health professionals work in resource and evidence challenged settings, there are certain barriers and facilitators, which need to be addressed. To implement practice-related research findings and uptake of evidence requires two essential components, namely, practical component and knowledge component. Research bench marking and research metrics for quality assurance and standardization through evidence-based practice will promote academic status and credibility of allied health profession. © 2012 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  12. Satisfaction with the neighborhood environment and health in older elderly: cross-sectional evidence from the Bambuí cohort study of aging

    Directory of Open Access Journals (Sweden)

    Tatiana Chama Borges Luz

    2011-01-01

    Full Text Available In order to investigate the association between satisfaction with the neighborhood environment and self-rated health among older elderly, data from 814 participants of the eleventh wave of the Bambuí Cohort Study of Aging were analyzed using robust Poisson regression analyses. Those elderly with higher satisfaction with their neighborhoods (PR = 0.75; 95%CI: 0.63-0.87 were less likely to report worse self-rated health. The number of chronic diseases (two, PR = 1.69; 95%CI: 1.05-2.70, three or more, PR = 1.99, 95%CI: 1.27-3.13, difficulty in performing daily activities (PR = 1.51; 95%CI: 1.28-1.78, presence of depressive symptoms (PR = 1.68; 95%CI: 1.44-1.95 and frequency of leisure-time exercise in previous 90 days (less than once a week, PR =1.24; 95%CI: 1.03-1.50 were all positively and significantly associated with poor self-rated health. This study provided empirical evidence that satisfaction with the neighborhood environment was associated with the health of the older elderly. The findings further suggest the potential importance of including this indicator in analyses of place and health among the elderly.

  13. Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda

    Directory of Open Access Journals (Sweden)

    Orem Juliet

    2012-02-01

    Full Text Available Abstract Background Use of evidence in health policymaking plays an important role, especially in resource-constrained settings where informed decisions on resource allocation are paramount. Several knowledge translation (KT models have been developed, but few have been applied to health policymaking in low income countries. If KT models are expected to explain evidence uptake and implementation, or lack of it, they must be contextualized and take into account the specificity of low income countries for example, the strong influence of donors. The main objective of this research is to elaborate a Middle Range Theory (MRT of KT in Uganda that can also serve as a reference for other low- and middle income countries. Methods This two-step study employed qualitative approaches to examine the principal barriers and facilitating factors to KT. Step 1 involved a literature review and identification of common themes. The results informed the development of the initial MRT, which details the facilitating factors and barriers to KT at the different stages of research and policy development. In Step 2, these were further refined through key informant interviews with policymakers and researchers in Uganda. Deductive content and thematic analysis was carried out to assess the degree of convergence with the elements of the initial MRT and to identify other emerging issues. Results Review of the literature revealed that the most common emerging facilitating factors could be grouped under institutional strengthening for KT, research characteristics, dissemination, partnerships and political context. The analysis of interviews, however, showed that policymakers and researchers ranked institutional strengthening for KT, research characteristics and partnerships as the most important. New factors emphasized by respondents were the use of mainstreamed structures within MoH to coordinate and disseminate research, the separation of roles between researchers and

  14. Empirical Evidence of Priming, Transfer, Reinforcement, and Learning in the Real and Virtual Trillium Trails

    Science.gov (United States)

    Harrington, M. C. R.

    2011-01-01

    Over the past 20 years, there has been a debate on the effectiveness of virtual reality used for learning with young children, producing many ideas but little empirical proof. This empirical study compared learning activity in situ of a real environment (Real) and a desktop virtual reality (Virtual) environment, built with video game technology,…

  15. Budget deficit, money growth and inflation: Empirical evidence from Vietnam

    OpenAIRE

    Khieu Van, Hoang

    2014-01-01

    This study empirically examines the nexus among budget deficit, money supply and inflation by using a monthly data set from January 1995 to December 2012 and a SVAR model with five endogenous variables, inflation, money growth, budget deficit growth, real GDP growth and interest rate. Since real GDP and budget deficit are unavailable on the monthly basis, we interpolate those series using Chow and Lin’s (1971) annualized approach from their annual series. Overall, we found that money growth h...

  16. The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand.

    Science.gov (United States)

    Ghislandi, Simone; Manachotphong, Wanwiphang; Perego, Viviana M E

    2015-07-01

    Thailand is among the first non-OECD countries to have introduced a form of Universal Health Coverage (UHC). This policy represents a natural experiment to evaluate the effects of public health insurance on health behaviours. In this paper, we examine the impact of Thailand's UHC programme on preventive activities, unhealthy or risky behaviours and health care consumption using data from the Thai Health and Welfare Survey. We use doubly robust estimators that combine propensity scores and linear regressions to estimate differences-in-differences (DD) and differences-in-DD models. Our results offer important insights. First, UHC increases individuals' likelihood of having an annual check-up, especially among women. Regarding health care consumption, we observe that UHC increases hospital admissions by over 2% and increases outpatient visits by 13%. However, there is no evidence that UHC leads to an increase in unhealthy behaviours or a reduction of preventive efforts. In other words, we find no evidence of ex ante moral hazard. Overall, these findings suggest positive health impacts among the Thai population covered by UHC.

  17. The Navigation Guide - evidence-based medicine meets environmental health: integration of animal and human evidence for PFOA effects on fetal growth.

    Science.gov (United States)

    Lam, Juleen; Koustas, Erica; Sutton, Patrice; Johnson, Paula I; Atchley, Dylan S; Sen, Saunak; Robinson, Karen A; Axelrad, Daniel A; Woodruff, Tracey J

    2014-10-01

    The Navigation Guide is a novel systematic review method to synthesize scientific evidence and reach strength of evidence conclusions for environmental health decision making. Our aim was to integrate scientific findings from human and nonhuman studies to determine the overall strength of evidence for the question "Does developmental exposure to perfluorooctanoic acid (PFOA) affect fetal growth in humans?" We developed and applied prespecified criteria to systematically and transparently a) rate the quality of the scientific evidence as "high," "moderate," or "low"; b) rate the strength of the human and nonhuman evidence separately as "sufficient," "limited," "moderate," or "evidence of lack of toxicity"; and c) integrate the strength of the human and nonhuman evidence ratings into a strength of the evidence conclusion. We identified 18 epidemiology studies and 21 animal toxicology studies relevant to our study question. We rated both the human and nonhuman mammalian evidence as "moderate" quality and "sufficient" strength. Integration of these evidence ratings produced a final strength of evidence rating in which review authors concluded that PFOA is "known to be toxic" to human reproduction and development based on sufficient evidence of decreased fetal growth in both human and nonhuman mammalian species. We concluded that developmental exposure to PFOA adversely affects human health based on sufficient evidence of decreased fetal growth in both human and nonhuman mammalian species. The results of this case study demonstrate the application of a systematic and transparent methodology, via the Navigation Guide, for reaching strength of evidence conclusions in environmental health.

  18. Sales effects of product health information at points of purchase: a systematic review.

    Science.gov (United States)

    van 't Riet, Jonathan

    2013-03-01

    Information about healthy and unhealthy nutrients is increasingly conveyed at the point of purchase. Many studies have investigated the effects of product health information on attitudes and intentions, but the empirical evidence becomes sketchier when the focus of research is actual purchase behaviour. The present paper provides an overview of empirical evidence on the effectiveness of product health information for food products at the point of purchase. A systematic literature review was conducted. Only studies were included that assessed the effect of product health information at the point of purchase on actual purchase behaviour, using data provided by stores' sales records or obtained by investigating customer receipts as the primary outcome measure. The included studies' target group comprised supermarket clientele. Several studies found no significant effects of product health information on actual purchase behaviour. Interventions were more likely to be effective when they lasted for a longer time, when they included additional intervention components, and when they targeted the absence of unhealthy nutrients instead of or in addition to the presence of healthy nutrients. No strong evidence for the effectiveness of product health information was found. The effect of intervention duration, additional promotional activities and targeting of healthy v. unhealthy nutrients should be closely examined in future studies.

  19. [Workplace violence in Latin America: A review of the scientific evidence].

    Science.gov (United States)

    Ansoleaga, Elisa; Gómez-Rubio, Constanza; Mauro, Amalia

    2015-01-01

    Workplace Violence has acquired social relevance given the evidence regarding there its health consequences. Has identified various effects such as mood disorders and sleep disorders, hostility, isolation, insecurity, among others. To describe and analyze scientific evidence published on workplace violence in studies in Latin American countries between 2009 and 2014. A descriptive and quantitative study. A search was made on the basis of Academic Search Complete (EBSCOhost) Academic Source Premier, PSICODOC, Scielo.org, JSTOR and SCOPUS. And indexed empirical studies were considered. We worked with 46 selected articles. The studies showed a higher amount of psychological violence at work, with a potential risk in women and health professionals. Also, the analysis categories were the most reported behaviors that express violence, health implications and facilitators. The literature on the study of workplace violence in Latin America is recent. Items are descriptive, interpretative studies with insufficient or analytical nature. Health personnel, particularly women, have conditions of vulnerability, with relevance with regard to sexual harassment, wage inequality and bullying.

  20. Behavioural processes in marketing channel relationships: Review and integration of empirical evidence

    DEFF Research Database (Denmark)

    Jensen, Nils Bøgelund; Skytte, Hans

    1997-01-01

    This paper reviews the empirical research on behavioural processes in marketing channel relationships. Systematically examining nine international journals, we find 49 papers on behavioural processes. On the basis of the hypothesis tests in the papers, we discuss the results and integrate...

  1. Obstacles to implementing evidence-based practice in Belgium: a context-specific qualitative evidence synthesis including findings from different health care disciplines.

    Science.gov (United States)

    Hannes, K; Goedhuys, J; Aertgeerts, B

    2012-01-01

    A number of barriers to the implementation of evidence-based practice have already been inventoried. However, little attention has been given to their context-specific nature. This qualitative evidence synthesis examines commonalities in the obstacles perceived by different groups of health care practitioners working in the Belgian health care system and sets out to discuss potential strategies to bridge some of these barriers. We actively searched for primary studies addressing our topic of interest in international and national databases (1990 to May 2008), consulted experts and screened references of retrieved studies. We opted for the meta-aggregative approach, developed by the Joanna Briggs Institute, to analyse our findings. The findings indicate that (1) evidence might have a limited role in decision-making processes; (2) aspects other than quality of care steer the evidence-based practice agenda; (3) some health care providers benefit less from evidence-based practice than others and (4) there is a lack of competences to put the evidence-based principles in practice. Belgian policy makers might consider health care system characteristics from and strategies developed or suggested by others to respond to country-specific obstacles. Examples include but are not limited to; (a) providing incentives for patient-centred care coordination and patient communication, (b) supporting practitioners interested in applying research-related activities, (c) considering direct access systems and interprofessional learning to respond to the demand for autonomous decision-making from satellite professional groups, (d) systematically involving allied health professionals in important governmental advisory boards, (e) considering pharmaceutical companies perceived as 'the enemy' an ally in filling in research gaps, (f) embedding the evaluation of evidence-based knowledge and skills in examinations (g) moving from (in)formative learning to transformative learning and (h

  2. Views of health journalists, industry employees and news consumers about disclosure and regulation of industry-journalist relationships: an empirical ethical study.

    Science.gov (United States)

    Lipworth, Wendy; Kerridge, Ian; Morrell, Bronwen; Forsyth, Rowena; Jordens, Christopher F C

    2015-03-01

    Bioethicists and policymakers are increasingly concerned about the effects on health journalism of relationships between journalists and private corporations. The concern is that relationships between journalists and manufacturers of medicines, medical devices, complementary medicines and food can and do distort health reporting. This is a problem because health news is known to have a major impact on the public's health-related expectations and behaviour. Commentators have proposed two related approaches to protecting the public from potential harms arising from industry-journalist interactions: greater transparency and external regulation. To date, few empirical studies have examined stakeholders' views of industry-journalist relationships and how these should be managed. We conducted interviews with 13 journalists and 12 industry employees, and 2 focus groups with consumers. Our findings, which are synthesised here, provide empirical support for the need for greater transparency and regulation of industry-journalist relationships. Our findings also highlight several likely barriers to instituting such measures, which will need to be overcome if transparency and regulation are to be accepted by stakeholders and have their intended effect on the quality of journalism and the actions of news consumers. 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.

  3. Children's sleep needs: is there sufficient evidence to recommend optimal sleep for children?

    Science.gov (United States)

    Matricciani, Lisa; Blunden, Sarah; Rigney, Gabrielle; Williams, Marie T; Olds, Tim S

    2013-04-01

    It is widely recognized that sleep is important for children's health and well-being and that short sleep duration is associated with a wide range of negative health outcomes. Recently, there has been much interest in whether or not there are sufficient data to support the specific recommendations made for how much sleep children need. In this article we explore concepts related to children's sleep need, discuss the theory, rationale, and empirical evidence for contemporary sleep recommendations, and outline future research directions for sleep recommendations. If sleep is to be treated as a therapeutic intervention, then consensus guidelines, statements, and evidence-based best-practice documents are needed to underpin sleep recommendations for children.

  4. Maternal depression and child development: Evidence from São Paulo’s Western Region Cohort Study

    OpenAIRE

    Brentani,Alexandra; Fink,Günther

    2016-01-01

    Summary Introduction: While a growing body of evidence has investigated the relationship between maternal mental health and child development, evidence on children’s early life outcomes remains mixed. We analyze the empirical relationship between maternal depression and children’s development at age one using data from the São Paulo Western Region Cohort project. Method: Seven hundred and ninety-eight (798) mother-child dyads living in the Butantã-Jaguaré’ region of São Pa...

  5. Maternal depression and child development: Evidence from São Paulo’s Western Region Cohort Study

    OpenAIRE

    Brentani, Alexandra; Fink, Günther

    2016-01-01

    Summary Introduction: While a growing body of evidence has investigated the relationship between maternal mental health and child development, evidence on children’s early life outcomes remains mixed. We analyze the empirical relationship between maternal depression and children’s development at age one using data from the São Paulo Western Region Cohort project. Method: Seven hundred and ninety-eight (798) mother-child dyads living in the Butantã-Jaguaré’ region of São Paulo were assessed ...

