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Sample records for policy intervention aimed

  1. Realist review of policy intervention studies aimed at reducing exposures to environmental hazards in the United States

    Directory of Open Access Journals (Sweden)

    Dorie E. Apollonio

    2016-08-01

    Full Text Available Abstract Background Exposure to pollution is a significant risk to human health. However few studies have attempted to identify the types of policy interventions that can reduce the health risks of pollution exposure in the United States. The study objective was to conduct a realist review of policy interventions conducted or aimed at reducing chemical exposures in humans or the environment where exposure was measured. Methods A systematic literature search identified published articles that assessed policy interventions using exposure data. Two coders independently extracted data from the studies, assessing methods, context, details of interventions, outcomes, and risks of bias. Data were analyzed iteratively and manually to identify the most effective and transferrable types of interventions. The reasons for variability in the success of different interventions were explored. Results The review found that regulatory interventions that eliminate point sources of pollution appeared to reduce exposure to environmental hazards. Regular monitoring to provide environmental and human exposure data helped assess compliance with the regulatory standards. Educational and economic interventions were less successful. Conclusions Although some types of regulatory interventions appear to reduce exposures, our findings are limited by the nature of existing interventions, the weaknesses of the study designs used in the literature, and the lack of details on implementation. Information on contextual factors that influence implementation would assist with future reviews and could help identify effective interventions.

  2. Multilevel interventions aimed at adult obesity prevention

    DEFF Research Database (Denmark)

    Benwell, Ann Fenger

    A growing body of literature emphasizes the importance of using both quantitative and qualitative methods to investigate the wide range of aspects which hinder or promote the success of health interventions. The pilot phase of this study highlights how mixed-method approaches can be strengthened ...... to investigate factors associated with multi-level obesity prevention....

  3. Interventions aiming to reduce early retirement due to rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Pedro Almeida Laires

    2017-07-01

    Full Text Available Introduction: Aging of the population and early retirement translates into productivity losses to society. Persistence of working life is crucial to counteract this sustainability issue faced by western countries. Musculoskeletal and rheumatic diseases (RD may cause work disability and early exit from work, including early retirement. The objective of this article is to review the current knowledge about interventions aiming to reduce early retirement due to RD. Methods: We searched PubMed and The Cochrane Library for studies either in English or Portuguese between January 2000 and June 2016 that evaluated the impact of interventions targeting early retirement in RD patients still at work. We also searched for grey literature from Portuguese institutional repositories. Results: We identified several published studies testing pharmacologic and non-pharmacologic vocational rehabilitation interventions. None was specifically identified for Portugal. The general low quality of the literature and its inconsistency makes it unfeasible to draw definitive conclusions. However, some broad recommendations might be outlined. An effective intervention must: 1 act upon different levels (e.g. RD patient, workplace, involving several stakeholders (e.g. rheumatologists, occupational physicians, employers; 2 prioritize the right patients (e.g. more disabling RD; and 3 consider the patients’ role, for instance by including an element of patient education and support. Despite the lack of good quality evidence on this field, there seems to be a growing interest in the international scientific community with several ongoing studies promoting such interventions. This promising data will be very useful to set up effective policies. Conclusions: This article summarizes the current knowledge about the impact of interventions to avoid or mitigate early retirement in RD patients. It highlights the demand for further research and it also contributes to aware decision

  4. A review of intervention studies aimed at household energy conservation

    NARCIS (Netherlands)

    Abrahamse, W; Steg, L; Vlek, C; Rothengatter, T; Rothengatter, J.A.

    This article reviews and evaluates the effectiveness of interventions aiming to encourage households to reduce energy consumption. Thirty-eight studies performed within the field of (applied) social and environmental psychology are reviewed, and categorized as involving either antecedent strategies

  5. Positive psychological interventions aimed at enhancing psychological ownership

    NARCIS (Netherlands)

    van Zyl, Llewellyn; van der Vaart, Leoni; Stemmet, Lehan; Olckers, Chantal; van Zyl, Llewellyn; van der Vaart, Leoni

    2017-01-01

    Interventions aimed at the enhancement of positive organisational behaviours, within organisational contexts, are imperative for creating and sustaining a high-performance culture, where individual and organisational strengths are optimized and top-talent retained. Psychological ownership, one form

  6. Determination of aims military-technical policy of Ukraine

    Directory of Open Access Journals (Sweden)

    O. F. Salnikova

    2014-06-01

    Full Text Available In the article the aims of military-technical policy are considered. Determination of aims (tasks of military-technical policy, its maintenance, requirements to it and directions of its further development it must come true by the analysis of different factors of external and internal environment. Among such factors: geopolitical and military-political position of Ukraine and its military doctrine; realized and operating programs of development (reformation of the soldiery forming and them technical rigging; terms of future military operations and progress of their maintenance, forms, methods and characteristic signs of battle actions trend; substantive provisions of art of war; conceptions, theories and doctrines of battle application of the soldiery forming of the different states; resources dedicated by the state on development of military-technical sphere and others like that. The fundamental chart of sequence of forming of public military-technical policy is presented in the article.

  7. An intervention aimed at reducing plagiarism in undergraduate nursing students.

    Science.gov (United States)

    Smedley, Alison; Crawford, Tonia; Cloete, Linda

    2015-05-01

    Plagiarism is a current and developing problem in the tertiary education sector where students access information and reproduce it as their own. It is identified as occurring in many tertiary level degrees including nursing and allied health profession degrees. Nursing specifically, is a profession where standards and ethics are required and honesty is paramount. The aim of this study was to evaluate the change in nursing student's knowledge and understanding of plagiarism before and after an educational intervention in their first semester of the Bachelor of nursing degree at a private college of higher education in Sydney, Australia. This study concluded that an educational intervention can increase knowledge and awareness of plagiarism among nursing students. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Development of AIM for analysing policy options to reduce greenhouse gas emissions

    International Nuclear Information System (INIS)

    Kainuma, M.; Morita, T.; Matsuoka, Y.

    1999-01-01

    AIM (Asian-Pacific Integrated Model) has been developed for predicting greenhouse gas emissions and evaluating policy measures to reduce them. Two socio-economic scenarios were assumed and CO 2 emissions were predicted based on these scenarios and policy intervention assumptions. It is found that mitigating CO 2 emissions without scaling back productive activities or standards of living in Japan is possible. However, if one relies on the market mechanism alone, it cannot be done. The analysis has shown that it is essential to introduce new policies and measures such as carbon tax and subsidies. (author)

  9. Institutional policy changes aimed at addressing obesity among mental health clients.

    Science.gov (United States)

    Knol, Linda L; Pritchett, Kelly; Dunkin, Jeri

    2010-05-01

    People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. This intervention was implemented in a rural mental health system in the southeastern United States. Clients live in small group homes, where they are served breakfast, dinner, and a snack, and attend outpatient day treatment programs, where they are served lunch and can purchase snacks from vending machines. This intervention included institutional policy changes that altered menus and vending machine options and implemented group walking programs. Primary outcome measures were changes in clients' weight at 3 and 6 months after policy implementation. At the 3-month follow-up, the median weight loss for overweight/obese clients (n = 45) was 1.4 kg. The 33 overweight/obese clients who were still in the group homes at the 6-month follow-up either maintained or continued to lose weight. Institutional policy changes aimed at improving dietary intake and physical activity levels among clients receiving mental health services can promote weight loss in overweight clients.

  10. Effects of Economic Policies Aimed at Encouraging a Healthier Grain Consumption

    OpenAIRE

    Nordstrom, Jonas; Thunstrom, Linda

    2007-01-01

    In this paper, we evaluate the effects of policy reforms aimed at achieving two policy objectives for grain consumption; (a) to double the intake of bread and breakfast cereals and (b) to ensure that half of the bread and breakfast cereals consumed are whole grain products. The overall aim of these policy objectives are to increase the dietary fibre intake from grain consumption so as to significantly contribute to the general recommended (minimum) increase of the fibre intake. Based on param...

  11. [A workplace intervention aimed at increasing awareness in nursing personnel performing manual handling activities].

    Science.gov (United States)

    Scorpiniti, A; Lorusso, A; L'Abbate, N

    2007-01-01

    Here we describe a workplace intervention aimed at reducing the risk of low back pain in nursing personnel. The intervention we carried out included a specific ergonomic training and an exercise program according to the Feldenkrais Method. After the intervention, we evaluated its effect on the execution of manual handling activities in nurses. We found an increased rate of correct manual handling in the post-intervention period.

  12. Using Intervention Mapping for Systematic Development of Two School-Based Interventions Aimed at Increasing Children's Fruit and Vegetable Intake

    Science.gov (United States)

    Reinaerts, E.; De Nooijer, J.; De Vries, N. K.

    2008-01-01

    Purpose: The purpose of this paper is to show how the intervention mapping (IM) protocol could be applied to the development of two school-based interventions. It provides an extensive description of the development, implementation and evaluation of two interventions which aimed to increase fruit and vegetable (F&V) consumption among primary…

  13. A RE-AIM evaluation of theory-based physical activity interventions.

    Science.gov (United States)

    Antikainen, Iina; Ellis, Rebecca

    2011-04-01

    Although physical activity interventions have been shown to effectively modify behavior, little research has examined the potential of these interventions for adoption in real-world settings. The purpose of this literature review was to evaluate the external validity of 57 theory-based physical activity interventions using the RE-AIM framework. The physical activity interventions included were more likely to report on issues of internal, rather than external validity and on individual, rather than organizational components of the RE-AIM framework, making the translation of many interventions into practice difficult. Furthermore, most studies included motivated, healthy participants, thus reducing the generalizability of the interventions to real-world settings that provide services to more diverse populations. To determine if a given intervention is feasible and effective in translational research, more information should be reported about the factors that affect external validity.

  14. Institutional Policy Changes Aimed at Addressing Obesity Among Mental Health Clients

    OpenAIRE

    Knol, Linda L.; Pritchett, Kelly; Dunkin, Jeri

    2010-01-01

    Background People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. Context This intervention was implemented in a rural mental health system in the southeastern U...

  15. Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

    Science.gov (United States)

    Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

    2015-05-03

    Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

  16. Armed To Learn: Aiming At California K 12 School Gun Policy

    Science.gov (United States)

    2016-03-01

    AIMING AT CALIFORNIA K-12 SCHOOL GUN POLICY by Catherine Wilson Jones March 2016 Thesis Co-Advisors: Kathleen Kiernan John Rollins...Master’s thesis 4. TITLE AND SUBTITLE ARMED TO LEARN: AIMING AT CALIFORNIA K-12 SCHOOL GUN POLICY 5. FUNDING NUMBERS 6. AUTHOR(S) Catherine...gap in viewpoints between gun control advocates who want tighter gun control and constitutionalists who believe as strongly in the Second Amendment

  17. The orientation, principles, priorities and aims of the state environmental policy

    International Nuclear Information System (INIS)

    1998-01-01

    This chapter contains: (A) The orientation and priorities of state environmental policy of the government of the Slovak Republic which were approved 18 November 1993 by the resolution No 339. On the basis of the Strategy, principles and priorities of state environmental policy 70 short-terminable aims up to 1996, next 59 middle-terminable of aims up to years 2000 - 2010 and 33 general and partial long-terminable aims up to 2030 and longer were formulated. The Strategy is determined by next 5 branches oriented priorities: (1) air protection before pollutants and the global environmental safety; (2) organization of sufficiency of drinking water and decreasing of pollution of other waters under permissible limits; (3) soil protection before degeneration and organization of non-defected food-stuffs and other wares; (4) minimization of formation, use and good waste liquidate; (5) preservation of bio-diversity, preservation and rational use of natural reserves and optimization of place structure and use of the country. (B) The principles and priorities of state environmental policy determinate implementation and observance of then principles of the state environmental policy. (C) Total 162 aims of the Strategy of the state environmental policy and next followed programs, projects and measures of the environmental policy of the Slovak Republic can be grouped into 4 blocks: (1) the environmental policy in the protection of air, water and before of risk factors, in the nuclear safety and waste economy (environmental safety; (2) the environmental policy in protection of the nature and the country, protection and use of mineral surroundings, soils and forest;; (3) the environmental policy in the economy; (4) the environmental policy in the guidance, education, public information, organization, control and coordination of the ministration on the environment. These aims are grouped into 10 sectors. (D) The government of the Slovak republic has first National environmental

  18. Process evaluation of a web-based intervention aimed at empowerment of disability benefit claimants

    NARCIS (Netherlands)

    Samoocha, D.; Snels, I.A.K.; Bruinvels, D.J.; Anema, J.R.; Kowalczyk, W.J.; van der Beek, A.J.

    2011-01-01

    Background: The objective of this process evaluation study was to gain insight into the reach, compliance, appreciation, usage barriers, and users' perceived effectiveness of a web-based intervention http://www.wiagesprek.nl. This intervention was aimed at empowerment of disability claimants, prior

  19. Process evaluation of a web-based intervention aimed at empowerment of disability benefit claimants

    NARCIS (Netherlands)

    Samoocha, David; Snels, Ingrid A. K.; Bruinvels, David J.; Anema, Johannes R.; Kowalczyk, Wojtek; van der Beek, Allard J.

    2011-01-01

    The objective of this process evaluation study was to gain insight into the reach, compliance, appreciation, usage barriers, and users' perceived effectiveness of a web-based intervention http://www.wiagesprek.nl. This intervention was aimed at empowerment of disability claimants, prior to the

  20. Process Evaluation of a Workplace Health Promotion Intervention Aimed at Improving Work Engagement and Energy Balance

    NARCIS (Netherlands)

    van Berkel, J.; Boot, C.R.L.; Proper, K.I.; Bongers, P.M.; van der Beek, A.J.

    2013-01-01

    OBJECTIVE:: To evaluate the process of the implementation of an intervention aimed at improving work engagement and energy balance, and to explore associations between process measures and compliance. METHODS:: Process measures were assessed using a combination of quantitative and qualitative

  1. Process evaluation of a workplace health promotion intervention aimed at improving work engagement and energy balance

    NARCIS (Netherlands)

    Berkel, J. van; Boot, C.R.L.; Proper, K.I.; Bongers, P.M.; Beek, A.J. van der

    2013-01-01

    OBJECTIVE:: To evaluate the process of the implementation of an intervention aimed at improving work engagement and energy balance, and to explore associations between process measures and compliance. METHODS:: Process measures were assessed using a combination of quantitative and qualitative

  2. Agricultural Productivity and Policy Interventions in Nyamagabe ...

    African Journals Online (AJOL)

    Improving agricultural productivity has received considerable policy intervention in many African countries and particularly in Rwanda. The question remains to know the extent to which the policy contributes to the variation being upwards or downwards of the crop productivity. There are number of determinant factors some ...

  3. Agricultural intensification and policy interventions

    NARCIS (Netherlands)

    Falconnier, Gatien N.; Descheemaeker, Katrien; Traore, Bouba; Bayoko, Arouna; Giller, Ken E.

    2018-01-01

    Assessing how livelihoods in rural sub-Saharan Africa might change given future trends in socio-economic and biophysical conditions helps to identify and direct effective efforts towards poverty reduction. Based on existing literature, hypothetical changes in farmer practices and policy

  4. Exploring Study Designs for Evaluation of Interventions Aimed to Reduce Occupational Diseases and Injuries

    Directory of Open Access Journals (Sweden)

    Henk F. van der Molen

    2016-03-01

    Full Text Available Effective interventions to reduce work-related exposures are available for many types of work-related diseases or injuries. However, knowledge of the impact of these interventions on injury or disease outcomes is scarce due to practical and methodological reasons. Study designs are considered for the evaluation of occupational health interventions on occupational disease or injury. Latency and frequency of occurrence of the health outcomes are two important features when designing an evaluation study with occupational disease or occupational injury as an outcome measure. Controlled evaluation studies—giving strong indications for an intervention effect—seem more suitable for more frequently occurring injuries or diseases. Uncontrolled evaluation time or case series studies are an option for evaluating less frequently occurring injuries or diseases. Interrupted time series offer alternatives to experimental randomized controlled trials to give an insight into the effectiveness of preventive actions in the work setting to decision and policy makers.

  5. Process evaluation of a web-based intervention aimed at empowerment of disability benefit claimants

    Directory of Open Access Journals (Sweden)

    Anema Johannes R

    2011-02-01

    Full Text Available Abstract Background The objective of this process evaluation study was to gain insight into the reach, compliance, appreciation, usage barriers, and users' perceived effectiveness of a web-based intervention http://www.wiagesprek.nl. This intervention was aimed at empowerment of disability claimants, prior to the assessment of disability by an insurance physician. Methods Reach was determined by registering claimants exposed to the study's invitation brochures, and by comparing trial participant characteristics with non-participants and nationwide claimant data. Compliance was registered by analyzing weblogs, which were automatically collected during the period of the trial. This made it possible to analyze individual use of the intervention. Appreciation, usage barriers, and users' perceived effectiveness were assessed using an online questionnaire that was sent to participants from the intervention group, 6 weeks after enrolment. Results Only 9% of the target population enrolled in the internet program. Because of selective enrolment, more females, higher educated claimants, and less ethnical minorities were reached. Compliance was ambiguous: out of the 123 participants randomized into the intervention group, a significant proportion (33% did not use the intervention at all, while, at the same time, many participants (32% used the intervention for more than two hours (i.e. in approximately two weeks. Overall satisfaction with the intervention was good. Claimants perceived the intervention most effective in increasing knowledge, while also a fair amount of users perceived the intervention effective in gaining right expectations or being able to communicate better with their physician. Conclusions The uptake of the intervention http://www.wiagesprek.nl was disappointing. Specifically, the poor reach and compliance of the intervention resulted in a small proportion of the target population using the intervention as intended. Improvements in the

  6. Interventions aimed at increasing research use in nursing: a systematic review

    Directory of Open Access Journals (Sweden)

    Moore Katherine

    2007-05-01

    Full Text Available Abstract Background There has been considerable interest recently in developing and evaluating interventions to increase research use by clinicians. However, most work has focused on medical practices; and nursing is not well represented in existing systematic reviews. The purpose of this article is to report findings from a systematic review of interventions aimed at increasing research use in nursing. Objective To assess the evidence on interventions aimed at increasing research use in nursing. Methods A systematic review of research use in nursing was conducted using databases (Medline, CINAHL, Healthstar, ERIC, Cochrane Central Register of Controlled Trials, and Psychinfo, grey literature, ancestry searching (Cochrane Database of Systematic Reviews, key informants, and manual searching of journals. Randomized controlled trials and controlled before- and after-studies were included if they included nurses, if the intervention was explicitly aimed at increasing research use or evidence-based practice, and if there was an explicit outcome to research use. Methodological quality was assessed using pre-existing tools. Data on interventions and outcomes were extracted and categorized using a pre-established taxonomy. Results Over 8,000 titles were screened. Three randomized controlled trials and one controlled before- and after-study met the inclusion criteria. The methodological quality of included studies was generally low. Three investigators evaluated single interventions. The most common intervention was education. Investigators measured research use using a combination of surveys (three studies and compliance with guidelines (one study. Researcher-led educational meetings were ineffective in two studies. Educational meetings led by a local opinion leader (one study and the formation of multidisciplinary committees (one study were both effective at increasing research use. Conclusion Little is known about how to increase research use in

  7. Interventions aimed at improving the ability to use everyday technology in work after brain injury.

    Science.gov (United States)

    Kassberg, Ann-Charlotte; Prellwitz, Maria; Malinowsky, Camilla; Larsson-Lund, Maria

    2016-01-01

    The aim of this study was to explore and describe how client-centred occupational therapy interventions may support and improve the ability to use everyday technology (ET) in work tasks in people with acquired brain injury (ABI). A qualitative, descriptive multiple-case study was designed, and occupation-based interventions were provided to three working-age participants with ABI. Multiple sources were used to collect data throughout the three intervention processes, including assessments, field notes, and interviews. The Canadian Occupational Performance Measure and the Management of Everyday Technology Assessment were administered before the interventions, after the interventions and at a follow-up session 2-3 months subsequent to the interventions. The three intervention processes initially consisted of similar actions, but subsequently the actions took on a different focus and intensity for each case. All of the goals in each of the three case processes were achieved, and both perceived and observed abilities to use ET in work tasks improved. Client-centred occupational therapy interventions might have the potential to improve the ability to use ET in work tasks in people with ABI.

  8. Integrated assessment of biodiesel policies aimed at family farms in Brazil

    NARCIS (Netherlands)

    Belo Leite, Dal J.G.; Nunes Vieira da Silva, J.V.; Ittersum, van M.K.

    2014-01-01

    With many of the poor people in Brazil living in rural areas, local governments have intensified their efforts to design and implement effective policies that boost rural development. In 2004, a national program for production and use of biodiesel was launched aiming at increasing income among less

  9. Interventions aimed at communities to inform and/or educate about early childhood vaccination.

    Science.gov (United States)

    Saeterdal, Ingvil; Lewin, Simon; Austvoll-Dahlgren, Astrid; Glenton, Claire; Munabi-Babigumira, Susan

    2014-11-19

    A range of strategies are used to communicate with parents, caregivers and communities regarding child vaccination in order to inform decisions and improve vaccination uptake. These strategies include interventions in which information is aimed at larger groups in the community, for instance at public meetings, through radio or through leaflets. This is one of two reviews on communication interventions for childhood vaccination. The companion review focuses on face-to-face interventions for informing or educating parents. To assess the effects of interventions aimed at communities to inform and/or educate people about vaccination in children six years and younger. We searched CENTRAL, MEDLINE, EMBASE and five other databases up to July 2012. We searched for grey literature in the Grey Literature Report and OpenGrey. We also contacted authors of included studies and experts in the field. There were no language, date or settings restrictions. Individual or cluster-randomised and quasi-randomised controlled trials, interrupted time series (ITS) and repeated measures studies, and controlled before-and-after (CBA) studies. We included interventions aimed at communities and intended to inform and/or educate about vaccination in children six years and younger, conducted in any setting. We defined interventions aimed at communities as those directed at a geographic area, and/or interventions directed to groups of people who share at least one common social or cultural characteristic. Primary outcomes were: knowledge among participants of vaccines or vaccine-preventable diseases and of vaccine service delivery; child immunisation status; and unintended adverse effects. Secondary outcomes were: participants' attitudes towards vaccination; involvement in decision-making regarding vaccination; confidence in the decision made; and resource use or cost of intervention. Two authors independently reviewed the references to identify studies for inclusion. We extracted data and

  10. An intervention programme using the ASE-model aimed at enhancing adherence in adolescents with asthma

    NARCIS (Netherlands)

    van Es, S M; Nagelkerke, A F; Colland, V T; Scholten, R J; Bouter, L M

    A randomised controlled trial, involving 112 adolescents with asthma, and a 2-year follow-up was conducted to assess the impact of an intervention programme aimed at enhancing adherence to asthma medication. This programme had a duration of 1 year and consisted of an experimental group which

  11. An intervention programme using the ASE-model aimed at enhancing adherence in adolescents with asthma

    NARCIS (Netherlands)

    van Es, S.M.; Nagelkerke, A.F.; Colland, V.T.; Scholten, R.J.P.M.; Bouter, L.M.

    2001-01-01

    A randomised controlled trial, involving 112 adolescents with asthma, and a 2-year follow-up was conducted to assess the impact of an intervention programme aimed at enhancing adherence to asthma medication. This programme had a duration of 1 year and consisted of an experimental group which

  12. RE-AIM Checklist for Integrating and Sustaining Tier 2 Social-Behavioral Interventions

    Science.gov (United States)

    Cheney, Douglas A.; Yong, Minglee

    2014-01-01

    Even though evidence-based Tier 2 programs are now more commonly available, integrating and sustaining these interventions in schools remain challenging. RE-AIM, which stands for Reach, Effectiveness, Adoption, Implementation, and Maintenance, is a public health framework used to maximize the effectiveness of health promotion programs in…

  13. Empowering employees with chronic diseases: process evaluation of an intervention aimed at job retention

    NARCIS (Netherlands)

    Varekamp, Inge; Krol, Boudien; van Dijk, Frank J. H.

    2011-01-01

    Purpose Employees with a chronic disease may experience work-related problems that contribute to the risk of job loss. We developed a group-based intervention programme aimed at clarifying problems, making these a subject of discussion at work, and realizing solutions. This process evaluation

  14. Empowering employees with chronic diseases : process evaluation of an intervention aimed at job retention

    NARCIS (Netherlands)

    Varekamp, Inge; Krol, Boudien; van Dijk, Frank J. H.

    Purpose Employees with a chronic disease may experience work-related problems that contribute to the risk of job loss. We developed a group-based intervention programme aimed at clarifying problems, making these a subject of discussion at work, and realizing solutions. This process evaluation

  15. Trade, tropical deforestation and policy interventions

    International Nuclear Information System (INIS)

    Barbier, E.B.; Rauscher, M.

