WorldWideScience

Sample records for patients policy makers

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

    Science.gov (United States)

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

    2016-11-01

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

  2. Policy Makers, Information and Learning.

    Science.gov (United States)

    Beers, Pieter J.; van Asselt, Marjolein B. A.; Vermunt, Jan D.; Kirschner, Paul A.

    2003-01-01

    Interviews explored the information needs of seven Dutch policymakers dealing with global sustainability. They sought information on cultural perspectives and linkages. Information gathering emphasized filtering to find specific information. Most used an application-oriented working style that, combined with policy-driven information seeking, was…

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

    Science.gov (United States)

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

    2015-08-01

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

  4. Women as decision and policy makers. Asia.

    Science.gov (United States)

    1995-09-01

    The focus of this news brief is on the Community-based Sustainable Family Planning/Maternal and Child Health (FP/MCH) Project promoted in Bangladesh, Laos, Nepal, and the Philippines. The project emphasizes women's involvement as policy makers and evaluators. The aim is to involve women at all project levels as part of an effort to correct gender imbalances. Programs are being directed toward sustainability. Women are placed in positions at each level of the tiered system of steering committees, which range from local village committees to central committees. Men may still retain the top positions, but women are given decision making power at the highest levels of policy and program development and implementation. The Asia region is challenged by quality of care issues related to reproductive health services. Program expansion is proceeding into rural areas with outreach services and fee charging. Projects are community-based, which means mobilization of community people. The community approach is suitable to an Asian culture that does not adhere to strict rules of privacy. Women's groups are eager to discuss sensitive issues such as contraception and to offer personal experiences and solutions to problems. Mass meetings and individual counseling sessions are available. IEC materials are available to the Asian FP/MCH program from JOICFP. Some of these materials promote the concept of the Asian community spirit as a building block of development. The Asian approach is an alternative to Western models and may be valid for other regions.

  5. Communicating the Needs of Climate Change Policy Makers to Scientists

    Science.gov (United States)

    Brown, Molly E.; Escobar, Vanessa M.; Lovell, Heather

    2012-01-01

    This chapter will describe the challenges that earth scientists face in developing science data products relevant to decision maker and policy needs, and will describe strategies that can improve the two-way communication between the scientist and the policy maker. Climate change policy and decision making happens at a variety of scales - from local government implementing solar homes policies to international negotiations through the United Nations Framework Convention on Climate Change. Scientists can work to provide data at these different scales, but if they are not aware of the needs of decision makers or understand what challenges the policy maker is facing, they are likely to be less successful in influencing policy makers as they wished. This is because the science questions they are addressing may be compelling, but not relevant to the challenges that are at the forefront of policy concerns. In this chapter we examine case studies of science-policy partnerships, and the strategies each partnership uses to engage the scientist at a variety of scales. We examine three case studies: the global Carbon Monitoring System pilot project developed by NASA, a forest biomass mapping effort for Silvacarbon project, and a forest canopy cover project being conducted for forest management in Maryland. In each of these case studies, relationships between scientists and policy makers were critical for ensuring the focus of the science as well as the success of the decision-making.

  6. Assessment of policy makers' individual and organizational capacity ...

    African Journals Online (AJOL)

    An evidence to policy self-assessment questionnaire was used to assess the capacity of forty MNCH policy makers to acquire, assess, adapt and apply research evidence for policy making. Results: Low mean ratings were observed ranging from 2.68-3.53 on a scale of 5 for knowledge about initiating/conducting research ...

  7. International benchmaking: Supplying the information for product efficiency policy makers

    NARCIS (Netherlands)

    Siderius, H.P.; Jeffcott, S.; Blok, K.

    2012-01-01

    In the development of effective product efficiency policy, the critical element for policy makers is comprehensive, independent information. However, easily accessible, reliable information on the energy performance of products and policies is often scarce within a particular market, and rarer still

  8. Stakeholder involvement: views from a policy maker

    International Nuclear Information System (INIS)

    Gray, Elizabeth

    2006-01-01

    In 1999 powers and responsibilities were devolved from the UK government to the new devolved administrations in Scotland, Wales and Northern Ireland. This paper deals with the issue of radioactive waste management in the Scottish context as, following devolution, responsibility for radioactive waste management in Scotland is a devolved responsibility of the Scottish Parliament. The founding principles of the Scottish Parliament are: Openness and participation, Accountability, Power sharing, Equal opportunities. The government of Scotland is known as the Scottish Executive and has 22 Ministers covering a wide range of devolved responsibilities including: wider environmental matters, health, socioeconomic, skills and education. The Scottish Ministers also have specific responsibility in legislation regarding the governance of the Nuclear Decommissioning Authority (NDA). Scotland also has its own agencies to deliver his government policies, such as the Scottish Environment Protection Agency (SEPA) and enterprise and skills delivery bodies. There is a high level of interest in nuclear and radioactive waste issues in Scotland as Scotland has both civil nuclear and defense sites around the country which generate radioactive waste. Alongside this is its close proximity to the largest nuclear site in the UK: Sellafield

  9. [The influence of the relationship between physicians and pharmaceutical companies on the patient from the point of view of policy-makers in Israel].

    Science.gov (United States)

    Nissanholtz-Gannot, Rachel; Shani, Segev; Shvarts, Shifra

    2010-11-01

    The relationship between doctors and pharmaceutical companies is an integral part of the health system in Israel and the whole world. The mutual need for such a relationship requires us, as a society, to examine its influence on the individual and the system as a whole. This research examines the relationship from the points of view of the relevant parties within the health system and outside the health system (decision-makers). The authors used in-depth interviews and qualitative research methods in order to examine and understand the various positions of decision-makers. The position of the decision-makers, regarding all the aspects of this relationship, expresses their wishes and depends on their point of view. The impact of the relationship between the doctors and the pharmaceutical companies was examined with regard to the prescription behavior of the doctor. All the government representatives, all the physicians' representatives and those of the health funds, believe that the physicians' prescription behavior is impacted by the relationship. There are those who perceive this to be a negative trend and some doctors believe it to be a positive trend. With regard to possible harm to the patient, the parties believe that the relationship does not harm the patient, whereas most of the government representatives identify harm to the patients, both on the economic and health levels. The authors believe that the "influence" which exists or could exist on the part of the pharmaceutical companies is the main stumbling block in this relationship, which is expressed in the decision-makers' perspective.

  10. Evidence-Informed Health Policies in Eastern Mediterranean Countries: Comparing Views of Policy Makers and Researchers

    Science.gov (United States)

    El-Jardali, Fadi; Lavis, John N.; Jamal, Diana; Ataya, Nour; Dimassi, Hani

    2014-01-01

    The objective of this paper is to conduct comparative analysis about the views and practices of policy makers and researchers on the use of health systems evidence in policy making in selected Eastern Mediterranean countries. We analysed data from two self-reported surveys, one targeted at policy makers and the other at researchers. Results show a…

  11. Green roofs : a resource manual for municipal policy makers

    Energy Technology Data Exchange (ETDEWEB)

    Lawlor, G.; Currie, B.A.; Doshi, H.; Wieditz, I. [Canada Mortgage and Housing Corp., Ottawa, ON (Canada)

    2006-05-15

    As knowledge of the environmental benefits of green roofs and technology improves, green roofs are quickly gaining acceptance in North America. European jurisdictions have been using green roof technology for stormwater management, to reduce energy use in buildings and to increase amenity space. By reviewing the reasons that municipalities throughout the world have set green roof policies and programs, policy makers can more easily determine which policies suit their needs. This manual provided an overview of international and Canadian green roof policies and programs. It presented information on 12 jurisdictions that demonstrated leadership in green roof policy development. The manual also presented information on an additional 13 jurisdictions with less-developed green roof policies. Activities that were discussed for each of these jurisdictions included: description of jurisdiction; key motivators; green roof policy; process to establish policy; effectiveness; lessons learned; future predictions; and applicability to Canada of international jurisdictions. The manual also provided general information on green roofs such as a definition of green roofs and green roof terminology. Key motivators for green roofs include stormwater runoff control; reduction in urban heat-island effect; reduction in building energy consumption; and air pollution control. refs., tabs., figs.

  12. Public and policy maker support for point-of-sale tobacco policies in New York.

    Science.gov (United States)

    Schmitt, Carol L; Juster, Harlan R; Dench, Daniel; Willett, Jeffrey; Curry, Laurel E

    2014-01-01

    To compare public and policy maker support for three point-of-sale tobacco policies. Two cross-sectional surveys--one of the public from the New York Adult Tobacco Survey and one of policy makers from the Local Opinion Leader Survey; both collected and analyzed in 2011. Tobacco control programs focus on educating the public and policy makers about tobacco control policy solutions. Six hundred seventy-six county-level legislators in New York's 62 counties and New York City's five boroughs (response rate: 59%); 7439 New York residents aged 18 or older. Landline response rates: 20.2% to 22%. Cell phone response rates: 9.2% to 11.1%. Gender, age, smoking status, presence of a child aged 18 years or younger in the household, county of residence, and policy maker and public support for three potential policy solutions to point-of-sale tobacco marketing. t-tests to compare the demographic makeup for the two samples. Adjusted Wald tests to test for differences in policy support between samples. The public was significantly more supportive of point-of-sale policy solutions than were policy makers: cap on retailers (48.0% vs. 19.2%, respectively); ban on sales at pharmacies (49.1% vs. 38.8%); and ban on retailers near schools (53.3% vs. 42.5%). cross-sectional data, sociodemographic differences, and variations in item wording. Tobacco control programs need to include information about implementation, enforcement, and potential effects on multiple constituencies (including businesses) in their efforts to educate policy makers about point-of-sale policy solutions.

  13. Bioenergy, Land Use Change and Climate Change Mitigation. Report for Policy Advisors and Policy Makers

    Energy Technology Data Exchange (ETDEWEB)

    Berndes, Goran [Chalmers Univ. of Technology (Sweden); Bird, Nell [Joanneum Research (Austria); Cowle, Annette [National Centre for Rural Greenhouse Gas Research (Australia)

    2010-07-01

    The report addresses a much debated issue - bioenergy and associated land use change, and how the climate change mitigation from use of bioenergy can be influenced by greenhouse gas emissions arising from land use change. The purpose of the report was to produce an unbiased, authoritative statement on this topic aimed especially at policy advisors and policy makers.

  14. Social values and solar energy policy: the policy maker and the advocate

    Energy Technology Data Exchange (ETDEWEB)

    Shama, A.; Jacobs, K.

    1980-07-01

    Solar energy policy makers and advocates have significantly different hierarchies (clusters) of values upon which they evaluate the adoption of solar technologies. Content analysis, which examines the frequency with which policy makers identify different types of values, indicates that they hold economic values to be of primary importance. Environmental, social, and national security values are also substantial elements of the policy makers' value clusters associated with solar energy. This finding is confirmed by a qualitative analysis of policy makers' values. Advocates, on the other hand, assign almost equal weights (33%) to economic values and social values, slightly less weight to environmental values, and significant attention to ethical and security values as well. These results of frequency analysis are made somewhat more complicated by a qualitative interpretation of the advocates' positions. As part of their more holistic approach, several of the advocates indicated that all values discussed by them are instrumental toward achieving higher-order, ethical and environmental values. In addition, our preliminary investigation indicates that neither group is entirely homogeneous. Testing this and other propositions, as well as obtaining a similar picture of the values which the public associates with solar energy, are topics of future research.

  15. Obesity prevention programs and policies: practitioner and policy-maker perceptions of feasibility and effectiveness.

    Science.gov (United States)

    Cleland, Verity; McNeilly, Briohny; Crawford, David; Ball, Kylie

    2013-09-01

    The aims of this study were to map obesity prevention activity being implemented by government, non-government, and community-based organizations; to determine practitioner and policy-maker perceptions of the feasibility and effectiveness of a range of evidence-based obesity prevention strategies; and to determine practitioner and policy-maker perceptions of preferred settings for obesity prevention strategies. This study involved a cross-sectional survey of 304 public health practitioners and policy-makers from government, non-government, and community organizations across Victoria, Australia. Participants reported their organizations' current obesity prevention programs and policies, their own perceptions of the feasibility and effectiveness of strategies to prevent obesity and their preferred settings for obesity prevention. Thirty-nine percent had an obesity prevention policy, and 92% were implementing obesity prevention programs. The most common programs focused on education, skill-building, and increasing access to healthy eating/physical activity opportunities. School curriculum-based initiatives, social support for physical activity, and family-based programs were considered the most effective strategies, whereas curriculum-based initiatives, active after-school programs, and providing access to and information about physical activity facilities were deemed the most feasible strategies. Schools were generally perceived as the most preferred setting for obesity prevention. Many organizations had obesity prevention programs, but far fewer had obesity prevention policies. Current strategies and those considered feasible and effective are often mismatched with the empirical literature. Systems to ensure better alignment between researchers, practitioners, and policy-makers, and identifying effective methods of translating empirical evidence into practice and policy are required. Copyright © 2012 The Obesity Society.

  16. It's All in the Lens: Differences in Views on Obesity Prevention between Advocates and Policy Makers

    Science.gov (United States)

    Jones, Ellen; Nguyen, Leah; Kong, Jooyoung; Brownson, Ross C.; Bailey, Jessica H.

    2012-01-01

    Abstract Background: Intervention strategies to reduce obesity include policy and environmental changes that are designed to provide opportunities, support, and cues to help people develop healthier behaviors. Policy changes at the state level are one way to influence access, social norms, and opportunities for better nutrition and increased physical activity among the population. Methods: Ten states were selected for a broad variance in obesity rates and number of enacted obesity prevention policies during the years of 2006–2009. Within the selected states, a purely qualitative study of attitudes of childhood obesity policy using semistructured telephone interviews was conducted. Interviews were conducted with state policy makers who serve on public health committees. A set of six states that had more than eight childhood obesity policies enacted were selected for subsequent qualitative interviews with a convenience sample of well-established advocates. Results: Policy makers in states where there was more childhood obesity policy action believed in the evidence behind obesity policy proposals. Policy makers also varied in the perception of obesity as a constituent priority. The major differences between advocates and policy makers included a disconnect in information dissemination, opposition, and effectiveness of these policies. Conclusions: The findings from this study show differences in perceptions among policy makers in states with a greater number of obesity prevention bills enacted. There are differences among policy makers and advocates regarding the role and effectiveness of state policy on obesity prevention. This presents an opportunity for researchers and practitioners to improve communication and translation of evidence to policy makers, particularly in states with low legislation. PMID:22799551

  17. Assessment of policy makers' individual and organizational capacity ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... An evidence to policy self-assessment questionnaire was used to assess the capacity of forty. MNCH policy ... search, lack of actionable messages in research reports, and limited ... of research evidence is but one factor influencing all stag- es of what ... However, in order to design an effective capacity en-.

  18. Evidence for Agile Policy Makers: The Contribution of Transformative Realism

    Science.gov (United States)

    Room, Graham

    2013-01-01

    Advocates of evidence-based policy making (EBPM) are typically concerned with the impact of particular interventions. This implicit ontology of the policy world, as disaggregated into a variety of independent interventions, has been challenged by Pawson (2006), in terms of the contingencies that activate, inhibit or reshape the impact of any…

  19. Teacher Education Research and Education Policy-Makers: An Australian Perspective

    Science.gov (United States)

    White, Simone

    2016-01-01

    As teacher educators, we want our research to be influential in contributing to educational policy and practice, but there remains little understanding about ways in which teacher educators might more productively engage with each other and policy-makers so as to maximise their research impact. Drawing on an empirical study and policy document…

  20. Experiences with a dialogue process between policy makers and global modellers

    International Nuclear Information System (INIS)

    Van Daalen, C.E.; Thissen, W.A.H.; Berk, M.M.

    1998-01-01

    Between 1995 and 1997, a series of five workshops, henceforth called the Delft process, took place with the aim to explore and enhance use of the IMAGE 2 model to support international climate negotiations. The IMAGE 2 model is a multi-disciplinary, integrated model designed to simulate the dynamics of the global society-biosphere-climate system. The workshops facilitated a dialogue between policy makers and scientists involved in the development and applications of the IMAGE 2 model. In this way, policy makers would benefit from the policy makers on how to improve the policy relevance of the IMAGE 2 model. The evaluation at the end of the workshop series showed that participants have used information from the workshop at international negotiation conferences and in preparation of policy documents. The process shows that creating a forum for direct science-policy interactions can be very useful and productive, and has confirmed the importance of creating an open and constructive atmosphere between policy makers, and between policy makers and analysts, to enhance utilisation of scientific knowledge. The authors' analysis also suggests that many factors have to be 'in the right position at the right time and place' to achieve such a success, and that it is difficult to prevent the occurrence of biases in processes like this. 33 refs

  1. The utilization of research evidence in Health Workforce Policies: the perspectives of Portuguese and Brazilian National Policy-Makers.

    Science.gov (United States)

    Craveiro, Isabel; Hortale, Virginia; Oliveira, Ana Paula Cavalcante de; Dal Poz, Mario; Portela, Gustavo; Dussault, Gilles

    2018-03-01

    The production of knowledge on Human Resources for Health (HRH) issues has increased exponentially since 2000 but integration of the research in the policy-making process is often lagging. We looked at how research on HRH contributes or not to inform policy decisions and interventions affecting the health workforce in Portugal and Brazil. We designed a comparative case study of semi-structured interviews with present and past national decision-makers, policy advisors and researchers. Issues explored included the existence of a national HRH policy and the use, or non-use, of research evidence by policy makers and reasons to do so. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Policy-makers in Brazil recognize a greater use of evidence in the process of defining HRH policy when compared to Portugal's. But the existence of formal instruments to support policy development is not sufficient to ensure that policies are informed by evidence. In both countries the importance of the use of evidence in the formulation of policies was recognized by policy-makers. However, the influence of other factors, such as political pressures from various lobby groups and from the media and the policy short timeframe which requires rapid responses, is predominant.

  2. Is Twitter a forum for disseminating research to health policy makers?

    Science.gov (United States)

    Kapp, Julie M; Hensel, Brian; Schnoring, Kyle T

    2015-12-01

    Findings from scientific research largely remain inside the scientific community. Research scientists are being encouraged to use social media, and especially Twitter, for dissemination of evidence. The potential for Twitter to narrow the gap on evidence translated into policy presents new opportunities. We explored the innovative question of the feasibility of Twitter as a tool for the scientific community to disseminate to and engage with health policy makers for research impact. We created a list of federal "health policy makers." In December 2014, we identified members using several data sources, then collected and summarized their Twitter usage data. Nearly all health policy makers had Twitter accounts. Their communication volume varied broadly. Policy makers are more likely to push information via Twitter than engage with constituents, although usage varied broadly. Twitter has the potential to aid the scientific community in dissemination of health-related research to health policy makers, after understanding how to effectively (and selectively) use Twitter. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Communication among scientists, decision makers and society: Developing policy-relevant global climate change research

    International Nuclear Information System (INIS)

    Bernabo, J.C.

    1995-01-01

    Defining the research most relevant to policy is not simply a technical task that can be answered by scientists. Decision makers need and value information differently than curiosity-driven scientists. In order to link science more effectively to policy, the two communities must gain a greater mutual understanding. Decision makers must define their needs so that scientists can determine how, and by when, research can address these needs. This vital dialogue between communities typically has been more ad hoc than systematic. The complexity and urgency of the global climate change issue necessitate ongoing communication between scientists and decision makers on the information needed for policy development and what research can provide The results of relevant science policy dialogues are discussed herein. Effective communication between researchers and decision makers is a crucial ingredient for successfully addressing society's pressing environmental concerns. The increase in policy makers' demands for research that is relevant to solving societal issues highlights the communication gap between the technical and policy communities. The gap, largely caused by lack of mutual understanding, results in flawed and inadequate communication that hinders decision making and confuses the public. This paper examines the cause of this communication gap and describes the significance of recent efforts to develop more fruitful science-policy dialogues on the issue of global climate change. First, the post-Cold War shift in government priorities for research funding is described; then the underlying relationship between science and policy is explored to identify key sources of ongoing mis-communication. The paper then explains the importance of defining policy-relevant science questions that research can address. Finally, three projects are described involving the elicitation of decision makers' information needs in The United States, The Netherlands, and internationally

  4. Engaging policy-makers, heath system managers, and policy analysts in the knowledge synthesis process: a scoping review.

    Science.gov (United States)

    Tricco, Andrea C; Zarin, Wasifa; Rios, Patricia; Nincic, Vera; Khan, Paul A; Ghassemi, Marco; Diaz, Sanober; Pham, Ba'; Straus, Sharon E; Langlois, Etienne V

    2018-02-12

    It is unclear how to engage a wide range of knowledge users in research. We aimed to map the evidence on engaging knowledge users with an emphasis on policy-makers, health system managers, and policy analysts in the knowledge synthesis process through a scoping review. We used the Joanna Briggs Institute guidance for scoping reviews. Nine electronic databases (e.g., MEDLINE), two grey literature sources (e.g., OpenSIGLE), and reference lists of relevant systematic reviews were searched from 1996 to August 2016. We included any type of study describing strategies, barriers and facilitators, or assessing the impact of engaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process. Screening and data abstraction were conducted by two reviewers independently with a third reviewer resolving discrepancies. Frequency and thematic analyses were conducted. After screening 8395 titles and abstracts followed by 394 full-texts, 84 unique documents and 7 companion reports fulfilled our eligibility criteria. All 84 documents were published in the last 10 years, and half were prepared in North America. The most common type of knowledge synthesis with knowledge user engagement was a systematic review (36%). The knowledge synthesis most commonly addressed an issue at the level of national healthcare system (48%) and focused on health services delivery (17%) in high-income countries (86%). Policy-makers were the most common (64%) knowledge users, followed by healthcare professionals (49%) and government agencies as well as patients and caregivers (34%). Knowledge users were engaged in conceptualization and design (49%), literature search and data collection (52%), data synthesis and interpretation (71%), and knowledge dissemination and application (44%). Knowledge users were most commonly engaged as key informants through meetings and workshops as well as surveys, focus groups, and interviews either in-person or by telephone and emails

  5. Engaging policy makers in road safety research in Malaysia: a theoretical and contextual analysis.

    Science.gov (United States)

    Tran, Nhan T; Hyder, Adnan A; Kulanthayan, Subramaniam; Singh, Suret; Umar, R S Radin

    2009-04-01

    Road traffic injuries (RTIs) are a growing public health problem that must be addressed through evidence-based interventions including policy-level changes such as the enactment of legislation to mandate specific behaviors and practices. Policy makers need to be engaged in road safety research to ensure that road safety policies are grounded in scientific evidence. This paper examines the strategies used to engage policy makers and other stakeholder groups and discusses the challenges that result from a multi-disciplinary, inter-sectoral collaboration. A framework for engaging policy makers in research was developed and applied to describe an example of collective road safety research in Malaysia. Key components of this framework include readiness, assessment, planning, implementation/evaluation, and policy development/sustainability. The case study of a collaborative intervention trial for the prevention of motorcycle crashes and deaths in Malaysia serves as a model for policy engagement by road safety and injury researchers. The analytic description of this research process in Malaysia demonstrates that the framework, through its five stages, can be used as a tool to guide the integration of needed research evidence into policy for road safety and injury prevention.

  6. High salt meals in staff canteens of salt policy makers: observational study

    NARCIS (Netherlands)

    Brewster, L.M.; Berentzen, C.A.; van Montfrans, G.A.

    2011-01-01

    To assess the salt content of hot meals served at the institutions of salt policy makers in the Netherlands. Observational study. 18 canteens at the Department of Health, the Health Council, the Food and Consumer Product Safety Authority, university hospitals, and affiliated non-university

  7. How do researchers influence decision-makers? Case studies of Mexican policies.

    Science.gov (United States)

    Trostle, J; Bronfman, M; Langer, A

    1999-06-01

    Though the problems translating or applying research in policy-making are legion, solutions are rare. As developing countries increase their capacities to develop effective local solutions to their health problems, they confront the research/policy dilemma. Yet few descriptive studies of research-policy links can be found from developing countries, and the relevance of European and North American models and data is questionable. We report the results of a descriptive study from Mexico of the relationship between health research and policy in four vertical programmes (AIDS, cholera, family planning, immunization). We interviewed 67 researchers and policy-makers from different institutions and levels of responsibility. We analyzed interviewee responses looking for factors that promoted or impeded exchanges between researchers and policy-makers. These were, in turn, divided into emphases on content, actors, process, and context. Many of the promoting factors resembled findings from studies in industrialized countries. Some important differences across the four programmes, which also distinguish them from industrialized country programmes, included extent of reliance on formal communication channels, role of the mass media in building social consensus or creating discord, levels of social consensus, role of foreign donors, and extent of support for biomedical versus social research. We recommend various ways to increase the impact of research on health policy-making in Mexico. Some of the largest challenges include the fact that researchers are but one of many interest groups, and research but one input among many equally legitimate elements to be considered by policy-makers. Another important challenge in Mexico is the relatively small role played by the public in policy-making. Further democratic changes in Mexico may be the most important incentive to increase the use of research in policy-making.

  8. 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

  9. 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

  10. 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

  11. Key Policy Makers' Awareness of Tobacco Taxation Effectiveness through a Sensitization Program.

    Science.gov (United States)

    Heydari, Gholamreza; Ebn Ahmady, Arezoo; Lando, Harry A; Chamyani, Fahimeh; Masjedi, Mohammadreza; Shadmehr, Mohammad B; Fadaizadeh, Lida

    2015-12-01

    The implementation of 5 of the 6 WHO MPOWER program in Iran is satisfactory; the only notable shortcoming is the lack of tobacco taxation increases. This study was designed to increase key policy makers' awareness of tobacco taxation effectiveness through a sensitization program in Iran. This analytical and semi-experimental study in 2014 included 110 tobacco control key policy makers, who were trained and received educational materials on the importance of tobacco taxation. A valid and reliable questionnaire was completed before and three months after intervention. Data were analyzed using mean (SD), t-Test and analysis of variance. The mean (SD) scores at pre- and post-test were 2.7 ± 3 and 8.8 ± 1 out of 10, respectively. Paired t-tests demonstrated a significant difference in the pre- post-test knowledge scores. Increasing knowledge and promoting favorable attitudes of policy makers can lead to greater attention which could in turn change tobacco taxation policies.

  12. As CMS makes another policy change, policy makers distinguish between different forms of care.

    Science.gov (United States)

    2013-10-01

    As observation care continues to draw fire from critics who charge that the designation ends up costing hospitals money while also sticking patients with exorbitant fees, the medical directors of dedicated observation units counter that the kind of care delivered by their specialized units actually saves money and gets patients out of the hospital sooner. They note that the problem is that only about one-third of hospitals actually have dedicated observation units, so patients placed on observation typically wind up in inpatient beds, where they may only be evaluated once a day. CMS has just released a new policy rule on observation that should help patients avoid excessive charges, but many experts would like to see the agency take steps to incentivize the kind of quality care that is delivered in dedicated units. The new CMS rule for 2014 caps observation stays at 48 hours. Patients who remain in the hospital beyond this point become inpatients, as long as they meet inpatient criteria. Proponents of observation care contend that the average length-of-stay in a dedicated observation unit is just 15 hours--typically much shorter than the LOS of patients who are placed on observation in inpatient beds. Care in a dedicated observation unit is generally driven by protocol in an emergency medicine environment where there is continuous rounding. Discharges can occur at any time of the day or night. Experts note that observation patients account for the largest portion of both misdiagnoses and malpractice lawsuits stemming from emergency settings.

  13. Communicating Scientific Findings to Lawyers, Policy-Makers, and the Public (Invited)

    Science.gov (United States)

    Thompson, W.; Velsko, S. P.

    2013-12-01

    This presentation will summarize the authors' collaborative research on inferential errors, bias and communication difficulties that have arisen in the area of WMD forensics. This research involves analysis of problems that have arisen in past national security investigations, interviews with scientists from various disciplines whose work has been used in WMD investigations, interviews with policy-makers, and psychological studies of lay understanding of forensic evidence. Implications of this research for scientists involved in nuclear explosion monitoring will be discussed. Among the issues covered will be: - Potential incompatibilities between the questions policy makers pose and the answers that experts can provide. - Common misunderstandings of scientific and statistical data. - Advantages and disadvantages of various methods for describing and characterizing the strength of scientific findings. - Problems that can arise from excessive hedging or, alternatively, insufficient qualification of scientific conclusions. - Problems that can arise from melding scientific and non-scientific evidence in forensic assessments.

  14. Open Education and OER - A guide and call to action for policy makers

    OpenAIRE

    Deepwell, Maren; Weller, Martin; Campbell, Lorna; Wilson, Joe

    2017-01-01

    Executive Summary ALT has produced this call to action to highlight to education policy makers and professionals how Open Education and OER can expand inclusive and equitable access to education and lifelong learning, widen participation, and create new opportunities for the next generation of teachers and learners, preparing them to become fully engaged digital citizens. Open Education can also promote knowledge transfer while enhancing quality and sustainability, supporting social inclu...

  15. Factors that explain how policy makers distribute resources to mental health services.

    Science.gov (United States)

    Corrigan, Patrick W; Watson, Amy C

    2003-04-01

    Advocates hope to influence the resource allocation decisions of legislators and other policy makers to capture more resources for mental health programs. Findings from social psychological research suggest factors that, if pursued, may improve advocacy efforts. In particular, allocation decisions are affected by policy makers' perceptions of the scarcity of resources, effectiveness of specific programs, needs of people who have problems that are served by these programs, and extent of personal responsibility for these problems. These perceptions are further influenced by political ideology. Conservatives are motivated by a tendency to punish persons who are perceived as having personal responsibility for their problems by withholding resources, whereas liberals are likely to avoid tough allocation decisions. Moreover, these perceptions are affected by political accountability, that is, whether politicians perceive that their constituents will closely monitor their decisions. Just as the quality of clinical interventions improves when informed by basic research on human behavior, the efforts of mental health advocates will be advanced when they understand the psychological forces that affect policy makers' decisions about resources.

  16. Green buildings in Malaysia towards greener environment: challenges for policy makers

    Science.gov (United States)

    Suhaida, M. S.; Tan, K. L.; Leong, Y. P.

    2013-06-01

    The launch of the National Green Technology Policy (NGTP) in 2009 is a manifesto of the government's seriousness in implementing "green" initiatives for the country. Specifically for buildings, the government promotes the application of renewable energy (RE) and energy efficiency (EE) and the application of green building index. With the introduction of Low Carbon Cities Framework, Green Pass, Green Neighbourhood, Green Building Index by various agencies and organisations in Malaysia, it is time to look back and see how all these tools could come together. This paper attempts to identify the challenges in harmonising the green initiatives for policy makers toward greener environment for sustainability.

  17. How do the public and policy makers communicate their perceptions of environmental risk to academics?

    Science.gov (United States)

    Holden, Jennifer

    2010-05-01

    This paper investigates the ways that the public and policy makers talk about environmental risk to academics. The case study is heavy-metal contamination of food in Zambia, Southern Africa. In several localities in Zambia, urban agriculture is practised using heavy-metal contamination wastewater for irrigation. This leads to contaminated food crops that are subsequently consumed. One case study site where this occurs is Chunga, situated in the northwest of the Zambian capital: Lusaka. For members of the public, six focus groups were carried out at the Chunga, Zambia study site, involving a total of 48 participants. The participants were those involved in urban agriculture through cultivation, selling and consumption of food crops. Urban agriculturalist focus group participants were recruited through key field informants. Focus group discussion starter questions involved pollution awareness, health impacts of pollution in the area and who is responsible for communicating environmental contamination risks to the general population. For policy stakeholders, 39 semi-structured interviews were conducted with individuals from various organisations including government ministries, non-governmental organisations, community based organisations and international institutions. Semi-structured interviews investigated the perceived major health issues in Zambia, food safety, environmental contamination and specifically heavy-metal contamination. Policy stakeholders were identified through policy mapping and organisations mentioned in focus group discussions and other interviews. The results at the Chunga study site show that members of the public perceive: (i) heavy metal pollution is not an issue in Lusaka and for their irrigation practices, (ii) dirty food can cause illness, (iii) heavy metals in foods can cause illness but they are not present at the Chunga site. Amongst urban agriculturalists the quantity of food available is the greatest issue, with some saying that they

  18. Energizing Government Decision-Makers with the Facts on Solar Technology, Policy, and Integration

    Energy Technology Data Exchange (ETDEWEB)

    2017-01-01

    The Solar Technical Assistance Team (STAT) is a network of solar technology and implementation experts who provide timely, unbiased expertise to assist policymakers and regulators in making informed decisions about solar programs and policies. Government officials can submit requests directly to the STAT for technical assistance. STAT then partners with experts in solar policy, regulation, finance, technology, and other areas to deliver accurate, up-to-date information to state and local decision makers. The STAT responds to requests on a wide range of issues -- including, but not limited to, feed-in tariffs, renewable portfolio standards, rate design, program design, workforce and economic impacts of solar on jurisdictions, and project financing.

  19. Knowledge and Attitudes of a Number of Iranian Policy-makers towards Abortion.

    Science.gov (United States)

    Hourieh, Shamshiri-Milani; Abolghasem, Pourreza; Feizollah, Akbari

    2010-10-01

    Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights.

  20. Moving towards tangible decision-making tools for policy makers: Measuring and monitoring energy access provision

    International Nuclear Information System (INIS)

    Bhanot, Jaya; Jha, Vivek

    2012-01-01

    Access to energy services has been recognised as central to achieving economic growth and sustainable development. However, almost 1.3 billion people in the world still lack access to electricity and 2.7 billion lack access to clean cooking facilities. In this backdrop, the issue of energy access is receiving more interest than ever before and this has brought to the fore, the need for a robust decision support tool for policy makers to measure the progress of energy access provision and also to provide direction for future policy making. The paper studies existing definitions of energy access and identifies the key requirements for an appropriate decision-making tool to measure and monitor energy access provision. In this context the paper assesses the strengths and weaknesses of the metrics currently being used to measure energy access in policy, as well as of contemporary monitoring and evaluation frameworks being used in other sectors. Based on these insights, a dashboard of indicators is proposed as an alternate decision support tool for policy makers to measure energy access. The paper concludes with a discussion on what is needed to operationalise this proposed framework. - Highlights: ► No one indicator or metric can successfully capture progress on energy access. ► A service oriented approach is necessary to measure energy access. ► Socio-economic and political contexts influence success of energy access policies.

  1. Communicating Geosciences with Policy-makers: a Grand Challenge for Academia

    Science.gov (United States)

    Harrison, W. J.; Walls, M. R.; Boland, M. A.

    2015-12-01

    Geoscientists interested in the broader societal impacts of their research can make a meaningful contribution to policy making in our changing world. Nevertheless, policy and public decision making are the least frequently cited Broader Impacts in proposals and funded projects within NSF's Geosciences Directorate. Academic institutions can play a lead role by introducing this societal dimension of our profession to beginning students, and by enabling interdisciplinary research and promoting communication pathways for experienced career geoscientists. Within the academic environment, the public interface of the geosciences can be presented through curriculum content and creative programs. These include undergraduate minors in economics or public policy designed for scientists and engineers, and internships with policy makers. Federal research institutions and other organizations provide valuable policy-relevant experiences for students. Academic institutions have the key freedom of mission to tackle interdisciplinary research challenges at the interface of geoscience and policy. They develop long-standing relationships with research partners, including national laboratories and state geological surveys, whose work may support policy development and analysis at local, state, regional, and national levels. CSM's Payne Institute for Earth Resources awards mini-grants for teams of researchers to develop collaborative research efforts between engineering/science and policy researchers. Current work in the areas of nuclear generation and the costs of climate policy and on policy alternatives for capturing fugitive methane emissions are examples of work at the interface between the geosciences and public policy. With academic engagement, geoscientists can steward their intellectual output when non-scientists translate geoscience information and concepts into action through public policies.

  2. Public perception on forestry issues in the Region of Valencia (Eastern Spain): diverging from policy makers

    Energy Technology Data Exchange (ETDEWEB)

    Fabra-Crespo, M.; Mola-Yudego, B.; Gritten, D.; Rojas-Briales, E.

    2012-11-01

    Are the policies designed by decision-makers differing from society's wishes and preferences. The present paper analyzes the divergences between forest policy and public opinion in the Region of Valencia (Comunidad Valenciana) in Eastern Spain. The data is based on an extensive telephone survey of the general public on their perception of forestry issues. The issues studied include attitudes regarding forest fires, silvicultural treatments, the externalise produced by forest owners, and the state forest services role related to these issues. In total, the answers of 823 respondents were analyzed using classification trees. The results of the analysis showed a large divergence between the desires, preferences and priorities of society, on the one hand, and the policies implemented by the regional government, on the other. The study concludes that communication strategies concerning sustainable forest management need to be further developed by the responsible authorities, with the input of the research community. (Author) 53 refs.

  3. Taking Legislators to the Field: Communicating with Policy Makers about Natural Resource Issues

    Science.gov (United States)

    Sawin, R. S.; Buchanan, R. C.

    2006-12-01

    Policy makers are among the most important audiences for scientific information. In particular, legislators, legislative staff, governmental agency staff, business leaders, environmental leaders, and others need accurate, objective natural-resource information to make policy decisions. This audience is busy and difficult to reach with technical information. As part of its public outreach program, the Kansas Geological Survey (a division of the University of Kansas) communicates directly with policy makers through an annual field conference. Operated since 1995, the conference presents information by combining field experiences, presentations by experts, and participant interaction. The primary objective is to give policy makers first-hand, unbiased information about the state's natural resource issues. The field conference takes policy makers to locations where natural resources are produced or used, or where there are important environmental issues, introducing them to experts and others who carry out (or are affected by) their decisions. The conference consists of three days of site visits, presentations, hands-on activities, and panel discussions. Participation is by invitation. Participants pay a small fee, but most costs are covered by co-sponsors, usually other state or local agencies, that are recruited to help defray expenses. Participants receive a guidebook before the trip. Travel is by chartered bus; lodging and meals are provided. Conferences have focused on topics (such as energy or water) or regions of the state. The most recent conference focused on cross-boundary issues and included stops in Kansas, Oklahoma, and Missouri. Written, post-conference evaluations are extremely positive. Legislators report that they regularly use conference information and contacts during the law-making process; conference information played a direct role in decisions related to underground natural-gas storage rules, water-rights by-back legislation, and sand and gravel

  4. Policy makers ignoring science and scientists ignoring policy: the medical ethical challenges of heroin treatment

    Directory of Open Access Journals (Sweden)

    Small Dan

    2006-05-01

    out, is it acceptable to require patients who have been successfully treated with heroin in Canada, to be forced to move back to less effective treatments (treatments that failed to be efficacious in the past? This essay discusses this dilemma and places it in the broader context of ethics, science, and health policy. It makes the case for continuation of the current successful patients in heroin treatment and the institution of heroin treatment to all Canadian patients living with active addictions who qualify.

  5. European electricity markets - policy deficiencies, design deficiencies, and opportunities for policy-makers

    International Nuclear Information System (INIS)

    Bettzuge, Marc Oliver

    2013-11-01

    Paraphrasing a well-known dictum, one can say that 'design follows policies'. Therefore, before discussing questions of market design, one has to clarify the policies which the desired market design is supposed to implement. Hence, this paper starts by briefly reviewing the status of current policies for the electricity sector. Specifically, it will discuss political objectives, the choice of the basic regulatory paradigm, and the issue of subsidiarity between the EU and the member states

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

    Directory of Open Access Journals (Sweden)

    Hansana Visanou

    2010-07-01

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

  7. A Framework for Using Qualitative Research To Inform Policy-Makers and Empower Practitioners: Lessons from Madagascar.

    Science.gov (United States)

    Heneveld, Ward; Craig, Helen

    National education policy reforms often do not translate into changes at the classroom level. This paper presents a conceptual framework developed for Sub-Saharan Africa to assist policy-makers in bridging the gap between school practice and national policies. It also describes how the framework was applied to current school-improvement efforts in…

  8. Sustainability of Long-term Care: Puzzling Tasks Ahead for Policy-Makers.

    Science.gov (United States)

    Mosca, Ilaria; van der Wees, Philip J; Mot, Esther S; Wammes, Joost J G; Jeurissen, Patrick P T

    2016-08-17

    The sustainability of long-term care (LTC) is a prominent policy priority in many Western countries. LTC is one of the most pressing fiscal issues for the growing population of elderly people in the European Union (EU) Member States. Country recommendations regarding LTC are prominent under the EU's European Semester. This paper examines challenges related to the financial- and organizational sustainability of LTC systems in the EU. We combined a targeted literature review and a descriptive selected country analysis of: (1) public- and private funding; (2) informal care and externalities; and (3) the possible role of technology in increasing productivity. Countries were selected via purposive sampling to establish a cohort of country cases covering the spectrum of differences in LTC systems: public spending, private funding, informal care use, informal care support, and cash benefits. The aging of the population, the increasing gap between availability of informal care and demand for LTC, substantial market failures of private funding for LTC, and fiscal imbalances in some countries, have led to structural reforms and enduring pressures for LTC policy-makers across the EU. Our exploration of national policies illustrates different solutions that attempt to promote fairness while stimulating efficient delivery of services. Important steps must be taken to address the sustainability of LTC. First, countries should look deeper into the possibilities of complementing public- and private funding, as well as at addressing market failures of private funding. Second, informal care externalities with spill-over into neighboring policy areas, the labor force, and formal LTC workers, should be properly addressed. Thirdly, innovations in LTC services should be stimulated to increase productivity through technology and process innovations, and to reduce costs. The analysis shows why it is difficult for EU Member State governments to meet all their goals for sustainable LTC

  9. Sustainability of Long-term Care: Puzzling Tasks Ahead for Policy-Makers

    Directory of Open Access Journals (Sweden)

    Ilaria Mosca

    2017-04-01

    Full Text Available Background The sustainability of long-term care (LTC is a prominent policy priority in many Western countries. LTC is one of the most pressing fiscal issues for the growing population of elderly people in the European Union (EU Member States. Country recommendations regarding LTC are prominent under the EU’s European Semester. Methods This paper examines challenges related to the financial- and organizational sustainability of LTC systems in the EU. We combined a targeted literature review and a descriptive selected country analysis of: (1 public- and private funding; (2 informal care and externalities; and (3 the possible role of technology in increasing productivity. Countries were selected via purposive sampling to establish a cohort of country cases covering the spectrum of differences in LTC systems: public spending, private funding, informal care use, informal care support, and cash benefits. Results The aging of the population, the increasing gap between availability of informal care and demand for LTC, substantial market failures of private funding for LTC, and fiscal imbalances in some countries, have led to structural reforms and enduring pressures for LTC policy-makers across the EU. Our exploration of national policies illustrates different solutions that attempt to promote fairness while stimulating efficient delivery of services. Important steps must be taken to address the sustainability of LTC. First, countries should look deeper into the possibilities of complementing public- and private funding, as well as at addressing market failures of private funding. Second, informal care externalities with spill-over into neighboring policy areas, the labor force, and formal LTC workers, should be properly addressed. Thirdly, innovations in LTC services should be stimulated to increase productivity through technology and process innovations, and to reduce costs. Conclusion The analysis shows why it is difficult for EU Member State

  10. The Appreciative System of Urban ICT Policies: An Analysis of Perceptions of Urban Policy Makers

    NARCIS (Netherlands)

    Cohen-Blankshtain, G.; Nijkamp, P.

    2004-01-01

    Information and Communication Technology (ICT) has become an important tool to promote a variety of public goals and policies. In the past years much attention has been given to the expected social benefits from deploying ICTs in different urban fields (transportation, education, public

  11. Water bodies typology system: a Chilean case of scientific stakeholders and policy makers dialogue

    Directory of Open Access Journals (Sweden)

    Rodrigo Fuster

    2012-12-01

    Full Text Available The aim of this project was to obtain a scientists-validated Typology System, which would allow to classify the surface waters bodies in Chile and, therefore, to facilitate the environmental institutional water management in the country. For this, during the years 2009 and 2011, a Typology System for the surface freshwater bodies was developed for Chile based on the methodology described by the Water Framework Directive of the European Union, which was adapted to local features through the knowledge of limnologist experts in the country, as well as policy makers' experience and their management requirements . In a first stage, national ecoregions were developed and abiotic variables were defined to compose the Typology System. The resulted Typology System for lakes and rivers was generated following an a priori and top down approach to difference biocenosis, based on geomorphologic, hydrologic and physic criteria. In a second stage, the proposed Typology System was validated by experts and policy makers, in which process new arrangements were included in the system. The working methodology used for both stages was bibliographic review, interviews to local experts in biocenosis and workshops. It is specially highlighted the participative processes and discussions in which all the agents involved were present, all of which resulted in the creation of a valid system from a scientific point of view and a product that is applicable to the necessities of the environmental institutions of the country. This work represents a successful experience in the improvement of the communication between scientists and politicians in Chile, which is a relevant factor for the elaboration of more efficient and effective environmental policies, integrating not only management and economic issues, but also more technical aspects that can influence in the final success of any long term strategy. For this reason, the replication of this kind of experiences, as well as

  12. An integrated assessment of climate change impacts for Athens- relevance to stakeholders and policy makers

    Science.gov (United States)

    Giannakopoulos, C.; Hatzaki, M.; Kostopoulou, E.; Varotsos, K.

    2010-09-01

    Analysing climate change and its impact needs a production of relevant elements for policy making that can be very different from the parameters considered by climate experts. In the framework of EU project CIRCE, a more realistic approach to match stakeholders and policy-makers demands is attempted. For this reason, within CIRCE selected case studies have been chosen that will provide assessments that can be integrated in practical decision making. In this work, an integrated assessment of climate change impacts on several sectors for the urban site of Athens in Greece is presented. The Athens urban case study has been chosen since it provides excellent opportunities for using an integrated approach across multiple temporal and spatial scales and sectors. In the spatial dimension, work extends from the inner city boundaries to the surrounding mountains and forests. In the temporal dimension, research ranges from the current observed time period (using available meteorological and sector data) to future time periods using data from several climate change projections. In addition, a multi-sector approach to climate change impacts is adopted. Impacts sectors covered range from direct climate impacts on natural ecosystems (such as flash floods, air pollution and forest fire risk) to indirect impacts resulting from combined climate-social-economic linkages (such as energy demand, tourism and health). Discussion of impact sector risks and adaptation measures are also exploited. Case-study work on impact sector risk to climate change is of particular interest to relevant policy makers and stakeholders, communication with who is ensured through a series of briefing notes and information sheets and through regional workshops.

  13. Getting from Here to There: The Roles of Policy Makers and Principals in Increasing Science Teacher Quality

    Science.gov (United States)

    Shen, Ji; Gerard, Libby; Bowyer, Jane

    2010-04-01

    In this study we investigate how federal and state policy makers, and school principals are working to improve science teacher quality. Interviews, focused discussions, and policy documents serve as the primary data source. Findings suggest that both policy makers and principals prioritize increasing incentives for teachers entering the science teaching profession, providing professional development for new teachers, and using students’ data to evaluate and improve instruction. Differences between the two leadership groups emerged in terms of the grain size and practicality of their concerns. Our findings indicate that the complexity of educational challenges to improve science teacher quality call for the co-construction of policy by multiple constituent groups including school principals, federal and state policy makers, and science education researchers.

  14. Bridging the gap between science and policy: an international survey of scientists and policy makers in China and Canada.

    Science.gov (United States)

    Choi, Bernard C K; Li, Liping; Lu, Yaogui; Zhang, Li R; Zhu, Yao; Pak, Anita W P; Chen, Yue; Little, Julian

    2016-02-06

    Bridging the gap between science and policy is an important task in evidence-informed policy making. The objective of this study is to prioritize ways to bridge the gap. The study was based on an online survey of high-ranking scientists and policy makers who have a senior position in universities and governments in the health sector in China and Canada. The sampling frame comprised of universities with schools of public health and medicine and various levels of government in health and public health. Participants included university presidents and professors, and government deputy ministers, directors general and directors working in the health field. Fourteen strategies were presented to the participants for ranking as current ways and ideal ways in the future to bridge the gap between science and policy. Over a 3-month survey period, there were 121 participants in China and 86 in Canada with response rates of 30.0 and 15.9 %, respectively. The top strategies selected by respondents included focus on policy (conducting research that focuses on policy questions), science-policy forums, and policy briefs, both as current ways and ideal ways to bridge the gap between science and policy. Conferences were considered a priority strategy as a current way, but not an ideal way in the future. Canadian participants were more in favor of using information technology (web-based portals and email updates) than their Chinese counterparts. Among Canadian participants, two strategies that were ranked low as current ways (collaboration in study design and collaboration in analysis) became a priority as ideal ways. This could signal a change in thinking in shifting the focus from the "back end" or "downstream" (knowledge dissemination) of the knowledge transfer process to the "front end" or "upstream" (knowledge generation). Our international study has confirmed a number of previously reported priority strategies to bridge the gap between science and policy. More importantly, our

  15. Lessons from Oil Pollution Research: Consensus, Controversy, and Education of Policy Makers and the Public.

    Science.gov (United States)

    Farrington, J. W.

    2007-12-01

    Controversies concerning scientific research findings, consensus of a majority of expert scientists, and attempts by vested interest groups to offer alternative interpretations from the consensus with the goal of influencing policy makers" and the public's understanding is not a new phenomenon with respect to complex environmental issues. For example, controversies about new scientific research findings from studies of oil spills and other aspects of petroleum and petroleum refined product inputs, fates and effects in the marine environment intensified in the late 1960s to early 1970s and continues today as evidenced by ongoing debates surrounding the Exxon Valdez Oil Spill. This paper provides an overview of the interactions between authentic new scientific findings with respect to oil pollution in the marine environment in the late 1960s and early 1970s, the consensus gained in the ensuing years by continued research, and through various science - policy processes, and a spectrum of concomitant public education efforts. Lessons learned from this ongoing process may be instructive to current debates in other arenas of environmental science.

  16. Spatial Knowledge Infrastructures - Creating Value for Policy Makers and Benefits the Community

    Science.gov (United States)

    Arnold, L. M.

    2016-12-01

    The spatial data infrastructure is arguably one of the most significant advancements in the spatial sector. It's been a game changer for governments, providing for the coordination and sharing of spatial data across organisations and the provision of accessible information to the broader community of users. Today however, end-users such as policy-makers require far more from these spatial data infrastructures. They want more than just data; they want the knowledge that can be extracted from data and they don't want to have to download, manipulate and process data in order to get the knowledge they seek. It's time for the spatial sector to reduce its focus on data in spatial data infrastructures and take a more proactive step in emphasising and delivering the knowledge value. Nowadays, decision-makers want to be able to query at will the data to meet their immediate need for knowledge. This is a new value proposal for the decision-making consumer and will require a shift in thinking. This paper presents a model for a Spatial Knowledge Infrastructure and underpinning methods that will realise a new real-time approach to delivering knowledge. The methods embrace the new capabilities afforded through the sematic web, domain and process ontologies and natural query language processing. Semantic Web technologies today have the potential to transform the spatial industry into more than just a distribution channel for data. The Semantic Web RDF (Resource Description Framework) enables meaning to be drawn from data automatically. While pushing data out to end-users will remain a central role for data producers, the power of the semantic web is that end-users have the ability to marshal a broad range of spatial resources via a query to extract knowledge from available data. This can be done without actually having to configure systems specifically for the end-user. All data producers need do is make data accessible in RDF and the spatial analytics does the rest.

  17. To bail out or not to bail out systemically relevant financial institutions: The incentives of policy makers

    Directory of Open Access Journals (Sweden)

    Lucas Marc Fuhrer

    2012-11-01

    Full Text Available The recent financial crisis has shown that many financial institutions may be systemically relevant. Their bankruptcy would cause significant costs for the overall economy. However, a clear definition of systemic risks still does not exist. Thus, the decision, whether an institution is, or is not systemically relevant is in the end made by policy makers. This paper takes a closer look at the incentives available to policy makers and their influence on the bailout decision. In the model presented here it is possible to show, that too many financial institutions get bailed out, when assuming that policy makers tend to be more risk-averse than socially optimal. The costs due to this misallocation of resources can be significant.

  18. The Policy Maker's Anguish: Regulating Personal Data Behavior Between Paradoxes and Dilemmas

    Science.gov (United States)

    Compañó, Ramón; Lusoli, Wainer

    Regulators in Europe and elsewhere are paying great attention to identity, privacy and trust in online and converging environments. Appropriate regulation of identity in a ubiquitous information environment is seen as one of the major drivers of the future Internet economy. Regulation of personal identity data has come to the fore including mapping conducted on digital personhood by the OECD; work on human rights and profiling by the Council of Europe andmajor studies by the European Commission with regard to self-regulation in the privacy market, electronic identity technical interoperability and enhanced safety for young people. These domains overlap onto an increasingly complex model of regulation of individuals' identity management, online and offline. This chapter argues that policy makers struggle to deal with issues concerning electronic identity, due to the apparently irrational and unpredictable behavior of users when engaging in online interactions involving identity management. Building on empirical survey evidence from four EU countries, we examine the first aspect in detail - citizens' management of identity in a digital environment. We build on data from a large scale (n = 5,265) online survey of attitudes to electronic identity among young Europeans (France, Germany, Spain, UK) conducted in August 2008. The survey asked questions about perceptions and acceptance of risks, general motivations, attitudes and behaviors concerning electronic identity. Four behavioral paradoxes are identified in the analysis: a privacy paradox (to date well known), but also a control paradox, a responsibility paradox and an awareness paradox. The chapter then examines the paradoxes in relation of three main policy dilemmas framing the debate on digital identity. The paper concludes by arguing for an expanded identity debate spanning policy circles and the engineering community.

  19. Timely injection of knowledge when interacting with stakeholders and policy makers.

    Science.gov (United States)

    Bouma, Johan

    2015-04-01

    Timely injection of knowledge when interacting with stakeholders and policy makers. J.Bouma Em. Prof. Soil Science, Wageningen University, the Netherlands During the last decade, the spectacular development of Information and Communication Technology (ICT) has strongly increased the accessible amount of data and information for stakeholders and policy makers and the science community is struggling to adjust to these developments. In the Netherlands not only industry has now a major impact on the research agenda but this is now to be extended to citizens at large. Rather than complain about an apparent "gap" between science and society and wrestle with the challenge to bridge it in a rather reactive manner, the science community would be well advised to initiate a proactive approach, showing that knowledge implies a deep understanding of issues and processes that does not necessarily follow from having data and information. The "gap" certainly applies to soil research in the context of sustainable development where many often well informed stakeholders are involved with widely different opinions, norms and values. Changes are suggested in the manner in which we frame our work: (i) longer involvement with projects from initiation to implementation in practice; (ii) active role of "knowledge brokers" who inject the right type of knowledge during the entire project run in a joint-learning mode, and (iii) not proposing new research from a science perspective but demonstrating a clear need because existing knowledge is inadequate. Yet more conceptual discussions about e.g. inter- and transdisciplinarity, worrysome soil degradation and lack of professional recognition are less meaningful than specific case studies demonstrating the crucial role of soil science when analysing land-based environmental problems. New narratives are needed instead of statistics, openness to learn from best practices and pilot projects as a necessary next step beyond awareness raising. Soil

  20. Changing the hearts and minds of policy makers: an exploratory study associated with the West Virginia Walks campaign.

    Science.gov (United States)

    Leyden, Kevin M; Reger-Nash, Bill; Bauman, Adrian; Bias, Tom

    2008-01-01

    To pilot test whether West Virginia Walks changed local policy makers' awareness of walking-related issues. A quasi-experimental design with preintervention and postintervention mail surveys. Morgantown, WV (intervention community), and Huntington, WV (comparison community). One hundred thirty-three and 134 public officials in Morgantown and 120 and 116 public officials in Huntington at baseline and at follow-up, respectively. An 8-week mass media social ecological campaign designed to encourage moderate-intensity walking among insufficiently active persons aged 40 to 65 years. Policy makers listed three problems they believed needed to be addressed in their community. They then rated the severity of several problems that many communities face using a Likert scale, with 1 representing "not a problem" and 5 representing "an extremely important problem." Independent sample t-tests were used to examine differences in mean responses at baseline and at follow-up. Statistically significant increases in the perceived importance of walking-related issues were observed among policy makers in Morgantown but not in the comparison community. Integrated communitywide health promotion campaigns designed to influence the public can also affect the perceptions of policy makers. Future research should examine this linkage and determine whether resource allocation and policy changes follow such interventions.