  6. The Determinants of Banking Performance: Empirical evidence from Tunisian Listed Banks

    Directory of Open Access Journals (Sweden)

    Khalfaoui Hamdi

    2015-06-01

    Full Text Available This paper aims to identify the determinants of performance of the Tunisian banking sector. The results found, following an empirical study using panel data of Tunisian banks listed on the stock market over the period 2000-2013, show that credit risk, liquidity, total assets and disclosure of information relating to credit are the main determinants of banking performance.

  7. Knowledge in health technology assessment

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2011-01-01

    Health systems are placing more and more emphasis on designing and delivering services that are focused on the patient, and there is a growing interest in patient aspects of health policy research and health technology assessment (HTA). Only a few HTA agencies use and invest in scientific methods...... to generate knowledge and evidence about the patient aspects of a given technology. This raises questions about how knowledge is produced in HTA reports and what kind of knowledge is considered relevant. This article uses a Danish HTA on patient education from 2009 as empirical material for a critical...

  8. Stress and Health

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej

    2014-01-01

    Background Stress is an important public health issue. One in ten Danish adults experience high levels of stress in their daily lives and stress is one of the main occupational health problems in Europe. The link between stress and health is still debated in the scientific literature...... and the pathways underlying these potential health effects are far from elucidated. The dissertation contributions to the literature on stress and health by empirically testing the relationship between stress and major chronic disorders and by providing new evidence on the underlying physiological, psychological...... and behavioral mechanisms. Stress is a complex concept and in order to better understand the relation between stress and health, the dissertation works with a clear distinction between the health consequences of different types of stress including external stressors, perceived stress, and measures of the stress...

  9. Innovations in mental health services implementation: a report on state-level data from the U.S. Evidence-Based Practices Project.

    Science.gov (United States)

    Magnabosco, Jennifer L

    2006-05-30

    The Evidence-Based Practice (EBP) Project has been investigating the implementation of evidence-based mental health practices (Assertive Community Treatment, Family Psychoeducation, Integrated Dual Diagnosis Treatment, Illness Management and Recovery, and Supported Employment) in state public mental health systems in the United States since 2001. To date, Project findings have yielded valuable insights into implementation strategy characteristics and effectiveness. This paper reports results of an effort to identify and classify state-level implementation activities and strategies employed across the eight states participating in the Project. Content analysis and Greenhalgh et al's (2004) definition of innovation were used to identify and classify state-level activities employed during three phases of EBP implementation: Pre-Implementation, Initial Implementation and Sustainability Planning. Activities were coded from site visit reports created from documents and notes from key informant interviews conducted during two periods, Fall 2002-Spring 2003, and Spring 2004. Frequency counts and rank-order analyses were used to examine patterns of implementation activities and strategies employed across the three phases of implementation. One hundred and six discreet implementation activities and strategies were identified as innovative and were classified into five categories: 1) state infrastructure building and commitment, 2) stakeholder relationship building and communications, 3) financing, 4) continuous quality management, and 5) service delivery practices and training. Implementation activities from different categories were employed at different phases of implementation. Insights into effective strategies for implementing EBPs in mental health and other health sectors require qualitative and quantitative research that seeks to: a) empirically test the effects of tools and methods used to implement EBPs, and b) establish a stronger evidence-base from which to plan

  10. Innovations in mental health services implementation: a report on state-level data from the U.S. Evidence-Based Practices Project

    Directory of Open Access Journals (Sweden)

    Magnabosco Jennifer L

    2006-05-01

    Full Text Available Abstract Background The Evidence-Based Practice (EBP Project has been investigating the implementation of evidence-based mental health practices (Assertive Community Treatment, Family Psychoeducation, Integrated Dual Diagnosis Treatment, Illness Management and Recovery, and Supported Employment in state public mental health systems in the United States since 2001. To date, Project findings have yielded valuable insights into implementation strategy characteristics and effectiveness. This paper reports results of an effort to identify and classify state-level implementation activities and strategies employed across the eight states participating in the Project. Methods Content analysis and Greenhalgh et al's (2004 definition of innovation were used to identify and classify state-level activities employed during three phases of EBP implementation: Pre-Implementation, Initial Implementation and Sustainability Planning. Activities were coded from site visit reports created from documents and notes from key informant interviews conducted during two periods, Fall 2002 – Spring 2003, and Spring 2004. Frequency counts and rank-order analyses were used to examine patterns of implementation activities and strategies employed across the three phases of implementation. Results One hundred and six discreet implementation activities and strategies were identified as innovative and were classified into five categories: 1 state infrastructure building and commitment, 2 stakeholder relationship building and communications, 3 financing, 4 continuous quality management, and 5 service delivery practices and training. Implementation activities from different categories were employed at different phases of implementation. Conclusion Insights into effective strategies for implementing EBPs in mental health and other health sectors require qualitative and quantitative research that seeks to: a empirically test the effects of tools and methods used to implement EBPs

  11. A comparison of usability methods for testing interactive health technologies: Methodological aspects and empirical evidence

    NARCIS (Netherlands)

    Jaspers, Monique W. M.

    2009-01-01

    OBJECTIVE: Usability evaluation is now widely recognized as critical to the success of interactive health care applications. However, the broad range of usability inspection and testing methods available may make it difficult to decide on a usability assessment plan. To guide novices in the

  12. empiric treatment based on helicobacter pylori serology cannot ...

    African Journals Online (AJOL)

    EMPIRIC TREATMENT BASED ON. HELICOBACTER PYLORI SEROLOGY. CANNOT SUBSTITUTE FOR EARLY. ENDOSCOPY IN THE. MANAGEMENT OF DYSPEPTIC. RURAL BLACK AFRICANS. Stephen JD O'Keefe, B Salvador, J Nainkin, S Majikir H. Stevens, A Atherstone. Background_ Evidence that chronic gastric ...

  13. Rising labor costs, earnings management, and financial performance of health care providers around the world.

    Science.gov (United States)

    Dong, Gang Nathan

    2015-01-01

    Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether health care providers behave similarly to their counterparts in other industries. The goal of this chapter is to study the degree to which health care providers manipulate accruals in periods of financial difficulties caused, in part, by the rising costs of labor. We collected the financial information of health care provider in 43 countries from 1984 to 2013 and conducted a pooled cross-sectional study with country and year fixed-effects. The empirical evidence shows that health care providers with higher wage costs are more likely to smooth their earnings in order to maintain financial sustainability. The finding of this study not only informs regulators that earnings management is pervasive in health care organizations around the world, but also contributes to the studies of financial booktax reporting alignment, given the existing empirical evidence linking earnings management to corporate tax avoidance in this very sector.

  14. Institutions and growth: theoretical foundations and empirical evidence

    International Nuclear Information System (INIS)

    Wagner, A.F.

    2000-09-01

    Institutions and growth rates are strongly linked both theoretically and empirically. They act through 'efficiency of governance'), as institutions of conflict management, and as devices for inter temporal optimization. Contrary to most of the literature, a non-linear (inversely u-shaped) influence of institutions on growth is also formally derived as a general hypothesis; this reflects the widely neglected notion that institutions also bring opportunity costs with them. Systematic econometric evaluations for a world-wide cross-sectional sample and a European Union panel show mixed results: the rule of law, property rights, and contract and law enforcement are consistently positively related to growth. In Europe, a non-linear relationship is often found for these and other institutions. Corporatism and trust are good for growth in Europe; both bring with them significant rent-seeking costs, though. Comparing the results one notes that no easy transfer of knowledge is possible from one sample to the other. This is an important policy conclusion in its own right. (author)

  15. The core determinants of health expenditure in the African context: some econometric evidence for policy.

    Science.gov (United States)

    Murthy, Vasudeva N R; Okunade, Albert A

    2009-06-01

    This paper, using cross-sectional data from 44 (83% of all) African countries for year 2001, presents econometric model estimates linking real per-capita health expenditure (HEXP) to a host of economic and non-economic factors. The empirical results of OLS and robust LAE estimators indicate that real per-capita GDP (PRGDP) and real per-capita foreign aid (FAID) resources are both core and statistically significant correlates of HEXP. Our empirical results suggest that health care in the African context is technically, a necessity rather than a luxury good (for the OECD countries). This suggests that the goal of health system in Africa is primarily 'physiological' or 'curative' rather than 'caring' or 'pampering'. The positive association of HEXP with FAID hints that external resource inflows targeting health could be instrumental for spurring economic progress in good policy environments. Most African countries until the late 1990s experienced economic and political instability, and faced stringent structural adjustment mandates of the major international financial institution lenders for economic development. Therefore, our finding a positive effect of FAID on HEXP could suggest that external resource inflows softened some of the macroeconomic fiscal deficit impacts on HEXP in the 2000s. Policy implications of country-specific elasticity estimates are given.

  16. The associations between early life circumstances and later life health and employment in the Netherlands and Spain

    NARCIS (Netherlands)

    Flores, M.; Kalwij, A.S.

    2011-01-01

    Using data from the Survey of Health, Ageing and Retirement in Europe, this paper provides empirical evidence for the Netherlands and Spain on the associations between individuals’ early life circumstances—measured by health and socioeconomic status (SES) during childhood—educational attainment, and

  17. Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments.

    Science.gov (United States)

    Allen, Peg; Jacob, Rebekah R; Lakshman, Meenakshi; Best, Leslie A; Bass, Kathryn; Brownson, Ross C

    2018-03-02

    Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders' role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners.

  18. Hospital Capacity, Waiting Times and Sick Leave Duration - an Empirical Analysis of a Norwegian Health Policy Reform

    OpenAIRE

    Aakvik, Arild; Holmås, Tor Helge; Kjerstad, Egil

    2012-01-01

    A health policy reform aiming to reduce hospital waiting times and sickness absences, the Faster Return to Work (FRW) scheme, is evaluated by creating treatment and control groups to facilitate causal interpretations of the empirical results. We use a unique dataset on individuals where we match hospital data with social security data and socio-economic characteristics. The main idea behind the reform is that long waiting times for hospital treatment lead to unnecessarily long periods of sick...

  19. Good jobs, good pay, better health? The effects of job quality on health among older European workers.

    Science.gov (United States)

    Henseke, Golo

    2018-01-01

    Using data from the Survey of Health, Ageing and Retirement in Europe, this study presents new evidence on the effects of job quality on the occurrence of severe acute conditions, the level of cardiovascular risk factors, musculoskeletal disorders, mental health, functional disabilities and self-assessed health among workers aged 50+. By combining intrinsic job quality with job insecurity and pay the study maps out multiple potential pathways through which work may affect health and well-being. Levering longitudinal data and external information on early retirement ages allows for accounting of unobserved heterogeneity, selection bias and reverse causality. The empirical findings suggest that inequities in health correlate with inequities in job quality, though a substantial fraction of these associations reflect time-constant unobserved heterogeneity. Still, there is evidence for genuine protective effects of better jobs on musculoskeletal disorders, mental health and general health. The effect could contribute to a substantial number of avoidable disorders among older workers, despite relatively modest effect sizes at the level of individuals. Mental health, in particular, responds to changes in job quality. Selection bias such as the healthy worker effect does not alter the results. But the influence of job quality on health may be transitional among older workers. An in-depth analysis of health dynamics reveals no evidence for persistence.

  20. Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico.

    Science.gov (United States)

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2006-11-18

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.

  1. [Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico].

    Science.gov (United States)

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2007-01-01

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular de Salud (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.

  2. Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol

    Directory of Open Access Journals (Sweden)

    Hill Sophie

    2012-03-01

    Full Text Available Abstract Background Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. Methods This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1, we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2, before being uploaded to the Internet and evaluated (Stages 3 and 4. Discussion This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader

  3. Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol.

    Science.gov (United States)

    Hill, Sophie; Filippini, Graziella; Synnot, Anneliese; Summers, Michael; Beecher, Deirdre; Colombo, Cinzia; Mosconi, Paola; Battaglia, Mario A; Shapland, Sue; Osborne, Richard H; Hawkins, Melanie

    2012-03-16

    Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS) integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1), we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2), before being uploaded to the Internet and evaluated (Stages 3 and 4). This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader efforts to provide evidence-based health information for

  4. The political economy of the assessment of value of new health technologies.

    Science.gov (United States)

    Karnon, Jonathan; Edney, Laura; Afzali, Hossein

    2018-04-01

    Health technology assessment provides a common framework for evaluating the costs and benefits of new health technologies to inform decisions on the public funding of new pharmaceuticals and other health technologies. In Australia and England, empirical analyses of the opportunity costs of government spending on new health technologies suggest more quality adjusted life years are being forgone than are being gained by a non-trivial proportion of funded health technologies. This essay considers the relevance of available empirical estimates of opportunity costs and explores the relationship between the public funding of health technologies and broader political and economic factors. We conclude that the benefits of a general reduction in the prices paid by governments for new technologies outweigh the costs, but evidence of informed public acceptance of reduced access to new health technologies may be required to shift the current approach to assessing the value of new health technologies.

  5. [Taxing unhealthy foods. A measure to promote public health in Germany?].

    Science.gov (United States)

    Lehnert, T; Riedel-Heller, S; König, H-H

    2013-04-01

    Due to the substantial health burden and costs caused by malnutrition in Germany, for instance as a result of obesity, diabetes, and cardiovascular diseases, the taxation of unhealthy foods/nutrients has been proposed as a possible health promoting measure. In order to evaluate whether such a fiscal intervention constitutes an effective and suitable measure to promote population health in Germany, the article outlines central empirical findings regarding malnutrition in Germany. Subsequently, the economic background (price elasticity of demand) is explained, and empirical evidence on the influence of changes in price on changes in consumption and health is presented. As a result of findings from the international literature being heterogeneous, and because very little research has been conducted in Germany on this matter until now, the taxation/subsidization of foods in order to promote population health is difficult to justify at this point.