    1992-01-01

    This paper examines several aspects of the links between the trade in tropical timber and deforestation from the perspective of an exporting country. The various versions of the model developed here have highlighted a number of important features of this linkage. First, if the producer country values its tropical forest solely as a source of timber export earnings then it will aim for a smaller forest stock in the long run than if it also considers the other values provided by the forest. Second, if importing nations want the exporting countries to conserve more of their forests, trade interventions appear to be second-best way of achieving this result. Third, increased market power by a large country exporter or group of exporters may actually lead to greater forest conservation. Finally, the existence of a foreign capital market may further ensure that the tropical timber country may conserve its forest stock in the long run. Several recent reviews of global forest sector policies have discussed implications similar to those analyzed theoretically in our model. Generally, the same conclusions have been reached. However, what is of increasing concern is that domestic market and policy failures within tropical forest countries continue to distort the incentives for more sustainable management of timber production and efficient development of processing capacity, while at the same time the international community increasingly contemplates the use of bans, tariffs and other trade measures to discourage 'unsustainable' tropical timber exploitation. As our paper has attempted to show, sometimes the more simple solutions lead neither to a straightforward, nor to the desired, results. 18 refs, 1 fig

  16. Cost-effectiveness of policies aimed at increasing organ donation: the case of Chile.

    Science.gov (United States)

    Domínguez, J; Harrison, R; Atal, R; Larraín, L

    2013-01-01

    In this article we present an economic evaluation of policies aimed at increasing deceased organ donation in Chile, a developing country that has low donation rates; it had 5.4 donors per million people (pmp) in 2010. Expert opinions of leading participants in donation and transplantation were analyzed, resulting in a set of local policies aimed at increasing donation rates. Using previous results of reported cost savings of increasing kidney transplantation in Chile, we estimated the net benefits of these policies, as a function of additional donors. The main problem of the Chilean system seems to be the low capability to identify potential donors and a deficit in intensive care unit (ICU) beds. Among considered policies central to increase donation are the following: increasing human and capital resources dedicated to identifying potential donors, providing ICU beds from private centers, and developing an online information system that facilitates procurement coordination and the evaluation of performance at each hospital. Our results show that there is a linear relationship between cost savings and incremental donors pmp. For example, if these policies are capable of elevating donation rates in Chile by 6 donors pmp net estimated cost savings are approximately US $1.9 million. Likewise, considering the effect on patients' quality of life, savings would amount to around $15.0 million dollars per year. Our estimates suggest that these policies have a large cost-saving potential. In fact, considering implementation costs, cost reduction is positive after 4 additional donors pmp, and increasing afterward. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Process evaluation of a tailored mobile health intervention aiming to reduce fatigue in airline pilots

    Directory of Open Access Journals (Sweden)

    Alwin van Drongelen

    2016-08-01

    Full Text Available Abstract Background MORE Energy is a mobile health intervention which aims to reduce fatigue and improve health in airline pilots. The primary objective of this process evaluation was to assess the reach, dose delivered, compliance, fidelity, barriers and facilitators, and satisfaction of the intervention. The second objective was to investigate the associations of adherence to the intervention with compliance and with participant satisfaction. Thirdly, we investigated differences between the subgroups within the target population. Methods The intervention consisted of a smartphone application, supported by a website. It provided advice on optimal light exposure, sleep, nutrition, and physical activity, tailored to flight and personal characteristics. The reach of the intervention was determined by comparing the intervention group participants and the airline pilots who did not participate. The dose delivered was defined as the total number of participants that was sent an instruction email. Objective compliance was measured through the Control Management System of the application. To determine the fidelity, an extensive log was kept throughout the intervention period. Subjective compliance, satisfaction, barriers, facilitators, and adherence were assessed using online questionnaires. Associations between the extent to which the participants applied the advice in daily life (adherence, compliance, and satisfaction were analysed as well. Finally, outcomes of participants of different age groups and haul types were compared. Results A total of 2222 pilots were made aware of the study. From this group, 502 pilots met the inclusion criteria and did agree to participate. The reach of the study proved to be 22 % and the dose delivered was 99 %. The included pilots were randomized into the intervention group (n = 251 or the control group (n = 251. Of the intervention group participants, 81 % consulted any advice, while 17 % did this during

  18. Process evaluation of a tailored mobile health intervention aiming to reduce fatigue in airline pilots.

    Science.gov (United States)

    van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; Smid, Tjabe; van der Beek, Allard J

    2016-08-26

    MORE Energy is a mobile health intervention which aims to reduce fatigue and improve health in airline pilots. The primary objective of this process evaluation was to assess the reach, dose delivered, compliance, fidelity, barriers and facilitators, and satisfaction of the intervention. The second objective was to investigate the associations of adherence to the intervention with compliance and with participant satisfaction. Thirdly, we investigated differences between the subgroups within the target population. The intervention consisted of a smartphone application, supported by a website. It provided advice on optimal light exposure, sleep, nutrition, and physical activity, tailored to flight and personal characteristics. The reach of the intervention was determined by comparing the intervention group participants and the airline pilots who did not participate. The dose delivered was defined as the total number of participants that was sent an instruction email. Objective compliance was measured through the Control Management System of the application. To determine the fidelity, an extensive log was kept throughout the intervention period. Subjective compliance, satisfaction, barriers, facilitators, and adherence were assessed using online questionnaires. Associations between the extent to which the participants applied the advice in daily life (adherence), compliance, and satisfaction were analysed as well. Finally, outcomes of participants of different age groups and haul types were compared. A total of 2222 pilots were made aware of the study. From this group, 502 pilots met the inclusion criteria and did agree to participate. The reach of the study proved to be 22 % and the dose delivered was 99 %. The included pilots were randomized into the intervention group (n = 251) or the control group (n = 251). Of the intervention group participants, 81 % consulted any advice, while 17 % did this during four weeks or more. Fidelity was 67 %. The

  19. Evaluation of a workplace intervention to promote commuter cycling: a RE-AIM analysis.

    Science.gov (United States)

    Dubuy, Veerle; De Cocker, Katrien; De Bourdeaudhuij, Ilse; Maes, Lea; Seghers, Jan; Lefevre, Johan; De Martelaer, Kristine; Cardon, Greet

    2013-06-17

    Originating from the interdisciplinary collaboration between public health and the transportation field a workplace intervention to promote commuter cycling, 'Bike to Work: cyclists are rewarded', was implemented. The intervention consisted of two cycling contests, an online loyalty program based on earning 'cycling points' and the dissemination of information through folders, newsletters, posters and a website. The study purpose was to evaluate the dissemination efforts of the program and to gain insights in whether free participation could persuade small and middle-sized companies to sign up. The RE-AIM framework was used to guide the evaluation. Two months after the start of the intervention a questionnaire was send to 4880 employees. At the end of the intervention each company contact person (n = 12) was interviewed to obtain information on adoption, implementation and maintenance.Comparison analyses between employees aware and unaware of the program were conducted using independent-samples t-tests for quantitative data and chi-square tests for qualitative data. Difference in commuter cycling frequency was assessed using an ANOVA test. Non-parametric tests were used for the comparison analyses between the adopting and non-adopting companies. In total seven of the twelve participating companies adopted the program and all adopting companies implemented all intervention components. No significant differences were found in the mean number of employees (p = 0.15) or in the type of business sector (p = 0.92) between adopting and non-adopting companies. Five out of seven companies had the intention to continue the program. At the individual level, a project awareness of 65% was found. Employees aware of the program had a significantly more positive attitude towards cycling and reported significantly more commuter cycling than those unaware of the program (both p sustainability of the intervention is needed.

  20. Process evaluation of a workplace health promotion intervention aimed at improving work engagement and energy balance.

    Science.gov (United States)

    van Berkel, Jantien; Boot, Cécile R L; Proper, Karin I; Bongers, Paulien M; van der Beek, Allard J

    2013-01-01

    To evaluate the process of the implementation of an intervention aimed at improving work engagement and energy balance, and to explore associations between process measures and compliance. Process measures were assessed using a combination of quantitative and qualitative methods. The mindfulness training was attended at least once by 81.3% of subjects, and 54.5% were highly compliant. With regard to e-coaching and homework exercises, 6.3% and 8.0%, respectively, were highly compliant. The training was appreciated with a 7.5 score and e-coaching with a 6.8 score. Appreciation of training and e-coaching, satisfaction with trainer and coach, and practical facilitation were significantly associated with compliance. The intervention was implemented well on the level of the mindfulness training, but poorly on the level of e-coaching and homework time investment. To increase compliance, attention should be paid to satisfaction and trainer-participant relationship.

  1. Impact of school-based health promotion interventions aimed at different behavioral domains: a systematic review.

    Science.gov (United States)

    Lima-Serrano, Marta; Lima-Rodríguez, Joaquín S

    2014-01-01

    Given that lifestyleshave similar determinants and that school-based interventions are usually targeted at all the risks that affect adolescents, the objective of this systematic review was to summarize the characteristics and effects of school-based interventions acting on different behavioral domains of adolescent health promotion. The review process was conducted by two independent reviewers who searched PubMed, Scopus, PsycINFO, and ERIC databases for experimental or observational studies with at least two measures of results published from 2007 to 2011, given that the research information available doubles every 5 years. Methodological quality was assessed with a standardized tool. Information was extracted from 35 studies aiming to prevent risk behaviors and promote healthy nutrition, physical activity, and mental and holistic health. Activities were based on theoretical models and were classified into interactive lessons, peer mediation, environmental changes, parents' and community activities, and tailored messages by computer-assisted training or other resources, usually including multiple components. In some cases, we identified some moderate to large, short- and long-term effects on behavioral and intermediate variable. This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. Empowering employees with chronic diseases: process evaluation of an intervention aimed at job retention.

    Science.gov (United States)

    Varekamp, Inge; Krol, Boudien; van Dijk, Frank J H

    2011-01-01

    Employees with a chronic disease may experience work-related problems that contribute to the risk of job loss. We developed a group-based intervention programme aimed at clarifying problems, making these a subject of discussion at work, and realizing solutions. This process evaluation investigates the intervention's feasibility and the satisfaction of 64 participants in eight groups. Data were collected through process evaluation forms and self-report questionnaires. The recruitment of participants was time-consuming. Highly educated women working in the service sector were overrepresented. The programme was administered as planned, although components were sometimes only discussed briefly, due to lack of time. Satisfaction with the overall programme among participants was high; it was perceived as effective and there were only three dropouts. In particular, the focus on feelings and thoughts about having a chronic disease was highly valued, as were the exchange of experiences and role-playing directed at more assertive communication. A vocational rehabilitation programme aimed at job retention is feasible and is perceived to be effective. Such a programme should address psychosocial aspects of working with a chronic disease beside practical problems. The recruitment of participants is time-consuming. Cooperation with outpatient clinics is necessary in order to reach all groups of employees with a chronic disease that might benefit from job retention programmes. ISRCTN77240155.

  3. Intervention Policies on Domestic Violence Against Women

    Directory of Open Access Journals (Sweden)

    Antonio Henrique Graciano Suxberger

    2016-10-01

    Full Text Available The article highlights multidisciplinary policies on gender based violence, acoording to the Maria da Penha Statute. It considers the context after the legal prohibition of probation during the criminal prosecution. From a literature review and document analysis, specially on researches conducted on the subject, the article sustains the importance of multidisciplinary actions combined or dissociated to formal criminal responses and focus the need of interventions considering the aggressors as well the victims, in order to assure a preventive efficiency regarding future cases of domestic violence against women.

  4. Effective Interventions Aimed at Reaching Out-of-School Children: A Literature Review

    Science.gov (United States)

    Shanker, Ashim; Marian, Diana; Swimmer, Christopher

    2015-01-01

    This paper aggregates the academic literature reviewing and reporting interventions for out-of-school children (OOSC) around the world to serve as a guide for potential interventions in South Asia and elsewhere. It complements the Global Initiative on Out-of-School Children (OOSCI) South Asia Regional Study (2014). Thus the interventions reviewed…

  5. Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries

    NARCIS (Netherlands)

    Spitters, H.P.E.M.; van Oers, J.A.M.; Sandu, P.; Lau, C.J.; Quanjel, M.; Dulf, D.; Chereches, R.; van de Goor, L.A.M.

    2017-01-01

    Background: One of the key elements to enhance the uptake of evidence in public health policies is stimulating cross-sector collaboration. An intervention stimulating collaboration is a policy game. The aim of this study was to describe the design and methods of the development process of the policy

  6. RE-AIM Analysis of a School-Based Nutrition Education Intervention in Kindergarteners

    Science.gov (United States)

    Larsen, Andrew L.; Liao, Yue; Alberts, Janel; Huh, Jimi; Robertson, Trina; Dunton, Genevieve F.

    2017-01-01

    Background: Few nutrition interventions in kindergarten classes have been evaluated, and none has been tested for program effectiveness, implementation, and dissemination. Building a Healthy Me (BHM) is a nutrition intervention for kindergarteners that is classroom-based and includes a family component. This study evaluated the public health…

  7. Impact of school-based health promotion interventions aimed at different behavioral domains: a systematic review

    Directory of Open Access Journals (Sweden)

    Marta Lima-Serrano

    2014-09-01

    Conclusions: This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed.

  8. From the point-of-purchase perspective: a qualitative study of the feasibility of interventions aimed at portion-size

    NARCIS (Netherlands)

    Vermeer, W.M.; Steenhuis, I.H.M.; Seidell, J.C.

    2009-01-01

    Objectives: Food portion-sizes might be a promising starting point for interventions targeting obesity. The purpose of this qualitative study was to assess how representatives of point-of-purchase settings perceived the feasibility of interventions aimed at portion-size. Methods: Semi-structured

  9. The process evaluation of two interventions aimed at portion size in worksite cafeterias.

    NARCIS (Netherlands)

    Vermeer, W.M.; Leeuwis, F.H.; Koprulu, S.; Zouitni, O.; Seidell, J.C.; Steenhuis, I.H.M.

    2012-01-01

    Background: In a previous study, the effectiveness of introducing a small meal in addition to the existing size and a proportional pricing strategy have been assessed in Dutch worksite cafeterias. To assess the degree of implementation and to inform the design of future interventions, the present

  10. Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic

    DEFF Research Database (Denmark)

    Rask, Mette Trøllund; Jensen, Mette Lund; Andersen, Jørn

    2009-01-01

    skills training program in nursing cancer care. Twenty-four nurses in an oncology outpatient clinic participated and were randomly assigned to the intervention program or a control group. A total of 413 patients treated in the clinic during 2 recruitment periods (before and after the communication skills...

  11. HIV and AIDS workplace interventions; Gaps between policy and ...

    African Journals Online (AJOL)

    Introduction This study set out to identify gaps between policy and practice of HIV and AIDS workplace interventions in the University of Malawi, in particular College of Medicine in line with the UNIMA HIV and AIDS policy. Objectives The main objective was to establish whether the HIV and AIDS workplace interventions at ...

  12. Policies and interventions on employment relations and health inequalities.

    Science.gov (United States)

    Quinlan, Michael; Muntaner, Carles; Solar, Orielle; Vergara, Montserrat; Eijkemans, Gerry; Santana, Vilma; Chung, Haejoo; Castedo, Antía; Benach, Joan

    2010-01-01

    The association between certain increasingly pervasive employment conditions and serious health inequalities presents a significant policy challenge. A critical starting point is the recognition that these problems have not arisen in a policy vacuum. Rather, policy frameworks implemented by governments over the past 35 years, in conjunction with corporate globalization (itself facilitated by neoliberal policies), have undermined preexisting social protection policies and encouraged the growth of health-damaging forms of work organization. After a brief description of the context in which recent developments should be viewed, this article describes how policies can be reconfigured to address health-damaging employment conditions. A number of key policy objectives and entry points are identified, with a summary of policies for each entry point, relating to particular employment conditions relevant to rich and poor countries. Rather than trying to elaborate these policy interventions in detail, the authors point to several critical issues in relation to these interventions, linking these to illustrative examples.

  13. The Conflicting Aims of the European Neighborhood Policy and its Secondary Effects

    DEFF Research Database (Denmark)

    Castan Pinos, Jaume

    2014-01-01

    to guarantee the security of Europe’s borders. The European Neighborhood Policy has played a pivotal role in ensuring that the neighbors complied with the EU’s interest by offering political and economic rewards. Compliance is also enhanced through the “Seville Doctrine.” The paper challenges the idea...... that the “war on migrants” is a common shared interest for the EU and North African states, arguing that it is rather an EU security interest which does not necessarily correspond with the neighbors priorities. Finally, the paper focuses on the implementation of externalization in Morocco and critically...... analyzes the non-desired secondary effects generated by the adoption of EU-made migration policies....

  14. Making the case for change: What researchers need to consider when designing behavior change interventions aimed at improving medication dispensing.

    Science.gov (United States)

    Cadogan, Cathal A; Ryan, Cristín; Hughes, Carmel

    2016-01-01

    There is a growing emphasis on behavior change in intervention development programmes aimed at improving public health and healthcare professionals' practice. A number of frameworks and methodological tools have been established to assist researchers in developing interventions seeking to change healthcare professionals' behaviors. The key features of behavior change intervention design involve specifying the target group (i.e. healthcare professional or patient cohort), the target behavior and identifying mediators (i.e. barriers and facilitators) of behavior change. Once the target behavior is clearly specified and understood, specific behavior change techniques can then be used as the basis of the intervention to target identified mediators of behavior change. This commentary outlines the challenges for pharmacy practice-based researchers in targeting dispensing as a behavior when developing behavior change interventions aimed at pharmacists and proposes a definition of dispensing to consider in future research. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Feasibility of a transition intervention aimed at adolescents with chronic illness

    DEFF Research Database (Denmark)

    Hanghøj, Signe; Boisen, Kirsten A; Schmiegelow, Kjeld

    2018-01-01

    BACKGROUND: International guidelines recommend planned and structured transition programmes for adolescents with chronic illness because inadequate transition may lead to poor disease control and risk of lacking outpatient follow-up. OBJECTIVE: To investigate the feasibility of a transition...... intervention. Reasons for decline and drop-outs were calculated. Adolescents' experiences of advantages and disadvantages of participating and reasons for no-shows were investigated through focus groups and telephone interviews, which were analysed using thematic analysis. RESULTS: One hundred and twenty...

  16. Governmentality and Relations of Inclusion/Exclusion: Social Intervention Devices Aimed at Immigrant Women in Spain

    OpenAIRE

    Galaz Valderrama, Caterine Joanna; Trabajo Social Universidad de Chile; Montenegro Martínez, Marisela; Universidad Autónoma de Barcelona

    2016-01-01

    International migration has emerged, in contemporary European societies, as an area of concern for control and governmentality processes, by means of its definition as a “social problem” that must be addressed by public organisms. Different laws, regulations, discourses, plans and intervention processes emerge from the need to manage these populations, generating as main effect the reproduction and solidification of power relations in host societies. Departing from different researches develo...

  17. The Netherlands and Liberia : Dutch policies and interventions with respect to the Liberian civil war

    NARCIS (Netherlands)

    Walraven, van K.

    1999-01-01

    This study analyses Dutch foreign policy towards Liberia during the civil war between 1990 and 1997 with the aim of identifying policy options for the improvement of the Dutch contribution to international interventions in violent conflicts in Third World countries. An introductory chapter on

  18. An Evaluation Framework for Obesity Prevention Policy Interventions

    Science.gov (United States)

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

    2012-01-01

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

  19. Organ and tissue donation in clinical settings: a systematic review of the impact of interventions aimed at health professionals

    Science.gov (United States)

    2014-01-01

    In countries where presumed consent for organ donation does not apply, health professionals (HP) are key players for identifying donors and obtaining their consent. This systematic review was designed to verify the efficacy of interventions aimed at HPs to promote organ and tissue donation in clinical settings. CINAHL (1982 to 2012), COCHRANE LIBRARY, EMBASE (1974 to 2012), MEDLINE (1966 to 2012), PsycINFO (1960 to 2012), and ProQuest Dissertations and Theses were searched for papers published in French or English until September 2012. Studies were considered if they met the following criteria: aimed at improving HPs’ practices regarding the donation process or at increasing donation rates; HPs working in clinical settings; and interventions with a control group or pre-post assessments. Intervention behavioral change techniques were analyzed using a validated taxonomy. A risk ratio was computed for each study having a control group. A total of 15 studies were identified, of which only 5 had a control group. Interventions were either educational, organizational or a combination of both, and had a weak theoretical basis. The most common behavior change technique was providing instruction. Two sets of interventions showed a significant risk ratio. However, most studies did not report the information needed to compute their efficacy. Therefore, interventions aimed at improving the donation process or at increasing donation rates should be based on sound theoretical frameworks. They would benefit from more rigorous evaluation methods to ensure good knowledge translation and appropriate organizational decisions to improve professional practices. PMID:24628967

  20. After the Conference of United Nations Conference on Environment and Development. The aims of the state environmental policy

    International Nuclear Information System (INIS)

    1996-01-01

    Total 162 aims of the Strategy of the state environmental policy and next followed programs, projects and measures of the environmental policy of the Slovak Republic can be grouped into 4 blocks: (1) the environmental policy in the protection of air, water and before of risk factors, in the nuclear safety and waste economy (environmental safety; (2) the environmental policy in protection of the nature and the country, protection and use of mineral surroundings, soils and forest;; (3) the environmental policy in the economy; (4) the environmental policy in the guidance, education, public information, organization, control and coordination of the ministration on the environment. These aims are grouped into 10 sectors: Sector A - Protection of the air and ozone layer; Sector B - Protection and rationalize waters use; Sector C - Waste economy; Sector D - Risk factors and nuclear safety; Sector E - The ministration on the nature and the country and land development; Sector F - The protection and using of mineral surroundings, soils and forest; Sector G - The economy of the environment; Sector H - Environmental information science and monitoring; Sector I - Environmental guidance, education, and promotion; Sector J - Organization and control of the ministration on the environment

  1. Physical activity interventions to promote positive youth development among indigenous youth: a RE-AIM review.

    Science.gov (United States)

    Baillie, Colin P T; Galaviz, Karla I; Emiry, Kevin; Bruner, Mark W; Bruner, Brenda G; Lévesque, Lucie

    2017-03-01

    Physical activity (PA) programs are a promising strategy to promote positive youth development (PYD). It is not known if published reports provide sufficient information to promote the implementation of effective PYD in indigenous youth. The purpose of this study was to assess the extent to which published literature on PA programs that promote PYD in indigenous youth report on RE-AIM (reach, effectiveness, adoption, implementation, maintenance) indicators. A systematic literature search was conducted to identify articles reporting on PA programs that promote PYD in indigenous youth. The search yielded 8084 articles. A validated 21-item RE-AIM abstraction tool assessing internal and external validity factors was used to extract data from 10 articles meeting eligibility criteria. The most commonly reported dimensions were effectiveness (73 %), adoption (48 %), and maintenance (43 %). Reach (34 %) and implementation (30 %) were less often reported. Published research provides insufficient information to inform real-world implementation of PA programs to promote PYD in indigenous youth.

  2. Evaluation of a Theory-Based Intervention Aimed at Improving Coaches' Recommendations on Sports Nutrition to Their Athletes.

    Science.gov (United States)

    Jacob, Raphaëlle; Lamarche, Benoît; Provencher, Véronique; Laramée, Catherine; Valois, Pierre; Goulet, Claude; Drapeau, Vicky

    2016-08-01

    Coaches are a major source of nutrition information and influence for young athletes. Yet, most coaches do not have training in nutrition to properly guide their athletes. The aim of this study was to evaluate the effectiveness of an intervention aimed at improving the accuracy of coaches' recommendations on sports nutrition. This was a quasi-experimental study with a comparison group and an intervention group. Measurements were made at baseline, post-intervention, and after a 2-month follow-up period. Coaches' recommendations on sports nutrition during the follow-up period were recorded in a diary. High school coaches from various sports (n=41) were randomly assigned to a comparison group or an intervention group. Both groups attended two 90-minute sessions of a theory-based intervention targeting determinants of coaches' intention to provide recommendations on sports nutrition. The intervention group further received an algorithm that summarizes sports nutrition guidelines to help promote decision making on sports nutrition recommendations. Nutrition knowledge and accuracy of coaches' recommendations on sports nutrition. χ(2) analyses and t-tests were used to compare baseline characteristics; mixed and general linear model analyses were used to assess the change in response to the intervention and differences in behaviors, respectively. Coaches in the intervention vs comparison group provided more nutrition recommendations during the 2-month post-intervention period (mean number of recommendations per coach 25.7±22.0 vs 9.4±6.5, respectively; P=0.004) and recommendations had a greater accuracy (mean number of accurate recommendations per coach 22.4±19.9 [87.1%] vs 4.3±3.2 [46.1%], respectively; Psports nutrition knowledge level over time and helped them to provide more accurate recommendations on sports nutrition. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  3. Effects of a Randomized Reading Intervention Study Aimed at 9-Year-Olds: A 5-Year Follow-up.

    Science.gov (United States)

    Wolff, Ulrika

    2016-05-01

    The present paper reports on a 5-year follow-up of a randomized reading intervention in grade 3 in Sweden. An intervention group (n = 57) received daily training for 12 weeks in phoneme/grapheme mapping, reading comprehension and reading speed, whereas a control group (n = 55) participated in ordinary classroom activities. The main aim was to investigate if there were remaining effects of the intervention on reading-related skills. Previous analyses showed that the intervention group performed significantly better than the control group on spelling, reading speed, reading comprehension and phoneme awareness at the immediate post-test with sustained effects 1 year later. Results from the 5-year follow-up show that the only significant difference between the intervention (n = 47) and the control group (n = 37) was on word decoding. There was also a significant interaction effect of group assignment and initial word decoding, in the way that the lowest-performing students benefitted the most from the intervention. Another aim was to examine if the children identified in a screening (n = 2212) as poor readers in grade 2 still performed worse than typical readers. The analyses showed that the typically developing students (n = 66) outperformed the students identified as poor readers in grade 2 on working memory, spelling, reading comprehension and word decoding. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Empowering employees with chronic diseases; development of an intervention aimed at job retention and design of a randomised controlled trial

    NARCIS (Netherlands)

    Varekamp, Inge; de Vries, Gabe; Heutink, Annelies; van Dijk, Frank J. H.

    2008-01-01

    ABSTRACT: BACKGROUND: Persons with a chronic disease are less often employed than healthy persons. If employed, many of them experience problems at work. Therefore, we developed a training programme aimed at job retention. The objective of this paper is to describe this intervention and to present

  5. Does tailoring really make a difference? : the development and evaluation of tailored interventions aimed at benzodiazepine cessation

    NARCIS (Netherlands)

    Wolde, Geeske Brecht ten

    2008-01-01

    Because of the problems associated with chronic benzodiazepine use, there is impetus to prevent and reduce chronic benzodiazepine use. The overall aim was to develop a 'tailor-made' intervention in order to reduce chronic use. Before developing tailored patient education, it is first of all

  6. Servicom policy intervention: Improving service quality in Nigerian ...

    African Journals Online (AJOL)

    In this case study we examine the raison d'être and implementation of a policy intervention, which was promulgated in 2005 for the purpose of eradicating inefficiency and corruption, and inculcating customer orientation in the Nigerian public sector. The policy goes by the acronym 'SERVICOM' -'service compact with all ...

  7. From the point-of-purchase perspective: a qualitative study of the feasibility of interventions aimed at portion-size.

    Science.gov (United States)

    Vermeer, Willemijn M; Steenhuis, Ingrid H M; Seidell, Jacob C

    2009-04-01

    Food portion-sizes might be a promising starting point for interventions targeting obesity. The purpose of this qualitative study was to assess how representatives of point-of-purchase settings perceived the feasibility of interventions aimed at portion-size. Semi-structured interviews were conducted with 22 representatives of various point-of-purchase settings. Constructs derived from the diffusion of innovations theory were incorporated into the interview guide. Each interview was recorded and transcribed verbatim. Data were coded and analysed with Atlas.ti 5.2 using the framework approach. According to the participants, offering a larger variety of portion-sizes had the most relative advantages, and reducing portions was the most disadvantageous. The participants also considered portion-size reduction and linear pricing of portion-sizes to be risky. Lastly, a larger variety of portion-sizes, pricing strategies and portion-size labelling were seen as the most complex interventions. In general, participants considered offering a larger variety of portion-sizes, portion-size labelling and, to a lesser extent, pricing strategies with respect to portion-sizes as most feasible to implement. Interventions aimed at portion-size were seen as innovative by most participants. Developing adequate communication strategies about portion-size interventions with both decision-makers in point-of-purchase settings and the general public is crucial for successful implementation.

  8. Mixed method evaluation of the Virtual Traveller physically active lesson intervention: An analysis using the RE-AIM framework.

    Science.gov (United States)

    Norris, E; Dunsmuir, S; Duke-Williams, O; Stamatakis, E; Shelton, N

    2018-02-02

    Physically active lessons integrating movement into academic content are a way to increase children's physical activity levels. Virtual Traveller was a physically active lesson intervention set in Year 4 (aged 8-9) primary school classes in Greater London, UK. Implemented by classroom teachers, it was a six-week intervention providing 10-min physically active Virtual Field Trips three times a week. The aim of this paper is to report the process evaluation of the Virtual Traveller randomized controlled trial according to RE-AIM framework criteria (Reach, Effectiveness, Adoption, Implementation and Maintenance). A mixed methods approach to evaluation was conducted with five intervention group classes. Six sources of data were collected via informed consent logs, teacher session logs, teacher and pupil questionnaires, teacher interviews and pupil focus groups. High participation and low attrition rates were identified (Reach) alongside positive evaluations of Virtual Traveller sessions from pupil and teachers (Effectiveness). Participants were from more deprived and ethnic backgrounds than local and national averages, with Virtual Traveller having the potential to be a free intervention (Adoption). 70% of sessions were delivered overall (Implementation) but no maintenance of the programme was evident at three month follow-up (Maintenance). Mixed method evaluation of Virtual Traveller showed potential for it to be implemented as a low-cost physically active lesson intervention in UK primary schools. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Efficiency of environmental policies aiming at fostering the adoption of new technologies: the case of renewable energies

    International Nuclear Information System (INIS)

    Lamy, M.L.

    2004-10-01

    This thesis aims to study the efficiency of promotion policies of renewable energies in electric power production taking into account the environment economy problems. The techniques at a commercial scale are particularly discussed. The first part deals with the incitement to technical progress in favor of the environmental protection. The second part proposes an empirical analysis based on the efficiency economical parameters and the last part analyses theoretically the efficiency of promotion tools of renewable energies. (A.L.B.)

  10. Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries.