  1. Global Assessment of Methane Gas Hydrates: Outreach for the public and policy makers

    Science.gov (United States)

    Beaudoin, Yannick

    2010-05-01

    The United Nations Environment Programme (UNEP), via its official collaborating center in Norway, GRID-Arendal, is in the process of implementing a Global Assessment of Methane Gas Hydrates. Global reservoirs of methane gas have long been the topic of scientific discussion both in the realm of environmental issues such as natural forces of climate change and as a potential energy resource for economic development. Of particular interest are the volumes of methane locked away in frozen molecules known as clathrates or hydrates. Our rapidly evolving scientific knowledge and technological development related to methane hydrates makes these formations increasingly prospective to economic development. In addition, global demand for energy continues, and will continue to outpace supply for the foreseeable future, resulting in pressure to expand development activities, with associated concerns about environmental and social impacts. Understanding the intricate links between methane hydrates and 1) natural and anthropogenic contributions to climate change, 2) their role in the carbon cycle (e.g. ocean chemistry) and 3) the environmental and socio-economic impacts of extraction, are key factors in making good decisions that promote sustainable development. As policy makers, environmental organizations and private sector interests seek to forward their respective agendas which tend to be weighted towards applied research, there is a clear and imminent need for a an authoritative source of accessible information on various topics related to methane gas hydrates. The 2008 United Nations Environment Programme Annual Report highlighted methane from the Arctic as an emerging challenge with respect to climate change and other environmental issues. Building upon this foundation, UNEP/GRID-Arendal, in conjunction with experts from national hydrates research groups from Canada, the US, Japan, Germany, Norway, India and Korea, aims to provide a multi-thematic overview of the key

  2. Barriers to optimizing investments in the built environment to reduce youth obesity: policy-maker perspectives.

    Science.gov (United States)

    Grant, Jill L; MacKay, Kathryn C; Manuel, Patricia M; McHugh, Tara-Leigh F

    2010-01-01

    To identify factors which limit the ability of local governments to make appropriate investments in the built environment to promote youth health and reduce obesity outcomes in Atlantic Canada. Policy-makers and professionals participated in focus groups to discuss the receptiveness of local governments to introducing health considerations into decision-making. Seven facilitated focus groups involved 44 participants from Atlantic Canada. Thematic discourse analysis of the meeting transcripts identified systemic barriers to creating a built environment that fosters health for youth aged 12-15 years. Participants consistently identified four categories of barriers. Financial barriers limit the capacities of local government to build, maintain and operate appropriate facilities. Legacy issues mean that communities inherit a built environment designed to facilitate car use, with inadequate zoning authority to control fast food outlets, and without the means to determine where schools are built or how they are used. Governance barriers derive from government departments with distinct and competing mandates, with a professional structure that privileges engineering, and with funding programs that encourage competition between municipalities. Cultural factors and values affect outcomes: people have adapted to car-oriented living; poverty reduces options for many families; parental fears limit children's mobility; youth receive limited priority in built environment investments. Participants indicated that health issues have increasing profile within local government, making this an opportune time to discuss strategies for optimizing investments in the built environment. The focus group method can foster mutual learning among professionals within government in ways that could advance health promotion.

  3. Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers.

    Science.gov (United States)

    Shaikh, Babar T; Hatcher, Juanita

    2005-03-01

    There is a growing literature on health seeking behaviours and the determinants of health services utilization especially in the context of developing countries. However, very few focused studies have been seen in Pakistan in this regard. This paper presents an extensive literature review of the situation in developing countries and relates the similar factors responsible for shaping up of a health seeking behaviour and health service utilization in Pakistan. The factors determining the health behaviours may be seen in various contexts: physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behaviour of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioural health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population.

  4. Handbook - TRACE-ing human trafficking : Handbook for policy makers, law enforcement agencies and civil society organisations

    NARCIS (Netherlands)

    Rijken, Conny; Pijnenburg, Annick

    2016-01-01

    Human trafficking is one of the largest criminal enterprises in the world. It is a multi-billiondollar crime of global scale. This is because human trafficking as a criminal enterprise continues to evolve as a high profit-low risk business for perpetrators and challenges policy makers, law

  5. Children's Participation in Decision-Making in the Philippines: Understanding the Attitudes of Policy-Makers and Service Providers

    Science.gov (United States)

    Bessell, Sharon

    2009-01-01

    This article explores the ideas about children's participation in decision-making held by government officials and non-government representatives engaged in promoting children's participation in the Philippines. It suggests that the ideas that policy-makers and service deliverers hold about children's participation are heterogeneous, diverse and…

  6. Do evidence summaries increase policy-makers' use of evidence from systematic reviews: A systematic review protocol.

    Science.gov (United States)

    Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter

    2015-09-28

    Systematic reviews are important for decision-makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision-makers. This systematic review will assess the effectiveness of systematic review summaries on increasing policymakers' use of systematic review evidence and to identify the components or features of these summaries that are most effective. We will include studies of policy-makers at all levels as well as health-system managers. We will include studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that present evidence in a summarized form. The primary outcomes are the following: (1) use of systematic review summaries decision-making (e.g., self-reported use of the evidence in policy-making, decision-making) and (2) policy-maker understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We will conduct a systematic review of randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series (ITS) studies. The results of this review will inform the development of future systematic review summaries to ensure that systematic review evidence is accessible to and used by policy-makers making health-related decisions.

  7. Patron Time-Use May Be an Effective Metric for Presenting Library Value to Policy Makers

    Directory of Open Access Journals (Sweden)

    Ann Glusker

    2016-04-01

    Full Text Available Objective – To test a metric for library use, that could be comparable to metrics used by competing government departments, for ease of understanding by policy makers. Design – Four types of data were collected and used: Time-diaries, exit surveys, gate counts, and circulation statistics. Setting – A large public library in British Columbia, Canada. Subjects – Time-diary subjects were 445 patrons checking out materials; exit survey subjects were 185 patrons leaving the library. Methods – A paper-based time diary, prototypes of which were tested, was given to patrons who checked out library materials during a one-week period. These patrons were charged with recording the use of the checked-out items during the entire three-week loan period. From this information, the average number of hours spent with various types of loaned material (print and audio/DVD was calculated. The average number of hours spent per item type was then applied to the circulation statistics for those items, across a month, to get a total of hours spent using all circulated material during that month. During the same one-week period of time-diary distribution, exit surveys were conducted by library staff with patrons leaving the library, asking them how long they had spent in the library during their current visit. The average number of minutes per visit was calculated and then applied to the gate count for the month, to get a total number of minutes/hours spent “resident” in the library that month. Adding the totals, a grand total of patron time-use hours was calculated. A monetary value was applied per hour, using the results of a contingent valuation study from Missoula, Montana (Dalenberg et al., 2004, in order to convert hours of library benefit into a dollar figure. Main Results – There was a 24% response rate for the time diaries (106/445. The diary entries yielded an average of 3.5 hours of time-use per print item, and 1.9 hours per DVD. The range for

  8. Ciclovía initiatives: engaging communities, partners, and policy makers along the route to success.

    Science.gov (United States)

    Zieff, Susan G; Hipp, J Aaron; Eyler, Amy A; Kim, Mi-Sook

    2013-01-01

    Recent efforts to increase physical activity through changes to the built environment have led to strategies and programs that use existing public space, including bicycle lanes, temporary parks, and the ciclovia initiative (scheduled events in which streets are closed to motorized vehicles and opened for recreational activities) popularized in South America. This article describes and compares the processes and structures involved in developing and implementing a ciclovia-type program in 2 US urban contexts: San Francisco, California, and St Louis, Missouri. Considering the current growth of and interest in ciclovia initiatives, important outcomes, lessons learned are offered for application in other, similar settings. Primary sources from both initiatives and from published research on ciclovias constitute the body of evidence and include year-end reports, grant applications, meeting minutes, budgets, published ciclovia guidelines, evaluation studies and Web sites, media sources, and interviews and personal communication with the organizers. Primary source documents were reviewed and included in this analysis if they offered information on 3 grounded questions: What processes were used in developing the initiative? What are the current structures and practices used in implementation of initiatives? What are important lessons learned and best practices from initiatives for recommendations to stakeholders and policy makers in other contexts? Among the categories compared, the structures and processes for implementation regarding buy-in and city department collaboration, route selection, programming, partnerships, media promotion, community outreach, and merchant support were relatively similar among the 2 initiatives. The categories that differed included staffing and volunteer engagement and funding. Buy-in from community partners, merchants, residents, and city agencies is critical for a positive experience in developing and implementing ciclovia-type initiatives

  9. Designing "Real-World" trials to meet the needs of health policy makers at marketing authorization.

    Science.gov (United States)

    Calvert, Melanie; Wood, John; Freemantle, Nick

    2011-07-01

    There is increasing interest in conducting "Real-World" trials that go beyond traditional assessment of efficacy and safety to examine market access and value for money questions before marketing authorization of a new pharmaceutical product or health technology. This commentary uses practical examples to demonstrate how high-quality evidence of the cost-effectiveness of an intervention may be gained earlier in the development process. Issues surrounding the design and analysis of "Real-World" trials to demonstrate relative cost-effectiveness early in the life of new technologies are discussed. The modification of traditional phase III trial designs, de novo trial designs, the combination of trial-based and epidemiological data, and the use of simulation model-based approaches to address reimbursement questions are described. Modest changes to a phase III trial protocol and case report form may be undertaken at the design stage to provide valid estimates of health care use and the benefits accrued; however, phase III designs often preclude "real-life" practice. Relatively small de novo trials may be used to address adherence to therapy or patient preference, although simply designed studies with active comparators enrolling large numbers of patients may provide evidence on long-term safety and rare adverse events. Practical examples demonstrate that it is possible to provide high-quality evidence of the cost-effectiveness of an intervention earlier in the development process. Payers and decision makers should preferentially adopt treatments with such evidence than treatments for which evidence is lacking or of lower quality. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. The Solutions Project: Educating the Public and Policy Makers About Solutions to Global Warming, Air Pollution, and Energy Security

    Science.gov (United States)

    Jacobson, M. Z.

    2015-12-01

    Three major global problems of our times are global warming, air pollution mortality and morbidity, and energy insecurity. Whereas, policy makers with the support of the public must implement solutions to these problems, it is scientists and engineers who are best equipped to evaluate technically sound, optimal, and efficient solutions. Yet, a disconnect exists between information provided by scientists and engineers and policies implemented. Part of the reason is that scientific information provided to policy makers and the public is swamped out by information provided by lobbyists and another part is the difficulty in providing information to the hundreds of millions of people who need it rather than to just a few thousand. What other ways are available, aside from issuing press releases on scientific papers, for scientists to disseminate information? Three growing methods are through social media, creative media, and storytelling. The Solutions Project is a non-profit non-governmental organization whose goal is to bring forth scientific information about 100% clean, renewable energy plans to the public, businesses, and policy makers using these and related tools. Through the use of social media, the development of engaging internet and video content, and storytelling, the group hopes to increase the dissemination of information for social good. This talk discusses the history and impacts to date of this group and its methods. Please see www.thesolutionsproject.org and 100.org for more information.

  11. The mass balance of production and consumption: Supporting policy-makers for aquatic food security

    Science.gov (United States)

    Lopes, A. S.; Ferreira, J. G.; Vale, C.; Johansen, J.

    2017-03-01

    the world, well above both Malaysia and South Korea (each with 58 kg ind-1 y-1). The corrected data show that Portugal had the highest consumption rate in the world until the mid-1970's, when it was overtaken by Iceland for reasons discussed herein. The lack of detailed per-species consumption data, as well as the grouping of species by commodities, hinders a more detailed seafood consumption analysis, required by policy makers and stakeholders to effectively develop management measures to reduce illegal fishing or bycatch, and to correctly formulate strategic options for development of aquaculture and fisheries, necessary for ensuring food security over the next decades.

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

    Science.gov (United States)

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

    2018-01-13

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

  13. Marginal Propensity to Consume in Hungary: The long-term versus Short-term Challenges to Policy Makers

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    Keith Write

    2017-11-01

    Full Text Available This study uses Hungarian quarterly data from the International Monetary Fund to estimate a distributed lag model whose coefficients allow derivation of the short-run and long-run marginal propensities to consume.  MPCs are main factors determining the consumption, investment, government spending, and export and import multipliers of the economy.  Hungary's economy has stagnated and its policy makers are exploring new ways to manage its economy.  Our model reveals that the numerical value of Hungarian short-run marginal propensity to consume (MPC is 0.4081181655 and the long-run MPC is 0.9458619.  These results are consistent with the corresponding figures in emerging and advanced economies.  These derived MPCs suggest that Hungarian economic policy makers should use fiscal instruments to bring these macroeconomic variables back to their long-term trend effectively

  14. CURRICULUM POLICY MAKERS PERCEPTIONS OF CURRICULUM DEVELOPMENT PROCESS BASED ON SOLO TAXONOMY IN SECONDARY LEVEL SCHOOLS IN SRI LANKA

    OpenAIRE

    P. H. Kusumawathie; Norhisham Mohamad; Ferdous Azam

    2017-01-01

    Purpose: The purpose of this study is to explore the conceptual awareness of curriculum policy makers on curriculum development process based on SOLO Taxonomy curriculum approach in secondary level schools. Further, the study explored the relationship between the curriculum development inputs and the SOLO based curriculum development process. The curriculum development inputs are teacher effectiveness, school community, school environment and technology availability. Method: Data was collecte...

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

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    Chigozie Jesse Uneke

    2015-09-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  17. "We noticed that suddenly the country has become full of MRI". Policy makers' views on diffusion and use of health technologies in Iran

    Directory of Open Access Journals (Sweden)

    Tishelman Carol

    2010-04-01

    Full Text Available Abstract Objective Uncontrolled proliferation of health technologies (HT is one contributor to the increasing pressure on health systems to adopt new technologies. With limited resources, policy-makers encounter difficulties in fulfilling their responsibility to meet the healthcare needs of the population. The aim of this study is to explore how policy-makers' reason about the diffusion and utilization of health technologies in Iran using magnetic resonance imaging (MRI and interferon beta as tracers. Method This qualitative exploration complements quantitative data generated in a research project investigating the diffusion and utilization of MRI and interferon beta in Iran. Qualitative semi-structured interviews were conducted with 13 informants in different positions and levels of authority in the Ministry of Health (MOH, University of Medical Sciences, Health Insurance Organizations, and Parliament. The data was analysed using the framework approach. Findings Although policy-makers appeared to be positive to health technology assessment (HTA, the processes of policy-making described by the interviewees did not seem to be based on a full understanding of this (discipline. Several obstacles to applying knowledge about HT and HTA were described. The current official plan for MRI adoption and diffusion in the country was said not to be followed, and no such plan was described for interferon beta. Instead, market forces such as advertising, and physician and consumer demand, appear to have strong influence on HT diffusion and use. Dual practice may have increased the induced demand and also reduced the supervision of the private sector by the MOH. Conclusion Management instability and lack of coordination in the MOH were found to be important obstacles to accumulation of knowledge and experience which, in turn, could have led to suboptimal managerial and policy-making processes. Furthermore marketing should be controlled in order to avoid

  18. Cancer beliefs and prevention policies: comparing Canadian decision-maker and general population views.

    Science.gov (United States)

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

    2014-12-01

    The knowledge, attitudes, and beliefs of key policy influencers and the general public can support or hinder the development of public policies that support cancer prevention. To address gaps in knowledge concerning healthy public policy development, views on cancer causation and endorsement of policy alternatives for cancer prevention among government influencers (elected members of legislative assemblies and senior ministry bureaucrats), non-governmental influencers (school board chairs and superintendents, print media editors and reporters, and workplace presidents and senior human resource managers), and the general public were compared. Two structured surveys, one administered to a convenience sample of policy influencers (government and non-governmental) and the other to a randomly selected sample of the general public, were used. The aim of these surveys was to understand knowledge, attitudes, and beliefs regarding health promotion principles and the priority and acceptability of policy actions to prevent four behavioral risk factors for cancer (tobacco use, alcohol misuse, unhealthy eating, and physical inactivity). Surveys were administered in Alberta and Manitoba, two comparable Canadian provinces. Although all groups demonstrated higher levels of support for individualistic policies (e.g., health education campaigns) than for fiscal and legislative measures, the general public expressed consistently greater support than policy influencers for using evidence-based policies (e.g., tax incentives or subsidies for healthy behaviors). These results suggest that Canadian policy influencers may be less open that the general public to adopt healthy public policies for cancer prevention, with potential detriment to cancer rates.

  19. The value of vaccination: results of an Italian survey among Medical Doctors, Policy Makers and General Population

    Directory of Open Access Journals (Sweden)

    Chiara Cadeddu

    2012-03-01

    Full Text Available

    Abstract:

    Background: In the Italian context, evolving toward the abandonment of compulsory vaccination, the
    maintenance of adequate levels of coverage appears as essential. The promotion of a good vaccination
    knowledge, supported by strong scientific evidence, and the collaboration of all the involved stakeholders,
    appears hence fundamental. The aim of this survey was to understand why vaccination is not appreciated
    for its real value by different stakeholders.
    Methods: In collaboration with other Italian Universities and Health Districts, in Summer 2011 we submitted
    a survey of 17 questions to a convenience sample of Italian Medical Doctors, Policy Makers and General
    Population. The main questions analyzed the importance of vaccination for health, actions to attain vaccination
    value and consequences of a free choice policy.
    Results: Of the 173 stakeholders interviewed, 78% of Medical Doctors, 82% Policy Makers and 46%
    General Population believe that vaccination is important for health. The most important actions suggested
    for strengthening vaccination were information about its efficacy and safety and studies on its impact on
    Public Health, according to most of General Population and of Medical Doctors and Policy Makers, respectively.
    According to 60.4% Medical Doctors, 72.8% Policy Makers and 56.3% General Population the abolition
    of compulsory vaccination would lead to a reduction of vaccinees in all the Italian regions.
    Conclusions: Our study confirms the need for a thorough “education in vaccination”. Among stakeholders
    there are still doubts that hinder the decision process about vaccination policies and programmes. On
    the other hand, a call for an “Alliance” for promoting and implementing vaccination to its full potential
    would be favoured, as

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

    Science.gov (United States)

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

    2018-02-23

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

  1. Lessons learnt for Public Policy Maker from Relocation of Tsunami Affected Villagers in Thailand

    Science.gov (United States)

    Kamthonkiat, Daroonwan; Thuy Vu, Tuong

    2013-04-01

    facilities such as water, electricity and dumping area were not enough supported in some donated areas. 3)A lot of fishermen had turned to wage-earners or unfamiliar jobs to earn for their living. Some were jobless more than a year after relocation because of less skill for other jobs, high competition for less vacancies and no capital to start their small business. 4)After a few years of relocation and adaptation in the donated houses, we found that old and young generation became a major residence while much of the working generation fishermen went back to their villages for their fishing career. Some of them leaved the right of living in the donated houses by renting out to non-tsunami impact people or leaving their houses abandoned. As a lesson learnt from the relocation of the tsunami impact villagers in Thailand during 2005 - 2010, we could summarize some critical concerns for government policy makers as listed; 1)The government may support the certificate of the ownership or title deed with some conditions to the villagers who occupied on their lands before the conservative zones were announced. They should have the right to stay further and do eco-friendly activities for earning their lives. The villagers have no right to transfer the title deed or certificate to the third parties. Only eco-friendly equipments are permitted for fishing in this area. 2)After relocation to the higher ground, basic facilities (such as water, electricity and dumping area) should be sufficiently furnished. 3)Not only skill practicing for career options should be supported, finding job vacancy should run in parallel to ensure that the tsunami impact villagers can afford their living. 4)For reducing the right transfer or leaving the donated houses abandoned, annual or continuous survey to these residences should be conducted by government sectors until 80% of them had settled on their careers and adaptations. Location analysis should be conducted before construction of houses for disaster

  2. Young Children as Language Policy-Makers: Studies of Interaction in Preschools in Finland and Sweden

    Science.gov (United States)

    Boyd, Sally; Huss, Leena

    2017-01-01

    This special issue has as its focus the agency of young children in relation to language policy and practice in bi- and multilingual preschools in Finland and Sweden. Studies of language policy in practice in early childhood education and care (ECEC) in these two countries can be particularly relevant even to those in other contexts, because they…

  3. Finding facts for policy makers. IPCC's Special Reports and the Third Assessment Report

    International Nuclear Information System (INIS)

    Leemans, R.; Verbeek, K.

    2000-01-01

    The Intergovernmental Panel on Climate Change (IPCC) is an international body of the WMO (World Meteorological Organization) and UNEP (United Nations Environmental Programme) that publishes authoritative reports on the scientific, technical and socio-economic aspects of climate change and climate policy. The knowledge contained in the IPCC reports forms the basis for the development of global climate policy by the UN Framework Convention on Climate Change (UNFCCC). The three volumes of the Third Assessment Report will be published early in 2001, shortly after Cop6 (Sixth Convention of Parties, The Hague, Netherlands, November 2000). This broadly supported summary of scientific insights will be important for the further substantiation of climate policy

  4. The Use of Social Ecological Hotspots Mapping: Co-Developing Adaptation Strategies for Resource Management by Communities and Policy Makers

    Science.gov (United States)

    Alessa, L.

    2014-12-01

    Ultimately, adaptation is based on a set of trade-offs rather than optimal conditions, something that is rarely seen in messy social ecological systems (SES). In this talk, we discuss the role of spatial hot-spot mapping using social and biophysical data to understand the feedbacks in SES. We review the types of data needed, their means of acquisition and the analytic methods involved. In addition, we outline the challenges faced in co-developing this type of inquiry based on lessons learned from several long-term programs. Finally, we present the utility of SES hotspots in developing adaptation strategies on the ground by communities and policy makers.

  5. Policy-maker attitudes to the ageing of the HIV cohort in Botswana ...

    African Journals Online (AJOL)

    Background: The roll out of antiretroviral therapy in Botswana, as in many countries ... planning, strategies and policies that govern social, physical and medical intervention ... Respondents also noted the lack of defined geriatric care within the ...

  6. Renewable electricity production costs-A framework to assist policy-makers' decisions on price support

    International Nuclear Information System (INIS)

    Dinica, Valentina

    2011-01-01

    Despite recent progress, the production costs for renewable electricity remain above those for conventional power. Expectations of continuous reductions in production costs, typically underpin governments' policies for financial support. They often draw on the technology-focused versions of the Experience Curve model. This paper discusses how national-contextual factors also have a strong influence on production costs, such as geographic, infrastructural, institutional, and resource factors. As technologies mature, and as they reach significant levels of diffusion nationally, sustained increases in production costs might be recorded, due to these nationally contextual factors, poorly accounted for in policy-making decisions for price support. The paper suggests an analytical framework for a more comprehensive understanding of production costs. Based on this, it recommends that the evolution of specific cost levels and factors be monitored to locate 'sources of changes'. The paper also suggests policy instruments that governments may use to facilitate cost decreases, whenever possible. The application of the framework is illustrated for the diffusion of wind power in Spain during the past three decades. - Highlights: → Models, frameworks for policy-making on price support for renewable electricity production costs. → Policy instruments to help reduce production costs. → Limits to the influence of policies of production costs reductions.

  7. Development of policies for Natura 2000 sites: a multi-criteria approach to support decision makers.

    Science.gov (United States)

    Cortina, Carla; Boggia, Antonio

    2014-08-01

    The aim of this study is to present a methodology to support decision makers in the choice of Natura 2000 sites needing an appropriate management plan to ensure a sustainable socio-economic development. In order to promote sustainable development in the Natura 2000 sites compatible with nature preservation, conservation measures or management plans are necessary. The main issue is to decide when only conservation measures can be applied and when the sites need an appropriate management plan. We present a case study for the Italian Region of Umbria. The methodology is based on a multi-criteria approach to identify the biodiversity index (BI), and on the development of a human activities index (HAI). By crossing the two indexes for each site on a Cartesian plane, four groups of sites were identified. Each group corresponds to a specific need for an appropriate management plan. Sites in the first group with a high level both of biodiversity and human activities have the most urgent need of an appropriate management plan to ensure sustainable development. The proposed methodology and analysis is replicable in other regions or countries by using the data available for each site in the Natura 2000 standard data form. A multi-criteria analysis is especially suitable for supporting decision makers when they deal with a multidimensional decision process. We found the multi-criteria approach particularly sound in this case, due to the concept of biodiversity itself, which is complex and multidimensional, and to the high number of alternatives (Natura 2000 sites) to be assessed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Special report on renewable energy sources and climate change mitigation, (SRREN). Summary for policy makers; FNs klimapanel: Spesialrapport om fornybar energi, sammendrag for beslutningstakere

    Energy Technology Data Exchange (ETDEWEB)

    2011-06-15

    In May 2011 the Intergovernmental Panel on Climate Change published a report on six renewable energy sources and their role in climate change mitigation. This is a Norwegian, unofficial translation of the Summary for Policy makers. (Author)

  9. Perspectives of policy and political decision makers on access to formal dementia care: expert interviews in eight European countries.

    Science.gov (United States)

    Broda, Anja; Bieber, Anja; Meyer, Gabriele; Hopper, Louise; Joyce, Rachael; Irving, Kate; Zanetti, Orazio; Portolani, Elisa; Kerpershoek, Liselot; Verhey, Frans; Vugt, Marjolein de; Wolfs, Claire; Eriksen, Siren; Røsvik, Janne; Marques, Maria J; Gonçalves-Pereira, Manuel; Sjölund, Britt-Marie; Woods, Bob; Jelley, Hannah; Orrell, Martin; Stephan, Astrid

    2017-08-03

    As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers. Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4-7 experts (total N = 38). The interview guide addressed the topics "Complexity and Continuity of Care", "Formal Services", and "Public Awareness". Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries. The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness. Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations.

  10. Examining the policy climate for HIV prevention in the Caribbean tourism sector: a qualitative study of policy makers in the Dominican Republic.

    Science.gov (United States)

    Padilla, Mark B; Reyes, Armando Matiz; Connolly, Maureen; Natsui, Shaw; Puello, Adrian; Chapman, Helena

    2012-05-01

    The Caribbean has the highest prevalence rates of HIV/AIDS outside sub-Saharan Africa, and a broad literature suggests an ecological association between tourism areas and sexual vulnerability. Tourism employees have been shown to engage in high rates of sexual risk behaviours. Nevertheless, no large-scale or sustained HIV prevention interventions have been conducted within the tourism industry. Policy barriers and resources are under-studied. In order to identify the policy barriers and resources for HIV prevention in the tourism sector, our research used a participatory approach involving a multisectoral coalition of representatives from the tourism industry, government, public health and civil society in the Dominican Republic. We conducted 39 in-depth semi-structured interviews with policy makers throughout the country focusing on: prior experiences with HIV prevention policies and programmes in the tourism sector; barriers and resources for such policies and programmes; and future priorities and recommendations. Findings suggest perceptions among policy makers of barriers related to the mobile nature of tourism employees; the lack of centralized funding; fear of the 'image problem' associated with HIV; and the lack of multisectoral policy dialogue and collaboration. Nevertheless, prior short-term experiences and changing attitudes among some private sector tourism representatives suggest emerging opportunities for policy change. We argue that the time is ripe for dialogue across the public-private divide in order to develop regulatory mechanisms, joint responsibilities and centralized funding sources to ensure a sustainable response to the HIV-tourism linkage. Policy priorities should focus on incorporating HIV prevention as a component of occupational health; reinforcing workers' health care rights as guaranteed by existing law; using private sector tourism representatives who support HIV prevention as positive role models for national campaigns; and

  11. What Do Policy Makers Think of Educational Research & Evaluation? Or Do They?

    Science.gov (United States)

    Florio, David H.; And Others

    1979-01-01

    Twenty-six congressional staff members dealing with educational legislation were surveyed concerning their sources of information and the relative importance and value of educational inquiry in various stages of the policy process. Conclusions were drawn and recommendations regarding improvement of the process were made. (MH)

  12. Europe's energy transition. The big five recommendations to guide and inspire EU policy-makers

    International Nuclear Information System (INIS)

    2014-09-01

    The energy transition is more than a shift from one energy system (finite resources) to another (more renewable and low energy-based). Our century's challenge is to radically reduce our energy use. The local level is where the new energy paradigm is happening. Ambitious policies at European level are crucial to speed up the movement

  13. Transfer Pricing and Developing Economies : A Handbook for Policy Makers and Practitioners

    OpenAIRE

    Cooper, Joel; Fox, Randall; Loeprick, Jan; Mohindra, Komal

    2016-01-01

    Recent years have seen unprecedented public scrutiny over the tax practices of Multinational Enterprise (MNE) groups. Tax policy and administration concerning international transactions, aggressive tax planning, and tax avoidance have become an issue of extensive national and international debate in developed and developing countries alike. Within this context, transfer pricing, historically a subject of limited specialist interest, has attained name recognition amongst a broader global audie...

  14. 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.

  15. Demographic indicators of trust in federal, state and local government: implications for Australian health policy makers.

    Science.gov (United States)

    Meyer, Samantha B; Mamerow, Loreen; Taylor, Anne W; Henderson, Julie; Ward, Paul R; Coveney, John

    2013-02-01

    To provide baseline findings regarding Australians' trust in federal, state and local government. A computer-assisted telephone interviewing (CATI) survey was administrated during October to December 2009 to a random sample (n=1109) across Australia (response rate 41.2%). Binary logistic regression analyses were carried out by means of SPSS. Age, household size, household income, IRSD and ARIA were found to be significant indicators for trust in federal, state and local government. Trust in state government is lower for older respondents and respondents living in inner and outer regional areas. Trust in local council is lower in respondents living in inner regional areas, respondents living in disadvantaged areas, and respondents in the income bracket of $60001 to $100000. Trust in federal government is lower for older respondents and respondents living in disadvantaged areas. Of note is diminished trust in government among older, regional and lower income ($30001-$60000) respondents. Trust in all levels of government was found to be the lowest in population groups that are identified by empirical research and media to have the poorest access to government services. As a consequence, improved access to services for these populations may increase trust in health policy. Increased trust in health governance may in turn, ensure effective dissemination and implementation of health policies and that existing inequities are not perpetuated through distrust of health information and policy initiatives.

  16. Summary for Policy Makers: Intergovernmental Panel on Climate Change Special Report Renewable Energy Sources (SRREN)

    Energy Technology Data Exchange (ETDEWEB)

    Arvizu, Dan; Bruckner, Thomas; Christensen, John; Devernay, Jean-Michel; Faaij , Andre; Fischedick, Manfred; Goldstein, Barry; Hansen, Gerrit; Huckerby , John; Jager-Waldau, Arnulf; Kadner, Susanne; Kammen, Daniel; Krey, Volker; Kumar, Arun; Lewis , Anthony; Lucon, Oswaldo; Matschoss, Patrick; Maurice, Lourdes; Mitchell , Catherine; Moomaw, William; Moreira, Jose; Nadai, Alain; Nilsson, Lars J.; Nyboer, John; Rahman, Atiq; Sathaye, Jayant; Sawin, Janet; Schaeffer, Roberto; Schei, Tormod; Schlomer, Steffen; Sims, Ralph; von Stechow, Christoph; Verbruggen, Aviel; Urama, Kevin; Wiser, Ryan; Yamba, Francis; Zwickel, Timm

    2011-05-08

    The Working Group III Special Report on Renewable Energy Sources and Climate Change Mitigation (SRREN) presents an assessment of the literature on the scientific, technological, environmental, economic and social aspects of the contribution of six renewable energy (RE) sources to the mitigation of climate change. It is intended to provide policy relevant information to governments, intergovernmental processes and other interested parties. This Summary for Policymakers provides an overview of the SRREN, summarizing the essential findings. The SRREN consists of 11 chapters. Chapter 1 sets the context for RE and climate change; Chapters 2 through 7 provide information on six RE technologies, and Chapters 8 through 11 address integrative issues.

  17. Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

    International Nuclear Information System (INIS)

    Simpson, Sarah; Mahoney, Mary; Harris, Elizabeth; Aldrich, Rosemary; Stewart-Williams, Jenny

    2005-01-01

    In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA

  18. A review of cyberbullying legislation in Qatar: Considerations for policy makers and educators.

    Science.gov (United States)

    Foody, Mairéad; Samara, Muthanna; El Asam, Aiman; Morsi, Hisham; Khattab, Azhar

    Cyberbullying is a worldwide problem affecting mental health, education, safety and general well-being for individuals across the globe. Despite the widespread availability of the Internet, research into prevalence rates of cyberbullying in Qatar is lacking and legislating for the crime has been slow to develop. Recently there have been some positive initiatives in the country such as a Cybercrime Prevention Law, the development of a National ICT Strategy, and a website detailing safe practice guidelines for Internet usage. However, the implementation and usage of these initiatives are still limited and there is a lack of awareness of cyberbullying in Qatar. As a result, the risk factors and consequences among school-aged children are unknown. The current paper presents an evaluation of the legislative and public policy solutions to cyberbullying available in Qatar, and outlines the critical challenges that could potentially face educators in shaping best practice guidelines for the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Jepson, Paul; Arakelyan, Irina

    2017-10-01

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

  20. Restructuring health services in Canada: challenges for policy makers, planners and managers in the eighties.

    Science.gov (United States)

    Crichton, A

    1985-11-01

    Is downsizing the latest jargon word applied to rationalization, a new concept or a different manifestation of a long term trend in health services management? At present, Canada is struggling to implement feasible reductions of expansionary pressures in the health care system. While provincial governments tend to see the issue as one of controlling chronic excess demand, federal government is still concerned to ensure free access to care on an equitable basis. Thus the problems of downsizing can be expressed by the provinces in terms of an ideological struggle with an unfeeling central government which does not understand their problems; although all know they are really about the feasibility of continuing to provide a service to meet demand. The present economic recession enables provincial governments to appeal to their voters for supporting a new way. Earlier, the appeal was to consumers to become involved in health service organization management and this policy succeeded, to a degree, where there were fluorishing grass roots communities; albeit that the service continued to be driven by professionals. Now the appeal is to taxpayers for their strong support in cost cutting. This has been more successful. Provincial governments are now permitted to 'touch the untouchables', that is to downsize the medical profession and previously sacrosanct health care institutions. They also are exploring the feasibility of introducing a two-tier system which would provide basic care for everyone and extra care for those able to pay, thus side-stepping federal conditions. By reorganizing support in this way, provincial governments have extended the range of policy choices, and two types of planning, the rational and the political, have now become combined into strategic management activity.

  1. Round Six Of Partners Investing In Nursing's Future: Implications For The Health Sector, Policy Makers, And Foundations.

    Science.gov (United States)

    Jellinek, Paul S; Reinhardt, Renee J; Ladden, Maryjoan D; Salmon, Marla E

    2015-07-01

    In its 2011 report on the future of nursing, the Institute of Medicine issued recommendations to position nursing to meet the challenges of twenty-first-century health care. Following release of the report, the Robert Wood Johnson Foundation funded eleven local and regional partnerships of nurses, foundations, and other stakeholders to begin implementing some of the recommendations in their regions. A qualitative evaluation of these partnerships found that although not all goals were met, most of the partnerships achieved meaningful gains. Partnership participants emphasized the value of engaging foundations and other stakeholders from outside nursing in the implementation process, the necessity of funding for implementation, the need for policy makers to address constraints that local and regional partnerships by themselves cannot address, and the unique leadership and convening role that local and regional foundations can play to help their regions respond to complex challenges for the nursing profession. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Health financing in Africa: overview of a dialogue among high level policy makers.

    Science.gov (United States)

    Sambo, Luis Gomes; Kirigia, Joses Muthuri; Ki-Zerbo, Georges

    2011-06-13

    Even though Africa has the highest disease burden compared with other regions, it has the lowest per capita spending on health. In 2007, 27 (51%) out the 53 countries spent less than US$50 per person on health. Almost 30% of the total health expenditure came from governments, 50% from private sources (of which 71% was from out-of-pocket payments by households) and 20% from donors. The purpose of this article is to reflect on the proceedings of the African Union Side Event on Health Financing in the African continent. Methods employed in the session included presentations, panel discussion and open public discussion with ministers of health and finance from the African continent. The current unsatisfactory state of health financing was attributed to lack of clear vision and plan for health financing; lack of national health accounts and other evidence to guide development and implementation of national health financing policies and strategies; low investments in sectors that address social determinants of health; predominance of out-of-pocket spending; underdeveloped prepaid health financing mechanisms; large informal sectors vis-à-vis small formal sectors; and unpredictability and non-alignment of majority of donor funds with national health priorities.Countries need to develop and adopt a comprehensive national health policy and a costed strategic plan; a comprehensive evidence-based health financing strategy; allocate at least 15% of the national budget to health development; use GFATM and PEPFAR funds for health systems strengthening; strengthen intersectoral collaboration to address health determinants; advocate among donors to implement the Paris Declaration on Aid Effectiveness and its Accra Agenda for Action; ensure universal access to health services for pregnant women, lactating mothers and children aged under five years; strengthen financial management capacities; and develop prepaid health financing systems, especially health insurance to complement tax

  3. Livestock-related greenhouse gas emissions: impacts and options for policy makers

    International Nuclear Information System (INIS)

    Garnett, Tara

    2009-01-01

    Research shows that livestock account for a significant proportion of greenhouse gas (GHG) emissions and global consumption of livestock products is growing rapidly. This paper reviews the life cycle analysis (LCA) approach to quantifying these emissions and argues that, given the dynamic complexity of our food system, it offers a limited understanding of livestock's GHG impacts. It is argued that LCA's conclusions need rather to be considered within a broader conceptual framework that incorporates three key additional perspectives. The first is an understanding of the indirect second order effects of livestock production on land use change and associated CO 2 emissions. The second compares the opportunity cost of using land and resources to rear animals with their use for other food or non-food purposes. The third perspective is need-the paper considers how far people need livestock products at all. These perspectives are used as lenses through which to explore both the impacts of livestock production and the mitigation approaches that are being proposed. The discussion is then broadened to consider whether it is possible to substantially reduce livestock emissions through technological measures alone, or whether reductions in livestock consumption will additionally be required. The paper argues for policy strategies that explicitly combine GHG mitigation with measures to improve food security and concludes with suggestions for further research.

  4. [The Intentions Affecting the Medical Decision-Making Behavior of Surrogate Decision Makers of Critically Ill Patients and Related Factors].

    Science.gov (United States)

    Su, Szu-Huei; Wu, Li-Min

    2018-04-01

    The severity of diseases and high mortality rates that typify the intensive care unit often make it difficult for surrogate decision makers to make decisions for critically ill patients regarding whether to continue medical treatments or to accept palliative care. To explore the behavioral intentions that underlie the medical decisions of surrogate decision makers of critically ill patients and the related factors. A cross-sectional, correlation study design was used. A total of 193 surrogate decision makers from six ICUs in a medical center in southern Taiwan were enrolled as participants. Three structured questionnaires were used, including a demographic datasheet, the Family Relationship Scale, and the Behavioral Intention of Medical Decisions Scale. Significantly positive correlations were found between the behavioral intentions underlying medical decisions and the following variables: the relationship of the participant to the patient (Eta = .343, p = .020), the age of the patient (r = .295, p medical decisions of the surrogate decision makers, explaining 13.9% of the total variance. In assessing the behavioral intentions underlying the medical decisions of surrogate decision makers, health providers should consider the relationship between critical patients and their surrogate decision makers, patient age, the length of ICU stay, and whether the patient has a pre-signed advance healthcare directive in order to maximize the effectiveness of medical care provided to critically ill patients.

  5. Frames of Reference: A Metaphor for Analyzing and Interpreting Attitudes of Environmental Policy Makers and Policy Influencers

    Science.gov (United States)

    Swaffield

    1998-07-01

    / The concept of frame of reference offers a potentially useful analytical metaphor in environmental management. This is illustrated by a case study in which attitudes of individuals involved in the management of trees in the New Zealand high country are classified into seven distinctive frames of reference. Some practical and theoretical implications of the use of the frame metaphor are explored, including its potential contribution to the emerg- ing field of communicative planning. KEY WORDS: Frames of reference; Environmental policy analysis; Metaphor; New Zealand high country

  6. Surrogate decision makers' perspectives on preventable breakdowns in care among critically ill patients: A qualitative study.

    Science.gov (United States)

    Fisher, Kimberly A; Ahmad, Sumera; Jackson, Madeline; Mazor, Kathleen M

    2016-10-01

    To describe surrogate decision makers' (SDMs) perspectives on preventable breakdowns in care among critically ill patients. We screened 70 SDMs of critically ill patients for those who identified a preventable breakdown in care, defined as an event where the SDM believes something "went wrong", that could have been prevented, and resulted in harm. In-depth interviews were conducted with SDMs who identified an eligible event. 32 of 70 participants (46%) identified at least one preventable breakdown in care, with a total of 75 discrete events. Types of breakdowns involved medical care (n=52), communication (n=59), and both (n=40). Four additional breakdowns were related to problems with SDM bedside access to the patient. Adverse consequences of breakdowns included physical harm, need for additional medical care, emotional distress, pain, suffering, loss of trust, life disruption, impaired decision making, and financial expense. 28 of 32 SDMs raised their concerns with clinicians, yet only 25% were satisfactorily addressed. SDMs of critically ill patients frequently identify preventable breakdowns in care which result in harm. An in-depth understanding of the types of events SDMs find problematic and the associated harms is an important step towards improving the safety and patient-centeredness of healthcare. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. The challenges of working in underserved areas: a qualitative exploratory study of views of policy makers and professionals.

    Science.gov (United States)

    AbuAlRub, Raeda F; El-Jardali, Fadi; Jamal, Diana; Iblasi, Abdulkareem S; Murray, Susan F

    2013-01-01

    The inadequate number of health care providers, particularly nurses, in underserved areas is one of the biggest challenges for health policymakers. There is a scarcity of research in Jordan about factors that affect nurse staffing and retention in underserved areas. To elucidate the views of staff nurses working in underserved areas, directors of health facilities in underserved areas and key informants from the policy and education arena on issues of staffing and retention of nurses in underserved areas. An exploratory study using a qualitative approach with semi-structured interviews was utilized to elucidate the views of 22 key informants from the policy and education arena, 11 directors of health centers, and 19 staff nurses on issues that contribute to low staffing and retention of nurses in underserved areas. The five stage 'framework approach' proposed by Bryman et al. (1993) was utilized for data analysis. Nursing shortage in underserved areas in Jordan are exacerbated by a lack of financial incentives, poor transportation and remoteness of these areas, bad working conditions, and lack of health education institutions in these areas, as well as by opportunities for internal and external migration. Young Jordanian male nurses usually grab any opportunity to migrate and work outside the country to improve their financial conditions; whereas, female nurses are more restricted and not encouraged to travel abroad to work. Several strategies are suggested to enhance retention in these areas, such as promoting financial incentives for staff to work there, enhancing the transportation system, and promoting continuous and academic education. Nurses' administrators and health care policy makers could utilize the findings of the present study to design and implement comprehensive interventions to enhance retention of staff in underserved areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Development of an interactive interface to raise awareness of public, policy makers, and practitioners about natural hazards.

    Science.gov (United States)

    Gordova, Yulia; Gordov, Evgeny; Okladnikov, Igor; Titov, Alexander

    2017-04-01

    used for undergraduate and graduate students training. In addition, the system capabilities allow creating information resources to raise public awareness about climate change, its causes and consequences, which is a necessary step for the subsequent adaptation to these changes. "Climate" allows climatologists, specialists in related fields, decision-makers, stakeholders and the public use a variety of geographically distributed spatially-referenced data, resources and processing services via a web-browser. Currently, an interactive System User Manual for decision-makers is developed. It contains not only the information needed to use the system and perform practical tasks, but also the basic concepts explained in detail. The knowledge necessary for understanding the causes and possible consequences of the processes is given. The results of implementation of practical tasks are available not only in the form of color surface maps, but also on the Internet and in the form of layers for most GIS. Thus these layers can be used in usual desktop GIS which is a common software for most of decision-makers. Thus, this manual helps to prepare qualified users, which in the future will be able to determine the policy of the region to adapt to climate change impacts and hazards. The work is supported by Russian Science Foundation grant № 16-19-10257.

  9. The domestic supply outlook, how the producing industry is reacting, and the challenge to regulators and policy makers

    International Nuclear Information System (INIS)

    Jordan, C.A.

    1992-01-01

    This paper addresses three main topics which include an overview of the nation's natural gas reserves; a discussion of the challenges the natural gas industry faces in extracting these reserves in the realm of regulations and cost-effective extraction; and a discussion on how the industry, regulators, and policy makers can work together to extract these reserves in an economic manner while effectively operating within existing regulations. The paper also promotes methods to update and change regulations when necessary as a result of technological change or advancement. The results of the reserve study have shown that there are over 2,000 trillion cubic feet of natural gas still available in the US and Canada, not including undiscovered or additional extraction brought about by new technology. The paper goes on to discuss the historical wellhead pricing of natural gas and what these new reserve figures mean to future natural gas costs. The paper then discusses the adequacy of current distribution systems to meet an increasing demand for natural gas. Finally the paper discusses the need for more deregulation of the gas industry to make it more competitive and keep the development of these resources alive in this country. The author presents information on the decline of exploration and development in this country as a result of increased regulation

  10. Vocations: The Link between Post-Compulsory Education and the Labour Market. What the Research Says For... Government & Policy-Makers

    Science.gov (United States)

    Wheelahan, Leesa; Buchanan, John; Yu, Serena

    2015-01-01

    This summary brings together the relevant key findings for government and policy-makers from the research program "Vocations: The Link between Post-Compulsory Education and the Labour Market." The program was comprised of three different strands: (1) pathways from VET in Schools, (2) pathways within and between vocational education and…

  11. Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review

    Directory of Open Access Journals (Sweden)

    Roxanne Keynejad

    2016-10-01

    Full Text Available Abstract Background Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs. We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. Methods We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review. Results Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. Conclusions This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed

  12. Games policy makers and providers play: introducing case-mix-based payment to hospital chronic care units in Japan.

    Science.gov (United States)

    Ikegami, Naoki

    2009-06-01

    Case-mix-based payment was developed for hospital chronic care units in Japan to replace the flat per diem rate and encourage the admission of patients with higher medical acuity and was part of a policy initiative to make the tariff more evidence based. However, although the criteria for grouping patients were developed from a statistical analysis of resource use, the tariff was subsequently set below costs, particularly for the groups with the lowest medical acuity, both because of the prime minister's decision to decrease total health expenditures and because of the health ministry's decision to target the reductions on chronic care units. Providers quickly adapted to the new payment system mainly by reclassifying their patients to higher medical acuity groups. Some hospitals reported high prevalence rates of urinary tract infections and pressure ulcers. The government responded by issuing directives to providers to calculate the prevalence rates and document the care that has been mandated for the patients at risk. However, in order to monitor compliance and to evaluate whether the patient is being billed for the appropriate case-mix group, the government must invest in developing a comprehensive patient-level database and in training staff for making on-site inspections.

  13. Joint research project to develop a training course or nuclear policy decision makers and planners in developing countries between KAERI and IAEA

    Energy Technology Data Exchange (ETDEWEB)

    Lee, E. J.; Suh, I. S.; Lee, H. Y. and others

    2000-12-01

    KAERI developed training course curricula on nuclear power policy and planning for decision makers and planners in developing countries under the assistance of the IAEA. It was utilized two IAEA staff members and a Korean consultation group were utilized for the development of curricula. Curriculum consists of training objectives, training contents in modular basis, detailed contents of each training module, training setting, training duration, session hours, and entry requirements of audience. One is workshop on nuclear energy policy for high-level decision makers in developing countries. The other is training course on nuclear power planning and project management for middle level managers in developing countries. The textbook in English will be printed by the end of February in 2001. Developed curricula will be implemented for Vietnam high level nuclear decision makers, middle level managers in developing countries and north Korea nuclear high level decision makers in 2001. These training courses' curricula and textbook will be utilized as basic technical documents to promote the national nuclear bilateral technical cooperation programs with Morocco, Egypt, Bangladesh, Indonesia, Ukraine, etc.

  14. Joint research project to develop a training course or nuclear policy decision makers and planners in developing countries between KAERI and IAEA

    International Nuclear Information System (INIS)

    Lee, E. J.; Suh, I. S.; Lee, H. Y. and others

    2000-12-01

    KAERI developed training course curricula on nuclear power policy and planning for decision makers and planners in developing countries under the assistance of the IAEA. It was utilized two IAEA staff members and a Korean consultation group were utilized for the development of curricula. Curriculum consists of training objectives, training contents in modular basis, detailed contents of each training module, training setting, training duration, session hours, and entry requirements of audience. One is workshop on nuclear energy policy for high-level decision makers in developing countries. The other is training course on nuclear power planning and project management for middle level managers in developing countries. The textbook in English will be printed by the end of February in 2001. Developed curricula will be implemented for Vietnam high level nuclear decision makers, middle level managers in developing countries and north Korea nuclear high level decision makers in 2001. These training courses' curricula and textbook will be utilized as basic technical documents to promote the national nuclear bilateral technical cooperation programs with Morocco, Egypt, Bangladesh, Indonesia, Ukraine, etc

  15. Implications for alcohol minimum unit pricing advocacy: what can we learn for public health from UK newsprint coverage of key claim-makers in the policy debate?

    Science.gov (United States)

    Hilton, Shona; Wood, Karen; Patterson, Chris; Katikireddi, Srinivasa Vittal

    2014-02-01

    On May 24th 2012, Scotland passed the Alcohol (Minimum Pricing) Bill. Minimum unit pricing (MUP) is an intervention that raises the price of the cheapest alcohol to reduce alcohol consumption and related harms. There is a growing literature on industry's influence in policymaking and media representations of policies, but relatively little about frames used by key claim-makers in the public MUP policy debate. This study elucidates the dynamic interplay between key claim-makers to identify lessons for policy advocacy in the media in the UK and internationally. Content analysis was conducted on 262 articles from seven UK and three Scottish national newspapers between 1st May 2011 and 31st May 2012, retrieved from electronic databases. Advocates' and critics' constructions of the alcohol problem and MUP were examined. Advocates depicted the problem as primarily driven by cheap alcohol and marketing, while critics' constructions focused on youth binge drinkers and dependent drinkers. Advocates justified support by citing the intervention's targeted design, but critics denounced the policy as illegal, likely to encourage illicit trade, unsupported by evidence and likely to be ineffective, while harming the responsible majority, low-income consumers and businesses. Critics' arguments were consistent over time, and single statements often encompassed multiple rationales. This study presents advocates with several important lessons for promoting policies in the media. Firstly, it may be useful to shift focus away from young binge drinkers and heavy drinkers, towards population-level over-consumption. Secondly, advocates might focus on presenting the policy as part of a wider package of alcohol policies. Thirdly, emphasis on the success of recent public health policies could help portray the UK and Scotland as world leaders in tackling culturally embedded health and social problems through policy; highlighting past successes when presenting future policies may be a valuable

  16. Renewables 2016 Global Status Report. Key findings. A Record Breaking Year for Renewable Energy: New Installations, Policy Targets, Investment and Jobs. Mainstreaming renewables: guidance for policy makers

    International Nuclear Information System (INIS)

    Sawin, Janet L.; Sverrisson, Freyr; Seyboth, Kristin; Adib, Rana; Murdock, Hannah E.; Lins, Christine; Brown, Adam; Di Domenico, Stefanie E.; Kielmanowicz, Daniele; Williamson, Laura E.; Jawahar, Rashmi; Appavou, Fabiani; Musolino, Evan; Petrichenko, Ksenia; Farrell, Timothy C.; Thorsch Krader, Thomas; Skeen, Jonathan; Epp, Baerbel; Anna Leidreiter; Tsakiris, Aristeidis; Sovacool, Benjamin; Saraph, Aarth; Mastny, Lisa; Martinot, Eric

    2016-01-01

    2015 was an extraordinary year for renewable energy. Renewables are now cost competitive with fossil fuels in many markets and are established around the world as mainstream sources of energy. Cities, communities and companies are leading the rapidly expanding '100% renewable' movement. Distributed renewable energy is advancing rapidly to close the energy access gap. The REN21 Renewables Global Status Report (GSR) provides an annual look at the tremendous advances in renewable energy markets, policy frameworks and industries globally. Each report uses formal and informal data to provide the most up-to-date information available. Reliable, timely and regularly updated data on renewables energy are essential as they are used for establishing baselines for decision makers; for demonstrating the increasing role that renewables play in the energy sector; and illustrating that the renewable energy transition is a reality. This year's GSR marks 11 years of REN21 reporting. Over the past decade the GSR has expanded in scope and depth with its thematic and regional coverage and the refinement of data collection. The GSR is the product of systematic data collection resulting in thousands of data points, the use of hundreds of documents, and personal communication with experts from around the world. It benefits from a multi-stakeholder community of over 700 experts. Country information for 148 countries were received and used as basis for GSR2016 preparation. The country data received is featured in the REN21 Renewables Interactive Map (www.ren21.net/map)

  17. Assessment of policy makers' individual and organizational capacity to acquire, assess, adapt and apply research evidence for maternal and child health policy making in Nigeria: a cross-sectional quantitative survey.

    Science.gov (United States)

    Uneke, Chigozie Jesse; Sombie, Issiaka; Keita, Namoudou; Lokossou, Virgil; Johnson, Ermel; Ongolo-Zogo, Pierre; Uro-Chukwu, Henry Chukwuemeka

    2017-09-01

    Throughout the world, there is increasing awareness and acknowledgement of the value of research evidence in the development of effective health policy and in quality health care practice and administration. Among the major challenges associated with the lack of uptake of research evidence into policy and practice in Nigeria is the capacity constraints of policymakers to use research evidence in policy making. To assess the capacity of maternal and child health policy makers to acquire, access, adapt and apply available research evidence. This cross-sectional quantitative survey was conducted at a national maternal, newborn and child health (MNCH) stakeholders' engagement event. An evidence to policy self-assessment questionnaire was used to assess the capacity of forty MNCH policy makers to acquire, assess, adapt and apply research evidence for policy making. Low mean ratings were observed ranging from 2.68-3.53 on a scale of 5 for knowledge about initiating/conducting research and capacity to assess authenticity, validity, reliability, relevance and applicability of research evidence and for organizational capacity for promoting and using of research for policy making. There is need to institute policy makers' capacity development programmes to improve evidence-informed policymaking.

  18. Solar Photovoltaic Energy Policy in Europe: Losing Sight of What is Right. Current Developments and Lessons Learned for Policy-makers and Industry

    International Nuclear Information System (INIS)

    Cherrelle, Eid

    2012-01-01

    interesting to examine China and the United States in regard to PV manufacturing and installation capacity. China may be characterized by its high and early PV production, exporting almost 90% of its output. What will this and other developments mean for European PV industry and job creation? At present, the deployment of PV is under much discussion in many countries, within and outside of Europe. Changes in Feed-in-Tariffs (FIT) are following each other closely and motivations behind deployment are presently frequently discussed in the political sphere. Still, there are important points to consider. What are the costs of PV? How are the costs expected to decrease and how effective are current policies concerning PV penetration? Are these policies also effective in eventually reaching the CO 2 reduction targets? PV technologies are still developing and it is important to not be moved by assumptions on efficiencies or effectiveness of the technology. The aim of this report is to provide recommendations for the debate concerning PV deployment in Europe and to provide suggestions for both policy-makers and industry in- and outside of Europe. This is done by analyzing the main developments related to PV worldwide. The report will furthermore present technical developments of PV and will present a comparison in the international context with US and Asia. In Section 2, the position of PV policy is given within the EU renewable projections for 2020. Before continuing with the support policies for PV in Section 4, the main developments in PV technologies with definitions are provided in Section 3. Afterwards, case studies of the five major European countries with the largest European installed capacities in PV are presented with their efforts and policies associated to PV in Section 5. In Section 6, an evaluation of the European Policy is presented, after which a brief review of the US and China and their PV industries is given with their policy incentives to increase PV installation

  19. Nuclear Belief Systems and Individual Policy-Makers: Duncan Sandys, Unmanned Weaponry, and the Impossibility of Defence

    OpenAIRE

    Betts, Lewis

    2014-01-01

    This thesis attempts to explore the influence that Duncan Sandys' experiences of the Second World War had on his policy preferences, and policy-making, in relation to British defence policy during his years in government. This is a significant period in British nuclear policy which began with thermonuclear weaponry being placed ostentatiously at the centre of British defence planning in the 1957 Defence White Paper, and ended with the British acquiring the latest American nuclear weapon techn...