  6. AN EMPIRICAL EXAMINATION OF ENTREPRENEURIAL ORIENTATION. EVIDENCE FROM ROMANIA

    Directory of Open Access Journals (Sweden)

    Alexandru CONSTANGIOARA

    2014-06-01

    Full Text Available In order to achieve the desired performances and the increased value added to the final consumer, organizations need not only to integrate their core businesses and align them to business strategy but also to develop essential entrepreneurial competences. After presenting the dimensions of entrepreneurial orientation and their specificity in a supply chain, we propose an empirical research using a working dataset of 64 firms from various industries to analyze the Romanian entrepreneurial supply chains. Structural equations are employed to estimate the complex relationships between organizational performances and entrepreneurial orientation in supply chains at national level. Results show that entrepreneurial orientation influences organizational competences only in the framework of the supply chain management strategic approach to operational excellence.

  7. Hypnosis Treatment of Gastrointestinal Disorders: A Comprehensive Review of the Empirical Evidence.

    Science.gov (United States)

    Palsson, Olafur S

    2015-10-01

    Hypnotherapy has been investigated for 30 years as a treatment for gastrointestinal (GI) disorders. There are presently 35 studies in the published empirical literature, including 17 randomized controlled trials (RCTs) that have assessed clinical outcomes of such treatment. This body of research is reviewed comprehensively in this article. Twenty-four of the studies have tested hypnotherapy for adult irritable bowel syndrome (IBS) and 5 have focused on IBS or abdominal pain in children. All IBS hypnotherapy studies have reported significant improvement in gastrointestinal symptoms, and 7 out of 10 RCTs in adults and all 3 RCTs in pediatric patient samples found superior outcomes for hypnosis compared to control groups. Collectively this body of research shows unequivocally that for both adults and children with IBS, hypnosis treatment is highly efficacious in reducing bowel symptoms and can offer lasting and substantial symptom relief for a large proportion of patients who do not respond adequately to usual medical treatment approaches. For other GI disorders the evidence is more limited, but preliminary indications of therapeutic potential can be seen in the single randomized controlled trials published to date on hypnotherapy for functional dyspepsia, functional chest pain, and ulcerative colitis. Further controlled hypnotherapy trials in those three disorders should be a high priority. The mechanisms underlying the impact of hypnosis on GI problems are still unclear, but findings from a number of studies suggest that they involve both modulation of gut functioning and changes in the brain's handling of sensory signals from the GI tract.

  8. Incorporation of a health economic modelling tool into public health commissioning: Evidence use in a politicised context.

    Science.gov (United States)

    Sanders, Tom; Grove, Amy; Salway, Sarah; Hampshaw, Susan; Goyder, Elizabeth

    2017-08-01

    This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency. The former highlighted the diverse evidence cultures present in the LA with politicians influenced by the 'soft' social care agendas affecting their local population and treating local opinion as evidence, whilst public health managers prioritised the scientific view of evidence informed by research. System interdependency further complicated the decision making process by recognizing interlinking with departments and other disease groups. To achieve legitimacy within the commissioning arena health economic modelling needs to function effectively in a highly politicised environment where decisions are made not only on the basis of research evidence, but on grounds of 'soft' data, personal opinion and intelligence. In this context decisions become politicised, with multiple opinions seeking a voice. The way that such decisions are negotiated and which ones establish authority is of importance. We analyse the data using Larson's (1990) discursive field concept to show how the tool becomes an object of research push and pull likely to be used instrumentally by stakeholders to advance specific agendas, not a means of informing complex decisions. In conclusion, LA decision making is underpinned by a transactional business ethic which is a further potential 'pull' mechanism for the incorporation of health economic modelling in local commissioning. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  9. The impact of orthopaedic research evidence on health financing in Australia.

    Science.gov (United States)

    Hua, Martin; Myers, Daniel; Host, Lachlan

    2018-05-02

    In Australia, approval by the Medical Services Advisory Committee (MSAC) is an important step in the implementation of new health technologies. The MSAC considers health technology assessments (HTA) when submitting a recommendation to the Minister of Health on a new technology's suitability for public funding. Despite being such a critical tool in formulating policy, there has been little scrutiny on the impact of limited evidence on the performance of a national HTA agency's mandate. We aim to determine the proportion of HTAs of orthopaedic technologies prepared for the MSAC that were supported by higher levels of evidence for effectiveness, and whether this affected the MSAC's ability to conclude on efficacy. We also investigated whether the availability of higher level evidence affected the performance of cost-effectiveness analyses. We performed a cohort study of all HTAs prepared for the MSAC from 1998 to 2017 with regards to new technologies in orthopaedic surgery. We identified seven HTAs encompassing nine orthopaedic technologies for inclusion. Higher levels of evidence were available for assessing the technology's effectiveness in six out of the nine technologies. The results did not show a statistically significant relationship between the availability of higher level evidence and MSAC's ability to make a clear conclusion on the assessment of effectiveness (P = 0.5). The proportion of HTAs where a cost-effectiveness analysis was performed was significantly higher (P decision-making.

  10. Is 'legal empowerment of the poor' relevant to people with disabilities in developing countries? An empirical and normative review.

    Science.gov (United States)

    Borg, Johan; Bergman, Anna-Karin; Östergren, Per-Olof

    2013-11-15

    Legal empowerment of the poor is highly relevant to public health as it aims to relieve income poverty, a main determinant of health. The Commission on Legal Empowerment of the Poor (CLEP) has proposed legal empowerment measures in the following four domains: access to justice and the rule of law, property, labor, and business rights. Despite being overrepresented among the poor, CLEP has not explicitly considered the situation of people with disabilities. To examine the empirical evidence for the relevance of the CLEP legal empowerment measures to people with disabilities in low- and lower middle-income countries, and to evaluate the extent to which the Convention on the Rights of Persons with Disabilities (CRPD) addresses those measures. Critical literature review of empirical studies and a checklist assessment of the CRPD. Fourteen included articles confirm that people with disabilities experience problems in the domains of access to justice and the rule of law, labor rights, and business rights. No texts on property rights were found. Evidence for the effectiveness of the proposed measures is insufficient. Overall, the CRPD fully or partially supports two-thirds of the proposed measures (seven out of nine measures for access to justice and the rule of law, none of the five measures for property rights, all seven measures for labor rights, and six out of nine measures for business rights). Although most of the domains of the CLEP legal empowerment measures are relevant to people with disabilities from both empirical and normative perspectives, it is uncertain whether the devised measures are of immediate relevance to them. Further research is warranted in this regard.

  11. The Built Environment and Child Health: An Overview of Current Evidence.

    Science.gov (United States)

    Gascon, Mireia; Vrijheid, Martine; Nieuwenhuijsen, Mark J

    2016-09-01

    Urbanization and the shaping of the built environment have provided a number of socioeconomic benefits, but they have also brought unwanted side effects on health. We aimed to review the current epidemiological evidence of the associations between the built environment, closely related exposures, and child health. We focused on growth and obesity, neuropsychological development, and respiratory and immune health. We used existing review articles and supplemented these with relevant work published and not included in existing reviews. The present review shows that there is good evidence for an association between air pollution and fetal growth restriction and respiratory health, whereas for other exposure and outcome combinations, further evidence is needed. Future studies should make efforts to integrate the different built environment features and to include the evaluation of environments other than home, as well as accessibility, qualitative and perception assessment of the built environment, and, if possible, with improved and standardized tools to facilitate comparability between studies. Efforts are also needed to conduct longitudinal and intervention studies and to understand potential mechanisms behind the associations observed. Finally, studies in low- and middle-income countries are needed.

  12. Health anxiety and illness behaviour in children of mothers with severe health anxiety

    DEFF Research Database (Denmark)

    Thorgaard, Mette Viller

    2017-01-01

    costs when untreated. Growing research suggests that health anxiety may originate in childhood, and studies have demonstrated that cognitive and behavioural features similar to those described for health anxiety in adults may be present. The development of health anxiety probably has a complex nature...... perspectives also assume an association between childhood experiences and family factors and a later development of health anxiety. This dissertation is based on a systematic review and a family case-control study and aims to answer the following questions: 1) What is the empirical evidence for the influence...... of childhood and family factors for the development of health anxiety? 2) Does exposure to severe maternal health anxiety contribute to health anxiety symptoms in their children or perhaps more broadly affect the children emotionally? 3) Do mothers with severe health anxiety express more health anxiety...

  13. Regional infrastructure and firm investment. Theory and empirical evidence for Italy

    OpenAIRE

    Aiello, Francesco; Iona, Alfonsina; Leonida, Leone

    2009-01-01

    We model the channels through which public expenditure on infrastructure influences firm value and shapes its investment decisions via both adjustment costs and marginal profitability of capital. We test these hypotheses by using a large panel of Italian firms. Empirical results show that infrastructure interacts with revenues and costs in shaping firm's profitability of capital and influences its adjustment costs. Finally we find that infrastructure expenditure contributes to reduce the econ...

  14. Effects of health insurance on labour supply: A systematic review

    NARCIS (Netherlands)

    Quynh, Nga Le Thi; Groot, Wim; Tomini, Sonila M.; Tomini, Florian

    2017-01-01

    This study provides a systematic review of empirical evidence on the labour supply effects of health insurance. The outcomes in the 63 studies reviewed include labour supply in terms of hours worked and the probability of employment, self-employment and the level of economic formalisation. One of

  15. Consumer attitudes towards evidence based mental health services among American mental health consumers.

    Science.gov (United States)

    Teh, Lisa B; Hayashi, Kentaro; Latner, Janet; Mueller, Charles W

    2016-10-01

    The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes. © 2016 Australian College of Mental Health Nurses Inc.

  16. Decision-Making in Audiology: Balancing Evidence-Based Practice and Patient-Centered Care

    Science.gov (United States)

    Clemesha, Jennifer; Lundmark, Erik; Crome, Erica; Barr, Caitlin; McMahon, Catherine M.

    2017-01-01

    Health-care service delivery models have evolved from a practitioner-centered approach toward a patient-centered ideal. Concurrently, increasing emphasis has been placed on the use of empirical evidence in decision-making to increase clinical accountability. The way in which clinicians use empirical evidence and client preferences to inform decision-making provides an insight into health-care delivery models utilized in clinical practice. The present study aimed to investigate the sources of information audiologists use when discussing rehabilitation choices with clients, and discuss the findings within the context of evidence-based practice and patient-centered care. To assess the changes that may have occurred over time, this study uses a questionnaire based on one of the few studies of decision-making behavior in audiologists, published in 1989. The present questionnaire was completed by 96 audiologists who attended the World Congress of Audiology in 2014. The responses were analyzed using qualitative and quantitative approaches. Results suggest that audiologists rank clinical test results and client preferences as the most important factors for decision-making. Discussion with colleagues or experts was also frequently reported as an important source influencing decision-making. Approximately 20% of audiologists mentioned utilizing research evidence to inform decision-making when no clear solution was available. Information shared at conferences was ranked low in terms of importance and reliability. This study highlights an increase in awareness of concepts associated with evidence-based practice and patient-centered care within audiology settings, consistent with current research-to-practice dissemination pathways. It also highlights that these pathways may not be sufficient for an effective clinical implementation of these practices. PMID:28752808

  17. Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda.

    Science.gov (United States)

    Nabyonga-Orem, Juliet; Mijumbi, Rhona

    2015-03-08

    Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors' views regarding what evidence they deemed appropriate to guide health policy development. Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. © 2015 by Kerman University of Medical Sciences.

  18. Evidence for Informing Health Policy Development in Low- Income Countries (LICS: Perspectives of Policy Actors in Uganda

    Directory of Open Access Journals (Sweden)

    Juliet Nabyonga-Orem

    2015-05-01

    Full Text Available Background Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs, the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods Using exploratory qualitative methods, we conducted interviews with 51 key informants using an indepth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion What LICslike Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making.

  19. The use of arts interventions for mental health and wellbeing in health settings.

    Science.gov (United States)

    Jensen, A; Bonde, L O

    2018-04-01

    This literature review aims to illustrate the variety and multitude of studies showing that participation in arts activities and clinical arts interventions can be beneficial for citizens with mental and physical health problems. The article is focused on mental health benefits because this is an emerging field in the Nordic countries where evidence is demanded from national health agencies that face an increasing number of citizens with poor mental health and a need for non-medical interventions and programmes. A total of 20 articles of interest were drawn from a wider literature review. Studies were identified through the search engines: Cochrane Library, Primo, Ebscohost, ProQuest, Web of Science, CINAHL, PsycINFO, PubMed and Design and Applied Arts Index. Search words included the following: arts engagement + health/hospital/recovery, arts + hospital/evidence/wellbeing, evidence-based health practice, participatory arts for wellbeing, health + poetry/literature/dance/singing/music/community arts, arts health cost-effectiveness and creative art or creative activity + health/hospital/recovery/mental health. The inclusion criteria for studies were (1) peer review and (2) empirical data. The studies document that participation in activities in a spectrum from clinical arts interventions to non-clinical participatory arts programmes is beneficial and an effective way of using engagement in the arts to promote holistic approaches with health benefits. Engagement in specially designed arts activities or arts therapies can reduce physical symptoms and improve mental health issues. Based on the growing evidence of the arts as a tool for enhancing mental health wellbeing, and in line with the global challenges in health, we suggest that participatory arts activities and clinical arts interventions are made more widely available in health and social settings. It is well-documented that such activities can be used as non-medical interventions to promote public health and

  20. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs

    Directory of Open Access Journals (Sweden)

    Melissa F. Peskin

    2017-08-01

    Full Text Available In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular, a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS, an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.

  1. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs.

    Science.gov (United States)

    Peskin, Melissa F; Hernandez, Belinda F; Gabay, Efrat K; Cuccaro, Paula; Li, Dennis H; Ratliff, Eric; Reed-Hirsch, Kelly; Rivera, Yanneth; Johnson-Baker, Kimberly; Emery, Susan Tortolero; Shegog, Ross

    2017-01-01

    In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CH oosing A nd M aintaining Effective P rograms for S ex Education in S chools ( iCHAMPSS ), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.

  2. Empiric treatment based on Helicobacter Pylori serology cannont ...

    African Journals Online (AJOL)

    Background: Evidence that chronic gastric Helicobacter pylori (HP) infection is an aetiological factor in dyspepsia, peptic ulcer disease, gastric carcinoma and lymphoma has led to the suggestion that all serologically positive dyspeptic patients should be treated empirically with antibiotics to eradicate the infection, without ...