    Science.gov (United States)

    Spitters, H P E M; van Oers, J A M; Sandu, P; Lau, C J; Quanjel, M; Dulf, D; Chereches, R; van de Goor, L A M

    2017-12-19

    One of the key elements to enhance the uptake of evidence in public health policies is stimulating cross-sector collaboration. An intervention stimulating collaboration is a policy game. The aim of this study was to describe the design and methods of the development process of the policy game ‘In2Action’ within a real-life setting of public health policymaking networks in the Netherlands, Denmark and Romania. The development of the policy game intervention consisted of three phases, pre intervention, designing the game intervention and tailoring the intervention. In2Action was developed as a role-play game of one day, with main focus to develop in collaboration a cross-sector implementation plan based on the approved strategic local public health policy. This study introduced an innovative intervention for public health policymaking. It described the design and development of the generic frame of the In2Action game focusing on enhancing collaboration in local public health policymaking networks. By keeping the game generic, it became suitable for each of the three country cases with only minor changes. The generic frame of the game is expected to be generalizable for other European countries to stimulate interaction and collaboration in the policy process.

  11. A mixed methods process evaluation of the implementation of JUMP-in, a multilevel school-based intervention aimed at physical activity promotion.

    Science.gov (United States)

    de Meij, Judith S B; van der Wal, Marcel F; van Mechelen, Willem; Chinapaw, Mai J M

    2013-09-01

    The aim of the present study was to investigate factors influencing the adoption, implementation, and institutionalization process of JUMP-in-a multilevel school-based physical activity promotion program-to optimize the dissemination of the intervention and improve its effectiveness. The process evaluation concerned the constraints and success and failure factors at sociopolitical, organizational, user, and intervention levels. A mixed methods approach including qualitative and quantitative data was conducted during two school years (2006-2008). JUMP-in was successfully embedded in the Amsterdam municipal policy and in the organizational structure and daily practices of the sectors involved. A general impeding factor was the complexity of the multilevel programme requiring multidisciplinary collaboration between organizations. In addition, there was a discrepancy between the recommendation to standardize and simplify the innovation and the need to tailor the strategies to local environmental, social, and cultural aspects. This process evaluation provides challenges and remedies for managing discrepancies between prerequisites for an effective innovation and demands of daily implementation practice. The main recommendations are (a) standardized, simplified guidelines; (b) stepwise implementation; (c) formalized coalitions, integration of policy, and synchronization of tasks and protocols; and (d) smart planning and control by clear communication and feedback instruments. If these recommendations are incorporated into the JUMP-in intervention and organization, increased effectiveness and long-term effects can be expected.

  12. The feasibility of multisectoral policy options aimed at reducing trans fats and encouraging its replacement with healthier oils in India.

    Science.gov (United States)

    Downs, Shauna M; Thow, Anne-Marie; Ghosh-Jerath, Suparna; Leeder, Stephen R

    2015-05-01

    The World Health Organization recommends replacement of trans fat with polyunsaturated fat to reduce cardiovascular disease risk. Although several high-income countries have been successful in reducing trans fat in the food supply, low- and middle-income countries such as India may face additional contextual challenges such as the large informal sector, lack of consumer awareness, less enforcement capacity and low availability and affordability of healthier unsaturated fats. The objective of this study was to examine the feasibility and acceptability of multisectoral policy options aimed at supporting trans fat reduction and its replacement with polyunsaturated fats in India. Multisectoral policy options examined in this study were identified using food supply chain analysis. Semi-structured interviews (n = 17) were conducted with key informants from agriculture, trade, finance, retail, industry, food standards, non-governmental organizations and the health professions to gain their views on the feasibility and acceptability of the policy options. Purposive sampling was used to identify key informants. Data were coded and organized based on key themes. There was support for policies aimed at improving the quality of seeds, supporting farmer co-operatives and developing affordable farming equipment suited to smallholders to improve the production of healthier oils. Increasing the role of the private sector to improve links among producers, processors and retailers may help to streamline the fats supply chain in India. Blending healthier oils with oils high in saturated fat, which are currently readily available, could help to improve the quality of fat in the short term. Improving consumer awareness through mass media campaigns and improved labelling may help increase consumer demand for healthier products. Reorienting agricultural policies to support production of healthier oils will help increase their uptake by industry. Policy coherence across sectors will be

  13. An implementation evaluation of a policy aiming to improve financial access to maternal health care in Djibo district, Burkina Faso

    Directory of Open Access Journals (Sweden)

    Belaid Loubna

    2012-12-01

    Full Text Available Abstract Background To bring down its high maternal mortality ratio, Burkina Faso adopted a national health policy in 2007 that designed to boost the assisted delivery rate and improving quality of emergency obstetrical and neonatal care. The cost of transportation from health centres to district hospitals is paid by the policy. The worst-off are exempted from all fees. Methods The objectives of this paper are to analyze perceptions of this policy by health workers, assess how this health policy was implemented at the district level, identify difficulties faced during implementation, and highlight interactional factors that have an influence on the implementation process. A multiple site case study was conducted at 6 health centres in the district of Djibo in Burkina Faso. The following sources of data were used: 1 district documents (n = 23; 2 key interviews with district health managers (n = 10, health workers (n = 16, traditional birth attendants (n = 7, and community management committees (n = 11; 3 non-participant observations in health centres; 4 focus groups in communities (n = 62; 5 a feedback session on the findings with 20 health staff members. Results All the activities were implemented as planned except for completely subsidizing the worst-off, and some activities such as surveys for patients and the quality assurance service team aiming to improve quality of care. District health managers and health workers perceived difficulties in implementing this policy because of the lack of clarity on some topics in the guidelines. Entering the data into an electronic database and the long delay in reimbursing transportation costs were the principal challenges perceived by implementers. Interactional factors such as relations between providers and patients and between health workers and communities were raised. These factors have an influence on the implementation process. Strained relations between the groups involved

  14. An implementation evaluation of a policy aiming to improve financial access to maternal health care in Djibo district, Burkina Faso.

    Science.gov (United States)

    Belaid, Loubna; Ridde, Valéry

    2012-12-08

    To bring down its high maternal mortality ratio, Burkina Faso adopted a national health policy in 2007 that designed to boost the assisted delivery rate and improving quality of emergency obstetrical and neonatal care. The cost of transportation from health centres to district hospitals is paid by the policy. The worst-off are exempted from all fees. The objectives of this paper are to analyze perceptions of this policy by health workers, assess how this health policy was implemented at the district level, identify difficulties faced during implementation, and highlight interactional factors that have an influence on the implementation process. A multiple site case study was conducted at 6 health centres in the district of Djibo in Burkina Faso. The following sources of data were used: 1) district documents (n = 23); 2) key interviews with district health managers (n = 10), health workers (n = 16), traditional birth attendants (n = 7), and community management committees (n = 11); 3) non-participant observations in health centres; 4) focus groups in communities (n = 62); 5) a feedback session on the findings with 20 health staff members. All the activities were implemented as planned except for completely subsidizing the worst-off, and some activities such as surveys for patients and the quality assurance service team aiming to improve quality of care. District health managers and health workers perceived difficulties in implementing this policy because of the lack of clarity on some topics in the guidelines. Entering the data into an electronic database and the long delay in reimbursing transportation costs were the principal challenges perceived by implementers. Interactional factors such as relations between providers and patients and between health workers and communities were raised. These factors have an influence on the implementation process. Strained relations between the groups involved may reduce the effectiveness of the policy

  15. The effect of interventions aiming to optimise the prescription of antibiotics in dental care-A systematic review.

    Science.gov (United States)

    Löffler, Christin; Böhmer, Femke

    2017-01-01

    Abundant evidence in dentistry suggests that antibiotics are prescribed despite the existence of guidelines aiming to reduce the development of antibiotic resistance. This review investigated (1) which type of interventions aiming to optimise prescription of antibiotics exist in dentistry, (2) the effect of these interventions and (3) the specific strengths and limitations of the studies reporting on these interventions. Literature search was based on Medline, Embase, Global Health, Cochrane CENTRAL, ClinicalTrials.gov and Current Controlled Trials. Studies with one of the two primary outcomes were included: (1) The number of antibiotics prescribed and/or (2) the accuracy of the prescription, commonly measured as a percentage of adherence to local clinical guidelines. Nine studies met these inclusion criteria. Five studies reported on the prescription of antibiotics in primary dental care and four studies focused on outpatient dental care. Interventions used in primary dental care included a combination of audit, feedback, education, local consensus, dissemination of guidelines and/or academic detailing. Trials in the outpatient setting made use of expert panel discussions, educational feedback on previous acts of prescribing, the dissemination of guidelines and the establishment of internal guidelines. All studies successfully reduced the number of antibiotics prescribed and/or increased the accuracy of the prescription. However, most studies were confounded by a high risk of selection bias, selective outcome reporting and high variance across study groups. In particular, information relating to study design and methodology was insufficient. Only three studies related the prescriptions to the number of patients treated with antibiotics. This systematic review was able to offer conclusions which took the limitations of the investigated studies into account. Unfortunately, few studies could be included and many of these studies were confounded by a low quality of

  16. The effect of interventions aiming to optimise the prescription of antibiotics in dental care-A systematic review.

    Directory of Open Access Journals (Sweden)

    Christin Löffler

    Full Text Available Abundant evidence in dentistry suggests that antibiotics are prescribed despite the existence of guidelines aiming to reduce the development of antibiotic resistance. This review investigated (1 which type of interventions aiming to optimise prescription of antibiotics exist in dentistry, (2 the effect of these interventions and (3 the specific strengths and limitations of the studies reporting on these interventions.Literature search was based on Medline, Embase, Global Health, Cochrane CENTRAL, ClinicalTrials.gov and Current Controlled Trials. Studies with one of the two primary outcomes were included: (1 The number of antibiotics prescribed and/or (2 the accuracy of the prescription, commonly measured as a percentage of adherence to local clinical guidelines.Nine studies met these inclusion criteria. Five studies reported on the prescription of antibiotics in primary dental care and four studies focused on outpatient dental care. Interventions used in primary dental care included a combination of audit, feedback, education, local consensus, dissemination of guidelines and/or academic detailing. Trials in the outpatient setting made use of expert panel discussions, educational feedback on previous acts of prescribing, the dissemination of guidelines and the establishment of internal guidelines. All studies successfully reduced the number of antibiotics prescribed and/or increased the accuracy of the prescription. However, most studies were confounded by a high risk of selection bias, selective outcome reporting and high variance across study groups. In particular, information relating to study design and methodology was insufficient. Only three studies related the prescriptions to the number of patients treated with antibiotics.This systematic review was able to offer conclusions which took the limitations of the investigated studies into account. Unfortunately, few studies could be included and many of these studies were confounded by a low

  17. Value of Information Analysis Applied to the Economic Evaluation of Interventions Aimed at Reducing Juvenile Delinquency: An Illustration.

    Directory of Open Access Journals (Sweden)

    Hester V Eeren

    Full Text Available To investigate whether a value of information analysis, commonly applied in health care evaluations, is feasible and meaningful in the field of crime prevention.Interventions aimed at reducing juvenile delinquency are increasingly being evaluated according to their cost-effectiveness. Results of cost-effectiveness models are subject to uncertainty in their cost and effect estimates. Further research can reduce that parameter uncertainty. The value of such further research can be estimated using a value of information analysis, as illustrated in the current study. We built upon an earlier published cost-effectiveness model that demonstrated the comparison of two interventions aimed at reducing juvenile delinquency. Outcomes were presented as costs per criminal activity free year.At a societal willingness-to-pay of €71,700 per criminal activity free year, further research to eliminate parameter uncertainty was valued at €176 million. Therefore, in this illustrative analysis, the value of information analysis determined that society should be willing to spend a maximum of €176 million in reducing decision uncertainty in the cost-effectiveness of the two interventions. Moreover, the results suggest that reducing uncertainty in some specific model parameters might be more valuable than in others.Using a value of information framework to assess the value of conducting further research in the field of crime prevention proved to be feasible. The results were meaningful and can be interpreted according to health care evaluation studies. This analysis can be helpful in justifying additional research funds to further inform the reimbursement decision in regard to interventions for juvenile delinquents.

  18. Public health economic evaluation of different European Union-level policy options aimed at reducing population dietary trans fat intake.

    Science.gov (United States)

    Martin-Saborido, Carlos; Mouratidou, Theodora; Livaniou, Anastasia; Caldeira, Sandra; Wollgast, Jan

    2016-11-01

    The adverse relation between dietary trans fatty acid (TFA) intake and coronary artery disease risk is well established. Many countries in the European Union (EU) and worldwide have implemented different policies to reduce the TFA intake of their populations. The aim of this study was to assess the added value of EU-level action by estimating the cost-effectiveness of 3 possible EU-level policy measures to reduce population dietary TFA intake. This was calculated against a reference situation of not implementing any EU-level policy (i.e., by assuming only national or self-regulatory measures). We developed a mathematical model to compare different policy options at the EU level: 1) to do nothing beyond the current state (reference situation), 2) to impose mandatory TFA labeling of prepackaged foods, 3) to seek voluntary agreements toward further reducing industrially produced TFA (iTFA) content in foods, and 4) to impose a legislative limit for iTFA content in foods. The model indicated that to impose an EU-level legal limit or to make voluntary agreements may, over the course of a lifetime (85 y), avoid the loss of 3.73 and 2.19 million disability-adjusted life-years (DALYs), respectively, and save >51 and 23 billion euros when compared with the reference situation. Implementing mandatory TFA labeling can also avoid the loss of 0.98 million DALYs, but this option incurs more costs than it saves compared with the reference option. The model indicates that there is added value of an EU-level action, either via a legal limit or through voluntary agreements, with the legal limit option producing the highest additional health benefits. Introducing mandatory TFA labeling for the EU common market may provide some additional health benefits; however, this would likely not be a cost-effective strategy.

  19. Empowering employees with chronic diseases; development of an intervention aimed at job retention and design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Heutink Annelies

    2008-11-01

    Full Text Available Abstract Background Persons with a chronic disease are less often employed than healthy persons. If employed, many of them experience problems at work. Therefore, we developed a training programme aimed at job retention. The objective of this paper is to describe this intervention and to present the design of a study to evaluate its effectiveness. Development and description of intervention A systematic review, a needs assessment and discussions with Dutch experts led to a pilot group training, tested in a pilot study. The evaluation resulted in the development of a seven-session group training combined with three individual counselling sessions. The training is based on an empowerment perspective that aims to help individuals enhance knowledge, skills and self-awareness. These advances are deemed necessary for problem solving in three stages: exploration and clarification of work related problems, communication at the workplace, and development and implementation of solutions. Seven themes are discussed and practised in the group sessions: 1 Consequences of a chronic disease in the workplace, 2 Insight into feelings and thoughts about having a chronic disease, 3 Communication in daily work situations, 4 Facilities for disabled employees and work disability legislation, 5 How to stand up for oneself, 6 A plan to solve problems, 7 Follow-up. Methods Participants are recruited via occupational health services, patient organisations, employers, and a yearly national conference on chronic diseases. They are eligible when they have a chronic physical medical condition, have a paid job, and experience problems at work. Workers on long-term, 100% sick leave that is expected to continue during the training are excluded. After filling in the baseline questionnaire, the participants are randomised to either the control or the intervention group. The control group will receive no care or care as usual. Post-test mail questionnaires will be sent after 4, 8

  20. Empowering employees with chronic diseases; development of an intervention aimed at job retention and design of a randomised controlled trial.

    Science.gov (United States)

    Varekamp, Inge; de Vries, Gabe; Heutink, Annelies; van Dijk, Frank J H

    2008-11-04

    Persons with a chronic disease are less often employed than healthy persons. If employed, many of them experience problems at work. Therefore, we developed a training programme aimed at job retention. The objective of this paper is to describe this intervention and to present the design of a study to evaluate its effectiveness. DEVELOPMENT AND DESCRIPTION OF INTERVENTION: A systematic review, a needs assessment and discussions with Dutch experts led to a pilot group training, tested in a pilot study. The evaluation resulted in the development of a seven-session group training combined with three individual counselling sessions. The training is based on an empowerment perspective that aims to help individuals enhance knowledge, skills and self-awareness. These advances are deemed necessary for problem solving in three stages: exploration and clarification of work related problems, communication at the workplace, and development and implementation of solutions. Seven themes are discussed and practised in the group sessions: 1) Consequences of a chronic disease in the workplace, 2) Insight into feelings and thoughts about having a chronic disease, 3) Communication in daily work situations, 4) Facilities for disabled employees and work disability legislation, 5) How to stand up for oneself, 6) A plan to solve problems, 7) Follow-up. Participants are recruited via occupational health services, patient organisations, employers, and a yearly national conference on chronic diseases. They are eligible when they have a chronic physical medical condition, have a paid job, and experience problems at work. Workers on long-term, 100% sick leave that is expected to continue during the training are excluded. After filling in the baseline questionnaire, the participants are randomised to either the control or the intervention group. The control group will receive no care or care as usual. Post-test mail questionnaires will be sent after 4, 8, 12 and 24 months. Primary outcome

  1. A systematic review of interventions aiming to improve involvement in physical activity among adults with intellectual disability.

    Science.gov (United States)

    Brooker, Katie; van Dooren, Kate; McPherson, Lyn; Lennox, Nick; Ware, Robert

    2015-03-01

    Evidence suggests that most adults with intellectual disability do not participate in sufficient amounts of physical activity (PA). A systematic review of peer-reviewed studies that reported an intervention aiming to improve PA levels of adults with intellectual disability was conducted. Keywords related to intellectual disability and physical activity were used to search relevant databases. Studies were excluded if they did not measure PA as an outcome for adults with intellectual disability, were non-English, and were not peer-reviewed. All relevant studies were included in the review regardless of methodological quality and design. Six articles met the inclusion criteria. These included health education or health promotion programs with PA, nutrition, and weight loss components. The quality of studies included in this review was generally poor. Most studies used a prepost design, sample sizes were small, and measurement tools were used that are not valid and reliable for the population assessed. PA interventions have the potential to improve the health and wellbeing of people with intellectual disability, a vulnerable group who require attention from public health practitioners and researchers. Given the health inequities that exist, public health researchers should target efforts to improve PA levels among this group.

  2. Grasping the thistle: The role of alcohol brief interventions in Scottish alcohol policy.

    Science.gov (United States)

    Graham, Lesley J C; Mackinnon, Donna

    2010-11-01

    Scotland has experienced a substantial rise in alcohol-related harm, which is now one of the biggest public health challenges it faces. Alcohol problems in Scotland are described along with national alcohol policy response in addressing them. The role of a program of Alcohol Brief Interventions is discussed therein. In Scotland, considerable proportions of the population are drinking hazardously or harmfully, common across different age and socioeconomic groups. Rising consumption has been set in wider environmental changes with alcohol becoming more available and affordable. Scotland has had one of the fastest growing chronic liver disease mortality rates in the world at a time when rates in most of Western Europe are falling. Scotland's alcohol policy has an explicit aim to reduce population consumption and includes legislative measures to tackle price and availability. A national program to deliver Alcohol Brief Interventions for hazardous drinkers is a key plank of this wider strategy. A portfolio of studies will monitor and evaluate national policy and, through contribution analysis, describe the role Alcohol Brief Interventions play in reducing alcohol misuse. Effective alcohol policy recognises that determinants of health not only lie at individual level, but include wider social, environmental and economic factors. Scotland's policy is addressing these determinants with both population-based and population-targeted interventions. Scotland has a serious problem with alcohol. A comprehensive, evidence-based, resourced alcohol policy is being implemented, which will need continual review to ensure it remains anchored in evidence while maintaining its ambition.[Graham LJC, MacKinnon D. GRASPING THE THISTLE: The role of alcohol brief interventions in Scottish alcohol policy. © 2010 Australasian Professional Society on Alcohol and other Drugs.

  3. The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse.

    Science.gov (United States)

    Edwards, Deborah; Hawker, Clare; Carrier, Judith; Rees, Colin

    2011-01-01

    Background: The transition period from student to newly qualified nurse where nurses are adjusting to their new role and consolidating their knowledge and skills can be stressful. It is a time when many newly qualified nurses are left feeling inadequately prepared. A variety of strategies to ease the transition process have been reported, which aim to increase confidence, competence, sense of belonging of new graduates, improve recruitment and retention and reduce turnover costs. To synthesise the best available evidence on the effectiveness of support strategies and interventions aimed for newly qualified nurses. A comprehensive search was undertaken on major electronic databases to identify both published and unpublished studies from 2000 to the present date. Reference lists of retrieved papers were searched and authors contacted. Only quantitative studies published in English language were considered.Methodological quality and data extraction: Two reviewers independently assessed methodological quality and extracted data from the included studies. A third reviewer resolved any disagreements through discussion. The review did not identify comparable Randomised Controlled Trials (RCTs), and as such meta-analysis of the data was not appropriate. The data extracted from the included studies were synthesized into a narrative summary. Thirty three studies were included in the review: RCT (1), Quasi-experimental (3) and observational/descriptive studies (29). Countries of origin were: USA (25), Australia (4), England (2), New Zealand (1) and Thailand (1). Studies were categorised according to the type of programme or support strategy provided: nurse internship/residency programmes (14) and graduate nurse orientation programmes (7), preceptorship (4), simulation (3) and mentoring (2), final year nursing students transition programs (2) and externship (1).Outcomes were categorised as being important to the employer (recruitment, retention, turnover rates, competence

  4. Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries

    DEFF Research Database (Denmark)

    Spitters, H P E M; van Oers, J A M; Sandu, P

    2017-01-01

    the design and development of the generic frame of the In2Action game focusing on enhancing collaboration in local public health policymaking networks. By keeping the game generic, it became suitable for each of the three country cases with only minor changes. The generic frame of the game is expected......BACKGROUND: One of the key elements to enhance the uptake of evidence in public health policies is stimulating cross-sector collaboration. An intervention stimulating collaboration is a policy game. The aim of this study was to describe the design and methods of the development process......: In2Action was developed as a role-play game of one day, with main focus to develop in collaboration a cross-sector implementation plan based on the approved strategic local public health policy. CONCLUSIONS: This study introduced an innovative intervention for public health policymaking. It described...

  5. Economic evaluation of an intervention program with the aim to improve at-work productivity for workers with rheumatoid arthritis.

    Science.gov (United States)

    Noben, Cindy; Vilsteren, Myrthe van; Boot, Cécile; Steenbeek, Romy; Schaardenburg, Dirkjan van; Anema, Johannes R; Evers, Silvia; Nijhuis, Frans; Rijk, Angelique de

    2017-05-25

    Evaluating the cost effectiveness and cost utility of an integrated care intervention and participatory workplace intervention for workers with rheumatoid arthritis (RA) to improve their work productivity. Twelve month follow-up economic evaluation alongside a randomized controlled trial (RCT) within specialized rheumatology treatment centers. Adults diagnosed with RA between 18-64 years, in a paid job for at least eight hours per week, experiencing minor difficulties in work functioning were randomized to the intervention (n = 75) or the care-as-usual (CAU) group (n = 75). Effect outcomes were productivity and quality of life (QALYs). Costs associated with healthcare, patient and family, productivity, and intervention were calculated from a societal perspective. Cost effectiveness and cost utility were assessed to indicate the incremental costs and benefits per additional unit of effect. Subgroup and sensitivity analyses evaluated the robustness of the findings. At-work productivity loss was about 4.6 hours in the intervention group and 3.5 hours in the care as usual (CAU) group per two weeks. Differences in QALY were negligible; 0.77 for the CAU group and 0.74 for the intervention group. In total, average costs after twelve months follow-up were highest in the intervention group (€7,437.76) compared to the CAU group (€5,758.23). The cost-effectiveness and cost-utility analyses show that the intervention was less effective and (often) more expensive when compared to CAU. Sensitivity analyses supported these findings. The integrated care intervention and participatory workplace intervention for workers with RA provides gains neither in productivity at the workplace nor in quality of life. These results do not justify the additional costs.

  6. Evaluation of a Theory-Based Intervention Aimed at Reducing Intention to Use Restrictive Dietary Behaviors Among Adolescent Female Athletes.

    Science.gov (United States)

    Laramée, Catherine; Drapeau, Vicky; Valois, Pierre; Goulet, Claude; Jacob, Raphaëlle; Provencher, Véronique; Lamarche, Benoît

    2017-06-01

    To evaluate the effectiveness of a theory-based intervention to reduce the intention to use restrictive dietary behaviors for losing weight among adolescent female athletes involved in aesthetic sports. Cluster-randomized controlled trial. Aesthetic sport teams of adolescent female athletes aged 12-17 years. Two teams (n = 37 athletes) in the intervention group and 3 teams (n = 33) in the comparison group. The 2 groups received nutrition education during 3 weekly 60-minute sessions. The intervention group was further exposed to a theory-based intervention targeting the specific determinant of intention to use restrictive dietary behaviors for losing weight, namely attitude. Difference over time between groups in intention to use restrictive dietary behaviors for losing weight and in nutrition knowledge. Mixed models for repeated measures. The theory-based intervention contributed to maintaining a low intention of using restrictive dietary behaviors for losing weight over time in the intervention group compared with the comparison group (P theory-based behavior change intervention may help maintain a low intention of using restrictive dietary behaviors for losing weight among female high school athletes involved in aesthetic sports. Copyright © 2017. Published by Elsevier Inc.

  7. Interventions aimed at reducing problems in adult patients discharged from hospital to home: a systematic meta-review.

    NARCIS (Netherlands)

    Mistiaen, P.; Francke, A.L.; Poot, E.

    2007-01-01

    BACKGROUND: Many patients encounter a variety of problems after discharge from hospital and many discharge (planning and support) interventions have been developed and studied. These primary studies have already been synthesized in several literature reviews with conflicting conclusions. We

  8. Effects of an intervention aimed at reducing the intake of sugar-sweetened beverages in primary school children: A controlled trial

    NARCIS (Netherlands)

    V.M.J. Kruitwagen - van de Gaar (Vivian); W. Jansen (Wilma); A. van Grieken (Amy); G.J.J.M. Borsboom (Gerard); S.P.J. Kremers (Stef); H. Raat (Hein)

    2014-01-01

    markdownabstractAbstract Background Since sugar-sweetened beverages (SSB) may contribute to the development of overweight in children, effective interventions to reduce their consumption are needed. Here we evaluated the effect of a combined school- and community-based intervention aimed at

  9. Portion size: a qualitative study of consumers' attitudes toward point-of-purchase interventions aimed at portion size.

    Science.gov (United States)

    Vermeer, Willemijn M; Steenhuis, Ingrid H M; Seidell, Jacob C

    2010-02-01

    This qualitative study assessed consumers' opinions of food portion sizes and their attitudes toward portion-size interventions located in various point-of-purchase settings targeting overweight and obese people. Eight semi-structured focus group discussions were conducted with 49 participants. Constructs from the diffusion of innovations theory were included in the interview guide. Each focus group was recorded and transcribed verbatim. Data were coded and analyzed with Atlas.ti 5.2 using the framework approach. Results showed that many participants thought that portion sizes of various products have increased during the past decades and are larger than acceptable. The majority also indicated that value for money is important when purchasing and that large portion sizes offer more value for money than small portion sizes. Furthermore, many experienced difficulties with self-regulating the consumption of large portion sizes. Among the portion-size interventions that were discussed, participants had most positive attitudes toward a larger availability of portion sizes and pricing strategies, followed by serving-size labeling. In general, reducing package serving sizes as an intervention strategy to control food intake met resistance. The study concludes that consumers consider interventions consisting of a larger variety of available portion sizes, pricing strategies and serving-size labeling as most acceptable to implement.