  20. Gaining Momentum: How Media Influences Public Opinion To Push Civil-Military Decision Makers Into Formulating Foreign Policy

    Science.gov (United States)

    2016-02-09

    1 AIR WAR COLLEGE AIR UNIVERSITY GAINING MOMENTUM: HOW MEDIA INFLUENCES PUBLIC OPINION TO PUSH CIVIL-MILITARY DECISION MAKERS INTO...engagements from the past, evidence suggest the media or press does have an influence over public opinion, especially during times of war and humanitarian...changes and that leaders must take into consideration that public opinion and the media may provide a large amount of influence over how the nation

  1. 'A preferred consultant and partner to the Royal Government, NGOs, and the community': British American Tobacco's access to policy-makers in Cambodia.

    Science.gov (United States)

    MacKenzie, Ross; Collin, Jeff

    2017-04-01

    British American Tobacco Cambodia (BATC) has dominated the country's tobacco market since its launch in 1996. Aggressive marketing in a weak regulatory environment and strategies to influence tobacco control policy have contributed to an emerging tobacco-related public health crisis. Analysis of internal tobacco industry documents, issues of BATC's in-house newsletter, civil society reports and media demonstrate that BATC officials have successfully sought to align the company with Cambodia's increasingly controversial political and business leadership that is centred around the Cambodian People's Party with the aim of gaining access to policy-makers and influencing the policy process. Connections to the political elite have resulted in official recognition of the company's ostensible contribution to Cambodia's economic and social development and, more significantly, provided BATC with opportunities to petition policy-makers and to dilute tobacco control regulation. Corporate promotion of its contribution to Cambodia's economic and social development is at odds with its determined efforts to thwart public health regulation and Cambodia's compliance with the Framework Convention on Tobacco Control.

  2. National health policy-makers' views on the clarity and utility of Countdown to 2015 country profiles and reports: findings from two exploratory qualitative studies.

    Science.gov (United States)

    Hunter, Benjamin M; Requejo, Jennifer H; Pope, Ian; Daelmans, Bernadette; Murray, Susan F

    2014-08-15

    The use of sets of indicators to assess progress has become commonplace in the global health arena. Exploratory research has suggested that indicators used for global monitoring purposes can play a role in national policy-making, however, the mechanisms through which this occurs are poorly understood. This article reports findings from two qualitative studies that aimed to explore national policy-makers' interpretation and use of indicators from country profiles and reports developed by Countdown to 2015. An initial study aimed at exploring comprehension of Countdown data was conducted at the 2010 joint Women Deliver/Countdown conference. A second study was conducted at the 64th World Health Assembly in 2011, specifically targeting national policy-makers. Semi-structured interviews were carried out with 29 and 22 participants, respectively, at each event. Participants were asked about their understanding of specific graphs and indicators used or proposed for use in Countdown country profiles, and their perception of how such data can inform national policy-making. Responses were categorised using a framework analysis. Respondents in both studies acknowledged the importance of the profiles for tracking progress on key health indicators in and across countries, noting that they could be used to highlight changes in coverage, possible directions for future policy, for lobbying finance ministers to increase resources for health, and to stimulate competition between neighbouring or socioeconomically similar countries. However, some respondents raised questions about discrepancies between global estimates and data produced by national governments, and some struggled to understand the profile graphs shown in the absence of explanatory text. Some respondents reported that use of Countdown data in national policy-making was constrained by limited awareness of the initiative, insufficient detail in the country profiles to inform policy, and the absence of indicators felt to

  3. Characteristics and use of urban health indicator tools by municipal built environment policy and decision-makers: a systematic review protocol.

    Science.gov (United States)

    Pineo, Helen; Glonti, Ketevan; Rutter, Harry; Zimmermann, Nicole; Wilkinson, Paul; Davies, Michael

    2017-01-13

    There is wide agreement that there is a lack of attention to health in municipal environmental policy-making, such as urban planning and regeneration. Explanations for this include differing professional norms between health and urban environment professionals, system complexity and limited evidence for causality between attributes of the built environment and health outcomes. Data from urban health indicator (UHI) tools are potentially a valuable form of evidence for local government policy and decision-makers. Although many UHI tools have been specifically developed to inform policy, there is poor understanding of how they are used. This study aims to identify the nature and characteristics of UHI tools and their use by municipal built environment policy and decision-makers. Health and social sciences databases (ASSIA, Campbell Library, EMBASE, MEDLINE, Scopus, Social Policy and Practice and Web of Science Core Collection) will be searched for studies using UHI tools alongside hand-searching of key journals and citation searches of included studies. Advanced searches of practitioner websites and Google will also be used to find grey literature. Search results will be screened for UHI tools, and for studies which report on or evaluate the use of such tools. Data about UHI tools will be extracted to compile a census and taxonomy of existing tools based on their specific characteristics and purpose. In addition, qualitative and quantitative studies about the use of these tools will be appraised using quality appraisal tools produced by the UK National Institute for Health and Care Excellence (NICE) and synthesised in order to gain insight into the perceptions, value and use of UHI tools in the municipal built environment policy and decision-making process. This review is not registered with PROSPERO. This systematic review focuses specifically on UHI tools that assess the physical environment's impact on health (such as transport, housing, air quality and greenspace

  4. Adolescent pregnancies and girls' sexual and reproductive rights in the amazon basin of Ecuador: an analysis of providers' and policy makers' discourses

    Directory of Open Access Journals (Sweden)

    Sebastian Miguel

    2010-06-01

    Full Text Available Abstract Background Adolescent pregnancies are a common phenomenon that can have both positive and negative consequences. The rights framework allows us to explore adolescent pregnancies not just as isolated events, but in relation to girls' sexual and reproductive freedom and their entitlement to a system of health protection that includes both health services and the so called social determinants of health. The aim of this study was to explore policy makers' and service providers' discourses concerning adolescent pregnancies, and discuss the consequences that those discourses have for the exercise of girls' sexual and reproductive rights' in the province of Orellana, located in the amazon basin of Ecuador. Methods We held six focus-group discussions and eleven in-depth interviews with 41 Orellana's service providers and policy makers. Interviews were transcribed and analyzed using discourse analysis, specifically looking for interpretative repertoires. Results Four interpretative repertoires emerged from the interviews. The first repertoire identified was "sex is not for fun" and reflected a moralistic construction of girls' sexual and reproductive health that emphasized abstinence, and sent contradictory messages regarding contraceptive use. The second repertoire -"gendered sexuality and parenthood"-constructed women as sexually uninterested and responsible mothers, while men were constructed as sexually driven and unreliable. The third repertoire was "professionalizing adolescent pregnancies" and lead to patronizing attitudes towards adolescents and disregard of the importance of non-medical expertise. The final repertoire -"idealization of traditional family"-constructed family as the proper space for the raising of adolescents while at the same time acknowledging that sexual abuse and violence within families was common. Conclusions Providers' and policy makers' repertoires determined the areas that the array of sexual and reproductive

  5. The Virtual Environmental Microbiology Center - A Social Network for Enhanced Communication between Water Researchers and Policy Makers

    Science.gov (United States)

    Effective communication within and between organizations involved in research and policy making activities is essential. Sharing information across organizational and geographic boundaries can also facilitate coordination and collaboration, promote a better understanding of tech...

  6. “Have policy makers erred?” Implications of mother tongue education for preprimary schooling in Uganda

    Directory of Open Access Journals (Sweden)

    Ssentanda, Medadi Erisa

    2014-12-01

    Full Text Available The Uganda language-in-education policy is silent about pre-primary schooling. This level of education is largely in the hands of private individuals who, because of wide-spread misconceptions about learning and acquiring English in Uganda (as in many other African countries, instruct pre-primary school learners in English. This article demonstrates how this omission in language-in-education policy is creating competition between rural government and private schools regarding the teaching of English and the development of initial literacy. The absence of an official language policy for pre-primary schooling has also dichotomised the implementation of mother tongue education in rural areas. The policy allows rural primary schools to use mother tongue as language of learning and teaching in the first three school grades. However, whereas private schools instruct through English only, government schools to a large extent adhere to the policy, albeit with undesirable consequences. The practical implications of lack of a language-in-education policy for and minimal government involvement in pre-primary schooling are discussed in this article.

  7. Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists.

    Science.gov (United States)

    Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott

    2012-01-01

    The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to

  8. Attitudes of policy makers in Hawaii towards public health and related issues before and after an economic recession in the United States

    Directory of Open Access Journals (Sweden)

    Jay E Maddock

    2015-05-01

    Full Text Available Legislation and regulation at the state and local level can often have a greater impact on the public’s health than individual-based approaches. Elected and appointed officials have an essential role in protecting and improving public health. Despite this important role, little systematic research has been done to assess the relative importance of public health issues compared to other policy issues in times of economic hardship. This study assessed attitudes of elected and appointed decision makers in Hawaii in 2007 and 2013 to determine if priorities differed before and after the economic recession. Methods: Elected and appointed state and county officials were mailed surveys at both time points. Respondents rated the importance of 23 specified problems, of which 9 asked about specific public health issues. Results: The survey was completed by 126 (70.4% respondents in 2007 and 117(60.9% in 2013. Among the public health issues, five saw significant mean decreases. These variables included: climate change, pedestrian safety, government response to natural disasters, access to healthcare, and pandemic influenza. Obesity was the only public health issue to increase in importance across the two time points. In terms of relative ranking across the time points, only drug abuse and obesity were among the top ten priorities. Lack of public health training, pandemic influenza, and government response to natural disasters were among the bottom five priorities. Conclusions: After the economic recession, many public health issues have a lower priority among Hawaii’s policy makers than before the downturn. Additional education and advocacy is needed to keep public health issues on the minds of decision makers during tough economic times.

  9. Public Acceptance on Nuclear Power: A Strategic Need to Shift to 5Ps (Politicians, Policy Makers, Professionals, Public and Press) Acceptance on Nuclear Power

    International Nuclear Information System (INIS)

    Dato Syed Ahmad Idid, S.N. K. A.-I.

    2015-01-01

    Business should not be as usual in formulating strategies and plans to enhance awareness regarding the benefits of nuclear power as an option for energy mix. Although, presently 435 nuclear power reactors in operation in 30 countries are delivering cost competitive electricity to consumers, creating significant job, investment and business opportunities, supporting enterprises, contributing significantly to these nations economic growth, however these positive impacts and benefits have not be sufficiently transmitted to the various stakeholders and population, who have until recently only received unbalanced views and news from an uninformed press. Negative and generally unbalanced press coverage of isolated nuclear incidents and accidents such as TMI, Chernobyl and most recently Fukushima has resulted in public protests to nuclear power, contributing to several nuclear power programmes being delayed or not able to take off. This situation is further exacerbated by uninformed politicians and policy makers who have the influence but were not able to harness their positions to assure the public due to lack of knowledge regarding the economic and social benefits of nuclear power. As the challenges to the nuclear industry presently also include ageing nuclear professionals, lack of updates regarding business and financing opportunities to business and financing professionals, thus the benefits of career, business and financing opportunities must also be disseminated to these Professionals. This paper aims to highlight the fundamental need to expand present Public Awareness Programme to become the 5Ps (Politicians, Policy makers, Professionals, Public and Press) Awareness Programme on Nuclear Power. (author)

  10. Making health system performance measurement useful to policy makers: aligning strategies, measurement and local health system accountability in ontario

    NARCIS (Netherlands)

    Veillard, Jeremy; Huynh, Tai; Ardal, Sten; Kadandale, Sowmya; Klazinga, Niek S.; Brown, Adalsteinn D.

    2010-01-01

    This study examined the experience of the Ontario Ministry of Health and Long-Term Care in enhancing its stewardship and performance management role by developing a health system strategy map and a strategy-based scorecard through a process of policy reviews and expert consultations, and linking

  11. Middlemen and Midwives of Reform: The In-Between Worlds of Albanian Educational Policy-Makers and Professionals

    Science.gov (United States)

    Gardinier, Meg P.

    2015-01-01

    Based on a vertical case study in post-communist Albania, this article examines how three local experts become "in-betweens" who strategically mediate processes of social change. For example, they negotiate constructions of time and place, East and West, policy and practice, state and society. As they localise global educational models,…

  12. Towards an adaptation action plan : climate change and health in the Toronto-Niagara region : summary for policy makers

    International Nuclear Information System (INIS)

    Chiotti, Q.; Morton, I.; Maarouf, A.

    2002-10-01

    The current science regarding climate change and its potential health effects was assessed in an effort to provide information to decision-makers dealing with health infrastructure in the Toronto-Niagara region. This report also presents an assessment of how the health care system can adapt to handle the increased demand for services resulting from the projected negative human health effects of climate change. The first part of the report presents some background information on climate change and health issues and demonstrates how the current health care infrastructure cannot deal effectively with the full range of health effects that may occur in heavily populated areas such as the Toronto-Niagara region. The second part of the report summarizes the scientific knowledge about the expected impacts of climate change and associated health effects, such as heat stress, extreme weather events, poor air quality, vector-borne diseases, food and water-borne diseases, and increased exposure to ultra-violet radiation. It was noted that children and the elderly are most vulnerable. The final part of the report outlines an adaptation action plan to improve the health care infrastructure through public education and communication, surveillance and monitoring, ecosystem intervention, infrastructure development, technical engineering, and medical intervention. 100 refs., 1 fig

  13. Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators.

    Science.gov (United States)

    Wildman, John; McMeekin, Peter; Grieve, Eleanor; Briggs, Andrew

    2016-11-01

    With an ageing population there is a move towards the use of assisted living technologies (ALTs) to provide social care and health care services, and to improve service processes. These technologies are at the forefront of the integration of health and social care. However, economic evaluations of ALTs, and indeed economic evaluations of any interventions providing both health benefits and benefits beyond health are complex. This paper considers the challenges faced by evaluators and presents a method of economic evaluation for use with interventions where traditional methods may not be suitable for informing funders and decision makers. We propose a method, combining economic evaluation techniques, that can accommodate health outcomes and outcomes beyond health through the use of a common numeraire. Such economic evaluations can benefit both the public and private sector, firstly by ensuring the efficient allocation of resources. And secondly, by providing information for individuals who, in the market for ALTs, face consumption decisions that are infrequent and for which there may be no other sources of information. We consider these issues in the welfarist, extra-welfarist and capabilities frameworks, which we link to attributes in an individual production model. This approach allows for the valuation of the health component of any such intervention and the valuation of key social care attributes and processes. Finally, we present a set of considerations for evaluators highlighting the key issues that need to be considered in this type of economic evaluation. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  14. The (Mis)understanding of Scientific Uncertainty? How Experts View Policy-Makers, the Media and Publics

    OpenAIRE

    Landstrom, Catharina; Hauxwell-Baldwin, Richard; Lorenzoni, Irene; Rogers-Hayden, Tee

    2015-01-01

    Frequent claims that publics ‘misunderstand’ science ignore the contested definition of scientific uncertainty itself. Scientific uncertainty means different things in the natural sciences, social sciences and the humanities, while public controversies show that these interpretations of scientific uncertainty have different implications for policy and decision-making. This prompts analysis of the ways that experts view scientific uncertainty and how they characterise the (mis)understandings o...

  15. 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.

  16. Marketing Authorization Procedures for Advanced Cancer Drugs: Exploring the Views of Patients, Oncologists, Healthcare Decision Makers, and Citizens in France.

    Science.gov (United States)

    Protiére, Christel; Baker, Rachel; Genre, Dominique; Goncalves, Anthony; Viens, Patrice

    2017-07-01

    The past decades have seen advances in cancer treatments in terms of toxicity and side effects but progress in the treatment of advanced cancer has been modest. New drugs have emerged improving progression free survival but with little impact on overall survival, raising questions about the criteria on which to base decisions to grant marketing authorizations and about the authorization procedure itself. For decisions to be fair, transparent and accountable, it is necessary to consider the views of those with relevant expertise and experience. We conducted a Q-study to explore the views of a range of stakeholders in France, involving: 54 patients (18 months after diagnosis); 50 members of the general population; 27 oncologists; 19 healthcare decision makers; and 2 individuals from the pharmaceutical industry. Three viewpoints emerged, focussing on different dimensions entitled: 1) 'Quality of life (QoL), opportunity cost and participative democracy'; 2)'QoL and patient-centeredness'; and 3) 'Length of life'. Respondents from all groups were associated with each viewpoint, except for healthcare decision makers, who were only associated with the first one. Our results highlight plurality in the views of stakeholders, emphasize the need for transparency in decision making processes, and illustrate the importance of a re-evaluation of treatments for all 3 viewpoints. In the context of advanced cancer, our results suggest that QoL should be more prominent amongst authorization criteria, as it is a concern for 2 of the 3 viewpoints.

  17. Experimentation at the interface of science and policy : a multi-case analysis of how policy experiments influence political decision-makers

    NARCIS (Netherlands)

    McFadgen, Belinda; Huitema, Dave

    2017-01-01

    For decades now, scholars have grappled with questions about how knowledge producers can enhance the influence of their knowledge on users and improve policy making. However, little attention has been paid to how policy experiments, a flexible and ex ante method of policy appraisal, obtain influence

  18. Why Do Policy-Makers Adopt Global Education Policies? Toward a Research Framework on the Varying Role of Ideas in Education Reform

    Science.gov (United States)

    Verger, Antoni

    2014-01-01

    Globalization is profoundly altering the education policy landscape. It introduces new problems in education agendas, compresses time and space in policy processes, and revitalizes the role of a range of supra-national players in educational reform. This deterritorialization of the education policy process has important theoretical and…

  19. Pizza makers' contact dermatitis.

    Science.gov (United States)

    Lembo, Serena; Lembo, Claudio; Patruno, Cataldo; Balato, Anna; Balato, Nicola; Ayala, Fabio

    2014-01-01

    Contact eczema to foods, spices, and food additives can occur in occupational and nonoccupational settings in those who grow, handle, prepare, or cook food. Pizza is one of the most eaten foods in every continent, and pizza making is a common work in many countries. We aimed to evaluate the occurrence and the causes of contact dermatitis in pizza makers in Naples. We performed an observational study in 45 pizza makers: all the enrolled subjects had to answer a questionnaire designed to detect personal history of respiratory or cutaneous allergy, atopy; work characteristics and timing were also investigated. Every subject attended the dermatology clinic for a complete skin examination, and when needed, patients were patch tested using the Italian baseline series of haptens integrated with an arbitrary pizza makers series. Our results reported that 13.3% of the enrolled pizza makers (6/45) presented hand eczema, and that 8.9% (4/45) were affected by occupational allergic contact dermatitis. Diallyl disulfide and ammonium persulfate were the responsible substances. Performing patch tests in pizza makers and food handlers affected by hand contact dermatitis is useful. We propose a specific series of haptens for this wide working category.

  20. Public health benefits of strategies to reduce greenhouse-gas emissions: overview and implications for policy makers.

    Science.gov (United States)

    Haines, Andy; McMichael, Anthony J; Smith, Kirk R; Roberts, Ian; Woodcock, James; Markandya, Anil; Armstrong, Ben G; Campbell-Lendrum, Diarmid; Dangour, Alan D; Davies, Michael; Bruce, Nigel; Tonne, Cathryn; Barrett, Mark; Wilkinson, Paul

    2009-12-19

    This Series has examined the health implications of policies aimed at tackling climate change. Assessments of mitigation strategies in four domains-household energy, transport, food and agriculture, and electricity generation-suggest an important message: that actions to reduce greenhouse-gas emissions often, although not always, entail net benefits for health. In some cases, the potential benefits seem to be substantial. This evidence provides an additional and immediate rationale for reductions in greenhouse-gas emissions beyond that of climate change mitigation alone. Climate change is an increasing and evolving threat to the health of populations worldwide. At the same time, major public health burdens remain in many regions. Climate change therefore adds further urgency to the task of addressing international health priorities, such as the UN Millennium Development Goals. Recognition that mitigation strategies can have substantial benefits for both health and climate protection offers the possibility of policy choices that are potentially both more cost effective and socially attractive than are those that address these priorities independently. Copyright 2009 Elsevier Ltd. All rights reserved.

  1. Children's knowledge of packaged and fast food brands and their BMI. Why the relationship matters for policy makers.

    Science.gov (United States)

    Cornwell, T Bettina; McAlister, Anna R; Polmear-Swendris, Nancy

    2014-10-01

    Studies regarding the advancing challenges of obesity in many countries are beginning to converge on the importance of early food exposure and consumption patterns. Across two studies (Study 1, 34 boys, 35 girls; Study 2, 40 boys, 35 girls, ages 3-6), child knowledge of brands offering products high in sugar, salt and fat was shown to be a significant predictor of child BMI, even after controlling for their age and gender and when also considering the extent of their TV viewing. Additionally, two different collage measures of brand knowledge (utilized across the two studies) performed similarly, suggesting that this measure may be serving as a surrogate indicator of an overall pattern of product exposure and consumption. Policy implications are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Views of policy makers and health promotion professionals on factors facilitating implementation and maintenance of interventions and policies promoting physical activity and healthy eating: results of the DEDIPAC project.

    Science.gov (United States)

    Muellmann, Saskia; Steenbock, Berit; De Cocker, Katrien; De Craemer, Marieke; Hayes, Catherine; O'Shea, Miriam P; Horodyska, Karolina; Bell, Justyna; Luszczynska, Aleksandra; Roos, Gun; Langøien, Lars Jørun; Rugseth, Gro; Terragni, Laura; De Bourdeaudhuij, Ilse; Brug, Johannes; Pischke, Claudia R

    2017-12-06

    The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. We aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors facilitating adoption, implementation, and maintenance of multi-level interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland. Six interventions and six policies were identified based on pre-defined criteria. Forty semi-structured interviews were conducted with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies. All interview transcripts were coded in NVivo, using a common categorization matrix. Coding in the respective countries was done by one researcher and validated by a second researcher. Active involvement of relevant stakeholders and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementation of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured. Despite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identify similar factors facilitating adoption, implementation, and maintenance of these interventions and policies.

  3. Daring to dream: reactions to tobacco endgame ideas among policy-makers, media and public health practitioners

    Directory of Open Access Journals (Sweden)

    Wilson Nick

    2011-07-01

    communicating these approaches. The current framing of tobacco as a risky but legal commodity was noted as an important potential barrier to implementing endgame approaches. Conclusions Endgame tobacco control approaches were considered to be viable policy options. Further policy analysis, research and public discussion are needed to develop endgame approaches. A significant change in the public framing of tobacco may be a prerequisite for implementing endgame solutions.

  4. Exposure ethics: does HIV pre-exposure prophylaxis raise ethical problems for the health care provider and policy maker?

    Science.gov (United States)

    Venter, Francois; Allais, Lucy; Richter, Marlise

    2014-07-01

    The last few years have seen dramatic progress in the development of HIV pre-exposure prophylaxis (PrEP). These developments have been met by ethical concerns. HIV interventions are often thought to be ethically difficult. In a context which includes disagreements over human rights, controversies over testing policies, and questions about sexual morality and individual responsibility, PrEP has been seen as an ethically complex intervention. We argue that this is mistaken, and that in fact, PrEP does not raise new ethical concerns. Some of the questions posed by PrEP are not specific to HIV prophylaxis, but simply standard public health considerations about resource allocation and striking a balance between individual benefit and public good. We consider sexual disinhibition in the context of private prescriptions, and conclude that only unjustified AIDS-exceptionalism or inappropriate moralism about sex supports thinking that PrEP raises new ethical problems. This negative conclusion is significant in a context where supposed ethical concerns about PrEP have been raised, and in the context of HIV exceptionalism. © 2013 John Wiley & Sons Ltd.

  5. Measuring equity in household's health care payments (Tehran-Iran 2013): technical points for health policy decision makers.

    Science.gov (United States)

    Rezapour, Aziz; Ebadifard Azar, Farbod; Azami Aghdash, Saber; Tanoomand, Asghar; Hosseini Shokouh, Seyed Morteza; Yousefzadeh, Negar; Atefi Manesh, Pezhman; Sarabi Asiabar, Ali

    2015-01-01

    Households' financial protection against health payments and expenditures and equity in utilization of health care services are of the most important tasks of governments. This study aims to measuring equity in household's health care payments according to fairness in financial contribution (FFC) and Kakwani indices in Tehran-Iran, 2013. This cross-sectional study was conducted in 2014.The study sample size was estimated to be 2200 households. Households were selected using stratified-cluster sampling including typical families who reside in the city of Tehran. The data were analyzed through Excel and Stata v.11software. Recall period for the inpatient care was 1 year and for outpatient1 month. The indicator of FFC for households in health financing was estimated to be 0.68 and the trend of the indicator was ascending by the rise in the ranking of households' financial level. The Kakwani index was estimated to be a negative number (-0.00125) which indicated the descending trend of health financing system. By redistribution of incomes or the exempt of the poorest quintiles from health payments, Kakwani index was estimated to be a positive number (0.090555) which indicated the ascending trend of health financing system. According to this study, the equity indices in health care financing denote injustice and a descending trend in the health care financing system. This finding clearly shows that deliberate policy making in health financing by national health authorities and protecting low-income households against health expenditures are required to improve the equity in health.

  6. The cost of diabetes in Latin America and the Caribbean in 2015: Evidence for decision and policy makers.

    Science.gov (United States)

    Barcelo, Alberto; Arredondo, Armando; Gordillo-Tobar, Amparo; Segovia, Johanna; Qiang, Anthony

    2017-12-01

    . Diabetes represented a major economic burden to the countries of Latin America and the Caribbean in 2015. The estimates presented here are key information for decision-making that can be used in the formulation of policies and programs to achieve greater efficiency and effectiveness in the use of resources for diabetes prevention in the 29 countries of LAC.

  7. Learned helplessness among families and surrogate decision-makers of patients admitted to medical, surgical, and trauma ICUs.

    Science.gov (United States)

    Sullivan, Donald R; Liu, Xinggang; Corwin, Douglas S; Verceles, Avelino C; McCurdy, Michael T; Pate, Drew A; Davis, Jennifer M; Netzer, Giora

    2012-12-01

    We sought to determine the prevalence of and clinical variables associated with learned helplessness, a psychologic state characterized by reduced motivation, difficulty in determining causality, and depression, in family members of patients admitted to ICUs. We conducted an observational survey study of a prospectively defined cohort of family members, spouses, and partners of patients admitted to surgical, medical, and trauma ICUs at a large academic medical center. Two validated instruments, the Learned Helplessness Scale and the Perceived Stress Scale, were used, and self-report of patient clinical characteristics and subject demographics were collected. Four hundred ninety-nine family members were assessed. Of these, 238 of 460 (51.7%) had responses consistent with a significant degree of learned helplessness. Among surrogate decision-makers, this proportion was 50% (92 of 184). Characteristics associated with significant learned helplessness included grade or high school education (OR, 3.27; 95% CI, 1.29-8.27; P = .01) and Perceived Stress Scale score > 18 (OR, 4.15; 95% CI, 2.65-6.50; P learned helplessness (OR, 0.56; 95% CI, 0.32-0.98; P = .05). The majority of family members of patients in the ICU experience significant learned helplessness. Risk factors for learned helplessness include lower educational levels, absence of an advance directive or DNR order, and higher stress levels among family members. Significant learned helplessness in family members may have negative implications in the collaborative decision-making process.

  8. Knowledge Translation to Advance the Nurse Practitioner Role in British Columbia: Researchers and decision-makers conduct policy-relevant research to guide legislative and regulatory development and the design of a nurse practitioner education program.

    OpenAIRE

    MacDonald, Marjorie; Regan, Sandra; Davidson, Heather; Schreiber, Rita; Crickmore, Jane; Moss, Lesley; Pinelli, Janet; Pauly, Bernadette

    2006-01-01

    This project brought together a team of researchers and decision-makers to conduct policy-relevant research to support the introduction of advanced nursing practice roles in British Columbia. All team members, including decision-makers, were actively involved in the conceptualization, design, data collection, analysis and interpretation of the study. This level of engagement, coupled with ongoing knowledge translation (KT) activities, led to the implementation by stakeholders of a majority of...

  9. Perceptions and Attitudes of Egyptian Health Professionals and Policy-Makers towards Pharmaceutical Sales Representatives and Other Promotional Activities.

    Science.gov (United States)

    Kamal, Susan; Holmberg, Christine; Russell, Jean; Bochenek, Tomasz; Tobiasz-Adamczyk, Beata; Fischer, Christiane; Tinnemann, Peter

    2015-01-01

    Pharmaceutical promotion activities in low and middle-income countries are often neither regulated nor monitored. While Egypt has the highest population and per capita use of medicines in the Arab world, we know very little about pharmaceutical companies promotional activities in the country. To explore and analyze the perceptions of physicians towards promotional and marketing activities of pharmaceutical companies among physicians and pharmacists in Egypt. Perspectives of different healthcare system stakeholders were explored through semi-structured, in-depth interviews conducted in 2014 in Cairo, Egypt. Interviewees were chosen via purposive sampling and snowball technique. Each interview was recorded and transcribed. Then qualitative, thematic analysis was conducted with the help of NVIVO software. The majority of physicians and pharmacists acknowledged exposure to pharmaceutical promotion. It was commonly believed that interaction with the pharmaceutical industry is necessary and both associated risks and benefits were acknowledged. The interviewed physicians considered themselves competent enough to minimize risks and maximize benefits to their prescribing habits. Views diverged on the extent and magnitude of the risks and benefits of pharmaceutical promotion, especially in regard to the influence on patients' health. Pharmaceutical promotion in Egypt is intensely directed at prescribers and dispensers. Physicians, pharmacists and policymakers expressed little skepticism to the influence of promotion towards their individual prescribing. Raising awareness of the pitfalls of pharmaceutical promotion is necessary, especially among the less experienced physicians.

  10. Educational Quasi-Market in Chile: The Discourse of Policy Makers Cuasi mercado educacional en Chile: el discurso de los tomadores de decisión.

    Directory of Open Access Journals (Sweden)

    Claudio Almonacid

    2008-04-01

    Full Text Available The Chilean educational system is characterized by the functioning of a cuasi (free market, in which increasing degrees of administrative, financial and curricular decentralization take place within a context where two constitutional rights are in conflict: the right to (free education and the freedom of teaching. This conflict arose from the design and implementation of said decentralization policy due to its negative effects in the processes of social inclusion of children and youngsters. In order to understand why those two constitutional rights are in conflict, it must be taken into account that such decentralization policy was designed by the military regime (1973-1990 as one of several neoliberal policies implemented in many different fields of the Chilean society, and that said policy has been kept in effect by the subsequent administrations of the “Concertación de Partidos por la Democracia” (Coalition of Parties for Democracy (since 1990 to present in a so called “transition process to democracy.” This research paper is intended to understand how the process of educational decentralization was conceived and how the system is in effect up to the present, as well as to understand the effects it has had on the process of social exclusion. To do that, the views of selected policy makers who have had active participation in this process are analyzed. First, there is a reference to the way the Chilean educational system works, and then the opinions of several educational policy makers about the processes of educational decentralization and social exclusion are analyzed. El sistema educacional chileno se caracteriza por el funcionamiento de un cuasi mercado en donde existen crecientes grados de descentralización administrativa, financiera y curricular, coexistiendo dos principios en tensión: el derecho a la educación y la libertad de enseñanza. Esta tensión se encuentra presente desde el diseño de esta política educativa

  11. The Experience of Surrogate Decision Makers on Being Approached for Consent for Patient Participation in Research. A Multicenter Study.

    Science.gov (United States)

    Burns, Karen E A; Prats, Clara Juando; Maione, Maria; Lanceta, Mary; Zubrinich, Celia; Jeffs, Lianne; Smith, Orla M

    2017-02-01

    Recruitment in critical care research differs from other contexts in important ways: patients lack decision-making capacity, uncertainty exists regarding patient prognosis, and critical illnesses are often associated with appreciable morbidity and mortality. We aimed to describe the experiences of surrogate decision makers (SDMs) in being approached for consent for critically ill patients to participate in research. A multicenter, qualitative study involving semistructured interviews with 26 SDMs, who provided or declined surrogate consent for research participation, at 5 Canadian centers nested within a multicenter observational study of research recruitment practices. Transcripts were reviewed by three qualitative researchers, and data were analyzed using grounded theory and a narrative critical analysis. SDMs were guided by an overarching desire for the patient to live. Surrogate research decision-making involved three sequential stages: (1) being approached; (2) reflecting on participation; and (3) making a decision. In stage 1, SDMs identified factors (their expectations, how they were approached, the attributes of the person approaching, and study risks and benefits) that characterized their consent encounter and affirmed a preference to be approached in person. If SDMs perceived the risk of participation to be too high or felt patients may not benefit from participation, they did not contemplate further. In stage 2, SDMs who knew the patient's wishes or had a deeper understanding of research prioritized the patient's wishes and the perceived benefits of participation. Without this information, SDMs prioritized obtaining more and better care for the patient, considered what was in their mutual best interests, and valued healthcare professional's knowledge. Trust in healthcare professionals was essential to proceeding further. In stage 3, SDMs considered six factors in rendering decisions. SDMs engaged in three sequential stages and considered six factors in

  12. Carbon footprint of canned mussels from a business-to-consumer approach. A starting point for mussel processors and policy makers

    International Nuclear Information System (INIS)

    Iribarren, Diego; Hospido, Almudena; Moreira, Maria Teresa; Feijoo, Gumersindo

    2010-01-01

    The increasing demand for environmental information on the global warming impact of products requires a solid methodological framework which guarantees comparability and communicability. The publicly available specification PAS 2050 combines approaches to a variety of greenhouse gas specific assessment issues to deliver a globally applicable product Carbon Footprinting (CF) method, which is expected to be widely accepted. Specifically, this paper aims to demonstrate the implementation of a CF scheme for a common canned mussel product according to PAS 2050 guidelines. A final value of 4.35 kg CO 2 e per triple pack of round cans of mussels was calculated. Furthermore, this CF study led to identify primary packaging (can production) and mussel shell management as the main activities where efforts should focus for climate change mitigation. Throughout this case study, CF opportunities and drawbacks are discussed. The whole text tries to provide a starting point for both mussel processors and policy makers to benefit from the potential advantages of a responsible use of this increasingly popular tool.

  13. Should we use a direct regulation to implement the Healthy Prisons Agenda in England? A qualitative study among prison key policy makers.

    Science.gov (United States)

    Ismail, N; de Viggiani, N

    2017-08-31

    The Healthy Prisons Agenda seeks to reduce prisoners' health risks, balance prisoners' rights with a security regime, ensure equivalent prison health service provisions to community health services, and facilitate the whole-prison approach. There is an established assumption that legislation will ensure better implementation of health promotion programmes. This study aimed to examine whether a legislative framework, via a direct regulation, could lead to enhanced implementation of the Healthy Prisons Agenda in England. A qualitative study design was conducted using semi-structured interviews with 30 key prison policy makers in England. Our findings contradict the established assumption that legislation improves the implementation of health promotion programmes. A direct regulation was perceived as restrictive, manifesting excessive compliance and encouraging a risk-averse culture, whilst preoccupation with security, order and discipline amongst prison governors and custody staff was deemed an internal institutional barrier to implementing the Healthy Prisons Agenda. External barriers included diminishing resources, lengthier or delayed sentencing, and an unsympathetic public and political stance towards prisoner rehabilitation. A direct regulation should not be used to operationalize the Healthy Prisons Agenda. Rather, self-regulation, along with proactive solutions for the identified barriers to implementing the Agenda, is the most appropriate path forward. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. Prospective analysis of energy security: A practical life-cycle approach focused on renewable power generation and oriented towards policy-makers

    International Nuclear Information System (INIS)

    García-Gusano, Diego; Iribarren, Diego; Garraín, Daniel

    2017-01-01

    Highlights: • Formulation and application of the Renewable Energy Security Index (RESI). • Prospective analysis combining Energy Systems Modelling and Life Cycle Assessment. • Feasibility proven through two case studies of power generation in Spain and Norway. • Good coverage of key energy security aspects (availability, affordability, etc.). • Novel and easy-to-report index suitable for energy policy-making. - Abstract: Energy security is a wide-ranging term to encompass issues such as security of supply, reliability of infrastructures, affordability and environmental friendliness. This article develops a robust indicator – the Renewable Energy Security Index, RESI – to enrich the body of knowledge associated with the presence of renewable energy technologies within national electricity production mixes. RESI is built by combining environmental life cycle assessment and techno-economic energy systems modelling. Spain and Norway are used as illustrative case studies for the prospective analysis of power generation from an energy security standpoint. In the Spanish case, with a diversified electricity production mix and a growing presence of renewable technologies, RESI favourably “evolves” from 0.36 at present to 0.65 in 2050 in a business-as-usual scenario, reaching higher values in a highly-restricted CO_2 scenario. The Norwegian case study attains RESI values similar to 1 due to the leading role of renewable electricity (mainly hydropower) regarding both satisfaction of national demand and exportation of electricity surplus. A widespread use of RESI as a quantifiable energy security index of national power generation sectors is found to be feasible and practical for both analysts and energy policy-makers, covering a significant number of energy security aspects.

  15. Developing and implementing global gender policy to reduce HIV and AIDS in low- and middle-income countries: policy makers' perspectives.

    Science.gov (United States)

    Olinyk, Shannon; Gibbs, Andrew; Campbell, Catherine

    2014-09-01

    Gender inequalities have been recognised as central to the HIV epidemic for many years. In response, a range of gender policies have been developed in attempts to mitigate the impact and transform gender relations. However, the effects of these policies have been less than successful. In March 2010 the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched the Agenda for accelerated country level action on women, girls, gender equality and HIV (the Agenda), an operational plan on how to integrate women, girls and gender equality into the HIV response. This paper explores the perspectives of those involved in developing and implementing the Agenda to understand its strengths and limitations. In-depth one-on-one interviews were conducted with 16 individuals involved in the development and implementation of the Agenda. The data were analysed using thematic network analysis. Facilitators of the Agenda centred on the Agenda's ability to create political space for women and girls within the global HIV/AIDS response and the collaborative process of developing the Agenda. Barriers to the implementation and development of the Agenda include the limited financial and non-financial resources, the top-down nature of the Agenda's development and implementation and a lack of political will from within UNAIDS to implement it. We suggest that the Agenda achieved many goals, but its effect was constrained by a wide range of factors.

  16. Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador.

    Science.gov (United States)

    Spiegel, Jerry M; Breilh, Jaime; Beltran, Efrain; Parra, Jorge; Solis, Fernanda; Yassi, Annalee; Rojas, Alejandro; Orrego, Elena; Henry, Bonnie; Bowie, William R; Pearce, Laurie; Gaibor, Juan; Velasquez, Patricio; Concepcion, Miriam; Parkes, Margot

    2011-11-08

    The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: "Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?" To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. By 2009, train-the-trainer project initiation involved 27 participatory action research Master's theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master's and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Strengthening capabilities for producing and applying knowledge through direct engagement with affected populations and

  17. Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

    Directory of Open Access Journals (Sweden)

    Henry Bonnie

    2011-11-01

    Full Text Available Abstract Background The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. Methods In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: “Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?” To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. Results By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Discussion Strengthening capabilities for producing and

  18. The Mexican hydro-meteorological disasters and climate network (redesclim) as model on outreach decision makers on disaster public policy in Mexico.

    Science.gov (United States)

    Welsh-Rodriguez, C. M.; Rodriguez-Estevez, J. M., Sr.; Romo-Aguilar, M. D. L.; Brito-Castillo, L.; Salinas-Prieto, A.; Gonzalez-Sosa, E.; Pérez-Campuzano, E.

    2017-12-01

    REDESCLIM was designed and develop in 2011 due to a public call from The Science and Technology Mexican Council (CONACYT); CONACYT lead the activities for its organization and development among the academic community. REDESCLIM was created to enhance the capacity of response to hydro-meteorological disasters and climate events through an integrative effort of researchers, technologists, entrepreneurs, politicians and society. Brief summary of our objectives: 1) Understand the causes of disasters, to reduce risks to society and ecosystems 2) Support research and interdisciplinary assessment of the physical processes in natural and social phenomena to improve understanding of causes and impacts 3) Strengths collaboration with academic, government, private and other interdisciplinary networks from Mexico and other countries 4) Build human capacity and promote the development of skills 5) Recommend strategies for climate hazard prevention, mitigation and response, especially for hazard with the greatest impacts in Mexico, such as hurricanes, floods, drought, wild fires and other extremes events. We provide a continues communication channel on members research results to provide scientific information that could be used for different proposes, specificaly for decision makers who are dealing with ecological and hydro meteorological problems that can result in disasters, and provide a services menu based on the members scientific projects, publications, teaching courses, in order to impact public policy as final result. http://www.redesclim.org.mx. So far we have some basic results: Fiver national meetings (participants from 35 countries around the world), 7 Workshops and seminars (virtual and in-person), Climatic data platforms ( http://clicom.mex.cicese.mx, http://clicom-mex.cicese.mx/malla, http://atlasclimatico.unam.mx/REDESCLIM2/ ), climate change scenarios for the general public at http://escenarios.inecc.gob.mx, 14 seed projects, one model to hurricane simulation

  19. Health worker and policy-maker perspectives on use of intramuscular artesunate for pre-referral and definitive treatment of severe malaria at health posts in Ethiopia

    Directory of Open Access Journals (Sweden)

    Takele Kefyalew

    2016-10-01

    Full Text Available Abstract Background The World Health Organization (WHO recommends injectable artesunate given either intravenously or by the intramuscular route for definitive treatment for severe malaria and recommends a single intramuscular dose of intramuscular artesunate or intramuscular artemether or intramuscular quinine, in that order of preference as pre-referral treatment when definitive treatment is not possible. Where intramuscular injections are not available, children under 6 years may be administered a single dose of rectal artesunate. Although the current malaria treatment guidelines in Ethiopia recommend intra-rectal artesunate or alternatively intramuscular artemether or intramuscular quinine as pre-referral treatment for severe malaria at the health posts, there are currently no WHO prequalified suppliers of intra-rectal artesunate and when available, its use is limited to children under 6 years of age leaving a gap for the older age groups. Intramuscular artesunate is not part of the drugs recommended for pre-referral treatment in Ethiopia. This study assessed the perspectives of health workers, and policy-makers on the use of intramuscular artesunate as a pre-referral and definitive treatment for severe malaria at the health post level. Methods In-depth interviews were held with 101 individuals including health workers, malaria focal persons, and Regional Health Bureaus from Oromia and southern nations, nationalities, and peoples’ region, as well as participants from the Federal Ministry of Health and development partners. An interview guide was used in the data collection and thematic content analysis was employed for analysis. Results Key findings from this study are: (1 provision of intramuscular artesunate as pre-referral and definitive treatment for severe malaria at health posts could be lifesaving; (2 with adequate training, and provision of facilities including beds, health posts can provide definitive treatment for severe

  20. State Decision-Makers Guide for Hazardous Waste Management: Defining Hazardous Wastes, Problem Recognition, Land Use, Facility Operations, Conceptual Framework, Policy Issues, Transportation.

    Science.gov (United States)

    Corson, Alan; And Others

    Presented are key issues to be addressed by state, regional, and local governments and agencies in creating effective hazardous waste management programs. Eight chapters broadly frame the topics which state-level decision makers should consider. These chapters include: (1) definition of hazardous waste; (2) problem definition and recognition; (3)…

  1. Finding common ground to achieve a "good death": family physicians working with substitute decision-makers of dying patients. A qualitative grounded theory study.

    Science.gov (United States)

    Tan, Amy; Manca, Donna

    2013-01-22

    Substitute decision-makers are integral to the care of dying patients and make many healthcare decisions for patients. Unfortunately, conflict between physicians and surrogate decision-makers is not uncommon in end-of-life care and this could contribute to a "bad death" experience for the patient and family. We aim to describe Canadian family physicians' experiences of conflict with substitute decision-makers of dying patients to identify factors that may facilitate or hinder the end-of-life decision-making process. This insight will help determine how to best manage these complex situations, ultimately improving the overall care of dying patients. Grounded Theory methodology was used with semi-structured interviews of family physicians in Edmonton, Canada, who experienced conflict with substitute decision-makers of dying patients. Purposeful sampling included maximum variation and theoretical sampling strategies. Interviews were audio-taped, and transcribed verbatim. Transcripts, field notes and memos were coded using the constant-comparative method to identify key concepts until saturation was achieved and a theoretical framework emerged. Eleven family physicians with a range of 3 to 40 years in clinical practice participated.The family physicians expressed a desire to achieve a "good death" and described their role in positively influencing the experience of death.Finding Common Ground to Achieve a "Good Death" for the Patient emerged as an important process which includes 1) Building Mutual Trust and Rapport through identifying key players and delivering manageable amounts of information, 2) Understanding One Another through active listening and ultimately, and 3) Making Informed, Shared Decisions. Facilitators and barriers to achieving Common Ground were identified. Barriers were linked to conflict. The inability to resolve an overt conflict may lead to an impasse at any point. A process for Resolving an Impasse is described. A novel framework for developing

  2. Breast Cancer Risk Estimation and Personal Insurance: A Qualitative Study Presenting Perspectives from Canadian Patients and Decision Makers

    Directory of Open Access Journals (Sweden)

    Gratien Dalpé

    2017-09-01

    Full Text Available Genetic stratification approaches in personalized medicine may considerably improve our ability to predict breast cancer risk for women at higher risk of developing breast cancer. Notwithstanding these advantages, concerns have been raised about the use of the genetic information derived in these processes, outside of the research and medical health care settings, by third parties such as insurers. Indeed, insurance applicants are asked to consent to insurers accessing their medical information (implicitly including genetic to verify or determine their insurability level, or eligibility to certain insurance products. This use of genetic information may result in the differential treatment of individuals based on their genetic information, which could lead to higher premium, exclusionary clauses or even the denial of coverage. This phenomenon has been commonly referred to as “Genetic Discrimination” (GD. In the Canadian context, where federal Bill S-201, An Act to prohibit and prevent genetic discrimination, has recently been enacted but may be subject to constitutional challenges, information about potential risks to insurability may raise issues in the clinical context. We conducted a survey with women in Quebec who have never been diagnosed with breast cancer to document their perspectives. We complemented the research with data from 14 semi-structured interviews with decision-makers in Quebec to discuss institutional issues raised by the use of genetic information by insurers. Our results provide findings on five main issues: (1 the reluctance to undergo genetic screening test due to insurability concerns, (2 insurers' interest in genetic information, (3 the duty to disclose genetic information to insurers, (4 the disclosure of potential impacts on insurability before genetic testing, and (5 the status of genetic information compared to other health data. Overall, both groups of participants (the women surveyed and the decision-makers

  3. Police Officer, Deal-Maker, or Healthcare Provider? Moving to a Patient-Centered Framework for Chronic Opioid Management

    Science.gov (United States)

    Nicolaidis, Christina

    2016-01-01

    How we frame our thoughts about chronic opioid therapy greatly influences our ability to practice patient-centered care. Even providers who strive to be non-judgmental may approach clinical decision-making about opioids by considering if the pain is real or they can trust the patient. Not only does this framework potentially lead to poor or unshared decision-making, it likely adds to provider and patient discomfort by placing the provider in the position of a police officer or judge. Similarly, providers often find themselves making deals with patients using a positional bargaining approach. Even if a compromise is reached, this framework can potentially inadvertently weaken the therapeutic relationship by encouraging the idea that the patient and provider have opposing goals. Reframing the issue can allow the provider to be in a more therapeutic role. As recommended in the APS/AAPM guidelines, providers should decide whether the benefits of opioid therapy are likely to outweigh the harms for a specific patient (or sometimes, for society) at a specific time. This paper discusses how providers can use a benefit-to-harm framework to make and communicate decisions about the initiation, continuation, and discontinuation of opioids for managing chronic non-malignant pain. Such an approach focuses decisions and discussions on judging the treatment, not the patient. It allows the provider and the patient to ally together and make shared decisions regarding a common goal. Moving to a risk-benefit framework may allow providers to provide more patient-centered care, while also increasing provider and patient comfort with adequately monitoring for harm. PMID:21539703

  4. Service line structure and decision-maker attention in three health systems: Implications for patient-centered care.

    Science.gov (United States)

    Louis, Christopher J; Clark, Jonathan R; Gray, Barbara; Brannon, Diane; Parker, Victoria

    2017-06-15

    Scholars have noted a disconnect between the level at which structure is typically examined (the organization) and the level at which the relevant coordination takes place (service delivery). Accordingly, our understanding of the role structure plays in care coordination is limited. In this article, we explore service line structure, with an aim of advancing our understanding of the role service line structure plays in producing coordinated, patient-centered care. We do so by giving special attention to the cognitive roots of patient-centeredness. Our exploratory study relied on comparative case studies of the breast cancer service lines in three health systems. Nonprobability discriminative snowball sampling was used to identify the final sample of key informants. We employed a grounded approach to analyzing and interpreting the data. We found substantial variation across the three service lines in terms of their structure. We also found corresponding variation across the three case sites in terms of where informant attention was primarily focused in the process of coordinating care. Drawing on the attention-based view of the firm, our results draw a clear connection between structural characteristics and the dominant focus of attention (operational tactics, provider roles and relationships, or patient needs and engagement) in health care service lines. Our exploratory results suggest that service line structures influence attention in two ways: (a) by regulating the type and intensity of the problems facing service line participants and (b) by encouraging (or discouraging) a shared purpose around patient needs. Patient-centered attention-a precursor to coordinated, patient-centered care-depends on the internal choices organizations make around service line structure. Moreover, a key task for organizational and service line leaders is to structure service lines to create a context that minimizes distractions and enables care providers to focus their attention on

  5. Decision makers, scientists and the public as stakeholders: the connection between traffic intervention policy and air quality in a local context.

    Science.gov (United States)

    Weiand, L.; von Schneidemesser, E.; Schmitz, S.; Niehoff, N.

    2017-12-01

    Urban mobility is a key issue to make cities more inclusive, safer, and more environmentally friendly. To ensure a sustainable future, local policy should, among other actions, aim to improve access to sustainable transport systems and enhance mobility opportunities, while at the same time addressing critical environmental and health targets. In order to assess whether these objectives are met, measures should be informed and evaluated from a social and environmental perspective. Citizens' opinions and the acceptance of environmental policies are crucial to successful implementation of urban mobility measures. The complexity of urban air quality issues require transparent decision-making processes that are grounded in evidence-based research and embrace local knowledge. From this basis, our research group and the city council collaborated to assess a new policy action intended to address environmental and health targets. This talk will present the results from the assessment of this new policy, that was implemented in large part to alleviate air quality exceedances, from the perspective of public acceptability of the measure and the approach taken by the city council to implement the measure. Parallel to assessing the effect of this policy on the recorded levels of air pollution and traffic counts, we conducted a social survey to examine public opinions of this measure, as well as the link between air quality awareness and mobility decisions. 4661 responses were collected over a one month period. Survey participants were those most affected by the traffic measure, including commuters and local residents. The results show that there is an overall low acceptance rate of the measure (8%) as well as low concern for air quality (2,90 - where 1 = not concerned and 6 = very concerned). We also found that there is a negative relationship between air quality rating and air quality concern. A similar approach was taken to understand climate change concern, which will be

  6. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: methods of a decision-maker-researcher partnership systematic review.

    Science.gov (United States)

    Haynes, R Brian; Wilczynski, Nancy L

    2010-02-05

    Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Data will be summarized using descriptive summary measures, including proportions

  7. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

    Directory of Open Access Journals (Sweden)

    Wilczynski Nancy L

    2010-02-01

    Full Text Available Abstract Background Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. Methods The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Results Data will be summarized

  8. "Rule of Thumb Methods No Longer Suffice": Development of British Coal Industry Education and Training 1900-circa 1970 and Lessons for Present-Day Education Policy-Makers

    Science.gov (United States)

    Walker, Martyn A.

    2015-01-01

    This paper traces the origins and development of coal mining education and training in Britain from 1900 to the 1970s, by which time the coal industry had substantially declined. It looks at the progress from working-class self-help to national policy in support of education and training. The research makes use of college prospectuses and…

  9. The unsustainable Makers

    Directory of Open Access Journals (Sweden)

    Adam Arvidsson

    2010-03-01

    Full Text Available The Makers is the latest novel of the American science fiction writer, blogger and Silicon Valley intellectual Cory Doctorow. Set in the 2010s, the novel describes the possible impact of the present trend towards the migration of modes of production and organization that have emerged online into the sphere of material production. Called New Work, this movement is indebted to a new maker culture that attracts people into a kind of neo-artisan, high tech mode of production. The question is: can a corporate-funded New Work movement be sustainable? Doctorow seems to suggest that a capitalist economy of abundance is unsustainable because it tends to restrict the reach of its value flows to a privileged managerial elite.

  10. Why the Critics of Poor Health Service Delivery Are the Causes of Poor Service Delivery: A Need to Train the Policy-makers

    Science.gov (United States)

    Harding, Nancy

    2015-01-01

    This comment on Professor Fotaki’s Editorial agrees with her arguments that training health professionals in more compassionate, caring and ethically sound care will have little value unless the system in which they work changes. It argues that for system change to occur, senior management, government members and civil servants themselves need training so that they learn to understand the effects that their policies have on health professionals. It argues that these people are complicit in the delivery of unethical care, because they impose requirements that contradict health professionals’ desire to deliver compassionate and ethical forms of care. PMID:26340498

  11. The Governance of Multi-Use Platforms at Sea for Energy Production and Aquaculture: Challenges for Policy Makers in European Seas

    Directory of Open Access Journals (Sweden)

    Marian Stuiver

    2016-04-01

    Full Text Available European seas are encountering an upsurge in competing marine activities and infrastructures. Traditional exploitation such as fisheries, tourism, transportation, and oil production are accompanied by new sustainable economic activities such as offshore windfarms, aquaculture, and tidal and wave energy. One proposed solution to overcome possible competing claims at sea lies in combining these economic activities as part of Multi-Use Platforms at Sea (MUPS. MUPS can be understood as areas at sea, designated for a combination of activities, either completely integrated in a platform or in shared marine space. MUPS can potentially benefit from each other in terms of infrastructure, maintenance, etc. Developing MUPS in the marine environment demands adequate governance. In this article, we investigate four European sites to find out how governance arrangements may facilitate or complicate MUPs. In particular, we apply a framework specifying policy, economic, social, technical, environmental, and legal (PESTEL factors to explore governance arrangements in four case study sites in different sea basins around Europe (the Mediterranean Sea, the Atlantic Ocean, the North Sea, and the Baltic Sea. The article concludes with policy recommendations on a governance regime for facilitating the development of MUPS in the future.

  12. What are the implications for policy makers? A systematic review of the cost-effectiveness of screening and brief interventions for alcohol misuse in primary care.

    Directory of Open Access Journals (Sweden)

    Colin eAngus

    2014-09-01

    Full Text Available IntroductionThe efficacy of screening and brief interventions (SBI for excessive alcohol use in primary care is well established; however evidence on their cost-effectiveness is limited. A small number of previous reviews have concluded that SBI programmes are likely to be cost-effective, but these results are equivocal and important questions around the cost-effectiveness implications of key policy decisions such as staffing choices for delivery of SBIs and the intervention duration remain unanswered. MethodsStudies reporting both the costs and a measure of health outcomes of programmes combining screening and brief interventions in primary care were identified by searching MEDLINE, EMBASE, Econlit, the Cochrane Library Database (including NHS EED, CINAHL, PsycINFO, Assia and the Social Science Citation Index and Science Citation Index via Web of Knowledge. Included studies have been stratified both by delivery staff and intervention duration and assessed for quality using the Drummond checklist for economic evaluations.ResultsThe search yielded a total of 23 papers reporting the results of 22 distinct studies. There was significant heterogeneity in methods and outcome measures between studies; however almost all studies reported SBI programmes to be cost-effective. There was no clear evidence that either the duration of the intervention or the delivery staff used had a substantial impact on this result.ConclusionThis review provides strong evidence that SBI programmes in primary care are a cost-effective option for tackling alcohol misuse.