  3. Moving Maternal, Newborn, and Child Health Evidence into Policy in ...

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

    This project brings together and supports the uptake of maternal and child health research evidence into policies and practices in West Africa. A part of the Innovating for Maternal and Child Health in Africa program, the project's impact will be felt at the national and regional levels in Ghana, Mali, Nigeria, and Senegal.

  4. Evidence-based Heuristics for Evaluating Demands on eHealth Literacy and Usability in a Mobile Consumer Health Application.

    Science.gov (United States)

    Monkman, Helen; Griffith, Janessa; Kushniruk, Andre W

    2015-01-01

    Heuristic evaluations have proven to be valuable for identifying usability issues in systems. Commonly used sets of heuritics exist; however, they may not always be the most suitable, given the specific goal of the analysis. One such example is seeking to evaluate the demands on eHealth literacy and usability of consumer health information systems. In this study, eight essential heuristics and three optional heuristics subsumed from the evidence on eHealth/health literacy and usability were tested for their utility in assessing a mobile blood pressure tracking application (app). This evaluation revealed a variety of ways the design of the app could both benefit and impede users with limited eHealth literacy. This study demonstrated the utility of a low-cost, single evaluation approach for identifying both eHealth literacy and usability issues based on existing evidence in the literature.

  5. Improving the quality of the evidence base of health informatics.

    Science.gov (United States)

    Talmon, Jan

    2008-11-06

    Evaluation of health informatics technology has had attention from quite a few researchers in health informatics in the last few decades. In the early nineties of the past century several working groups and research projects have discussed evaluation methods and methodologies. Despite these activities, evaluation of health informatics has not received the recognition it deserves. In this presentation we will reiterate the arguments put forward in the Declaration of Innsbruck to consider evaluation an essential element of the evidence base of health informatics. Not only are evaluation studies essential, it is also required that such studies are properly reported. A joint effort of the IMIA, EFMI and AMIA working groups on evaluation has resulted in a guideline for reporting the results of evaluation studies of health informatics applications (STARE-HI). STARE-HI is currently endorsed by EFMI. The general assembly of IMIA has adopted STARE-HI as an official IMIA document. Endorsement from AMIA is being sought. A pilot study in which STARE-HI was applied to assess the quality of current reporting clearly indicates that there is quite some room for improvement. Application of guidelines such as STARE-HI would contribute to a further improvement of the evidence base of health informatics and would open the road for high quality reviews and meta-analyses.

  6. An Empirical Analysis of the Default Rate of Informal Lending—Evidence from Yiwu, China

    Science.gov (United States)

    Lu, Wei; Yu, Xiaobo; Du, Juan; Ji, Feng

    This study empirically analyzes the underlying factors contributing to the default rate of informal lending. This paper adopts snowball sampling interview to collect data and uses the logistic regression model to explore the specific factors. The results of these analyses validate the explanation of how the informal lending differs from the commercial loan. Factors that contribute to the default rate have particular attributes, while sharing some similarities with commercial bank or FICO credit scoring Index. Finally, our concluding remarks draw some inferences from empirical analysis and speculate as to what this may imply for the role of formal and informal financial sectors.

  7. [Evidence-based medicine and public health law: statutory health insurance].

    Science.gov (United States)

    Dreher, Wolfgang

    2004-09-01

    Beyond all differences in terminology and legal principles between the laws governing private health insurance, the governmental financial support for civil, servants and statutory health insurance the fundamental issues to be solved by the courts in case of litigation are quite similar. But only a part of these refer to the quality of medical services, which is the main concern of Evidence-based Medicine (EbM); EbM, though, is not able to contribute towards answering the equally important question of how to distinguish between "treatment" and "(health-relevant) lifestyle". The respective definitions that have been developed in the particular fields of law are only seemingly divergent from each other and basically unsuitable to aid the physician in his clinical decision-making because the common blanket clauses of public health law are regularly interpreted as rules for the exclusion of certain claims and not as a confirmatory paraphrase of what is clinically necessary. If on the other hand medical quality is what lies at the core of litigation, reference to EbM may become necessary. In fact, it is already common practice in the statutory health insurance system that decision-making processes in the Federal Committee being responsible for quality assurance (Bundesausschuss) are based on EbM principles and that in exceptional cases only the courts have to medically review the Federal Committee's decisions.

  8. Measuring the Level of Industrial Green Development and Exploring Its Influencing Factors: Empirical Evidence from China’s 30 Provinces

    Directory of Open Access Journals (Sweden)

    Chaofan Chen

    2016-02-01

    Full Text Available Nowadays, with the green economy becoming mainstream in the world, an industrial revolution as the core of green development has emerged. Based on the empirical evidence from China’s 30 provinces, this study establishes an evaluation index system of China’s industrial green development and applies the analytic hierarchy process to determine the indices’ weights and properties to measure the level of industrial green development in China’s 30 provinces. Then, an empirical study is conducted to explore the relevant factors influencing China’s industrial green development by using the dynamic panel data model and a panel threshold test. The results show that China’s level of industrial green development has the characteristic of typical regional differentiation with a ladder-like distribution from the east and middle to the west, and the eastern region has the highest level on industrial green output, industrial green efficiency and industrial green innovation. Technological progress and innovation can stimulate industrial green development. The impact of environmental regulation and foreign investment on industrial green development presents a nonlinear “N”-type trend, and the positive effects are mainly observed in eastern China. Capital deepening, heavy chemical industries and an unreasonable energy structure are not effective in industrial green development. There is no direct relation between the enterprise scale and industrial green development.

  9. Ownership unbundling of gas transmission networks. Empirical evidence

    Energy Technology Data Exchange (ETDEWEB)

    Growitsch, Christian [Koeln Univ. (Germany). Energiewirtschaftliches Inst.; Stronzik, Marcus [Scientific Institute for Infrastructure and Communication Services (WIK), Bad Honnef (Germany)

    2011-07-15

    The European Commission has intensively discussed the mandatory separation of natural gas transmission from production and services. However, economic theory is ambiguous on the price effects of vertical separation. In this paper, we empirically analyse the effect of ownership unbundling of gas transmission networks as the strongest form of vertical separation on the level of end-user prices. Therefore, we apply different dynamic estimators as system GMM and the bias-corrected least-squares dummy variable or LSDVC estimator on an unbalanced panel out of 18 EU countries over 19 years, allowing us to avoid the endogeneity problem and to estimate the long-run effects of regulation. We introduce a set of regulatory indicators as market entry regulation, ownership structure, vertical separation and market structure and account for structural and economic country specifics. Among these different estimators, we consistently find that ownership unbundling has no impact on natural gas end-user prices, while the more modest legal unbundling reduces them significantly. Furthermore, third-party access, market structure and privatisation show significant influence with the latter leading to higher price levels.

  10. Evidence acquisition and evaluation for evidence summit on enhancing provision and use of maternal health services through financial incentives.

    Science.gov (United States)

    Higgs, Elizabeth S; Stammer, Emily; Roth, Rebecca; Balster, Robert L

    2013-12-01

    Recognizing the need for evidence to inform US Government and governments of the low- and middle-income countries on efficient, effective maternal health policies, strategies, and programmes, the US Government convened the Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives in April 2012 in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used for achieving the goals of the Summit. The goal of the Summit was to obtain multidisciplinary expert review of literature to inform both US Government and governments of the low- and middle-income countries on evidence-informed practice, policies, and strategies for financial incentives. Several steps were undertaken to define the tasks for the Summit and identify the appropriate evidence for review. The process began by identifying focal questions intended to inform governments of the low-and middle-income countries and the US Government about the efficacy of supply- and demand-side financial incentives for enhanced provision and use of quality maternal health services. Experts were selected representing the research and programme communities, academia, relevant non-governmental organizations, and government agencies and were assembled into Evidence Review Teams. This was followed by a systematic process to gather relevant peer-reviewed literature that would inform the focal questions. Members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliography. The Evidence Review Teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. Details of the search processes and methods used for screening and quality reviews are described.

  11. Using decision-analytic modelling to transfer international evidence from health technology assessment to the context of the German health care system

    Directory of Open Access Journals (Sweden)

    Siebert, Uwe

    2005-11-01

    Full Text Available The objective of this Health Technology Assessment (HTA methods report was to examine and to assess decision analysis (DA as a method to transfer and adapt international scientific evidence in HTA to the German health care context. Furthermore, we sought to develop a systematic framework to facilitate the selection, transfer, adaptation, and synthesis of these data in German HTA projects. In this report, we review and summarise the concepts and methods of DA; present potential areas of applications, and provide a basis for the critical assessment of decision-analytic studies. The two main methods of DA, decision trees and Markov models, as well as various approaches to sensitivity analyses are described. Examples of typical situations for the use of DA in scientific evidence transfer are described, and a list of main health care domains and parameters in evidence transfer is presented. Finally, we developed a framework to transfer and apply international evidence to the national health care context. The strengths and limitations of the decision-analytic approach are critically examined. In summary, this HTA report describes different situations, in which decision-analytic models can be useful, and demonstrates the utility of DA in transferring and applying international evidence to the national health care context. We developed a systematic instrument to transfer international evidence to the context of other countries and successfully applied this instrument in two German HTA projects. The use of this instrument is recommended in further HTA projects dealing with the application of international evidence to the German health care context. The use of decision-analytic models to transfer international evidence is endorsed. However, the limitations of DA should be clearly stated discussed transparently in all HTA reports.

  12. Moving Maternal, Newborn, and Child Health Evidence into Policy in ...

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

    This project brings together and supports the uptake of maternal and child health research evidence into policies and practices in East Africa. A part of the Innovating for Maternal and Child Health in Africa program, the project's impact will be felt at the national and regional levels in East Africa, specifically in Ethiopia, Malawi ...

  13. Clustered Pricing in the Corporate Loan Market: Theory and Empirical Evidence

    OpenAIRE

    Bajoori, Elnaz; Nandeibam, Shasikanta; Chaudhry, Sajid Mukhtar

    2016-01-01

    Existing theories explaining security price clustering as well as clustering in the retail depositand mortgage markets are incompatible with the clustering in the corporate loan market. Wedevelop a new theoretical argument that the attitude of the lender toward the uncertaintyabout the quality of the borrower leads to the clustering of spreads. Our empirical resultssupport these arguments and we find that clustering increases with the degree of uncertaintybetween the lender and the borrower. ...

  14. Tax-and-Spend or Spend-and-Tax? Empirical Evidence from Malaysia

    OpenAIRE

    Tan Juat Hong

    2009-01-01

    The paper investigates the causal relationships between government spending and revenue for Malaysia. The study uses annual data, a Johansen cointegration test and an error-correction model. A preliminary test shows that government revenue and expenditure are cointegrated. Empirical results support the spend-and-tax hypothesis. Furthermore, they underscore the fact that fiscal policy may not be effective enough to curb the rising budget deficits over the long term and may even reduce private ...

  15. Is Malaysia exempted from impossible trinity: empirical evidence from 1991-2009

    OpenAIRE

    Lim, Ewe Ghee; Goh, SooKhoon

    2011-01-01

    This paper examines Bank Negara Malaysia’s (BNM) monetary policy autonomy in 1991-2009, a period of volatile capital flows, during which BNM operated under several exchange regimes: managed floating; fixed exchange rates; and fixed exchange rates with selective capital controls. Using a modified version of the Brissimis, Gibson and Tsakalotos (2002) model, the paper’s empirical estimates show that the same-period offset coefficients are significantly less than unity under all regimes, indicat...

  16. Stress and Health

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej

    2014-01-01

    and behavioral mechanisms. Stress is a complex concept and in order to better understand the relation between stress and health, the dissertation works with a clear distinction between the health consequences of different types of stress including external stressors, perceived stress, and measures of the stress......’s disease patients. Results The combined evidence of this dissertation shows a moderately higher risk of some common chronic disorders including cardiovascular disease and atopic disorders among individuals exposed to work-related stressors and perceived stress. Most empirical studies also report higher...... of pathways. The physiological stress response has the ability to directly affect vital body systems including the cardiovascular, immune, and metabolic systems. Further, stress can lead to unfavorable changes in health-related behavior, impaired sleep and poor mental health. An increasing number of well...

  17. Psychiatric mental health evidence-based practice.

    Science.gov (United States)

    Rice, Michael J

    2008-05-01

    This article is the first in a new column focusing on evidence-based practice (EBP) in psychiatric mental health nursing. The EBP movement was strongly influenced by a British epidemiologist, Dr. Cochrane, who advocated care based on randomized clinical controlled trials in the late 1900s. Although the majority of the EBP movement is directed toward developing clinical guidelines, the critical element focuses on the therapeutic relationship and clinical judgment associated with providing care. This column will address a clinical problem, define PICO questions, report knowledge base searches, and present existing evidence. Recommendations will be offered for potential interventions and suggestions for evaluating clinical outcomes. Nurses can no longer view clinical studies as academic exercises discarded on graduation and not applied to the clinical setting. Conscientiously applying what is known about treatments and interventions of ethical, if not legal, value is consistent with the professional definition of care. J Am Psychiatr Nurses Assoc, 2008; 14(2), 107-111. DOI: 10.1177/1078390308315798.

  18. The use of six sigma in health care management: are we using it to its full potential?

    Science.gov (United States)

    DelliFraine, Jami L; Wang, Zheng; McCaughey, Deirdre; Langabeer, James R; Erwin, Cathleen O

    2014-01-01

    Popular quality improvement tools such as Six Sigma (SS) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether this quality improvement tool is being used correctly and improves health care quality. The authors conducted a comprehensive literature review to assess the correct use and implementation of SS and the empirical evidence demonstrating the relationship between SS and improved quality of care in health care organizations. The authors identified 310 articles on SS published in the last 15 years. However, only 55 were empirical peer-reviewed articles, 16 of which reported the correct use of SS. Only 7 of these articles included statistical analyses to test for significant changes in quality of care, and only 16 calculated defects per million opportunities or sigma level. This review demonstrates that there are significant gaps in the Six Sigma health care quality improvement literature and very weak evidence that Six Sigma is being used correctly to improve health care quality.