  10. Interventions aimed at preventing and reducing overweight/obesity among children and adolescents: a meta-synthesis

    NARCIS (Netherlands)

    Kobes, Annita; Kretschmer, Tina; Timmerman, Margaretha; Schreuder, Pauline

    The prevalence of child and adolescent obesity has been a major worldwide problem for decades. To stop the number of youth with overweight/obesity from increasing, numerous interventions focusing on improving children’s weight status have been implemented. The growing body of research on

  11. Development and evaluation of an intervention aiming to reduce fatigue in airline pilots: design of a randomised controlled trial.

    Science.gov (United States)

    van Drongelen, Alwin; van der Beek, Allard J; Hlobil, Hynek; Smid, Tjabe; Boot, Cécile R L

    2013-08-26

    A considerable percentage of flight crew reports to be fatigued regularly. This is partly caused by irregular and long working hours and the crossing of time zones. It has been shown that persistent fatigue can lead to health problems, impaired performance during work, and a decreased work-private life balance. It is hypothesized that an intervention consisting of tailored advice regarding exposure to daylight, optimising sleep, physical activity, and nutrition will lead to a reduction of fatigue in airline pilots compared to a control group, which receives a minimal intervention with standard available information. The study population will consist of pilots of a large airline company. All pilots who posses a smartphone or tablet, and who are not on sick leave for more than four weeks at the moment of recruitment, will be eligible for participation.In a two-armed randomised controlled trial, participants will be allocated to an intervention group that will receive the tailored advice to optimise exposure to daylight, sleep, physical activity and nutrition, and a control group that will receive standard available information. The intervention will be applied using a smartphone application and a website, and will be tailored on flight- and participant-specific characteristics. The primary outcome of the study is perceived fatigue. Secondary outcomes are need for recovery, duration and quality of sleep, dietary and physical activity behaviours, work-private life balance, general health, and sickness absence. A process evaluation will be conducted as well. Outcomes will be measured at baseline and at three and six months after baseline. This paper describes the development of an intervention for airline pilots, consisting of tailored advice (on exposure to daylight and sleep-, physical activity, and nutrition) applied into a smartphone application. Further, the paper describes the design of the randomised controlled trial evaluating the effect of the intervention on

  12. The effectiveness of policy interventions in CEE countries

    Directory of Open Access Journals (Sweden)

    Alin-Marius ANDRIEȘ

    2016-06-01

    Full Text Available This paper assesses the effectiveness of intervention measures adopted by central authorities during 2005-2012 in CEE. We investigate their impact on bank stability in 15 countries from CEE using bank-level data and OLS estimation method. The bank stability is proxied by the natural logarithm of the Z-Score and the non-performing loans to gross loans ratio. Empirical findings suggest that interest rates cuts, as well as domestic and foreign liquidity injections have a significant impact on bank stability in Emerging Europe. Moreover, their effectiveness differs according to several bank characteristics. Policy measures adopted by CEE countries significantly reduced the stability of domestic banks, but increased the stability of banks with a lower level of capitalization. The impact on the Z–score of banking system liquidity policy measures and the policy interest rates cuts is significantly lower in the case of domestic banks, amplified for less-capitalized banks (except for the category regarding banks’ solvency, while their impact on large banks remains statistically insignificant.

  13. School-based programs aimed at the prevention and treatment of obesity: evidence-based interventions for youth in Latin America.

    Science.gov (United States)

    Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K; Nagle, Brian J; Arredondo, Elva M; Barquera, Simón; Elder, John P

    2013-09-01

    Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions. We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed. Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes. We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  14. Development and evaluation of an intervention aiming to reduce fatigue in airline pilots: design of a randomised controlled trial

    OpenAIRE

    van Drongelen, Alwin; van der Beek, Allard J; Hlobil, Hynek; Smid, Tjabe; Boot, C?cile RL

    2013-01-01

    Background: A considerable percentage of flight crew reports to be fatigued regularly. This is partly caused by irregular and long working hours and the crossing of time zones. It has been shown that persistent fatigue can lead to health problems, impaired performance during work, and a decreased work-private life balance. It is hypothesized that an intervention consisting of tailored advice regarding exposure to daylight, optimising sleep, physical activity, and nutrition will lead to a redu...

  15. Effectiveness of cultural adaptations of interventions aimed at smoking cessation, diet, and/or physical activity in ethnic minorities. a systematic review.

    Directory of Open Access Journals (Sweden)

    Vera Nierkens

    Full Text Available BACKGROUND: The importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions. AIM: To systematically review the effectiveness of specific cultural adaptations in interventions that target smoking cessation, diet, and/or physical activity and to explore features of such adaptations that may account for their effectiveness. METHODS: Systematic review using MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials registers (1997-2009. INCLUSION CRITERIA: a effectiveness study of a lifestyle intervention targeted to ethnic minority populations living in a high income society; b interventions included cultural adaptations and a control group that was exposed to the intervention without the cultural adaptation under study; c primary outcome measures included smoking cessation, diet, or physical activity. RESULTS: Out of 44904 hits, we identified 17 studies, all conducted in the United States. In five studies, specific cultural adaptations had a statistically significant effect on primary outcomes. The remaining studies showed no significant effects on primary outcomes, but some presented trends favorable for cultural adaptations. We observed that interventions incorporating a package of cultural adaptations, cultural adaptations that implied higher intensity and those incorporating family values were more likely to report statistically significant effects. Adaptations in smoking cessation interventions seem to be more effective than adaptations in interventions aimed at diet and physical activity. CONCLUSION: This review indicates that culturally targeted behavioral interventions may be more effective if cultural adaptations are implemented as a package of adaptations, the adaptation includes family level, and where the adaptation results in a

  16. Effects of an intervention strategy for school children aimed at reducing overweight and obesity within the State of Mexico.

    Science.gov (United States)

    Morales-Ruán, María del Carmen; Shamah-Levy, Teresa; Amaya-Castellanos, Claudia Isabel; Salazar-Coronel, Araceli Apolonia; Jiménez-Aguilar, Alejandra; Amaya-Castellanos, Maritza Alejandra; Méndez-Gómez Humarán, Ignacio

    2014-01-01

    This study explored the intervention effect of the "Nutrition on the Go" strategy on the prevalence of overweight and obesity (OW+O), according to the role played by different patterns. Pattern Groups (PG) were determined based on schools' food availability and other variables at individual level: nutrition knowledge, physical activity, socioeconomic level and self-efficacy, using an ecological approach. The PG classification was achieved using Ward's cluster method. The prevalence of OW+O was higher in PGI (intermediate food availability and high socioeconomic index [SEI]) compared to PG 2 (high availability of food and lower SEI) and PG 3 (low availability of food and medium SEI) with a lower prevalence (p<0.00I). The PG-intervention interaction showed differences for PG 3 (p=0.066), the stage-PG interaction showed differences between PGs I and 3 (p=0.014) and between PGs 2 and 3 (p=0.055). Differences between PGs have important implications for the prevalence of OW+O.

  17. Effectiveness of cultural adaptations of interventions aimed at smoking cessation, diet, and/or physical activity in ethnic minorities. a systematic review.

    Science.gov (United States)

    Nierkens, Vera; Hartman, Marieke A; Nicolaou, Mary; Vissenberg, Charlotte; Beune, Erik J A J; Hosper, Karen; van Valkengoed, Irene G; Stronks, Karien

    2013-01-01

    The importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions. To systematically review the effectiveness of specific cultural adaptations in interventions that target smoking cessation, diet, and/or physical activity and to explore features of such adaptations that may account for their effectiveness. Systematic review using MEDLINE, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials registers (1997-2009). a) effectiveness study of a lifestyle intervention targeted to ethnic minority populations living in a high income society; b) interventions included cultural adaptations and a control group that was exposed to the intervention without the cultural adaptation under study; c) primary outcome measures included smoking cessation, diet, or physical activity. Out of 44904 hits, we identified 17 studies, all conducted in the United States. In five studies, specific cultural adaptations had a statistically significant effect on primary outcomes. The remaining studies showed no significant effects on primary outcomes, but some presented trends favorable for cultural adaptations. We observed that interventions incorporating a package of cultural adaptations, cultural adaptations that implied higher intensity and those incorporating family values were more likely to report statistically significant effects. Adaptations in smoking cessation interventions seem to be more effective than adaptations in interventions aimed at diet and physical activity. This review indicates that culturally targeted behavioral interventions may be more effective if cultural adaptations are implemented as a package of adaptations, the adaptation includes family level, and where the adaptation results in a higher intensity of the intervention. More systematic experiments are needed in which

  18. The Desegregation Aims and Demographic Contexts of Magnet Schools: How Parents Choose and Why Siting Policies Matter

    Science.gov (United States)

    Smrekar, Claire; Honey, Ngaire

    2015-01-01

    This paper is designed to specify a set of new opportunities for educators, school administrators, and scholars to realize the practical aims and strategic advantages envisioned in magnet schools. The paper is divided into three distinct sections. In Section I, we examine the extensive research literature on parents' choice patterns and…

  19. Identification, assessment and intervention--Implications of an audit on dyslexia policy and practice in Scotland.

    Science.gov (United States)

    Reid, Gavin; Deponio, Pamela; Davidson Petch, Louise

    2005-08-01

    This article reports on research commissioned by the Scottish Executive Education Department (SEED). It aimed to establish the range and extent of policy and provision in the area of specific learning difficulties (SpLD) and dyslexia throughout Scotland. The research was conducted between January and June 2004 by a team from the University of Edinburgh. The information was gathered from a questionnaire sent to all education authorities (100% response rate was achieved). Additional information was also obtained from supplementary interviews and additional materials provided by education authorities. The results indicated that nine education authorities in Scotland (out of 32) have explicit policies on dyslexia and eight authorities have policies on SpLD. It was noted however that most authorities catered for dyslexia and SpLD within a more generic policy framework covering aspects of Special Educational Needs or within documentation on 'effective learning'. In relation to identification thirty-six specific tests, or procedures, were mentioned. Classroom observation, as a procedure was rated high by most authorities. Eleven authorities operated a formal staged process combining identification and intervention. Generally, authorities supported a broader understanding of the role of identification and assessment and the use of standardized tests was only part of a wider assessment process. It was however noted that good practice in identification and intervention was not necessarily dependent on the existence of a dedicated policy on SpLD/dyslexia. Over fifty different intervention strategies/programmes were noted in the responses. Twenty-four authorities indicated that they had developed examples of good practice. The results have implications for teachers and parents as well as those involved in staff development. Pointers are provided for effective practice and the results reflect some of the issues on the current debate on dyslexia particularly relating to early

  20. 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.

  1. Public nursing home staff's experience of participating in an intervention aimed at enhancing their self-esteem.

    Science.gov (United States)

    Wadensten, Barbro; Engström, Maria; Häggström, Elisabeth

    2009-11-01

    The aim of the present study was to gain an understanding of how nursing staff experienced participating in a training programme aimed at strengthening their self-esteem and empowering them, to determine whether participation benefited them in any way, and to describe their opinions about possible benefits or disadvantages. Staff working in institutions such as nursing homes have a low status in society. A training programme was introduced to staff in a public nursing home. It focused on helping them understand factors in the work situation that influence them and on empowering them. The study was explorative and qualitative in design. The participants in the programme were generally satisfied with it. Their opinions about the benefits they received from the programme can be described using three themes: 'improved communication skills', 'enhanced self-esteem' and 'sees work in a different light'. The most important finding of the present study is that it was possible to strengthen and empower staff. Staff members were generally pleased and satisfied with the content/organization of the training programme. They felt the programme had been of value to them by improving their communication skills and increasing their self-esteem. The present result could be of value to managers and educators working in the area of nursing home care when planning education and development activities for staff. Learning to communicate better and understand the social structure at the workplace could improve staff members' self-esteem, thereby enhancing the work situation and atmosphere as well as empowering the individuals.

  2. Policy efforts used to develop awareness aimed at increased students' scientific literacy and career choices in mathematics, science and engineering

    Science.gov (United States)

    Whitfield, Frank Albert

    The lack of an adequate supply of human resources in science and engineering has been well documented. Efforts from a number of agencies, such as the National Science Foundation, have been implemented to alleviate this national problem. However, it is unclear what concerted efforts state agencies are taking to increase the number of African American students' scientific literacy, and career choices in science and engineering. The purpose of this study was to select a talent pool of African American students who are academically able to pursue a career in a math-based major. The selection of this talent pool lead to the recommendation of an encouragement process model to be used by the Tennessee Board of Regents (TBR) system to encourage the selectees of this talent pool to enter math-based programs at TBR universities. An integrated literature review was conducted. This review includes perspectives on national, state, and local educational policy decisions which affect educational purposes, institutional governance and secondary-postsecondary linkages. Existing TBR system data were analyzed and tabulated. This tabulated data along with the recommended model will be offered to the TBR system for possible adoption. The results of these data support the methodological notion that there are an appreciable number of potential TBR system African American students academically able to enter math related majors who, however, may be reluctant to choose a career direction in a math-based career field. Implications of this study and suggestions for further research are discussed. On an applied level, the study might suggest to other states ways in which to deal with similar problems.

  3. Evaluation of an mHealth intervention aiming to improve health-related behavior and sleep and reduce fatigue among airline pilots.

    Science.gov (United States)

    van Drongelen, Alwin; Boot, Cécile Rl; Hlobil, Hynek; Twisk, Jos Wr; Smid, Tjabe; van der Beek, Allard J

    2014-11-01

    The aim of this study was to evaluate the effects of an mHealth intervention (intervention using mobile technology) consisting of tailored advice regarding exposure to daylight, sleep, physical activity, and nutrition, and aiming to improve health-related behavior, thereby reducing sleep problems and fatigue and improving health perception of airline pilots. A randomized controlled trial was conducted among 502 airline pilots. The intervention group was given access to both the MORE Energy mobile application (app) with tailored advice and a website with background information. The control group was directed to a website with standard information about fatigue. Health-related behavior, fatigue, sleep, and health perception outcomes were measured through online questionnaires at baseline and at three and six months after baseline. The effectiveness of the intervention was determined using linear and Poisson mixed model analyses. After six months, compared to the control group, the intervention group showed a significant improvement on fatigue (β= -3.76, P<0.001), sleep quality (β= -0.59, P=0.007), strenuous physical activity (β=0.17, P=0.028), and snacking behavior (β= -0.81, P<0.001). No significant effects were found for other outcome measures. The MORE Energy mHealth intervention reduced self-reported fatigue compared to a minimal intervention. Some aspects of health-related behavior (physical activity and snacking behavior) and sleep (sleep quality) improved as well, but most did not. The results show offering tailored advice through an mHealth intervention is an effective means to support employees who have to cope with irregular flight schedules and circadian disruption. This kind of intervention might therefore also be beneficial for other working populations with irregular working hours.

  4. Applying Intervention Mapping to develop a community-based intervention aimed at improved psychological and social well-being of unmarried teenage mothers in Uganda

    NARCIS (Netherlands)

    Leerlooijer, J.N.; Kok, G.; Weyusya, J.; Bos, A.E.R.; Ruiter, R.A.C.; Rijsdijk, E.; Nshakira, N.; Bartholomew, L.K.

    2014-01-01

    Out-of-wedlock pregnancy among adolescents in sub-Saharan Africa is a major concern, because of its association with health, social, psychological, economic and demographic factors. This article describes the development of the Teenage Mothers Project, a community-based intervention to improve

  5. Applying Intervention Mapping to Develop a Community-Based Intervention Aimed at Improved Psychological and Social Well-Being of Unmarried Teenage Mothers in Uganda

    Science.gov (United States)

    Leerlooijer, Joanne N.; Kok, Gerjo; Weyusya, Joseph; Bos, Arjan E. R.; Ruiter, Robert A. C.; Rijsdijk, Liesbeth E.; Nshakira, Nathan; Bartholomew, Leona K.

    2014-01-01

    Out-of-wedlock pregnancy among adolescents in sub-Saharan Africa is a major concern, because of its association with health, social, psychological, economic and demographic factors. This article describes the development of the Teenage Mothers Project, a community-based intervention to improve psychological and social well-being of unmarried…

  6. Working environment interventions – Bridging the gap between policy instruments and practice

    DEFF Research Database (Denmark)

    Hasle, Peter; Limborg, Hans Jørgen; Nielsen, Klaus T.

    2014-01-01

    is paid to why and how public and private organisations subsequently are to improve their working environment. This paper suggests a model which can bridge this gap. It is based on a combination of theories about basic policy instruments (regulation, incentives and information) with realistic analysis...... focusing on mechanisms and context, and finally institutional theory proposing coercive, normative and mimetic mechanisms as explanations for organisational behaviour. The model is applied to an intervention aimed at reduction of the risk of musculoskeletal disorders among bricklayers in Denmark. Our...

  7. Citizenship and Nationality in Changing Europe: A Comparative Study of the Aims of Citizenship Education in Russian and Finnish National Education Policy Texts

    Science.gov (United States)

    Piattoeva, Nelli

    2009-01-01

    The paper analyses how the formal aims of citizenship education, as declared in legislation and policy documents, have changed since the end of the 1980s in response to the transformation of the political scenery in Finland and the Russian Federation. One central question framing the analysis of Finnish citizenship education is whether…

  8. Is Team Sport the Key to Getting Everybody Active, Every Day? A Systematic Review of Physical Activity Interventions Aimed at Increasing Girls' Participation in Team Sport.

    Science.gov (United States)

    Allison, Rosalie; Bird, Emma L; McClean, Stuart

    2017-01-01

    It is estimated that 21% of boys and 16% of girls in England meet recommended physical activity guidelines. Team sport has the potential to increase physical activity levels; however, studies show that gender-based factors can influence girls' participation in team sport. Furthermore, evidence for the effectiveness of interventions promoting team sport among girls is limited. This systematic review aimed to assess the impact of physical activity interventions on secondary school-aged girls' (aged 11-18 years) participation in team sport and to identify potential strategies for increasing participation. Electronic databases and grey literature were systematically searched for studies of interventions targeting team sport participation among girls in the UK. Results were exported to Refworks, duplicates removed and eligible studies identified. Extracted data included: participant details, such as sample size and age; components of the intervention; outcomes assessed; and each study was quality appraised. Due to heterogeneity across studies, results were presented narratively. Four studies sourced from the grey literature met the inclusion criteria. Findings suggest that physical activity interventions can encourage girls to try new sports, but evidence is limited in relation to sustained participation. Potential strategies for promoting participation included: consultation with girls, implementation of appropriate peer-leaders and friendship group strategies, early intervention and consideration of intervention setting. This review highlights the limited availability of evidence on the effectiveness of physical activity interventions for promoting team sport participation among girls in the UK. Findings indicate that future research is needed to improve the methodological quality of complex intervention evaluation. Physical activity interventions may have the potential to encourage girls to try team sport, but their impact on sustained participation, and subsequent

  9. LCoMotion - Learning, Cognition and Motion; a multicomponent cluster randomized school-based intervention aimed at increasing learning and cognition - rationale, design and methods

    DEFF Research Database (Denmark)

    Bugge, Anna; Tarp, Jakob; Ostergaard, Lars

    2014-01-01

    BACKGROUND: The aim of the study; LCoMotion - Learning, Cognition and Motion was to develop, document, and evaluate a multi-component physical activity (PA) intervention in public schools in Denmark. The primary outcome was cognitive function. Secondary outcomes were academic skills, body composi...

  10. Utilizing the RE-AIM Framework in formative evaluation and program planning for a healthy food choice intervention in the Lower Mississippi Delta

    Science.gov (United States)

    A robust approach to program planning is needed for the development and execution of effective and sustainable behavioral interventions with large public health impact. The purpose of this formative research was to apply dimensions of the RE-AIM (i.e., Reach, Effectiveness, Adoption, Implementation,...

  11. How can we help employees with chronic diseases to stay at work? A review of interventions aimed at job retention and based on an empowerment perspective

    NARCIS (Netherlands)

    Varekamp, Inge; Verbeek, Jos H. A. M.; van Dijk, Frank J. H.

    2006-01-01

    OBJECTIVES: A growing number of persons aged 16-65 is hampered by a chronic condition in performing job activities. Some of them quit the labour market prematurely. Vocational rehabilitation used to focus on (re)entering the labour market. Recently more attention is paid to interventions aimed at

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

    Science.gov (United States)

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

    2018-03-06

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

  13. Policy recommendations for addressing privacy challenges associated with cell-based research and interventions.

    Science.gov (United States)

    Ogbogu, Ubaka; Burningham, Sarah; Ollenberger, Adam; Calder, Kathryn; Du, Li; El Emam, Khaled; Hyde-Lay, Robyn; Isasi, Rosario; Joly, Yann; Kerr, Ian; Malin, Bradley; McDonald, Michael; Penney, Steven; Piat, Gayle; Roy, Denis-Claude; Sugarman, Jeremy; Vercauteren, Suzanne; Verhenneman, Griet; West, Lori; Caulfield, Timothy

    2014-02-03

    The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors' clinical information for research and regulatory purposes, and existing practices that limit research participants' ability to control what is done with their genetic data, amplify the privacy concerns. To date, the privacy issues associated with cell-based research and interventions have not received much attention in the academic and policymaking contexts. This paper, arising out of a multi-disciplinary workshop, aims to rectify this by outlining the issues, proposing novel governance strategies and policy recommendations, and identifying areas where further evidence is required to make sound policy decisions. The authors of this paper take the position that existing rules and norms can be reasonably extended to address privacy risks in this context without compromising emerging developments in the research environment, and that exceptions from such rules should be justified using a case-by-case approach. In developing new policies, the broader framework of regulations governing cell-based research and related areas must be taken into account, as well as the views of impacted groups, including scientists, research participants and the general public. This paper outlines deliberations at a policy development workshop focusing on privacy challenges associated with cell-based research and interventions. The paper provides an overview of these challenges, followed by a discussion of key themes and recommendations that emerged from discussions at the workshop. The paper concludes that privacy risks associated with cell

  14. Implementing multiple intervention strategies in Dutch public health-related policy networks

    NARCIS (Netherlands)

    Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

    2017-01-01

    Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to

  15. Systematic review of randomised controlled trials of interventions that aim to reduce the risk, either directly or indirectly, of overweight and obesity in infancy and early childhood.

    Science.gov (United States)

    Redsell, Sarah A; Edmonds, Barrie; Swift, Judy Anne; Siriwardena, Aloysius Niroshan; Weng, Stephen; Nathan, Dilip; Glazebrook, Cris

    2016-01-01

    The risk factors for childhood overweight and obesity are known and can be identified antenatally or during infancy, however, the majority of effective interventions are designed for older children. This review identified interventions designed to reduce the risk of overweight/obesity that were delivered antenatally or during the first 2 years of life, with outcomes reported from birth to 7 years of age. Six electronic databases were searched for papers reporting randomised controlled trials of interventions published from January 1990 to September 2013. A total of 35 eligible studies were identified, describing 27 unique trials of which 24 were behavioural and three were non-behavioural. The 24 behavioural trials were categorised by type of intervention: (1) nutritional and/or responsive feeding interventions targeted at parents of infants, which improved feeding practices and had some impact on child weight (n = 12); (2) breastfeeding promotion and lactation support for mothers, which had a positive effect on breastfeeding but not child weight (n = 5); (3) parenting and family lifestyle (n = 4); and (4) maternal health (n = 3) interventions that had some impact on feeding practices but not child weight. The non-behavioural trials comprised interventions manipulating formula milk composition (n = 3). Of these, lower/hydrolysed protein formula milk had a positive effect on weight outcomes. Interventions that aim to improve diet and parental responsiveness to infant cues showed most promise in terms of self-reported behavioural change. Despite the known risk factors, there were very few intervention studies for pregnant women that continue during infancy which should be a priority for future research. © 2015 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

  16. Legislative, educational, policy and other interventions targeting physicians' interaction with pharmaceutical companies: a systematic review.

    Science.gov (United States)

    Alkhaled, Lina; Kahale, Lara; Nass, Hala; Brax, Hneine; Fadlallah, Racha; Badr, Kamal; Akl, Elie A

    2014-07-01

    Pharmaceutical company representatives likely influence the prescribing habits and professional behaviour of physicians. The objective of this study was to systematically review the effects of interventions targeting practising physicians' interactions with pharmaceutical companies. We included observational studies, non-randomised controlled trials (non-RCTs) and RCTs evaluating legislative, educational, policy or other interventions targeting the interactions between physicians and pharmaceutical companies. The search strategy included an electronic search of MEDLINE and EMBASE. Two reviewers performed duplicate and independent study selection, data abstraction and assessment of risk of bias. We assessed the risk of bias in each included study. We summarised the findings narratively because the nature of the data did not allow a meta-analysis to be conducted. We assessed the quality of evidence by outcome using the GRADE methodology. Of 11 189 identified citations, one RCT and three observational studies met the eligibility criteria. All four studies specifically targeted one type of interaction with pharmaceutical companies, that is, interactions with drug representatives. The RCT provided moderate quality evidence of no effect of a 'collaborative approach' between the pharmaceutical industry and a health authority. The three observational studies provided low quality evidence suggesting a positive effect of policies aiming to reduce interaction between physicians and pharmaceutical companies (by restricting free samples, promotional material, and meetings with pharmaceutical company representatives) on prescription behaviour. We identified too few studies to allow strong conclusions. Available evidence suggests a potential impact of policies aiming to reduce interaction between physicians and drug representatives on physicians' prescription behaviour. We found no evidence concerning interventions affecting other types of interaction with pharmaceutical

  17. An exploration of factors related to dissemination of and exposure to internet-delivered behavior change interventions aimed at adults: a Delphi study approach.

    Science.gov (United States)

    Brouwer, Wendy; Oenema, Anke; Crutzen, Rik; de Nooijer, Jascha; de Vries, Nanne K; Brug, Johannes

    2008-04-16

    The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of and exposure to these Internet interventions is important to be able to increase the reach and improve exposure. The aim was to identify potentially important factors that determine whether adults visit an Internet-delivered behavior change intervention, extend their visit, and revisit the intervention. A systematic, three-round Delphi study was conducted among national and international experts from Internet intervention research and practice, e-marketing/e-commerce, Web design, and technical website development. In the first round, 30 experts completed a structured, open-ended online questionnaire assessing factors that were, in their opinion, important for a first visit, an extended visit, a revisit and for effective promotion strategies. Based on the responses in this first questionnaire, a closed-ended online questionnaire was developed for use in the second round. A total of 233 experts were invited to complete this questionnaire. Median and interquartile deviation (IQD) scores were computed to calculate agreement and consensus on the importance of the factors. The factors for which no consensus was obtained (IQD > 1) were included in the third-round questionnaire. Factors with a median score of six or higher and with an IQD word-of-mouth by family and friends, a publicity campaign with simultaneous use of various mass media, and recommendation by health professionals, were indicated as effective ways to encourage adults to visit an Internet intervention. This systematic study identified important factors related to the dissemination of and exposure to Internet interventions aimed at adults. In order to improve optimal use of and exposure to Internet interventions, potential users may

  18. Equity impact of population-level interventions and policies to reduce smoking in adults: a systematic review.

    Science.gov (United States)

    Brown, Tamara; Platt, Stephen; Amos, Amanda

    2014-05-01

    There is strong evidence about which tobacco control policies reduce smoking. However, their equity impact is uncertain. The aim was to assess the effectiveness of population-level interventions/policies to reduce socioeconomic inequalities in adult smoking. Systematic review of studies of population-level interventions/policies reporting smoking-related outcomes in adults of lower compared to higher socioeconomic status (SES). References were screened and independently checked. Studies were quality assessed. Results are presented in a narrative synthesis. Equity impact was assessed as: positive (reduced inequality), neutral (no difference by SES), negative (increased inequality), mixed (equity impact varied) or unclear. 117 studies of 130 interventions/policies were included: smokefree (44); price/tax (27); mass media campaigns (30); advertising controls (9); cessation support (9); settings-based interventions (7); multiple policies (4). The distribution of equity effects was: 33 positive, 36 neutral, 38 negative, 6 mixed, 17 unclear. Most neutral equity studies benefited all SES groups. Fourteen price/tax studies were equity positive. Voluntary, regional and partial smokefree policies were more likely to be equity negative than national, comprehensive smokefree policies. Mass media campaigns had inconsistent equity effects. Cigarette marketing controls were equity positive or neutral. Targeted national smoking cessation services can be equity positive by achieving higher reach among low SES, compensating for lower quit rates. Few studies have assessed the equity impact of tobacco control policy/interventions. Price/tax increases had the most consistent positive equity impact. More research is needed to strengthen the evidence-base for reducing smoking inequalities and to develop effective equity-orientated tobacco control strategies. Copyright © 2014. Published by Elsevier Ireland Ltd.