  13. Licensing Surrogate Decision-Makers.

    Science.gov (United States)

    Rosoff, Philip M

    2017-06-01

    As medical technology continues to improve, more people will live longer lives with multiple chronic illnesses with increasing cumulative debilitation, including cognitive dysfunction. Combined with the aging of society in most developed countries, an ever-growing number of patients will require surrogate decision-makers. While advance care planning by patients still capable of expressing their preferences about medical interventions and end-of-life care can improve the quality and accuracy of surrogate decisions, this is often not the case, not infrequently leading to demands for ineffective, inappropriate and prolonged interventions. In 1980 LaFollette called for the licensing of prospective parents, basing his argument on the harm they can do to vulnerable people (children). In this paper, I apply his arguments to surrogate decision-makers for cognitively incapacitated patients, rhetorically suggesting that we require potential surrogates to qualify for this position by demonstrating their ability to make reasonable and rational decisions for others. I employ this theoretical approach to argue that the loose criteria by which we authorize surrogates' generally unchallenged power should be reconsidered.

  14. Water Footprint of Milk Produced and Processed in South Africa: Implications for Policy-Makers and Stakeholders along the Dairy Value Chain

    Directory of Open Access Journals (Sweden)

    Enoch Owusu-Sekyere

    2016-07-01

    Full Text Available The current water scarcity situation in South Africa is a threat to sustainable development. The present paper has assessed the water footprint of milk produced and processed in South Africa using the procedures outlined in the water footprint assessment manual. The results show that 1352 m3 of water is required to produce one tonne of milk with 4% fat and 3.3% protein in South Africa. The water used in producing feed for lactating cows alone accounts for 86.35% of the total water footprint of milk. The water footprint of feed ration for lactating cows is about 85% higher than that of non-lactating cows. Green water footprint accounts for more than 86% of the total water footprint of feed ration for lactating cows. Green and blue water footprints are the highest contributors to the total water footprint milk production in South Africa. Water used for feed production for both lactating and non-lactating cows accounts for about 99% of the total water footprint of milk production in South Africa. Particular attention should be given to feed crops with low water footprints and high contribution to dry matter to provide balanced ration with low water footprint. Water users, managers and livestock producers should pay attention to green and blue water consumption activities along the milk value chain and design strategies to minimize them. Corn, sorghum and lucerne production under irrigation in the greater Orange River basin is sustainable, whereas oats production for silage in the same catchment area is not sustainable. Our findings provide the rationale for dairy producers and water users in the dairy industry to get an understanding of the degree of sustainability of their input and output combinations, production choices, and policy interventions, in terms of water use.

  15. A new multidimensional population health indicator for policy makers: absolute level, inequality and spatial clustering - an empirical application using global sub-national infant mortality data

    Directory of Open Access Journals (Sweden)

    Benn K.D. Sartorius

    2014-11-01

    Full Text Available The need for a multidimensional measure of population health that accounts for its distribution remains a central problem to guide the allocation of limited resources. Absolute proxy measures, like the infant mortality rate (IMR, are limi- ted because they ignore inequality and spatial clustering. We propose a novel, three-part, multidimensional mortality indi- cator that can be used as the first step to differentiate interventions in a region or country. The three-part indicator (MortalityABC index combines absolute mortality rate, the Theil Index to calculate mortality inequality and the Getis-Ord G statistic to determine the degree of spatial clustering. The analysis utilises global sub-national IMR data to empirically illu- strate the proposed indicator. The three-part indicator is mapped globally to display regional/country variation and further highlight its potential application. Developing countries (e.g. in sub-Saharan Africa display high levels of absolute mortality as well as variable mortality inequality with evidence of spatial clustering within certain sub-national units (“hotspots”. Although greater inequality is observed outside developed regions, high mortality inequality and spatial clustering are com- mon in both developed and developing countries. Significant positive correlation was observed between the degree of spatial clustering and absolute mortality. The proposed multidimensional indicator should prove useful for spatial allocation of healthcare resources within a country, because it can prompt a wide range of policy options and prioritise high-risk areas. The new indicator demonstrates the inadequacy of IMR as a single measure of population health, and it can also be adapted to lower administrative levels within a country and other population health measures.

  16. Why We Need to Have Broad-Based Societal Discussions of the Governance of Geoengineering, at national and international levels, starting with scientists and increasingly with policy makers?

    Science.gov (United States)

    Anbar, A. D.; Rowan, L. R.; Field, L. A.; Keith, D.; Robock, A.; Anbar, A. D.; van der Pluijm, B.; Pasztor, J.

    2017-12-01

    . Geoengineering has planet-wide consequences and must therefore be discussed within intergovernmental institutions, including the United Nations. The research community has been addressing many of these issues, but the global policy community and the public largely have not. It's time to do so.

  17. Política de autogestión hospitalaria en Chile: percepciones de los tomadores de decisiones Hospital self-management policy in Chile: perceptions of decision-makers

    Directory of Open Access Journals (Sweden)

    Claudio A. Méndez

    2013-01-01

    Full Text Available OBJETIVO: Conocer las percepciones de los tomadores de decisiones respecto de la etapa de implementación de la política de autogestión hospitalaria en dos hospitales de alta complejidad del sur de Chile. MÉTODOS: Se realizó un estudio cualitativo descriptivo y exploratorio basado en entrevistas semiestructuradas en profundidad a tomadores de decisiones de los hospitales Regional de la ciudad de Valdivia y San José de la ciudad de Osorno, durante el período de agosto de 2010 a diciembre de 2011. Se seleccionó una muestra por conveniencia de 26 tomadores de decisiones. Las 26 entrevistas fueron grabadas y transcritas en forma literal. El análisis de la información se hizo utilizando la técnica de análisis de contenido, en su aproximación inductiva. RESULTADOS: Para los entrevistados, la conceptualización de la autogestión está determinada por la autonomía para la toma de decisiones respecto de la asignación de recursos y el financiamiento de la provisión de servicios de salud en las instituciones hospitalarias. También manifestaron que para mejorar la etapa de implementación se deben incluir políticas de recursos humanos y de financiamiento de la función de provisión de servicios de salud. A las debilidades, por su parte, las relacionaron con la ausencia de capacidades organizacionales y competencias gerenciales de los equipos de salud para la implementación de los cambios. CONCLUSIONES: La política de autogestión hospitalaria es conceptualizada desde la autonomía financiera, y su implementación está determinada por las brechas de capacidad que persisten en el diseño de la política.OBJECTIVE: To learn the perceptions of decision-makers concerning the imple­men­t­ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. METHODS: A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia

  18. Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes.

    Science.gov (United States)

    Souza, Nathan M; Sebaldt, Rolf J; Mackay, Jean A; Prorok, Jeanette C; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    Computerized clinical decision support systems (CCDSSs) are claimed to improve processes and outcomes of primary preventive care (PPC), but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs) assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63%) RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34%) trials assessed patient outcomes, and four (29%) reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15%) and two (5%) trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Evidence supports the effectiveness of CCDSSs for screening and

  19. Computerized clinical decision support systems for primary preventive care: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes

    Directory of Open Access Journals (Sweden)

    Wilczynski Nancy L

    2011-08-01

    Full Text Available Abstract Background Computerized clinical decision support systems (CCDSSs are claimed to improve processes and outcomes of primary preventive care (PPC, but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63% RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34% trials assessed patient outcomes, and four (29% reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15% and two (5% trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Conclusions

  20. Understanding Mali: Lessons for Policy Makers

    Science.gov (United States)

    2014-06-01

    Maliennes. Une Histoire En Trompe-L’œil,” Note de l’Ifri (2010), 11.. The case of the OCRS is further developed in the colonial legacy section. 74...Une Histoire En Trompe-L’œil,” 12. 18 Grémont, “Touaregs Et Arabes Dans Les Forces Armées Coloniales Et Maliennes. Une Histoire En Trompe-L’œil...Les Forces Armées Coloniales Et Maliennes. Une Histoire En Trompe-L’œil.” Note de l’Ifri (2010): 110 Gyimah-Brempong, Kwabena. “Corruption

  1. The Reddy maker

    Science.gov (United States)

    Nof, Doron; Paldor, Nathan; Gorder, Stephen Van

    2002-09-01

    alterations bring the outflow closer and closer to the critical condition and it is, therefore, argued that all outflows ultimately reach the critical point (unless diffusion and mixing destroy them prior to that stage). It is suggested that Reddies (i.e., isolated lenses containing Red Sea water) are formed by the above processes. Namely, we propose that the "Reddy maker" is a combination of three processes, the natural reduction in the bottom slope which the outflow senses as it approaches the bottom of the ocean, the entrainment-induced increase in the outflow's thickness, and the entrainment-induced decrease in the outflow's density. An animation of the eddy generation process can be viewed at http://doronnof.net/features.html#video (click on "Reddy maker video").

  2. The True Cost of Electric Power. An Inventory of Methodologies to Support Future Decision-making in Comparing the Cost and Competitiveness of Electricity Generation Technologies. Summary for policy-makers

    International Nuclear Information System (INIS)

    Burtraw, Dallas; Krupnick, Alan

    2012-06-01

    investments are directed at the electricity generation methods with the lowest true costs to investors and society. The aim of the report is to provide the background for policy-makers and investors who want to incorporate the concept of 'true costs' into the discussion of electricity generation. In some geographic areas, adequate data and methods exist to make a solid estimate of the total social costs of energy production. In those places where the data or methods (or both) are less robust, it is possible to use a benefits transfer approach that still gives stakeholders important guidance about the scale of the true costs of their investments and to get started in formulating policies to incorporate those costs into the market price. Whatever the state of the data and methods, the process of the analysis and stakeholder discussion can be just as important as the final results in providing guidance to decision-makers. Consideration of the true costs should be a component of decision-making for all energy investment worldwide. (authors)

  3. Budget-makers and health care systems.

    Science.gov (United States)

    White, Joseph

    2013-10-01

    Health programs are shaped by the decisions made in budget processes, so how budget-makers view health programs is an important part of making health policy. Budgeting in any country involves its own policy community, with key players including budgeting professionals and political authorities. This article reviews the typical pressures on and attitudes of these actors when they address health policy choices. The worldview of budget professionals includes attitudes that are congenial to particular policy perspectives, such as the desire to select packages of programs that maximize population health. The pressures on political authorities, however, are very different: most importantly, public demand for health care services is stronger than for virtually any other government activity. The norms and procedures of budgeting also tend to discourage adoption of some of the more enthusiastically promoted health policy reforms. Therefore talk about rationalizing systems is not matched by action; and action is better explained by the need to minimize blame. The budget-maker's perspective provides insight about key controversies in healthcare policy such as decentralization, competition, health service systems as opposed to health insurance systems, and dedicated vs. general revenue finance. It also explains the frequency of various "gaming" behaviors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. The effect of prognostic data presentation format on perceived risk among surrogate decision makers of critically ill patients: a randomized comparative trial.

    Science.gov (United States)

    Chapman, Andy R; Litton, Edward; Chamberlain, Jenny; Ho, Kwok M

    2015-04-01

    The purpose of this study is to determine whether varying the format used to present prognostic data alters the perception of risk among surrogate decision makers in the intensive care unit (ICU). This was a prospective randomized comparative trial conducted in a 23-bed adult tertiary ICU. Enrolled surrogate decision makers were randomized to 1 of 2 questionnaires, which presented hypothetical ICU scenarios, identical other than the format in which prognostic data were presented (eg, frequencies vs percentages). Participants were asked to rate the risk associated with each prognostic statement. We enrolled 141 surrogate decision makers. The perception of risk varied significantly dependent on the presentation format. For "quantitative data," risks were consistently perceived as higher, when presented as frequencies (eg, 1 in 50) compared with equivalent percentages (eg, 2%). Framing "qualitative data" in terms of chance of "death" rather than "survival" led to a statistically significant increase in perceived risks. Framing "quantitative" data in this way did not significantly affect risk perception. Data format had a significant effect on how surrogate decision makers interpreted risk. Qualitative statements are interpreted widely and affected by framing. Where possible, multiple quantitative formats should be used for presenting prognostic information. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  5. Using secondary analysis of qualitative data of patient experiences of health care to inform health services research and policy.

    Science.gov (United States)

    Ziebland, Sue; Hunt, Kate

    2014-07-01

    Qualitative research is recognized as an important method for including patients' voices and experiences in health services research and policy-making, yet the considerable potential to analyse existing qualitative data to inform health policy and practice has been little realized. This failure may partly be explained by: a lack of awareness amongst health policy makers of the increasing wealth of qualitative data available; and around 15 years of internal debates among qualitative researchers on the strengths, limitations and validity of re-use of qualitative data. Whilst acknowledging the challenges of qualitative secondary data analysis, we argue that there is a growing imperative to be pragmatic and to undertake analysis of existing qualitative data collections where they have the potential to contribute to health policy formulation. Time pressures are inherent in the policy-making process and in many circumstances it is not possible to seek funding, conduct and analyse new qualitative studies of patients' experiences in time to inform a specific policy. The danger then is that the patient voice, and the experiences of relatives and carers, is either excluded or included in a way that is easily dismissed as 'unrepresentative'. We argue that secondary analysis of qualitative data collections may sometimes be an effective means to enable patient experiences to inform policy decision-making. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Beginning RPG Maker VX Ace

    CERN Document Server

    Perez, Darrin

    2014-01-01

    Beginning RPG Maker VX Ace takes you through the process of using the RPG Maker VX Ace game development engine to create your very own role playing game. The book has been designed with the complete beginner in mind who has little to no experience with the engine. Tutorials and exercises will take you from installing the software to putting the final touches upon your first project. Game design can be quite a daunting challenge, as it generally involves a large amount of programming know-how on top of having to plan everything out that makes a good game what it is. RPG Maker VX Ace

  8. The Impact of Hospital Visiting Hour Policies on Pediatric and Adult Patients and their Visitors.

    Science.gov (United States)

    Smith, Lisa; Medves, Jennifer; Harrison, Margaret B; Tranmer, Joan; Waytuck, Brett

    Policies concerning restricted or open visiting hours are being challenged in health care institutions internationally, with no apparent consensus on the appropriateness of the visiting hour policies for pediatric and adult patients. The rules that govern practice are often based on the institutional precedent and assumptions of staff, and may have little or no evidence to support them. Policy and practice related to visiting hours is of pressing concern in Canada, and in Ontario specifically, following the reaction to the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 and subsequent changes in visiting policies in most health care settings. A systematic investigation of the impact of hospital visiting hours on visitors (including patients, families, and significant others) would inform decision-makers who are responsible for hospital policies about the best available evidence. The objective of this review was to appraise and synthesize the best available evidence on the impact of hospital visiting hours on patients and their visitors. Types of participants This review considered studies that included both pediatric and adult hospital patients and their visitors. Participants were either patients, visitors, or health care providers in the following hospital settings: medical/surgical units, critical care (ICU, CCU, NICU), pediatrics, maternity, or general hospital wards.Articles were excluded if participants came from the following settings: post-operative and post-anaesthesia care units (PACU), dementia wards, long-term care settings or retirement homes, or delivery rooms. PACUs were excluded because there are aspects of the presence of visitors to these units that are very specific, and differ from the general visits to patients who are not in the immediate post-operative stage. Dementia wards, long-term care settings and retirement homes were excluded because these were considered to be their "home", so visiting would be quite different from that on

  9. HAC-POA Policy Effects on Hospitals, Patients and Other...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in HAC-POA Policy Effects on Hospitals, Patients, and Other Payers, published in Volume 4, Issue 3 of the Medicare and Medicaid...

  10. Educational Goods and Values: A Framework for Decision Makers

    Science.gov (United States)

    Brighouse, Harry; Ladd, Helen F.; Loeb, Susanna; Swift, Adam

    2016-01-01

    This article articulates a framework suitable for use when making decisions about education policy. Decision makers should establish what the feasible options are and evaluate them in terms of their contribution to the development, and distribution, of educational goods in children, balanced against the negative effect of policies on important…

  11. What Attracts Decision Makers' Attention?

    DEFF Research Database (Denmark)

    Bentzen, Eric; Christiansen, John K.; Varnes, Claus J.

    2011-01-01

    portfolio meetings. The study seeks to investigate how managers allocate their attention and the role of different factors for their attention. Observations also make it possible to compare prior research and expectations with the actual observed behavior of decision makers. Design....../methodology/approach – The present analysis draws on insights from previous research into decision making in product and portfolio management and studies on organizational decision making. The authors frame why the attention of decision makers is so critical in complex situations. Data for this study were collected through direct......Purpose – Managers' attention is a scarce resource in complex innovation settings. Prior research on the factors to which managers pay attention is mostly based on surveys. The present study aims to address the need for knowledge about the behavior of decision makers based on observations from...

  12. FileMaker Pro 9

    CERN Document Server

    Coffey, Geoff

    2007-01-01

    FileMaker Pro 9: The Missing Manual is the clear, thorough and accessible guide to the latest version of this popular desktop database program. FileMaker Pro lets you do almost anything with the information you give it. You can print corporate reports, plan your retirement, or run a small country -- if you know what you're doing. This book helps non-technical folks like you get in, get your database built, and get the results you need. Pronto.The new edition gives novices and experienced users the scoop on versions 8.5 and 9. It offers complete coverage of timesaving new features such as the Q

  13. MakerBot projects blueprints

    CERN Document Server

    Larson, Joseph

    2013-01-01

    MakerBot Projects Blueprints is a project-based book, with each chapter taking you through the creation of an awesome stand-alone project. MakerBot Project Blueprints is for anyone with an interest in the 3D printing revolution and the slightest bit of computer skills. Whether you own a 3D printer or not you can design for them. All it takes is Blender, a free 3D modeling tool, this book and a little creativity and someday you'll be able to hold something you designed in the computer in your hands.

  14. FAmily CEntered (FACE) advance care planning: Study design and methods for a patient-centered communication and decision-making intervention for patients with HIV/AIDS and their surrogate decision-makers.

    Science.gov (United States)

    Kimmel, Allison L; Wang, Jichuan; Scott, Rachel K; Briggs, Linda; Lyon, Maureen E

    2015-07-01

    Although the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a chronic illness, disease-specific advance care planning has not yet been evaluated for the palliative care needs of adults with HIV/AIDS. This prospective, longitudinal, randomized, two-arm controlled clinical trial aims to test the efficacy of FAmily CEntered advance care planning among adults living with AIDS and/or HIV with co-morbidities on congruence in treatment preferences, healthcare utilization, and quality of life. The FAmily CEntered intervention arm is two face-to-face sessions with a trained, certified facilitator: Session 1) Disease-Specific Advance Care Planning Respecting Choices Interview; Session 2) Completion of advance directive. The Healthy Living Control arm is: Session 1) Developmental/Relationship History; Session 2) Nutrition. Follow-up data will be collected at 3, 6, 12, and 18 months post-intervention. A total of 288 patient/surrogate dyads will be enrolled from five hospital-based, out-patient clinics in Washington, District of Columbia. Participants will be HIV positive and ≥ 21 years of age; surrogates will be ≥ 18 years of age. Exclusion criteria are homicidality, suicidality, psychosis, and impaired cognitive functioning. We hypothesize that this intervention will enhance patient-centered communication with a surrogate decision-maker about end of life treatment preferences over time, enhance patient quality of life and decrease health care utilization. We further hypothesize that this intervention will decrease health disparities for Blacks in completion of advance directives. If proposed aims are achieved, the benefits of palliative care, particularly increased treatment preferences about end-of-life care and enhanced quality of life, will be extended to people living with AIDS. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. How to link health research to policy makers, practitioners and patients: use of Dutch health services by non-Dutch patients

    NARCIS (Netherlands)

    de Graaff, F.

    2009-01-01

    This article presents experiences with research-related implementation activities in the field of intercultural communication in palliative health care in the Netherlands. It is argued that sharing research aims with relevant stakeholders, organizing resulting feedback, translating findings into

  16. Research for health policy

    National Research Council Canada - National Science Library

    Bell, Erica

    2010-01-01

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

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

    Science.gov (United States)

    Bynum, Julie P W

    2014-04-01

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

  18. Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

    Directory of Open Access Journals (Sweden)

    Olga Skriabikova

    2010-06-01

    Full Text Available This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee or indirectly as a level of deductibles and/or co-insurance defined by the insurance coverage. The paper also discusses the relevance of these models for the assessment of patient payment policies. For this purpose, a systematic literature review is carried out. In total, 46 relevant publications were identified. These publications are classified into categories based on their general approach to demand modeling, specifications of data collection, data analysis, and main empirical findings. The analysis indicates a rising research interest in the empirical micro-level models of demand for out-patient physician services that incorporate the size of patient payment. Overall, the size of patient payments, consumer socio-economic and demographic features, and quality of services provided emerge as important determinants of demand for out-patient physician services. However, there is a great variety in the modeling approaches and inconsistencies in the findings regarding the impact of price on demand for out-patient physician services. Hitherto, the empirical research fails to offer policy-makers a clear strategy on how to develop a country-specific model of demand for out-patient physician services suitable for the assessment of patient payment policies in their countries. In particular, theoretically important factors, such as provider behavior, consumer attitudes, experience and culture, and informal patient payments, are not considered. Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes.

  19. Empirical models of demand for out-patient physician services and their relevance to the assessment of patient payment policies: a critical review of the literature.

    Science.gov (United States)

    Skriabikova, Olga; Pavlova, Milena; Groot, Wim

    2010-06-01

    This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee) or indirectly as a level of deductibles and/or co-insurance defined by the insurance coverage. The paper also discusses the relevance of these models for the assessment of patient payment policies. For this purpose, a systematic literature review is carried out. In total, 46 relevant publications were identified. These publications are classified into categories based on their general approach to demand modeling, specifications of data collection, data analysis, and main empirical findings. The analysis indicates a rising research interest in the empirical micro-level models of demand for out-patient physician services that incorporate the size of patient payment. Overall, the size of patient payments, consumer socio-economic and demographic features, and quality of services provided emerge as important determinants of demand for out-patient physician services. However, there is a great variety in the modeling approaches and inconsistencies in the findings regarding the impact of price on demand for out-patient physician services. Hitherto, the empirical research fails to offer policy-makers a clear strategy on how to develop a country-specific model of demand for out-patient physician services suitable for the assessment of patient payment policies in their countries. In particular, theoretically important factors, such as provider behavior, consumer attitudes, experience and culture, and informal patient payments, are not considered. Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes.

  20. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

    OpenAIRE

    Wilczynski Nancy L; Haynes R Brian

    2010-01-01

    Abstract Background Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this...

  1. A proactive transfer policy for critical patient flow management.

    Science.gov (United States)

    González, Jaime; Ferrer, Juan-Carlos; Cataldo, Alejandro; Rojas, Luis

    2018-02-17

    Hospital emergency departments are often overcrowded, resulting in long wait times and a public perception of poor attention. Delays in transferring patients needing further treatment increases emergency department congestion, has negative impacts on their health and may increase their mortality rates. A model built around a Markov decision process is proposed to improve the efficiency of patient flows between the emergency department and other hospital units. With each day divided into time periods, the formulation estimates bed demand for the next period as the basis for determining a proactive rather than reactive transfer decision policy. Due to the high dimensionality of the optimization problem involved, an approximate dynamic programming approach is used to derive an approximation of the optimal decision policy, which indicates that a certain number of beds should be kept free in the different units as a function of the next period demand estimate. Testing the model on two instances of different sizes demonstrates that the optimal number of patient transfers between units changes when the emergency patient arrival rate for transfer to other units changes at a single unit, but remains stable if the change is proportionally the same for all units. In a simulation using real data for a hospital in Chile, significant improvements are achieved by the model in key emergency department performance indicators such as patient wait times (reduction higher than 50%), patient capacity (21% increase) and queue abandonment (from 7% down to less than 1%).

  2. Health System Decision Makers' Feedback on Summaries and Tools Supporting the Use of Systematic Reviews: A Qualitative Study

    Science.gov (United States)

    Ellen, Moriah E.; Lavis, John N.; Wilson, Michael G.; Grimshaw, Jeremy; Haynes, R. Brian; Ouimet, Mathieu; Raina, Parminder; Gruen, Russell

    2014-01-01

    Health system managers and policy makers need timely access to high quality, policy-relevant systematic reviews. Our objectives were to obtain managers' and policy makers' feedback about user-friendly summaries of systematic reviews and about tools related to supporting or assessing their use. Our interviews identified that participants prefer key…

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

    Science.gov (United States)

    Jensen, Casper Bruun

    2008-03-01

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

  4. An analytical comparison of the patient-to-doctor policy and the doctor-to-patient policy in the outpatient clinic

    NARCIS (Netherlands)

    Hulshof, P.J.H.; Vanberkel, P.T.; Boucherie, Richardus J.; Hans, Elias W.; van Houdenhoven, Mark; van Ommeren, Jan C.W.

    Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room, while patients visit for consultation, we call this the Patient-to-Doctor policy. A different approach is the Doctor-to-Patient policy, whereby the doctor travels between multiple consultation

  5. An innovative influenza vaccination policy: targeting last season's patients.

    Science.gov (United States)

    Yamin, Dan; Gavious, Arieh; Solnik, Eyal; Davidovitch, Nadav; Balicer, Ran D; Galvani, Alison P; Pliskin, Joseph S

    2014-05-01

    Influenza vaccination is the primary approach to prevent influenza annually. WHO/CDC recommendations prioritize vaccinations mainly on the basis of age and co-morbidities, but have never considered influenza infection history of individuals for vaccination targeting. We evaluated such influenza vaccination policies through small-world contact networks simulations. Further, to verify our findings we analyzed, independently, large-scale empirical data of influenza diagnosis from the two largest Health Maintenance Organizations in Israel, together covering more than 74% of the Israeli population. These longitudinal individual-level data include about nine million cases of influenza diagnosed over a decade. Through contact network epidemiology simulations, we found that individuals previously infected with influenza have a disproportionate probability of being highly connected within networks and transmitting to others. Therefore, we showed that prioritizing those previously infected for vaccination would be more effective than a random vaccination policy in reducing infection. The effectiveness of such a policy is robust over a range of epidemiological assumptions, including cross-reactivity between influenza strains conferring partial protection as high as 55%. Empirically, our analysis of the medical records confirms that in every age group, case definition for influenza, clinical diagnosis, and year tested, patients infected in the year prior had a substantially higher risk of becoming infected in the subsequent year. Accordingly, considering individual infection history in targeting and promoting influenza vaccination is predicted to be a highly effective supplement to the current policy. Our approach can also be generalized for other infectious disease, computer viruses, or ecological networks.

  6. An innovative influenza vaccination policy: targeting last season's patients.

    Directory of Open Access Journals (Sweden)

    Dan Yamin

    2014-05-01

    Full Text Available Influenza vaccination is the primary approach to prevent influenza annually. WHO/CDC recommendations prioritize vaccinations mainly on the basis of age and co-morbidities, but have never considered influenza infection history of individuals for vaccination targeting. We evaluated such influenza vaccination policies through small-world contact networks simulations. Further, to verify our findings we analyzed, independently, large-scale empirical data of influenza diagnosis from the two largest Health Maintenance Organizations in Israel, together covering more than 74% of the Israeli population. These longitudinal individual-level data include about nine million cases of influenza diagnosed over a decade. Through contact network epidemiology simulations, we found that individuals previously infected with influenza have a disproportionate probability of being highly connected within networks and transmitting to others. Therefore, we showed that prioritizing those previously infected for vaccination would be more effective than a random vaccination policy in reducing infection. The effectiveness of such a policy is robust over a range of epidemiological assumptions, including cross-reactivity between influenza strains conferring partial protection as high as 55%. Empirically, our analysis of the medical records confirms that in every age group, case definition for influenza, clinical diagnosis, and year tested, patients infected in the year prior had a substantially higher risk of becoming infected in the subsequent year. Accordingly, considering individual infection history in targeting and promoting influenza vaccination is predicted to be a highly effective supplement to the current policy. Our approach can also be generalized for other infectious disease, computer viruses, or ecological networks.

  7. Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers

    Science.gov (United States)

    Macdonald, Marilyn; Lang, Ariella; MacDonald, Jo-Anne

    2011-01-01

    The purpose of this qualitative interpretive design was to explore the perspectives of researchers, health care providers, policy makers, and decision makers on key risks, concerns, and emerging issues related to home care safety that would inform a line of research inquiry. Defining safety specifically in this home care context has yet to be…

  8. Why the Critics of Poor Health Service Delivery Are the Causes of Poor Service Delivery: A Need to Train the Policy-makers; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

    Directory of Open Access Journals (Sweden)

    Nancy Harding

    2015-09-01

    Full Text Available This comment on Professor Fotaki’s Editorial agrees with her arguments that training health professionals in more compassionate, caring and ethically sound care will have little value unless the system in which they work changes. It argues that for system change to occur, senior management, government members and civil servants themselves need training so that they learn to understand the effects that their policies have on health professionals. It argues that these people are complicit in the delivery of unethical care, because they impose requirements that contradict health professionals’ desire to deliver compassionate and ethical forms of care.

  9. What do decision makers learn from public forums on climate-related hazards and resilience?

    Science.gov (United States)

    Weller, N.; Farooque, M.; Sittenfeld, D.

    2017-12-01

    Public engagement around climate resilience efforts can foster learning for both public audiences and decision makers. On the one hand, public audiences learn about environmental hazards and strategies to increase community resilience through effective public engagement. On the other, decision makers and scientists learn about community members' values and priorities and their relation to environmental hazards and resilience strategies. Evidence from other public engagement efforts involving decision makers suggests that decision maker involvement results in reflection by officials on their own values, capacities, and roles. However, few public engagement exercises evaluate impacts on decision makers. As part of the Science Center Public Forums project, which aims to conduct public forums in eight cities across the country on resiliency to drought, heat, extreme precipitation, and sea level rise, we sought to 1) build partnerships with local decision makers and scientists around public forums and 2) explore how decision makers and scientists interacted with the planning and undertaking of those public forums. We held workshops with decision makers and scientists to inform forum content and identify local resilience issues. We will conduct interviews with local decision makers regarding their involvement in forum planning, their reflections and takeaways from the forum itself, and their perspectives on the value of public engagement for policy making. We will present our model of engagement with decision makers, initial findings from interviews, and lessons learned from connecting decision makers and scientists to public engagement efforts.

  10. Nuclear power: the decision makers speak

    International Nuclear Information System (INIS)

    Cohen, R.L.; Lichter, S.R.

    1983-01-01

    In October 1980, the authors surveyed selected scientific experts, decision-makers in financial and regulatory communities and Congress, and directors of major activist groups for national environmental organizations. Questions concerned policy preferences for and general attitudes toward nuclear energy, problems, energy resources, and considerations important to most influential groups in nuclear development. The survey revealed, surprisingly, that most regulators, congressional leaders, outside experts, and financiers are as united in their support of nuclear energy development as are industry executives, Three Mile Island notwithstanding. The antinuclear perspective is represented almost entirely by the heads of activist groups and a few scattered allies in Congress, the Environmental Protection Agency, and the Department of Energy. A relatively few dissenters have played a major role in blocking nuclear development. Implications for the regulatory process from these survey results are that cost-benefit analyses and empirical findings on nuclear power issues will not convince activists and their followers; it appears that they have acquired a kind of veto over nuclear development. Through actively political behavior in the contest for nuclear energy's future, and through sympathetic media, activists have won the American public to their side. 7 tables

  11. Statins: antimicrobial resistance breakers or makers?

    Directory of Open Access Journals (Sweden)

    Humphrey H.T. Ko

    2017-10-01

    is probable that statins’ mechanism of antibacterial activity involves interference of bacterial cell regulatory functions via binding and disrupting cell surface structures such as wall teichoic acids, lipoteichoic acids, lipopolysaccharides, and/or surface proteins. The widespread use of statins for cardiovascular protection may favor selective pressures or co-selection for resistance, including dysbiosis of the human gut microbiota, sublethal plasma concentrations in bacteremic patients, and statin persistence in the environment, all possibly culminating in AMR. Conclusion Simvastatin appears to be the most suitable statin for repurposing as a novel adjuvant antibiotic. Current evidence better supports statins as potential AMR breakers, but their role as plausible AMR makers cannot be excluded. Elucidating the mechanism of statins’ antibacterial activity is perhaps the most important knowledge gap to address as this will likely clarify statins’ role as AMR breakers or makers.

  12. 2007 status of climate change: Mitigation of Climate Change. Contribution of Working Group III to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Summary for Policy-makers

    International Nuclear Information System (INIS)

    Barker, T.; Bashmakov, I.; Bernstein, L.; Bogner, J.; Bosch, P.; Dave, R.; Davidson, O.; Fisher, B.; Grubb, M.; Gupta, S.; Halsnaes, K.; Heij, B.; Kahn Ribeiro, S.; Kobayashi, S.; Levine, M.; Martino, D.; Masera Cerutti, O.; Metz, B.; Meyer, L.; Nabuurs, G.J.; Najam, A.; Nakicenovic, N.; Holger Rogner, H.; Roy, J.; Sathaye, J.; Schock, R.; Shukla, P.; Sims, R.; Smith, P.; Swart, R.; Tirpak, D.; Urge-Vorsatz, D.; Dadi, Z.

    2007-01-01

    The Working Group III contribution to the IPCC Fourth Assessment Report (AR4) focuses on new literature on the scientific, technological, environmental, economic and social aspects of mitigation of climate change, published since the IPCC Third Assessment Report (TAR) and the Special Reports on CO 2 Capture and Storage (SRCCS) and on Safeguarding the Ozone Layer and the Global Climate System (SROC).The main aim of this summary report is to assess options for mitigating climate change. Several aspects link climate change with development issues. This report explores these links in detail, and illustrates where climate change and sustainable development are mutually reinforcing. Economic development needs, resource endowments and mitigative and adaptive capacities differ across regions. There is no one-size-fits-all approach to the climate change problem, and solutions need to be regionally differentiated to reflect different socio-economic conditions and, to a lesser extent, geographical differences. Although this report has a global focus, an attempt is made to differentiate the assessment of scientific and technical findings for the various regions. Given that mitigation options vary significantly between economic sectors, it was decided to use the economic sectors to organize the material on short- to medium-term mitigation options. Contrary to what was done in the Third Assessment Report, all relevant aspects of sectoral mitigation options, such as technology, cost, policies etc., are discussed together, to provide the user with a comprehensive discussion of the sectoral mitigation options. The report is organised into six sections after the introduction: - Greenhouse gas (GHG) emission trends; - Mitigation in the short and medium term, across different economic sectors (until 2030); - Mitigation in the long-term (beyond 2030); - Policies, measures and instruments to mitigate climate change; - Sustainable development and climate change mitigation; - Gaps in

  13. Suicide Risk Response: Enhancing Patient Safety Through Development of Effective Institutional Policies

    National Research Council Canada - National Science Library

    Bonner, Laura; Felker, Bradford; Chaney, Edmund; Vollen, Karen; Berry, Karen; Revay, Barbara; Simon, Barbara; Kofoed, Lial; Ober, Scott; Worley, Linda

    2004-01-01

    A suicidal patient requires a prompt, coordinated intervention. In this paper, we describe a process for developing a suicidality policy, which may help clinics develop effective, locally adapted policies...

  14. [The Catalan Patient Council: the direct voice of the patient in health policies in Catalonia].

    Science.gov (United States)

    Vallès Navarro, Roser; Costa Vilar, Núria; Davins Miralles, Josep; Garcia Cirera, Montserrat; Hernando Ortega, Maria Rosario; Iniesta Blasco, Cristina

    2015-11-01

    The transition from a more paternalistic model of care focused on the disease and on the medical professional's authority towards a more participatory model centered on the rights and duties of informed patients represents a significant change in public health policy. One of the most widespread methods of social participation in Catalonia today is the tendency to form associations around a particular disease. This kind of organizational participation is a pioneering tool in the debate around public health policy. The Government of the Generalitat de Catalunya undertook to promote the Strategic Plan of patient participation within the public health system. The Department of Health created the Patient Advisory Council of Catalonia (CCPC, as per the acronym in Catalan). This initiative constitutes a permanent consultative and participatory body for patient representatives in the Catalan healthcare system. The CCPC was set up with a solid determination to place the patient at the centre of the healthcare system, including them in the decision-making processes which directly affect them. This patient participation plan has defined and developed 8 different lines approved by the government, with consensus approval between regional government and the organisations. The CCPC has proven itself to be an effective tool for fostering active patient participation in health policy and its relationship with the system has evolved from that of a monologue to becoming the mechanism for dialogue it is today. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  15. A translation table for patient-centered comparative effectiveness research: guidance to improve the value of research for clinical and health policy decision-making.

    Science.gov (United States)

    Tunis, Sean R; Messner, Donna A; Mohr, Penny; Gliklich, Richard E; Dubois, Robert W

    2012-05-01

    This article provides background and context for a series of papers stemming from a collaborative effort by Outcome Sciences, Inc., the National Pharmaceutical Council and the Center for Medical Technology Policy to use a stakeholder-driven process to develop a decision tool to select appropriate methods for comparative effectiveness research. The perceived need and origins of the 'translation table' concept for method selection are described and the legislative history and role of the Patient-Centered Outcomes Research Institute are reviewed. The article concludes by stressing the significance of this effort for future health services and clinical research, and the importance of consulting end-users--patients, providers, payers and policy-makers--in the process of defining research questions and approaches to them.

  16. Does the market maker stabilize the market?

    NARCIS (Netherlands)

    Zhu, M.; Chiarella, C.; He, X.Z.; Wang, D.

    2009-01-01

    The market maker plays an important role in price formation, but his/her behavior and stabilizing impact on the market are relatively unclear, in particular in speculative markets. This paper develops a financial market model that examines the impact on market stability of the market maker, who acts

  17. Thermodynamic analysis of a solar coffee maker

    International Nuclear Information System (INIS)

    Sosa-Montemayor, F.; Jaramillo, O.A.; Rio, J.A. del

    2009-01-01

    In this paper we present a novel solar concentrating application, a coffee brewing system using a satellite TV mini-Dish concentrator coupled to a stovetop espresso coffee maker. We present a theoretical model for the thermal behavior of the water in the lower chamber of the coffee maker. We validate the model obtaining good agreement with the experimental results. Our findings indicate that the coffee brewing system works, it takes 30-50 min to complete its task. The model and our practical experience encourage us to improve the concentration device in order to obtain a useful solar coffee maker, using the theoretical model as a safe guide to achieve this.

  18. Thermodynamic analysis of a solar coffee maker

    Energy Technology Data Exchange (ETDEWEB)

    Sosa-Montemayor, F.; Jaramillo, O.A. [Centro de Investigacion en Energia, Universidad Nacional Autonoma de Mexico, Privada Xochicalco S/N, Temixco, Morelos CP 62580 (Mexico); del Rio, J.A. [Centro Morelense de Innovacion y Tranferencia Tecnologica, CCyTEM, Camino Temixco a Emiliano Zapata, Km 0.3, Colonia Emiliano Zapata, Morelos CP 62760 (Mexico)

    2009-09-15

    In this paper we present a novel solar concentrating application, a coffee brewing system using a satellite TV mini-Dish concentrator coupled to a stovetop espresso coffee maker. We present a theoretical model for the thermal behavior of the water in the lower chamber of the coffee maker. We validate the model obtaining good agreement with the experimental results. Our findings indicate that the coffee brewing system works, it takes 30-50 min to complete its task. The model and our practical experience encourage us to improve the concentration device in order to obtain a useful solar coffee maker, using the theoretical model as a safe guide to achieve this. (author)

  19. Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers

    Directory of Open Access Journals (Sweden)

    Stephen Bornstein

    2017-11-01

    Full Text Available Abstract Background The Contextualized Health Research Synthesis Program (CHRSP, developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. Methods As an integrated knowledge translation (KT method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies. Although it was developed in the Canadian province of Newfoundland and Labrador, the CHRSP methodology is adaptable to a variety of settings with distinctive features, such as those in rural, remote, and small-town locations. Results CHRSP has published 25 syntheses on priority topics chosen by the provincial healthcare system, including: Clinical and cost-effectiveness: telehealth, rural renal dialysis, point-of-care testing; Community-based health services: helping seniors age in place, supporting seniors with dementia, residential treatment centers for at-risk youth; Healthcare organization/service delivery: reducing acute-care length of stay, promoting flu vaccination among health workers, safe patient handling, age-friendly acute care; and Health promotion: diabetes prevention, promoting healthy dietary habits. These studies have been used by decision makers to inform local policy and practice decisions. Conclusions By asking the health

  20. Rural emergency care 360°: mobilising healthcare professionals, decision-makers, patients and citizens to improve rural emergency care in the province of Quebec, Canada: a qualitative study protocol.

    Science.gov (United States)

    Fleet, Richard; Dupuis, Gilles; Fortin, Jean-Paul; Gravel, Jocelyn; Ouimet, Mathieu; Poitras, Julien; Légaré, France

    2017-08-17

    Emergency departments (EDs) are an important safety net for rural populations. Results of our earlier studies suggest that rural Canadian hospitals have limited access to advanced imaging services and intensive care units and that patients are transferred over large distances. They also revealed significant geographical variations in rural services. In the absence of national standards, our studies raise questions about inequities in rural access to emergency services and the risks for citizens. Our goal is to build recommendations for improving services by mobilising stakeholders interested in rural emergency care. With help and full engagement of stakeholders, we will (1) identify solutions for improving quality and performance in rural EDs; (2) formulate and prioritise recommendations; (3) transfer knowledge of the recommendations to rural EDs and support operationalisation and (4) assess knowledge transfer and explore further impacts of this participatory action research project. We will use a participatory action research approach. We will plan for a governance structure that includes all stakeholders’ representatives, so throughout this project, stakeholders are fully engaged at every step. Our sample will be 26 EDs in rural Quebec. We will conduct semistructured individual and focus group interviews with relevant and representative participants, including patients and citizens (estimated n=200). Interviews will be thematically analysed to extract potential solutions and other qualitative information.An expert panel (±15) will use an analysis grid to develop consensus recommendations from solutions suggested and will evaluate feasibility, impacts, costs, conditions for implementation and establish monitoring indicators. Recommendations will be transferred to stakeholders using tailored knowledge translation strategies (web platform, meetings and so on). This study will result in a comprehensive consensus list of feasible and high

  1. 76 FR 28308 - Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects-Criteria for...

    Science.gov (United States)

    2011-05-17

    .... FDA-2011-D-0258] Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects... Compliance Policy Guide Sec. 335.700, Surgeons' Gloves and Patient Examination Gloves; Defects--Criteria for... FDA staff on the submission of seizure recommendations for medical gloves that exceed the defect...

  2. DEFINING HUMAN MIGRATION – A POLICY MAKERS PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Paul-Panfil IVAN

    2015-06-01

    Full Text Available Migration is a global phenomenon gradually increased in scope, impact and complexity. Practically all countries are simultaneously countries of destination, origin and transit for migrants. Traditionally migration flows are complemented by new changes generated by economic, demographic, political or social conditions, and these trends affect both the size and structure of the migrant population and also economies and societies. Of course this has sparked international interest from various NGOs and by the European Union and the United Nations. This paper aims to present the vision of international organizations concerned with migration and how they define migration and its typologies.

  3. Transparency in Nigeria's public pharmaceutical sector: perceptions from policy makers

    Directory of Open Access Journals (Sweden)

    Kohler Jillian C

    2009-10-01

    Full Text Available Abstract Background Pharmaceuticals are an integral component of health care systems worldwide, thus, regulatory weaknesses in governance of the pharmaceutical system negatively impact health outcomes especially in developing countries 1. Nigeria is one of a number of countries whose pharmaceutical system has been impacted by corruption and has struggled to curtail the production and trafficking of substandard drugs. In 2001, the National Agency for Food and Drug Administration and Control (NAFDAC underwent an organizational restructuring resulting in reforms to reduce counterfeit drugs and better regulate pharmaceuticals 2. Despite these changes, there is still room for improvement. This study assessed the perceived level of transparency and potential vulnerability to corruption that exists in four essential areas of Nigeria's pharmaceutical sector: registration, procurement, inspection (divided into inspection of ports and of establishments, and distribution. Methods Standardized questionnaires were adapted from the World Health Organization assessment tool and used in semi-structured interviews with key stakeholders in the public and private pharmaceutical system. The responses to the questions were tallied and converted to scores on a numerical scale where lower scores suggested greater vulnerability to corruption and higher scores suggested lower vulnerability. Results The overall score for Nigeria's pharmaceutical system was 7.4 out of 10, indicating a system that is marginally vulnerable to corruption. The weakest links were the areas of drug registration and inspection of ports. Analysis of the qualitative results revealed that the perceived level of corruption did not always match the qualitative evidence. Conclusion Despite the many reported reforms instituted by NAFDAC, the study findings suggest that facets of the pharmaceutical system in Nigeria remain fairly vulnerable to corruption. The most glaring deficiency seems to be the absence of conflict of interest guidelines which, if present and consistently administered, limit the promulgation of corrupt practices. Other major contributing factors are the inconsistency in documentation of procedures, lack of public availability of such documentation, and inadequacies in monitoring and evaluation. What is most critical from this study is the identification of areas that still remain permeable to corruption and, perhaps, where more appropriate checks and balances are needed from the Nigerian government and the international community.

  4. Transparency in Nigeria's public pharmaceutical sector: perceptions from policy makers.

    Science.gov (United States)

    Garuba, Habibat A; Kohler, Jillian C; Huisman, Anna M

    2009-10-29

    Pharmaceuticals are an integral component of health care systems worldwide, thus, regulatory weaknesses in governance of the pharmaceutical system negatively impact health outcomes especially in developing countries 1. Nigeria is one of a number of countries whose pharmaceutical system has been impacted by corruption and has struggled to curtail the production and trafficking of substandard drugs. In 2001, the National Agency for Food and Drug Administration and Control (NAFDAC) underwent an organizational restructuring resulting in reforms to reduce counterfeit drugs and better regulate pharmaceuticals 2. Despite these changes, there is still room for improvement. This study assessed the perceived level of transparency and potential vulnerability to corruption that exists in four essential areas of Nigeria's pharmaceutical sector: registration, procurement, inspection (divided into inspection of ports and of establishments), and distribution. Standardized questionnaires were adapted from the World Health Organization assessment tool and used in semi-structured interviews with key stakeholders in the public and private pharmaceutical system. The responses to the questions were tallied and converted to scores on a numerical scale where lower scores suggested greater vulnerability to corruption and higher scores suggested lower vulnerability. The overall score for Nigeria's pharmaceutical system was 7.4 out of 10, indicating a system that is marginally vulnerable to corruption. The weakest links were the areas of drug registration and inspection of ports. Analysis of the qualitative results revealed that the perceived level of corruption did not always match the qualitative evidence. Despite the many reported reforms instituted by NAFDAC, the study findings suggest that facets of the pharmaceutical system in Nigeria remain fairly vulnerable to corruption. The most glaring deficiency seems to be the absence of conflict of interest guidelines which, if present and consistently administered, limit the promulgation of corrupt practices. Other major contributing factors are the inconsistency in documentation of procedures, lack of public availability of such documentation, and inadequacies in monitoring and evaluation. What is most critical from this study is the identification of areas that still remain permeable to corruption and, perhaps, where more appropriate checks and balances are needed from the Nigerian government and the international community.

  5. Research a 'revolution' for academics and policy makers

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

    Barbara Fraser

    esos hallazgos al frente del nuevo Ministerio de Desarrollo e Inclusión Social de ... se basa en los resultados del programa Dinámicas Territoriales Rurales, ... para estimular los mercados y brindar servicios tales como salud y educación.

  6. Soil biodiversity: functions, threats and tools for policy makers

    NARCIS (Netherlands)

    Putten, van der W.H.; Mudgal, S.; Turbé, A.; Toni, de A.; Lavelle, P.; Benito, P.; Ruiz, N.

    2010-01-01

    Human societies rely on the vast diversity of benefits provided by nature, such as food, fibres, construction materials, clean water, clean air and climate regulation. All the elements required for these ecosystem services depend on soil, and soil biodiversity is the driving force behind their

  7. Socio-demographic determinants of stigma among patients with ...

    African Journals Online (AJOL)

    Administrator

    2011-08-01

    Aug 1, 2011 ... stigma and discrimination. ... Healthcare workers and policy makers need to pay closer attention to the identified determinants for ... Analysis was done using the Statistical ... determine whether or not patients obtained support.

  8. A critical analysis of national policies, systems, and structures of patient empowerment in England and Greece.

    Science.gov (United States)

    Boudioni, Markella; McLaren, Susan; Lister, Graham

    2017-01-01

    Comparison of patient empowerment (PE) policies in European countries can provide evidence for improvement and reform across different health systems. It may also influence patient and public involvement, patient experience, preference, and adherence. The objective of this study was to compare PE within national policies, systems, and structures in England and Greece for achieving integrated people-centered health services. We performed a critical search and review of policy and legislation papers in English and Greek languages. This included 1) general health policy and systems papers, 2) PE, patient and/or public involvement or patients' rights policy and legislation (1990-2015), and 3) comparative or discussion papers for England and/or Greece. A total of 102 papers on PE policies, systems, and structures were identified initially; 80 papers were included, in which 46 were policy, legislative, and discussion papers about England, 21 were policy, legislation, and discussion papers about Greece, and 13 were comparative or discussion papers including both the countries. In England, National Health Service policies emphasized patient-centered services, involvement, and empowerment, with recent focus on patients' rights; while in Greece, they emphasized patients' rights and quality of services, with recent mentions on empowerment. The health ombudsman is a very important organization across countries; however, it may be more powerful in Greece, because of the nonexistence of local mediating bodies. Micro-structures at trusts/hospitals are comparable, but legislation gives more power to the local structures in Greece. PE policies and systems have been developed and expressed differently in these countries. However, PE similarities, comparable dimensions and mechanisms, were identified. For both the countries, comparative research and these findings could be beneficial in building connections and relationships, contributing to wider European and international

  9. A scientist's guide to engaging decision makers

    Science.gov (United States)

    Vano, J. A.

    2015-12-01

    Being trained as a scientist provides many valuable tools needed to address society's most pressing environmental issues. It does not, however, provide training on one of the most critical for translating science into action: the ability to engage decision makers. Engagement means different things to different people and what is appropriate for one project might not be for another. However, recent reports have emphasized that for research to be most useful to decision making, engagement should happen at the beginning and throughout the research process. There are an increasing number of boundary organizations (e.g., NOAA's Regional Integrated Sciences and Assessment program, U.S. Department of the Interior's Climate Science Centers) where engagement is encouraged and rewarded, and scientists are learning, often through trial and error, how to effectively include decision makers (a.k.a. stakeholders, practitioners, resource managers) in their research process. This presentation highlights best practices and practices to avoid when scientists engage decision makers, a list compiled through the personal experiences of both scientists and decision makers and a literature review, and how this collective knowledge could be shared, such as through a recent session and role-playing exercise given at the Northwest Climate Science Center's Climate Boot Camp. These ideas are presented in an effort to facilitate conversations about how the science community (e.g., AGU researchers) can become better prepared for effective collaborations with decision makers that will ultimately result in more actionable science.

  10. Legal and Policy Issues for LGBT Patients with Cancer or at Elevated Risk of Cancer.

    Science.gov (United States)

    Cahill, Sean R

    2018-02-01

    To understand the major legal and policy issues for lesbian, gay, bisexual and transgender (LGBT) cancer patients. LGBT health policy research. Major policy issues include discrimination, lack of cultural competency and clinically appropriate care, insurance coverage, family recognition, and sexual orientation and gender identity data collection. Nurses play a major role in providing affirming and competent care to LGBT cancer patients. Using correct names and pronouns with transgender patients, and collecting sexual orientation and gender identity data can send an affirming message to LGBT patients, as well as inform decision support and preventive screenings, and improve treatment outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. On avoiding framing effects in experienced decision makers.

    Science.gov (United States)

    Garcia-Retamero, Rocio; Dhami, Mandeep K

    2013-01-01

    The present study aimed to (a) demonstrate the effect of positive-negative framing on experienced criminal justice decision makers, (b) examine the debiasing effect of visually structured risk messages, and (c) investigate whether risk perceptions mediate the debiasing effect of visual aids on decision making. In two phases, 60 senior police officers estimated the accuracy of a counterterrorism technique in identifying whether a known terror suspect poses an imminent danger and decided whether they would recommend the technique to policy makers. Officers also rated their confidence in this recommendation. When information about the effectiveness of the counterterrorism technique was presented in a numerical format, officers' perceptions of accuracy and recommendation decisions were susceptible to the framing effect: The technique was perceived to be more accurate and was more likely to be recommended when its effectiveness was presented in a positive than in a negative frame. However, when the information was represented visually using icon arrays, there were no such framing effects. Finally, perceptions of accuracy mediated the debiasing effect of visual aids on recommendation decisions. We offer potential explanations for the debiasing effect of visual aids and implications for communicating risk to experienced, professional decision makers.

  12. Does the market maker stabilize the market?

    Science.gov (United States)

    Zhu, Mei; Chiarella, Carl; He, Xue-Zhong; Wang, Duo

    2009-08-01

    The market maker plays an important role in price formation, but his/her behavior and stabilizing impact on the market are relatively unclear, in particular in speculative markets. This paper develops a financial market model that examines the impact on market stability of the market maker, who acts as both a liquidity provider and an active investor in a market consisting of two types of boundedly rational speculative investors-the fundamentalists and trend followers. We show that the market maker does not necessarily stabilize the market when he/she actively manages the inventory to maximize profits, and that rather the market maker’s impact depends on the behavior of the speculators. Numerical simulations show that the model is able to generate outcomes for asset returns and market inventories that are consistent with empirical findings.

  13. Decision Making with Imperfect Decision Makers

    CERN Document Server

    Guy, Tatiana Valentine; Wolpert, David H

    2012-01-01

    Prescriptive Bayesian decision making has reached a high level of maturity and is well-supported algorithmically. However, experimental data shows that real decision makers choose such Bayes-optimal decisions surprisingly infrequently, often making decisions that are badly sub-optimal. So prevalent is such imperfect decision-making that it should be accepted as an inherent feature of real decision makers living within interacting societies. To date such societies have been investigated from an economic and gametheoretic perspective, and even to a degree from a physics perspective. However, lit

  14. The Art of Influencing Decision Makers.

    Science.gov (United States)

    Diegmueller, Karen

    1992-01-01

    Influencing educational decision makers requires creating ongoing relationships, keeping everyone informed, and developing persuasive skills. Persuasion requires preparation, refinement, hard work, and a sound understanding of the people being lobbied. Lobbying must be factual and relevant to the audience. The article looks at influence from the…

  15. Change Makers: The Struggle for Consumer Rights.

    Science.gov (United States)

    Nelson, Helen E.; And Others

    1995-01-01

    "Video Documentary Project: A Brief History" (Nelson, Clark) describes "Change Makers: The Struggle for Consumer Rights," a documentary that tells stories of ordinary people who participated in the struggle to obtain fairness in the marketplace. "An Appraisal" (Mayer) offers a review of the film. (JOW)

  16. The Morality of University Decision-Makers

    Science.gov (United States)

    Hatier, Cécile

    2014-01-01

    Ethical failures in UK higher education have recently made the news but are not a recent development. University decision-makers can, in order to adopt an ethical way of reasoning, resort to several ethical traditions. This article focuses, through the use of concrete examples, on three which have had a significant impact in recent higher…

  17. Clinical review: impact of statin substitution policies on patient outcomes

    NARCIS (Netherlands)

    Atar, Dan; Carmena, Rafael; Clemmensen, Peter; K-Laflamme, Annik; Wassmann, Sven; Lansberg, Peter; Hobbs, Richard

    2009-01-01

    The increasing awareness of cost issues in health care has led to the increasing use of policy-driven substitution of branded for generic medications, particularly relative to statin treatment for cardiovascular diseases. While there are potential short-term health care savings, the consequences for

  18. Clinical review: impact of statin substitution policies on patient outcomes

    DEFF Research Database (Denmark)

    Atar, Dan; Carmena, Rafael; Clemmensen, Peter

    2009-01-01

    BACKGROUND: The increasing awareness of cost issues in health care has led to the increasing use of policy-driven substitution of branded for generic medications, particularly relative to statin treatment for cardiovascular diseases. While there are potential short-term health care savings...