  19. Start making sense: Art informing health psychology.

    Science.gov (United States)

    Kaptein, Ad A; Hughes, Brian M; Murray, Michael; Smyth, Joshua M

    2018-01-01

    Growing evidence suggests that the arts may be useful in health care and in the training of health care professionals. Four art genres - novels, films, paintings and music - are examined for their potential contribution to enhancing patient health and/or making better health care providers. Based on a narrative literature review, we examine the effects of passive (e.g. reading, watching, viewing and listening) and active (e.g. writing, producing, painting and performing) exposure to the four art genres, by both patients and health care providers. Overall, an emerging body of empirical evidence indicates positive effects on psychological and physiological outcome measures in patients and some benefits to medical training. Expressive writing/emotional disclosure, psychoneuroimmunology, Theory of Mind and the Common Sense Model of Self-Regulation are considered as possible theoretical frameworks to help incorporate art genres as sources of inspiration for the further development of health psychology research and clinical applications.

  20. Start making sense: Art informing health psychology

    Science.gov (United States)

    Hughes, Brian M; Murray, Michael; Smyth, Joshua M

    2018-01-01

    Growing evidence suggests that the arts may be useful in health care and in the training of health care professionals. Four art genres – novels, films, paintings and music – are examined for their potential contribution to enhancing patient health and/or making better health care providers. Based on a narrative literature review, we examine the effects of passive (e.g. reading, watching, viewing and listening) and active (e.g. writing, producing, painting and performing) exposure to the four art genres, by both patients and health care providers. Overall, an emerging body of empirical evidence indicates positive effects on psychological and physiological outcome measures in patients and some benefits to medical training. Expressive writing/emotional disclosure, psychoneuroimmunology, Theory of Mind and the Common Sense Model of Self-Regulation are considered as possible theoretical frameworks to help incorporate art genres as sources of inspiration for the further development of health psychology research and clinical applications. PMID:29552350

  1. The relation between wealth and health: Evidence from a world panel of countries

    DEFF Research Database (Denmark)

    Worm Hansen, Casper

    2012-01-01

    Based on a world sample of countries, this paper presents panel data evidence that documents a U-shaped relation between GDP per capita (wealth) and life expectancy (health). The evidence also shows that excluding the possibility of a nonmonotonic relationship induces erroneous conclusions about...... the time-varying wealth-health correlation. (C) 2011 Elsevier B.V. All rights reserved....

  2. Place shaping to create health and wellbeing using health impact assessment: health geography applied to develop evidence-based practice.

    Science.gov (United States)

    Learmonth, Alyson; Curtis, Sarah

    2013-11-01

    In a political milieu where there is pressure towards localised and participative decisionmaking, and an environment of global recession and environmental degradation, it is crucial that population health considerations inform strategic decisions. The paper puts forward 'place shaping to create health and wellbeing' as a strategic tool, drawing on ideas that are fundamental in health geography, and argues that this is an important emerging application of Health Impact Assessment (HIA), as part of evidence-based practice. These views developed primarily from case study work in the North East of England aiming to enhance health and wellbeing in a population with significant health disadvantages. © 2013 Elsevier Ltd. All rights reserved.

  3. Patients' perceptions of service quality dimensions: an empirical examination of health care in New Zealand.

    Science.gov (United States)

    Clemes, M D; Ozanne, L K; Laurensen, W L

    2001-01-01

    The 1984 liberalization of the New Zealand economy has resulted in a health care sector that has become very competitive (Zwier and Clarke, 1999). The private sector is now able to supply health care services and, as a result, a greater value is being placed on patient satisfaction (Zwier and Clarke, 1999). However, despite the increasing focus on customer satisfaction, research into health care patients' perceptions of the dimensions of service quality is scarce. This can be problematic, as quality of care is an essential issue in the strategic marketing of health care services (Turner and Pol, 1995). This study takes a step towards addressing this deficiency by identifying patients' perceptions of the dimensions of service quality in health care. The findings of this study are based on the empirical analysis of a sample of 389 respondents interviewed by telephone. The findings indicate that the service quality dimensions identified in this health care specific study differ in number and dimensional structure from the widely adopted service quality dimensions first identified by Parasuraman, Berry and Zeithaml (1988): reliability, responsiveness, assurance, empathy and tangibles. The service quality dimensions identified in this study were: reliability, tangibles, assurance, empathy, food, access, outcome, admission, discharge and responsiveness. In addition, health care patients perceive the service quality dimensions relating to the core product in health care delivery (for example, outcome and reliability) as more important than the service quality dimensions relating to the peripheral product in health care delivery (for example, food, access and tangibles). Finally, the results of this study suggest that patients with different geographic, demographic, and behavioristic characteristics have different needs and wants during health care delivery and therefore perceive different service quality dimensions as important.

  4. Development of Evidence-Based Health Policy Documents in Developing Countries: A Case of Iran

    Science.gov (United States)

    Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

    2014-01-01

    Background: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. Methods: In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. Results: 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Conclusion: Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers

  5. Development of evidence-based health policy documents in developing countries: a case of Iran.

    Science.gov (United States)

    Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

    2014-02-07

    Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policy-making. 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.

  6. Negotiated forms of worker involvement in the European Company (SE): First empirical evidence and conclusions

    OpenAIRE

    Keller, Berndt; Werner, Frank

    2008-01-01

    This article analyses the negotiations on worker involvement in the first almost four years of the European Company SE and their outcomes. First, some basic institutional aspects of the SE itself and its current empirical situation are described and explained. Then, the focus is on questions of employee involvement in this new legal form. Again some main institutional provisions on employee involvement are assessed, before a detailed empirical analysis on specific issues is presented. A final...

  7. Empiric evidence for ceramic sector in Spain; Influencia de los recursos y capacidades territoriales sobre las empresas en un distrito industrial

    Energy Technology Data Exchange (ETDEWEB)

    Hervas Oliver, J. L.; Dalmau Porta, J. I.; Albors Garrigos, J.

    2008-07-01

    One of the differences on the firms performance is based on the strategic location on a specific geographic place: the territorial effect. Firstly, we develop a theoretical framework which includes the located assets in an industrial district. Thus, in order to measure the influence of territorial assets over located firms, we analyze quantitatively that district effect or territorial effect on a sample of 343 firms from the Spanish ceramic tile industry in 2000, 1999 and 1998, finding empirical evidence of the existence of externalities shown on different financial and economic indicators in the companies located in the industrial district area compared to the outside (or isolated) companies. (Author) 94 refs.

  8. Sixty years of fear appeal research: current state of the evidence.

    Science.gov (United States)

    Ruiter, Robert A C; Kessels, Loes T E; Peters, Gjalt-Jorn Y; Kok, Gerjo

    2014-04-01

    Fear arousal is widely used in persuasive campaigns and behavioral change interventions. Yet, experimental evidence argues against the use of threatening health information. The authors reviewed the current state of empirical evidence on the effectiveness of fear appeals. Following a brief overview of the use of fear arousal in health education practice and the structure of effective fear appeals according to two main theoretical frameworks-protection motivation theory and the extended parallel process model-the findings of six meta-analytic studies in the effectiveness of fear appeals are summarized. It is concluded that coping information aimed at increasing perceptions of response effectiveness and especially self-efficacy is more important in promoting protective action than presenting threatening health information aimed at increasing risk perceptions and fear arousal. Alternative behavior change methods than fear appeals should be considered. © 2014 The Authors. International Journal of Psychology published by John Wiley © Sons Ltd on behalf of International Union of Psychological Science.

  9. Is ‘legal empowerment of the poor’ relevant to people with disabilities in developing countries? An empirical and normative review

    Directory of Open Access Journals (Sweden)

    Johan Borg

    2013-11-01

    Full Text Available Background: Legal empowerment of the poor is highly relevant to public health as it aims to relieve income poverty, a main determinant of health. The Commission on Legal Empowerment of the Poor (CLEP has proposed legal empowerment measures in the following four domains: access to justice and the rule of law, property, labor, and business rights. Despite being overrepresented among the poor, CLEP has not explicitly considered the situation of people with disabilities. Objectives: To examine the empirical evidence for the relevance of the CLEP legal empowerment measures to people with disabilities in low- and lower middle-income countries, and to evaluate the extent to which the Convention on the Rights of Persons with Disabilities (CRPD addresses those measures. Methods: Critical literature review of empirical studies and a checklist assessment of the CRPD. Results: Fourteen included articles confirm that people with disabilities experience problems in the domains of access to justice and the rule of law, labor rights, and business rights. No texts on property rights were found. Evidence for the effectiveness of the proposed measures is insufficient. Overall, the CRPD fully or partially supports two-thirds of the proposed measures (seven out of nine measures for access to justice and the rule of law, none of the five measures for property rights, all seven measures for labor rights, and six out of nine measures for business rights. Conclusions: Although most of the domains of the CLEP legal empowerment measures are relevant to people with disabilities from both empirical and normative perspectives, it is uncertain whether the devised measures are of immediate relevance to them. Further research is warranted in this regard.

  10. Evidence-informed health policy 2 - survey of organizations that support the use of research evidence.

    Science.gov (United States)

    Lavis, John N; Paulsen, Elizabeth J; Oxman, Andrew D; Moynihan, Ray

    2008-12-17

    Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs) or undertake health technology assessments (HTAs). Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs) that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs). We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE) collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone. We received completed questionnaires from 152 (86%) organizations. More than one-half of the organizations (and particularly HTA agencies) reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer) full-time equivalent (FTE) staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations do not collect data systematically about

  11. Health Technology Assessment: Global Advocacy and Local Realities Comment on "Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness".

    Science.gov (United States)

    Chalkidou, Kalipso; Li, Ryan; Culyer, Anthony J; Glassman, Amanda; Hofman, Karen J; Teerawattananon, Yot

    2016-08-29

    Cost-effectiveness analysis (CEA) can help countries attain and sustain universal health coverage (UHC), as long as it is context-specific and considered within deliberative processes at the country level. Institutionalising robust deliberative processes requires significant time and resources, however, and countries often begin by demanding evidence (including local CEA evidence as well as evidence about local values), whilst striving to strengthen the governance structures and technical capacities with which to generate, consider and act on such evidence. In low- and middle-income countries (LMICs), such capacities could be developed initially around a small technical unit in the health ministry or health insurer. The role of networks, development partners, and global norm setting organisations is crucial in supporting the necessary capacities. © 2017 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.

  12. Identifying electricity-saving potential in rural China: Empirical evidence from a household survey

    International Nuclear Information System (INIS)

    Yu, Yihua; Guo, Jin

    2016-01-01

    In recent years, there has been a fast-growing body of literature examining energy-saving potential in relation to electricity. However, empirical studies focusing on non-Western nations are limited. To fill this gap, this study intends to examine the electricity-saving potential of rural households in China using a unique data set from the China Residential Electricity Consumption Survey (CRECS) in collaboration with the China General Social Survey (CGSS), conducted nationwide at the household level in rural China. We use a stochastic frontier model, which allows us to decompose residential electricity consumption into the minimum necessary amount of consumption based on physical characteristics (e.g. house size, house age, number of televisions or refrigerators) and estimate the consumption slack (i.e. the amount of electricity consumption that could be saved), which depends on various factors. We find that rural households in China are generally efficient in electricity saving and the saving potential is affected by (fast) information feedback and social-demographic characteristics, instead of by the (averaged) electricity price, or energy efficiency labelling signals. In addition, we find no evidence of regional heterogeneity on electricity saving potential for rural households. Policy implications are derived. - Highlights: •Electricity saving potential of rural households in China is examined. •Unique survey data from the CRECS in collaboration with the CGSS are used. •A stochastic frontier model is applied. •Information feedback and social-demographic characteristics matter. •Electricity price or energy efficiency tier rating does not matter.

  13. Interventions to reduce corruption in the health sector

    OpenAIRE

    Gaitonde, Rakhal; Oxman, Andrew D; Okebukola, Peter O; Rada, Gabriel

    2016-01-01

    Background Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. Objectives Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector. Our secondary objective w...

  14. What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey

    Science.gov (United States)

    Manwell, Laurie A; Barbic, Skye P; Roberts, Karen; Durisko, Zachary; Lee, Cheolsoon; Ware, Emma; McKenzie, Kwame

    2015-01-01

    Objective Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health? Design and participants 50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience. Results 46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act. The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented. Conclusions Answers to the question, ‘What are the core concepts of mental health?’ are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations. PMID:26038353

  15. Whither voluntary communities of co-located patients in Vietnam? Empirical evidence from a 2016 medical survey dataset

    Directory of Open Access Journals (Sweden)

    Quan-Hoang Vuong

    2016-12-01

    Full Text Available Background: Empirical evidence on quality of life of poor patients falls short for policy-making in Vietnam. Financial burdens and isolation give rise to Vietnamese voluntary co-location clusters where patients seek to rely on each other. These communities, although important, have been under-researched. Increasingly, there are questions about their sustainability. Aim & Objectives: This study aims to identify factors that affect sustainability of such co-location clusters, seeking to measure the community prospect through critical determinants as seen by member patients. An in-depth analysis is expected to yield insights that help shape future policies contributing to improvement of healthcare systems.  Material & Method: A dataset containing responses from 336 patients living in four clusters in Hanoi was obtained from a survey during 2015Q4-2016Q1. The processing of data is performed using R 3.2.3, employing baseline category logit models (BCL. Coefficients are estimated to compute empirical probabilities. Results: 1 There is a 50% probability that a patient seeing his/her benefits as unsatisfactory views the community prospect as dim; 2 The more a patient contributes time/effort, the less he/she believes in future growth; 3 There is a 80.8% probability that a patient who makes a significant financial contribution and receives back in-kind benefits predicts no growth. Conclusion: Patients predict community growth when receiving what they need/expect. There exists a kind of “liquidity preference”. Only 14% and 32% make significant financial and labor contributions, respectively. There exists a “risk aversion” attitude, viewing contribution as certain while future benefits to be uncertain.

  16. Broader health coverage is good for the nation's health: evidence from country level panel data.

    Science.gov (United States)

    Moreno-Serra, Rodrigo; Smith, Peter C

    2015-01-01

    Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserved country-specific characteristics. We employ various proxies for the coverage level in a health system. Our results indicate that expanded health coverage, particularly through higher levels of publicly funded health spending, results in lower child and adult mortality, with the beneficial effect on child mortality being larger in poorer countries.