  19. Environmental and occupational interventions for primary prevention of cancer: a cross-sectorial policy framework.

    Science.gov (United States)

    Espina, Carolina; Porta, Miquel; Schüz, Joachim; Aguado, Ildefonso Hernández; Percival, Robert V; Dora, Carlos; Slevin, Terry; Guzman, Julietta Rodriguez; Meredith, Tim; Landrigan, Philip J; Neira, Maria

    2013-04-01

    Nearly 13 million new cancer cases and 7.6 million cancer deaths occur worldwide each year; 63% of cancer deaths occur in low- and middle-income countries. A substantial proportion of all cancers are attributable to carcinogenic exposures in the environment and the workplace. We aimed to develop an evidence-based global vision and strategy for the primary prevention of environmental and occupational cancer. We identified relevant studies through PubMed by using combinations of the search terms "environmental," "occupational," "exposure," "cancer," "primary prevention," and "interventions." To supplement the literature review, we convened an international conference titled "Environmental and Occupational Determinants of Cancer: Interventions for Primary Prevention" under the auspices of the World Health Organization, in Asturias, Spain, on 17-18 March 2011. Many cancers of environmental and occupational origin could be prevented. Prevention is most effectively achieved through primary prevention policies that reduce or eliminate involuntary exposures to proven and probable carcinogens. Such strategies can be implemented in a straightforward and cost-effective way based on current knowledge, and they have the added benefit of synergistically reducing risks for other noncommunicable diseases by reducing exposures to shared risk factors. Opportunities exist to revitalize comprehensive global cancer control policies by incorporating primary interventions against environmental and occupational carcinogens.

  20. Policy Interventions Favouring Small Business: Rationales, Results and Recommendations

    Directory of Open Access Journals (Sweden)

    John Lester

    2017-05-01

    harming economic performance. The federal government provides a 35% tax credit for R&D performed by small firms. Provincial tax credits raise the subsidy rate to about 42%. And those firms receiving support from the federal Industrial Research Assistance Program can have almost 60% of their project costs paid by the government. By way of contrast, large firms performing R&D receive subsidies from federal and provincial tax credits amounting to under a quarter of their costs, an intervention which improves economic performance. Canada has had what could be described as a small business policy – broad-based support for all small businesses. The newish federal government is moving to an entrepreneurship policy: new initiatives emphasize support for the high-impact firms and individuals that make an outsized contribution to Canada’s innovation and prosperity. Making the transition to the new framework will require overhauling legacy small business policies to free up resources for new initiatives and to secure fiscal savings. Three changes would pay big dividends: • Eliminate the small-business corporate income tax deduction. • Reduce the enhanced R&D tax credit rate to the same level as the regular credit. • Replace the BDC’s direct loan program with a loan guarantee program.

  1. LCoMotion - Learning, Cognition and Motion; a multicomponent cluster randomized school-based intervention aimed at increasing learning and cognition - rationale, design and methods.

    Science.gov (United States)

    Bugge, Anna; Tarp, Jakob; Østergaard, Lars; Domazet, Sidsel Louise; Andersen, Lars Bo; Froberg, Karsten

    2014-09-18

    The aim of the study; LCoMotion - Learning, Cognition and Motion was to develop, document, and evaluate a multi-component physical activity (PA) intervention in public schools in Denmark. The primary outcome was cognitive function. Secondary outcomes were academic skills, body composition, aerobic fitness and PA. The primary aim of the present paper was to describe the rationale, design and methods of the LCoMotion study. LCoMotion was designed as a cluster-randomized controlled study. Fourteen schools from all five regions in Denmark participated. All students from 6th and 7th grades were invited to participate (n = 869) and consent was obtained for 87% (n = 759). Baseline measurements were obtained in November/December 2013 and follow-up measurements in May/June 2014. The intervention lasted five months and consisted of a "package" of three main components: PA during academic lessons, PA during recess and PA homework. Furthermore a cycling campaign was conducted during the intervention period. Intervention schools should endeavor to ensure that students were physically active for at least 60 min every school day. Cognitive function was measured by a modified Eriksen flanker task and academic skills by a custom made mathematics test. PA was objectively measured by accelerometers (ActiGraph, GT3X and GT3X+) and aerobic fitness assessed by an intermittent shuttle-run test (the Andersen intermittent running test). Furthermore, compliance with the intervention was assessed by short message service (SMS)-tracking and questionnaires were delivered to students, parents and teachers. LCoMotion has ability to provide new insights on the effectiveness of a multicomponent intervention on cognitive function and academic skills in 6th and 7th grade students. Clinicaltrials.gov: NCT02012881 (10/10/2013).

  2. Long-term effect of a practice-based intervention (HAPPY AUDIT) aimed at reducing antibiotic prescribing in patients with respiratory tract infections.

    Science.gov (United States)

    Llor, Carl; Bjerrum, Lars; Molero, José M; Moragas, Ana; González López-Valcárcel, Beatriz; Monedero, M José; Gómez, Manuel; Cid, Marina; Alcántara, Juan de Dios; Cots, Josep M; Ribas, Joana M; García, Guillermo; Ortega, Jesús; Pineda, Vicenta; Guerra, Gloria; Munuera, Susana

    2018-04-27

    Few studies have evaluated the long-term effects of educational interventions on antibiotic prescription and the results are controversial. This study was aimed at assessing the effect of a multifaceted practice-based intervention carried out 6 years earlier on current antibiotic prescription for respiratory tract infections (RTIs). The 210 general practitioners (GPs) who completed the first two registrations in 2008 and 2009 were invited to participate in a third registration. The intervention held before the second registration consisted of discussion about the first registration of results, appropriate use of antibiotics for RTIs, patient brochures, a workshop and the provision of rapid tests. As in the previous registrations, GPs were instructed to complete a template for all the patients with RTIs during 15 working days in 2015. A new group of GPs from the same areas was also invited to participate and acted as controls. A multilevel logistic regression analysis was performed considering the prescription of antibiotics as the dependent variable. A total of 121 GPs included in the 2009 intervention (57.6%) and 117 control GPs registered 22 247 RTIs. On adjustment for covariables, compared with the antibiotic prescription observed just after the intervention, GPs assigned to intervention prescribed slightly more antibiotics 6 years later albeit without statistically significant differences (OR 1.08, 95% CI 0.89-1.31, P = 0.46), while GPs in the control group prescribed significantly more antibiotics (OR 2.74, 95% CI 2.09-3.59, P < 0.001). This study shows that a single multifaceted intervention continues to reduce antibiotic prescribing 6 years later.

  3. Lessons for integrated household energy conservation policies from an intervention study in Singapore

    International Nuclear Information System (INIS)

    Kua, H.W.; Wong, S.E.

    2012-01-01

    In preparation for a community energy conservation program in the southwest district of Singapore, a pilot intervention study was conducted between August and November 2008 to study the effectiveness of tailored information and feedback in promoting household conservation. A sample of 125 households was involved in the study, of which 63 were the control group. Both self-reported behavioral changes and actual energy reductions were measured and any Hawthorne effect was identified. It was found that self-reported behavioral changes were strongly correlated to the level of trust in the energy conservation information given, the need for ease in practicing the recommended conservation measures and feeling of satisfaction in executing the measures; these results differ from several past studies on energy interventions. 60.7% of those who reported behavioral changes actually reduced energy consumption. Reasons were found and discussed. Lessons from this intervention study can be applied to design integrated policies aimed at promoting energy conservation in households. - Highlights: ► Energy intervention was implemented on 125 households. ► Outreach instruments included stickers, pamphlets and counseling. ► Self-reported behavioral and actual reductions were recorded. ► Self-reported behavioral change was only correlated to trust of information given. ► It was also correlated to ease of actions and feeling of satisfaction from actions.

  4. Leadership as a Health Research Policy Intervention: An Evaluation of the NIHR Leadership Programme (Phase 2).

    Science.gov (United States)

    Marjanovic, Sonja; Cochrane, Gavin; Manville, Catriona; Harte, Emma; Chataway, Joanna; Jones, Molly Morgan

    2016-01-29

    In early 2012, the National Institute for Health Research (NIHR) leadership programme was re-commissioned for a further three years following an evaluation by RAND Europe. During this new phase of the programme, we conducted a real-time evaluation, the aim of which was to allow for reflection on and adjustment of the programme on an on-going basis as events unfold. This approach also allowed for participants on the programme to contribute to and positively engage in the evaluation. The study aimed to understand the outputs and impacts from the programme, and to test the underlying assumptions behind the NIHR Leadership Programme as a science policy intervention. Evidence on outputs and impacts of the programme were collected around the motivations and expectations of participants, programme design and individual-, institutional- and system-level impacts.

  5. Supporting Policy In health with Research: an Intervention Trial (SPIRIT)—protocol for a stepped wedge trial

    Science.gov (United States)

    2014-01-01

    Introduction Governments in different countries have committed to better use of evidence from research in policy. Although many programmes are directed at assisting agencies to better use research, there have been few tests of the effectiveness of such programmes. This paper describes the protocol for SPIRIT (Supporting Policy In health with Research: an Intervention Trial), a trial designed to test the effectiveness of a multifaceted programme to build organisational capacity for the use of research evidence in policy and programme development. The primary aim is to determine whether SPIRIT results in an increase in the extent to which research and research expertise is sought, appraised, generated and used in the development of specific policy products produced by health policy agencies. Methods and analysis A stepped wedge cluster randomised trial involving six health policy agencies located in Sydney, Australia. Policy agencies are the unit of randomisation and intervention. Agencies were randomly allocated to one of three start dates (steps) to receive the 1-year intervention programme, underpinned by an action framework. The SPIRIT intervention is tailored to suit the interests and needs of each agency and includes audit, feedback and goal setting; a leadership programme; staff training; the opportunity to test systems to assist in the use of research in policies; and exchange with researchers. Outcome measures will be collected at each agency every 6 months for 30 months (starting at the beginning of step 1). Ethics and dissemination Ethics approval was granted by the University of Western Sydney Human Research and Ethics Committee HREC Approval H8855. The findings of this study will be disseminated broadly through peer-reviewed publications and presentations at conferences and used to inform future strategies. PMID:24989620

  6. Public social monitoring reports and their effect on a policy programme aimed at addressing the social determinants of health to improve health equity in New Zealand.

    Science.gov (United States)

    Pega, Frank; Valentine, Nicole B; Matheson, Don; Rasanathan, Kumanan

    2014-01-01

    The important role that monitoring plays in advancing global health is well established. However, the role of social monitoring as a tool for addressing social determinants of health (SDH) and health equity-focused policies remains under-researched. This paper assesses the extent and ways in which New Zealand's (NZ) Social Reports (SRs) supported a SDH- and health equity-oriented policy programme nationally over the 2000-2008 period by documenting the SRs' history and assessing its impact on policies across sectors in government and civil society. We conducted key-informant interviews with five senior policy-makers and an e-mail survey with 24 government and civil society representatives on SRs' history and policy impact. We identified common themes across these data and classified them accordingly to assess the intensity of the reports' use and their impact on SDH- and health equity-focused policies. Bibliometric analyses of government publications and media items were undertaken to empirically assess SRs' impact on government and civil society. SRs in NZ arose out of the role played by government as the "benevolent social welfare planner" and an understanding of the necessity of economic and social security for "progress". The SRs were linked to establishing a government-wide programme aimed at reducing inequalities. They have been used moderately to highly in central and local government and in civil society, both within and outside the health sector, but have neither entered public treasury and economic development departments nor the commercial sector. The SRs have not reached the more universal status of economic indicators. However, they have had some success at raising awareness of, and have stimulated isolated action on, SDH. The NZ case suggests that national-level social monitoring provides a valuable tool for raising awareness of SDH across government and civil society. A number of strategies could improve social reports' effectiveness in stimulating

  7. The GLAMA (Girls! Lead! Achieve! Mentor! Activate!) physical activity and peer leadership intervention pilot project: A process evaluation using the RE-AIM framework

    Science.gov (United States)

    2012-01-01

    Background Implementing new initiatives and physical activity interventions in schools represents a myriad of challenges that if overcome can potentially facilitate a range of behavioural changes. The aim of this paper is to describe the process evaluation of specific design constructs used in the GLAMA (Girls! Lead! Achieve! Mentor! Activate!) peer leadership and physical activity pilot project. Conducted in a state secondary school in Australia, the intervention was designed to provide students with opportunities to develop leadership skills, school and social connectedness in addition to a range of physical activity experiences. Methods This process evaluation used the RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) health promotion evaluation framework to assess three design constructs of the intervention: the effectiveness of leadership training and leader preparedness, activity suitability and participation, and the barriers to implementation of the intervention and potential solutions to overcome these barriers. As it was not the specific aim of this pilot, no behavioural change data were collected from students. Data were collected using a mixed methods approach including student questionnaires, teachers and researchers reporting on their own observations and feedback from students. Results There were three main considerations evident across more than one RE-AIM dimension that need to be addressed to assist with future GLAMA dissemination. Firstly, the development of teacher, school and student participation. This needs to be through a variety of professional development opportunities for teachers, integration of the program within timetabled classes within the school and promoting the program to students as an opportunity to develop a range of skills to apply to future learning and workplace environments. Secondly, the successful translation of leadership training to practice is necessary to ensure that leaders are effectively able to

  8. Assessing the impact of policy interventions on the adoption of plug-in electric vehicles: An agent-based model

    International Nuclear Information System (INIS)

    Silvia, Chris; Krause, Rachel M.

    2016-01-01

    Heightened concern regarding climate change and energy independence has increased interest in plug-in electric vehicles as one means to address these challenges and governments at all levels have considered policy interventions to encourage their adoption. This paper develops an agent-based model that simulates the introduction of four policy scenarios aimed at promoting electric vehicle adoption in an urban community and compares them against a baseline. These scenarios include reducing vehicle purchase price via subsidies, expanding the local public charging network, increasing the number and visibility of fully battery electric vehicles (BEVs) on the roadway through government fleet purchases, and a hybrid mix of these three approaches. The results point to the effectiveness of policy options that increased awareness of BEV technology. Specifically, the hybrid policy alternative was the most successful in encouraging BEV adoption. This policy increases the visibility and familiarity of BEV technology in the community and may help counter the idea that BEVs are not a viable alternative to gasoline-powered vehicles. - Highlights: •Various policy interventions to encourage electric vehicle adoption are examined. •An agent based model is used to simulate individual adoption decisions. •Policies that increase the familiarity of electric vehicles are most effective.

  9. 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,…

  10. The outcomes of a 12-week Internet intervention aimed at improving fitness and health-related quality of life in overweight adolescents: the Young & Active controlled trial.

    Directory of Open Access Journals (Sweden)

    Kirsti Riiser

    Full Text Available Overweight and obesity among adolescents may have consequences, with potentially lasting effects on health and health-related quality of life (HRQoL. Excess weight is also associated with decreases in physical activity and cardiorespiratory fitness. The aim of the current study was to investigate the short-term effects of a 12-week Internet intervention in a primary care setting intended to increase cardiorespiratory fitness and HRQoL among overweight and obese adolescents.In this controlled trial, participants (13-15 years were non-randomly allocated to an intervention- or a control group. The intervention group received 12-weeks access to an online program providing tailored physical activity counseling based on principles from Self-determination Theory and Motivational Interviewing. The control group received standard follow-up by the school nurses. The primary outcome measure of cardiorespiratory fitness was determined using a shuttle run test. The secondary outcomes: HRQoL, leisure time exercise, body image and self-determined motivation for physical activity and exercise, were assessed by self-report measures. Age- and gender-adjusted body mass index (BMI was calculated based on measurements of height and weight. To compare pre-to post intervention differences within groups, a paired samples t-test was used while crude differences between groups were analyzed with an independent samples t-test.Of the 120 participants, 108 completed the study, 75 in the intervention group and 33 in the control group. Exposure to the intervention had a small effect on cardiorespiratory fitness (0.14; 95% CI [0.01;0.28]; P = 0.04, and a moderate effect on HRQoL (5.22; 95% CI [0.90; 9.53]; P = 0.02. Moreover, the control group increased significantly in BMI, yielding a moderate preventive effect on BMI (-0.39; 95% CI [-0.74;-0.03]; P = 0.03 for the intervention group.The results suggest that the Internet intervention with tailored physical activity counseling

  11. Municipal policies and plans of action aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm, Sweden: a cross-sectional study.

    Science.gov (United States)

    Guldbrandsson, Karin; Wennerstad, Karin Modig; Rasmussen, Finn

    2009-08-03

    Promoting physical activity and healthy eating habits by structural measures that reach most children in a society is presumably the most sustainable way of preventing development of overweight and obesity in childhood. The main purpose of the present study was to analyse whether policies and plans of action at the central level in municipalities increased the number of measures that aim to promote physical activity and healthy eating habits among schoolchildren aged six to 16. Another purpose was to analyse whether demographic and socio-economic characteristics were associated with the level of such measures. Questionnaires were used to collect data from 25 municipalities and 18 town districts in Stockholm County, Sweden. The questions were developed to capture municipal structural work and factors facilitating physical activity and the development of healthy eating habits for children. Local policy documents and plans of action were gathered. Information regarding municipal demographic and socio-economic characteristics was collected from public statistics. Policy documents and plans of action in municipalities and town districts did not seem to influence the number of measures aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm County. Municipal demographic and socio-economic characteristics were, however, shown to influence the number of measures. In town districts with a high total population size, and in municipalities and town districts with a high proportion of adults with more than 12 years of education, a higher level of health-promoting measures was found. In municipalities with a high annual population growth, the number of measures was lower than in municipalities with a lower annual population growth. Another key finding was the lack of agreement between what was reported in the questionnaires regarding existence and contents of local policies and plans of action and what was actually found when these

  12. Study protocol for a group randomized controlled trial of a classroom-based intervention aimed at preventing early risk factors for drug abuse: integrating effectiveness and implementation research.

    Science.gov (United States)

    Poduska, Jeanne; Kellam, Sheppard; Brown, C Hendricks; Ford, Carla; Windham, Amy; Keegan, Natalie; Wang, Wei

    2009-09-02

    While a number of preventive interventions delivered within schools have shown both short-term and long-term impact in epidemiologically based randomized field trials, programs are not often sustained with high-quality implementation over time. This study was designed to support two purposes. The first purpose was to test the effectiveness of a universal classroom-based intervention, the Whole Day First Grade Program (WD), aimed at two early antecedents to drug abuse and other problem behaviors, namely, aggressive, disruptive behavior and poor academic achievement. The second purpose--the focus of this paper--was to examine the utility of a multilevel structure to support high levels of implementation during the effectiveness trial, to sustain WD practices across additional years, and to train additional teachers in WD practices. The WD intervention integrated three components, each previously tested separately: classroom behavior management; instruction, specifically reading; and family-classroom partnerships around behavior and learning. Teachers and students in 12 schools were randomly assigned to receive either the WD intervention or the standard first-grade program of the school system (SC). Three consecutive cohorts of first graders were randomized within schools to WD or SC classrooms and followed through the end of third grade to test the effectiveness of the WD intervention. Teacher practices were assessed over three years to examine the utility of the multilevel structure to support sustainability and scaling-up. The design employed in this trial appears to have considerable utility to provide data on WD effectiveness and to inform the field with regard to structures required to move evidence-based programs into practice. NCT00257088.

  13. Study protocol for a group randomized controlled trial of a classroom-based intervention aimed at preventing early risk factors for drug abuse: integrating effectiveness and implementation research

    Directory of Open Access Journals (Sweden)

    Keegan Natalie

    2009-09-01

    Full Text Available Abstract Background While a number of preventive interventions delivered within schools have shown both short-term and long-term impact in epidemiologically based randomized field trials, programs are not often sustained with high-quality implementation over time. This study was designed to support two purposes. The first purpose was to test the effectiveness of a universal classroom-based intervention, the Whole Day First Grade Program (WD, aimed at two early antecedents to drug abuse and other problem behaviors, namely, aggressive, disruptive behavior and poor academic achievement. The second purpose--the focus of this paper--was to examine the utility of a multilevel structure to support high levels of implementation during the effectiveness trial, to sustain WD practices across additional years, and to train additional teachers in WD practices. Methods The WD intervention integrated three components, each previously tested separately: classroom behavior management; instruction, specifically reading; and family-classroom partnerships around behavior and learning. Teachers and students in 12 schools were randomly assigned to receive either the WD intervention or the standard first-grade program of the school system (SC. Three consecutive cohorts of first graders were randomized within schools to WD or SC classrooms and followed through the end of third grade to test the effectiveness of the WD intervention. Teacher practices were assessed over three years to examine the utility of the multilevel structure to support sustainability and scaling-up. Discussion The design employed in this trial appears to have considerable utility to provide data on WD effectiveness and to inform the field with regard to structures required to move evidence-based programs into practice. Trial Registration Clinical Trials Registration Number: NCT00257088

  14. How can we help employees with chronic diseases to stay at work? A review of interventions aimed at job retention and based on an empowerment perspective.

    Science.gov (United States)

    Varekamp, Inge; Verbeek, Jos H A M; van Dijk, Frank J H

    2006-11-01

    A growing number of persons aged 16-65 is hampered by a chronic condition in performing job activities. Some of them quit the labour market prematurely. Vocational rehabilitation used to focus on (re)entering the labour market. Recently more attention is paid to interventions aimed at job retention. Some of these use an empowerment perspective. The objective of this study is to describe the characteristics, feasibility and effectiveness of such vocational rehabilitation interventions in order to decide which approaches are fruitful. The Medline, Embase, Cinahl and Psycinfo databases were systematically researched for studies published between 1988 and March 2004. Studies were included if they were experimental, included an intervention that aimed at job retention by means of solving work-related problems, used an empowerment perspective and concerned employees with one of the following chronic illnesses: diabetes mellitus, rheumatic diseases, hearing disorders, multiple sclerosis, inflammatory bowel disease, epilepsy, chronic kidney failure, COPD and asthma. Nine studies were detected. The aims of the intervention programs were to improve psychosocial skills or implement work accommodations. They were structured as individual (6x) or group programmes (3x). They used methods like education (9x), assessment (7x), counselling (5x), training or role playing (5x). The most important outcome measures were employment status (5x), actions to arrange work accommodations (3x), and psychosocial measures like self-efficacy and social competence (3x). Employment status was claimed to be positively influenced in four out of five studies, obtaining work accommodations was successful in all three studies and psychological outcome measures improved in two out of three studies. There is some evidence that vocational rehabilitation interventions that pay attention to training in requesting work accommodations and feelings of self-confidence or self-efficacy in dealing with work

  15. servicom policy intervention: improving service quality in nigerian ...

    African Journals Online (AJOL)

    Admin

    customer orientation in the Nigerian public sector. The policy goes by ..... Graham Effect' (Arnold, Cooper and Robertson,. 1995). .... system and budgeting time and money to pursue services ... customer relationships, and facilitating a safe and.

  16. Government policy interventions to reduce human antimicrobial use: protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Rogers Van Katwyk, Susan; Grimshaw, Jeremy M; Mendelson, Marc; Taljaard, Monica; Hoffman, Steven J

    2017-12-13

    for use by policymakers, public health practitioners, and researchers to inform future government policies aiming to address antimicrobial resistance. This review will also identify gaps in the evidence about the effectiveness of different policy interventions to inform future research priorities. PROSPERO CRD42017067514 .

  17. Using the Theory of Planned Behavior to Guide Focus Group Development of Messages Aimed at Increasing Compliance With a Tobacco-Free Policy.

    Science.gov (United States)

    Record, Rachael A; Harrington, Nancy G; Helme, Donald W; Savage, Matthew W

    2018-01-01

    This study details the persuasive message development for a theory-based campaign designed to increase compliance with a university's tobacco-free policy. The theory of planned behavior (TPB) guided message design and evaluation for focus group-tested messages that were adapted to the context of complying with a tobacco-free policy. The study was conducted at a university located in the tobacco belt. Undergraduate focus group participants (n = 65) were mostly male (69%), white (82%), and freshman (62%) who smoked at least 1 cigarette in the last 30 days; on-campus smoking percentages were never/rare (60%), occasionally (23%), and often/frequently (16%). Data analysis used a theoretical thematic approach to identify how the TPB constructs related to perceptions of message effectiveness. Participants responded favorably to attitudinal strategies about health, respect, and university figures; they rejected approaches they considered juvenile and offensive. They also discussed the impact of noncompliance and avoiding overgeneralized statements for addressing subjective norms, suggesting shortening text, adjusting picture location, and emphasizing the importance of compliance to increase perceptions of behavioral control. Applying theory to preexisting messages is challenging. The design approach in this study is an evidence-based strategy that can be used as a universal process for message adaptation. Results offer health promotion suggestions for designing messages aimed at improving undergraduate smokers' willingness to comply with tobacco-free campus policies.

  18. Public health economic evaluation of different European Union–level policy options aimed at reducing population dietary trans fat intake12

    Science.gov (United States)

    Mouratidou, Theodora; Livaniou, Anastasia

    2016-01-01

    Background: The adverse relation between dietary trans fatty acid (TFA) intake and coronary artery disease risk is well established. Many countries in the European Union (EU) and worldwide have implemented different policies to reduce the TFA intake of their populations. Objective: The aim of this study was to assess the added value of EU-level action by estimating the cost-effectiveness of 3 possible EU-level policy measures to reduce population dietary TFA intake. This was calculated against a reference situation of not implementing any EU-level policy (i.e., by assuming only national or self-regulatory measures). Design: We developed a mathematical model to compare different policy options at the EU level: 1) to do nothing beyond the current state (reference situation), 2) to impose mandatory TFA labeling of prepackaged foods, 3) to seek voluntary agreements toward further reducing industrially produced TFA (iTFA) content in foods, and 4) to impose a legislative limit for iTFA content in foods. Results: The model indicated that to impose an EU-level legal limit or to make voluntary agreements may, over the course of a lifetime (85 y), avoid the loss of 3.73 and 2.19 million disability-adjusted life-years (DALYs), respectively, and save >51 and 23 billion euros when compared with the reference situation. Implementing mandatory TFA labeling can also avoid the loss of 0.98 million DALYs, but this option incurs more costs than it saves compared with the reference option. Conclusions: The model indicates that there is added value of an EU-level action, either via a legal limit or through voluntary agreements, with the legal limit option producing the highest additional health benefits. Introducing mandatory TFA labeling for the EU common market may provide some additional health benefits; however, this would likely not be a cost-effective strategy. PMID:27680991

  19. Turning risk assessment and adaptation policy priorities into meaningful interventions and governance processes

    Science.gov (United States)

    Brown, Kathryn; DiMauro, Manuela; Johns, Daniel; Holmes, Gemma; Thompson, David; Russell, Andrew; Style, David

    2018-06-01

    The UK is one of the first countries in the world to have set up a statutory system of national climate risk assessments followed by a national adaptation programme. Having this legal framework has been essential for enabling adaptation at the government level in a challenging political environment. However, using this framework to create an improvement in resilience to climate change across the country requires more than publishing a set of documents; it requires careful thought about what interventions work, how they can be enabled and what level of risk acceptability individuals, organizations and the country should be aiming for. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  20. Egalitarian paternalism: interactional forms of negotiating equality and intervention in Dutch policy practices

    NARCIS (Netherlands)

    van den Berg, M.