  19. Health policy considerations for our sexual minority patients.

    Science.gov (United States)

    O'Hanlan, Katherine A

    2006-03-01

    Homosexuality and transsexuality are still widely viewed by lay individuals as morally negative and deserving of legal proscription. Peer-reviewed data confirm that experiences of legal discrimination are associated with stress-related health problems, reduced utilization of health care, and financial and legal challenges for individuals and families, especially those with children. In the last 3 years, the American Psychiatric Association, American Psychological Association, and American Psychoanalytic Association have each reviewed the research on sexual orientation and identity, and each has confirmed that sexual orientation and gender identity do not correlate with mental illness or immorality. They have each endorsed laws that confer equality to sexual minorities, including nondiscrimination in employment, medical insurance coverage, adoption, and access to civil marriage. The American College of Obstetricians and Gynecologists (ACOG), by virtue of its history of advocacy for women's health, is in a position to promote policy and make similar recommendations, recognizing that sexual minority women's health and their family issues are an integral component of taking care of all women. The College should review the policies of America's premier mental health associations and consider including sexual orientation and gender identity in its own nondiscrimination policy, and ACOG should issue a policy statement in support of laws to provide safety from violence and discrimination, equal employment opportunities, equal health insurance coverage, and equal access to civil marriage.

  20. Citizen participation in patient prioritization policy decisions: an empirical and experimental study on patients' characteristics.

    Directory of Open Access Journals (Sweden)

    Adele Diederich

    Full Text Available Health systems worldwide are grappling with the need to control costs to maintain system viability. With the combination of worsening economic conditions, an aging population and reductions in tax revenues, the pressures to make structural changes are expected to continue growing. Common cost control mechanisms, e.g. curtailment of patient access and treatment prioritization, are likely to be adversely viewed by citizens. It seems therefore wise to include them in the decision making processes that lead up to policy changes. In the context of a multilevel iterative mixed-method design a quantitative survey representative of the German population (N = 2031 was conducted to probe the acceptance of priority setting in medicine and to explore the practicability of direct public involvement. Here we focus on preferences for patients' characteristics (medical aspects, lifestyle and socio-economic status as possible criteria for prioritizing medical services. A questionnaire with closed response options was fielded to gain insight into attitudes toward broad prioritization criteria of patient groups. Furthermore, a discrete choice experiment was used as a rigorous approach to investigate citizens' preferences toward specific criteria level in context of other criteria. Both the questionnaire and the discrete choice experiment were performed with the same sample. The citizens' own health and social situation are included as explanatory variables. Data were evaluated using corresponding analysis, contingency analysis, logistic regression and a multinomial exploded logit model. The results show that some medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria are rejected.

  1. Citizen participation in patient prioritization policy decisions: an empirical and experimental study on patients' characteristics.

    Science.gov (United States)

    Diederich, Adele; Swait, Joffre; Wirsik, Norman

    2012-01-01

    Health systems worldwide are grappling with the need to control costs to maintain system viability. With the combination of worsening economic conditions, an aging population and reductions in tax revenues, the pressures to make structural changes are expected to continue growing. Common cost control mechanisms, e.g. curtailment of patient access and treatment prioritization, are likely to be adversely viewed by citizens. It seems therefore wise to include them in the decision making processes that lead up to policy changes. In the context of a multilevel iterative mixed-method design a quantitative survey representative of the German population (N = 2031) was conducted to probe the acceptance of priority setting in medicine and to explore the practicability of direct public involvement. Here we focus on preferences for patients' characteristics (medical aspects, lifestyle and socio-economic status) as possible criteria for prioritizing medical services. A questionnaire with closed response options was fielded to gain insight into attitudes toward broad prioritization criteria of patient groups. Furthermore, a discrete choice experiment was used as a rigorous approach to investigate citizens' preferences toward specific criteria level in context of other criteria. Both the questionnaire and the discrete choice experiment were performed with the same sample. The citizens' own health and social situation are included as explanatory variables. Data were evaluated using corresponding analysis, contingency analysis, logistic regression and a multinomial exploded logit model. The results show that some medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria are rejected.

  2. Heterogeneous fundamentalists and market maker inventories

    International Nuclear Information System (INIS)

    Carraro, Alessandro; Ricchiuti, Giorgio

    2015-01-01

    In this paper, we develop a heterogeneous agents model of asset price and inventory with a market maker who considers the excess demand of two groups of agents that employ the same trading rule (i.e. fundamentalists) with different beliefs on the fundamental value. The dynamics of our model is driven by a bi-dimensional discrete non-linear map. We show that the market maker has a destabilizing role when she actively manages the inventory. Moreover, inventory share and the distance between agents’ beliefs strongly influence the results: market instability and periodic, or even, chaotic price fluctuations can be generated. Finally, we show through simulations that endogenous fluctuations of the fractions of agents may trigger instability for a larger set of parameters.

  3. Working for Policy

    NARCIS (Netherlands)

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

    2010-01-01

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

  4. Nordsøen Movie Maker

    DEFF Research Database (Denmark)

    2013-01-01

    Tag på ekspedition under havets overflade med Nordsøen Movie Maker, hvor din tur i Nordsøen Oceanarium får et helt nyt virtuelt lag. Rejs ud til de syv destinationer og hold øje med de unikke ‘moviespots‘ i nærheden af akvarierne. Her kan du med Nordsøen Movie Maker filme og dokumentere dine...... oplevelser med legesyge sæler, susende hvirvelstrømme og gigantiske klumpfisk. Nordsøen Movie Maker giver filmen et ekstra virtuelt lag, og via augmented reality bliver der tilføjet seje og morsomme, animerede specialeffekter. 1) Download app’en 2) Find et moviespot ved ekspeditionsposterne i Nordsøen...... Oceanarium. Kig efter klaptræet. 3) Vælg den rigtige post i app’en og start med at filme dit filmklip Downloader du app’en før dit besøg, er du allerede klar til at starte ekspeditionen i det øjeblik, du træder ind i Oceanariets tusmørke, hvor de første moviespots er gemt. God fornøjelse med ekspeditionen...

  5. Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

    Science.gov (United States)

    Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.

  6. Doctor-Patient Knowledge Transfer: Innovative Technologies and Policy Implications

    OpenAIRE

    Sára, Zoltán; Csedő, Zoltán; Tóth, Tamás; Fejes, József; Pörzse, Gábor

    2013-01-01

    The aim of this study was to empirically investigate the barriers in doctor-patient communication and knowledge transfer and the role of innovative technologies in overcoming these barriers. We applied qualitative research methods. Our results show that patients extensively use information sources, primarily the Internet before the visits. Patients regularly apply a self-diagnosis regarding their diseases. This implies several risks as many of them are not able to properly inte...

  7. Educate patients on billing policies to improve your bottom line.

    Science.gov (United States)

    May, Jonathan

    2006-01-01

    In no other industry are the consumers of goods or services so unaware and uninvolved in the reimbursement for the goods or services received. The United States healthcare industry has created and allowed to perpetuate a "hands-off" compensation approach that has created a consumer mentality proving quite difficult to change. In this article, the author describes the origin of this outdated approach and suggests a restructured office and clear communication with patients as starting points to change this deep-rooted mind-set. He describes how an up-front approach to patients' financial responsibilities and proactive staff can help reduce miscommunication between provider, patient, and insurance carrier and improve your practice's cash flow. The author also suggests that the patient's financial burden will continue to increase and offers tips to maintain positive patient relationships, improve your accounts receivable management, and protect you financially.

  8. 77 FR 72721 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-12-06

    ... 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... Patient Protection and Affordable Care Act on issuers of certain health insurance policies and plan... arrangements) or Rebecca L. Baxter at (202) 622-3970 (regarding health insurance policies). SUPPLEMENTARY...

  9. Eco-informatics for decision makers advancing a research agenda

    Science.gov (United States)

    Cushing, J.B.; Wilson, T.; Brandt, L.; Gregg, V.; Spengler, S.; Borning, A.; Delcambre, L.; Bowker, G.; Frame, M.; Fulop, J.; Hert, C.; Hovy, E.; Jones, J.; Landis, E.; Schnase, J.L.; Schweik, C.; Sonntag, W.; ,

    2005-01-01

    Resource managers often face significant information technology (IT) problems when integrating ecological or environmental information to make decisions. At a workshop sponsored by the NSF and USGS in December 2004, university researchers, natural resource managers, and information managers met to articulate IT problems facing ecology and environmental decision makers. Decision making IT problems were identified in five areas: 1) policy, 2) data presentation, 3) data gaps, 4) tools, and 5) indicators. To alleviate those problems, workshop participants recommended specific informatics research in modeling and simulation, data quality, information integration and ontologies, and social and human aspects. This paper reports the workshop findings, and briefly compares these with research that traditionally falls under the emerging eco-informatics rubric. ?? Springer-Verlag Berlin Heidelberg 2005.

  10. Monitoring Values and Practices of Oak Woodland Decision Makers on the Urban Fringe

    Science.gov (United States)

    William Stewart

    1991-01-01

    Concern over oak woodlands has shifted away from ranch management towards residential areas. This shift has been accompanied by the involvement of decision makers who previously had little involvement with rangeland policies and practices. A survey of three recent Cooperative Extension workshops illustrates a number of important patterns regarding interest and...

  11. Coping Strategies and Posttraumatic Stress Symptoms in Post-ICU Family Decision Makers.

    Science.gov (United States)

    Petrinec, Amy B; Mazanec, Polly M; Burant, Christopher J; Hoffer, Alan; Daly, Barbara J

    2015-06-01

    To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. A single-group descriptive longitudinal correlational study. Medical, surgical, and neurological ICUs in a large tertiary care university hospital. Consecutive family decision makers of adult critical care patients from August 2012 to November 2013. Study inclusion occurred after the patient's fifth day in the ICU. None. Family decision makers of incapacitated adult ICU patients completed the Brief COPE instrument assessing coping strategy use 5 days after ICU admission and 30 days after hospital discharge or death of the patient and completed the Impact of Event Scale-Revised assessing posttraumatic stress symptoms 60 days after hospital discharge. Seventy-seven family decision makers of the eligible 176 completed all data collection time points of this study. The use of problem-focused (p=0.01) and emotion-focused (pstress symptoms than coping strategies 5 days after ICU admission (R2=0.30, p=0.001) controlling for patient and decision-maker characteristics. The role of decision maker for a parent and patient death were the only noncoping predictors of posttraumatic stress symptoms. Avoidant coping use 30 days after hospitalization mediated the relationship between patient death and later posttraumatic stress symptom severity. Coping strategy use is a significant predictor of posttraumatic stress symptom severity 60 days after hospitalization in family decision makers of ICU patients.

  12. Eli Hecksher as a Portrait Maker

    Directory of Open Access Journals (Sweden)

    Benny Carlson

    2017-04-01

    Full Text Available Eli Heckscher was not only author of extensive investigations into economic history. He was also skillful in depicting phenomena in small format in encyclopædias, journals and newspapers. This article presents Heckscher as portrait maker of economic scholars. In these portraits—what he emphasized, what he praised, what he criticized—one can discern the stance of the portrait maker himself. Overall, his portraits are permeated by admiration of sharp theoretical analyses and massive economic historical investigations. He admires the founding fathers of political economy, Adam Smith and David Ricardo, stresses continuity in the development of economic thought, praises humble innovators like David Davidson, Knut Wicksell and Alfred Marshall and denounces (what he perceives as pretentious innovators like Gustav Cassel and John Maynard Keynes. He is critical towards economists who attempt to break out of the classical and neoclassical tradition, especially representatives of the German historical school, and what he judges to be a new type of mercantilism, represented by Bertil Ohlin and Keynes. At the same time he appreciates voluminous and solid investigations into economic history, even if performed without theoretical beacons, by scholars like William Cunningham, William Ashley, John Clapham, Marc Bloch, Richard Ehrenberg and Werner Sombart.

  13. PROBLEMATIC FEATURES OF THE POLITICAL DECISION MAKERS

    Directory of Open Access Journals (Sweden)

    Aleksey Sergeevih Voynov

    2014-11-01

    Full Text Available Purpose: identify the most important features in the process of making political decisions that affect the effectiveness of problem-solving situationsScientific novelty: as a result of the analysis identified the problematic features of major importance for the efficiency of the development and adoption of the most rational solution to a problem situation.Results: the analysis of the most significant features affecting the quality of decisions among them the interest of the person making decisions in the search for causes of the problem situation; decisions from the influence of the immediate environment; populism in decision making, creating a visibility problem-solving; decision making based on personal emotional factor face decision-makers; the perception of the population face decision-makers in relation to the current problem situation and possible ways of its resolution.Defined facts influencing the process of political decision-making such as: corruption, the struggle for influence on the process of political decision-making, lack of qualified specialists, staff shortage, including arose as the result of substitution of notions of "succession" to "nepotism".

  14. PUBLIC POLICIES OF RIGHT TO EDUCATION FOR ELDERLY PATIENTS

    Directory of Open Access Journals (Sweden)

    Hamilton de Oliveira Telles Júnior

    2017-08-01

    Full Text Available The people are living more. The population is going by great transformations, so much social as technological, that point to the need of specific education processes for senior people. The seniors tend to be separated socially, with damages for his/her health and, consequently, his/her life quality. This study, of qualitative approach, has as objective to describe the public politics for the senior's education interned in hospitals or institutions and to analyze the applicable Public Politics to the education based an express analysis model by Di Giovanni, where there are the actors of this public policy and its related interests. How possible middle for attainment of a program driven to the seniors' education is evidenced in the inclusion possibility in the hospital class and the possibility of the use of education programs for youths and adults, with the initiative of third sector, that in the extent of the education no formal he/she brings great transformations for society and education for the senior.

  15. Towards Patient-Centered Conflicts of Interest Policy

    Directory of Open Access Journals (Sweden)

    Peter D. Young

    2018-02-01

    Full Text Available Financial conflicts of interest exist between industry and physicians, and these relationships have the power to influence physicians’ medical practice. Transparency about conflicts matters for ensuring adequate informed consent, controlling healthcare expenditure, and encouraging physicians’ reflection on professionalism. The US Centers for Medicare & Medicaid Services (CMS launched the Open Payments Program (OPP to publicly disclose and bring transparency to the relationships between industry and physicians in the United States. We set out to explore user awareness of the database and the ease of accessibility to disclosed information, however, as we show, both awareness and actual use are very low. Two practical policies can greatly enhance its intended function and help alleviate ethical tension. The first is to provide data for individual physicians not merely in absolute terms, but in meaningful context, that is, in relation to the zip code, city, and state averages. The second increases access to the OPP dataset by adding hyperlinks from physicians’ professional websites directly to their Open Payments disclosure pages. These changes considerably improve transparency and the utility of available data, and can furthermore enhance professionalism and accountability by encouraging physicians to reflect more actively on their own practices.

  16. Policies for patient access to clinical data via PHRs: current state and recommendations.

    Science.gov (United States)

    Collins, Sarah A; Vawdrey, David K; Kukafka, Rita; Kuperman, Gilad J

    2011-12-01

    Healthcare delivery organizations are increasingly using online personal health records (PHRs) to provide patients with direct access to their clinical information; however, there may be a lack of consistency in the data made available. We aimed to understand the general use and functionality of PHRs and the organizational policies and decision-making structures for making data available to patients. A cross-sectional survey was administered by telephone structured interview to 21 organizations to determine the types of data made available to patients through PHRs and the presence of explicit governance for PHR data release. Organizations were identified based on a review of the literature, PHR experts, and snowball sampling. Organizations that did not provide patients with electronic access to their data via a PHR were excluded. Interviews were conducted with 17 organizations for a response rate of 81%. Half of the organizations had explicit governance in the form of a written policy that outlined the data types made available to patients. Overall, 88% of the organizations used a committee structure for the decision-making process and included senior management and information services. All organizations sought input from clinicians. Discussion There was considerable variability in the types of clinical data and the time frame for releasing these data to patients. Variability in data release policies may have implications for PHR use and adoption. Future policy activities, such as requirement specification for the latter stages of Meaningful Use, should be leveraged as an opportunity to encourage standardization of functionality and broad deployment of PHRs.

  17. Assessing Patient Participation in Health Policy Decision-Making in Cyprus.

    Science.gov (United States)

    Souliotis, Kyriakos; Agapidaki, Eirini; Peppou, Lily Evangelia; Tzavara, Chara; Samoutis, George; Theodorou, Mamas

    2016-06-20

    Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients' involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus. © 2016 by Kerman University of Medical Sciences.

  18. Rational use of medicines--an important issue in pharmaceutical policy

    DEFF Research Database (Denmark)

    Almarsdóttir, Anna Birna; Traulsen, Janine Marie

    2005-01-01

    to adapt its way of thinking to include the issue of context. They point out that clinical pharmacists today already adapt their decisons to each patient and patient group. Policy-makers are encouraged to adopt a similar approach because populations as well as particular market situations vary...

  19. Quantum decision-maker theory and simulation

    Science.gov (United States)

    Zak, Michail; Meyers, Ronald E.; Deacon, Keith S.

    2000-07-01

    A quantum device simulating the human decision making process is introduced. It consists of quantum recurrent nets generating stochastic processes which represent the motor dynamics, and of classical neural nets describing the evolution of probabilities of these processes which represent the mental dynamics. The autonomy of the decision making process is achieved by a feedback from the mental to motor dynamics which changes the stochastic matrix based upon the probability distribution. This feedback replaces unavailable external information by an internal knowledge- base stored in the mental model in the form of probability distributions. As a result, the coupled motor-mental dynamics is described by a nonlinear version of Markov chains which can decrease entropy without an external source of information. Applications to common sense based decisions as well as to evolutionary games are discussed. An example exhibiting self-organization is computed using quantum computer simulation. Force on force and mutual aircraft engagements using the quantum decision maker dynamics are considered.

  20. Assessing Patient Participation in Health Policy Decision-Making in Cyprus

    Directory of Open Access Journals (Sweden)

    Kyriakos Souliotis

    2016-08-01

    Full Text Available Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA. PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI, an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.

  1. Nurses and Lifelong Learning: Creating "Makers and Shapers" or "Users and Choosers"?

    Science.gov (United States)

    Butcher, Diane; Bruce, Anne

    2016-04-01

    How have the meaning and goals of lifelong learning for nurses shifted under neoliberal political policy? This article critically scrutinizes the political undercurrents of lifelong learning. While the original intent of lifelong learning was to foster intellectual, critical, social, and political citizen engagement (creating "makers and shapers" of social policy), instrumental learning-learning to meet practical economic ends-has taken priority and is instead creating marketable workers (creating "users and choosers"). International educational neoliberal policy reform has altered the very nature of education. Under pervasive neoliberal political influence, lifelong learning has become distorted as the goals of learning have shifted towards creating marketable workers who are expected, while unsupported, to engage in learning to ensure ongoing employability in an open market. By examining new understandings of lifelong learning, nurses can make informed choices as to whether they aspire to be a "user and chooser" or "maker and shaper" of lifelong learning in their workplaces. © 2015 Wiley Periodicals, Inc.

  2. A review of illicit psychoactive drug use in elective surgery patients: Detection, effects, and policy.

    Science.gov (United States)

    Selvaggi, Gennaro; Spagnolo, Antonio G; Elander, Anna

    2017-12-01

    Limited information is present in literature regarding detection of illicit drug users visiting physicians when planning elective surgery; also, there is no update manuscript that is illustrating the effects of illicit drugs use that require reconstructive surgery interventions. Aims of this manuscript are: 1) to summarize existing knowledge, and give surgeons information how to detect patients who might possible use illicit drugs; 2) to review the effects of illicit drug use that specifically require reconstructive surgery interventions; 3) to assess on existing policies on asymptomatic illicit drug users when planning elective surgery. Studies were identified by searching systematically in the electronic databases PubMed, Medline, The Cochrane Library and SveMed+. Because of the nature of research questions to be investigated (drug policy and surgery), a "systematic review" was not possible. In spite of some existing policies to detect illicit drug use in specific situations such as workplaces or acute trauma patients, there is a lack of data and lack of information, and subsequently no policy has ever been made, for detection and management of illicit drug use asymptomatic patients requesting or referred for plastic surgery interventions. This manuscript poses questions for further ethical evaluations and future policy. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  3. An Investigation into the Decision Makers's Risk Attitude Index ...

    African Journals Online (AJOL)

    An Investigation into the Decision Makers's Risk Attitude Index Ranking Technique for Fuzzy Critical Path Analysis. ... Nigerian Journal of Technology ... for a benchmark problem, the decision maker's risk attitude index ranking method produces unrealistic results when the decision maker's attitude towards risk was neutral.

  4. Trajectories to reconcile sharing and commercialization in the maker movement

    NARCIS (Netherlands)

    Langley, David; Zirngibl, M.; Sbeih, J.; Devoldere, B.

    2017-01-01

    Maker technologies, including collaborative digital fabrication tools like 3-D printers, enable entrepreneurial opportunities and new business models. To date, relatively few highly successful maker startups have emerged, possibly due to the dominant mindset of the makers being one of cooperation

  5. 77 FR 22691 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-04-17

    ... 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... certain health insurance policies and plan sponsors of certain self-insured health plans to fund the... health insurance policies) or R. Lisa Mojiri-Azad at (202) 622-6080 (regarding self- insured health...

  6. MyHealthAtVanderbilt: policies and procedures governing patient portal functionality

    Science.gov (United States)

    Rosenbloom, S Trent; Stenner, Shane P; Anders, Shilo; Muse, Sue; Johnson, Kevin B; Jirjis, Jim; Jackson, Gretchen Purcell

    2011-01-01

    Explicit guidelines are needed to develop safe and effective patient portals. This paper proposes general principles, policies, and procedures for patient portal functionality based on MyHealthAtVanderbilt (MHAV), a robust portal for Vanderbilt University Medical Center. We describe policies and procedures designed to govern popular portal functions, address common user concerns, and support adoption. We present the results of our approach as overall and function-specific usage data. Five years after implementation, MHAV has over 129 800 users; 45% have used bi-directional messaging; 52% have viewed test results and 45% have viewed other medical record data; 30% have accessed health education materials; 39% have scheduled appointments; and 29% have managed a medical bill. Our policies and procedures have supported widespread adoption and use of MHAV. We believe other healthcare organizations could employ our general guidelines and lessons learned to facilitate portal implementation and usage. PMID:21807648

  7. TableMaker: An Excel Macro for Publication-Quality Tables

    Directory of Open Access Journals (Sweden)

    Marek Hlavac

    2016-04-01

    Full Text Available This article introduces TableMaker, a Microsoft Excel macro that produces publicationquality tables and includes them as new sheets in workbooks. The macro provides an intuitive graphical user interface that allows for the full customization of all table features. It also allows users to save and load table templates, and thus allows layouts to be both reproducible and transferable. It is distributed in a single computer file. As such, the macro is easy to share, as well as accessible to even beginning and casual users of Excel. Since it allows for the quick creation of reproducible and fully customizable tables, TableMaker can be very useful to academics, policy-makers and businesses by making the presentation and formatting of results faster and more efficient.

  8. The message is the message-maker.

    Science.gov (United States)

    Chalkley, A B

    1977-03-01

    For those engaged in family planning or other demographic work of an active kind, serious errors can be made and much money and skill wasted unless there is a clear idea of available means of communication. Literacy and media-diffusion figures offer vague parameters, especially in Asia, and the role of spoken communication -- considered key in "illiterate" societies -- is even more difficult to assess. For mass media, the starting point is "diffusion rates" representing numbers of TV sets owned or newspapers sold per 1000 population and so on -- measures of quantity. This article surveys the population growth rates, urban-rural distribution, educational levels, literacy rates, numbers of newspapers bought, radios and TVs owned (per 1000 population) for 12 Asian countries, and discusses their meaning in terms of media use. Chief among the points made are that print media still have an enormous role to play in the developing countries -- newspaper diffusion rates are quite high, even in countries with low urban population (especially India). The quality of electronic media (too often considered the natural "wave of the future" everywhere) varies but is generally not high. Where they are fully developed their role is vital -- but it might be noted that it is the message makers themselves who are most vital. Choosing the right medium and the proper message for it is essential.

  9. Do Women Have a Choice? Care Providers' and Decision Makers' Perspectives on Barriers to Access of Health Services for Birth after a Previous Cesarean.

    Science.gov (United States)

    Munro, Sarah; Kornelsen, Jude; Corbett, Kitty; Wilcox, Elizabeth; Bansback, Nick; Janssen, Patricia

    2017-06-01

    Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean. In-depth, semi-structured interviews were conducted with family physicians, midwives, obstetricians, nurses, anesthetists, and health service decision makers recruited from three rural and two urban Canadian communities. Constructivist grounded theory informed iterative data collection and analysis. Analysis of interviews (n = 35) revealed that the factors influencing decisions resulted from interactions between the clinical, organizational, and policy levels of the health care system. Physicians acted as information providers of clinical risks and benefits, with limited discussion of patient preferences. Decision makers serving large hospitals revealed concerns related to liability and patient safety. These stemmed from competing access to surgical resources. To facilitate women's increased access to planned VBAC, it is necessary to address the barriers perceived by care providers and decision makers. Strategies to mitigate concerns include initiating decision support immediately after the primary cesarean, addressing the social risks that influence women's preferences, and managing perceptions of patient and litigation risks through shared decision making. © 2016 Wiley Periodicals, Inc.

  10. Physicians' tacit and stated policies for determining patient benefit and referral to cardiac rehabilitation.

    Science.gov (United States)

    Beckstead, Jason W; Pezzo, Mark V; Beckie, Theresa M; Shahraki, Farnaz; Kentner, Amanda C; Grace, Sherry L

    2014-01-01

    The benefits of prescribing cardiac rehabilitation (CR) for patients following heart surgery is well documented; however, physicians continue to underuse CR programs, and disparities in the referral of women are common. Previous research into the causes of these problems has relied on self-report methods, which presume that physicians have insight into their referral behavior and can describe it accurately. In contrast, the research presented here used clinical judgment analysis (CJA) to discover the tacit judgment and referral policies of individual physicians. The specific aims were to determine 1) what these policies were, 2) the degree of self-insight that individual physicians had into their own policies, 3) the amount of agreement among physicians, and 4) the extent to which judgments were related to attitudes toward CR. Thirty-six Canadian physicians made judgments and decisions regarding 32 hypothetical cardiac patients, each described on 5 characteristics (gender, age, type of cardiovascular procedure, presence/absence of musculoskeletal pain, and degree of motivation) and then completed the 19 items of the Attitude towards Cardiac Rehabilitation Referral scale. Consistent with previous studies, there was wide variation among physicians in their tacit and stated judgment policies, and self-insight was modest. On the whole, physicians showed evidence of systematic gender bias as they judged women as less likely than men to benefit from CR. Insight data suggest that 1 in 3 physicians were unaware of their own bias. There was greater agreement among physicians in how they described their judgments (stated policies) than in how they actually made them (tacit policies). Correlations between attitude statements and CJA measures were modest. These findings offer some explanation for the slow progress of efforts to improve CR referrals and for gender disparities in referral rates.

  11. Physicians’ Tacit and Stated Policies for Determining Patient Benefit and Referral to Cardiac Rehabilitation

    Science.gov (United States)

    Beckstead, Jason W.; Pezzo, Mark V.; Beckie, Theresa M.; Shahraki, Farnaz; Kentner, Amanda C.; Grace, Sherry L.

    2015-01-01

    Background The benefits of prescribing cardiac rehabilitation (CR) for patients following heart surgery is well documented. However physicians continue to underutilize CR programs and disparities in the referral of women are common. Previous research into the causes of these problems has relied on self-report methods which presume that physicians have insight into their referral behavior and can describe it accurately. In contrast, the research presented here employed clinical judgment analysis (CJA) to discover the tacit judgment and referral policies of individual physicians. Purpose The specific aims were to determine 1) what these policies were, 2) the degree of self-insight that individual physicians had into their own policies, 3) the amount of agreement among physicians, and 4) the extent to which judgments were related to attitudes toward CR. Method Thirty-six Canadian physicians made judgments and decisions regarding 32 hypothetical cardiac patients, each described on five characteristics (gender, age, type of surgical procedure, presence/absence of musculoskeletal pain, and degree of motivation) and then completed the 19 items of the Attitude towards Cardiac Rehabilitation Referral instrument. Results There was wide variation among physicians in their tacit and stated judgment policies. Physicians exhibited greater agreement in what they believed they were doing (stated policies) than in what they actually did (tacit policies). Nearly one-third of the physicians showed evidence of systematic, and perhaps subliminal, gender bias as they judged women as less likely than men to benefit from CR. Correlations between attitude statements and CJA measures were modest. Conclusions These findings offer some explanation for the slow progress of efforts to improve CR referrals and for gender disparities in referral rates. PMID:23784848

  12. Working to improve the management of sarcoma patients across Europe: a policy checklist.

    Science.gov (United States)

    Kasper, Bernd; Lecointe-Artzner, Estelle; Wait, Suzanne; Boldon, Shannon; Wilson, Roger; Gronchi, Alessandro; Valverde, Claudia; Eriksson, Mikael; Dumont, Sarah; Drove, Nora; Kanli, Athanasia; Wartenberg, Markus

    2018-04-16

    The Sarcoma Policy Checklist was created by a multidisciplinary expert group to provide policymakers with priority areas to improve care for sarcoma patients. This paper draws on this research, by looking more closely at how France, Germany, Italy, Spain, Sweden and the United Kingdom are addressing each of these priority areas. It aims to highlight key gaps in research, policy and practice, as well as ongoing initiatives that may impact the future care of sarcoma patients in different European countries. A pragmatic review of the published and web-based literature was undertaken. Telephone interviews were conducted in each country with clinical and patient experts to substantiate findings. Research findings were discussed within the expert group and developed into five core policy recommendations. The five identified priority areas were: the development of designated and accredited centres of reference; more professional training; multidisciplinary care; greater incentives for research and innovation; and more rapid access to effective treatments. Most of the countries studied have ongoing initiatives addressing many of these priorities; however, many are in early stages of development, or require additional funding and resources. Gaps in access to quality care are particularly concerning in many of Europe's lower-resourced countries. Equitable access to information, clinical trials, innovative treatments and quality specialist care should be available to all sarcoma patients. Achieving this across Europe will require close collaboration between all stakeholders at both the national and European level.

  13. Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement.

    Science.gov (United States)

    Garner, Kimberly K; Dubbert, Patricia; Lensing, Shelly; Sullivan, Dennis H

    2017-01-01

    The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. To better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker. Examination of patient responses to self-assessment questions from advance health care planning educational groups conducted in one medical center primary care clinic and seven community-based outpatient primary care clinics. We assessed the concordance between patient reports of identifying and naming a surrogate decision maker and having completed an advance directive (AD) with presence of an AD in the electronic medical record. Of veterans without a documented AD on file, more than half (66%) reported that they had talked with someone they trusted and nearly half (52%) reported that they had named someone to communicate their preferences. Our clinical project data suggest that many more veterans may have initiated communications with surrogate decision makers than is evident in the electronic medical record. System changes are needed to close the gap between veterans' plans for a surrogate decision maker and the documentation available to acute care health care providers. Published by Elsevier Inc.

  14. Impact of a smoke-free policy in a large psychiatric hospital on staff attitudes and patient behavior.

    Science.gov (United States)

    Voci, Sabrina; Bondy, Susan; Zawertailo, Laurie; Walker, Louise; George, Tony P; Selby, Peter

    2010-01-01

    The objectives of this work were to examine changes over time in degree of staff support for the implementation of a smoke-free policy in Canada's largest public mental health and addiction teaching hospital and to assess the impact of the policy on patient behavior. Staff completed an anonymous survey, which assessed views toward the smoke-free policy and perceived change in patient behavior, 2-7 and 31-33 months after an indoor smoke-free policy was implemented (September 21, 2005). Objective indicators of patient behavior were also collected in the form of number of emergency code whites (aggressive behavior) and that of code reds (fire) called 1 year prior to and 2 years following policy implementation. Survey response rates were 19.0% (n=481) and 18.1% (n=500) at 2-7 and 31-33 months, respectively. The proportion of staff who supported the policy increased from pre-implementation (82.6%) to post-implementation (89.1%), and a high level of support was maintained 2 years after policy enactment (90.1%). The number of emergency codes did not significantly change after policy implementation, and staff did not perceive a change in most forms of patient behavior. A smoke-free policy can be implemented in a large psychiatric hospital with a high degree of support from staff and no substantial negative impact on patient behavior. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Communicating Ecological Indicators to Decision Makers and the Public

    Directory of Open Access Journals (Sweden)

    Andrew Schiller

    2001-06-01

    Full Text Available Ecological assessments and monitoring programs often rely on indicators to evaluate environmental conditions. Such indicators are frequently developed by scientists, expressed in technical language, and target aspects of the environment that scientists consider useful. Yet setting environmental policy priorities and making environmental decisions requires both effective communication of environmental information to decision makers and consideration of what members of the public value about ecosystems. However, the complexity of ecological issues, and the ways in which they are often communicated, make it difficult for these parties to fully engage such a dialogue. This paper describes our efforts to develop a process for translating the indicators of regional ecological condition used by the U.S. Environmental Protection Agency into common language for communication with public and decision-making audiences. A series of small-group sessions revealed that people did not want to know what these indicators measured, or how measurements were performed. Rather, respondents wanted to know what such measurements can tell them about environmental conditions. Most positively received were descriptions of the kinds of information that various combinations of indicators provide about broad ecological conditions. Descriptions that respondents found most appealing contained general reference to both the set of indicators from which the information was drawn and aspects of the environment valued by society to which the information could be applied. These findings can assist with future efforts to communicate scientific information to nontechnical audiences, and to represent societal values in ecological programs by improving scientist-public communication.

  16. Evaluation of an interdisciplinary re-isolation policy for patients with previous Clostridium difficile diarrhea.

    Science.gov (United States)

    Boone, N; Eagan, J A; Gillern, P; Armstrong, D; Sepkowitz, K A

    1998-12-01

    Diarrhea caused by Clostridium difficile is increasingly recognized as a nosocomial problem. The effectiveness and cost of a new program to decrease nosocomial spread by identifying patients scheduled for readmission who were previously positive for toxin was evaluated. The Memorial Sloan-Kettering Cancer Center is a 410-bed comprehensive cancer center in New York City. Many patients are readmitted during their course of cancer therapy. In 1995 as a result of concern about the nosocomial spread of C difficile, we implemented a policy that all patients who were positive for C difficile toxin in the previous 6 months with no subsequent toxin-negative stool as an outpatient would be placed into contact isolation on readmission pending evaluation of stool specimens. Patients who were previously positive for C difficile toxin were identified to infection control and admitting office databases via computer. Admitting personnel contacted infection control with all readmissions to determine whether a private room was required. Between July 1, 1995, and June 30, 1996, 47 patients who were previously positive for C difficile toxin were readmitted. Before their first scheduled readmission, the specimens for 15 (32%) of these patients were negative for C difficile toxin. They were subsequently cleared as outpatients and were readmitted without isolation. Workup of the remaining 32 patients revealed that the specimens for 7 patients were positive for C difficile toxin and 86 isolation days were used. An additional 25 patients used 107 isolation days and were either cleared after a negative specimen was obtained in-house or discharged without having an appropriate specimen sent. Four patients (9%) had reoccurring C difficile after having toxin-negative stools. We estimate (because outpatient specimens were not collected) the cost incurred at $48,500 annually, including the incremental cost of hospital isolation and equipment. Our policy to control the spread of nosocomial C

  17. Technical and policy approaches to balancing patient privacy and data sharing in clinical and translational research.

    Science.gov (United States)

    Malin, Bradley; Karp, David; Scheuermann, Richard H

    2010-01-01

    Clinical researchers need to share data to support scientific validation and information reuse and to comply with a host of regulations and directives from funders. Various organizations are constructing informatics resources in the form of centralized databases to ensure reuse of data derived from sponsored research. The widespread use of such open databases is contingent on the protection of patient privacy. We review privacy-related problems associated with data sharing for clinical research from technical and policy perspectives. We investigate existing policies for secondary data sharing and privacy requirements in the context of data derived from research and clinical settings. In particular, we focus on policies specified by the US National Institutes of Health and the Health Insurance Portability and Accountability Act and touch on how these policies are related to current and future use of data stored in public database archives. We address aspects of data privacy and identifiability from a technical, although approachable, perspective and summarize how biomedical databanks can be exploited and seemingly anonymous records can be reidentified using various resources without hacking into secure computer systems. We highlight which clinical and translational data features, specified in emerging research models, are potentially vulnerable or exploitable. In the process, we recount a recent privacy-related concern associated with the publication of aggregate statistics from pooled genome-wide association studies that have had a significant impact on the data sharing policies of National Institutes of Health-sponsored databanks. Based on our analysis and observations we provide a list of recommendations that cover various technical, legal, and policy mechanisms that open clinical databases can adopt to strengthen data privacy protection as they move toward wider deployment and adoption.

  18. Knowledge Translation Research: The Science of Moving Research into Policy and Practice

    Science.gov (United States)

    Curran, Janet A.; Grimshaw, Jeremy M.; Hayden, Jill A.; Campbell, Barbara

    2011-01-01

    Research findings will not change health outcomes unless health care organizations, systems, and professionals adopt them in practice. Knowledge translation research is the scientific study of the methods to promote the uptake of research findings by patients, health care providers, managers, and policy makers. Many forms of enquiry addressing…

  19. A model to create an efficient and equitable admission policy for patients arriving to the cardiothoracic ICU.

    Science.gov (United States)

    Yang, Muer; Fry, Michael J; Raikhelkar, Jayashree; Chin, Cynthia; Anyanwu, Anelechi; Brand, Jordan; Scurlock, Corey

    2013-02-01

    To develop queuing and simulation-based models to understand the relationship between ICU bed availability and operating room schedule to maximize the use of critical care resources and minimize case cancellation while providing equity to patients and surgeons. Retrospective analysis of 6-month unit admission data from a cohort of cardiothoracic surgical patients, to create queuing and simulation-based models of ICU bed flow. Three different admission policies (current admission policy, shortest-processing-time policy, and a dynamic policy) were then analyzed using simulation models, representing 10 yr worth of potential admissions. Important output data consisted of the "average waiting time," a proxy for unit efficiency, and the "maximum waiting time," a surrogate for patient equity. A cardiothoracic surgical ICU in a tertiary center in New York, NY. Six hundred thirty consecutive cardiothoracic surgical patients admitted to the cardiothoracic surgical ICU. None. Although the shortest-processing-time admission policy performs best in terms of unit efficiency (0.4612 days), it did so at expense of patient equity prolonging surgical waiting time by as much as 21 days. The current policy gives the greatest equity but causes inefficiency in unit bed-flow (0.5033 days). The dynamic policy performs at a level (0.4997 days) 8.3% below that of the shortest-processing-time in average waiting time; however, it balances this with greater patient equity (maximum waiting time could be shortened by 4 days compared to the current policy). Queuing theory and computer simulation can be used to model case flow through a cardiothoracic operating room and ICU. A dynamic admission policy that looks at current waiting time and expected ICU length of stay allows for increased equity between patients with only minimum losses of efficiency. This dynamic admission policy would seem to be a superior in maximizing case-flow. These results may be generalized to other surgical ICUs.

  20. The disappearance of the “revolving door” patient in Scottish general practice: successful policies

    Directory of Open Access Journals (Sweden)

    Williamson Andrea E

    2012-10-01

    Full Text Available Abstract Background We describe the health of "revolving door" patients in general practice in Scotland, estimate changes in their number over the timescale of the study, and explore reasons for changes, particularly related to NHS and government policy. Methods A mixed methods predominantly qualitative study, using a grounded theory approach, set in Scottish general practice. Semi-structured interviews were conducted with professional key informants, 6 Practitioner Services staff who administer the GP registration system and 6 GPs with managerial or clinical experience of working with “revolving door” patients. Descriptive statistical analysis and qualitative analysis of patient removal episodes linked with routine hospital admissions, outpatient appointments, drug misuse treatment episodes and deaths were carried out with cohorts of “revolving door” patients identified from 1999 to 2005 in Scotland. Results A “revolving door” patient is removed 4 or more times from GP lists in 7 years. Patients had complex health issues including substance misuse, psychiatric and physical health problems and were at high risk of dying. There was a dramatic reduction in the number of “revolving door” patients during the course of the study. Conclusions “Revolving door” patients in general practice had significant health problems. Their numbers have reduced dramatically since 2004 and this probably resulted from improved drug treatment services, pressure from professional bodies to reduce patient removals and the positive ethical regulatory and financial climate of the 2004 GMS GP contract. This is a positive development for the NHS.

  1. Health management and patients who lack capacity: forms of guardianship in European health policy.

    Science.gov (United States)

    Bonsignore, Alessandro; Smith, Anna; De Stefano, Francesco; Molinelli, Andrea

    2014-02-01

    The focus of healthcare debate has in recent years shifted from doctors and healthcare professionals in general to patients and the principle of patient self-determination. Patient competence therefore plays an increasingly central role in the legal framework of many Europeans countries. Consequently, healthcare policy has to address the possible repercussions of a non-systematic approach to cases of patient incapacity. The diverse nature of the experiences of the mentally or physically disadvantaged clearly raises problems for the healthcare professional. In this setting, we examine Italy's Law no. 6/2004 from a comparative perspective, in particular analysing legislation in the same area from Spain, France, Great Britain and the Netherlands. Copyright © 2013. Published by Elsevier Ireland Ltd.

  2. Science and technology policy

    DEFF Research Database (Denmark)

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

  3. Radioactive waste management policy

    International Nuclear Information System (INIS)

    Morrison, R.W.

    1983-06-01

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

  4. Maker Movement Spreads Innovation One Project at a Time

    Science.gov (United States)

    Peppler, Kylie; Bender, Sophia

    2013-01-01

    The maker movement consists of a growing culture of hands-on making, creating, designing, and innovating. A hallmark of the maker movement is its do-it-yourself (or do-it-with-others) mindset that brings individuals together around a range of activities, both high- and low-tech, all involving some form of creation or repair. The movement's…

  5. Criminal Liability of Political Decision-Makers in the Netherlands

    NARCIS (Netherlands)

    Geelhoed, Willem; Zimmermann, Frank

    2017-01-01

    Dutch criminal law does not provide for criminal liability for a political decision-maker who decides to build a bridge, if thereafter the project runs out of control or the bridge appears not to justify the funds spent on the project. This is most probably even the case if the decision-maker knew

  6. A software platform to analyse the ethical issues of electronic patient privacy policy: the S3P example.

    Science.gov (United States)

    Mizani, M A; Baykal, N

    2007-12-01

    Paper-based privacy policies fail to resolve the new changes posed by electronic healthcare. Protecting patient privacy through electronic systems has become a serious concern and is the subject of several recent studies. The shift towards an electronic privacy policy introduces new ethical challenges that cannot be solved merely by technical measures. Structured Patient Privacy Policy (S3P) is a software tool assuming an automated electronic privacy policy in an electronic healthcare setting. It is designed to simulate different access levels and rights of various professionals involved in healthcare in order to assess the emerging ethical problems. The authors discuss ethical issues concerning electronic patient privacy policies that have become apparent during the development and application of S3P.

  7. The ICU trial: a new admission policy for cancer patients requiring mechanical ventilation.

    Science.gov (United States)

    Lecuyer, Lucien; Chevret, Sylvie; Thiery, Guillaume; Darmon, Michael; Schlemmer, Benoît; Azoulay, Elie

    2007-03-01

    Cancer patients requiring mechanical ventilation are widely viewed as poor candidates for intensive care unit (ICU) admission. We designed a prospective study evaluating a new admission policy titled The ICU Trial. Prospective study. Intensive care unit. One hundred eighty-eight patients requiring mechanical ventilation and having at least one other organ failure. Over a 3-yr period, all patients with hematologic malignancies or solid tumors proposed for ICU admission underwent a triage procedure. Bedridden patients and patients in whom palliative care was the only cancer treatment option were not admitted to the ICU. Patients at earliest phase of the malignancy (diagnosis ventilation, vasopressors, or dialysis after 3 days in the ICU died. Survival was 40% in mechanically ventilated cancer patients who survived to day 5 and 21.8% overall. If these results are confirmed in future interventional studies, we recommend ICU admission with full-code management followed by reappraisal on day 6 in all nonbedridden cancer patients for whom lifespan-extending cancer treatment is available.

  8. 77 FR 47573 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-08-09

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 40 and 46 [REG-136008-11] RIN 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... on issuers of certain health insurance policies and plan sponsors of certain self-insured health...

  9. Moldova: Background and U.S. Policy

    National Research Council Canada - National Science Library

    Woehrel, Steven

    2004-01-01

    .... policy makers, including trafficking in persons and weapons. This short report provides information and analysis on Moldova, including its political and economic situation, foreign policy, and on U.S...

  10. Moldova: Background and U.S. Policy

    National Research Council Canada - National Science Library

    Woehrel, Steven

    2005-01-01

    .... policy makers, including trafficking in persons and weapons. This short report provides information and analysis on Moldova, including its political and economic situation, foreign policy, and on U.S...

  11. Toward an Innovation Policy for Pakistan

    OpenAIRE

    Speakman, John; Afzal, Kiran; Yuge, Yasuhiko; Hanna, James

    2012-01-01

    This policy paper aims to assist policy makers, as they develop the Pakistan Innovation Policy, with an independent assessment of where Pakistan stands now, an international perspective on policy priorities, a review of policy options and some implementation and institutional perspectives. The paper begins with a review of the key lessons of international experience together with a study of ...

  12. An analytical framework to assist decision makers in the use of forest ecosystem model predictions

    Science.gov (United States)

    Larocque, Guy R.; Bhatti, Jagtar S.; Ascough, J.C.; Liu, J.; Luckai, N.; Mailly, D.; Archambault, L.; Gordon, Andrew M.

    2011-01-01

    The predictions from most forest ecosystem models originate from deterministic simulations. However, few evaluation exercises for model outputs are performed by either model developers or users. This issue has important consequences for decision makers using these models to develop natural resource management policies, as they cannot evaluate the extent to which predictions stemming from the simulation of alternative management scenarios may result in significant environmental or economic differences. Various numerical methods, such as sensitivity/uncertainty analyses, or bootstrap methods, may be used to evaluate models and the errors associated with their outputs. However, the application of each of these methods carries unique challenges which decision makers do not necessarily understand; guidance is required when interpreting the output generated from each model. This paper proposes a decision flow chart in the form of an analytical framework to help decision makers apply, in an orderly fashion, different steps involved in examining the model outputs. The analytical framework is discussed with regard to the definition of problems and objectives and includes the following topics: model selection, identification of alternatives, modelling tasks and selecting alternatives for developing policy or implementing management scenarios. Its application is illustrated using an on-going exercise in developing silvicultural guidelines for a forest management enterprise in Ontario, Canada.

  13. The Current Mind-Set of Federal Information Security Decision-Makers on the Value of Governance: An Informative Study

    Science.gov (United States)

    Stroup, Jay Walter

    2014-01-01

    Understanding the mind-set or perceptions of organizational leaders and decision-makers is important to ascertaining the trends and priorities in policy and governance of the organization. This study finds that a significant shift in the mind-set of government IT and information security leaders has started and will likely result in placing a…

  14. FileMaker Pro 11 The Missing Manual

    CERN Document Server

    Prosser, Susan

    2010-01-01

    This hands-on, friendly guide shows you how to harness FileMaker's power to make your information work for you. With a few mouse clicks, the FileMaker Pro 11 database helps you create and print corporate reports, manage a mailing list, or run your entire business. FileMaker Pro 11: The Missing Manual helps you get started, build your database, and produce results, whether you're running a business, pursuing a hobby, or planning your retirement. It's a thorough, accessible guide for new, non-technical users, as well as those with more experience. Start up: Get your first database up and runnin

  15. Use of queue modelling in the analysis of elective patient treatment governed by a maximum waiting time policy

    DEFF Research Database (Denmark)

    Kozlowski, Dawid; Worthington, Dave

    2015-01-01

    chain and discrete event simulation models, to provide an insightful analysis of the public hospital performance under the policy rules. The aim of this paper is to support the enhancement of the quality of elective patient care, to be brought about by better understanding of the policy implications...... on the utilization of public hospital resources. This paper illustrates the use of a queue modelling approach in the analysis of elective patient treatment governed by the maximum waiting time policy. Drawing upon the combined strengths of analytic and simulation approaches we develop both continuous-time Markov...

  16. Macroprudential Policy: A Summary

    OpenAIRE

    Mahdi Ebrahimi Kahou; Alfred Lehar

    2016-01-01

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

  17. EDUCATION MANAGEMENT DECISION-MAKERS IN EUROPEAN PRE – UNIVERSITY EDUCATION

    Directory of Open Access Journals (Sweden)

    DUMITRAȘCU DANUȚ DUMITRU

    2012-12-01

    Full Text Available EDUCATION MANAGEMENT DECISION-MAKERS IN EUROPEAN PRE – UNIVERSITY EDUCATION Ana Tuºa, 1 Affiliation , “Lucian Blaga” University of Sibiu, Faculty of Economics, Department of management Claudiu Sorin Voinia 2 , Affiliation, “Lucian Blaga” University of Sibiu Faculty of Engineering, Department of Industrial Engineering Dãnuþ Dumitru Dumitraºcu 3 Affiliation, “Lucian Blaga” University of Sibiu, Faculty of Economics, Department of management The theme paper consists in a comparative analysis of European preuniveristary education decision makers. Decision makers in preuniversity education management remain the key issue in the political agenda of most European countries. The diversity of educational policies in each European country aims to increase school autonomy, in a way that allows comparison of their main elements of management. Scientific research carried out aimed both theoretical and practical terms: - comparative analysis of how the makers of European schools are responsible for the management practiced in the educational institution. - identification of the achievement of school autonomy. Lately, in terms of policy makers and school autonomy, schools have gone through many reforms. It was felt the need to improve the democratic management and the quality of the educational process. The analysis and the approaches differ in terms of pace of reform, scale transfer of authority and areas that apply. No approach can be chosen as the ideal one or more effective than others, because the contexts in which they were made are so diverse. However, as it moves along, educational policy makers can learn from the approaches and experiences of others. The methodology was based on: the study of scientific literature from the country and abroad, on the theory and practice regarding the decision in the management of school education activities. Comparative analysis was conducted based on questionnaires

  18. Learning a decision maker's utility function from (possibly) inconsistent behavior

    DEFF Research Database (Denmark)

    Nielsen, Thomas Dyhre; Jensen, Finn Verner

    2004-01-01

    developed for learning the probabilities from a database.However, methods for learning the utilities have only received limitedattention in the computer science community. A promising approach for learning a decision maker's utility function is to takeoutset in the decision maker's observed behavioral...... patterns, and then find autility function which (together with a domain model) can explainthis behavior. That is, it is assumed that decision maker's preferences arereflected in the behavior. Standard learning algorithmsalso assume that the decision maker is behavioralconsistent, i.e., given a model ofthe...... decision problem, there exists a utility function which canaccount for all the observed behavior. Unfortunately, this assumption israrely valid in real-world decision problems, and in these situationsexisting learning methods may only identify a trivial utilityfunction. In this paper we relax...

  19. Bridging the gap among healthcare workers and decision-makers ...

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

    Bridging the gap among healthcare workers and decision-makers through improved ... Through this project, researchers will build on insights gained from previous ... and identify the critical factors required for the scale-up and integration of the ...

  20. Bioenergy systems sustainability assessment & management (BIOSSAM) guidance portal for policy, decision and development support of integrated bioenergy supply interventions

    CSIR Research Space (South Africa)

    Stafford, WHL

    2010-08-01

    Full Text Available . There are several new bioenergy interventions (policies, projects, or programmes) that are being considered and these developments must be assessed in terms of their sustainability. Both public and private sector policy makers, decision makers, and technology...

  1. Clarity versus complexity: land-use modeling as a practical tool for decision-makers

    Science.gov (United States)

    Sohl, Terry L.; Claggett, Peter

    2013-01-01

    The last decade has seen a remarkable increase in the number of modeling tools available to examine future land-use and land-cover (LULC) change. Integrated modeling frameworks, agent-based models, cellular automata approaches, and other modeling techniques have substantially improved the representation of complex LULC systems, with each method using a different strategy to address complexity. However, despite the development of new and better modeling tools, the use of these tools is limited for actual planning, decision-making, or policy-making purposes. LULC modelers have become very adept at creating tools for modeling LULC change, but complicated models and lack of transparency limit their utility for decision-makers. The complicated nature of many LULC models also makes it impractical or even impossible to perform a rigorous analysis of modeling uncertainty. This paper provides a review of land-cover modeling approaches and the issues causes by the complicated nature of models, and provides suggestions to facilitate the increased use of LULC models by decision-makers and other stakeholders. The utility of LULC models themselves can be improved by 1) providing model code and documentation, 2) through the use of scenario frameworks to frame overall uncertainties, 3) improving methods for generalizing key LULC processes most important to stakeholders, and 4) adopting more rigorous standards for validating models and quantifying uncertainty. Communication with decision-makers and other stakeholders can be improved by increasing stakeholder participation in all stages of the modeling process, increasing the transparency of model structure and uncertainties, and developing user-friendly decision-support systems to bridge the link between LULC science and policy. By considering these options, LULC science will be better positioned to support decision-makers and increase real-world application of LULC modeling results.

  2. Trouble makers : Laura Poitras and the problem of dissent

    OpenAIRE

    Danchev, Alex

    2015-01-01

    This review article considers three works by the distinguished documentary film-maker Laura Poitras: My country, my country (2006); The oath (2010); and the recently released Citizenfour (2014), focusing on the whistle-blower Edward Snowden. Poitras describes these works as a trilogy about American power after 9/11, but they are also about disobedience and resistance, or the problem of dissent. The article argues for the significance (and the virtue) of Poitras's project, as film maker and tr...

  3. The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

    Science.gov (United States)

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

    2016-10-18

    Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable

  4. Solving the Policy Implementation Problem

    Directory of Open Access Journals (Sweden)

    Gregg A. Garn

    1999-08-01

    Full Text Available When Republican legislators in Arizona failed to approve educational vouchers in four consecutive legislative sessions, a charter school program was approved as a compromise. The charter school policy was written during a special summer session and within three years, over 30,000 students were enrolled in 260 charter schools across the state. Republican policy makers, who failed to enact voucher legislation, proclaimed the charter school program to be an overwhelming success and protected it from amendments by Democrats and potential actions of bureaucrats that could have altered the policy intent. Research on the implementation of policy indicates that state and local implementors frequently undermine or alter legislative intentions. However, when Arizona policy makers approved the charter school policy, they overcame this persistent implementation phenomenon and, in fact, succeeded in preserving the legislative intentions in the working program. This policy study analyzes how they were able to achieve this elusive result. Key policy makers attended to four significant features of policy implementation in creating the charter school policy: communication, financial resources, implementor attitudes, and bureaucratic structure. Manipulating these key variables allowed policy makers to reduce implementation slippage.

  5. A case study exploring the ethical and policy dimensions of allocating acute care resources to a dying patient.

    Science.gov (United States)

    Cooke, Mary; Hurley, Ciarán

    2008-05-01

    We aimed to identify policy, process and ethical issues related to allocation of National Health Service resources when patients with end-of-life illness are referred to acute care services. Sharing healthcare decisions denotes a different partnership between professionals and patients when patients are empowered to define their needs. Implementation of a transition from professional to patient decision-making appears to be dependent upon its interpretation by personnel delivering care using the local trust policy. The outcome of this is a reformation of responsibility for budget allocation, choice of acute care provider and selecting services, currently in the realm of primary care; be it the general practitioner, community practitioners, or the patient. We used a 'lens' approach to case study analysis in which the lens is constructed of a model of policy analysis and four principles of biomedical ethics. A patient's decision to decline care proposed by an Accident and Emergency department nurse and the nurse's response to that decision expose a policy that restricts the use of ambulance transport and with that, flexibility in responses to patients' decisions. End-of-life care partnership decisions require sensitivity and flexibility from all healthcare practitioners. We found that policy-based systems currently used to deliver care across the primary care - hospital care border are far from seamless and can lead to foreseeable problems. Health professionals responsible for the care of a patient at the end of life should consider the holistic outcomes of resource allocation decisions for patients. Government and health professional agenda suggest that patients should be given a greater element of control over their healthcare than has historically been the case. When patients take responsibility for their decisions, healthcare personnel should recognize that this signals a shift in the nature of the professional-patient relationship to one of partnership.