  17. The rebound effect for heavy industry: Empirical evidence from China

    International Nuclear Information System (INIS)

    Lin, Boqiang; Li, Jianglong

    2014-01-01

    Energy efficiency improvement will reduce the effective price of energy services, and hence at least partially mitigate original expected energy conservation. Therefore, the magnitude of rebound effect is important for the design and timing of an effective energy conservation policy. Under the framework of translog cost share equations, we estimates the direct rebound effect for heavy industry in China for the first time by conducting an empirical research on the relationship between the direct rebound effect and the ease with which energy services can substitute for other inputs. Additionally, asymmetric price responses are specified in the model for the rebound effect estimation. Empirical results in our paper indicate that the rebound effect for heavy industry in China is about 74.3%. This reveals that energy efficiency improvement can save energy to a certain degree since the rebound effect is less than 100% (“back-fire”), but most of the expected reduction in heavy industry energy consumption is mitigated. These findings prove that energy pricing reforms and energy taxes should be further implemented to achieve effective energy conservation in China’s 12th Five Years Plan. - Highlights: • Heavy industry is energy intensive and accounts for over 60% of China’s energy consumption. • Direct rebound effect for heavy industry in China is estimated for the first time. • Asymmetric price responses are specified in the model for the direct rebound effect estimation. • Finding the existence of direct rebound effect in China’s heavy industry with a magnitude of 74.3%. • Proving that energy pricing reforms and energy taxes should be further implemented

  18. Evidências empirícas sobre a relação entre EVA e Retorno Acionário nas empresas brasileiras - Empirical evidence on the relationship beween EVA and Stock Returns in brazilian firms

    Directory of Open Access Journals (Sweden)

    Otavio Ribeiro de Medeiros

    2009-05-01

    Full Text Available Este artigo fornece evidências empíricas sobre a relação entre Valor Econômico Adicionado (EVA e retornos acionários de empresas brasileiras. A relação entre essas variáveis têm sido motivo de controvérsia nos últimos anos, com alguns autores encontrando associações significativas entre elas, enquanto outros não encontrando nenhuma. A hipótese de que o EVA afeta os retornos acionários é testada através de regressão linear, utilizando-se modelos alternativos. A amostra é composta de empresas negociadas na mais importante bolsa de valores brasileira. Uma comparação entre os resultados deste estudo com os de estudos anteriores mostram que resultados significativos dependem da determinação das variáveis apropriadas (retornos acionários versus preços das ações, bem como da correta relação dinâmica entre a variável dependente e a independente. This paper provides empirical evidence on the relationship between Economic Value Added (EVA and stock returns in Brazilian firms. This relationship between these variables has been subject to controversy in recent years, with some authors finding significant associations between them while others find none. The hypothesis that EVA affects stock returns is tested through linear regression, using alternative models. The sample is comprised of companies that are traded on the most important Brazilian stock exchange. A comparison of the outcomes of our study with those of previous studies shows that significant results depend on determination of the appropriate variables (stock returns versus stock prices, as well as of the correct dynamic structure between the dependent and the explanatory variable.

  19. Review of NASA's Evidence Reports on Human Health Risks. 2015 Letter Report

    Science.gov (United States)

    Scott-Conner, Carol E. H.; Masys, Daniel R.; Liverman, Catharyn T.

    2016-01-01

    NASA has requested a study from the Institute of Medicine (IOM) to provide an independent review of more than 30 evidence reports on human health risks for long duration and exploration spaceflight. The evidence reports, which are publicly available, are categorized into five broad categories: (1) behavioral health and performance; (2) human health countermeasures (with a focus on bone metabolism and orthopedics, nutrition, immunology, and cardiac and pulmonary physiology); (3) radiation; (4) human factors issues; and (5) exploration medical capabilities. The reports are revised on an ongoing basis to incorporate new scientific information. In conducting this study, an IOM ad hoc committee will build on the 2008 IOM report Review of NASA's Human Research Program Evidence Books. That report provided an assessment of the process used for developing the evidence reports and provided an initial review of the evidence reports that had been completed at that time. Each year, NASA staff will identify a set of evidence reports for committee review. Over the course of the study all evidence reports will be reviewed. The committee will hold an annual scientific workshop to receive input on the evidence reports it is reviewing that year and an update on the recent literature. The committee will issue an annual letter report that addresses the following questions relevant to each evidence report: 1. Does the evidence report provide sufficient evidence, as well as sufficient risk context, that the risk is of concern for long-term space missions? 2. Does the evidence report make the case for the research gaps presented? 3. Are there any additional gaps in knowledge or areas of fundamental research that should be considered to enhance the basic understanding of this specific risk? 4. Does the evidence report address relevant interactions among risks? 5. Is input from additional disciplines needed? 6. Is the breadth of the cited literature sufficient? 7. What is the overall

  20. The growth of business firms: theoretical framework and empirical evidence.

    Science.gov (United States)

    Fu, Dongfeng; Pammolli, Fabio; Buldyrev, S V; Riccaboni, Massimo; Matia, Kaushik; Yamasaki, Kazuko; Stanley, H Eugene

    2005-12-27

    We introduce a model of proportional growth to explain the distribution P(g)(g) of business-firm growth rates. The model predicts that P(g)(g) is exponential in the central part and depicts an asymptotic power-law behavior in the tails with an exponent zeta = 3. Because of data limitations, previous studies in this field have been focusing exclusively on the Laplace shape of the body of the distribution. In this article, we test the model at different levels of aggregation in the economy, from products to firms to countries, and we find that the predictions of the model agree with empirical growth distributions and size-variance relationships.

  1. What evidence and support do state-level public health practitioners need to address obesity prevention.

    Science.gov (United States)

    Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

    2014-01-01

    Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

  2. An exploratory study identifying where local government public health decision makers source their evidence for policy.

    Science.gov (United States)

    Stoneham, Melissa; Dodds, James

    2014-08-01

    The Western Australian (WA) Public Health Bill will replace the antiquated Health Act 1911. One of the proposed clauses of the Bill requires all WA local governments to develop a Public Health Plan. The Bill states that Public Health Plans should be based on evidence from all levels, including national and statewide priorities, community needs, local statistical evidence, and stakeholder data. This exploratory study, which targeted 533 WA local government officers, aimed to identify the sources of evidence used to generate the list of public health risks to be included in local government Public Health Plans. The top four sources identified for informing local policy were: observation of the consequences of the risks in the local community (24.5%), statewide evidence (17.6%), local evidence (17.6%) and coverage in local media (16.2%). This study confirms that both hard and soft data are used to inform policy decisions at the local level. Therefore, the challenge that this study has highlighted is in the definition or constitution of evidence. SO WHAT? Evidence is critical to the process of sound policy development. This study highlights issues associated with what actually constitutes evidence in the policy development process at the local government level. With the exception of those who work in an extremely narrow field, it is difficult for local government officers, whose role includes policymaking, to read the vast amount of information that has been published in their area of expertise. For those who are committed to the notion of evidence-based policymaking, as advocated within the WA Public Health Bill, this presents a considerable challenge.

  3. The judgement process in evidence-based medicine and health technology assessment.

    Science.gov (United States)

    Kelly, Michael P; Moore, Tessa A

    2012-02-01

    This article describes the judgements used to interpret evidence in evidence-based medicine (EBM) and health technology assessment (HTA). It outlines the methods and processes of EBM and HTA. Respectively, EBM and HTA are approaches to medical clinical decision making and efficient allocation of scarce health resources. At the heart of both is a concern to review and synthesise evidence, especially evidence derived from randomised controlled trials (RCTs) of clinical effectiveness. The driver of the approach of both is a desire to eliminate, or at least reduce, bias. The hierarchy of evidence, which is used as an indicator of the likelihood of bias, features heavily in the process and methods of EBM and HTA. The epistemological underpinnings of EBM and HTA are explored with particular reference to the distinction between rationalism and empiricism, developed by the philosopher David Hume and elaborated by Immanuel Kant in the Critique of Pure Reason. The importance of Humian and Kantian principles for understanding the projects of EBM and HTA is considered and the ways in which decisions are made in both, within a judgemental framework originally outlined by Kant, are explored.

  4. The judgement process in evidence-based medicine and health technology assessment

    Science.gov (United States)

    Kelly, Michael P; Moore, Tessa A

    2012-01-01

    This article describes the judgements used to interpret evidence in evidence-based medicine (EBM) and health technology assessment (HTA). It outlines the methods and processes of EBM and HTA. Respectively, EBM and HTA are approaches to medical clinical decision making and efficient allocation of scarce health resources. At the heart of both is a concern to review and synthesise evidence, especially evidence derived from randomised controlled trials (RCTs) of clinical effectiveness. The driver of the approach of both is a desire to eliminate, or at least reduce, bias. The hierarchy of evidence, which is used as an indicator of the likelihood of bias, features heavily in the process and methods of EBM and HTA. The epistemological underpinnings of EBM and HTA are explored with particular reference to the distinction between rationalism and empiricism, developed by the philosopher David Hume and elaborated by Immanuel Kant in the Critique of Pure Reason. The importance of Humian and Kantian principles for understanding the projects of EBM and HTA is considered and the ways in which decisions are made in both, within a judgemental framework originally outlined by Kant, are explored. PMID:23226973

  5. HMIS and decision-making in Zambia: re-thinking information solutions for district health management in decentralized health systems.

    Science.gov (United States)

    Mutemwa, Richard I

    2006-01-01

    At the onset of health system decentralization as a primary health care strategy, which constituted a key feature of health sector reforms across the developing world, efficient and effective health management information systems (HMIS) were widely acknowledged and adopted as a critical element of district health management strengthening programmes. The focal concern was about the performance and long-term sustainability of decentralized district health systems. The underlying logic was that effective and efficient HMIS would provide district health managers with the information required to make effective strategic decisions that are the vehicle for district performance and sustainability in these decentralized health systems. However, this argument is rooted in normative management and decision theory without significant unequivocal empirical corroboration. Indeed, extensive empirical evidence continues to indicate that managers' decision-making behaviour and the existence of other forms of information outside the HMIS, within the organizational environment, suggest a far more tenuous relationship between the presence of organizational management information systems (such as HMIS) and effective strategic decision-making. This qualitative comparative case-study conducted in two districts of Zambia focused on investigating the presence and behaviour of five formally identified, different information forms, including that from HMIS, in the strategic decision-making process. The aim was to determine the validity of current arguments for HMIS, and establish implications for current HMIS policies. Evidence from the eight strategic decision-making processes traced in the study confirmed the existence of different forms of information in the organizational environment, including that provided by the conventional HMIS. These information forms attach themselves to various organizational management processes and key aspects of organizational routine. The study results point

  6. Mediation, moderation, and context: Understanding complex relations among cognition, affect, and health behaviour.

    Science.gov (United States)

    Kiviniemi, Marc T; Ellis, Erin M; Hall, Marissa G; Moss, Jennifer L; Lillie, Sarah E; Brewer, Noel T; Klein, William M P

    2018-01-01

    Researchers have historically treated cognition and affect as separate constructs in motivating health behaviour. We present a framework and empirical evidence for complex relations between cognition and affect in predicting health behaviour. Main Outcome, Design and Results: First, affect and cognition can mediate each other's relation to health behaviour. Second, affect and cognition can moderate the other's impact. Third, context can change the interplay of affect and cognition. Fourth, affect and cognition may be indelibly fused in some psychological constructs (e.g. worry, anticipated regret and reactance). These four propositions in our framework are not mutually exclusive. Examination of the types of complex relations described here can benefit theory development, empirical testing of theories and intervention design. Doing so will advance the understanding of mechanisms involved in regulation of health behaviours and the effectiveness of interventions to change health behaviours.

  7. Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review.

    Science.gov (United States)

    Eysenbach, Gunther; Powell, John; Kuss, Oliver; Sa, Eun-Ryoung

    The quality of consumer health information on the World Wide Web is an important issue for medicine, but to date no systematic and comprehensive synthesis of the methods and evidence has been performed. To establish a methodological framework on how quality on the Web is evaluated in practice, to determine the heterogeneity of the results and conclusions, and to compare the methodological rigor of these studies, to determine to what extent the conclusions depend on the methodology used, and to suggest future directions for research. We searched MEDLINE and PREMEDLINE (1966 through September 2001), Science Citation Index (1997 through September 2001), Social Sciences Citation Index (1997 through September 2001), Arts and Humanities Citation Index (1997 through September 2001), LISA (1969 through July 2001), CINAHL (1982 through July 2001), PsychINFO (1988 through September 2001), EMBASE (1988 through June 2001), and SIGLE (1980 through June 2001). We also conducted hand searches, general Internet searches, and a personal bibliographic database search. We included published and unpublished empirical studies in any language in which investigators searched the Web systematically for specific health information, evaluated the quality of Web sites or pages, and reported quantitative results. We screened 7830 citations and retrieved 170 potentially eligible full articles. A total of 79 distinct studies met the inclusion criteria, evaluating 5941 health Web sites and 1329 Web pages, and reporting 408 evaluation results for 86 different quality criteria. Two reviewers independently extracted study characteristics, medical domains, search strategies used, methods and criteria of quality assessment, results (percentage of sites or pages rated as inadequate pertaining to a quality criterion), and quality and rigor of study methods and reporting. Most frequently used quality criteria used include accuracy, completeness, readability, design, disclosures, and references provided

  8. Intervention mapping: a process for developing theory- and evidence-based health education programs.

    Science.gov (United States)

    Bartholomew, L K; Parcel, G S; Kok, G

    1998-10-01

    The practice of health education involves three major program-planning activities: needs assessment, program development, and evaluation. Over the past 20 years, significant enhancements have been made to the conceptual base and practice of health education. Models that outline explicit procedures and detailed conceptualization of community assessment and evaluation have been developed. Other advancements include the application of theory to health education and promotion program development and implementation. However, there remains a need for more explicit specification of the processes by which one uses theory and empirical findings to develop interventions. This article presents the origins, purpose, and description of Intervention Mapping, a framework for health education intervention development. Intervention Mapping is composed of five steps: (1) creating a matrix of proximal program objectives, (2) selecting theory-based intervention methods and practical strategies, (3) designing and organizing a program, (4) specifying adoption and implementation plans, and (5) generating program evaluation plans.