    2016-01-01

    Governments develop new strategies to ‘guide’ citizens’ behaviour. Simultaneously, hierarchical policy intervention is increasingly frowned upon. The apparent tension in contemporary social policy between the will to intervene, on the one hand, and the will to be equal on the other hand is the

  1. Evaluating a Dutch cardiology primary care plus intervention on the Triple Aim outcomes: study design of a practice-based quantitative and qualitative research.

    Science.gov (United States)

    Quanjel, Tessa C C; Spreeuwenberg, Marieke D; Struijs, Jeroen N; Baan, Caroline A; Ruwaard, Dirk

    2017-09-06

    In an attempt to deal with the pressures on the health-care system and to guarantee sustainability, changes are needed. This study focuses on a cardiology primary care plus intervention. Primary care plus (PC+) is a new health-care delivery model focused on substitution of specialist care in the hospital setting with specialist care in the primary care setting. The intervention consists of a cardiology PC+ centre in which cardiologists, supported by other health-care professionals, provide consultations in a primary care setting. The PC+ centre aims to improve the health of the population and quality of care as experienced by patients, and reduce the number of referrals to hospital-based outpatient specialist care in order to reduce health-care costs. These aims reflect the Triple Aim principle. Hence, the objectives of the study are to evaluate the cardiology PC+ centre in terms of the Triple Aim outcomes and to evaluate the process of the introduction of PC+. The study is a practice-based, quantitative study with a longitudinal observational design, and an additional qualitative study to supplement, interpret and improve the quantitative study. The study population of the quantitative part will consist of adult patients (≥18 years) with non-acute and low-complexity cardiology-related health complaints, who will be referred to the cardiology PC+ centre (intervention group) or hospital-based outpatient cardiology care (control group). All eligible patients will be asked to complete questionnaires at three different time points consisting of questions about their demographics, health status and experience of care. Additionally, quantitative data will be collected about health-care utilization and related health-care costs at the PC+ centre and the hospital. The qualitative part, consisting of semi-structured interviews, focus groups, and observations, is designed to evaluate the process as well as to amplify, clarify and explain quantitative results. This study

  2. Effectiveness of interventions aimed at improving physical and psychological outcomes of fall-related injuries in people with dementia: a narrative systematic review

    Directory of Open Access Journals (Sweden)

    Shannon Robalino

    2018-02-01

    Full Text Available Abstract Background The annual prevalence of falls in people with dementia ranges from 47 to 90%. Falls are a common reason for hospital admission in people with dementia, and there is limited research evidence regarding the care pathways experienced by this population. In addition to immediate management of an injury, prevention of further falls is likely to be an important part of any successful intervention. This review aims to assess the effectiveness of interventions for improving the physical and psychological wellbeing of people with dementia who have sustained a fall-related injury. Methods Systematic review methodologies were employed utilising searches across multiple databases (MEDLINE, CENTRAL, Health Management Information Consortium, EMBASE, CINAHL, Web of Science, Allied and Complementary Medicine Database, and Physiotherapy Evidence Database (PEDro and citation chaining. Studies including people with a known diagnosis of dementia living in the community and who present at health services with a fall, with or without injury, were included. Outcomes of interest included mobility, recurrent falls, activities of daily living, length of hospital stay, and post-discharge residence. Results were independently reviewed and quality assessed by two researchers, and data extracted using a customised form. A narrative synthesis was performed due to heterogeneity of the included studies. Results Seven studies were included. Interventions clustered into three broad categories: multidisciplinary in-hospital post-surgical geriatric assessment; pharmaceuticals; and multifactorial assessment. Multidisciplinary care and early mobilisation showed short-term improvements for some outcomes. Only an annual administration of zoledronic acid showed long-term reduction in recurrent falls. Conclusions Due to high heterogeneity across the studies, definitive conclusions could not be reached. Most post-fall interventions were not aimed at patients with

  3. Factors influencing physicians' choice of workplace: systematic review of drivers of attrition and policy interventions to address them.

    Science.gov (United States)

    El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E

    2016-12-01

    The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians' choice of workplace, and policy interventions for retaining physicians in the public sector. Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Nineteen articles met the inclusion criteria. Six major themes that affected physicians' choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. While factors affecting physicians' choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross-country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public sector.

  4. Factors influencing physicians’ choice of workplace: systematic review of drivers of attrition and policy interventions to address them

    Science.gov (United States)

    El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E

    2016-01-01

    Objectives The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians’ choice of workplace, and policy interventions for retaining physicians in the public sector. Methods Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Results Nineteen articles met the inclusion criteria. Six major themes that affected physicians’ choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. Conclusion While factors affecting physicians’ choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross–country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public

  5. Policy-level interventions and work-related psychosocial risk management in the European Union

    NARCIS (Netherlands)

    Leka, S.; Jain, A.; Zwetsloot, G.I.J.M.; Cox, T.

    2010-01-01

    There exists a substantial degree of diversity across strategies to prevent and manage work- related psychosocial risks and their associated health effects. Whereas it is common to distinguish between organizational and individual interventions, the important level of policy- level interventions has

  6. Implementing multiple intervention strategies in Dutch public health-related policy networks.

    Science.gov (United States)

    Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

    2017-10-13

    Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to implement an intervention mix. Data were collected (2009-14) from 29 Dutch public health policy networks. Surveys were used to identify the number of policy sectors, participation of actors, level of trust, networking by the project leader, and intervention strategies implemented. Conditions sufficient for an intervention mix (≥3 of 4 non-educational strategies present) were determined in a fuzzy-set qualitative comparative analysis. A multisectoral policy network (≥7 of 14 sectors present) was neither a necessary nor a sufficient condition. In multisectoral networks, additionally required was either the active participation of network actors (≥50% actively involved) or active networking by the project leader (≥monthly contacts with network actors). In policy networks that included few sectors, a high level of trust (positive perceptions of each other's intentions) was needed-in the absence though of any of the other conditions. If the network actors were also actively involved, an extra requirement was active networking by the project leader. We conclude that the multisectoral composition of policy networks can contribute to the implementation of a variety of intervention strategies, but not without additional efforts. However, policy networks that include only few sectors are also able to implement an intervention mix. Here, trust seems to be the most important condition. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Impact of two policy interventions on dietary diversity in Ecuador.

    Science.gov (United States)

    Ponce, Juan; Ramos-Martin, Jesus

    2017-06-01

    To differentiate the effects of food vouchers and training in health and nutrition on consumption and dietary diversity in Ecuador by using an experimental design. Interventions involved enrolling three groups of approximately 200 randomly selected households per group in three provinces in Ecuador. Power estimates and sample size were computed using the Optimal Design software, with a power of 80 %, at 5 % of significance and with a minimum detectable effect of 0·25 (sd). The first group was assigned to receive a monthly food voucher of $US 40. The second group was assigned to receive the same $US 40 voucher, plus training on health and nutrition issues. The third group served as the control. Weekly household values of food consumption were converted into energy intake per person per day. A simple proxy indicator was constructed for dietary diversity, based on the Food Consumption Score. Finally, an econometric model with three specifications was used for analysing the differential effect of the interventions. Three provinces in Ecuador, two from the Sierra region (Carchi and Chimborazo) and one from the Coastal region (Santa Elena). Members of 773 households randomly selected (n 4343). No significant impact on consumption for any of the interventions was found. However, there was evidence that voucher systems had a positive impact on dietary diversity. No differentiated effects were found for the training intervention. The most cost-effective intervention to improve dietary diversity in Ecuador is the use of vouchers to support family choice in food options.

  8. The Question of Sustainability of Green Electricity Policy Intervention

    Directory of Open Access Journals (Sweden)

    Simona Bigerna

    2014-08-01

    Full Text Available In this paper, we analyse the financial viability and economic sustainability implications of government programs for the development of renewable energy sources, explicitly considering that consumers take environmental issues into account. We envisage a broad policy strategy for the future, which we label the “World Sustainable Scenario”, and we quantify the inter-temporal resource requirement in terms of investment necessary to achieve it. We perform an empirical meta-analysis to quantify the willingness to pay for green electricity worldwide. Subsequently, we compare the amount of resources required according to policy programs and the populations’ willingness to sacrifice current resources for future benefits (i.e., willingness to finance future investments to assess the plausibility of current policies. The main empirical findings show that the population’s attitude toward green electricity will support, on average, 50% of the total investment required. We conclude that this is a positive result, which will make possible the success of the renewable energy sources development policy.

  9. Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood.

    Science.gov (United States)

    Helle, Christine; Hillesund, Elisabet Rudjord; Omholt, Mona Linge; Øverby, Nina Cecilie

    2017-09-20

    Childhood overweight and obesity is a global public health challenge. Primary prevention initiatives targeting parents have been called for to encourage a positive feeding environment and healthy eating habits that may lay a good foundation for future health. At the same time, there is a need for interventions which combine accessibility and scalability with cost effectiveness. Today's parents are extensive Internet-users, but only a few randomized controlled trials have investigated the use of Internet to promote healthy eating habits in early childhood. In Early Food for Future Health we have developed and will evaluate an Internet-based tool for parents of children between 6 and 12 months, aiming to increase knowledge about infant nutrition and foster protective feeding behavior. During springtime 2016, parents of children aged between 3 and 5 months were recruited through Norwegian child health centres and announcements on Facebook. After completing the baseline questionnaire, 718 parents were individually randomized to intervention- or control group. The intervention group received monthly emails with links to an age-appropriate web-site when their child was between 6 and 12 months. The control group received ordinary care from the child health centres. The data-collection is ongoing. All participants will be followed up at ages 12 and possibly 24 and 48 months, with questionnaires relating to eating behaviour and feeding practices, food variety and diet quality. Providing guidance and counseling to parents of infants is an important task for health authorities and the public child health services. Early Food for Future health is an intervention focusing on promoting early healthy food-habits which may prevent childhood overweight and obesity. If proven to be effective, Early Food for Future Health can be used by parents and public health nurses for supplementary guidance on feeding practices and diet. This study has the potential to provide greater

  10. Macroeconomic stabilization and intervention policy under an exchange rate band

    NARCIS (Netherlands)

    Beetsma, R.M.W.J.; van der Ploeg, F.

    1998-01-01

    Macroeconomic stabilization and foreign exchange market interventions are investigated for a small open economy with a nominal exchange rate band. In a first-best situation, a band is not advisable from a stabilization perspective, even though with money demand shocks no welfare losses are incurred.

  11. Homeless Families in the Netherlands: Intervention Policies and Practices

    Directory of Open Access Journals (Sweden)

    Catelijne Akkermans

    2011-07-01

    Full Text Available The demographics of the homeless population in many countries are currently shifting, and this cannot be explained by the different welfare systems to be found in these countries. Nevertheless, there is some evidence that the homelessness policies of some countries are converging, and we observe a combination of decentralisation, housing first, and a taylor-made, individualised approach. However, what is interesting is the question as to what extent these policies are based on a punitive dimension or on a justice dimension. This aspect is little discussed in the Netherlands where policies to combat homelessness are intended to put an end to public nuisance and to get the homeless off the street. Research into evicted families demonstrates that combining elements of (mild coercion with efforts to solve homelessness leads to problems in at least three domains: the motivation of homeless families to accept help and support, the quality of life in the individualised approach, and the matter of registration. These problems need investigating, also from an international perspective.

  12. Food waste disposal units in UK households: The need for policy intervention

    International Nuclear Information System (INIS)

    Iacovidou, Eleni; Ohandja, Dieudonne-Guy; Voulvoulis, Nikolaos

    2012-01-01

    The EU Landfill Directive requires Member States to reduce the amount of biodegradable waste disposed of to landfill. This has been a key driver for the establishment of new waste management options, particularly in the UK, which in the past relied heavily on landfill for the disposal of municipal solid waste (MSW). MSW in the UK is managed by Local Authorities, some of which in a less conventional way have been encouraging the installation and use of household food waste disposal units (FWDs) as an option to divert food waste from landfill. This study aimed to evaluate the additional burden to water industry operations in the UK associated with this option, compared with the benefits and related savings from the subsequent reductions in MSW collection and disposal. A simple economic analysis was undertaken for different FWD uptake scenarios, using the Anglian Region as a case study. Results demonstrated that the significant savings from waste collection arising from a large-scale uptake of FWDs would outweigh the costs associated with the impacts to the water industry. However, in the case of a low uptake, such savings would not be enough to cover the increased costs associated with the wastewater provision. As a result, this study highlights the need for policy intervention in terms of regulating the use of FWDs, either promoting them as an alternative to landfill to increase savings from waste management, or banning them as a threat to wastewater operations to reduce potential costs to the water industry. - Highlights: ► FWDs can be a less conventional way for diverting food waste from landfill. ► We compared water industry costs to savings from MSW collection and treatment. ► A large-scale uptake of FWDs would outweigh the costs to the water industry. ► At a low uptake, MSW collection savings are not enough to cover these costs. ► Findings highlight the need for policy intervention, regulating the use of FWDs.

  13. Modeling spatial segregation and travel cost influences on utilitarian walking: Towards policy intervention.

    Science.gov (United States)

    Yang, Yong; Auchincloss, Amy H; Rodriguez, Daniel A; Brown, Daniel G; Riolo, Rick; Diez-Roux, Ana V

    2015-05-01

    We develop an agent-based model of utilitarian walking and use the model to explore spatial and socioeconomic factors affecting adult utilitarian walking and how travel costs as well as various educational interventions aimed at changing attitudes can alter the prevalence of walking and income differentials in walking. The model is validated against US national data. We contrast realistic and extreme parameter values in our model and test effects of changing these parameters across various segregation and pricing scenarios while allowing for interactions between travel choice and place and for behavioral feedbacks. Results suggest that in addition to income differences in the perceived cost of time, the concentration of mixed land use (differential density of residences and businesses) are important determinants of income differences in walking (high income walk less), whereas safety from crime and income segregation on their own do not have large influences on income differences in walking. We also show the difficulty in altering walking behaviors for higher income groups who are insensitive to price and how adding to the cost of driving could increase the income differential in walking particularly in the context of segregation by income and land use. We show that strategies to decrease positive attitudes towards driving can interact synergistically with shifting cost structures to favor walking in increasing the percent of walking trips. Agent-based models, with their ability to capture dynamic processes and incorporate empirical data, are powerful tools to explore the influence on health behavior from multiple factors and test policy interventions.

  14. Policy interventions to promote healthy eating: a review of what works, what does not, and what is promising.

    Science.gov (United States)

    Brambila-Macias, Jose; Shankar, Bhavani; Capacci, Sara; Mazzocchi, Mario; Perez-Cueto, Federico J A; Verbeke, Wim; Traill, W Bruce

    2011-12-01

    Unhealthy diets can lead to various diseases, which in turn can translate into a bigger burden for the state in the form of health services and lost production. Obesity alone has enormous costs and claims thousands of lives every year. Although diet quality in the European Union has improved across countries, it still falls well short of conformity with the World Health Organization dietary guidelines. In this review, we classify types of policy interventions addressing healthy eating and identify through a literature review what specific policy interventions are better suited to improve diets. Policy interventions are classified into two broad categories: information measures and measures targeting the market environment. Using this classification, we summarize a number of previous systematic reviews, academic papers, and institutional reports and draw some conclusions about their effectiveness. Of the information measures, policy interventions aimed at reducing or banning unhealthy food advertisements generally have had a weak positive effect on improving diets, while public information campaigns have been successful in raising awareness of unhealthy eating but have failed to translate the message into action. Nutritional labeling allows for informed choice. However, informed choice is not necessarily healthier; knowing or being able to read and interpret nutritional labeling on food purchased does not necessarily result in consumption of healthier foods. Interventions targeting the market environment, such as fiscal measures and nutrient, food, and diet standards, are rarer and generally more effective, though more intrusive. Overall, we conclude that measures to support informed choice have a mixed and limited record of success. On the other hand, measures to target the market environment are more intrusive but may be more effective.

  15. Social Analysis in Development Interventions: Policy Artefact or Constructive Transformation?

    Directory of Open Access Journals (Sweden)

    SUSANNA PRICE

    2012-02-01

    Full Text Available Recently attention has focused on the role of social researchers in the processes of construction and transmission of knowledge about global poverty and its reduction. This paper examines some of the formative efforts by pioneering social researchers in development institutions to step into the realm of policy making to construct processes for project preparation and management through social analysis. Before 1970 development planners invoked ‘social' or ‘human' factors only as an excuse to explain away project failures - they designed and implemented development projects in the absence of any strategies or regulatory frameworks for managing their social impacts. Recognizing that project investments represent induced change and constitute a social process in themselves, pioneering social researchers constructed policies and procedures to introduce sociological content and method into the project cycle and so re-order social outcomes. Were such constructs merely policy artefacts? Even as the constructs helped to shift the statements of the development discourse towards ‘people oriented' poverty reduction, new modalities appeared which tested the limits of the agreed methods. Institutions may forget, neglect, contest or re-write the documents if in perceived conflict with the institutional ‘core business'. Yet those pioneering efforts created institutional space for, and understanding of, social analysis, with a measure of flow-on international recognition. Tracking social analysis in several international institutions and in a significant emerging economy, China, this paper highlights not only a history full of lessons to be learned where social analysis is not practiced systematically but also outlines some future challenges.

  16. Making multiple 'online counsellings' through policy and practice: an evidence-making intervention approach.

    Science.gov (United States)

    Savic, Michael; Dilkes-Frayne, Ella; Carter, Adrian; Kokanovic, Renata; Manning, Victoria; Rodda, Simone N; Lubman, Dan I

    2018-03-01

    Online counselling services for a range of health conditions have proliferated in recent years. However, there is ambiguity and tension around their role and function. It is often unclear whether online counselling services are intended to provide only a brief intervention, the provision of information or referral, or constitute an alternative to face-to-face treatment. In line with recent analyses of alcohol and other drug (AOD) policy and interventions that draw on a critical social science perspective, we take an evidence-making intervention approach to examine how online counselling in the AOD field is made in policy and through processes of local implementation. In this article, we analyse how online AOD counselling interventions and knowledges are enacted in Australia's AOD policy, and compare these enactments with an analysis of information about Australia's national online AOD counselling service, Counselling Online, and transcripts of counselling sessions with clients of Counselling Online. We suggest that while the policy enacts online counselling as a brief intervention targeting AOD use, and as an avenue to facilitate referral to face-to-face treatment services, in its implementation in practice online counselling is enacted in more varied ways. These include online counselling as attempting to attend to AOD use and interconnected psychosocial concerns, as a potential form of treatment in its own right, and as supplementing face-to-face AOD treatment services. Rather than viewing online counselling as a singular and stable intervention object, we suggest that multiple 'online counsellings' emerge in practice through local implementation practices and knowledges. We argue that the frictions that arise between policy and practice enactments need to be considered by policy makers, funders, clinicians and researchers as they affect how the concerns of those targeted by the intervention are attended to. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Equity impact of interventions and policies to reduce smoking in youth: systematic review.

    Science.gov (United States)

    Brown, Tamara; Platt, Stephen; Amos, Amanda

    2014-11-01

    A systematic review to assess the equity impact of interventions/policies on youth smoking. Biosis, Cinahl, Cochrane Library, Conference Proceedings Citation Index, Embase, Eric, Medline, Psycinfo, Science Citation Index Expanded, Social Sciences Citation Index and tobacco control experts. Published January 1995 to October 2013. Primary studies of interventions/policies reporting smoking-related outcomes in youth (11-25 years) of lower compared to higher socioeconomic status (SES). References were screened and independently checked. Studies were quality assessed; characteristics and outcomes were extracted. A narrative synthesis by intervention/policy type. Equity impact was assessed as: positive (reduced inequity), neutral (no difference by SES), negative (increased inequity), mixed (equity impact varied) or unclear.Thirty-eight studies of 40 interventions/policies were included: smokefree (12); price/tax (7); mass media campaigns (1); advertising controls (4); access controls (5); school-based programmes (5); multiple policies (3), individual-level cessation support (2), individual-level support for smokefree homes (1). The distribution of equity effects was: 7 positive, 16 neutral, 12 negative, 4 mixed, 1 unclear. All 7 positive equity studies were US-based: price/tax (4), age-of-sales laws (2) and text-messaging cessation support (1). A British school-based intervention (A Stop Smoking in Schools Trial (ASSIST)) showed mixed equity effects (neutral and positive). Most neutral equity studies benefited all SES groups. Very few studies have assessed the equity impact of tobacco control interventions/policies on young people. Price/tax increases had the most consistent positive equity impact. There is a need to strengthen the evidence base for the equity impact of youth tobacco control interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Development of an intervention delivered by mobile phone aimed at decreasing unintended pregnancy among young people in three lower middle income countries.

    Science.gov (United States)

    McCarthy, Ona L; Wazwaz, Ola; Osorio Calderon, Veronica; Jado, Iman; Saibov, Salokhiddin; Stavridis, Amina; López Gallardo, Jhonny; Tokhirov, Ravshan; Adada, Samia; Huaynoca, Silvia; Makleff, Shelly; Vandewiele, Marieka; Standaert, Sarah; Free, Caroline

    2018-05-02

    Unintended pregnancies can result in poorer health outcomes for women, children and families. Young people in low and middle income countries are at particular risk of unintended pregnancies and could benefit from innovative contraceptive interventions. There is growing evidence that interventions delivered by mobile phone can be effective in improving a range of health behaviours. This paper describes the development of a contraceptive behavioural intervention delivered by mobile phone for young people in Tajikistan, Bolivia and Palestine, where unmet need for contraception is high among this group. Guided by Intervention Mapping, the following steps contributed to the development of the interventions: (1) needs assessment; (2) specifying behavioural change to result from the intervention; (3) selecting behaviour change methods to include in the intervention; (4) producing and refining the intervention content. The results of the needs assessment produced similar interventions across the countries. The interventions consist of short daily messages delivered over 4 months (delivered by text messaging in Palestine and mobile phone application instant messages in Bolivia and Tajikistan). The messages provide information about contraception, target attitudes that are barriers to contraceptive uptake and support young people in feeling that they can influence their reproductive health. The interventions each contain the same ten behaviour change methods, adapted for delivery by mobile phone. The development resulted in a well-specified, theory-based intervention, tailored to each country. It is feasible to develop an intervention delivered by mobile phone for young people in resource-limited settings.

  19. Effectiveness of cultural adaptations of interventions aimed at smoking cessation, diet, and/or physical activity in ethnic minorities. a systematic review

    NARCIS (Netherlands)

    Nierkens, Vera; Hartman, Marieke A.; Nicolaou, Mary; Vissenberg, Charlotte; Beune, Erik J. A. J.; Hosper, Karen; van Valkengoed, Irene G.; Stronks, Karien

    2013-01-01

    The importance of cultural adaptations in behavioral interventions targeting ethnic minorities in high-income societies is widely recognized. Little is known, however, about the effectiveness of specific cultural adaptations in such interventions. To systematically review the effectiveness of

  20. The Effectiveness of a 6-Week Intervention Program Aimed at Modifying Running Style in Patients With Chronic Exertional Compartment Syndrome: Results From a Series of Case Studies.

    Science.gov (United States)

    Helmhout, Pieter H; Diebal, Angela R; van der Kaaden, Lisanne; Harts, Chris C; Beutler, Anthony; Zimmermann, Wes O

    2015-03-01

    Previous studies have reported on the promising effects of changing running style in patients with chronic exertional compartment syndrome (CECS) using a 6-week training program aimed at adopting a forefoot strike technique. This study expands that work by comparing a 6-week in-house, center-based run training program with a less extensive, supervised, home-based run training program (50% home training). An alteration in running technique will lead to improvements in CECS complaints and running performance, with the less supervised program producing less dramatic results. Cohort study; Level of evidence, 3. Nineteen patients with CECS were prospectively enrolled. Postrunning intracompartmental pressure (ICP), run performance, and self-reported questionnaires were taken for all patients at baseline and after 6 weeks of running intervention. Questionnaires were also taken from 14 patients (7 center-based, 6 home-based) 4 months posttreatment. Significant improvement between preintervention and postintervention rates was found for running distance (43%), ICP values (36%), and scores on the questionnaires Single Assessment Numeric Evaluation (SANE; 36%), Lower Leg Outcome Survey (LLOS; 18%), and Patient Specific Complaints (PSC; 60%). The mean posttreatment score on the Global Rating of Change (GROC) was between +4 and +5 ("somewhat better" to "moderately better"). In 14 participants (74%), no elevation of pain was reported posttreatment, compared with 3 participants (16%) at baseline; in all these cases, the running test was aborted because of a lack of cardiorespiratory fitness. Self-reported scores continued to improve 4 months after the end of the intervention program, with mean improvement rates of 48% (SANE), 26% (LLOS), and 81% (PSC). The mean GROC score improved to +6 points ("a great deal better"). In 19 patients diagnosed with CECS, a 6-week forefoot running intervention performed in both a center-based and home-based training setting led to decreased

  1. Can early intervention policies improve wellbeing? Evidence from a randomized controlled trial

    OpenAIRE

    Michael Daly; Liam Delaney; Orla Doyle; Nick Fitzpatrick; Christine O'Farrelly

    2014-01-01

    Many authors have proposed incorporating measures of well-being into evaluations of public policy. Yet few evaluations use experimental design or examine multiple aspects of well-being, thus the causal impact of public policies on well-being is largely unknown. In this paper we examine the effect of an intensive early intervention program on maternal well-being in a targeted disadvantaged community. Using a randomized controlled trial design we estimate and compare treatment effects on global...

  2. Can Early Intervention Policies Improve Well-being? Evidence from a randomized controlled trial

    OpenAIRE

    Daly, Michael; Delaney, Liam; Doyle, Orla; Fitzpatrick, Nick; O'Farrelly, Christine

    2014-01-01

    Many authors have proposed incorporating measures of well-being into evaluations of public policy. Yet few evaluations use experimental design or examine multiple aspects of wellbeing, thus the causal impact of public policies on well-being is largely unknown. In this paper we examine the effect of an intensive early intervention program on maternal wellbeing in a targeted disadvantaged community. Using a randomized controlled trial design we estimate and compare treatment effects on global w...

  3. Promoting physical activity, healthy eating and gross motor skills development among preschoolers attending childcare centers: Process evaluation of the Healthy Start-Départ Santé intervention using the RE-AIM framework.

    Science.gov (United States)

    Ward, Stéphanie; Chow, Amanda Froehlich; Humbert, M Louise; Bélanger, Mathieu; Muhajarine, Nazeem; Vatanparast, Hassan; Leis, Anne

    2018-06-01

    The Healthy Start-Départ Santé intervention was developed to promote physical activity, gross motor skills and healthy eating among preschoolers attending childcare centers. This process evaluation aimed to report the reach, effectiveness, adoption, implementation and maintenance of the Healthy Start-Départ Santé intervention. The RE-AIM framework was used to guide this process evaluation. Data were collected across 140 childcare centers who received the Healthy Start-Départ Santé intervention in the provinces of Saskatchewan and New Brunswick, Canada. Quantitative data were collected through director questionnaires at 10 months and 2 years after the initial training and analyzed using descriptive statistics. Qualitative data were collected throughout the intervention. The intervention was successful in reaching a large number of childcare centres and engaging both rural and urban communities across Saskatchewan and New Brunswick. Centres reported increasing opportunities for physical activity and healthy eating, which were generally low-cost, easy and quick to implement. However, these changes were rarely transformed into formal written policies. A total of 87% of centers reported using the physical activity resource and 68% using the nutrition resource on a weekly basis. Implementation fidelity of the initial training was high. Of those centers who received the initial training, 75% participated in the mid-point booster session training. Two year post-implementation questionnaires indicated that 47% of centers were still using the Active Play Equipment kit, while 42% were still using the physical activity resource and 37% were still using the nutrition resource. Key challenges to implementation and sustainability identified during the evaluation were consistent among all of the REAIM elements. These challenges included lack of time, lack of support from childcare staff and low parental engagement. Findings from this study suggest the implementation of

  4. Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review

    Science.gov (United States)

    Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo

    2017-01-01

    Background The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. Aim The goal of this scoping review is to delineate and “map” the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. Methods A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O’Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. Results The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. Discussion The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this

  5. 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...