  6. Clearing the air. Air quality modelling for policy support

    NARCIS (Netherlands)

    Hendriks, C.

    2017-01-01

    The studies presented in this thesis were performed to provide policy makers with more accurate information about the sources of air pollution and the possible consequences of future developments on air quality. This enables policy makers to make better informed decisions when formulating policies

  7. Tragedy into policy: a quantitative study of nurses' attitudes toward patient advocacy activities.

    Science.gov (United States)

    Black, Lisa M

    2011-06-01

    In 2007 and 2008, 115 patients were found to be either certainly or presumptively infected with the hepatitis C virus through the reuse of contaminated medication vials at two southern Nevada endoscopy clinics. A subsequent joint investigation by federal and state agencies found multiple breaches of infection control protocols. There was also strong anecdotal evidence that among clinic staff, unsafe patient care conditions often went unreported because of a general fear of retaliation. At the request of the Nevada legislature's Legislative Committee on Health Care, a study was conducted to examine Nevada RNs' experiences with workplace attitudes toward patient advocacy activities. This article presents the study findings and reviews how one public health tragedy led to the creation of effective health care policy. A study questionnaire was developed and tested for reliability and validity. Questionnaires were then sent to an initial sample of 1,725 Nevada RNs, representing 10% of all RNs in the Nevada State Board of Nursing database with active licenses and current Nevada addresses. The response rate was modest at 33% (564 respondents). Of those who responded, 34% indicated that they'd been aware of a patient care condition that could have caused harm to a patient, yet hadn't reported it. The most common reasons given for nonreporting included fears of workplace retaliation (44%) and a belief that nothing would come of reports that were made (38%). The study findings underscore the need for a shift in organizational culture toward one that encourages clear and open communication when patient safety may be in jeopardy. These findings were ultimately used to support the passage of whistleblower protection legislation in Nevada. Las Vegas hepatitis C outbreak, patient advocacy, whistleblower.

  8. Optimal Offering and Operating Strategy for a Large Wind-Storage System as a Price Maker

    DEFF Research Database (Denmark)

    Ding, Huajie; Pinson, Pierre; Hu, Zechun

    2017-01-01

    Wind farms and energy storage systems are playing increasingly more important roles in power systems, which makes their offering non-negligible in some markets. From the perspective of wind farm-energy storage systems (WF-ESS), this paper proposes an integrated strategy of day-ahead offering...... and real-time operation policies to maximize their overall profit. As participants with large capacity in electricity markets can influence cleared prices by strategic offering, a large scaled WFESS is assumed to be a price maker in day-ahead markets. Correspondingly, the strategy considers influence...

  9. The sixteenth-century altar painting of the Cattaran (Kotor fraternity of leather-makers

    Directory of Open Access Journals (Sweden)

    Živković Valentina

    2009-01-01

    Full Text Available The altar painting that the Cattaran Fraternity of Leather-makers commissioned from the Venetian painter Girolamo da Santa Croce in the first half of the sixteenth century contains the images of Sts Bartholomew, George and Antoninus. The presence of the first two saints is looked at from the perspective of a long-established religious tradition, while the reasons for depicting the archbishop Antoninus giving alms to the poor appear to reside in the then prevailing religious policy and the local social situation.

  10. Maker Cultures and the Prospects for Technological Action.

    Science.gov (United States)

    Nascimento, Susana; Pólvora, Alexandre

    2018-06-01

    Supported by easier and cheaper access to tools and expanding communities, maker cultures are pointing towards the ideas of (almost) everyone designing, creating, producing and distributing renewed, new and improved products, machines, things or artefacts. A careful analysis of the assumptions and challenges of maker cultures emphasizes the relevance of what may be called technological action, that is, active and critical interventions regarding the purposes and applications of technologies within ordinary lives, thus countering the deterministic trends of current directions of technology. In such transformative potential, we will explore a set of elements what is and could be technological action through snapshots of maker cultures based on the empirical research conducted in three particular contexts: the Fab Lab Network, Maker Media core outputs and initiatives such as Maker Faires, and the Open Source Hardware Association (OSHWA). Elements such as control and empowerment through material engagement, openness and sharing, and social, cultural, political and ethical values of the common good in topics such as diversity, sustainability and transparency, are critically analysed.

  11. Information processing by networks of quantum decision makers

    Science.gov (United States)

    Yukalov, V. I.; Yukalova, E. P.; Sornette, D.

    2018-02-01

    We suggest a model of a multi-agent society of decision makers taking decisions being based on two criteria, one is the utility of the prospects and the other is the attractiveness of the considered prospects. The model is the generalization of quantum decision theory, developed earlier for single decision makers realizing one-step decisions, in two principal aspects. First, several decision makers are considered simultaneously, who interact with each other through information exchange. Second, a multistep procedure is treated, when the agents exchange information many times. Several decision makers exchanging information and forming their judgment, using quantum rules, form a kind of a quantum information network, where collective decisions develop in time as a result of information exchange. In addition to characterizing collective decisions that arise in human societies, such networks can describe dynamical processes occurring in artificial quantum intelligence composed of several parts or in a cluster of quantum computers. The practical usage of the theory is illustrated on the dynamic disjunction effect for which three quantitative predictions are made: (i) the probabilistic behavior of decision makers at the initial stage of the process is described; (ii) the decrease of the difference between the initial prospect probabilities and the related utility factors is proved; (iii) the existence of a common consensus after multiple exchange of information is predicted. The predicted numerical values are in very good agreement with empirical data.

  12. Climate science information needs among natural resource decision-makers in the Northwest US

    Directory of Open Access Journals (Sweden)

    Elizabeth Allen

    2017-01-01

    Full Text Available Managing water resources, air quality, forests, rangelands and agricultural systems in the context of climate change requires a new level of integrated knowledge. In order to articulate a role for university-based research teams as providers of climate services, this paper analyzes environmental change concerns and expectations about climate models among natural resources decision-makers in the Northwest US. Data were collected during a series of workshops organized by researchers from BioEarth, a regional earth systems modeling initiative. Eighty-three stakeholders from industry, government agencies and non-governmental organizations engaged with a team of academic researchers developing integrated biophysical and economic climate modeling tools. Analysis of transcripts of workshop discussions, surveys, and questionnaires reveals diverse attitudes among stakeholders about: 1 preferred modes of engaging in climate science research, 2 specific concerns and questions about climate change impacts, and 3 the most relevant and usable scope and scale of climate change impacts projections. Diverse concerns and information needs among natural resource decision-makers highlight the need for research teams to define clear and precise goals for stakeholder engagement. Utilizing the skills of research team members who have communication and extension expertise is pivotally important. We suggest impactful opportunities for research teams and natural resource decision-makers to interface and learn from one another. Effective approaches include structuring group discussions to identify gaps in existing climate change impacts information, explicitly considering changing policies, technologies and management practices, and exploring possible unintended consequences of decisions.

  13. [Equality in clinical practice. Proposals for patients, professionals and managers and policies to limit discrimination].

    Science.gov (United States)

    Soler-González, J; Fernández de Sanmamed, M J; Gérvas, J

    2015-01-01

    To make feasible and practical proposals to improve equality in the course of clinical care during the patient-provider encounter. Design: A focus group study was conducted with a qualitative approach from the perspective of reducing health inequalities in the clinic. Setting: A classroom discussion focused on equality in clinical work. Subjects: 98 professionals from several countries. Measurement tools: An analysis of the responses was performed, grouped by themes interpreted by analysts, and restructured to provide consistency and uniformity to responses given. Data were collected using a questionnaire with open answers, allowing free-form answers to three general questions that addressed improving equality from the perspective of the professional themselves, patients, and health policy managers. No saturation horizon of analytical discourses was set, to understand that from this subjective prioritization of opinion there is no possibility that discourses reached saturation. Responses were added to the 3 principal axes, recommending that professionals be aware of their discriminatory ability. Patients were asked to trust their health professionals and that they should be assigned to a professional. It was also proposed that managers provide information systems, help reduce health inequalities, and encourage professional freedom. The paper presents concrete measures to promote improved equality in clinics during the delivery of health care. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  14. Helping decision makers frame, analyze, and implement decisions

    Science.gov (United States)

    Runge, Michael C.; McDonald-Madden, Eve

    2018-01-01

    All decisions have the same recognizable elements. Context, objectives, alternatives, consequences, and deliberation. Decision makers and analysts familiar with these elements can quickly see the underlying structure of a decision.There are only a small number of classes of decisions. These classes differ in the cognitive and scientific challenge they present to the decision maker; the ability to recognize the class of decision leads a decision maker to tools to aid in the analysis.Sometimes we need more information, sometimes we don’t. The role of science in a decision-making process is to provide the predictions that link the alternative actions to the desired outcomes. Investing in more science is only valuable if it helps to choose a better action.Implementation. The successful integration of decision analysis into environmental decisions requires careful attention to the decision, the people, and the institutions involved.

  15. SU-E-J-16: A Review of the Magnitude of Patient Imaging Shifts in Relation to Departmental Policy Changes

    Energy Technology Data Exchange (ETDEWEB)

    O' Connor, M; Sansourekidou, P [Health Quest, Poughkeepsie, NY (United States)

    2014-06-01

    Purpose: To evaluate how changes in imaging policy affect the magnitude of shifts applied to patients. Methods: In June 2012, the department's imaging policy was altered to require that any shifts derived from imaging throughout the course of treatment shall be considered systematic only after they were validated with two data points that are consistent in the same direction. Multiple additions and clarifications to the imaging policy were implemented throughout the course of the data collection, but they were mostly of administrative nature. Entered shifts were documented in MOSAIQ (Elekta AB) through the localization offset. The MOSAIQ database was queried to identify a possible trend. A total of 25,670 entries were analyzed, including four linear accelerators with a combination of MV planar, kV planar and kV three dimensional imaging. The monthly average of the magnitude of the vector was used. Plan relative offsets were excluded. During the evaluated period of time, one of the satellite facilities acquired and implemented Vision RT (AlignRT Inc). Results: After the new policy was implemented the shifts variance and standard deviation decreased. The decrease is linear with time elapsed. Vision RT implementation at one satellite facility reduced the number of overall shifts, specifically for breast patients. Conclusion: Changes in imaging policy have a significant effect on the magnitude of shifts applied to patients. Using two statistical points before applying a shift as persistent decreased the overall magnitude of the shifts applied to patients.

  16. The gap between policy and practice: a systematic review of patient-centred care interventions in chronic heart failure.

    Science.gov (United States)

    Kane, P M; Murtagh, F E M; Ryan, K; Mahon, N G; McAdam, B; McQuillan, R; Ellis-Smith, C; Tracey, C; Howley, C; Raleigh, C; O'Gara, G; Higginson, I J; Daveson, B A

    2015-11-01

    Patient-centred care (PCC) is recommended in policy documents for chronic heart failure (CHF) service provision, yet it lacks an agreed definition. A systematic review was conducted to identify PCC interventions in CHF and to describe the PCC domains and outcomes. Medline, Embase, CINAHL, PsycINFO, ASSIA, the Cochrane database, clinicaltrials.gov, key journals and citations were searched for original studies on patients with CHF staged II-IV using the New York Heart Association (NYHA) classification. Included interventions actively supported patients to play informed, active roles in decision-making about their goals of care. Search terms included 'patient-centred care', 'quality of life' and 'shared decision making'. Of 13,944 screened citations, 15 articles regarding 10 studies were included involving 2540 CHF patients. Three studies were randomised controlled trials, and seven were non-randomised studies. PCC interventions focused on collaborative goal setting between patients and healthcare professionals regarding immediate clinical choices and future care. Core domains included healthcare professional-patient collaboration, identification of patient preferences, patient-identified goals and patient motivation. While the strength of evidence is poor, PCC has been shown to reduce symptom burden, improve health-related quality of life, reduce readmission rates and enhance patient engagement for patients with CHF. There is a small but growing body of evidence, which demonstrates the benefits of a PCC approach to care for CHF patients. Research is needed to identify the key components of effective PCC interventions before being able to deliver on policy recommendations.

  17. Pharmaceutical policy and the lay public

    DEFF Research Database (Denmark)

    Traulsen, Janine Marie; Almarsdóttir, Anna Birna

    2005-01-01

    Almost every national and supranational health policy document accords high importance to the need to listen to and 'empower' patients. The relationship between pharmaceutical policy and the lay public is not direct but mediated by several actors, including health care workers, patient organisati......Almost every national and supranational health policy document accords high importance to the need to listen to and 'empower' patients. The relationship between pharmaceutical policy and the lay public is not direct but mediated by several actors, including health care workers, patient...... organisations, industry and, most recently, the media. Although the overall aim of health and pharmaceutical policy is to address the needs of all citizens, there are only a few, well organised groups who are actually consulted and involved in the policymaking process, often with the support of the industry....... The reasons for this lack of citizen involvement in health and pharmaceutical policymaking are many, for example: there is no consensus about what public involvement means; there is a predominance of special interest groups with narrow, specific agendas; not all decision makers welcome lay participation...

  18. Market Makers' Supply and Pricing of Financial Market Liquidity

    OpenAIRE

    Shen, Pu; Starr, Ross M.

    2000-01-01

    This study models the bid-ask spread in financial markets as a function of asset price variability and order flow. The market-maker is characterized as passively accepting orders to buy and to sell a security at the market's prevailing price (plus or minus half the bid-ask spread). The bid-ask spread adjusts to cover market-makers' average costs. The bid-ask spread then varies positively with: the security's price volatility, the volatility of order flow, and the absolute value of the market-...

  19. From DTCA-PD to patient information to health information: the complex politics and semantics of EU health policy.

    Science.gov (United States)

    Brooks, Eleanor; Geyer, Robert

    2012-12-01

    Between 2001 and 2011 the pharmaceutical industry, supported by DG Enterprise, was engaged in an ongoing campaign to repeal/amend the European Union (EU) ban on direct-to-consumer advertising of prescription drugs (DTCA-PD). As it became increasingly clear that the ban would not be repealed, DTCA-PD supporters tried to shift the debate away from advertising and towards the provision of 'patient information' and the rights of patients to access such information. Meanwhile, a variety of national and European health organizations, supported by DG SANCO, sought to maintain the ban and oppose the industry-supported 'patient information' campaign. Instead, they promoted a concept of 'health information' that included all aspects of citizens' health, not just pharmaceuticals. This article aims to analyse the transition from DTCA-PD to patient information to health information and examine its implications for EU health policy as a complex policy space. The article examines the emergence and development of EU health policy and the evolution of the DTCA-PD debate through the lens of complexity theory. It analyses the nature of the semantic, political and policy transition and asks why it occurred, what it tells us about EU health policy and future EU health legislation and how it may be understood from a complexity perspective. The article concludes that the complexity framework is ideally suited for the field of public health and, in particular, the DTCA-PD debate. Having successfully shifted the policy-focus of the debate to patients' rights and health information, opponents of the legislation are likely to face their next battle in the realm of cyberspace, where regulatory issues change the nature of advertising. © 2012 Blackwell Publishing Ltd.

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

    Science.gov (United States)

    Bovolenta, Tânia M; Felicio, Andre C

    2017-01-01

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

  1. The social adjustment of patients with schizophrenia: implications to the mental health policy in Brazil

    Directory of Open Access Journals (Sweden)

    Menezes Paulo R.

    1993-01-01

    Full Text Available A sample (n=124 of schizophrenic patients from a defined catchment area of the city os S.Paulo, Brazil, who had been consecutively admitted to hospital, was assessed for psychopathological status and social adjustment levels. Sociodemographic, socio-economic and occupational characteristics were recorded: almost 30% of the subjects had no occupation and received no social benefit, more than two-thirds had a monthly per capita income of US$ 100.00 or less. Sixty-five percent presented with Schneiderian firstrank symptoms. Nearly half the sample showed poor or very poor social adjustment in the month prior to admission. The most affected areas of social functioning were participation in the household activities, work and social withdrawal. The current mental health policy of promoting extra-mural care as an alternative to the previous hospital-based model will then mean the investment in a network of new community-based services, that give effective treatment and support to patients and their families. The need of further research into the current picture of mental disorders in the country is stressed.

  2. The social adjustment of patients with schizophrenia: implications to the mental health policy in Brazil

    Directory of Open Access Journals (Sweden)

    Paulo R. Menezes

    1993-10-01

    Full Text Available A sample (n=124 of schizophrenic patients from a defined catchment area of the city os S.Paulo, Brazil, who had been consecutively admitted to hospital, was assessed for psychopathological status and social adjustment levels. Sociodemographic, socio-economic and occupational characteristics were recorded: almost 30% of the subjects had no occupation and received no social benefit, more than two-thirds had a monthly per capita income of US$ 100.00 or less. Sixty-five percent presented with Schneiderian firstrank symptoms. Nearly half the sample showed poor or very poor social adjustment in the month prior to admission. The most affected areas of social functioning were participation in the household activities, work and social withdrawal. The current mental health policy of promoting extra-mural care as an alternative to the previous hospital-based model will then mean the investment in a network of new community-based services, that give effective treatment and support to patients and their families. The need of further research into the current picture of mental disorders in the country is stressed.

  3. Gender inequalities in the workplace: the effects of organizational structures, processes, practices, and decision makers' sexism.

    Science.gov (United States)

    Stamarski, Cailin S; Son Hing, Leanne S

    2015-01-01

    Gender inequality in organizations is a complex phenomenon that can be seen in organizational structures, processes, and practices. For women, some of the most harmful gender inequalities are enacted within human resources (HRs) practices. This is because HR practices (i.e., policies, decision-making, and their enactment) affect the hiring, training, pay, and promotion of women. We propose a model of gender discrimination in HR that emphasizes the reciprocal nature of gender inequalities within organizations. We suggest that gender discrimination in HR-related decision-making and in the enactment of HR practices stems from gender inequalities in broader organizational structures, processes, and practices. This includes leadership, structure, strategy, culture, organizational climate, as well as HR policies. In addition, organizational decision makers' levels of sexism can affect their likelihood of making gender biased HR-related decisions and/or behaving in a sexist manner while enacting HR practices. Importantly, institutional discrimination in organizational structures, processes, and practices play a pre-eminent role because not only do they affect HR practices, they also provide a socializing context for organizational decision makers' levels of hostile and benevolent sexism. Although we portray gender inequality as a self-reinforcing system that can perpetuate discrimination, important levers for reducing discrimination are identified.

  4. Getting ocean acidification on decision makers' to-do lists: dissecting the process through case studies

    Science.gov (United States)

    Cooley, Sarah R.; Jewett, Elizabeth B.; Reichert, Julie; Robbins, Lisa L.; Shrestha, Gyami; Wieczorek, Dan; Weisberg, Stephen B.

    2015-01-01

    Much of the detailed, incremental knowledge being generated by current scientific research on ocean acidification (OA) does not directly address the needs of decision makers, who are asking broad questions such as: Where will OA harm marine resources next? When will this happen? Who will be affected? And how much will it cost? In this review, we use a series of mainly US-based case studies to explore the needs of local to international-scale groups that are making decisions to address OA concerns. Decisions concerning OA have been made most naturally and easily when information needs were clearly defined and closely aligned with science outputs and initiatives. For decisions requiring more complex information, the process slows dramatically. Decision making about OA is greatly aided (1) when a mixture of specialists participates, including scientists, resource users and managers, and policy and law makers; (2) when goals can be clearly agreed upon at the beginning of the process; (3) when mixed groups of specialists plan and create translational documents explaining the likely outcomes of policy decisions on ecosystems and natural resources; (4) when regional work on OA fits into an existing set of priorities concerning climate or water quality; and (5) when decision making can be reviewed and enhanced.

  5. Overcoming Fear: Helping Decision Makers Understand Risk in Outdoor Education

    Science.gov (United States)

    Haras, Kathy

    2010-01-01

    The long history of outdoor education does little to alleviate the fears of many parents, teachers, principals and superintendents who believe that outdoor education is too risky. These decision makers often lack both the knowledge to make informed decisions and the time and resources to investigate their assumptions. Pair these circumstances with…

  6. The Promise of the Maker Movement for Education

    Science.gov (United States)

    Martin, Lee

    2015-01-01

    The Maker Movement is a community of hobbyists, tinkerers, engineers, hackers, and artists who creatively design and build projects for both playful and useful ends. There is growing interest among educators in bringing making into K-12 education to enhance opportunities to engage in the practices of engineering, specifically, and STEM more…

  7. The Virtual Workplace Ethnography: Positioning Student Writers as Knowledge Makers

    Science.gov (United States)

    Sommers, Jeff

    2015-01-01

    The Virtual Workplace Ethnography is a first-year composition assignment that positions students as knowledge makers by requiring them to apply a theoretical lens ("Working Knowledge") to a video representation of a workplace. The lens provides multiple terms for analysis of workplace behaviors in context, providing a scaffolding for…

  8. Creativity Assessment in the Context of Maker-Based Projects

    Science.gov (United States)

    Lille, Benjamin; Romero, Margarida

    2017-01-01

    Creativity is a key competence in 21st century education. Among the active learning pedagogies which aims to develop creativity, learning by making is an emerging approach in which the students are engaged in the co-creation of a shared artefact. In this study, we aim to analyse the creativity competency through a maker-based projects.…

  9. Imaginative Thinking: Addressing Social Justice Issues through MovieMaker

    Science.gov (United States)

    Boske, Christa A.

    2009-01-01

    Purpose: The purpose of this paper is to examine the experiences of aspiring school leaders who utilized artmaking in this case, photography, poetry, music, collage, and short films through Microsoft MovieMaker as a means for addressing injustices within surrounding school communities. The paper aims to explore how aspiring school leaders…

  10. Anesthetic Implications of Ebola Patient Management: A Review of the Literature and Policies.

    Science.gov (United States)

    Missair, Andres; Marino, Michael J; Vu, Catherine N; Gutierrez, Juan; Missair, Alfredo; Osman, Brian; Gebhard, Ralf E

    2015-09-01

    met search criteria for information related to inpatient Ebola virus disease management or animal virology studies as primary or secondary sources. In addition, 9 articles met search criteria as tertiary sources, representing published guidelines. The recommendations developed in this article are based on these 29 source documents. Anesthesia-specific literature regarding the care of Ebola patients is very limited. Secondary-source guidelines and policies represent the majority of available information. Data from controlled animal experiments and tuberculosis patient research provide some evidence for the existing recommendations and identify future guideline considerations.

  11. Big ideas: innovation policy

    OpenAIRE

    John Van Reenen

    2011-01-01

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

  12. Innovation: Editorial Policies

    African Journals Online (AJOL)

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

  13. Privacy policies for health social networking sites

    Science.gov (United States)

    Li, Jingquan

    2013-01-01

    Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in health care and presents a practical example that demonstrates how the risks might be intrinsic to some HSNS. The aim of this study is to identify and sketch the policy implications of using HSNS and how policy makers and stakeholders should elaborate upon them to protect the privacy of online health data. PMID:23599228

  14. Privacy policies for health social networking sites.

    Science.gov (United States)

    Li, Jingquan

    2013-01-01

    Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in health care and presents a practical example that demonstrates how the risks might be intrinsic to some HSNS. The aim of this study is to identify and sketch the policy implications of using HSNS and how policy makers and stakeholders should elaborate upon them to protect the privacy of online health data.

  15. [Optimizing antibiotics policy in the Netherlands. VI. SWAB advice: no selective decontamination of intensive care patients on mechanical ventilation

    NARCIS (Netherlands)

    Bonten, M.J.; Kullberg, B.J.; Filius, P.M.

    2001-01-01

    The Working Party on Antibiotic Policy (Dutch acronym is SWAB) has issued a guideline in which the pro and cons of the routine use of selective decontamination (SD) in patients in intensive care (IC) on mechanical ventilation are compared in order to decide whether SD is indicated. The effectiveness

  16. Improving policy implementation through collaborative policymaking

    DEFF Research Database (Denmark)

    Ansell, Christopher; Sørensen, Eva; Torfing, Jacob

    2017-01-01

    We offer a fresh perspective on implementation problems by suggesting that collaborative policy design and adaptive policy implementation will help public policy makers to improve policy execution. Classical implementation theories have focused too narrowly on administrative stumbling blocks and ...... collaborative policymaking and adaptive policy implementation might work in theory and practice......We offer a fresh perspective on implementation problems by suggesting that collaborative policy design and adaptive policy implementation will help public policy makers to improve policy execution. Classical implementation theories have focused too narrowly on administrative stumbling blocks...... and New Public Management has reinforced the split between politics and administration. Attempts to improve policy implementation must begin by looking at policy design, which can be improved through collaboration and deliberation between upstream and downstream actors. We provide a broad overview of how...

  17. Emodnet Med Sea Check-Point - Indicators for decision- maker

    Science.gov (United States)

    Besnard, Sophie; Claverie, Vincent; Blanc, Frédérique

    2015-04-01

    The Emodnet Checkpoint projects aim is to assess the cost-effectiveness, reliability and utility of the existing monitoring at the sea basin level. This involves the development of monitoring system indicators and a GIS Platform to perform the assessment and make it available. Assessment or production of Check-Point information is made by developing targeted products based on the monitoring data and determining whether the products are meeting the needs of industry and public authorities. Check-point users are the research community, the 'institutional' policy makers for IMP and MSFD implementation, the 'intermediate users', i.e., users capable to understand basic raw data but that benefit from seeing the Checkpoint targeted products and the assessment of the fitness for purpose. We define assessment criteria aimed to characterize/depict the input datasets in terms of 3 territories capable to show performance and gaps of the present monitoring system, appropriateness, availability and fitness for purpose. • Appropriateness: What is made available to users? What motivate/decide them to select this observation rather than this one. • Availability: How this is made available to the user? Place to understand the readiness and service performance of the EU infrastructure • Fitness for use / fitness for purpose: Ability for non-expert user to appreciate the data exploitability (feedback on efficiency & reliability of marine data) For each territory (appropriateness, Availability and Fitness for purpose / for use), we define several indicators. For example, for Availability we define Visibility, Accessibility and Performance. And Visibility is itself defined by "Easily found" and "EU service". So these indicators can be classified according to their territory and sub-territory as seen above, but also according to the complexity to build them. Indicators are built from raw descriptors in 3 stages:  Stage 1: to give a neutral and basic status directly computed from

  18. Sustainable energy catalogue - for European decision-makers. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Gram, S.; Jacobsen, Soeren

    2006-10-15

    The Green paper - A European Strategy for Sustainable, Competitive and Secure Energy, 2006 states that Europe has a rising dependency on imported energy reserves, which are concentrated in a few countries. The Rising gas and oil prices along with demands on lower emissions of CO2 adds pressure on the need for a new energy future for Europe. EU has since 1990 planned to become world leader in the renewable energy field. Therefore the EU member states have agreed that by 2010 21% of the consumed electricity and 5,75% of the consumed gasoline and diesel should originate from renewable energy sources. If the EU countries are to reach their goals, a commitment on several levels to develop and install energy from sustainable energy sources is needed. The purpose of this catalogue is to offer planners and decision-makers in EU states an inspirational tool to be used during local or regional transition towards sustainable energy technologies. The catalogue can also be used by everyone else who needs an overview of the sustainable energy technologies and their current development level and future potential, among others educational use is relevant. The catalogue provides an introduction to the following technologies that are already or are estimated to become central to a development with renewable energy in EU: Technologies for wind energy, wave energy, geothermal energy, bioenergy, solar energy, hydropower and fuel cells. The catalogue also includes a section about energy systems, which also includes a part about technologies for efficient use of energy. The catalogue could have included a few other technologies as e.g. heating pumps, but due to the size of the catalogue a priority was necessary. The catalogue does not claim to give all answers or to be complete regarding all details about the individual technologies; even so it offers information, which cannot easily be looked up on the Internet. In the back of the catalogue, under 'References and links' there

  19. Metrics for evaluating patient navigation during cancer diagnosis and treatment: crafting a policy-relevant research agenda for patient navigation in cancer care.

    Science.gov (United States)

    Guadagnolo, B Ashleigh; Dohan, Daniel; Raich, Peter

    2011-08-01

    Racial and ethnic minorities as well as other vulnerable populations experience disparate cancer-related health outcomes. Patient navigation is an emerging health care delivery innovation that offers promise in improving quality of cancer care delivery to these patients who experience unique health-access barriers. Metrics are needed to evaluate whether patient navigation can improve quality of care delivery, health outcomes, and overall value in health care during diagnosis and treatment of cancer. Information regarding the current state of the science examining patient navigation interventions was gathered via search of the published scientific literature. A focus group of providers, patient navigators, and health-policy experts was convened as part of the Patient Navigation Leadership Summit sponsored by the American Cancer Society. Key metrics were identified for assessing the efficacy of patient navigation in cancer diagnosis and treatment. Patient navigation data exist for all stages of cancer care; however, the literature is more robust for its implementation during prevention, screening, and early diagnostic workup of cancer. Relatively fewer data are reported for outcomes and efficacy of patient navigation during cancer treatment. Metrics are proposed for a policy-relevant research agenda to evaluate the efficacy of patient navigation in cancer diagnosis and treatment. Patient navigation is understudied with respect to its use in cancer diagnosis and treatment. Core metrics are defined to evaluate its efficacy in improving outcomes and mitigating health-access barriers. Copyright © 2011 American Cancer Society.

  20. Policies for Renewable Heat

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

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

  1. The role of financial intermediaries in monetary policy transmission

    NARCIS (Netherlands)

    Beck, T.H.L.; Colciago, A.; Pfajfar, D.

    The recent financial crisis has stimulated theoretical and empirical research on the propagation mechanisms underlying business cycles, in particular on the role of financial frictions. Many issues concerning the interactions between banking and monetary policy forced policy makers to redefine

  2. Cost-containment as part of pharmaceutical policy

    DEFF Research Database (Denmark)

    Almarsdóttir, Anna Birna; Traulsen, Janine Marie

    2005-01-01

    and profit controls; 2) reimbursement system charges; 3) other fiscal measures; 4) quality measures. Pharmaceuticals policy has suffered from the pervasive misunderstanding that drugs are like any other commodity; resulting in policy makers viewing pharmaceuticals expenditures without thinking about drugs...

  3. Introducing a change in hospital policy using FMEA methodology as a tool to reduce patient hazards.

    Science.gov (United States)

    Ofek, Fanny; Magnezi, Racheli; Kurzweil, Yaffa; Gazit, Inbal; Berkovitch, Sofia; Tal, Orna

    2016-01-01

    Intravenous potassium chloride (IV KCl) solutions are widely used in hospitals for treatment of hypokalemia. As ampoules of concentrated KCL must be diluted before use, critical incidents have been associated with its preparation and administration. Currently, we have introduced ready-to-use diluted KCl infusion solutions to minimize the use of high-alert concentrated KCl. Since this process may be associated with considerable risks, we embraced a proactive hazard analysis as a tool to implement a change in high-alert drug usage in a hospital setting. Failure mode and effect analysis (FMEA) is a systematic tool to analyze and identify risks in system operations. We used FMEA to examine the hazards associated with the implementation of the ready-to-use solutions. A multidisciplinary team analyzed the risks by identifying failure modes, conducting a hazard analysis and calculating the criticality index (CI) for each failure mode. A 1-day survey was performed as an evaluation step after a trial run period of approximately 4 months. Six major possible risks were identified. The most severe risks were prioritized and specific recommendations were formulated. Out of 28 patients receiving IV KCl on the day of the survey, 22 received the ready-to-use solutions and 6 received the concentrated solutions as instructed. Only 1 patient received inappropriate ready-to-use KCl. Using the FMEA tool in our study has proven once again that by creating a gradient of severity of potential vulnerable elements, we are able to proactively promote safer and more efficient processes in health care systems. This article presents a utilization of this method for implementing a change in hospital policy regarding the routine use of IV KCl.

  4. Routine HIV testing among hospitalized patients in Argentina. is it time for a policy change?

    Directory of Open Access Journals (Sweden)

    María Eugenia Socías

    Full Text Available INTRODUCTION: The Argentinean AIDS Program estimates that 110,000 persons are living with HIV/AIDS in Argentina. Of those, approximately 40% are unaware of their status, and 30% are diagnosed in advanced stages of immunosuppression. Though studies show that universal HIV screening is cost-effective in settings with HIV prevalence greater than 0.1%, in Argentina, with the exception of antenatal care, HIV testing is always client-initiated. OBJECTIVE: We performed a pilot study to assess the acceptability of a universal HIV screening program among inpatients of an urban public hospital in Buenos Aires. METHODS: Over a six-month period, all eligible adult patients admitted to the internal medicine ward were offered HIV testing. Demographics, uptake rates, reasons for refusal and new HIV diagnoses were analyzed. RESULTS: Of the 350 admissions during this period, 249 were eligible and subsequently enrolled. The enrolled population was relatively old compared to the general population, was balanced on gender, and did not report traditional high risk factors for HIV infection. Only 88 (39% reported prior HIV testing. One hundred and ninety (76% patients accepted HIV testing. In multivariable analysis only younger age (OR 1.02; 95%CI 1.003-1.05 was independently associated with test uptake. Three new HIV diagnoses were made (undiagnosed HIV prevalence: 1.58%; none belonged to a most-at-risk population. CONCLUSIONS: Our findings suggest that universal HIV screening in this setting is acceptable and potentially effective in identifying undiagnosed HIV-infected individuals. If confirmed in a larger study, our findings may inform changes in the Argentinean HIV testing policy.

  5. A Policy Analysis of the Coast Guard's Existing Patient Satisfaction System and Recommendations for Improvement

    National Research Council Canada - National Science Library

    Coughlin, Kelly A

    2007-01-01

    .... This paper evaluates CG organizational demands, describes CG practice landscape, presents standards, reviews initial clinic process analysis, and evaluates the cost and criteria of proposed policy alternatives...

  6. The "Good Governance" of Evidence in Health Policy

    Science.gov (United States)

    Hawkins, Benjamin; Parkhurst, Justin

    2016-01-01

    Calls for evidence-based policy often fail to recognise the fundamentally political nature of policy making. Policy makers must identify, evaluate and utilise evidence to solve policy problems in the face of competing priorities and political agendas. Evidence should inform but cannot determine policy choices. This paper draws on theories of…

  7. Policies and place-making for competitive cities

    NARCIS (Netherlands)

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

    2013-01-01

    Policy-makers are making efforts to strengthen the competitiveness of their cities and urban regions. This book is about these policies and their implications for place-making and competitive cities. Policies driven by ‘classic’ location theory, cluster policies, ‘creative class’ policies aimed at

  8. Scenarios use to engage scientists and decision-makers in a changing Arctic

    Science.gov (United States)

    Lee, O. A.; Eicken, H.; Payne, J. F.

    2015-12-01

    Scenarios provide a framework to develop more adaptive Arctic policies that allow decision makers to consider the best available science to address complex relationships and key uncertainties in drivers of change. These drivers may encompass biophysical factors such as climate change, socioeconomic drivers, and wild-cards that represent low likelihood but influential events such as major environmental disasters. We outline some of the lessons learned from the North Slope Science Initiative (NSSI) scenarios project that could help in the development of adaptive science-based policies. Three spatially explicit development scenarios were identified corresponding to low, medium and high resource extraction activities on the North Slope and adjacent seas. In the case of the high energy development scenario science needs were focused on new technology, oil spill response, and the effects of offshore activities on marine mammals important for subsistence. Science needs related to community culture, erosion, permafrost degradation and hunting and trapping on land were also identified for all three scenarios. The NSSI science needs will guide recommendations for future observing efforts, and data from these observing activities could subsequently improve policy guidance for emergency response, subsistence management and other issues. Scenarios at pan-Arctic scales may help improve the development of international policies for resilient northern communities and encourage the use of science to reduce uncertainties in plans for adapting to change in the Arctic.

  9. Communication with U.S. federal decision makers : a primer with notes on the use of computer models as a means of communication.

    Energy Technology Data Exchange (ETDEWEB)

    Webb, Erik Karl; Tidwell, Vincent Carroll

    2009-10-01

    This document outlines ways to more effectively communicate with U.S. Federal decision makers by outlining the structure, authority, and motivations of various Federal groups, how to find the trusted advisors, and how to structure communication. All three branches of Federal governments have decision makers engaged in resolving major policy issues. The Legislative Branch (Congress) negotiates the authority and the resources that can be used by the Executive Branch. The Executive Branch has some latitude in implementation and prioritizing resources. The Judicial Branch resolves disputes. The goal of all decision makers is to choose and implement the option that best fits the needs and wants of the community. However, understanding the risk of technical, political and/or financial infeasibility and possible unintended consequences is extremely difficult. Primarily, decision makers are supported in their deliberations by trusted advisors who engage in the analysis of options as well as the day-to-day tasks associated with multi-party negotiations. In the best case, the trusted advisors use many sources of information to inform the process including the opinion of experts and if possible predictive analysis from which they can evaluate the projected consequences of their decisions. The paper covers the following: (1) Understanding Executive and Legislative decision makers - What can these decision makers do? (2) Finding the target audience - Who are the internal and external trusted advisors? (3) Packaging the message - How do we parse and integrate information, and how do we use computer simulation or models in policy communication?

  10. Market Makers' Recognition of Key Success Factors in Electronic Marketplaces

    Directory of Open Access Journals (Sweden)

    Rosemary Stockdale

    2003-05-01

    Full Text Available This study examines the recognition and use of critical success factors by market makers in electronic marketplaces. A content analysis of e-marketplace websites enabled an examination of how these factors have been incorporated into marketplace sites. Evidence of market makers’ awareness of the success factors was found in all the sites although there remain questions and issues to be addressed. Awareness of the need for critical mass and privacy were very evident, but the key factors of security, technological infrastructure and neutrality were identified as areas of concern. Evidence of an awareness of the importance of trust by market makers was found, but more effective signalling of trust to buyers and sellers within the marketplaces is required.

  11. The Power Makers' Challenge And the Need for Fission Energy

    CERN Document Server

    Nicholson, Martin

    2012-01-01

    The Power Makers - the producers of our electricity - must meet the demands of their customers while also addressing the threat of climate change. There are widely differing views about solutions to electricity generation in an emission constrained world. Some see the problem as relatively straight forward, requiring deep cuts in emissions now by improving energy efficiency, energy conservation and using only renewable resources. Many electricity industry engineers and scientists see the problem as being much more involved.   The Power Makers ’ Challenge: and the need for Fission Energy looks at why using only conventional renewable energy sources is not quite as simple as it seems. Following a general introduction to electricity and its distribution, the author quantifies the reductions needed in greenhouse gas emissions from the power sector in the face of ever increasing world demands for electricity. It provides some much needed background on the many energy sources available for producing electricity ...

  12. Market orientation in the mental models of decision-makers

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Trondsen, Torbjørn; Campos, Emilio Gonzalo

    2010-01-01

    Purpose: This study determines whether predictions about different degrees of market orientation in two cross-border value chains also appear in the mental models of decision makers at two levels of these value chains. Design: The laddering method elicits mental models of actors in two value chains......: Norwegian salmon exported to Japan and Danish pork exported to Japan. The analysis of the mental models centers on potential overlap and linkages between actors in the value chain, including elements in the mental models that may relate to the actors' market orientation. Findings: In both value chains......, decision makers exhibit overlap in their views of what drives their business. The pork chain appears dominated by a focus on efficiency, technology, and quality control, though it also acknowledges communication as important. The salmon chain places more emphasis on new product development and good...

  13. Comparison of Infliximab and Adalimumab in Biologic-Naive Patients With Ulcerative Colitis: A Nationwide Danish Cohort Study

    DEFF Research Database (Denmark)

    Singh, Siddharth; Nyboe Andersen, Nynne; Andersson, Mikael

    2017-01-01

    of hospitalization and serious infections, though risk of surgery was not different. In the absence of trials to directly compare these drugs, these findings could assist patients, healthcare providers, purchasers, and policy makers in making decisions that might improve care for patients with UC....

  14. How Qualitative Research Informs Clinical and Policy Decision Making in Transplantation: A Review.

    Science.gov (United States)

    Tong, Allison; Morton, Rachael L; Webster, Angela C

    2016-09-01

    Patient-centered care is no longer just a buzzword. It is now widely touted as a cornerstone in delivering quality care across all fields of medicine. However, patient-centered strategies and interventions necessitate evidence about patients' decision-making processes, values, priorities, and needs. Qualitative research is particularly well suited to understanding the experience and perspective of patients, donors, clinicians, and policy makers on a wide range of transplantation-related topics including organ donation and allocation, adherence to prescribed therapy, pretransplant and posttransplant care, implementation of clinical guidelines, and doctor-patient communication. In transplantation, evidence derived from qualitative research has been integrated into strategies for shared decision-making, patient educational resources, process evaluations of trials, clinical guidelines, and policies. The aim of this article is to outline key concepts and methods used in qualitative research, guide the appraisal of qualitative studies, and assist clinicians to understand how qualitative research may inform their practice and policy.

  15. Health and Marketing: Essays on Physician and Patient Decision-Making

    OpenAIRE

    Camacho, Nuno

    2011-01-01

    textabstractIn this dissertation, I focus on physician and patient behavior. I model patient and physician decisions by integrating robust insights from different behavioral sciences (e.g. economics, psychology and sociology) in econometric models calibrated on individual data. This approach allows me to bring novel insights for managers, policy-makers and patients about: (1) how physicians learn from patient feedback about a new drug (in particular, how switching patients are 7 to 10 times m...

  16. Dynamic Model of Market with Uninformed Market Maker

    Czech Academy of Sciences Publication Activity Database

    Šmíd, Martin; Kopa, Miloš

    2017-01-01

    Roč. 53, č. 5 (2017), s. 922-958 ISSN 0023-5954 R&D Projects: GA ČR(CZ) GBP402/12/G097 Institutional support: RVO:67985556 Keywords : market maker * optimal decision * price and inventory * high frequency data * dynamic model Subject RIV: BB - Applied Statistics, Operational Research OBOR OECD: Statistics and probability Impact factor: 0.379, year: 2016 http://www.library.utia.cas.cz/separaty/2017/E/smid-0483753.pdf

  17. Allergic contact dermatitis to propolis in a violin maker.

    Science.gov (United States)

    Lieberman, Heather D; Fogelman, Joshua P; Ramsay, David L; Cohen, David E

    2002-02-01

    Allergy to colophony is well noted in the literature, however, there have been few case reports of allergic contact dermatitis to propolis in musicians and instrument makers. We report a case of a stringed instrument craftsman who developed allergic contact dermatitis to propolis, a component of Italian varnish. A review of the components, applications, and the clinical manifestations of hypersensitivity reactions to propolis are presented.

  18. Strategic issues in information technology international implications for decision makers

    CERN Document Server

    Schütte, Hellmut

    1988-01-01

    Strategic Issues in Information Technology: International Implications for Decision Makers presents the significant development of information technology in the output of components, computers, and communication equipment and systems. This book discusses the integration of information technology into factories and offices to increase productivity.Organized into six parts encompassing 12 chapters, this book begins with an overview of the advancement towards an automated interpretation communication system to achieve real international communication. This text then examines the main determining

  19. On avoiding framing effects in experienced decision makers.

    OpenAIRE

    Garcia-Retamero, R; Dhami, MK

    2012-01-01

    The present study aimed to (a) demonstrate the effect of positive-negative framing on experienced criminal justice decision makers, (b) examine the debiasing effect of visually structured risk messages, and (c) investigate whether risk perceptions mediate the debiasing effect of visual aids on decision making. In two phases, 60 senior police officers estimated the accuracy of a counterterrorism technique in identifying whether a known terror suspect poses an imminent danger and decided whethe...

  20. Identitetskonstruktioner af patienter

    DEFF Research Database (Denmark)

    Lassen, Inger; Ottesen, Aase Marie; Strunck, Jeanne

    2015-01-01

    of New Public Management affects the welfare model and creates increasing inequality among citizens. These developments make it relevant to study how underlying ideologies may affect the construction of patient identity and health in the Danish welfare system. This would imply studying the role...... of identity at societal level, and in this paper we therefore ask whether the Danish Health Act constructs persons in need of care as vulnerable patients or as empowered citizens in line with recommendations by policy makers. The question we ask is whether the construction of patient identity in the Danish...

  1. Compulsory Attendance Policies: About Age or Intervention? SREB Focus Report

    Science.gov (United States)

    Grove, Jeffrey

    2014-01-01

    Over the past decade, SREB state policy-makers have focused on actions to reduce dropout rates and increase high school graduation rates. Some policy-makers have suggested that raising their state's compulsory attendance age (often called the dropout age) to require students to stay in school until age 17 or 18 is an important step. However,…

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Typology and Financial Performance of Champagne Makers According to Distribution Channel

    OpenAIRE

    Declerck, Francis

    2005-01-01

    A typology of strategies related to the distribution channels used by Champagne makers is established. Champagne makers' operating profit depends on their distribution network, which affects selling prices. Based on a sample of 20 Champagne makers ("Maisons de Champagne"), economic and financial performance indicators for Champagne makers are analyzed with reference to the type of distribution channel.

  5. Decision makers' experiences of prioritisation and views about how to finance healthcare costs.

    Science.gov (United States)

    Werntoft, Elisabet; Edberg, Anna-Karin

    2009-10-01

    Prioritisation in healthcare is an issue of growing importance due to scarcity of resources. The aims of this study were firstly to describe decision makers' experience of prioritisation and their views concerning willingness to pay and how to finance healthcare costs. An additional aim was to compare the views of politicians and physicians. The study was a cross-sectional study based on a questionnaire administered to 700 Swedish politicians and physicians. This was analysed using both quantitative and qualitative methods. A majority of the decision makers (55%) suggested that increasing costs should be financed through higher taxation but more physicians than politicians thought that higher patient fees, private health insurance and a reduction in social expenditure were better alternatives. Prioritisation aroused anxiety; politicians were afraid of displeasing voters while physicians were afraid of making medically incorrect decisions. This study do not answer the question about how to make prioritisation in health care but the result highlights the different ways that the decision makers view the subject and thereby elicit that publicly elected politicians and physicians perhaps not always work with the same goal ahead. There are needs for more research but also more media focus on the subject so the citizens will be aware and take part in the debate.

  6. Energy policy and externalities

    International Nuclear Information System (INIS)

    Bertel, E.; Fraser, P.

    2002-01-01

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

  7. Culturally acceptable health care services for Saudi's elderly population: the decision-maker's perception.

    Science.gov (United States)

    al-Shammari, S A; Felemban, F M; Jarallah, J S; Ali el-S; al-Bilali, S A; Hamad, J M

    1995-01-01

    This article reports on a study carried out in 1993 to elicit the opinions of decision makers (medical and non-medical) as to the types of facilities, locations and culturally acceptable levels of health care appropriate for the elderly in Saudi Arabia. In addition, the study sought to find out the procedures and likely constraints in the development of future health care services for the elderly. An opinion survey was carried out on a randomly selected sample of decision makers, drawn from: hospitals of 100-bed capacity or more; and, from directorates of education, agriculture, police, municipalities, commerce, transport and media, in each of the regions of Saudi Arabia. A predesigned Arabic questionnaire was completed by the respondents during February-April, 1993. Of the 244 respondents, the most important categories of elderly to be cared for were considered to be those with handicaps, the chronically ill, and those without family support. The non-medical decision makers gave higher scores to these alternatives than did the medical decision makers (P < 0.05). Use of the family home for elderly health care was rated as the most appropriate, followed by medical rehabilitation centres, and only then by hospitals. Non-medical respondents gave more emphasis on rehabilitation centres (P < 0.02). Medical respondents thought that primary care doctors (87.2%), physiotherapists (87.2%) and general nurses (78.2%) can adequately fulfil the needs of most elderly patients. In contrast, non-medical respondents demanded the presence of specialist doctors (72.3%), specialist nurses (78.9%), laboratory and X-ray facilities to run such services (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Credibility of Policy Announcements Under Asymmetric Information

    DEFF Research Database (Denmark)

    Christensen, Michael

    1999-01-01

    In a simple macro-economic model, where the monetary authorities process superior information about a real shocks, the scope for an active stabilization policy is shown to depend on the credibility of the policy maker. Lack of credibility increases the need for an active stabilization policy...

  9. Why Social Policy Needs Objective Indicators

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2002-01-01

    textabstractThere are many qualms about subjective indicators, and some believe that social policy would be better for not using them. This paper consists of a review of these objections. It is argued that policy makers need subjective indicators. The main reasons being: 1. Social policy is never

  10. The Influence Of Policy Implementation From The Change Of Institutional Status Toward Quality Of Patient Service In Hospital

    Directory of Open Access Journals (Sweden)

    Dadang Kusnadi

    2015-08-01

    Full Text Available Abstract Fenomenon and comunity problem in goverment hospital management not aware to wont and need public. Silent safety and consumen satisfaction is fenomenon lack quallity care. Goal this research goal for analysis about influence of policy implementation of hospital change institution status to the quality of patien service in Hospital. Kind of reserch is the quantity desain on approach the eksplanatory survey research analysis regresi linier multipel with analysis method validitas product moment pearson exam and reliability exam is alpha cronbach technique to hypotesis exam is path analysis and statistic exam t. Datum transformation is Skala Likert with measurement the method succesive interval. The population one thausand seventh two person with sample technique stratified random sampling the instrument research is quesioner and interview patien on caunter imforman. The result of assuming research that it is anticipated that implementation of change policy of institution status of hospital X there is significant influence to quality of service of patient Y is 66.31 and the other factor e is 33.69. In the implementation factor is significant to positif influence to quality service is communication X1 is 049 human resources X2 is 025 disposition X3 is 032 and structure birocratic X4 is 033. The conculsion from four factor independen variable X is the implementation of policy to quality service patient Y to influence and can receive in knowledge. To concept the development in implementation of policy need culture job factor because every product policy to contac direct with the community as to basic public policy.

  11. Dose/response relationships and policy formulation

    International Nuclear Information System (INIS)

    Robinson, P.D.

    1981-01-01

    The ICRP 26 cost/benefit approach to establishing operational radiation protection guidelines is discussed. The purpose is to aid the policy maker in the decision making process, using as a basis the dose-response curve

  12. Pool Strategy of a Price-Maker Wind Power Producer

    DEFF Research Database (Denmark)

    Zugno, Marco; Morales González, Juan Miguel; Pinson, Pierre

    2013-01-01

    We consider the problem of a wind power producer trading energy in short-term electricity markets. The producer is a price-taker in the day-ahead market, but a price-maker in the balancing market, and aims at optimizing its expected revenues from these market floors. The problem is formulated...... or median forecast of wind power distribution. Finally, sensitivity analyses are carried out to assess the impact on the offering strategy of the producer's penetration in the market, of the correlation between wind power production and residual system deviation, and of the shape of the forecast...

  13. Factors that encourage and discourage policy-making to prevent childhood obesity: Experience in the United States.

    Science.gov (United States)

    Rutkow, Lainie; Jones-Smith, Jesse; Walters, Hannah J; O'Hara, Marguerite; Bleich, Sara N

    2016-12-01

    Policy-makers throughout the world seek to address childhood obesity prevention, yet little is known about factors that influence policy-makers' decisions on this topic. From September 2014 to April 2015, we conducted 43 semi-structured interviews about factors that encourage and discourage policy-makers' support for childhood obesity prevention policies. We interviewed policy-makers (n = 12) and two other groups engaged with childhood obesity prevention policies: representatives of non-governmental organizations (n = 24) and academics (n = 7). Factors that encourage policy-makers' support for childhood obesity prevention policies included: positive impact on government finances, an existing evidence base, partnerships with community-based collaborators, and consistency with policy-makers' priorities. Factors that discourage policy-makers' support included the following: perceptions about government's role, food and beverage industry opposition, and policy-makers' beliefs about personal responsibility. As public health practitioners, advocates, and others seek to advance childhood obesity prevention in the U.S. and elsewhere, the factors we identified offer insights into ways to frame proposed policies and strategies to influence policy-makers.

  14. Nurses' engagement in AIDS policy development.

    Science.gov (United States)

    Richter, M S; Mill, J; Muller, C E; Kahwa, E; Etowa, J; Dawkins, P; Hepburn, C

    2013-03-01

    A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care. One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking. A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews. Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development. The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address

  15. Trust makers, breakers and brokers: building trust in the Australian food system.

    Science.gov (United States)

    Wilson, Annabelle; Coveney, John; Henderson, Julie; Meyer, Samantha; Calnan, Michael; Caraher, Martin; Webb, Trevor; Elliott, Anthony; Ward, Paul

    2013-03-15

    The importance of consumer trust in the food supply has previously been identified, and dimensions of consumer trust in food-who they trust and the type of trust that they exhibit-has been explored. However, there is a lack of research about the mechanisms through which consumer trust in the food supply is developed, maintained, broken and repaired. This study seeks to address this gap by exploring if, and how, consumer trust in the food supply is considered by the media, food industry and governments when responding to food scares. The aim of the research is to develop models of trust building that can be implemented following food scares. Semi-structured interviews will be undertaken with media, public relations officials and policy makers in Australia, New Zealand and the United Kingdom. Participants will be recruited through purposive sampling and will be asked to discuss a hypothetical case study outlining a food incident, and any experiences of specific food scares. Models of trust development, maintenance and repair will be developed from interview data. Comment on these models will be sought from experts in food-related organizations through a Delphi study, where participants will be asked to consider the usefulness of the models. Participants' comments will be used to revise the models until consensus is reached on the suitability and usability of the models. This study will contribute to the literature about systems-based trust, and explore trust as a social and regulatory process. The protocol and results will be of interest and use to the food industry, food regulators, consumer advocate groups, media seeking to report food-related issues and policy makers concerned with public health and consumer health and well-being. This research represents an important contribution to the translation of the theoretical conceptualizations of trust into practical use in the context of food.

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

    Science.gov (United States)

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

    2016-08-02

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

  17. Engaging with communities, engaging with patients: amendment to the NAPCRG 1998 Policy Statement on Responsible Research With Communities.

    Science.gov (United States)

    Allen, Michele L; Salsberg, Jon; Knot, Michaela; LeMaster, Joseph W; Felzien, Maret; Westfall, John M; Herbert, Carol P; Vickery, Katherine; Culhane-Pera, Kathleen A; Ramsden, Vivian R; Zittleman, Linda; Martin, Ruth Elwood; Macaulay, Ann C

    2017-06-01

    In 1998, the North American Primary Care Research Group (NAPCRG) adopted a groundbreaking Policy Statement endorsing responsible participatory research (PR) with communities. Since that time, PR gained prominence in primary care research. To reconsider the original 1998 Policy Statement in light of increased uptake of PR, and suggest future directions and applications for PR in primary care. This work contributed to an updated Policy Statement endorsed by NAPCRG in 2015. 32 university and 30 community NAPCRG-affiliated research partners, convened a workshop to document lessons learned about implementing processes and principles of PR. This document emerged from that session and reflection and discussion regarding the original Policy Statement, the emerging PR literature, and our own experiences. The foundational principles articulated in the 1998 Policy Statement remain relevant to the current PR environment. Lessons learned since its publication include that the maturation of partnerships is facilitated by participatory processes that support increased community responsibility for research projects, and benefits generated through PR extend beyond research outcomes. Future directions that will move forward the field of PR in primary care include: (i) improve assessment of PR processes to better delineate the links between how PR teams work together and diverse PR outcomes, (ii) increase the number of models incorporating PR into translational research from project inception to dissemination, and (iii) increase application of PR approaches that support patient engagement in clinical settings to patient-provider relationship and practice change research. PR has markedly altered the manner in which primary care research is undertaken in partnership with communities and its principles and philosophies continue to offer means to assure that research results and processes improve the health of all communities. © The Author 2016. Published by Oxford University Press. All

  18. Population policy.

    Science.gov (United States)

    1987-03-01

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

  19. Ethical challenges related to elder care. High level decision-makers' experiences

    Directory of Open Access Journals (Sweden)

    Kihlgren Mona

    2007-04-01

    Full Text Available Abstract Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to

  20. Ethical challenges related to elder care. High level decision-makers' experiences.

    Science.gov (United States)

    Mamhidir, Anna-Greta; Kihlgren, Mona; Sorlie, Venke

    2007-04-10

    Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health

  1. Digital stereoscopic photography using StereoData Maker

    Science.gov (United States)

    Toeppen, John; Sykes, David

    2009-02-01

    Stereoscopic digital photography has become much more practical with the use of USB wired connections between a pair of Canon cameras using StereoData Maker software for precise synchronization. StereoPhoto Maker software is now used to automatically combine and align right and left image files to produce a stereo pair. Side by side images are saved as pairs and may be viewed using software that converts the images into the preferred viewing format at the time of display. Stereo images may be shared on the internet, displayed on computer monitors, autostereo displays, viewed on high definition 3D TVs, or projected for a group. Stereo photographers are now free to control composition using point and shoot settings, or are able to control shutter speed, aperture, focus, ISO, and zoom. The quality of the output depends on the developed skills of the photographer as well as their understanding of the software, human vision and the geometry they choose for their cameras and subjects. Observers of digital stereo images can zoom in for greater detail and scroll across large panoramic fields with a few keystrokes. The art, science, and methods of taking, creating and viewing digital stereo photos are presented in a historic and developmental context in this paper.