  9. Grasping intentions: from thought experiments to empirical evidence

    Directory of Open Access Journals (Sweden)

    Cristina eBecchio

    2012-05-01

    Full Text Available Skepticism has been expressed concerning the possibility to understand others’ intentions by simply observing their movements: Since a number of different intentions may have produced a particular action, motor information – it has been argued - might be sufficient to understand what an agent is doing, but not her remote goal in performing that action. Here we challenge this conclusion by showing that in the absence of contextual information, intentions can be inferred from body movement. Based on recent empirical findings, we shall contend that: i intentions translate into differential kinematic patterns; ii observers are especially attuned to kinematic information and can use early differences in visual kinematics to anticipate the intention of an agent in performing a given action; iii during interacting activities, predictions about the future course of others’ actions tune online action planning; iv motor activation during action observation subtends a complementary understanding of what the other is doing. These findings demonstrate that intention understanding is deeply rooted in social interaction: by simply observing others’ movements, we might know what they have in mind to do and how we should act in response.

  10. Promoting mental wellbeing: developing a theoretically and empirically sound complex intervention.

    Science.gov (United States)

    Millar, S L; Donnelly, M

    2014-06-01

    This paper describes the development of a complex intervention to promote mental wellbeing using the revised framework for developing and evaluating complex interventions produced by the UK Medical Research Council (UKMRC). Application of the first two phases of the framework is described--development and feasibility and piloting. The theoretical case and evidence base were examined analytically to explicate the theoretical and empirical foundations of the intervention. These findings informed the design of a 12-week mental wellbeing promotion programme providing early intervention for people showing signs of mental health difficulties. The programme is based on the theoretical constructs of self-efficacy, self-esteem, purpose in life, resilience and social support and comprises 10 steps. A mixed methods approach was used to conduct a feasibility study with community and voluntary sector service users and in primary care. A significant increase in mental wellbeing was observed following participation in the intervention. Qualitative data corroborated this finding and suggested that the intervention was feasible to deliver and acceptable to participants, facilitators and health professionals. The revised UKMRC framework can be successfully applied to the development of public health interventions. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Empirical Studies of Exchange Rates: Price Behavior, Rate Determinationand Market Efficiency

    OpenAIRE

    Richard M. Levich

    1983-01-01

    Theoretical and empirical research completed over the last decade has dramatically increased our understanding of exchange rate behavior. The major insight to come from this decade of research is that foreign exchange is a financial asset. In an asset pricing framework, current exchange rates reflect the expected values of future exogenous variables. The purpose of this paper is to survay the empirical evidence on exchange rate behavior, market efficiency and related topics. Section 2 present...

  12. A Service Design Thinking Approach for Stakeholder-Centred eHealth.

    Science.gov (United States)

    Lee, Eunji

    2016-01-01

    Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

  13. Just-in-Time Training of the Evidence-Based Public Health Framework, Oklahoma, 2016-2017.

    Science.gov (United States)

    Douglas, Malinda R; Lowry, Jon P; Morgan, Latricia A

    2018-03-07

    Training of practitioners on evidence-based public health has shown to be beneficial, yet overwhelming. Chunking information and proximate practical application are effective techniques to increase retention in adult learning. Evidence-based public health training for practitioners from African American and Hispanic/Latino community agencies and tribes/tribal nations incorporated these 2 techniques. The community-level practitioners alternated attending training and implementing the steps of the evidence-based public health framework as they planned state-funded programs. One year later, survey results showed that participants reported increased confidence in skills that were reinforced by practical and practiced application as compared with posttraining survey results. In addition, at 1 year, reported confidence in skills that were not fortified by proximate application decreased when compared with posttraining confidence levels. All 7 community programs successfully created individualized evidence-based action plans that included evidence-based practices and policies across socioecological levels that fit with the unique culture and climate of their own community.

  14. Employment Precariousness and Poor Mental Health: Evidence from Spain on a New Social Determinant of Health

    Science.gov (United States)

    Vives, Alejandra; Amable, Marcelo; Ferrer, Montserrat; Moncada, Salvador; Llorens, Clara; Muntaner, Carles; Benavides, Fernando G.; Benach, Joan

    2013-01-01

    Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondent's sex and age. Prevalence proportion ratios (PPRs) of poor mental health across quintiles of employment precariousness (reference: 1st quintile) were calculated with log-binomial regressions, separately for women and men. Results. Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95–3.31) for women and 2.23 (95% CI: 1.86–2.68) for men. Conclusion. The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making. PMID:23431322

  15. The lending channel and budget balance: empirical evidences from Central and Eastern European economies

    Directory of Open Access Journals (Sweden)

    Bogdan-Gabriel MOINESCU

    2013-03-01

    Full Text Available The study aims to deepen the analysis on the indirect dependence of government budget balance on private sector credit flow in the countries of Central and Eastern Europe. The added value of this approach consists of two elements. First, the analysis suggests developing the traditional analytical framework of assessing risks to public finance stability by including second round effects of negative fiscal impulses on credit to private sector during recession periods. Second, the study provides empirical evidence on the importance of economic growth transmission channel for the impact of credit accelerator effects on primary deficit. At the same time, nonperforming loans channel proved to be insignificant, especially in relation to the persistency of last year’s budget deficit and the effects of budget allocations pro-cyclicality. However, loan portfolio quality seems to be more relevant in the case of public debt service, through its influence on the evolution of the yield on long-term government securities that is closely related to sovereign risk premium. Nevertheless, strengthening the financial safety net by the introduction of resolution funds will most probably break the link investors saw between credit portfolio quality and the impending increase in budget spending. This expected development across not only CEE countries, but at the EU level also, will facilitate the isolation of sovereign risk premium from non-performing loans’ dynamics.

  16. A taxonomy of state public health preparedness units: an empirical examination of organizational structure.

    Science.gov (United States)

    Menachemi, Nir; Yeager, Valerie A; Duncan, W Jack; Katholi, Charles R; Ginter, Peter M

    2012-01-01

    State public health preparedness units (SPHPUs) were developed in response to federal funding to improve response to disasters: a responsibility that had not traditionally been within the purview of public health. The SPHPUs were created within the existing public health organizational structure, and their placement may have implications for how the unit functions, how communication takes place, and ultimately how well the key responsibilities are performed. This study empirically identifies a taxonomy of similarly structured SPHPUs and examines whether this structure is associated with state geographic, demographic, and threat-vulnerability characteristics. Data representing each SPHPU were extracted from publically available sources, including organizational charts and emergency preparedness plans for 2009. A cross-sectional segmentation analysis was conducted of variables representing structural attributes. Fifty state public health departments. Variables representing "span of control" and "hierarchal levels" were extracted from organizational charts. Structural "complexity" and "centralization" were extracted from state emergency preparedness documents and other secondary sources. On average, 6.6 people report to the same manager as the SPHPU director; 2.1 levels separate the SPHPU director from the state health officer; and a mean of 13.5 agencies collaborate with SPHPU during a disaster. Despite considerable variability in how SPHPUs had been structured, results of the cluster and principal component analysis identified 7 similarly structured groups. Neither the taxonomic groups nor the individual variables representing structure were found to be associated with state characteristics, including threat vulnerabilities. Our finding supports the hypothesis that SPHPUs are seemingly inadvertently (eg, not strategically) organized. This taxonomy provides the basis for which future research can examine how SPHPU structure relates to performance measures and

  17. The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Systematic Review of Nonhuman Evidence for PFOA Effects on Fetal Growth

    Science.gov (United States)

    Lam, Juleen; Sutton, Patrice; Johnson, Paula I.; Atchley, Dylan S.; Sen, Saunak; Robinson, Karen A.; Axelrad, Daniel A.; Woodruff, Tracey J.

    2014-01-01

    Background: In contrast to current methods of expert-based narrative review, the Navigation Guide is a systematic and transparent method for synthesizing environmental health research from multiple evidence streams. The Navigation Guide was developed to effectively and efficiently translate the available scientific evidence into timely prevention-oriented action. Objectives: We applied the Navigation Guide systematic review method to answer the question “Does fetal developmental exposure to perfluorooctanoic acid (PFOA) or its salts affect fetal growth in animals ?” and to rate the strength of the experimental animal evidence. Methods: We conducted a comprehensive search of the literature, applied prespecified criteria to the search results to identify relevant studies, extracted data from studies, obtained additional information from study authors, conducted meta-analyses, and rated the overall quality and strength of the evidence. Results: Twenty-one studies met the inclusion criteria. From the meta-analysis of eight mouse gavage data sets, we estimated that exposure of pregnant mice to increasing concentrations of PFOA was associated with a change in mean pup birth weight of –0.023 g (95% CI: –0.029, –0.016) per 1-unit increase in dose (milligrams per kilogram body weight per day). The evidence, consisting of 15 mammalian and 6 nonmammalian studies, was rated as “moderate” and “low” quality, respectively. Conclusion: Based on this first application of the Navigation Guide methodology, we found sufficient evidence that fetal developmental exposure to PFOA reduces fetal growth in animals. Citation: Koustas E, Lam J, Sutton P, Johnson PI, Atchley DS, Sen S, Robinson KA, Axelrad DA, Woodruff TJ. 2014. The Navigation Guide—evidence-based medicine meets environmental health: systematic review of nonhuman evidence for PFOA effects on fetal growth. Environ Health Perspect 122:1015–1027; http://dx.doi.org/10.1289/ehp.1307177 PMID:24968374

  18. Evidence-based information needs of public health workers: a systematized review

    Directory of Open Access Journals (Sweden)

    Jill Barr-Walker, MPH, MS

    2017-01-01

    Conclusions: Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers’ information needs.

  19. Partisan Politics or Public-Health Need? An empirical analysis of state choice during initial implementation of the Affordable Care Act.

    Science.gov (United States)

    Mayer, Martin; Kenter, Robert; Morris, John C

    2015-01-01

    States' policy decisions regarding the Affordable Care Act (ACA) of 2010 have often been explained as predominantly, if not solely, partisan. Might rival explanations also apply? Using a cross-sectional 50-state regression model, we studied standard political variables coupled with public-health indicators. This work differs from existing research by employing a dependent variable of five additive measures of ACA support, examining the impact of both political and socioeconomic indicators on state policy decisions. Expanding on recent empirical studies with our more nuanced additive index of support measures, we found that same-party control of a state's executive and legislative branches was indeed by far the single best predictor of policy decisions. Public-health indicators, overwhelmed by partisan effect, did not sufficiently explain state policy choice. This result does not allay the concerns that health policy has become synonymous with health politics and that health politics now has little to do with health itself.

  20. Moving on: researching, surviving, and thriving in the evidence-saturated world of health care.

    Science.gov (United States)

    Cheek, Julianne

    2011-05-01

    In the worlds inhabited by qualitative inquirers working in health-related areas, health care, evidence, qualitative research, and qualitative researchers are four areas of potential tension and, at times, collision. These areas, or at least aspects of them, are constantly reinvented and realigned as the effects of such encounters are navigated. This article is about some of these close encounters, what we might learn from them, and how we might use this to "survive" as qualitative inquirers in an evidence-based world of health care and health care delivery.

  1. Challenges in mental health care in the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Consuelo Helena Aires de Freitas

    2011-06-01

    Full Text Available Objective: To discuss the practice of mental health care performed by healthcare professionals from the Family Health Strategy in Fortaleza-CE, Brazil. Methods: This is a critical and reflective study conducted in six Basic Health Units in Fortaleza-Ce. The study subjects were 12 health workers of the following professions: doctor, nurse, community health agents and technical and/or nursing assistant. Semi-structured interviews, systematic observationand questionnaire were used for data collection. The empirical analysis was based on an understanding of the discourses through critical hermeneutics. Results: It was evident that the mental health services are developed by some health workers in the ESF, such as, matrix support, relational technologies, home visits and community group therapy. However, there is still deficiency in training/coaching by most professionals in primary care, due to anenduring model of pathological or curative health care. Conclusion: Mental health care is still occasionally held by some workers in primary care. However, some progresses are already present as matrix support, relational technologies in health care, home visits andcommunity therapy.

  2. Challenges in Creating Evidence in Environmental Health Risk Assessments: The Example of Second-Hand Smoke

    Directory of Open Access Journals (Sweden)

    Florian Fischer

    2016-01-01

    Full Text Available Public health interventions are directed to influence the (state of a risk factor, either by behavioral or environmental changes. Therefore, environmental health risk assessments are highly relevant for public health decision making and policy development. The credibility of an environmental health risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. In this article, the main challenges for assessing the impact of a potential adverse health effect from an environmental pollutant are described. Second-hand smoke (SHS was chosen to illustrate the current state of evidence. The assessment of the impact of potential adverse health effects from environmental risk factors is dependent on several issues, such as the hypothesized health outcome, the nature of the exposure, the dose-response-relationship and the variability and susceptibility of the exposed population. The example of SHS exposure highlights the need for evidence-based public health. Several challenges in terms of study design, assessment methods, as well as data analysis and synthesis with respect to the stratification of results, and consideration of bias and confounding exist. Future research needs to take into account which methods and techniques will be used to generate evidence for population-level decisions.

  3. Macroeconomic and financial market volatilities: an empirical evidence of factor model

    OpenAIRE

    Wei-Choun Yu

    2008-01-01

    In this paper, we provide two empirical findings. First, exploring 140 monthly macroeconomic and financial variables and applying the principal components method, we find 12 static factors and 8 dynamic factors from 1959 to 2005 in the US. Second, we find the real factor and interest rate factor have been less volatile since the mid 1980s. The price factor and foreign exchange factor, in contrast, became more volatile in the late 1990s. The rest of the factors show no obvious pattern. We find...

  4. A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology

    Science.gov (United States)

    Forbes, Miriam K.; Baillie, Andrew J.; Eaton, Nicholas R.; Krueger, Robert F.