  6. Adapted Intervention Mapping: A Strategic Planning Process for Increasing Physical Activity and Healthy Eating Opportunities in Schools via Environment and Policy Change

    Science.gov (United States)

    Belansky, Elaine S.; Cutforth, Nick; Chavez, Robert; Crane, Lori A.; Waters, Emily; Marshall, Julie A.

    2013-01-01

    Background: School environment and policy changes have increased healthy eating and physical activity; however, there has been modest success in translating research ?ndings to practice. The School Environment Project tested whether an adapted version of Intervention Mapping (AIM) resulted in school change. Methods: Using a pair randomized design,…

  7. Policy interventions implemented through sporting organisations for promoting healthy behaviour change.

    Science.gov (United States)

    Priest, Naomi; Armstrong, Rebecca; Doyle, Jodie; Waters, Elizabeth

    2008-07-16

    Sporting organisations provide an important setting for health promotion strategies that involve policies, communication of healthy messages and creation of health promoting environments. The introduction of policy interventions within sporting organisations is one strategy to target high risk behaviours such as smoking, alcohol consumption, excess sun exposure, unhealthy eating and discrimination. To update a review of all controlled studies evaluating policy interventions organised through sporting settings to increase healthy behaviour (related to smoking, alcohol, healthy eating, sun protection, discrimination, safety and access). We updated the original (2004) searches in May 2007. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2 2007); MEDLINE and MEDLINE In-Process and Other Non-Indexed Citations (2004 to Week 3 April 2007); EMBASE (2004 to Week 17 2007); PsyclNFO (2004 to April Week 1 2007); CINAHL (2004 to Week 1 May 2007); SPORTDiscus (2004 to April 2007); Sociological Abstracts (2004 to 2007); Dissertation Abstracts (2004 to May 2007), ERIC (2000 to 2007), freely available online health promotion and sports-related databases hosted by leading agencies, and the internet using sport and policy-related key words. Controlled studies evaluating any policy intervention implemented through sporting organisations to instigate and/or sustain healthy behaviour change, intention to change behaviour, or changes in attitudes, knowledge or awareness of healthy behaviour, in people of all ages. Policies must address any of the following: smoking, alcohol, healthy eating, sun protection, access for disadvantaged groups, physical safety (not including injuries), and social and emotional health (e.g. anti-vilification, anti-discrimination). Uncontrolled studies which met the other inclusion criteria were to be reported in an annex to the review. We assessed whether identified citations met the inclusion criteria

  8. The Effectiveness of Policy Interventions for School Bullying: A Systematic Review

    Science.gov (United States)

    Hall, William

    2017-01-01

    Objective Bullying threatens the mental and educational well-being of students. Although anti-bullying policies are prevalent, little is known about their effectiveness. This systematic review evaluates the methodological characteristics and summarizes substantive findings of studies examining the effectiveness of school bullying policies. Method Searches of 11 bibliographic databases yielded 489 studies completed since January 1, 1995. Following duplicate removal and double-independent screening based on a priori inclusion criteria, 21 studies were included for review. Results Substantially more educators perceive anti-bullying policies to be effective rather than ineffective. Whereas several studies show that the presence or quality of policies is associated with lower rates of bullying among students, other studies found no such associations between policy presence or quality and reductions in bullying. Consistent across studies, this review found that schools with anti-bullying policies that enumerated protections based on sexual orientation and gender identity were associated with better protection of lesbian, gay, bisexual, transgender, and queer (LGBTQ) students. Specifically, LGBTQ students in schools with such policies reported less harassment and more frequent and effective intervention by school personnel. Findings are mixed regarding the relationship between having an anti-bullying policy and educators’ responsiveness to general bullying. Conclusions Anti-bullying policies might be effective at reducing bullying if their content is based on evidence and sound theory and if they are implemented with a high level of fidelity. More research is needed to improve on limitations among extant studies. PMID:28344750

  9. Evaluation of Community-Based Policy, Systems, and Environment Interventions Targeting the Vending Machines.

    Science.gov (United States)

    Garcia, Kristen M; Garney, Whitney R; Primm, Kristin M; McLeroy, Kenneth R

    The American Heart Association conducted policy, systems, and environmental (PSE) focused interventions to increase healthy vending in 8 communities. PSE interventions were assessed using the Nutrition Environment Measures Survey Vending Assessment to see changes in the food environment. Baseline and follow-up assessments were conducted with 3 settings and a total of 19 machines. PSE changes resulted in increased availability of healthy options and decreased unhealthy options. Implementation of PSE interventions targeting the food environment can be an effective method of providing increased access to healthy foods and beverages with the goal of increasing consumption to decrease chronic diseases.

  10. Sustaining School-Based Asthma Interventions through Policy and Practice Change

    Science.gov (United States)

    Carpenter, Laurie M.; Lachance, Laurie; Wilkin, Margaret; Clark, Noreen M.

    2013-01-01

    Background: Schools are an ideal setting for implementation of asthma interventions for children; however, sustaining school-based programs can be challenging. This study illustrates policy and practice changes brought about through the Childhood Asthma Linkages in Missouri (CALM) program to sustain such programs. Methods: Researchers analyzed…

  11. A Training Intervention for Supervisors to Support a Work-Life Policy Implementation

    Science.gov (United States)

    Laharnar, Naima; Glass, Nancy; Perrin, Nancy; Hanson, Ginger; Kent Anger, W.

    2013-01-01

    Background Effective policy implementation is essential for a healthy workplace. The Ryan-Kossek 2008 model for work-life policy adoption suggests that supervisors as gatekeepers between employer and employee need to know how to support and communicate benefit regulations. This article describes a workplace intervention on a national employee benefit, Family and Medical Leave Act (FMLA), and evaluates the effectiveness of the intervention on supervisor knowledge, awareness, and experience with FMLA. Methods The intervention consisted of computer-based training (CBT) and a survey measuring awareness and experience with FMLA. The training was administered to 793 county government supervisors in the state of Oregon, USA. Results More than 35% of supervisors reported no previous training on FMLA and the training pre-test revealed a lack of knowledge regarding benefit coverage and employer responsibilities. The CBT achieved: (1) a significant learning effect and large effect size of d = 2.0, (2) a positive reaction to the training and its design, and (3) evidence of increased knowledge and awareness regarding FMLA. Conclusion CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA. PMID:24106648

  12. Representing causal knowledge in environmental policy interventions: Advantages and opportunities for qualitative influence diagram applications.

    Science.gov (United States)

    Carriger, John F; Dyson, Brian E; Benson, William H

    2018-05-01

    This article develops and explores a methodology for using qualitative influence diagrams in environmental policy and management to support decision-making efforts that minimize risk and increase resiliency. Influence diagrams are representations of the conditional aspects of a problem domain. Their graphical properties are useful for structuring causal knowledge relevant to policy interventions and can be used to enhance inference and inclusivity of multiple viewpoints. Qualitative components of influence diagrams are beneficial tools for identifying and examining the interactions among the critical variables in complex policy development and implementation. Policy interventions on social-environmental systems can be intuitively diagrammed for representing knowledge of critical relationships among economic, environmental, and social attributes. Examples relevant to coastal resiliency issues in the US Gulf Coast region are developed to illustrate model structures for developing qualitative influence diagrams useful for clarifying important policy intervention issues and enhancing transparency in decision making. Integr Environ Assess Manag 2018;14:381-394. Published 2018. This article is a US Government work and is in the public domain in the USA. Published 2018. This article is a US Government work and is in the public domain in the USA.

  13. Effect of an intervention aimed at reducing the risk of allergic respiratory disease in bakers: change in flour dust and fungal alpha-amylase levels.

    NARCIS (Netherlands)

    Meijster, T.; Tielemans, E.; Heederik, D.J.J.

    2009-01-01

    INTRODUCTION: We evaluated the effect on exposure of an intervention programme, which focused on risk education and providing information on good work practices. This intervention programme was enrolled as part of a Dutch covenant in the flour processing industry (industrial bakeries, flour mills,

  14. The efforts of a multidisciplinary approach in the rehabilitation institute for deaf children: A psychosocial intervention aimed at breaking the pattern of stalled productivity

    Directory of Open Access Journals (Sweden)

    Langher Viviana

    2012-01-01

    Full Text Available The multidisciplinary approach for the treatment of hearing impaired children presented the work group with several tasks: the group had to integrate different competences and techniques, to share common treatment goals, to manage relational dynamics with the children and their parents, and to explore the families' expectancies. These efforts may create stressful conditions for the work group and, consequently, might negatively affect the quality of the intervention to be carried out. Our aim was to illustrate a psychosocial analysis performed in a religious Institute for hearing impaired children, intended to break the pattern of the Institute's stalled productivity, to avoid inefficient and fragmented treatments, to prevent unelaborated relational dynamics among the staff members and between the staff and the children's families. By means of the Content Analysis of semi-structured interviews administered to staff-members and families we have analyzed the quality of the teamwork, the relational arrangements towards the families and local services (25 interviews with 5 staff members; the family-Institute relationship and the family's representation and satisfaction of the Institute (7 interviews with 13 hearing impaired parents and non-hearing impaired parents. The institute activity seemed to be more characterized by the maintenance of the relationship with the families per se, rather than oriented to productive goals. The non hearing impaired parents seemed to be more satisfied than the hearing-impaired parents, possibly because the former are more prepared to receive the Institute's help. The stalled productivity can only be overcome by the elaboration of those relational/emotional dynamics which prevent staff members and children's parents from focusing on productive goals. The staffmembers' training should be improved in order to develop specific competences, to perform an integrated, multidisciplinary approach in treatments, to negotiate

  15. Product reformulation in the food system to improve food safety. Evaluation of policy interventions.

    Science.gov (United States)

    Marotta, Giuseppe; Simeone, Mariarosaria; Nazzaro, Concetta

    2014-03-01

    The objective of this study is to understand the level of attention that the consumer awards to a balanced diet and to product ingredients, with a twofold purpose: to understand whether food product reformulation can generate a competitive advantage for companies that practice it and to evaluate the most appropriate policy interventions to promote a healthy diet. Reformulation strategy, in the absence of binding rules, could be generated by consumers. Results from qualitative research and from empirical analysis have shown that the question of health is a latent demand influenced by two main factors: a general lack of information, and the marketing strategies adopted by companies which bring about an increase in the information asymmetry between producers and consumers. In the absence of binding rules, it is therefore necessary that the government implement information campaigns (food education) aimed at increasing knowledge regarding the effects of unhealthy ingredients, in order to inform and improve consumer choice. It is only by means of widespread information campaigns that food product reformulation can become a strategic variable and allow companies to gain a competitive advantage. This may lead to virtuous results in terms of reducing the social costs related to an unhealthy diet. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Planned development and evaluation protocol of two versions of a web-based computer-tailored nutrition education intervention aimed at adults, including cognitive and environmental feedback.

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; Oenema, Anke

    2014-01-17

    Despite decades of nutrition education, the prevalence of unhealthy dietary patterns is still high and inequalities in intake between high and low socioeconomic groups still exist. Therefore, it is important to innovate and improve existing nutrition education interventions. This paper describes the development, design and evaluation protocol of a web-based computer-tailored nutrition education intervention for adults targeting fruit, vegetable, high-energy snack and fat intake. This intervention innovates existing computer-tailored interventions by not only targeting motivational factors, but also volitional and self-regulation processes and environmental-level factors. The intervention development was guided by the Intervention Mapping protocol, ensuring a theory-informed and evidence-based intervention. Two versions of the intervention were developed: a basic version targeting knowledge, awareness, attitude, self-efficacy and volitional and self-regulation processes, and a plus version additionally addressing the home environment arrangement and the availability and price of healthy food products in supermarkets. Both versions consist of four modules: one for each dietary behavior, i.e. fruit, vegetables, high-energy snacks and fat. Based on the self-regulation phases, each module is divided into three sessions. In the first session, feedback on dietary behavior is provided to increase awareness, feedback on attitude and self-efficacy is provided and goals and action plans are stated. In the second session goal achievement is evaluated, reasons for failure are explored, coping plans are stated and goals can be adapted. In the third session, participants can again evaluate their behavioral change and tips for maintenance are provided. Both versions will be evaluated in a three-group randomized controlled trial with measurements at baseline, 1-month, 4-months and 9-months post-intervention, using online questionnaires. Both versions will be compared with a generic

  17. Feasibility and efficacy of a computer-based intervention aimed at preventing reading decoding deficits among children undergoing active treatment for medulloblastoma: results of a randomized trial.

    Science.gov (United States)

    Palmer, Shawna L; Leigh, Laurie; Ellison, Susan C; Onar-Thomas, Arzu; Wu, Shengjie; Qaddoumi, Ibrahim; Armstrong, Gregory T; Wright, Karen; Wetmore, Cynthia; Broniscer, Alberto; Gajjar, Amar

    2014-05-01

    To investigate the feasibility of a computer-based reading intervention completed by patients diagnosed with a brain tumor. Patients were randomized to the intervention (n = 43) or standard of care group (n = 38). The intervention consisted of 30 sessions using Fast ForWord® exercises in a game-like format. Change in reading decoding scores over time since diagnosis was examined. Gender, race, parent education, parent marital status, and age at diagnosis were examined as covariates. 17 patients (39.5%) were able to complete the target goal of 30 intervention sessions. Females had significantly greater training time than males (p = .022). Age at diagnosis was associated with average training time/session for females (r = .485, p = .041). No significant differences were found in reading scores between the randomized groups. The study was well accepted by families and adherence by patients undergoing radiation therapy for medulloblastoma was moderate. Suggestions for improved methodology are discussed.

  18. Translating models of antisocial behavioral development into efficacious intervention policy to prevent adolescent violence.

    Science.gov (United States)

    Dodge, Kenneth A; McCourt, Sandra N

    2010-04-01

    Adolescent chronic antisocial behavior is costly but concentrated in a relatively small number of individuals. The search for effective preventive interventions draws from empirical findings of three kinds of gene-by-environment interactions: (1) parenting behaviors mute the impact of genes; (2) genes alter the impact of traumatic environmental experiences such as physical abuse and peer social rejection; and (3) individuals and environments influence each other in a dynamic developmental cascade. Thus, environmental interventions that focus on high-risk youth may prove effective. The Fast Track intervention and randomized controlled trial are described. The intervention is a 10-year series of efforts to produce proximal change in parenting, peer relations, social cognition, and academic performance in order to lead to distal prevention of adolescent conduct disorder. Findings indicate that conduct disorder cases can be prevented, but only in the highest risk group of children. Implications for policy are discussed. (c) 2010 Wiley Periodicals, Inc.

  19. The effectiveness of interventions aimed at increasing physical activity in adults with persistent musculoskeletal pain: a systematic review and meta-analysis.

    Science.gov (United States)

    Marley, Joanne; Tully, Mark A; Porter-Armstrong, Alison; Bunting, Brendan; O'Hanlon, John; Atkins, Lou; Howes, Sarah; McDonough, Suzanne M

    2017-11-22

    Individuals with persistent musculoskeletal pain (PMP) have an increased risk of developing co-morbid health conditions and for early-mortality compared to those without pain. Despite irrefutable evidence supporting the role of physical activity in reducing these risks; there has been limited synthesis of the evidence, potentially impacting the optimisation of these forms of interventions. This review examines the effectiveness of interventions in improving levels of physical activity and the components of these interventions. Randomised and quasi-randomised controlled trials were included in this review. The following databases were searched from inception to March 2016: CENTRAL in the Cochrane Library, Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Embase, CINAHL, PsycINFO and AMED. Two reviewers independently screened citations, assessed eligibility, extracted data, assessed risk of bias and coded intervention content using the behaviour change taxonomy (BCTTv1) of 93 hierarchically clustered techniques. GRADE was used to rate the quality of the evidence. The full text of 276 articles were assessed for eligibility, twenty studies involving 3441 participants were included in the review. Across the studies the mean number of BCTs coded was eight (range 0-16); with 'goal setting' and 'instruction on how to perform the behaviour' most frequently coded. For measures of subjective physical activity: interventions were ineffective in the short term, based on very low quality evidence; had a small effect in the medium term based on low quality evidence (SMD 0.25, 95% CI 0.01 to 0.48) and had a small effect in the longer term (SMD 0.21 95% CI 0.08 to 0.33) based on moderate quality evidence. For measures of objective physical activity: interventions were ineffective - based on very low to low quality evidence. There is some evidence supporting the effectiveness of interventions in improving subjectively measured physical activity however, the evidence is mostly

  20. The relationship between health policy and public health interventions: a case study of the DRIVE project to "end" the HIV epidemic among people who inject drugs in Haiphong, Vietnam.

    Science.gov (United States)

    Hammett, Theodore M; Trang, Nguyen Thu; Oanh, Khuat Thi Hai; Huong, Nguyen Thi; Giang, Le Minh; Huong, Duong Thi; Nagot, Nicolas; Des Jarlais, Don C

    2018-03-12

    We present a case study of the effects of health policies on the implementation and potential outcomes of a public health intervention, using the DRIVE project, that aims to 'end' the HIV epidemic among people who inject drugs in Haiphong, Vietnam. DRIVE's success depends on two policy transitions: (1) integration of donor-funded HIV outpatient clinics into public health clinics and expansion of social health insurance; (2) implementation of a "Renovation Plan" for substance use treatment. Interviews and focus group discussions with key informants and review of policy documents and clinic data reveal that both policy transitions are underway but face challenges. DRIVE promises to show how evolving policy affects health interventions and how advocacy based on project data can improve policy. Broad lessons include the importance of clear and consistent policies, vigorous enforcement, and adequate funding of promulgated policies.

  1. AIMD - a validated, simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies

    Directory of Open Access Journals (Sweden)

    Peter Bragge

    2017-03-01

    Full Text Available Abstract Background Proliferation of terms describing the science of effectively promoting and supporting the use of research evidence in healthcare policy and practice has hampered understanding and development of the field. To address this, an international Terminology Working Group developed and published a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. This paper presents results of validation work and a second international workgroup meeting, culminating in the updated AIMD framework [Aims, Ingredients, Mechanism, Delivery]. Methods Framework validity was evaluated against terminology schemas (n = 51; primary studies (n = 37; and reporting guidelines (n = 10. Framework components were independently categorized as fully represented, partly represented, or absent by two researchers. Opportunities to refine the framework were systematically recorded. A meeting of the expanded international Terminology Working Group updated the framework by reviewing and deliberating upon validation findings and refinement proposals. Results There was variation in representativeness of the components across the three types of literature, in particular for the component ‘causal mechanisms’. Analysis of primary studies revealed that representativeness of this concept lowered from 92 to 68% if only explicit, rather than explicit and non-explicit references to causal mechanisms were included. All components were very well represented in reporting guidelines, however the level of description of these was lower than in other types of literature. Twelve opportunities were identified to improve the framework, 9 of which were operationalized at the meeting. The updated AIMD framework comprises four components: (1 Aims: what do you want your intervention to achieve and for whom? (2 Ingredients: what comprises the intervention? (3 Mechanisms: how do you propose the intervention will

  2. The Effect of an Intervention Aimed at Reducing Errors when Administering Medication through Enteral Feeding Tubes in an Institution for Individuals with Intellectual Disability

    Science.gov (United States)

    Idzinga, J. C.; de Jong, A. L.; van den Bemt, P. M. L. A.

    2009-01-01

    Background: Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to…

  3. An exploration of factors related to dissemination of and exposure to internet-delivered behavior change interventions aimed at adults: A Delphi study approach

    NARCIS (Netherlands)

    W. Brouwer (Wendy); A. Oenema (Anke); R. Crutzen (Rik); J. de Nooijer (Jascha); N.K. de Vries (Nanne); J. Brug (Hans)

    2008-01-01

    textabstractBackground: The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of

  4. School-Based Programs Aimed at the Prevention and Treatment of Obesity: Evidence-Based Interventions for Youth in Latin America

    Science.gov (United States)

    Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K.; Nagle, Brian J.; Arredondo, Elva M.; Barquera, Simon; Elder, John P.

    2013-01-01

    Background: Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be…

  5. Using the RE-AIM Framework in formative evaluation and program planning for a nutrition intervention in the Lower Mississippi Delta.

    Science.gov (United States)

    Huye, Holly F; Connell, Carol L; Crook, LaShaundrea B; Yadrick, Kathy; Zoellner, Jamie

    2014-01-01

    Identification of prominent themes to be considered when planning a nutrition intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Qualitative formative research. Women's social and civic organizations in the Lower Mississippi Delta. Thirty-seven (5 white and 32 black) women with a college degree or higher. Impact of dietary and contextual factors related to the Lower Mississippi Delta culture on intervention planning. Case analysis strategy using question-by-question coding. Major themes that emerged were "healthy eating focus" and "promoting a healthy lifestyle" when recruiting organizations (Reach); "positive health changes" as a result of the intervention (Effectiveness); "logistics: time commitment, location, and schedule" to initiate a program (Adoption); "expense of healthy foods" and "cooking and meal planning" as barriers to participation (Implementation); and "resources and training" and "motivation" as necessary for program continuation (Maintenance). The "health of the Delta" theme was found across all dimensions, which reflected participants' compassion for their community. Results were used to develop an implementation plan promoting optimal reach, effectiveness, adoption, implementation, and maintenance of a nutrition intervention. This research emphasizes the benefits of formative research using a systematic process at organizational and individual levels. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  6. A cluster randomized implementation trial to measure the effectiveness of an intervention package aiming to increase the utilization of skilled birth attendants by women for childbirth: study protocol.

    Science.gov (United States)

    Bhandari, Gajananda P; Subedi, Narayan; Thapa, Janak; Choulagai, Bishnu; Maskey, Mahesh K; Onta, Sharad R

    2014-03-19

    Nepal is on track to achieve MDG 5 but there is a huge sub-national disparity with existing high maternal mortality in western and hilly regions. The national priority is to reduce this disparity to achieve the goal at sub-national level. Evidences from developing countries show that increasing utilization of skilled attendant at birth is an important indicator for reducing maternal death. Further, there is a very low utilization during childbirth in western and hilly regions of Nepal which clearly depicts the barriers in utilization of skilled birth attendants. So, there is a need to overcome the identified barriers to increase the utilization thereby decreasing the maternal mortality. The hypothesis of this study is that through a package of interventions the utilization of skilled birth attendants will be increased and hence improve maternal health in Nepal. This study involves a cluster randomized controlled trial involving approximately 5000 pregnant women in 36 clusters. The 18 intervention clusters will receive the following interventions: i) mobilization of family support for pregnant women to reach the health facility, ii) availability of emergency funds for institutional childbirth, iii) availability of transport options to reach a health facility for childbirth, iv) training to health workers on communication skills, v) security provisions for SBAs to reach services 24/24 through community mobilization; 18 control clusters will not receive the intervention package. The final evaluation of the intervention is planned to be completed by October 2014. Primary study output of this study is utilization of SBA services. Secondary study outputs measure the uptake of antenatal care, post natal checkup for mother and baby, availability of transportation for childbirth, operation of emergency fund, improved reception of women at health services, and improved physical security of SBAs. The intervention package is designed to increase the utilization of skilled

  7. Strategic choices: Swedish climate intervention policies and the forest industry's role in reducing CO2 emissions

    International Nuclear Information System (INIS)

    Nystroem, Ingrid; Cornland, Deborah W.

    2003-01-01

    Given adequate incentive, the forest industry could play a significant role in achieving Swedish objectives for reducing CO 2 emissions. Whether or not this potential can be harnessed depends on the types of energy policy interventions that are introduced. An analysis of the potential impacts of four policy-intervention strategies on the forest industry is presented in this article. The focus of the analysis is on the four strategies' impacts on forest industry electricity demand from, and renewable energy supply to, the energy system. The strategies analyzed include a reference strategy and strategies targeting electricity production, transportation and the energy system as a whole. The method applied combines scenario analysis with systems engineering modeling. Separate scenario sets were used to reflect visions of development from the forest industry and the energy sector. Separate models were used to enable a more in-depth analysis of the forest industry's role than is commonly the case in energy systems engineering studies

  8. Community Psychology and Psychosocial Expressions of Poverty: Contributions for Public Policy Intervention

    OpenAIRE

    Morais Ximenes, Verônica; Universidade Federal do Ceará; Camurça Cidade, Elívia; Universidade Federal do Ceará.; Barbosa Nepomuceno, Bárbara; Universidade Federal do Ceará.

    2016-01-01

    The purposeis to analyze, from Community Psychology’s perspective, psychosocial expressions of poverty and their contributions for intervention in public policy. Community Psychology accents the critique about the factors that maintain those material and symbolic aspects that interfere with the subjective constitution of the poor. Exploratory research, quantitative and qualitative, was conducted with 417 adult subjects of a rural and urban community in Brazil. Poverty involves moral explanati...

  9. New Zealand policy experts’ appraisal of interventions to reduce smoking in young adults: a qualitative investigation

    Science.gov (United States)

    Hoek, Janet; Tautolo, El Shadan; Gifford, Heather

    2017-01-01

    Objectives Reducing smoking in young adults, particularly young Māori and Pacific, is vital for reducing tobacco harm and health inequalities in New Zealand (NZ). We investigated how NZ policy experts appraised the feasibility and likely effectiveness of interventions designed to reduce smoking prevalence among 18–24 year olds. Design We used a qualitative design, conducting semistructured interviews and applying thematic analysis. Participants We interviewed 15 key informants, including politicians, senior policy analysts and leading tobacco control advocates. Participant selection was based on seniority and expertise and ensuring diverse perspectives were represented. Interventions We examined nine interventions that could either promote greater mindfulness or introduce barriers impeding smoking uptake: smoke-free outdoor dining and bars; no tobacco sales where alcohol is sold; social marketing campaigns; real life stories (testimonials); life skills training; raise purchase age to 21; tobacco-free generation; smokers’ licence; make tobacco retail premises R18. Results The policies perceived as more effective denormalised tobacco; made it less convenient to access and use; highlighted immediate disadvantages (eg, impact on fitness); aligned with young people’s values; and addressed the underlying causes of smoking (eg, stress). Participants highlighted some political barriers and noted concerns that some interventions might widen ethnic disparities. Exceptions were social marketing campaigns and extending smoke-free regulations to include outdoor areas of cafes and bars, which participants saw as politically feasible and likely to be effective. Conclusions Our findings suggest the merit of an approach that combines social marketing with regulation that makes accessing and using tobacco less convenient for young adults; however, political barriers may limit the regulatory options available in the short term. Strategies to support self-determination and

  10. Food waste disposal units in UK households: the need for policy intervention.

    Science.gov (United States)

    Iacovidou, Eleni; Ohandja, Dieudonne-Guy; Voulvoulis, Nikolaos

    2012-04-15

    The EU Landfill Directive requires Member States to reduce the amount of biodegradable waste disposed of to landfill. This has been a key driver for the establishment of new waste management options, particularly in the UK, which in the past relied heavily on landfill for the disposal of municipal solid waste (MSW). MSW in the UK is managed by Local Authorities, some of which in a less conventional way have been encouraging the installation and use of household food waste disposal units (FWDs) as an option to divert food waste from landfill. This study aimed to evaluate the additional burden to water industry operations in the UK associated with this option, compared with the benefits and related savings from the subsequent reductions in MSW collection and disposal. A simple economic analysis was undertaken for different FWD uptake scenarios, using the Anglian Region as a case study. Results demonstrated that the significant savings from waste collection arising from a large-scale uptake of FWDs would outweigh the costs associated with the impacts to the water industry. However, in the case of a low uptake, such savings would not be enough to cover the increased costs associated with the wastewater provision. As a result, this study highlights the need for policy intervention in terms of regulating the use of FWDs, either promoting them as an alternative to landfill to increase savings from waste management, or banning them as a threat to wastewater operations to reduce potential costs to the water industry. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Intra Sector Policy Interventions for Improvement of Iranian Health Financing System

    Directory of Open Access Journals (Sweden)

    Peivand Bastani

    2013-09-01

    Full Text Available Background and purpose: To determine an appropriate financial model for the health system of Iran, several studies have been conducted. But it seems that these studies were not comprehensive and further investigation is required. So to design a valid and enforceable mechanism, the study of policy interventions will be considered through consensus of all stakeholders. This investigation was done to determine the necessary policies and internal interventions for health care system financial improvement in Iran. Materials and methods: The present work was carried out through investigating all key stakeholders in the medical system and the related sectors in Iran, along with the analysis of internal and external communication by using SWOT and STEEP.V methods. Results: Strategic management of health-care costs, the development of a new financial system, clarity of costs, benefiting from health national accounts, the regulation of budget based on operations, preparing the credit of per capita from prepayment and risk accumulation, the development of referral systems and mechanisms, the establishment of public fund for services purchase, preventing the involvement of insurances in non-insurance cases, competing services with the private sector and increasing resources for the promotion of equality level have been determined as the key proposed interventions. Conclusion: It seems that the interventions based to the development of improving health financial system including the deployment of full accrual basis instead of cash basis, preparing and using services cost and operational budgeting and finally, cost management and productivity are the prerequisites of reforming health financial system.