  2. Informing the Romanian decision makers on nuclear energy

    International Nuclear Information System (INIS)

    Chirica, T.; Sandru, P.

    1997-01-01

    The paper describes the 'pro-nuclear' sector of the Romanian civil society activity to better inform the Romanian Decision Makers on nuclear power issues. The 'Romanian Nuclear Energy Association' - AREN and the Romanian Radioprotection Society - SRRp, having the support of the 'Romanian General Association of Engineers' - AGIR, started on December 1996 a strong campaign to form a correct opinion among the new elected bodies and the new Government of the country, related to the future development of the Romanian Nuclear Program as a national priority and to expedite the restart of the Cernavoda NPP-Unit 2 completion. The paper describes the strategy of this lobby campaign, the objectives assumed and the results. The authors have taken advantage of the OECD - Nuclear Energy Agency information exchange about the Decision Makers informing process about nuclear energy and have the intention to share their experience with other sister societies dealing with similar conditions. This could be also a good experience for other areas of activity. (authors)

  3. Training Conservation Practitioners to be Better Decision Makers

    Directory of Open Access Journals (Sweden)

    Fred A. Johnson

    2015-06-01

    Full Text Available Traditional conservation curricula and training typically emphasizes only one part of systematic decision making (i.e., the science, at the expense of preparing conservation practitioners with critical skills in values-setting, working with decision makers and stakeholders, and effective problem framing. In this article we describe how the application of decision science is relevant to conservation problems and suggest how current and future conservation practitioners can be trained to be better decision makers. Though decision-analytic approaches vary considerably, they all involve: (1 properly formulating the decision problem; (2 specifying feasible alternative actions; and (3 selecting criteria for evaluating potential outcomes. Two approaches are available for providing training in decision science, with each serving different needs. Formal education is useful for providing simple, well-defined problems that allow demonstrations of the structure, axioms and general characteristics of a decision-analytic approach. In contrast, practical training can offer complex, realistic decision problems requiring more careful structuring and analysis than those used for formal training purposes. Ultimately, the kinds and degree of training necessary depend on the role conservation practitioners play in a decision-making process. Those attempting to facilitate decision-making processes will need advanced training in both technical aspects of decision science and in facilitation techniques, as well as opportunities to apprentice under decision analysts/consultants. Our primary goal should be an attempt to ingrain a discipline for applying clarity of thought to all decisions.

  4. Lawsuits allege price fixing by generic drug makers

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-12-01

    Full Text Available No abstract available. Article truncated at 150 words. Two years after high generic drug prices became a public controversy, Reuters is reporting that 20 states filed a lawsuit Thursday against Mylan, Teva Pharmaceuticals and four other generic drug makers (1. The suit alleges the companies conspired to fix prices or allocated markets to prop up prices. The civil lawsuit, led by antitrust investigators in Connecticut, comes one day after the U.S. Department of Justice filed criminal charges against two former executives of the generic drug maker, Heritage. The states attorneys general asked the court to order the companies to disgorge ill-gotten gains, which were not defined, pay attorneys' fees and stop collusion. Of the states in the Southwest only Nevada is participating in the lawsuit. The cases are part of a broader generic drug pricing probe that remains under way at the state and federal level, as well as in the U.S. Congress. In 2014, media reports of …

  5. Policy-maker attitudes to the ageing of the HIV cohort in Botswana

    African Journals Online (AJOL)

    2017-09-19

    Sep 19, 2017 ... aPhD Candidate (Medicine) at School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia, .... due to medical complications, poorer mental health, social .... PLWH were on medication and adhering to treatment to avoid ... ally active, and that is one major misconception.

  6. Towards a Green Economy. Pathways to Sustainable Development and Poverty Eradication. A Synthesis for Policy Makers

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    Nearly 20 years after the Earth Summit, nations are again on the Road to Rio, but in a world very different and very changed from that of 1992. Then we were just glimpsing some of the challenges emerging across the planet from climate change and the loss of species to desertification and land degradation. Today many of those seemingly far off concerns are becoming a reality with sobering implications for not only achieving the UN's Millennium Development Goals, but challenging the very opportunity for close to seven billion people - rising to nine billion by 2050 - to be able to thrive, let alone survive. Rio 1992 did not fail the world - far from it. It provided the vision and important pieces of the multilateral machinery to achieve a sustainable future. But this will only be possible if the environmental and social pillars of sustainable development are given equal footing with the economic one: where the often invisible engines of sustainability, from forests to freshwaters, are also given equal if not greater weight in development and economic planning. Towards a Green Economy is among UNEP's key contributions to the Rio+20 process and the overall goal of addressing poverty and delivering a sustainable 21st century. The report makes a compelling economic and social case for investing two per cent of global GDP in greening ten central sectors of the economy in order to shift development and unleash public and private capital flows onto a low-carbon, resource-efficient path. Such a transition can catalyse economic activity of at least a comparable size to business as usual, but with a reduced risk of the crises and shocks increasingly inherent in the existing model. New ideas are by their very nature disruptive, but far less disruptive than a world running low on drinking water and productive land, set against the backdrop of climate change, extreme weather events and rising natural resource scarcities. A green economy does not favour one political perspective over another. It is relevant to all economies, be they state or more market-led. Neither is it a replacement for sustainable development. Rather, it is a way of realizing that development at the national, regional and global levels and in ways that resonate with and amplify the implementation of Agenda 21. A transition to a green economy is already underway, a point underscored in the report and a growing wealth of companion studies by international organizations, countries, corporations and civil society. But the challenge is clearly to build on this momentum. Rio+20 offers a real opportunity to scale-up and embed these 'green shoots'. In doing so, this report offers not only a roadmap to Rio but beyond 2012, where a far more intelligent management of the natural and human capital of this planet finally shapes the wealth creation and direction of this world.

  7. Impact assessment tools for policy makers on the European and national level

    NARCIS (Netherlands)

    Bakker, W.E.; van der Kolk, M.

    2017-01-01

    Since the Treaty of Maastricht (1992), every person holding the nationality of a European Union (EU) Member State is automatically a citizen of the EU and is granted an additional set of rights. In 2007, the Lisbon Treaty strengthened EU citizenship by making the EU Charter of Fundamental Rights

  8. THE VITAL IMPORTANCE OF PROVIDING SOUND SCIENTIFIC ADVICE TO POLICY MAKERS IN GOVERNMENT

    Directory of Open Access Journals (Sweden)

    G. S. Pearson

    2013-08-01

    Full Text Available The article gives an idea of the scope of professional activity of scientists working in the field of biosafety in terms of providing timely and effective advice for politicians and diplomats in the government. It should be acknowledged that politicians and diplomats are also involved in a varying degree with biosafety issues such as toxicological and biological weapons, formulated in the relevant Convention: Biological and Toxin Weapons Convention. However taking into account their professional interests, they mightn’t have appropriate information on relevant events in these and other activities. The value of these activities of qualified scientists knowing the latest information in the field of biosafety is difficult to overestimate, as they have the possibility to analyze any situation on the range of relevant activities and use their knowledge to make informed proposals which could be acceptable for their co-worker scientists in other areas of biological science. For highly qualified scientists such activities appeared to be effective, it is a vital aspect of their professional activity, because such scientists are able to provide scientific advice, analyze and summarize relevant scientific aspects on a specific topic of interest for politicians and diplomats. Such an analysis should include identification of key elements that are relevant to a given scientific problem and should be formulated so as the consequences of the various elements of the Convention were clearly appreciated and understood by politicians and diplomats. In other words, the rele vant scientific aspects should be analyzed, summarized and presented in the context of the Convention, together with suggestions on what steps in this direction should be taken by politicians and diplomats.

  9. Unmanned Aircraft Systems for Emergency Management: A Guide for Policy Makers and Practitioners

    Science.gov (United States)

    2016-07-29

    75 Figure 8. New Mexico State University Approved COA ................................ 76 Figure 9. Decision Tree ...APPENDIX B. UNMANNED AIRCRAFT SYSTEMS DECISION TREE .......... 107 LIST OF REFERENCES...maritime border, which is patrolled in collaboration with the U.S. Coast Guard (USCG).66 Between 2011 and 2014, the UASs operated by the CBP logged over

  10. Advances in bovine tuberculosis diagnosis and pathogenesis: what policy makers need to know.

    Science.gov (United States)

    Palmer, Mitchell V; Waters, W Ray

    2006-02-25

    The mainstay of tuberculosis diagnosis in cattle and deer has been the tuberculin skin test. Recent advances have allowed the incorporation of blood based assays to the diagnostic arsenal for both cattle and deer. Use of defined and specific antigens has allowed for improved specificity of cell mediated assays in both cattle and deer and advances in antibody tests for tuberculosis have potential for use in free-ranging and captive cervid populations. Combined use of blood-based assays with skin testing will require further understanding of the effect of skin testing on the accuracy of blood based assays. Models of experimental infection of cattle have allowed for increased understanding of natural disease pathogenesis. Differences likely exist; however, between cattle and deer in both disease distribution and primary route of inoculation in naturally infected animals.

  11. 2007 status of climate changes: synthesis report. Summary for policy-makers

    International Nuclear Information System (INIS)

    2007-01-01

    This Synthesis Report is based on the assessment carried out by the three Working Groups of the Intergovernmental Panel on Climate Change (IPCC). It provides an integrated view of climate change as the final part of the IPCC's Fourth Assessment Report (AR4). Topic 1 summarises observed changes in climate and their effects on natural and human systems, regardless of their causes, while topic 2 assesses the causes of the observed changes. Topic 3 presents projections of future climate change and related impacts under different scenarios. Topic 4 discusses adaptation and mitigation options over the next few decades and their interactions with sustainable development. Topic 5 assesses the relationship between adaptation and mitigation on a more conceptual basis and takes a longer-term perspective. Topic 6 summarises the major robust findings and remaining key uncertainties in this assessment

  12. Extent of Anaemia among Preschool Children in EAG States, India: A Challenge to Policy Makers

    Science.gov (United States)

    Singh, Rakesh Kumar; Patra, Shraboni

    2014-01-01

    Background. India is the highest contributor to child anemia. About 89 million children in India are anemic. The study determines the factors that contributed to child anemia and examines the role of the existing programs in reducing the prevalence of child anemia particularly in the EAG states. Methods. The data from the latest round of the National Family Health Survey (NFHS-3) is used. Simple bivariate and multinomial logistics regression analyses are used. Results. About 70% children are anemic in all the EAG states. The prevalence of severe anemia is the highest (6.7%) in Rajasthan followed by Uttar Pradesh (3.6%) and Madhya Pradesh (3.4%). Children aged 12 to 17 months are significantly seven times (RR = 7.99, P children of 36 to 59 months. Children of severely anemic mothers are also found to be more severely anemic (RR = 15.97, P children of not anemic mothers. Conclusions. The study reveals that the existing government program fails to control anemia among preschool children in the backward states of India. Therefore, there is an urgent need for monitoring of program in regular interval, particularly for EAG states to reduce the prevalence of anemia among preschool children. PMID:25140250

  13. Nutrition labelling and the choices logo in Israel: positions and perceptions of leading health policy makers.

    Science.gov (United States)

    Gesser-Edelsburg, A; Endevelt, R; Tirosh-Kamienchick, Y

    2014-02-01

    Based on the Social Marketing approach and Diffusion of Innovations Theory that indicates the importance of opinion leaders with respect to the spreading of new ideas, concepts or practices within a community, the present study aimed to examine positions and perceptions of Israeli leading dietitians and health officials regarding nutrition labelling and the Choices logo, before it was launched in Israel in February 2011, as well as how they would communicate it to the public as agents of influence. The study involved in-depth face-to-face and telephone interviews with 15 senior dietitians and Health Ministry officials using semi-structured protocols including questions about nutrition labelling and the Choices logo. The respondents considered that the nutrition facts panels usually found on the backs of packages are too complicated for the average consumer. Simiularly, fronts of packages are cluttered with advertisements and health claims, causing confusion. The study participants would like to see an integrative label on the front of the package to facilitate consumers' decisions. However, the Choices logo raises ethical and social questions about the conflict between corporate interests and public health: (i) the label's relativity versus objectivity; (ii) the consumer's responsibility to create a balanced diet; (iii) the label's credibility; and (iv) bias against companies, products and audiences. The results of the present study highlight the importance of a need for an integrated programme of nutrition promotion, including the use of social marketing based on a cooperative effort between the food industry, regulators and professionals, to recommend changes and adjustments in nutritional front of package labelling with the aim of promoting healthier nutrition consumption. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  14. Uncertainty communication in the Environmental Balance 2005. Results of the User Group Policy Makers

    International Nuclear Information System (INIS)

    Wardekker, J.A.; Van der Sluijs, J.P.; Janssen, P.H.M.

    2006-02-01

    In 2003 recommendations were formulated how to deal with uncertainties in scientific studies. Currently a so-called 'Styleguide for Uncertainty Communication' is under development to report on information about uncertainties. The guide is based on literature survey and knowledge from experts in the field. A group of users of the Dutch Environmental Balance 2005 was set up to communicate and inform about uncertainties with respect to the Balance [nl

  15. How corporatist institutions shape the access of citizen groups to policy makers

    DEFF Research Database (Denmark)

    Christiansen, Peter Munk; Mach, André; Varone, Frédéric

    2018-01-01

    similar socio-economic and political challenges during this period, but the political opportunity structure is more favorable towards citizen groups in Switzerland than in Denmark. The Swiss referendum institution makes parliamentarians more open to popular demands while in Denmark strong unions, a strong...

  16. Building new university hospital--what citizens know and policy makers should be aware of.

    Science.gov (United States)

    Oresković, S; Letica, S; Mastilica, M; Babić-Bosanac, S; Civljak, M; Bozicević, I; Borovecki, A

    2002-12-01

    Survey of citizens' attitudes in the process of strategic decision making is one of the most important methods for determining health care priorities. We describe the results of a survey carried out in December 2001, with an aim to collect and analyze the attitudes of the citizens and health care professionals toward the possibilities and strategies of construction of the University Hospital in Blato, Zagreb. The first referendum on the construction of the new hospital was conducted among Zagreb citizens in 1982, when they agreed that the new University Hospital was much needed. Zagreb citizens confirmed once again their attitudes toward and opinions on the need to continue the construction of new hospital in the city outskirts. By 1992, when the construction of the hospital was halted due to insufficient financial means, Zagreb citizens had already invested over 150 epsilon million in the project. It is interesting that today, 89.4% of the citizens and 74.5% of physicians agree that the new hospital building should be completed. Also, 66.7% of the citizens and 88% of physicians think that this hospital should be a University hospital that could offer the most complex treatments and medical education. To finish the construction of the new hospital further 200 epsilon million needs to be invested. Survey showed that 71% of citizens and 82.2% of physicians think that funds should be raised from some form of credit or budget rather than by special local tax, additional tax or voluntary tax. This project will significantly determine the future of hospital and health care system in Croatia due to its capacities in terms of space, technology, and staff. Before the decision to continue with the new hospital construction be made, the expected future needs, demands, and supply of the health care services in hospital sector in Zagreb and Croatia should be provided using SWOT analysis for each of existing the facilities.

  17. Development assistance for health: should policy-makers worry about its macroeconomic impact?

    Science.gov (United States)

    Cavagnero, Eleonora; Lane, Christopher; Evans, David B; Carrin, Guy

    2008-11-01

    Many low-income countries need to substantially increase expenditure to meet universal coverage goals for essential health services but, because they have very low-incomes, most will be unable to raise adequate funds exclusively from domestic sources in the short to medium term. Increased aid for health will be required. However, there has long been a concern that the rapid arrival of large amounts of foreign exchange in a country could lead to an increase in inflation and loss of international competitiveness, with an adverse impact on exports and economic growth, an economic phenomenon termed 'Dutch disease'. We review cross-country and country-level empirical studies and propose a simple framework to gauge the extent of macroeconomic risks. Of the 15 low-income countries that are increasing aid-financed health spending, 7 have high macroeconomic risks that may constrain the sustained expansion of spending. These conditions also apply in one-quarter of the 42 countries not presently increasing spending. Health authorities should be aware of the multiple risk factors at play, including factors that are health-sector specific and others that generally are not. They should also realize that there are effective means for mitigating the risk of Dutch disease associated with increasing development assistance for health. International partners also have an important role to play since more sustainable and predictable flows of donor funding will allow more productivity enhancing investment in physical and human capital, which will also contribute to ensuring there are few harmful macroeconomic effects of increases in aid.

  18. Multifarious networks in climate change research: scientists, policy makers and the public

    OpenAIRE

    Delicado, Ana

    2011-01-01

    This paper explores the networks of collaborations that are formed in climate change research, both within the scientific community and with the political and social spheres. It draws on the case of climate change research in a particular national setting, Portugal.

  19. Master plan for renewable energies + Summary for policy makers + Presentation to the Council of Ministers

    International Nuclear Information System (INIS)

    Blanc, Julien; Bitot, Stephane

    2012-01-01

    This document reports a study which aimed at determining a master plan which would allow a mix with 50 per cent of renewable energies for electricity production to be reached by 2020 in the specific case of French Polynesia. It proposes a comprehensive analysis of of the present energetic situation in Tahiti and in eleven islands of the French Polynesia. After a presentation of the social and economic context, the report proposes a diagnosis of energy and electricity consumption in Polynesia, an analysis of electricity demand and of its possible evolutions (scenarios), and an analysis of the present production (fossil thermal, hydroelectric, photovoltaic, and wind energy, quality and requirements for an island grid). It reports the analysis the potential of development of renewable energies (hydroelectricity, photovoltaic, other solar production, wind, biomass, marine renewable energies, seawater air conditioning), and the analysis of the supply-demand balance in the different scenarios for Tahiti and the other islands. Short term perspectives are discussed, and an overview of installed renewable powers is provided. A second document proposes a summary of this study under the form of a Power Point presentation illustrated by many graphs

  20. Climate change trade measures : considerations for U.S. policy makers

    Science.gov (United States)

    2009-07-01

    GAO was asked to examine the potential effects of greenhouse gas emissions pricing on U.S. industries international competitiveness and trade measures being considered as part of U.S. legislative proposals to address climate change. Specifically, ...

  1. Electronic Cigarettes in Mississippi: Issues Facing Healthcare Providers and Policy Makers.

    Science.gov (United States)

    Valentine, Nell; McClelland, Emily; Bryant, Jessica; McMillen, Robert

    2016-06-01

    Electronic cigarettes (e-cigarettes) are currently unregulated nicotine delivery products, and use is increasing among youth and young adults in the U.S. Little is known about use in Mississippi. Surveys assessed e-cigarette use among Mississippi adolescents and adults. UMMC provided data on reported cases of e-cigarette poisonings. From 2010 to 2014, current e-cigarette use increased from 0.6% to 6.7% among middle school students, from 1.2% to 10.1% among high school students, and from 0.2% to 6.8% among adults. There were no reported cases of e-cigarette poisonings in 2010, 2011, or 2013. There was one case in 2012. Cases increased to 26 in 2014, and 17 cases were reported in 2015. E-cigarette use has increased substantially. E-cigarettes expose users and bystanders to harmful chemicals and cancer-causing compounds. Regulation of e-cigarettes at the local, state, and federal levels is needed to address the clear harms to non-smokers.

  2. Home care in Europe: growing interest among decision makers, but little information available for policy development.

    NARCIS (Netherlands)

    Genet, N.

    2010-01-01

    Research problem: Integrated systems of home care are assumed to be an adequate response to current and future challenges to health and social services that result from demographic and social developments. The interest in home care systems and the willingness to learn from foreign experiences is

  3. A Survey of School Administrators and Policy Makers: Executive Summary of the Final Report.

    Science.gov (United States)

    Stallworth, John T.; Williams, David L., Jr.

    Although parental involvement can be important for improving schools, very few parents are involved. This paper explores attitudinal barriers to such involvement from the perspectives of 1,200 superintendents, 664 school board presidents, and 30 state agency officials in six states (Arkansas, Louisiana, Mississippi, New Mexico, Oklahoma, and…

  4. Policy-maker attitudes to the ageing of the HIV cohort in Botswana

    African Journals Online (AJOL)

    2017-09-19

    Sep 19, 2017 ... Background: The roll out of antiretroviral therapy in Botswana, as in many ... govern social, physical and medical intervention aimed at people living with ... Respondents also noted the lack of defined geriatric care within the ...

  5. Human genetics for non-scientists: Practical workshops for policy makers and opinion leaders

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    These workshops form part of a series of workshops that the Banbury and the DNA Learning Centers of Cold Spring Harbor Laboratory have held for a number of years, introducing genetics, and the ways in which scientific research is done, to non-scientists. The purpose of the workshops as stated in the grant application was: {open_quotes}Our objective is to foster a better understanding of the societal impact of human genome research by providing basic information on genetics to non-scientists whose professions or special interests interface with genetic technology.... Participants will be chosen for their interest in human genetics and for their roles as opinion leaders in their own communities. Primary care physicians are of particular interest to us for this series of workshops.{close_quotes} Two workshops were held under this grant. The first was held in 21-24 April, 1994 and attended by 20 participants, and the second was held 16-19 November, 1995, and attended by 16 participants. In each case, there was a combination of concept lectures on the foundations of human molecular genetics; lectures by invited specialists; and laboratory experiments to introduce non-scientists to the techniques used in molecular genetics.

  6. The Geopolitics of Energy: Engaging the Public and Policy-makers

    International Nuclear Information System (INIS)

    Wright, J.; Conca, J.L.

    2009-01-01

    If the world is to attain global peace and prosperity in this century, a rational mix of energy sources must be achieved quickly, by about 2040. This mix should be about 1/3-fossil fuel, 1/3-renewable and 1/3-nuclear, each source generating over 10 trillion kW-hrs/year, the amount generated by all fossil fuels in the world today. Without a comprehensive push for both renewable and nuclear, humanity will not avert environmental and economic catastrophe by mid-century, and we will not be able to prevent worldwide weapons proliferation. Public mis-perception of nuclear energy is probably the greatest hurdle to achieving a third of this mix by nuclear energy, while a similar but opposite overly optimistic perception of renewable may cause renewable to fail in achieving their third of this mix. This 1/3-1/3-1/3 mix requires committed leadership among the nations of the world, and full understanding and support from their citizens, with an understanding that failure will result in developed nations losing their high standards of living and developing nations losing the opportunity to achieve such standards, while the planetary ecosystem teeters on the brink of collapse. (authors)

  7. Over-the-counter antibiotics in Saudi Arabia, an urgent call for policy makers.

    Science.gov (United States)

    Bin Nafisah, Sharafaldeen; Bin Nafesa, Salahaldin; Alamery, Aliyah H; Alhumaid, Mazen A; AlMuhaidib, Haitham M; Al-Eidan, Fahad A

    Antibiotics over-consumption is a pandemic that has a tremendous cost on the overwhelmed healthcare system. The accessibility of antibiotics coupled with the misconception of public toward those drugs both of which implicated in the use and misuse of antibiotics. The aim of this study was to investigate the perception of the community toward antibiotics, its purpose and harmfulness, in addition to the accessibility of those drugs as over the counter and without prescriptions. We also investigated the behavior toward antibiotic prescriptions when perceived unnecessary. This is a cross-sectional study in Riyadh-Saudi Arabia based upon a structured self-administered questionnaire. The study included 473 individuals with a mean age of 27 years old. Forty eight percent (n=227) of the participants obtain antibiotics without prescriptions. Ninety two percent (n=208) of those noted pharmacist counseling as their method of acquisition. Self-prescription noted in 8.4% (n=19). Viral illnesses accounted for the highest percentage for seeking antibiotics in 35.5% (n=166) more commonly among females. Thirty one point eight percent (n=149) used antibiotics for analgesia while 13.7% (n=64) believed in their prophylactic use. We also noted that the prevalence of sharing antibiotics is 19.7%. The perceived unnecessary prescriptions uncovered 122 of the participants who reported throwing the prescribed antibiotics away after acquisition. Dispensing antibiotics without prescription is an issue that mandates a political intervention and implementation of the existing laws that prohibit dispensing without proper prescription. We advocate public health measures targeting both healthcare providers and the public on the use and misuse of antibiotics. Copyright © 2017 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  8. "Seeing" the School Reform Elephant: Connecting Policy Makers, Parents, Practioners, and Students.

    Science.gov (United States)

    Wagner, Tony; Sconyers, Nancy

    This report is part of a multi-year project conducted by the Institute for Responsive Education (IRE) and Boston University components of the Center on Families, Communities, Schools and Children's Learning. The report draws on results of a series of focus groups and interviews conducted in 1994 and 1995 to explore how policymakers and parents,…

  9. Project ARBRE: Lessons for bio-energy developers and policy-makers

    International Nuclear Information System (INIS)

    Piterou, Athena; Shackley, Simon; Upham, Paul

    2008-01-01

    Project Arable Biomass Renewable Energy (ARBRE) was a 'flagship' project in the UK to demonstrate electricity generation from dedicated energy crops, employing the high efficiency of gasification combined cycle technology while also contributing to the waste management problem of sewage disposal. The plant never reached commercial operation and this paper provides the first detailed public account of the reasons, drawing on interviews with the main actors. Project ARBRE failed due to three unfortunate developments: the withdrawal for reasons of commercial strategy of the main company that initiated and financed the project; bankruptcy of the turnkey contractor appointed to oversee the project; and technical problems with the gasification technology, which could not be resolved within the financial and time constraints. All these factors acted in reinforcing manner and they were individually preventable: documenting the process of failure is a learning experience that can prevent their recurrence

  10. Community-based interventions for obesity prevention: lessons learned by Australian policy-makers

    Directory of Open Access Journals (Sweden)

    Haby Michelle M

    2012-01-01

    Full Text Available Abstract Background Interest in community-based interventions (CBIs for health promotion is increasing, with a lot of recent activity in the field. This paper aims, from a state government perspective, to examine the experience of funding and managing six obesity prevention CBIs, to identify lessons learned and to consider the implications for future investment. Specifically, we focus on the planning, government support, evaluation, research and workforce development required. Methods The lessons presented in this paper come from analysis of key project documents, the experience of the authors in managing the projects and from feedback obtained from key program stakeholders. Results CBIs require careful management, including sufficient planning time and clear governance structures. Selection of interventions should be based on evidence and tailored to local needs to ensure adequate penetration in the community. Workforce and community capacity must be assessed and addressed when selecting communities. Supporting the health promotion workforce to become adequately skilled and experienced in evaluation and research is also necessary before implementation. Comprehensive evaluation of future projects is challenging on both technical and affordability grounds. Greater emphasis may be needed on process evaluation complemented by organisation-level measures of impact and monitoring of nutrition and physical activity behaviours. Conclusions CBIs offer potential as one of a mix of approaches to obesity prevention. If successful approaches are to be expanded, care must be taken to incorporate lessons from existing and past projects. To do this, government must show strong leadership and work in partnership with the research community and local practitioners.

  11. Towards a Green Economy. Pathways to Sustainable Development and Poverty Eradication. A Synthesis for Policy Makers

    International Nuclear Information System (INIS)

    2011-01-01

    Nearly 20 years after the Earth Summit, nations are again on the Road to Rio, but in a world very different and very changed from that of 1992. Then we were just glimpsing some of the challenges emerging across the planet from climate change and the loss of species to desertification and land degradation. Today many of those seemingly far off concerns are becoming a reality with sobering implications for not only achieving the UN's Millennium Development Goals, but challenging the very opportunity for close to seven billion people - rising to nine billion by 2050 - to be able to thrive, let alone survive. Rio 1992 did not fail the world - far from it. It provided the vision and important pieces of the multilateral machinery to achieve a sustainable future. But this will only be possible if the environmental and social pillars of sustainable development are given equal footing with the economic one: where the often invisible engines of sustainability, from forests to freshwaters, are also given equal if not greater weight in development and economic planning. Towards a Green Economy is among UNEP's key contributions to the Rio+20 process and the overall goal of addressing poverty and delivering a sustainable 21st century. The report makes a compelling economic and social case for investing two per cent of global GDP in greening ten central sectors of the economy in order to shift development and unleash public and private capital flows onto a low-carbon, resource-efficient path. Such a transition can catalyse economic activity of at least a comparable size to business as usual, but with a reduced risk of the crises and shocks increasingly inherent in the existing model. New ideas are by their very nature disruptive, but far less disruptive than a world running low on drinking water and productive land, set against the backdrop of climate change, extreme weather events and rising natural resource scarcities. A green economy does not favour one political perspective over another. It is relevant to all economies, be they state or more market-led. Neither is it a replacement for sustainable development. Rather, it is a way of realizing that development at the national, regional and global levels and in ways that resonate with and amplify the implementation of Agenda 21. A transition to a green economy is already underway, a point underscored in the report and a growing wealth of companion studies by international organizations, countries, corporations and civil society. But the challenge is clearly to build on this momentum. Rio+20 offers a real opportunity to scale-up and embed these 'green shoots'. In doing so, this report offers not only a roadmap to Rio but beyond 2012, where a far more intelligent management of the natural and human capital of this planet finally shapes the wealth creation and direction of this world.

  12. Manhunts: A Policy Maker’s Guide to High-Value Targeting

    Science.gov (United States)

    2013-06-01

    consistent moral relativism could be accomodated. More relevant, however, is that the recommended approach excludes a purely consequentialist viewpoint... culture context determines morality . This viewpoint would support a nation looking after its own interests while at the same time subscribing to an...the Eichmann capture, the mission represented a moral imperative to Israeli leaders. The domestic support for the operation well outweighed the

  13. How to form on food and nutritional security for decision makers of communities and cooperative on Cuban

    Directory of Open Access Journals (Sweden)

    Inés Margarita Torres Rivero

    2013-12-01

    Full Text Available The purpose of this work is to support a training strategy for policy decision makers and managers of local projects Integrated in Alimentary and Nutritional Security (SAN in communities and cooperative, sustained on a pedagogical approach, based on the relationship between the components of the SAN, the government official's functions (FG and the administration of local projects integrated as way of performance of this subject. The objective of the strategy is to achieve that decision makers of Pinar del Rio province, can appropriate the knowledge, abilities and values for facilitating their integral preparation related with the SAN, and can negotiate the existent potentialities in communities and cooperative, develop local projects in SAN that supplement the emanated politics from state upper level, then the strategy allows a pertinent acting that impacts in the town that is an inevitable necessity for Cuba and specifically for this province, which is the most vulnerable province to environmental changes that so much influences in SAN.

  14. Care as a mutual endeavour : experiences of a multiple sclerosis patient and her healthcare professionals

    NARCIS (Netherlands)

    Oeseburg, B.; Abma, T.A.

    2006-01-01

    In Dutch healthcare policy patients are seen as informed, autonomous experts and active decision makers with control over their illness and care. Healthcare professionals are expected to operate as providers of information. The purpose of this article is to argue that the consumerist approach of the

  15. Addressing the Challenges in Tonsillectomy Research to Inform Health Care Policy: A Review.

    Science.gov (United States)

    Mandavia, Rishi; Schilder, Anne G M; Dimitriadis, Panagiotis A; Mossialos, Elias

    2017-09-01

    Eighty-five percent of investment in medical research has been wasted, with lack of effect on clinical practice and policy. There is increasing effort to improve the likelihood of research being used to influence clinical practice and policy. Tonsillectomy is one of the most common otorhinolaryngologic surgical procedures, and its frequency, cost, and morbidity create a clear need for evidence-based guidelines and policy. The first systematic review on tonsillectomy was conducted 40 years ago and highlighted the lack of definitive evidence for the procedure. Since that study, the body of evidence has still not been able to sufficiently inform policy. This review provides an overview of the key challenges in research to inform tonsillectomy policy and recommendations to help bridge the evidence-policy gap. The challenges in using research to inform policy can be summarized as 4 main themes: (1) non-policy-focused evidence and lack of available evidence, (2) quality of evidence, (3) communication of research findings, and (4) coordinating time frames. Researchers and decision makers should be aware of the limitations of research designs and conflicts of interest that can undermine policy decisions. Researchers must work with decision makers and patients throughout the research process to identify areas of unmet need and political priority, align research and policy time frames, and disseminate research findings. Incentives for researchers should be reorganized to promote dissemination of findings. It is important to consider why evidence gaps in tonsillectomy research have not been addressed during the past 40 years despite considerable investment in time and resources. These findings and recommendations will help produce research that is more responsive to policy gaps and more likely to result in policy changes.

  16. Policy Review on Adult Learning: The Adult Non-Formal Education Policy of Mali, West Africa

    Science.gov (United States)

    Gadio, Moussa

    2011-01-01

    This article focuses on the issue of policy development for adult learning in Mali, West Africa. On January 2007, the Malian government adopted the "Adult Non-formal Education Policy Document," which was intended to regulate the adult learning sector and federate the actions of policy makers, adult education providers, and adult…

  17. Producing More Actionable Science Isn't the Problem; It's Providing Decision-Makers with Access to Right Actionable Knowledge

    Science.gov (United States)

    Trexler, M.

    2017-12-01

    Policy-makers today have almost infinite climate-relevant scientific and other information available to them. The problem for climate change decision-making isn't missing science or inadequate knowledge of climate risks; the problem is that the "right" climate change actionable knowledge isn't getting to the right decision-maker, or is getting there too early or too late to effectively influence her decision-making. Actionable knowledge is not one-size-fit-all, and for a given decision-maker might involve scientific, economic, or risk-based information. Simply producing more and more information as we are today is not the solution, and actually makes it harder for individual decision-makers to access "their" actionable knowledge. The Climatographers began building the Climate Web five years ago to test the hypothesis that a knowledge management system could help navigate the gap between infinite information and individual actionable knowledge. Today the Climate Web's more than 1,500 index terms allow instant access to almost any climate change topic. It is a curated public-access knowledgebase of more than 1,000 books, 2,000 videos, 15,000 reports and articles, 25,000 news stories, and 3,000 websites. But it is also much more, linking together tens of thousands of individually extracted ideas and graphics, and providing Deep Dives into more than 100 key topics from changing probability distributions of extreme events to climate communications best practices to cognitive dissonance in climate change decision-making. The public-access Climate Web is uniquely able to support cross-silo learning, collaboration, and actionable knowledge dissemination. The presentation will use the Climate Web to demonstrate why knowledge management should be seen as a critical component of science and policy-making collaborations.

  18. Lessons Learned from the Energy Policies of IEA Countries

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    This information paper provides policy makers and managers, facing tough energy policy challenges, with a wider perspective of how the same issues are being addressed by different IEA member countries. The topics included are: Government structures for co-ordinating energy and climate policies; The use of long-term energy forecasts and scenarios; and Progress in the delivery of key energy security policies.

  19. Towards health in all policies for childhood obesity prevention

    NARCIS (Netherlands)

    A.-M. Hendriks (Anna-Marie); S.P.J. Kremers (Stef); J.S. Gubbels (Jessica); H. Raat (Hein); N.K. de Vries (Nanne); M.W.J. Jansen (Maria W.)

    2013-01-01

    textabstractThe childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from

  20. Dutch general practitioners’ weight management policy for overweight and obese patients.

    NARCIS (Netherlands)

    Kloek, C.J.J.; Tol, J.; Veenhof, C.; Wulp, I. van der; Swinkels, I.C.S.

    2014-01-01

    Background: General practitioners (GPs) can play an important role in both the prevention and management of overweight and obesity. Current general practice guidelines in the Netherlands allow room for GPs to execute their own weight management policy. Objective: To examine GPs’ current weight

  1. eHealth Policy

    CERN Document Server

    Capello, Fabio

    2014-01-01

    The rising of a new technological era has brought within it opportunities and threats the health systems worldwide have to deal with. In such a changed scenario the role of decision-makers is crucial to identify the real and perceived needs of the population and those areas on intervention in which eHealth can help to improve the quality and efficacy of care. Therefore, in-depth analysis of the state of the art both in industrialized and in developing countries is paramount. Many in fact are constraints that mine the designing and implementation of electronic systems for health. Only if policymakers understand the real implication of eHealth and the complexities of the human being, working model could be introduced. Otherwise the systems proposed will follow the same schemes that have produced failures so far. It implies also that the mutated role of the patient had to be known, together with his expectations and needs. Nevertheless, in a globalize world, a policy for eHealth have to consider also those facto...

  2. Geographic information systems for the Chernobyl decision makers in Ukraine

    International Nuclear Information System (INIS)

    Palko, S.; Glieca, M.; Dombrowski, A.

    1997-01-01

    Following numerous national and international studies conducted on the overall impact of the 1986 Chernobyl nuclear power plant disaster, decision-makers of the affected countries have oriented their efforts on environmental clean-up and population safety. They have focused on activities leading to a better understanding of radionuclide contamination and to the development of effective environmental rehabilitation programs. Initial developments involved the use of domestic USSR technologies consisting of mainframe IBM computers and DEC minicomputers. Later, personal computers with imported software packages were introduced into the decision-making process. Following the breakup of the former USSR, the Ministry of Chernobyl was created in Ukraine in 1991. One of the Ministry's mandate was the elimination of the environmental after-effects of the Chernobyl disaster

  3. Rade-aid: an operational tool for decision-makers

    International Nuclear Information System (INIS)

    Wagenaar, G.; van den Bosch, C.J.H.; Ehrhardt, J.; Steinhauer, C.; Morrey, M.; Robinson, C.A.

    1991-01-01

    If an accidental release of radionuclides occurs, decisions on countermeasures are required. Since the making of a decision involves many competing factors (for instance, the health risk versus the costs relating to a countermeasure), the decision-maker faces a problem. The aim of the RADE-AID (Radiological Accident DEcision AIDing) project is the development of a computer decision support system which can be used in the formulation of decisions. The theoretical background of the decision technique and its methods are outlined, together with the practical application of the technique in the form of the software package developed. Both the benefits of formal techniques and computerized tools in this field are discussed. In order to explore the appropriateness of the decision technique for the management of radiological emergencies, illustrative, but stylized, applications were carried out. Conclusions from these applications are discussed

  4. Knowledge Management Portal: A Simplified Model to Help Decision Makers

    International Nuclear Information System (INIS)

    Ogawa, I.; Hernandes Tabares, R.

    2015-01-01

    The aim of this work is to present a simplified model that could help the nuclear industry to keep the expertise of safeguards professionals in touch with the state of the art, and also to have available information in the Portal of Knowledge Management. It can also provide indicators and general data for decision makers. Authors have developed the concept based on their own experience through systems running in hydroelectric and gas fired plants, and one exclusive system that manage all courses in one University. It is under development a Portal of Knowledge Management for NPP dealing with information obtained of Strategic Plans, Budgets and Economics, Operation Performance, Maintenance and Surveillance Plans, Training and Education Programs, QA Programs, Operational Experience, Safety Culture, and Engineering of Human Factors. This model will provide indicators for decision makers. Training and education module is prepared according to profile of each individual and his attributes, tasks and capabilities, and training and education programmes. The system could apply self-assessment questionnaires; immersive learning using media (video) classes, and test applications using questions randomly selected from data bank, as well as could make applications to certificate people. All these data are analyzed and generate indicators about strongest and weakness points. Managers could have indication of individual's deficiency even though in training programmes on a real time basis. Another tool that could be applied to the model is the remote operation of supervision equipment. The model is developed using web-based tools, like ASP.NET encrypted by 128 bits, and web site https. Finally, it is important to stress that the model can be customized according to industry preference. (author)

  5. Psychology, behavioral economics, and public policy

    OpenAIRE

    Amir, O; Ariely, D; Cooke, A; Dunning, D; Epley, N; Gneezy, U; Koszegi, B; Lichtenstein, D; Mazar, N; Mullainathan, S; Prelec, D; Shafir, E; Silva, J

    2005-01-01

    Economics has typically been the social science of choice to inform public policy and policymakers. In the current paper we contemplate the role behavioral science can play in enlightening policymakers. In particular, we provide some examples of research that has and can be used to inform policy, reflect on the kind of behavioral science that is important for policy, and approaches for convincing policy-makers to listen to behavioral scientists. We suggest that policymakers are unlikely to in...

  6. Pragmatism and Nationalism: Industrialization Policy in Indonesia and Nigeria

    Directory of Open Access Journals (Sweden)

    Ahmad Helmy Fuady

    2015-04-01

    Full Text Available This paper examines industrialization policy in two oil giant economies, Indonesia and Nigeria. What are the key features of continued economic divergence in these two countries since the 1980s? It shows that Indonesia’s policy-makers adopted a series of liberalization measures and switched to an export-oriented strategy to develop manufacturing industries from the mid-1980s, while Nigeria’s policy-makers was reluctant to do so. This paper also seeks to understand the rationale behind the different policy choices. This paper argues that policy-makers’ experience and educational background are possible explanation to the different industrialization policies in these two countries.

  7. Improving adolescent health policy: incorporating a framework for assessing state-level policies.

    Science.gov (United States)

    Brindis, Claire D; Moore, Kristin

    2014-01-01

    Many US policies that affect health are made at the state, not the federal, level. Identifying state-level policies and data to analyze how different policies affect outcomes may help policy makers ascertain the usefulness of their public policies and funding decisions in improving the health of adolescent populations. A framework for describing and assessing the role of federal and state policies on adolescent health and well-being is proposed; an example of how the framework might be applied to the issue of teen childbearing is included. Such a framework can also help inform analyses of whether and how state and federal policies contribute to the variation across states in meeting adolescent health needs. A database on state policies, contextual variables, and health outcomes data can further enable researchers and policy makers to examine how these factors are associated with behaviors they aim to impact.

  8. Physical Computing for STEAM Education: Maker-Educators' Experiences in an Online Graduate Course

    Science.gov (United States)

    Hsu, Yu-Chang; Ching, Yu-Hui; Baldwin, Sally

    2018-01-01

    This research explored how K-16 educators learned physical computing, and developed as maker-educators in an online graduate course. With peer support and instructor guidance, these educators designed maker projects using Scratch and Makey Makey, and developed educational maker proposals with plans of teaching the topics of their choice in STEAM…

  9. Radiological reporting system developed with FileMakerPro. Cooperation with HIS, RIS, and PACS

    International Nuclear Information System (INIS)

    Kawakami, Satoshi

    2004-01-01

    This article briefly describes our original radiological reporting system. This system was developed with the widely used database software FileMakerPro (ver 5.5). The reporting system can obtain information about patients and examinations from a radiology information system (RIS) by the Open DataBase Connectivity (ODBC) technique. By clicking the button on the reporting system, the corresponding Digital Imaging and Communications in Medicine (DICOM) images can be displayed on a picture archiving and communication system (PACS) workstation monitor. Reference images in JPEG format can be easily moved from PACS to the reporting system. Reports produced by the reporting system are distributed to the hospital information system (HIS) in Portable Document Format (PDF), through another web server. By utilizing the capacity of FileMakerPro, the human-machine interface of the system has been able to be improved easily. In addition, cooperation with HIS, RIS, and PACS could be constructed. Therefore, this original system would contribute to increasing the efficiency of radiological diagnosis. (author)

  10. Innovation Policy in European Union

    Directory of Open Access Journals (Sweden)

    Marta-Christina Suciu

    2006-11-01

    Full Text Available The innovation policies aim to analyze priority factors shaping innovative performance and to reflect the increasing appreciation of the economic and social importance of innovation. This paper is commissioned to examine topics of current interest or concern to innovation policy-makers in Europe. Based on literature and the framework of the European Action Plan for Innovation, this paper investigates different levels and fields of European innovational systems and practices.

  11. Policy, inquiries, and the courts

    International Nuclear Information System (INIS)

    Jowell, J.

    1982-01-01

    In relation to nuclear power policy, two objectives of a liberal democracy are examined: the accountability of the decision-maker to the public; and the efficient and effective implementation of management policy. The places of Parliament, administrative law, planning constraints and the public enquiry are discussed, with special reference to legal aspects of the procedure at the public enquiry to ensure that it is as fair and effective as possible. (U.K.)

  12. Of Marx and Makers: an Historical Perspective on Generative Justice

    Directory of Open Access Journals (Sweden)

    Ron Eglash

    2016-06-01

    Full Text Available In Marxist frameworks “distributive justice” depends on extracting value through a centralized state. Many new social movements—peer to peer economy, maker activism, community agriculture, queer ecology, etc.—take the opposite approach, keeping value in its unalienated form and allowing it to freely circulate from the bottom up. Unlike Marxism, there is no general theory for bottom-up, unalienated value circulation. This paper examines the concept of “generative justice” through an historical contrast between Marx’s writings and the indigenous cultures that he drew upon. Marx erroneously concluded that while indigenous cultures had unalienated forms of production, only centralized value extraction could allow the productivity needed for a high quality of life. To the contrary, indigenous cultures now provide a robust model for the “gift economy” that underpins open source technological production, agroecology, and restorative approaches to civil rights. Expanding Marx’s concept of unalienated labor value to include unalienated ecological (nonhuman value, as well as the domain of freedom in speech, sexual orientation, spirituality and other forms of “expressive” value, we arrive at an historically informed perspective for generative justice. 

  13. Conceptualizing Education Policy in Democratic Societies

    Science.gov (United States)

    Perry, Laura B.

    2009-01-01

    Although theorists and policy makers agree that schooling should be democratic, what this exactly means often varies. This article establishes a conceptual model for analyzing education policy in democratic societies, based on the key concepts of equality, diversity, participation, choice, and cohesion. The model facilitates the design,…

  14. Marijuana: A Study of State Policies & Penalties.

    Science.gov (United States)

    Peat, Marwick, Mitchell and Co., Columbia, MD.

    This study is a comprehensive analysis of issues concerning marijuana that are of importance to state policy makers. It reviews the medical, legal, and historical dimensions of marijuana use and examines the range of policy approaches toward marijuana possession and use which state officials have considered. Attention is directed to the experience…

  15. Patient and nurse preferences for nurse handover-using preferences to inform policy: a discrete choice experiment protocol.

    Science.gov (United States)

    Spinks, Jean; Chaboyer, Wendy; Bucknall, Tracey; Tobiano, Georgia; Whitty, Jennifer A

    2015-11-11

    Nursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. BCG vaccination in patients with severe combined immunodeficiency: complications, risks, and vaccination policies.

    Science.gov (United States)

    Marciano, Beatriz E; Huang, Chiung-Yu; Joshi, Gyan; Rezaei, Nima; Carvalho, Beatriz Costa; Allwood, Zoe; Ikinciogullari, Aydan; Reda, Shereen M; Gennery, Andrew; Thon, Vojtech; Espinosa-Rosales, Francisco; Al-Herz, Waleed; Porras, Oscar; Shcherbina, Anna; Szaflarska, Anna; Kiliç, Şebnem; Franco, Jose L; Gómez Raccio, Andrea C; Roxo, Persio; Esteves, Isabel; Galal, Nermeen; Grumach, Anete Sevciovic; Al-Tamemi, Salem; Yildiran, Alisan; Orellana, Julio C; Yamada, Masafumi; Morio, Tomohiro; Liberatore, Diana; Ohtsuka, Yoshitoshi; Lau, Yu-Lung; Nishikomori, Ryuta; Torres-Lozano, Carlos; Mazzucchelli, Juliana T L; Vilela, Maria M S; Tavares, Fabiola S; Cunha, Luciana; Pinto, Jorge A; Espinosa-Padilla, Sara E; Hernandez-Nieto, Leticia; Elfeky, Reem A; Ariga, Tadashi; Toshio, Heike; Dogu, Figen; Cipe, Funda; Formankova, Renata; Nuñez-Nuñez, M Enriqueta; Bezrodnik, Liliana; Marques, Jose Gonçalo; Pereira, María I; Listello, Viviana; Slatter, Mary A; Nademi, Zohreh; Kowalczyk, Danuta; Fleisher, Thomas A; Davies, Graham; Neven, Bénédicte; Rosenzweig, Sergio D

    2014-04-01

    Severe combined immunodeficiency (SCID) is a syndrome characterized by profound T-cell deficiency. BCG vaccine is contraindicated in patients with SCID. Because most countries encourage BCG vaccination at birth, a high percentage of patients with SCID are vaccinated before their immune defect is detected. We sought to describe the complications and risks associated with BCG vaccination in patients with SCID. An extensive standardized questionnaire evaluating complications, therapeutics, and outcomes regarding BCG vaccination in patients given a diagnosis of SCID was widely distributed. Summary statistics and association analysis was performed. Data on 349 BCG-vaccinated patients with SCID from 28 centers in 17 countries were analyzed. Fifty-one percent of the patients had BCG-associated complications, 34% disseminated and 17% localized (a 33,000- and 400-fold increase, respectively, over the general population). Patients receiving early vaccination (≤1 month) showed an increased prevalence of complications (P = .006) and death caused by BCG-associated complications (P vaccine has a very high rate of complications in patients with SCID, which increase morbidity and mortality rates. Until safer and more efficient antituberculosis vaccines become available, delay in BCG vaccination should be considered to protect highly vulnerable populations from preventable complications. Published by Mosby, Inc.

  17. Information Flow and Health Policy Literacy: The Role of the Media

    Directory of Open Access Journals (Sweden)

    Sophya Yumakulov

    2012-08-01

    Full Text Available People increasingly can and want to obtain and generate health information themselves. With the increasing do-it-yourself sentiment comes also the desire to be more involved in one’s health care decisions. Patient driven health-care and health research models are emerging; terms such as participatory medicine and quantified-self are visible increasingly. Given the health consumer’s desire to be more involved in health data generation and health care decision making processes the authors submit that it is important to be health policy literate, to understanding how health policies are developed, what themes are discussed among health policy researchers and policy makers, to understand how ones demands would be discussed within health policy discourses. The public increasingly obtains their knowledge through the internet by searching web browsers for keywords. Question is whether the “health consumer” to come has knowledge of key terms defining key health policy discourses which would enable them to perform targeted searches for health policy literature relevant to their situation. The authors found that key health policy terms are virtually absent from printed and online news media which begs the question how the “health consumer” might learn about key health policy terms needed for web based searches that would allow the “health consumer” to access health policy discourses relevant to them.

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

    Directory of Open Access Journals (Sweden)

    Siriporn Pooripussarakul

    2016-08-01

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

  19. Create the conditions - renewable energy and energy storage policies choices for island nations

    International Nuclear Information System (INIS)

    Timmins, Thomas

    2015-01-01

    This fast moving, detailed presentation offers an in-depth look at the development, launch and renewal of renewable energy procurement programs worldwide, with an eye to (a) educating renewable energy policy makers and procurement program designers with up-to-date information on issues, investor concerns and trends from island nations around the globe, (b) informing industry participants and industry advocates regarding divergent public policy choices facing policy makers, and (c) helping industry stakeholders to assist public policy choice makers in formulating effective and sustainable policy choices. (full text)

  20. Privacy Policy Implementation on the Nation-Wide EHR in Japan for Hospitals and Patients.

    Science.gov (United States)

    Kume, Naoto; Kobayashi, Shinji; Araki, Kenji; Yoshihara, Hiroyuki

    2017-01-01

    Shared clinical information is an important contribution to regional medicine. Clinical information sharing with patients is also recommended to motivate patients and promote health. On the other hand, the threat of information leaks, caused by internet connected records, is critical to hospitals. The traditional approach is complete isolation of hospital networks, instead of information sharing. The authors propose methods here to maximize information sharing by following hospital preferences for electronic health records.

  1. Policy based Agents in Wireless Body Sensor Mesh Networks for Patient Health Monitoring

    OpenAIRE

    Kevin Miller; Suresh Sankaranarayanan

    2009-01-01

    There is presently considerable research interest in using wireless and mobile technologies in patient health monitoring particularly in hospitals and nursing homes. For health monitoring,, an intelligent agent based hierarchical architecture has already been published by one of the authors of this paper. Also, the technique of monitoring and notifying the health of patients using an intelligent agent, to the concerned hospital personnel, has also been proposed. We now present the details of ...

  2. Belonging together: dealing with the politics of disenchantment in Australian Indigenous policy

    National Research Council Canada - National Science Library

    Sullivan, Patrick

    2011-01-01

    .... Advancing the body of knowledge in the field of the anthropology of policy and public administration, this empirical study is a must-read for policy-makers, academics, and indigenous peoples alike.

  3. Perspective: Improving nutritional guidelines for sustainable health policies: Current status and perspectives

    DEFF Research Database (Denmark)

    Magni, Paolo; Bier, Dennis M; Pecorelli, Sergio

    2017-01-01

    a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic...

  4. Residents' perceptions about surrogate decision makers' financial conflicts of interest in ventilator withdrawal.

    Science.gov (United States)

    Wastila, Lisa J; Farber, Neil J

    2014-05-01

    There have been no studies to date that examine physicians' decisions to withdraw life-sustaining treatment for patients based on their surrogates' financial gain. The authors' objective was to ascertain physician attitudes about withdrawing life-sustaining treatment when financial considerations are involved. A survey was developed and pretested containing eight scenarios in which a terminally ill patient's spouse had a decision to make regarding withdrawal of the ventilator, which was deemed medically futile. Nested variables included agreement or disagreement between the spouse and patient, decision to withdraw or continue the ventilator, and financial gain or no financial gain for the spouse. The authors surveyed all internal medicine residents at the University of California, San Diego in the autumn of 2011 and winter of 2012. The responses on each of the three variables for which respondents were likely to withdraw the ventilator were analyzed via student's t-tests. Residents were more likely to withdraw the ventilator when requested to do so than when it was requested to be continued. They were also more likely to withdraw the ventilator when there was agreement in the decision between the spouse and the patient. Residents were more likely to withdraw the ventilator when the spouse would not benefit financially. Internal medicine residents make some decisions about whether to withdraw life-sustaining treatment based on financial considerations. There needs to be ongoing communication with residents about end-of-life decisions where conflicts may exist between the surrogate decision makers and patients or physicians.

  5. Allergic airway disease in Italian bakers and pastry makers.

    Science.gov (United States)

    De Zotti, R; Larese, F; Bovenzi, M; Negro, C; Molinari, S

    1994-08-01

    A survey was carried out on respiratory symptoms and skin prick test response to common allergens (atopy), storage mites, and occupational allergens among 226 bakers and pastry makers from 105 small businesses in northern Italy. Atopy was present in 54 workers (23.4%); 40 workers (17.7%) were skin positive to at least one storage mite, 27 (11.9%) to wheat flour and 17 (7.5%) to alpha-amylase. Work related asthma was reported by 11 (4.9%) workers and rhinoconjunctivitis by 31 (17.7%); 22 workers (10.2%) complained of chronic bronchitis. The distribution of skin prick test results among bakers and among 119 white collar workers did not indicate (by logistic analysis) an increased risk for bakers to skin sensitisation to common allergens, storage mite, or to a group of five flours. Sensitisation to wheat flour, on the other hand, was present only among exposed workers. Skin sensitisation to occupational allergens was significantly associated with atopy (p < 0.001), smoking habit (p = 0.015), and work seniority (p = 0.027). The risk of work related symptoms was associated with sensitisation to wheat or alpha-amylase, and with atopy, but not with sensitisation to storage mites, work seniority, or smoking habit. The results of the study indicate that there is still a significant risk of allergic respiratory disease among Italian bakers. Not only wheat allergens, but also alpha-amylase must be considered as causative agents, although sensitisation to storage mites is not important in the occupational allergic response. Atopy must be regarded as an important predisposing factor for skin sensitisation to occupational allergens and for the onset of symptoms at work. The data confirm that for effective prevention, greater care should be taken not only in limiting environmental exposure, but also in identifying susceptible people.