    2017-01-01

    Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or “spectra”). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research. PMID:28121167

  5. OBESITY AND METABOLIC SYNDROME IN CHILDREN AND YOUTH: A HEALTH RISK WE CANNOT AFFORD

    OpenAIRE

    Serge P. von Duvillard

    2012-01-01

    Ample observational and empirical evidence has been provided that indicates that childhood metabolic syndrome risk factors inevitably lead to significantly more profound health risk factors of developing potent adulthood metabolic syndrome. Much of these data has been provided from medical, nutritional, health, pediatric, physical education and associated communities. Perhaps the most visible and observable health risk factor among children (here referred to as youth) is the childhood obesit...

  6. Are CEOs incentivized to avoid Corporate Taxes? - Empirical Evidence on Managerial Bonus Contracts

    NARCIS (Netherlands)

    H. Schmittdiel (Heiner)

    2014-01-01

    markdownabstract__Abstract__ In this paper, we test empirically whether there is a relationship between corporate income taxes and CEO bonus payments. Using Compustat and ExecuComp data from 1992 to 2010, we find mixed results. Looking at the whole sample, the average bonus contract rewards

  7. Changing trends in health care tourism.

    Science.gov (United States)

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

    Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers.

  8. Local perceptions as a guide for the sustainable management of natural resources: empirical evidence from a small-scale society in Bolivian Amazonia

    Directory of Open Access Journals (Sweden)

    Álvaro Fernández-Llamazares

    2016-03-01

    Full Text Available Research on natural resource management suggests that local perceptions form the basis upon which many small-scale societies monitor availability and change in the stock of common-pool natural resources. In contrast, this literature debates whether local perceptions can be effective in guiding the sustainable management of natural resources. With empirical evidence on this matter still highly limited, we explored the role of local perceptions as drivers of harvesting and management behavior in a small-scale society in Bolivian Amazonia. We conducted structured interviews to capture local perceptions of availability and change in the stock of thatch palm (Geonoma deversa among the Tsimane', an indigenous society of foragers-horticulturalists (n = 296 adults in 13 villages. We analyzed whether perceptions of availability match estimates of abundance obtained from ecological data and whether differences in perception help to explain harvesting behavior and local management of thatch palm. Perceptions of availability of G. deversa are highly contingent upon the social, economic, and cultural conditions within which the Tsimane' have experienced changes in the availability of the resource, thus giving a better reflection of the historical, rather than of the ecological, dimensions of the changes undergone. Although local perceptions might fall short in precision when scrutinized from an ecological standpoint, their importance in informing sustainable management should not be underestimated. Our findings show that most of the harvesting and management actions that the Tsimane' undertake are, at least partially, shaped by their local perceptions. This paper contributes to the broader literature on natural resource management by providing empirical evidence of the critical role of local perceptions in promoting collective responses for the sustainable management of natural resources.

  9. PATIENT-CITIZEN-CONSUMERS: JUDICIALIZATION OF HEALTH AND METAMORPHOSIS OF BIOPOLITICS

    OpenAIRE

    Biehl,João

    2016-01-01

    Abstract Situated at the meeting points of Law and Medicine, the "judicialization of the right to health" is a contested and hotly debated phenomenon in Brazil. While government officials and some scholars argue that it is driven by urban elites and private interests, and used primarily to access high-cost drugs, empirical evidence refute narratives depicting judicialization as a harbinger of inequity and an antagonist of the public health system. This article's quantitative and ethnographic ...

  10. Engagement of Sectors Other than Health in Integrated Health Governance, Policy, and Action.

    Science.gov (United States)

    de Leeuw, Evelyne

    2017-03-20

    Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.

  11. Financial health and customer satisfaction in private health care providers in Brazil.

    Science.gov (United States)

    Schiozer, Rafael Felipe; Saito, Cristiana Checchia; Saito, Richard

    2011-11-01

    This paper analyzes the relationship between the financial health and organizational form of private health care providers in Brazil. It also examines the major determinants of customer satisfaction associated with the provider's organizational form. An adjusted Altman's z-score is used as an indicator of financial health. A proxy variable based on customer complaints filed at the Brazilian National Agency for Supplementary Health is used as an indicator for customer satisfaction. The study uses a sample of 270 private health care providers and their operations over the period 2003-2005. Panel data analysis includes control variables related to market, operations, and management. Principal results indicate that: (1) private health care providers benefit from economies of scale; (2) self-funded health plans have better financial health; (3) spending on marketing does not have a significant impact on customer satisfaction in Brazil; (4) weak empirical evidence exists showing that good financial performance enhances customer's satisfaction.

  12. Lifelong brain health is a lifelong challenge: from evolutionary principles to empirical evidence.

    Science.gov (United States)

    Mattson, Mark P

    2015-03-01

    Although the human brain is exceptional in size and information processing capabilities, it is similar to other mammals with regard to the factors that promote its optimal performance. Three such factors are the challenges of physical exercise, food deprivation/fasting, and social/intellectual engagement. Because it evolved, in part, for success in seeking and acquiring food, the brain functions best when the individual is hungry and physically active, as typified by the hungry lion stalking and chasing its prey. Indeed, studies of animal models and human subjects demonstrate robust beneficial effects of regular exercise and intermittent energy restriction/fasting on cognitive function and mood, particularly in the contexts of aging and associated neurodegenerative disorders. Unfortunately, the agricultural revolution and the invention of effort-sparing technologies have resulted in a dramatic reduction or elimination of vigorous exercise and fasting, leaving only intellectual challenges to bolster brain function. In addition to disengaging beneficial adaptive responses in the brain, sedentary overindulgent lifestyles promote obesity, diabetes and cardiovascular disease, all of which may increase the risk of cognitive impairment and Alzheimer's disease. It is therefore important to embrace the reality of the requirements for exercise, intermittent fasting and critical thinking for optimal brain health throughout life, and to recognize the dire consequences for our aging population of failing to implement such brain-healthy lifestyles. Published by Elsevier B.V.

  13. Lifelong Brain Health is a Lifelong Challenge: From Evolutionary Principles to Empirical Evidence

    Science.gov (United States)

    Mattson, Mark P.

    2015-01-01

    Although the human brain is exceptional in size and information processing capabilities, it is similar to other mammals with regards to the factors that promote its optimal performance. Three such factors are the challenges of physical exercise, food deprivation/fasting, and social/intellectual engagement. Because it evolved, in part, for success in seeking and acquiring food, the brain functions best when the individual is hungry and physically active, as typified by the hungry lion stalking and chasing its prey. Indeed, studies of animal models and human subjects demonstrate robust beneficial effects of regular exercise and intermittent energy restriction/fasting on cognitive function and mood, particularly in the contexts of aging and associated neurodegenerative disorders. Unfortunately, the agricultural revolution and the invention of effort-sparing technologies have resulted in a dramatic reduction or elimination of vigorous exercise and fasting, leaving only intellectual challenges to bolster brain function. In addition to disengaging beneficial adaptive responses in the brain, sedentary overindulgent lifestyles promote obesity, diabetes and cardiovascular disease, all of which may increase the risk of cognitive impairment and Alzheimer’s disease. It is therefore important to embrace the reality of the requirements for exercise, intermittent fasting and critical thinking for optimal brain health throughout life, and to recognize the dire consequences for our aging population of failing to implement such brain-healthy lifestyles. PMID:25576651

  14. Same-sex marriage and mental health.

    Science.gov (United States)

    Liangas, Georgios; Athanasou, James A

    2016-12-01

    It has been proposed that legislation for same-sex marriage has a positive mental health benefit. The purpose of this paper is to review and evaluate the empirical and conceptual links between same-sex marriage and mental health. There are substantive methodological issues in the four surveys and comparisons undertaken. Difficulties with the validity of the evidence are discussed. Conceptual difficulties in the arguments relating to victimisation as well as the psychology of marriage are highlighted. It was concluded that it is premature to make claims of causality vis-a-vis same-sex marriage legislation and mental health. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  15. Information Architecture of Web-Based Interventions to Improve Health Outcomes: Systematic Review.

    Science.gov (United States)

    Pugatch, Jillian; Grenen, Emily; Surla, Stacy; Schwarz, Mary; Cole-Lewis, Heather

    2018-03-21

    The rise in usage of and access to new technologies in recent years has led to a growth in digital health behavior change interventions. As the shift to digital platforms continues to grow, it is increasingly important to consider how the field of information architecture (IA) can inform the development of digital health interventions. IA is the way in which digital content is organized and displayed, which strongly impacts users' ability to find and use content. While many information architecture best practices exist, there is a lack of empirical evidence on the role it plays in influencing behavior change and health outcomes. Our aim was to conduct a systematic review synthesizing the existing literature on website information architecture and its effect on health outcomes, behavioral outcomes, and website engagement. To identify all existing information architecture and health behavior literature, we searched articles published in English in the following databases (no date restrictions imposed): ACM Digital Library, CINAHL, Cochrane Library, Google Scholar, Ebsco, and PubMed. The search terms used included information terms (eg, information architecture, interaction design, persuasive design), behavior terms (eg, health behavior, behavioral intervention, ehealth), and health terms (eg, smoking, physical activity, diabetes). The search results were reviewed to determine if they met the inclusion and exclusion criteria created to identify empirical research that studied the effect of IA on health outcomes, behavioral outcomes, or website engagement. Articles that met inclusion criteria were assessed for study quality. Then, data from the articles were extracted using a priori categories established by 3 reviewers. However, the limited health outcome data gathered from the studies precluded a meta-analysis. The initial literature search yielded 685 results, which was narrowed down to three publications that examined the effect of information architecture on

  16. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010?2016

    OpenAIRE

    Grumbach, Kevin; Vargas, Roberto A.; Fleisher, Paula; Arag?n, Tom?s J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

    2017-01-01

    Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report o...

  17. Abortion and mental health disorders: evidence from a 30-year longitudinal study.

    Science.gov (United States)

    Fergusson, David M; Horwood, L John; Boden, Joseph M

    2008-12-01

    Research on the links between abortion and mental health has been limited by design problems and relatively weak evidence. To examine the links between pregnancy outcomes and mental health outcomes. Data were gathered on the pregnancy and mental health history of a birth cohort of over 500 women studied to the age of 30. After adjustment for confounding, abortion was associated with a small increase in the risk of mental disorders; women who had had abortions had rates of mental disorder that were about 30% higher. There were no consistent associations between other pregnancy outcomes and mental health. Estimates of attributable risk indicated that exposure to abortion accounted for 1.5% to 5.5% of the overall rate of mental disorders. The evidence is consistent with the view that abortion may be associated with a small increase in risk of mental disorders. Other pregnancy outcomes were not related to increased risk of mental health problems.

  18. Questioning gender norms with men to improve health outcomes: evidence of impact.

    Science.gov (United States)

    Barker, G; Ricardo, C; Nascimento, M; Olukoya, A; Santos, C

    2010-01-01

    This article describes a review of 58 evaluation studies of programmes with men and boys in sexual and reproductive health (including HIV prevention, treatment, care and support); father involvement; gender-based violence; maternal, newborn and child health; and gender socialisation more broadly. While few of the programmes go beyond the pilot stage, or a relatively short-term timeframe, they offer compelling evidence that well-designed programmes with men and boys can lead to positive changes in their behaviours and attitudes related to sexual and reproductive health; maternal, newborn and child health; their interaction with their children; their use of violence against women; their questioning of violence with other men; and their health-seeking behaviour. The evidence indicates that programmes that incorporate a gender-transformative approach and promote gender-equitable relationships between men and women are more effective in producing behaviour change than narrowly focused interventions, as are programmes which reach beyond the individual level to the social context.

  19. Establishing evidence-informed core intervention competencies in psychological first aid for public health personnel.

    Science.gov (United States)

    Parker, Cindy L; Everly, George S; Barnett, Daniel J; Links, Jonathan M

    2006-01-01

    A full-scale public health response to disasters must attend to both the physical and mental health needs of affected communities. Public health preparedness efforts can be greatly expanded to address the latter set of needs, particularly in light of the high ratio of psychological to physical casualties that often rapidly overwhelms existing mental health response resources in a large-scale emergency. Psychological first aid--the provision of basic psychological care in the short term aftermath of a traumatic event--is a mental health response skill set that public health personnel can readily acquire with proper training. The application of psychological first aid by public health workers can significantly augment front-line community-based mental health responses during the crisis phase of an event. To help achieve this augmented response, we have developed a set of psychological first aid intervention competencies for public health personnel. These competencies, empirically grounded and based on best practice models and consensus statements from leading mental health organizations, represent a necessary step for developing a public health workforce that can better respond to the psychological needs of impacted populations in disasters.

  20. An empirical research on the influencing factors of regional CO2 emissions: Evidence from Beijing city, China

    International Nuclear Information System (INIS)

    Wang, Zhaohua; Yin, Fangchao; Zhang, Yixiang; Zhang, Xian

    2012-01-01

    Highlights: ► We adapt STIRPAT model to regional context and conduct PLS regress analysis. ► Energy technology related patent is innovatively used to measure technical factors. ► Urbanization level has the greatest interpretative ability for CO 2 emissions. ► We do not find evidence of Environmental Kuznets Curve in Beijing. ► Beijing should focus more on tertiary industry and residential energy consumption. -- Abstract: In order to further study the realization of carbon intensity target, find the key influencing factors of CO 2 emissions, and explore the path of developing low-carbon economy, this paper empirically studied the influences of urbanization level, economic level, industry proportion, tertiary industry proportion, energy intensity and R and D output on CO 2 emissions in Beijing using improved STIRPAT (stochastic impacts by regression on population, affluence and technology) model. The model is examined using partial least square regression. Results show that urbanization level, economic level and industry proportion positively influence the CO 2 emissions, while tertiary industry proportion, energy intensity and R and D output negatively do. Urbanization level is the main driving factor of CO 2 emissions, and tertiary industry proportion is the main inhibiting factor. In addition, along with the growth of per capita GDP, the increase of CO 2 emissions does not follow the Environmental Kuznets Curve model. Based on these empirical findings and the specific circumstances of Beijing, we provide some policy recommendations on how to reduce carbon intensity. Beijing should pay more attention to tertiary industry and residential energy consumption for carbon emission reduction. It is necessary to establish a comprehensive evaluation index of social development. Investing more capital on carbon emission reduction science and technology, and promoting R and D output is also an efficient way to reduce CO 2 emissions.