  6. Hormones as Difference Makers in Cognitive and Socioemotional Aging Processes

    Directory of Open Access Journals (Sweden)

    Natalie eEbner

    2015-01-01

    Full Text Available Aging is associated with well-recognized alterations in brain function, some of which are reflected in cognitive decline. While less appreciated, there is also considerable evidence of socioemotional changes later in life, some of which are beneficial. In this review, we examine age-related changes and individual differences in four neuroendocrine systems—cortisol, estrogen, testosterone, and oxytocin—as difference makers in these processes. This suite of interrelated hormonal systems actively coordinates regulatory processes in brain and behavior throughout development, and their level and function fluctuate during the aging process. Despite these facts, their specific impact in cognitive and socioemotional aging has received relatively limited study. It is known that chronically elevated levels of the stress hormone cortisol exert neurotoxic effects on the aging brain with negative impacts on cognition and socioemotional functioning. In contrast, the sex hormones estrogen and testosterone appear to have neuroprotective effects in cognitive aging, but may decrease prosociality. Higher levels of the neuropeptide oxytocin benefit socioemotional functioning, but little is known about the effects of oxytocin on cognition or about age-related changes in the oxytocin system. In this paper, we will review the role of these hormones in the context of cognitive and socioemotional aging. In particular, we address the aforementioned gap in the literature by: 1 examining both singular actions and interrelations of these four hormonal systems; 2 exploring their correlations and causal relationships with aspects of cognitive and socioemotional aging; and 3 considering multilevel internal and external influences on these hormone systems within the framework of explanatory pluralism. We conclude with a discussion of promising future research directions.

  7. CItyMaker. Designing Grammars for Urban Design

    Directory of Open Access Journals (Sweden)

    José Beirão

    2013-01-01

    Full Text Available Due to its complexity, the evolution of cities is something that is difficult to predict and planning new developments for cities is therefore a difficult task. This complexity can be identified on two levels: on a micro level, it emerges from the multiple relations between the many components and actors in cities, whereas on a macro level it stems from the geographical, social and economic relations between cities. However, many of these relations can be measured. The design of plans for cities can only be improved if designers are able to address measurements of some of the relationships between the components of cities during the design process. These measurements are called urban indicators. By calculating such measurements, designers can grasp the meaning of the changes being proposed, not just as simple alternative layouts, but also in terms of the changes in indicators adding a qualitative perception.This thesis presents a method and a set of tools to generate alternative solutions for an urban context. The method proposes the use of a combined set of design patterns encoding typical design moves used by urban designers. The combination of patterns generates different layouts which can be adjusted by manipulating several parameters in relation to updated urban indicators. The patterns were developed from observation of typical urban design procedures, first encoded as discursive grammars and later translated into parametric design patterns. The CItyMaker method and tools allows the designer to compose a design solution from a set of programmatic premises and fine-tune it by pulling parameters whilst checking the changes in urban indicators. These tools improve the designer’s awareness of the consequences of their design moves.

  8. CItyMaker. Designing Grammars for Urban Design

    Directory of Open Access Journals (Sweden)

    José Beirão

    2017-11-01

    Full Text Available Due to its complexity, the evolution of cities is something that is difficult to predict and planning new developments for cities is therefore a difficult task. This complexity can be identified on two levels: on a micro level, it emerges from the multiple relations between the many components and actors in cities, whereas on a macro level it stems from the geographical, social and economic relations between cities. However, many of these relations can be measured. The design of plans for cities can only be improved if designers are able to address measurements of some of the relationships between the components of cities during the design process. These measurements are called urban indicators. By calculating such measurements, designers can grasp the meaning of the changes being proposed, not just as simple alternative layouts, but also in terms of the changes in indicators adding a qualitative perception. This thesis presents a method and a set of tools to generate alternative solutions for an urban context. The method proposes the use of a combined set of design patterns encoding typical design moves used by urban designers. The combination of patterns generates different layouts which can be adjusted by manipulating several parameters in relation to updated urban indicators. The patterns were developed from observation of typical urban design procedures, first encoded as discursive grammars and later translated into parametric design patterns. The CItyMaker method and tools allows the designer to compose a design solution from a set of programmatic premises and fine-tune it by pulling parameters whilst checking the changes in urban indicators. These tools improve the designer’s awareness of the consequences of their design moves.

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

    Science.gov (United States)

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

    2010-01-01

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

  10. Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 8: patient-reported outcomes in electronic health records can inform clinical and policy decisions.

    Science.gov (United States)

    Ahmed, Sara; Ware, Patrick; Gardner, William; Witter, James; Bingham, Clifton O; Kairy, Dahlia; Bartlett, Susan J

    2017-09-01

    Given that the goal of health care systems is to improve and maintain the health of the populations they serve, the indicators of performance must include outcomes that are meaningful to patients. The growth of health technologies provides an unprecedented opportunity to integrate the patient voice into clinical care by linking electronic health records (EHRs) to patient-reported outcome (PRO) data collection. However, PRO data must be relevant, meaningful, and actionable for those who will have to invest the time and effort to collect it. In this study, we highlight opportunities to integrate PRO data collection into EHRs. We consider how stakeholder perspectives should influence the selection of PROs and ways to enhance engagement in and commitment to PRO implementation. We propose a research and policy agenda to address unanswered questions and facilitate the widespread adoption of PRO data collection into EHRs. Building a learning health care system that gathers PRO data in ways that can inform individual patient care, quality improvement, and comparative effectiveness research has the potential to accelerate the application of new evidence and knowledge to patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The female community health volunteer programme in Nepal: decision makers' perceptions of volunteerism, payment and other incentives.

    Science.gov (United States)

    Glenton, Claire; Scheel, Inger B; Pradhan, Sabina; Lewin, Simon; Hodgins, Stephen; Shrestha, Vijaya

    2010-06-01

    The Female Community Health Volunteer (FCHV) Programme in Nepal has existed since the late 1980s and includes almost 50,000 volunteers. Although volunteer programmes are widely thought to be characterised by high attrition levels, the FCHV Programme loses fewer than 5% of its volunteers annually. The degree to which decision makers understand community health worker motivations and match these with appropriate incentives is likely to influence programme sustainability. The purpose of this study was to explore the views of stakeholders who have participated in the design and implementation of the Female Community Health Volunteer regarding Volunteer motivation and appropriate incentives, and to compare these views with the views and expectations of Volunteers. Semi-structured interviews were carried out in 2009 with 19 purposively selected non-Volunteer stakeholders, including policy makers and programme managers. Results were compared with data from previous studies of Female Community Health Volunteers and from interviews with four Volunteers and two Volunteer activists. Stakeholders saw Volunteers as motivated primarily by social respect, religious and moral duty. The freedom to deliver services at their leisure was seen as central to the volunteer concept. While stakeholders also saw the need for extrinsic incentives such as micro-credit, regular wages were regarded not only as financially unfeasible, but as a potential threat to the Volunteers' social respect, and thereby to their motivation. These views were reflected in interviews with and previous studies of Female Community Health Volunteers, and appear to be influenced by a tradition of volunteering as moral behaviour, a lack of respect for paid government workers, and the Programme's community embeddedness. Our study suggests that it may not be useful to promote a generic range of incentives, such as wages, to improve community health worker programme sustainability. Instead, programmes should ensure that

  12. Engaging the Voice of Patients Affected by Gender-Based Violence: Informing Practice and Policy.

    Science.gov (United States)

    Lewis-O'Connor, Annie; Chadwick, Mardi

    2015-01-01

    Evidence regarding the benefits, opportunities, and risks associated with providing health care to patients experiencing gender-based violence (GBV) and, moreover, their satisfaction with health care services is sparse. Using a patient- and trauma-informed relationship-based framework, survivors of GBV who were referred for follow-up care were asked to participate in a quality improvement (QI) initiative in an effort to understand their perspectives of receiving healthcare services. Patients were asked to answer three open-ended questions in regard to their healthcare experience. Individuals who were eligible for evidence collection after sexual assault (<5 days) were asked two additional questions. Of the 353 women and six men (359) referred to the C.A.R.E. (Coordinated Approach to Recovery and Empowerment) Clinic, 327 patients were contacted. Of the participants, 24% (86) had a mental health diagnosis; 41% (145) reported their incident to the police; 8% (28) had comorbidities of substance abuse, mental health, and/or homelessness; and 33% (118) of the incidents involved alcohol or drugs. Most of the patients stated that they were well cared for and felt safe during their visit. However, many reported "long waits," "disjointed," "chaotic," "too many" providers, "conflicting" and "miss-information," and "confusion" about what to do after their acute care visit. Over half (59%) did not report incident to the police. Some reported regrets with reporting to the police (16%) and regrets in having evidence collection (15%). Of the patients who did not have evidence collected (47), none expressed regret over choosing not to have evidence collected. Five patients with mental health problems were hospitalized within 5 days of their emergency department visit for suicidal thoughts. A number of opportunities to improve the healthcare response were identified. Patients affected by GBV require an improved coordinated and trauma-informed approach. Explicit consent related to

  13. Development of a Clinical Forecasting Model to Predict Comorbid Depression Among Diabetes Patients and an Application in Depression Screening Policy Making.

    Science.gov (United States)

    Jin, Haomiao; Wu, Shinyi; Di Capua, Paul

    2015-09-03

    Depression is a common but often undiagnosed comorbid condition of people with diabetes. Mass screening can detect undiagnosed depression but may require significant resources and time. The objectives of this study were 1) to develop a clinical forecasting model that predicts comorbid depression among patients with diabetes and 2) to evaluate a model-based screening policy that saves resources and time by screening only patients considered as depressed by the clinical forecasting model. We trained and validated 4 machine learning models by using data from 2 safety-net clinical trials; we chose the one with the best overall predictive ability as the ultimate model. We compared model-based policy with alternative policies, including mass screening and partial screening, on the basis of depression history or diabetes severity. Logistic regression had the best overall predictive ability of the 4 models evaluated and was chosen as the ultimate forecasting model. Compared with mass screening, the model-based policy can save approximately 50% to 60% of provider resources and time but will miss identifying about 30% of patients with depression. Partial-screening policy based on depression history alone found only a low rate of depression. Two other heuristic-based partial screening policies identified depression at rates similar to those of the model-based policy but cost more in resources and time. The depression prediction model developed in this study has compelling predictive ability. By adopting the model-based depression screening policy, health care providers can use their resources and time better and increase their efficiency in managing their patients with depression.

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  15. Selective digestive decontamination in patients in intensive care. The Dutch Working Group on Antibiotic Policy

    NARCIS (Netherlands)

    Bonten, M. J.; Kullberg, B. J.; van Dalen, R.; Girbes, A. R.; Hoepelman, I. M.; Hustinx, W.; van der Meer, J. W.; Speelman, P.; Stobberingh, E. E.; Verbrugh, H. A.; Verhoef, J.; Zwaveling, J. H.

    2000-01-01

    Selective digestive decontamination (SDD) is the most extensively studied method for the prevention of infection in patients in intensive care units (ICUs). Despite 27 prospective randomized studies and six meta-analyses, routine use of SDD is still controversial. In this review, we summarize the

  16. Patient Suffering and Caregiver Compassion: New Opportunities for Research, Practice, and Policy

    Science.gov (United States)

    Schulz, Richard; Hebert, Randy S.; Dew, Mary Amanda; Brown, Stephanie L.; Scheier, Michael F.; Beach, Scott R.; Czaja, Sara J.; Martire, Lynn M.; Coon, David; Langa, Kenneth M.; Gitlin, Laura N.; Stevens, Alan B.; Nichols, Linda

    2007-01-01

    The purpose of this article is to stimulate discussion and research about patient suffering and caregiver compassion. It is our view that these constructs are central to understanding phenomena such as family caregiving, and that recognizing their unique role in the caregiving experience provides new directions for intervention research, clinical…

  17. Self-help organisations as patient representatives in health care and policy decision-making.

    Science.gov (United States)

    Rojatz, Daniela; Forster, Rudolf

    2017-10-01

    A crucial question about participation is who is legitimised, willing and capable of representing particular collectives. Social insurance health care systems tend to focus on representation by patient organisations. Self-help organisations (SHOs), as one type of 'health consumer and patient organisation', often take over this role. Research findings indicate that participation by SHOs is accompanied by high expectations, but also by concerns about the risks of instrumental abuse, overload and professionalisation. However, there is a dearth of in-depth knowledge about both potential and risks of participating for the SHO. To tackle this research gap, a qualitative study design was used to investigate fifteen SHOs in Austria. Data were generated by expert interviews with SHO representatives and documentary analysis of SHO websites. Content analysis was applied. SHOs in Austria advocate for patients' interests, participate in invited spaces and have various forms of cooperative relations with the health care system. Thereby, they draw on the experiential knowledge of their members without, however, systematising it. Experiences with professionalisation and instrumental use are ambiguous, whereas overload is prevalent. SHOs need resources for reflection in order to define their position visà- vis the health system and to realise their potential as patient representatives. Deepening co-operation with the health care system might lead to new participatory practices acknowledging differences in culture and the resources of both sides. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Who speaks for the climate? Considering `expert' and `authorized' claims-makers in the media (Invited)

    Science.gov (United States)

    Boykoff, M.

    2010-12-01

    In this presentation, I analyze representations of climate change in traditional and new/social media, and examine contextual elements as well as journalistic pressures that contribute to how claims-makers become ‘experts’ and/or ‘authorities’ as well as how climate-related information becomes ‘news’. These considerations seek to help make sense of how/why particular climate-related discourses find traction in traditional and new/social media, while others remain muffled or silent. In so doing, I explore how power flows through culture, politics, and society, constructing knowledge, norms, conventions and (un)truths about variegated dimensions of climate change via processes of media portrayals. I interrogate how (un)authorized voices in mass media shape claims on ‘truth’ about various facets of present day climate challenges. I argue that these significantly meld our individual and collective ‘ways of knowing’ about climate change, and in turn, vitally shape our ongoing material and social practices. The contested and complex elements explored here contribute critically to cultural interpretations via citizen perceptions and deliberations for action, as media practices stitch together formal science and policy with everyday activities in the public sphere.

  19. Six-Month Market Exclusivity Extensions To Promote Research Offer Substantial Returns For Many Drug Makers.

    Science.gov (United States)

    Kesselheim, Aaron S; Rome, Benjamin N; Sarpatwari, Ameet; Avorn, Jerry

    2017-02-01

    To incentivize pharmaceutical manufacturers to invest in areas of unmet medical need, policy makers frequently propose extending the market exclusivity period of desired drugs. Some such proposals are modeled after the pediatric exclusivity patent extension program, which since 1997 has provided six additional months of market exclusivity for drugs studied in children. The most recent proposal would encourage rare disease research by providing six months of extended exclusivity for any existing drug that is granted subsequent FDA approval for a new rare disease indication. Yet the economic impact of such proposals is rarely addressed. We found that for the thirteen FDA-approved drugs that gained supplemental approval for a rare disease indication from 2005 through 2010, the median projected cost of clinical trials leading to approval was $29.8 million. If the exclusivity extension had been in place, the median discounted financial gain to manufacturers would have been $94.6 million. Median net returns would have been $82.4 million, with higher returns for drugs with higher annual sales. Extending market exclusivity would provide substantial compensation to many manufacturers, particularly for top-selling products, far in excess of the cost of conducting these trials. Alternative strategies to incentivize the study of approved drugs for rare diseases may offer similar benefits at a lower cost. Project HOPE—The People-to-People Health Foundation, Inc.

  20. Development of the England Wildlife Health Strategy--a framework for decision makers.

    Science.gov (United States)

    Hartley, M; Lysons, R

    2011-02-12

    Diseases in wildlife have been recognised as having the potential to affect human health, livestock health and species conservation. In order to assess and respond to these potential risks in an effective and a proportionate way, the UK Government initiated development of the Wildlife Health Strategy to provide a framework for decision making. The England Wildlife Health Strategy (EWHS) has been developed through extensive consultation. Discussions and negotiations with government departments, agencies, non-governmental public bodies and wildlife organisations were held to obtain advice and input on specific and specialised aspects of wildlife health. A series of workshops to investigate the application of innovative science to wildlife health policy contributed further. A formal public consultation was held that proposed a range of actions to implement the strategy. A summary of responses to this consultation was published in October 2007. The EWHS was published in June 2009 and provides a framework for a generic four-stage approach to wildlife health that can be adopted by decision makers both within and outside government.

  1. NIGERIA AND THE ENIGMA OF POLICY IMPLEMENTATION Osita ...

    African Journals Online (AJOL)

    NGOZI

    This calls for a change of attitude on the part of policy implementers and the target .... implementation by policy decision makers while it is often taken that once a policy is ... only to attract public acclaim and attention with less regard to their.

  2. Travelling Policies and Contextual Considerations: On Threshold Criteria

    Science.gov (United States)

    Nir, Adam; Kondakci, Yasar; Emil, Serap

    2018-01-01

    Educational policy borrowing has become rather common in our globalised world. However, the literature lacks contextual criteria that may be employed by researchers and policy makers to assess the correspondence of a particular policy to the local context of a borrowing system. Based on a secondary analysis of documents and research reports, this…

  3. Nigerian language policy and its implication in the school curriculum ...

    African Journals Online (AJOL)

    This paper observes that the Nigerian language policy, failed to take into consideration the socio-linguistic habits of Nigerians. Since English language is a focal point for communication it then implies that policy makers to formulate language policies based on realities of language need. This is the only way that the ...

  4. Public Policy and Protection from Exclusion - Phase III | IDRC ...

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

    Public Policy and Protection from Exclusion - Phase III ... and decision-makers active in the promotion of equitable health policies, with a view to promoting the emergence of an observatory of health systems in the ... Policy in Focus publishes a special issue profiling evidence to empower women in the labour market.

  5. Language Policy, Multilingual Education, and Power in Rwanda

    Science.gov (United States)

    Samuelson, Beth Lewis; Freedman, Sarah Warshauer

    2010-01-01

    The evolution of Rwanda's language policies since 1996 has played and continues to play a critical role in social reconstruction following war and genocide. Rwanda's new English language policy aims to drop French and install English as the only language of instruction. The policy-makers frame the change as a major factor in the success of social…

  6. Collaboration in public policy and practice: perspectives on boundary spanners

    National Research Council Canada - National Science Library

    Williams, Paul

    2012-01-01

    .... It will be of interest to academics, researchers and students interested in this field of study, and provides learning for policy makers and practitioners active in the fields of collaboration...

  7. Global change research: Science and policy

    International Nuclear Information System (INIS)

    Rayner, S.

    1993-05-01

    This report characterizes certain aspects of the Global Change Research Program of the US Government, and its relevance to the short and medium term needs of policy makers in the public and private sectors. It addresses some of the difficulties inherent in the science and policy interface on the issues of global change. Finally, this report offers some proposals for improving the science for policy process in the context of global environmental change

  8. Patient attributes warranting consideration in clinical practice guidelines, health workforce planning and policy

    Directory of Open Access Journals (Sweden)

    Segal Leonie

    2011-09-01

    Full Text Available Abstract Background In order for clinical practice guidelines (CPGs to meet their broad objective of enhancing the quality of care and supporting improved patient outcomes, they must address the needs of diverse patient populations. We set out to explore the patient attributes that are likely to demand a unique approach to the management of chronic disease, and which are crucial if evidence or services planning is to reflect clinic populations. These were incorporated into a new conceptual framework; using diabetes mellitus as an exemplar. Methods The patient attributes that informed the framework were identified from CPGs, the diabetes literature, an expert academic panel, and two cross-disciplinary panels; and agreed upon using a modified nominal group technique. Results Full consensus was reached on twenty-four attributes. These factors fell into one of three themes: (1 type/stage of disease, (2 morbid events, and (3 factors impacting on capacity to self-care. These three themes were incorporated in a convenient way in the workforce evidence-based (WEB model. Conclusions While biomedical factors are frequently recognised in published clinical practice guidelines, little attention is given to attributes influencing a person's capacity to self-care. Paying explicit attention to predictable threats to effective self-care in clinical practice guidelines, by drawing on the WEB model, may assist in refinements that would address observed disparities in health outcomes across socio-economic groups. The WEB model also provides a framework to inform clinical training, and health services and workforce planning and research; including the assessment of healthcare needs, and the allocation of healthcare resources.

  9. Associations between non-discrimination and training policies and physicians' attitudes and knowledge about sexual and gender minority patients: a comparison of physicians from two hospitals.

    Science.gov (United States)

    Jabson, Jennifer M; Mitchell, Jason W; Doty, S Benjamin

    2016-03-12

    Some physicians lack knowledge and awareness about health issues specific to sexual and gender minority (SGM) individuals. To help improve this, hospitals have implemented policies that mandate non-discrimination and training to promote sexual and gender minority health. There is limited evidence about how such policies relate to physicians' knowledge, attitudes, and gender and sexual minority affirmative practices. A random sample of 1000 physicians was recruited from a complete list of physicians affiliated with one of two university Hospitals located in Tennessee and 180 physicians completed the survey concerning attitudes and knowledge about SGM individuals. Physicians were affiliated with either Hospital A that had not implemented policies for non-discrimination and training, or Hospital B that did. Physicians held different attitudes about SGM patients than non-patients. Physicians affiliated with Hospital A held more negative attitudes about SGM individuals who were non-patients than physicians affiliated with Hospital B. There were no differences between the two hospitals in physicians' attitudes and knowledge about SGM patients. Policies that mandate non-discrimination and training as they currently exist may not improve physicians' attitudes and knowledge about SGM individuals. Additional research is needed to understand how these policies and trainings relate to physicians' SGM affirmative practices.

  10. Associations between non-discrimination and training policies and physicians’ attitudes and knowledge about sexual and gender minority patients: a comparison of physicians from two hospitals

    Directory of Open Access Journals (Sweden)

    Jennifer M. Jabson

    2016-03-01

    Full Text Available Abstract Background Some physicians lack knowledge and awareness about health issues specific to sexual and gender minority (SGM individuals. To help improve this, hospitals have implemented policies that mandate non-discrimination and training to promote sexual and gender minority health. There is limited evidence about how such policies relate to physicians’ knowledge, attitudes, and gender and sexual minority affirmative practices. Method A random sample of 1000 physicians was recruited from a complete list of physicians affiliated with one of two university Hospitals located in Tennessee and 180 physicians completed the survey concerning attitudes and knowledge about SGM individuals. Physicians were affiliated with either Hospital A that had not implemented policies for non-discrimination and training, or Hospital B that did. Results Physicians held different attitudes about SGM patients than non-patients. Physicians affiliated with Hospital A held more negative attitudes about SGM individuals who were non-patients than physicians affiliated with Hospital B. There were no differences between the two hospitals in physicians’ attitudes and knowledge about SGM patients. Conclusion Policies that mandate non-discrimination and training as they currently exist may not improve physicians’ attitudes and knowledge about SGM individuals. Additional research is needed to understand how these policies and trainings relate to physicians’ SGM affirmative practices.

  11. A Collaborative Approach to Bridging the Research-Policy Gap through the Development of Policy Advice Software

    Science.gov (United States)

    Milne, Barry John; Lay-Yee, Roy; McLay, Jessica; Tobias, Martin; Tuohy, Pat; Armstrong, Ann; Lynn, Robert; Pearson, Janet; Mannion, Oliver; Davis, Peter

    2014-01-01

    We have developed a software-based tool to support a dynamic micro-simulation model of life-course development (to age 13) as an aid to policy makers assessing the impact of policies affecting children. We demonstrate how this approach bridges the research-policy gap by creating: (1) an easy transfer of evidence in a form that policymakers can use…

  12. Energy policy and public administration

    Energy Technology Data Exchange (ETDEWEB)

    Daneke, G.A.; Lagassa, G.K. (eds.)

    1980-01-01

    At the 1979 conference of the American Society for Public Administration, each editor chaired a separate panel on the administrative dimensions of energy policy. Both panels revealed the importance of involvement in energy decision making by all levels of government. It turns out that energy policy makers are confronted with unrealistic, and therefore paralyzing, choices between two rather extreme sets of energy stategies and futures: large-scale, centralized technologies vs. small-scale, decentralized, appropriate technologies. The nineteen chapters selected and compiled here represent the basic policy issues that must be confronted along whichever path that is chosen. A separate abstract was prepared for each chapter.

  13. Patient access to medicines in two countries with similar health systems and differing medicines policies: Implications from a comprehensive literature review.

    Science.gov (United States)

    Babar, Zaheer-Ud-Din; Gammie, Todd; Seyfoddin, Ali; Hasan, Syed Shahzad; Curley, Louise E

    2018-04-13

    Countries with similar health systems but different medicines policies might result in substantial medicines usage differences and resultant outcomes. The literature is sparse in this area. To review pharmaceutical policy research in New Zealand and Australia and discuss differences between the two countries and the impact these differences may have on subsequent medicine access. A review of the literature (2008-2016) was performed to identify relevant, peer-reviewed articles. Systematic searches were conducted across the six databases MEDLINE, PubMed, Science Direct, Springer Links, Scopus and Google Scholar. A further search of journals of high relevance was also conducted. Using content analysis, a narrative synthesis of pharmaceutical policy research influencing access to medicines in Australia and New Zealand was conducted. The results were critically assessed in the context of policy material available via grey literature from the respective countries. Key elements regarding pharmaceutical policy were identified from the 35 research papers identified for this review. Through a content analysis, three broad categories of pharmaceutical policy were found, which potentially could influence patient access to medicines in each country; the national health system, pricing and reimbursement. Within these three categories, 9 subcategories were identified: national health policy, pharmacy system, marketing authorization and regulation, prescription to non-prescription medicine switch, orphan drug policies, generic medicine substitution, national pharmaceutical schedule and health technology assessment, patient co-payment and managed entry agreements. This review systematically evaluated the current literature and identified key areas of difference in policy between Australia and NZ. Australia appears to cover and reimburse a greater number of medicines, while New Zealand achieves much lower prices for medicines than their Australian counterparts and has been more

  14. Environmental policy and environment-saving technologies. Economic aspects of policy making under uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Ossokina, I.

    2003-07-01

    It is generally known that natural environment is profoundly influenced by technological change. The direction and the size of this influence are, however, surrounded by uncertainties, which substantially complicate environmental policy making. This dissertation uses game-theoretical models to study policy making under uncertainty about (a) the costs of technological advances in pollution control, (b) the preferences of the policy maker and the voters, and (c) the consequences of policy measures. From a positive point of view the analysis provides explanations for environmental policies in modern democracies. From a normative point of view it gives a number of recommendations to improve environmental policies.

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

    Directory of Open Access Journals (Sweden)

    Bovolenta TM

    2017-01-01

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

  16. The effect of the Accreditation Council for Graduate Medical Education Duty Hours Policy on plastic surgery resident education and patient care: an outcomes study.

    Science.gov (United States)

    Basu, Chandrasekhar Bob; Chen, Li-Mei; Hollier, Larry H; Shenaq, Saleh M

    2004-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) Work-Hours Duty Policy became effective on July 1, 2003, mandating the reduction of resident duty work hours. The Baylor College of Medicine Multi-Institutional Integrated Plastic Surgery Program instituted a resident duty work-hours policy on July 1, 2002 (1 year ahead of the national mandate). Outcomes data are needed to facilitate continuous improvements in plastic surgical residency training while maintaining high-quality patient care. To assess the effect of this policy intervention on plastic surgery resident education as measured through the six core competencies and patient/resident safety, the investigators surveyed all categorical plastic surgery residents 6 months after implementation of the policy. This work represents the first empiric study investigating the effect of duty hours reduction on plastic surgery training and education. The categorical plastic surgery residents at the Baylor College of Medicine Multi-Institutional Integrated Plastic Surgery Program completed a 68-item survey on a five-point Likert scale (1 = strongly disagree to 5 = strongly agree). Residents were asked to rate multiple parameters based on the ACGME six core competencies, including statements on patient care and clinical/operative duties, resident education, resident quality of life, and resident perceptions on this policy. All surveys were completed anonymously. The sample size was n = 12 (program year 3 through program year 6), with a 100 percent response rate. Univariate and bivariate statistical analysis was conducted with SPSS version 10.0 statistical software. Specifically, interquartile deviations were used to find consensus among resident responses to each statement. Descriptive statistics indicated higher percentages of agreement on a majority of statements in three categories, including patient care and clinical/operative duties, academic duties, and resident quality of life. Using interquartile

  17. Applying ethical and legal principles to new technology: the University of Auckland Faculty of Medical and Health Sciences' policy 'Taking and Sharing Images of Patients.'

    Science.gov (United States)

    Jonas, Monique; Malpas, Phillipa; Kersey, Kate; Merry, Alan; Bagg, Warwick

    2017-01-27

    To develop a policy governing the taking and sharing of photographic and radiological images by medical students. The Rules of the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers' Rights were applied to the taking, storing and sharing of photographic and radiological images by medical students. Stakeholders, including clinicians, medical students, lawyers at district health boards in the Auckland region, the Office of the Privacy Commissioner and the Health and Disability Commissioner were consulted and their recommendations incorporated. The policy 'Taking and Sharing Images of Patients' sets expectations of students in relation to: photographs taken for the purpose of providing care; photographs taken for educational or professional practice purposes and photographic or radiological images used for educational or professional practice purposes. In addition, it prohibits students from uploading images of patients onto image-sharing apps such as Figure 1. The policy has since been extended to apply to all students at the Faculty of Medical and Health Sciences at the University of Auckland. Technology-driven evolutions in practice necessitate regular review to ensure compliance with existing legal regulations and ethical frameworks. This policy offers a starting point for healthcare providers to review their own policies and practice, with a view to ensuring that patients' trust in the treatment that their health information receives is upheld.

  18. Dreams and nightmares: practical and ethical issues for patients and physicians using personal health records.

    Science.gov (United States)

    Wynia, Matthew; Dunn, Kyle

    2010-01-01

    Electronic health records for patients, personal health records (PHRs), have become increasingly popular among policy makers and purchasers, but uptake among patients and physicians has been relatively slow. PHRs have varying uses that might make them more or less appealing to different stakeholders. The three core uses for PHRs - promoting communication, data use, and patient responsibility - each raises a set of potential practical and financial dilemmas. But some ethical concerns are also at play, some of which are rarely recognized as values-based barriers to the use of PHRs. Recognizing these ethical issues, and addressing them explicitly in PHR design and policy making, would help PHRs to achieve their promise.

  19. The Impact of Success Maker Software on Grade 4 Math Proficiency on State Tests

    Science.gov (United States)

    Geer, Brandon Terrell

    2014-01-01

    Success Maker is an educational software that differentiates and personalizes K-8 reading and math. Limited research has been conducted on the impact of Success Maker on Grade 4 math state tests. At the research site, located in southeastern United States, 33.7% of fourth grade students did not pass the Palmetto Assessment of State Standards…

  20. Makification: Towards a Framework for Leveraging the Maker Movement in Formal Education

    Science.gov (United States)

    Cohen, Jonathan; Jones, W. Monty; Smith, Shaunna; Calandra, Brendan

    2017-01-01

    Maker culture is part of a burgeoning movement in which individuals leverage modern digital technologies to produce and share physical artifacts with a broader community. Certain components of the maker movement, if properly leveraged, hold promise for transforming formal education in a variety of contexts. The authors here work towards a…

  1. Using Cognitive Conflict to Promote the Use of Dialectical Learning for Strategic Decision-Makers

    Science.gov (United States)

    Woods, Jeffrey G.

    2012-01-01

    Purpose: The purpose of this paper is to develop a conceptual model that uses dialectical inquiry (DI) to create cognitive conflict in strategic decision-makers for the purpose of improving strategic decisions. Activation of the dialectical learning process using DI requires strategic decision-makers to integrate conflicting information causing…

  2. Digital maker-entrepreneurs in open design: What activities make up their business model?

    NARCIS (Netherlands)

    Dr. P. Troxler; Patricia Wolf

    2017-01-01

    The business models of digital maker-entrepreneurs in open design are inextricably linked to the broader open design community. Digital makers share designs on online platforms such as Thingiverse and use digital manufacturing technology such as 3-D printing as a generative mechanism for their

  3. Religious hospital policies on reproductive care: what do patients want to know?

    Science.gov (United States)

    Freedman, Lori R; Hebert, Luciana E; Battistelli, Molly F; Stulberg, Debra B

    2018-02-01

    Religious hospitals are a large and growing part of the American healthcare system. Patients who receive obstetric and other reproductive care in religious hospitals may face religiously-based restrictions on the treatment their doctor can provide. Little is known about patients' knowledge or preferences regarding religiously restricted reproductive healthcare. We aimed to assess women's preferences for knowing a hospital's religion and religiously based restrictions before deciding where to seek care and the acceptability of a hospital denying miscarriage treatment options for religious reasons, with and without informing the patient that other options may be available. We conducted a national survey of women aged 18-45 years. The sample was recruited from AmeriSpeak, a probability-based research panel of civilian noninstitutionalized adults. Of 2857 women invited to participate, 1430 completed surveys online or over the phone, for a survey response rate of 50.1%. All analyses adjusted for the complex sampling design and were weighted to generate estimates representative of the population of US adult reproductive-age women. We used χ 2 tests and multivariable logistic regression to evaluate associations. One third of women aged 18-45 years (34.5%) believe it is somewhat or very important to know a hospital's religion when deciding where to get care, but 80.7% feel it is somewhat or very important to know about a hospital's religious restrictions on care. Being Catholic or attending religious services more frequently does not make one more or less likely to want this information. Compared with Protestant women who do not identify as born-again, women of other religious backgrounds are more likely to consider it important to know a hospital's religious affiliation. These include religious minority women (adjusted odds ratio, 2.17; 95% confidence interval, 1.11-4.27), those who reported no religion/atheist/agnostic (adjusted odds ratio, 2.27; 95% confidence interval

  4. Woodrow Wilson's hidden stroke of 1919: the impact of patient-physician confidentiality on United States foreign policy.

    Science.gov (United States)

    Menger, Richard P; Storey, Christopher M; Guthikonda, Bharat; Missios, Symeon; Nanda, Anil; Cooper, John M

    2015-07-01

    World War I catapulted the United States from traditional isolationism to international involvement in a major European conflict. Woodrow Wilson envisaged a permanent American imprint on democracy in world affairs through participation in the League of Nations. Amid these defining events, Wilson suffered a major ischemic stroke on October 2, 1919, which left him incapacitated. What was probably his fourth and most devastating stroke was diagnosed and treated by his friend and personal physician, Admiral Cary Grayson. Grayson, who had tremendous personal and professional loyalty to Wilson, kept the severity of the stroke hidden from Congress, the American people, and even the president himself. During a cabinet briefing, Grayson formally refused to sign a document of disability and was reluctant to address the subject of presidential succession. Wilson was essentially incapacitated and hemiplegic, yet he remained an active president and all messages were relayed directly through his wife, Edith. Patient-physician confidentiality superseded national security amid the backdrop of friendship and political power on the eve of a pivotal juncture in the history of American foreign policy. It was in part because of the absence of Woodrow Wilson's vocal and unwavering support that the United States did not join the League of Nations and distanced itself from the international stage. The League of Nations would later prove powerless without American support and was unable to thwart the rise and advance of Adolf Hitler. Only after World War II did the United States assume its global leadership role and realize Wilson's visionary, yet contentious, groundwork for a Pax Americana. The authors describe Woodrow Wilson's stroke, the historical implications of his health decline, and its impact on United States foreign policy.

  5. Bridging Science and Policy: The AGU Science Policy Conference

    Science.gov (United States)

    Hankin, E. R.; Uhlenbrock, K.; Landau, E. A.

    2013-12-01

    In recent years, science has become inextricably linked to the political process. As such, it is more important now than ever for science to forge a better relationship with politics, for the health of both science and society. To help meet this need, the American Geophysical Union (AGU) strives to engage its members, shape policy, and inform society about the excitement of Earth and space science and its role in developing solutions for the sustainability of the planet. In June 2013, AGU held its second annual Science Policy Conference in Washington, D.C. The goal of the conference is to provide a new forum for diverse discussions and viewpoints on the challenges and opportunities of science policy, with a focus on applications of Earth and space science that serve local, national, and international communities. The meeting brought together more than 300 scientists, policy makers, industry professionals, members of the press, and other stakeholders to discuss the topics concerning the Arctic, climate change, oceans, energy, technology and infrastructure, and natural hazards science as they relate to challenges impacting society. Sessions such as 'The Water-Energy Nexus,' 'Potential for Megadisasters,' 'The Changing Ocean and Impacts on Human Health,' and 'Drowning and Drought: Agricultural Impacts of Climate Change' are examples of some of the intriguing and timely science policy issues addressed at the conference. The findings from the conference were used to develop a summary report. The report highlights key facts and figures to be used as a resource in discussions with policy makers and other stakeholders regarding the conference topics. This presentation will discuss the goals and outcomes of the conference and how the event represents one of the many ways AGU is approaching its 'Science and Society' priority objective as part of the Union's strategic plan; namely by increasing the effectiveness and recognition of AGU among policy makers as an authoritative

  6. 'Cable-maker's clavicle': stress fracture of the medial clavicle

    International Nuclear Information System (INIS)

    Peebles, C.R.; Sulkin, T.; Sampson, M.A.

    2000-01-01

    A 50-year-old man presented with a non-traumatic painful swelling over the medial clavicle. Radiographs showed a poorly defined fracture and the possibility of an underlying pathology was raised. Computed tomography suggested a stress fracture. This prompted a further, more detailed occupational history to be obtained from the patient, which revealed a hitherto undescribed cause of clavicular stress fracture and obviated the need for further imaging or biopsy. (orig.)

  7. Improving Communication With Surrogate Decision-Makers: A Pilot Initiative.

    Science.gov (United States)

    Meltzer, Ellen C; Shi, Zhenzhen; Suppes, Alexandra; Hersh, Jennifer E; Orlander, Jay D; Calhoun, Aaron W; Tung, Judy; Logio, Lia; Manna, Ruth; Bialer, Philip A; Acres, Cathleen A; Fins, Joseph J

    2017-08-01

    Difficult conversations in medical care often occur between physicians and patients' surrogates, individuals entrusted with medical decisions for patients who lack the capacity to make them. Poor communication between patients' surrogates and physicians may exacerbate anxiety and guilt for surrogates, and may contribute to physician stress and burnout. This pilot study assesses the effectiveness of an experiential learning workshop that was conducted in a clinical setting, and aimed at improving resident physician communication skills with a focus on surrogate decision-making. From April through June 2016, we assessed internal medicine residents' baseline communication skills through an objective structured clinical examination (OSCE) with actors representing standardized surrogates. After an intensive, 6-hour communication skills workshop, residents were reassessed via an OSCE on the same day. A faculty facilitator and the surrogate evaluated participants' communication skills via the expanded Gap Kalamazoo Consensus Statement Assessment Form. Wilcoxon signed rank tests (α of .05) compared mean pre- and postworkshop scores. Of 44 residents, 33 (75%) participated. Participants' average preworkshop OSCE scores ( M  = 3.3, SD = 0.9) were significantly lower than postworkshop scores ( M  = 4.3; SD = 0.8; Z  = 4.193; P  decision-making benefit from focused interventions. Our pilot assessment of a workshop showed promise, and additionally demonstrated the feasibility of bringing OSCEs and simulated encounters into a busy clinical practice.

  8. A decision-maker's view on future research decisions

    International Nuclear Information System (INIS)

    Catania, M.; McGeorge, L.; Smith, R.; Tucker, R.; Moser, F.; Telford, S.

    1992-01-01

    Partly as a result of its strategic geographic location as a northeastern port state, New Jersey has long been a heavily industrialized state. The potential, as well as actual, severity of the hazardous waste problem in New Jersey is demonstrated by an evaluation of the extent of industrial use of toxic substances, the significant number of actual hazardous waste generators and treatment facilities, and the extensive number of known or suspected hazardous waste sites in the state. In a 1987 report environmental contamination from hazardous and toxic waste was listed as the issue New Jersey citizens consider to be of the greatest importance. In response to the severity of the problems and citizen concerns, New Jersey's Hazardous Waste Program has assumed one of the most aggressive roles in the nation and has become the most successful state program for site remediation and control. As a result, the Hazardous Waste Program in New Jersey has been emulated by other states and by the US EPA in the development of its federal programs. Since its establishment, New Jersey has cleaned up nearly 1,000 non-national priorities list (non-NPL) sites and is in the process of cleaning up another 700 sites, including 109 in the NPL. New Jersey has cleaned up more hazardous waste sites than any other state or the federal government; in fact, three times as many sites as the next closest state and more than the next 14 states combined. This active program has amassed over $2.5 billion in public and private funds for its work. The program has also received several awards over the years for its outstanding efforts and its ability to incorporate innovative technologies and policies into its approaches

  9. 2007 status of climate change: Mitigation of Climate Change. Contribution of Working Group III to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Summary for Policy-makers; Bilan 2007 des changements climatiques: l'attenuation des changements climatiques. Contribution du Groupe de travail 3 au quatrieme rapport d'evaluation du Groupe d'Experts Intergouvernemental sur l'Evolution du Climat (GIEC). Resume a l'attention des decideurs

    Energy Technology Data Exchange (ETDEWEB)

    Barker, T.; Bashmakov, I.; Bernstein, L.; Bogner, J.; Bosch, P.; Dave, R.; Davidson, O.; Fisher, B.; Grubb, M.; Gupta, S.; Halsnaes, K.; Heij, B.; Kahn Ribeiro, S.; Kobayashi, S.; Levine, M.; Martino, D.; Masera Cerutti, O.; Metz, B.; Meyer, L.; Nabuurs, G.J.; Najam, A.; Nakicenovic, N.; Holger Rogner, H.; Roy, J.; Sathaye, J.; Schock, R.; Shukla, P.; Sims, R.; Smith, P.; Swart, R.; Tirpak, D.; Urge-Vorsatz, D.; Dadi, Z

    2007-07-01

    The Working Group III contribution to the IPCC Fourth Assessment Report (AR4) focuses on new literature on the scientific, technological, environmental, economic and social aspects of mitigation of climate change, published since the IPCC Third Assessment Report (TAR) and the Special Reports on CO{sub 2} Capture and Storage (SRCCS) and on Safeguarding the Ozone Layer and the Global Climate System (SROC).The main aim of this summary report is to assess options for mitigating climate change. Several aspects link climate change with development issues. This report explores these links in detail, and illustrates where climate change and sustainable development are mutually reinforcing. Economic development needs, resource endowments and mitigative and adaptive capacities differ across regions. There is no one-size-fits-all approach to the climate change problem, and solutions need to be regionally differentiated to reflect different socio-economic conditions and, to a lesser extent, geographical differences. Although this report has a global focus, an attempt is made to differentiate the assessment of scientific and technical findings for the various regions. Given that mitigation options vary significantly between economic sectors, it was decided to use the economic sectors to organize the material on short- to medium-term mitigation options. Contrary to what was done in the Third Assessment Report, all relevant aspects of sectoral mitigation options, such as technology, cost, policies etc., are discussed together, to provide the user with a comprehensive discussion of the sectoral mitigation options. The report is organised into six sections after the introduction: - Greenhouse gas (GHG) emission trends; - Mitigation in the short and medium term, across different economic sectors (until 2030); - Mitigation in the long-term (beyond 2030); - Policies, measures and instruments to mitigate climate change; - Sustainable development and climate change mitigation; - Gaps in

  10. 2007 status of climate change: Mitigation of Climate Change. Contribution of Working Group III to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Summary for Policy-makers; Bilan 2007 des changements climatiques: l'attenuation des changements climatiques. Contribution du Groupe de travail 3 au quatrieme rapport d'evaluation du Groupe d'Experts Intergouvernemental sur l'Evolution du Climat (GIEC). Resume a l'attention des decideurs

    Energy Technology Data Exchange (ETDEWEB)

    Barker, T; Bashmakov, I; Bernstein, L; Bogner, J; Bosch, P; Dave, R; Davidson, O; Fisher, B; Grubb, M; Gupta, S; Halsnaes, K; Heij, B; Kahn Ribeiro, S; Kobayashi, S; Levine, M; Martino, D; Masera Cerutti, O; Metz, B; Meyer, L; Nabuurs, G J; Najam, A; Nakicenovic, N; Holger Rogner, H; Roy, J; Sathaye, J; Schock, R; Shukla, P; Sims, R; Smith, P; Swart, R; Tirpak, D; Urge-Vorsatz, D; Dadi, Z

    2007-07-01

    The Working Group III contribution to the IPCC Fourth Assessment Report (AR4) focuses on new literature on the scientific, technological, environmental, economic and social aspects of mitigation of climate change, published since the IPCC Third Assessment Report (TAR) and the Special Reports on CO{sub 2} Capture and Storage (SRCCS) and on Safeguarding the Ozone Layer and the Global Climate System (SROC).The main aim of this summary report is to assess options for mitigating climate change. Several aspects link climate change with development issues. This report explores these links in detail, and illustrates where climate change and sustainable development are mutually reinforcing. Economic development needs, resource endowments and mitigative and adaptive capacities differ across regions. There is no one-size-fits-all approach to the climate change problem, and solutions need to be regionally differentiated to reflect different socio-economic conditions and, to a lesser extent, geographical differences. Although this report has a global focus, an attempt is made to differentiate the assessment of scientific and technical findings for the various regions. Given that mitigation options vary significantly between economic sectors, it was decided to use the economic sectors to organize the material on short- to medium-term mitigation options. Contrary to what was done in the Third Assessment Report, all relevant aspects of sectoral mitigation options, such as technology, cost, policies etc., are discussed together, to provide the user with a comprehensive discussion of the sectoral mitigation options. The report is organised into six sections after the introduction: - Greenhouse gas (GHG) emission trends; - Mitigation in the short and medium term, across different economic sectors (until 2030); - Mitigation in the long-term (beyond 2030); - Policies, measures and instruments to mitigate climate change; - Sustainable development and climate change mitigation; - Gaps in

  11. Development of a Clinical Forecasting Model to Predict Comorbid Depression Among Diabetes Patients and an Application in Depression Screening Policy Making

    OpenAIRE

    Jin, Haomiao; Wu, Shinyi; Di Capua, Paul

    2015-01-01

    Introduction Depression is a common but often undiagnosed comorbid condition of people with diabetes. Mass screening can detect undiagnosed depression but may require significant resources and time. The objectives of this study were 1) to develop a clinical forecasting model that predicts comorbid depression among patients with diabetes and 2) to evaluate a model-based screening policy that saves resources and time by screening only patients considered as depressed by the clinical forecasting...

  12. Between system maker and privileges taker: the role of China in the Greater Mekong Sub-region

    Directory of Open Access Journals (Sweden)

    Truong-Minh Vu

    2014-01-01

    Full Text Available Utilizing China's leadership projects in the Great Mekong Sub-Region (GMS as a case study, this paper aims to investigate whether China qualifies as an international leader. This work argues that its geographic position and economic rise allow China to be a "system maker and privilege taker," which is a dual role forming in economic-political relations in the GMS in the last ten years. China is among major driving forces to set up an economic zone in GMS. Growing Chinese regional power is intimately related to the creation of various hubs connecting regional transportation, communication and energy systems that foster the economic development of this region. However, China also proves dark sides of rising powers which take advantage of their privileges to gain benefits. As a "system maker" with its own position and capability, China has notably benefited from building hydropower systems. More importantly, while China is pursuing its benefits and privileges, its hydropower projects have caused some negative effects for the ecosystem in the region. The inflation of dam constructions in both China and GMS countries is raising concerns about using natural resources of the Mekong River. Our concluding part addresses the pressing need to start a serious discussion on the balance between national interests and regional solidarity within the formulation of Chinese foreign policy in GMS.

  13. Defining products for a new health technology assessment agency in Madrid, Spain: a survey of decision makers.

    Science.gov (United States)

    Andradas, Elena; Blasco, Juan-Antonio; Valentín, Beatriz; López-Pedraza, María-José; Gracia, Francisco-Javier

    2008-01-01

    The aim of this study was to explore the needs and requirements of decision makers in our regional healthcare system for health technology assessment (HTA) products to support portfolio development planning for a new HTA agency in Madrid, Spain. A Delphi study was conducted during 2003. Questionnaires were developed based on a review of products and services offered by other agency members of the International Network of Agencies for Health Technology Assessment, and included preference and prioritization questions to evaluate twenty-two different products and services. The initial Delphi panel involved eighty-seven experts from twenty-one public hospitals, eleven primary healthcare centers, six private hospitals, and eight departments of the Regional Ministry of Health of the Community of Madrid. The global participation rate was 83.9 percent. Ten of the twenty-two possible products were rated of high interest by more than 80 percent of respondents. Important differences in preferences and priorities were detected across different settings. Public hospitals and primary healthcare centers shared a more "micro" perspective, preferring classic technology-centered HTA products, whereas private hospitals and Ministry representatives demanded more "macro" products and services such as organizational model and information system assessments. The high participation rate supports the representativeness of the results for our regional context. The strategic development of an HTA portfolio based on decision makers' needs and requirements as identified in this type of exercise should help achieve a better impact on policy development and decision making.

  14. Permanent pace maker implantation through axillary vein approach

    International Nuclear Information System (INIS)

    Shah, B.; Hussain, C.; Awan, Z.A.

    2017-01-01

    Device implantation is an integral part of interventional cardiology particularly electrophysiology. In this study, we are going to share our experience of device implantation technique at electrophysiology department Hayatabad Medical Complex, Peshawar. Methods: the study was conducted from June 2011 to December 2015. Axillary vein was used to implant the devices but in some cases when this rout was not convenient due to any reason then subclavian vein was entered through the Seldinger technique. Fluoroscopy time was less than 10 minutes and total procedure time was not more than 45 minutes. Electric cautery was used only in two cases. Pressure dressing was used in a few cases. Results: Total numbers of permanent pacemakers (PPM) remain 800 during the study period. There were 450 single chamber pacemakers and 350 dual chambers pacemakers. No case of any major bleeding was documented and in very few cases there was mild ooze from the procedure site after the operation which was tackled with pressure dressing. Four cases of pneumothorax were noted during the study period and in three cases chest intubation were done and one patient was kept on conservative management. Patient were followed after one month of discharge from the hospital and then yearly. Eight cases of lead dislodgment were documented during the study period. Conclusion: Axillary vein approach for implantation of permanent pacemakers is a safe and less time-consuming technique. (author)

  15. The policy debate over public investment in comparative effectiveness research.

    Science.gov (United States)

    Rich, Eugene C

    2009-06-01

    Policy makers across the political spectrum, as well as many clinicians and physician professional associations, have proposed that better information on comparative clinical effectiveness should be a key element of any solution to the US health-care cost crisis. This superficial consensus hides intense disagreements over critical issues essential to any new public effort to promote more comparative effectiveness research (CER). This article reviews the background for these disputes, summarizes the different perspectives represented by policy makers and advocates, and offers a framework to aid both practicing and academic internists in understanding the key elements of the emerging debate. Regarding the fundamental question of "what is CER," disagreements rage over whether value or cost effectiveness should be a consideration, and how specific patient perspectives should be reflected in the development and the use of such research. The question of how to pay for CER invokes controversies over the role of the market in producing such information and the private (e.g., insurers and employers) versus public responsibility for its production. The financing debate further highlights the high stakes of comparative effectiveness research, and the risks of stakeholder interests subverting any public process. Accordingly there are a range of proposals for the federal government's role in prioritization, development, and dissemination of CER. The internal medicine community, with its long history of commitment to scientific medical practice and its leadership in evidence-based medicine, should have a strong interest and play an active role in this debate.

  16. A Comparative Analysis of Education Policy and Practice: The Case of Institutions in Mumbai and Delhi

    Science.gov (United States)

    Iyengar, Radhika; Surianarain, Sharmi

    2010-01-01

    There exist many actors within the realm of education policy planning and implementation, namely: the policy makers; the national, local and regional institutions engaged in the dissemination and interpretation of these policies; and the educational institutions that implement these policies at the ground level (schools). While schools are largely…

  17. An In-Depth Analysis of Adult Learning Policies and Their Effectiveness in Europe

    Science.gov (United States)

    European Union, 2015

    2015-01-01

    Adult learning policies, like any other policies, need to be effective: they need to reach their objectives and attain the desired impacts, which should be carefully defined. Understanding the performance of policies allows policy makers to change and improve them. A growing body of research and statistics provides important insights into how…

  18. The development of health policy in Malawi: The influence of context ...

    African Journals Online (AJOL)

    Within the health policy field, a growing literature is attempting to understand the diverse responses of policy makers to research, and to explain why certain research findings make their way into policy while others are effectively ignored. In this paper we apply a policy analysis framework to the development of cotrimoxazole ...

  19. Ensuring Adequate Health and Safety Information for Decision Makers during Large-Scale Chemical Releases

    Science.gov (United States)

    Petropoulos, Z.; Clavin, C.; Zuckerman, B.

    2015-12-01

    The 2014 4-Methylcyclohexanemethanol (MCHM) spill in the Elk River of West Virginia highlighted existing gaps in emergency planning for, and response to, large-scale chemical releases in the United States. The Emergency Planning and Community Right-to-Know Act requires that facilities with hazardous substances provide Material Safety Data Sheets (MSDSs), which contain health and safety information on the hazardous substances. The MSDS produced by Eastman Chemical Company, the manufacturer of MCHM, listed "no data available" for various human toxicity subcategories, such as reproductive toxicity and carcinogenicity. As a result of incomplete toxicity data, the public and media received conflicting messages on the safety of the contaminated water from government officials, industry, and the public health community. Two days after the governor lifted the ban on water use, the health department partially retracted the ban by warning pregnant women to continue avoiding the contaminated water, which the Centers for Disease Control and Prevention deemed safe three weeks later. The response in West Virginia represents a failure in risk communication and calls to question if government officials have sufficient information to support evidence-based decisions during future incidents. Research capabilities, like the National Science Foundation RAPID funding, can provide a solution to some of the data gaps, such as information on environmental fate in the case of the MCHM spill. In order to inform policy discussions on this issue, a methodology for assessing the outcomes of RAPID and similar National Institutes of Health grants in the context of emergency response is employed to examine the efficacy of research-based capabilities in enhancing public health decision making capacity. The results of this assessment highlight potential roles rapid scientific research can fill in ensuring adequate health and safety data is readily available for decision makers during large

  20. The influence of science funding agencies in support of effective decision-maker scientist partnerships

    Science.gov (United States)

    Arnott, J. C.; Lemos, M. C.

    2017-12-01

    A wealth of evidence supports the idea that collaboration between scientists and decision-makers is an influential factor in generating actionable knowledge. Nevertheless, persistent obstacles across the research-policy-practice interface limit the amount of engagement that may be necessary to satisfy demands for information to support decisions. Funding agencies have been identified as one possible driver of change, but few multi-year studies have been conducted to trace the influence of program designs on research practices or other outcomes. To fill this gap, we examine a body of applied science projects (n=120) funded through NOAA's National Estuarine Research Reserve System from 1998-2014. Periodic innovation in the structure of this funding program, including requirements for end user engagement and the inclusion of collaboration specialists, offers a natural experiment from which to test hypotheses about the how funding program design influences research practice, utilization, and broader impacts. Using content analysis of project reports and interviews of project team members, end users, and program managers (n=40), we produce a data that can be analyzed through both statistical and qualitative methods. We find that funder mandates significantly influence the intensity of interaction between researchers and practitioners as well as affect long-term change in research cultures. When interaction intensifies, corresponding gains appear in the readiness of research to support decision-making and the readiness of user groups to incorporate findings into their work. While collaborative methods transform research practice and positively influence the applied contexts in which partnerships occur, it remains less clear whether this actually increases the direct use of scientific to inform decisions. For example, collaboration may lead to outcomes other than new knowledge or knowledge application, yielding many positive outcomes that are distinct from knowledge use