  12. Policy interventions related to medicines: Survey of measures taken in European countries during 2010-2015.

    Science.gov (United States)

    Vogler, Sabine; Zimmermann, Nina; de Joncheere, Kees

    2016-12-01

    Policy-makers can use a menu of pharmaceutical policy options. This study aimed to survey these measures that were implemented in European countries between 2010 and 2015. We did bi-annual surveys with competent authorities of the Pharmaceutical Pricing and Reimbursement Information network. Additionally, we consulted posters produced by members of this network as well as further published literature. Information on 32 European countries (all European Union Member States excluding Luxembourg; Iceland, Norway, Serbia, Switzerland, Turkey) was included. 557 measures were reported between January 2010 and December 2015. The most frequently mentioned measure was price reductions and price freezes, followed by changes in patient co-payments, modifications related to the reimbursement lists and changes in distribution remuneration. Most policy measures were identified in Portugal, Greece, Belgium, France, the Czech Republic, Iceland, Spain and Germany. 22% of the measures surveyed could be classified as austerity. Countries that were strongly hit by the financial crisis implemented most policy changes, usually aiming to generate savings and briefly after the emergence of the crisis. Improvements in the economic situation tended to lead to an easing of austerity measures. Countries also implemented policies that aimed to enhance enforcement of existing measures and increase efficiency. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Analysis of the French system for persons in complex situation in regard of the implementation of a public policy aiming to integrate health and social services

    Science.gov (United States)

    Somme, Dominique; de Stampa, Matthieu; Périsset, Catherine; Dupont, Olivier; Ankri, Joël; Saint-Jean, Olivier

    2009-01-01

    Introduction The French Alzheimer plan, states that one of its principle orientations is the implementation of ‘Homes for Integration and Autonomy for Alzheimer patients’. Alzheimer disease is taken as a model to implement integration for all persons in complex situation (handicap…). Method Seventeen experimental sites were selected in January 2009 for the first two years. They were selected by policy-makers taking into account the readiness of the local policy-makers to implement the program, the diversity of sizes of sites, the diversity of the experimentation leaders' organizational link (public administrations, not for profit organizations, private organizations) and the diversity of societal structure (rural, urban and mega-urban). The experimental sites were analyzed considering six components of integration: coordination boards, unique point of access, case-management, standardized assessment tool, individualized services plan and information system. A complete and computerized tool was specifically developed for the organizational diagnosis. Results During the session, results will be exposed. These results will give a contrasted image of the French system for persons in complex situation. The tool will be also exposed and the receptivity will be discussed. Conclusion The French Alzheimer plan gives a unique opportunity to have a portrait of the French system in regard of integration challenges.

  14. Analysing policy interventions to prohibit over-the-counter antibiotic sales in four Latin American countries.

    Science.gov (United States)

    Wirtz, V J; Herrera-Patino, J J; Santa-Ana-Tellez, Y; Dreser, A; Elseviers, M; Vander Stichele, R H

    2013-06-01

    To describe and evaluate policies implemented in Chile, Colombia, Venezuela and Mexico (1995-2009) to prohibit antibiotic OTC sales and explore limitations in available data. We searched and analysed legislation, grey literature and peer-reviewed publications on regulatory interventions and implementation strategies to enforce prohibition of OTC antibiotic sales. We also assessed the impact using private sector retail sales data of antibiotics studying changes in level and consumption trends before and after the policy change using segmented time series analysis. Finally, we assessed the completeness and data quality through an established checklist to test the suitability of the data for analysis of the interventions. Whereas Chile implemented a comprehensive package of interventions to accompany regulation changes, Colombia's reform was limited to the capital district and Venezuela's limited to only some antibiotics and without awareness campaigns. In Mexico, no enforcement was enacted. The data showed a differential effect of the intervention among the countries studied with a significant change in level of consumption in Chile (-5.56 DID) and in Colombia (-1.00DID). In Venezuela and Mexico, no significant change in level and slope was found. Changes in population coverage were identified as principal limitations of using sales data for evaluating the reform impact. Retail sales data can be useful when assessing policy impact but should be supplemented by other data sources such as public sector sales and prescription data. Implementing regulatory enforcement has shown some impact, but a sustainable, concerted approach will be needed to address OTC sales in the future. © 2013 John Wiley & Sons Ltd.

  15. Identification, Assessment and Intervention--Implications of an Audit on Dyslexia Policy and Practice in Scotland

    Science.gov (United States)

    Reid, Gavin; Deponio, Pamela; Petch, Louise Davidson

    2005-01-01

    This article reports on research commissioned by the Scottish Executive Education Department (SEED). It aimed to establish the range and extent of policy and provision in the area of specific learning difficulties (SpLD) and dyslexia throughout Scotland. The research was conducted between January and June 2004 by a team from the University of…

  16. International policy on intervention in the event of a nuclear accident

    International Nuclear Information System (INIS)

    Jensen, P.H.; Crick, M.J.; Gonzalez, A.J.

    1996-01-01

    Criteria for taking particular protective actions with the aim of preventing or reducing radiation exposures to the population or to workers in the event of a nuclear accident or radiological emergency can be established on the basis of radiological protection principles for intervention situations. It is of utmost importance that pre-established intervention levels for different protective measures form an integral part of an emergency response plan. Generic optimized intervention levels and their derived operational quantities based on the principles given in this paper are judged to provide protection that would be justified and reasonable optimized for a wide range of accident situations although they can only be used as guidelines. Any specific optimization would lead to intervention levels that might be either higher or lower than those emerging from a generic optimization. (author). 9 refs

  17. International policy on intervention in the event of a nuclear accident

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, P H [Risoe National Lab., Roskilde (Denmark); Crick, M J; Gonzalez, A J [International Atomic Energy Agency, Vienna (Austria)

    1996-08-01

    Criteria for taking particular protective actions with the aim of preventing or reducing radiation exposures to the population or to workers in the event of a nuclear accident or radiological emergency can be established on the basis of radiological protection principles for intervention situations. It is of utmost importance that pre-established intervention levels for different protective measures form an integral part of an emergency response plan. Generic optimized intervention levels and their derived operational quantities based on the principles given in this paper are judged to provide protection that would be justified and reasonable optimized for a wide range of accident situations although they can only be used as guidelines. Any specific optimization would lead to intervention levels that might be either higher or lower than those emerging from a generic optimization. (author). 9 refs.

  18. Effect of Policy Interventions on Food Security in Tigray, Northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Anne van der Veen

    2011-03-01

    Full Text Available Following the design of a conservation-based agricultural development strategy and food security strategy, the Tigray government has implemented different pro-poor development programs over the past years to address the problems of food security. This study attempts to investigate the effectiveness of government policy interventions at different scales addressed to improve food security. Food security both at the regional and district level was investigated by deriving food balance sheets for the period 2000-2008. An empirical analysis based on a logit model was also employed to analyze household level food security status. The results of the logit model reveal that government policy interventions such as water harvesting schemes, employment generation schemes, and promotion of technology adoption significantly contribute to a higher likelihood of household food security status. The findings of the food balance sheet also indicate that the region has made some impressive development gains in improving regional food self-sufficiency, indicating the importance of government interventions in improving food security both at the household and regional level.

  19. Evaluation of physical activity interventions in children via the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework: A systematic review of randomized and non-randomized trials.

    Science.gov (United States)

    McGoey, Tara; Root, Zach; Bruner, Mark W; Law, Barbi

    2016-01-01

    Existing reviews of physical activity (PA) interventions designed to increase PA behavior exclusively in children (ages 5 to 11years) focus primarily on the efficacy (e.g., internal validity) of the interventions without addressing the applicability of the results in terms of generalizability and translatability (e.g., external validity). This review used the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance) framework to measure the degree to which randomized and non-randomized PA interventions in children report on internal and external validity factors. A systematic search for controlled interventions conducted within the past 12years identified 78 studies that met the inclusion criteria. Based on the RE-AIM criteria, most of the studies focused on elements of internal validity (e.g., sample size, intervention location and efficacy/effectiveness) with minimal reporting of external validity indicators (e.g., representativeness of participants, start-up costs, protocol fidelity and sustainability). Results of this RE-AIM review emphasize the need for future PA interventions in children to report on real-world challenges and limitations, and to highlight considerations for translating evidence-based results into health promotion practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Outcomes of biomarker feedback on physical activity, eating habits, and emotional health: from the Americans in Motion-Healthy Intervention (AIM-HI) study.

    Science.gov (United States)

    Mitchell, Nia S; Manning, Brian K; Staton, Elizabeth W; Emsermann, Caroline D; Dickinson, L Miriam; Pace, Wilson D

    2014-01-01

    The purpose of this article was to test whether physical activity, healthy eating, and emotional well-being would improve if patients received feedback about biomarkers that have been shown to be responsive to changes in weight and fitness. Patients were randomized to limited feedback (weight, body mass index [BMI], and blood pressure at 4 and 10 months) or enhanced feedback (weight, BMI, blood pressure, homeostatic insulin resistance, and nuclear magnetic resonance lipoprotein profiles at 2, 4, 7, and 10 months). Repeated measures mixed effects multivariate regression models were used to determine whether BMI, fitness, diet, and quality of life changed over time. Major parameters were similar in both groups at baseline. BMI, measures of fitness, healthy eating, quality of life, and health state improved in both patient groups, but there was no difference between patient groups at 4 or 10 months. Systolic blood pressure improved in the enhanced feedback group, and there was a difference between the enhanced and limited feedback groups at 10 months (95% confidence interval, -6.011 to -0.5113). Providing patients with enhanced feedback did not dramatically change outcomes. However, across groups, many patients maintained or lost weight, suggesting the need for more study of nondiet interventions.

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  2. Slowing Amazon deforestation through public policy and interventions in beef and soy supply chains.

    Science.gov (United States)

    Nepstad, Daniel; McGrath, David; Stickler, Claudia; Alencar, Ane; Azevedo, Andrea; Swette, Briana; Bezerra, Tathiana; DiGiano, Maria; Shimada, João; Seroa da Motta, Ronaldo; Armijo, Eric; Castello, Leandro; Brando, Paulo; Hansen, Matt C; McGrath-Horn, Max; Carvalho, Oswaldo; Hess, Laura

    2014-06-06

    The recent 70% decline in deforestation in the Brazilian Amazon suggests that it is possible to manage the advance of a vast agricultural frontier. Enforcement of laws, interventions in soy and beef supply chains, restrictions on access to credit, and expansion of protected areas appear to have contributed to this decline, as did a decline in the demand for new deforestation. The supply chain interventions that fed into this deceleration are precariously dependent on corporate risk management, and public policies have relied excessively on punitive measures. Systems for delivering positive incentives for farmers to forgo deforestation have been designed but not fully implemented. Territorial approaches to deforestation have been effective and could consolidate progress in slowing deforestation while providing a framework for addressing other important dimensions of sustainable development. Copyright © 2014, American Association for the Advancement of Science.

  3. The Sydney playground project: popping the bubblewrap--unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children's physical activity and social skills.

    Science.gov (United States)

    Bundy, Anita C; Naughton, Geraldine; Tranter, Paul; Wyver, Shirley; Baur, Louise; Schiller, Wendy; Bauman, Adrian; Engelen, Lina; Ragen, Jo; Luckett, Tim; Niehues, Anita; Stewart, Gabrielle; Jessup, Glenda; Brentnall, Jennie

    2011-09-01

    In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills. This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment. These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health. Australian and New Zealand Clinical Trials Registration Number ACTRN12611000089932.

  4. The sydney playground project: popping the bubblewrap - unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children's physical activity and social skills

    Science.gov (United States)

    2011-01-01

    Background In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills. Methods/Design This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment. Discussion These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health. Trial registration Australian and New Zealand Clinical

  5. The sydney playground project: popping the bubblewrap - unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children's physical activity and social skills

    Directory of Open Access Journals (Sweden)

    Luckett Tim

    2011-09-01

    Full Text Available Abstract Background In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills. Methods/Design This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT, in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention, with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1 Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2 Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment. Discussion These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health. Trial registration Australian

  6. Healthy Eating for Life English as a second language curriculum: applying the RE-AIM framework to evaluate a nutrition education intervention targeting cancer risk reduction.

    Science.gov (United States)

    Martinez, J L; Duncan, L R; Rivers, S E; Bertoli, M C; Latimer-Cheung, A E; Salovey, P

    2017-12-01

    Medically underserved US immigrants are at an increased risk for death from preventable or curable cancers due to economic, cultural, and/or linguistic barriers to medical care. The purpose of this study was to describe the evaluation of the pilot study of the Healthy Eating for Life (HE4L) English as a second language curriculum. The Reach, Effectiveness Adoption, Implementation, Maintenance (RE-AIM) model was used to design a mixed-methods approach to the evaluation of the HE4L curriculum. Successful implementation was dependent upon enthusiastic teacher and manager support of the curriculum, teachers' ability to flexibly apply the curriculum to meet student needs, and researcher provision of curriculum workbooks. HE4L can be implemented successfully in various adult education settings to teach healthy eating behaviors and English language principles. Scale-up of HE4L may depend on the development of an online version of the curriculum to avoid the costs associated with printing and distributing curriculum materials.

  7. A case study evaluation of an intervention aiming to strengthen the midwifery professional role in Morocco: anticipated barriers to reaching outcomes

    Science.gov (United States)

    Abou Malham, Sabina; Hatem, Marie; Leduc, Nicole

    2015-01-01

    Background In order to reduce the high maternal mortality ratio, Morocco is strongly committed to strengthen its midwifery professional role. This study aimed to identify barriers that could potentially hinder an action plan to strengthen the midwifery professional role from achieving desired outcomes. We used a conceptual framework, which is derived from Hatem-Asmar’s (1997) framework on the interaction of educational, professional, and sociocultural systems in which a professional role evolves and from Damschroder et al’s (2009) framework for the implementation analysis. Methods This paper builds on a qualitative case study on the factors affecting the action plan’s implementation process that also revealed rich data about anticipated barriers to reaching outcomes. Data were collected through training sessions, field observations, documents, focus groups (n=20), and semistructured interviews (n=11) with stakeholders pertaining to the three systems under study. Content analysis was used to identify themes related to barriers. Results Seven barriers that may compromise the achievement of desired results were found. They relate to the legal framework, social representations, and media support in the sociocultural system and the practice environment, networks and communication mechanisms, and characteristics related to the role and the readiness in the professional system. Conclusion Disregarding sociocultural and professional system level, barriers may impede efforts to strengthen the midwife’s role and to provide qualified midwives who can improve the quality of maternal care. Making changes in the educational system cannot be thought of as an isolated process. Its success is closely tied with multiple contextual factors pertaining to the two other systems. Activities recommended to address these barriers may have great potential to build a competent midwifery workforce that contributes to positive maternal and neonatal health outcomes. PMID:26445547

  8. INSTITUTIONAL BARRIERS TO EFFICIENT POLICY INTERVENTION IN THE EUROPEAN PORT SECTOR

    Directory of Open Access Journals (Sweden)

    Barry UBBELS

    2005-01-01

    Full Text Available Despite the growing role of private involvement in recent port developments, most maritime trade is still largely handled in ports where investments, pricing and other managerial decisions are, to a varying extent, dependent, or at least influenced by public bodies. This paper shows that the extent and type of public intervention differs considerably between ports in the Hamburg-Le Havre range. The wide variety in ownership, financing and management of ports throughout Europe indicates that there is no level playing field at present. Because ports operate in an increasingly competitive environment (intensified by globalisation trends and the completion of the internal market, this may lead to situations of unfair competition. The European Union emphasises the importance of a more harmonised approach of port regulation by national governments (in terms of financing and pricing of infrastructure. Given the differences in (national port management styles and the low levels of transparency, the creation of a level playing field in the European port industry seems far away. This suggests the presence of a major institutional difference in European transport policy that hampers efficient policy intervention.

  9. The vulnerabilities in childhood and adolescence and the Brazilian public policy intervention.

    Science.gov (United States)

    Fonseca, Franciele Fagundes; Sena, Ramony Kris R; dos Santos, Rocky Lane A; Dias, Orlene Veloso; Costa, Simone de Melo

    2013-06-01

    To review and discuss childhood and adolescence vulnerabilities, as well as Brazilian public policies of intervention. A narrative review was performed, considering studies published between 1990 and 2012, found in the Virtual Health Library databases (Biblioteca Virtual em Saúde - BVS). A combination of the following descriptors was used in the search strategy: "Adolescent Health", "Child Health", "Health Public Politics" and "Vulnerability". In addition, Brazilian official documents, the Statute of the Child and the Adolescent, Guardianship Council, Bolsa Família and Saúde na Escola Programs were evaluated. The results were divided into five categories of analysis: Vulnerability of Children and Adolescents in Brazil, Public Politics of Intervention to Risk Factors in Childhood and Adolescence, the Statute of the Child and the Adolescent and Guardianship Council, Bolsa Família Program and Saúde na Escola Program. The studies show that children and adolescents are vulnerable to environmental and social situations. Vulnerabilities are exhibited in daily violence within families and schools, which results in the premature entrance of children and adolescents in the work environment and/or in the drug traffic. To deal with these problems, the Brazilian Government established the Statute of the Child and the Adolescent as well as social programs. Literature exposes the risks experienced by children and adolescents in Brazil. In the other hand, a Government endeavor was identified to eliminate or minimize the suffering of those in vulnerable situations through public policies targeted to this population group.

  10. New Zealand policy experts' appraisal of interventions to reduce smoking in young adults: a qualitative investigation.

    Science.gov (United States)

    Ball, Jude; Hoek, Janet; Tautolo, El Shadan; Gifford, Heather

    2017-12-10

    Reducing smoking in young adults, particularly young Māori and Pacific, is vital for reducing tobacco harm and health inequalities in New Zealand (NZ). We investigated how NZ policy experts appraised the feasibility and likely effectiveness of interventions designed to reduce smoking prevalence among 18-24 year olds. We used a qualitative design, conducting semistructured interviews and applying thematic analysis. We interviewed 15 key informants, including politicians, senior policy analysts and leading tobacco control advocates. Participant selection was based on seniority and expertise and ensuring diverse perspectives were represented. We examined nine interventions that could either promote greater mindfulness or introduce barriers impeding smoking uptake: smoke-free outdoor dining and bars; no tobacco sales where alcohol is sold; social marketing campaigns; real life stories (testimonials); life skills training; raise purchase age to 21; tobacco-free generation; smokers' licence; make tobacco retail premises R18. The policies perceived as more effective denormalised tobacco; made it less convenient to access and use; highlighted immediate disadvantages (eg, impact on fitness); aligned with young people's values; and addressed the underlying causes of smoking (eg, stress). Participants highlighted some political barriers and noted concerns that some interventions might widen ethnic disparities. Exceptions were social marketing campaigns and extending smoke-free regulations to include outdoor areas of cafes and bars, which participants saw as politically feasible and likely to be effective. Our findings suggest the merit of an approach that combines social marketing with regulation that makes accessing and using tobacco less convenient for young adults; however, political barriers may limit the regulatory options available in the short term. Strategies to support self-determination and address the underlying causes of smoking in young people warrant further

  11. A pilot study of StopAdvisor: a theory-based interactive internet-based smoking cessation intervention aimed across the social spectrum.

    Science.gov (United States)

    Brown, Jamie; Michie, Susan; Geraghty, Adam W A; Miller, Sascha; Yardley, Lucy; Gardner, Benjamin; Shahab, Lion; Stapleton, John A; West, Robert

    2012-12-01

    This article reports a pilot study of a new smoking cessation website ('StopAdvisor'), which has been developed on the basis of PRIME theory, evidence, web-design expertise and user-testing. The aims were to i) evaluate whether cessation, website usage and satisfaction were sufficiently high to warrant a randomised controlled trial (RCT) and ii) assess whether outcomes were affected by socio-economic status. This was an uncontrolled pilot study. Two hundred and four adult daily smokers willing to make a serious quit attempt were included. All participants received support from 'StopAdvisor', which recommends a structured quit plan and a variety of evidence-based behaviour change techniques for smoking cessation. A series of tunnelled sessions and a variety of interactive menus provide tailored support for up to a month before quitting through until one-month post-quit (http://www.lifeguideonline.org/player/play/stopadvisordemonstration). The primary outcome was self-report of at least 1month of continuous abstinence collected at 2months post-enrolment and verified by saliva cotinine or anabasine. Usage was indexed by log-ins and page views. Satisfaction was assessed by dichotomous ratings of helpfulness, personal relevance, likelihood of recommendation and future use, which were collected using an online questionnaire at 2months post-enrolment. Outcomes according to socio-economic status were assessed. At 8weeks post-enrolment, 19.6% (40/204) of participants were abstinent according to the primary outcome criteria (95% C.I.=14.1% to 25.1%). Participants viewed a mean of 133.5 pages (median=71.5) during 6.4 log-ins (median=3). A majority of respondents rated the website positively on each of the four satisfaction `ratings (range=66.7% to 75.3%). There was no evidence of an effect of socio-economic status on abstinence (OR=1.01, C.I.=0.50-2.07), usage (page-views, t(202)=0.11, p=.91; log-ins, t(202)=0.21, p=.83), or satisfaction (helpfulness, OR=1.09, C.I.=0

  12. Social Environmental Correlates of Health Behaviors in a Faith-Based Policy and Environmental Change Intervention.

    Science.gov (United States)

    Hermstad, April; Honeycutt, Sally; Flemming, Shauna StClair; Carvalho, Michelle L; Hodge, Tarccara; Escoffery, Cam; Kegler, Michelle C; Arriola, Kimberly R Jacob

    2018-03-01

    Diet and physical activity are behavioral risk factors for many chronic diseases, which are among the most common health conditions in the United States. Yet most Americans fall short of meeting established dietary and physical activity guidelines. Faith-based organizations as settings for health promotion interventions can affect members at multiple levels of the social ecological model. The present study investigated whether change in the church social environment was associated with healthier behavior at church and in general at 1-year follow-up. Six churches received mini-grants and technical assistance for 1 year to support policy and environmental changes for healthy eating (HE) and physical activity (PA). Socioenvironmental (social support and social norms) and behavioral (HE and PA at church and in general) outcomes were derived from baseline and 1-year follow-up church member surveys ( n = 258). Three of six churches demonstrated significant improvements in all three socioenvironmental aspects of HE. Two of five churches exhibited significant socioenvironmental improvements for PA at follow-up. Church social environmental changes were related to health behaviors at church and in general ( p Change in social support for HE, social support for PA, and social norms for PA were each associated with three church-based and general behavioral outcomes. Social norms for healthy eating were related to two general behavior outcomes and social norms for unhealthy eating to one general behavioral outcome. Study findings demonstrate that socioenvironmental characteristics are essential to multilevel interventions and merit consideration in designing policy and environmental change interventions.

  13. Reporting the characteristics of the policy context for population-level alcohol interventions: a proposed 'Transparent Reporting of Alcohol Intervention ContExts' (TRAICE) checklist.

    Science.gov (United States)

    Holmes, John; Meier, Petra S; Booth, Andrew; Brennan, Alan

    2014-11-01

    Effectiveness of alcohol policy interventions varies across times and places. The circumstances under which effective polices can be successfully transferred between contexts are typically unexplored with little attention given to developing reporting requirements that would facilitate systematic investigation. Using purposive sampling and expert elicitation methods, we identified context-related factors impacting on the effectiveness of population-level alcohol policies. We then drew on previous characterisations of alcohol policy contexts and methodological-reporting checklists to design a new checklist for reporting contextual information in evaluation studies. Six context factor domains were identified: (i) baseline alcohol consumption, norms and harm rates; (ii) baseline affordability and availability; (iii) social, microeconomic and demographic contexts; (iv) macroeconomic context; (v) market context; and (vi) wider policy, political and media context. The checklist specifies information, typically available in national or international reports, to be reported in each domain. The checklist can facilitate evidence synthesis by providing: (i) a mechanism for systematic and more consistent reporting of contextual data for meta-regression and realist evaluations; (ii) information for policy-makers on differences between their context and contexts of evaluations; and (iii) an evidence base for adjusting prospective policy simulation models to account for policy context. Our proposed checklist provides a tool for gaining better understanding of the influence of policy context on intervention effectiveness. Further work is required to rationalise and aggregate checklists across interventions types to make such checklists practical for use by journals and to improve reporting of important qualitative contextual data. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and

  14. Protocol for the process evaluation of a complex intervention designed to increase the use of research in health policy and program organisations (the SPIRIT study).

    Science.gov (United States)

    Haynes, Abby; Brennan, Sue; Carter, Stacy; O'Connor, Denise; Schneider, Carmen Huckel; Turner, Tari; Gallego, Gisselle

    2014-09-27

    Process evaluation is vital for understanding how interventions function in different settings, including if and why they have different effects or do not work at all. This is particularly important in trials of complex interventions in 'real world' organisational settings where causality is difficult to determine. Complexity presents challenges for process evaluation, and process evaluations that tackle complexity are rarely reported. This paper presents the detailed protocol for a process evaluation embedded in a randomised trial of a complex intervention known as SPIRIT (Supporting Policy In health with Research: an Intervention Trial). SPIRIT aims to build capacity for using research in health policy and program agencies. We describe the flexible and pragmatic methods used for capturing, managing and analysing data across three domains: (a) the intervention as it was implemented; (b) how people participated in and responded to the intervention; and (c) the contextual characteristics that mediated this relationship and may influence outcomes. Qualitative and quantitative data collection methods include purposively sampled semi-structured interviews at two time points, direct observation and coding of intervention activities, and participant feedback forms. We provide examples of the data collection and data management tools developed. This protocol provides a worked example of how to embed process evaluation in the design and evaluation of a complex intervention trial. It tackles complexity in the intervention and its implementation settings. To our knowledge, it is the only detailed example of the methods for a process evaluation of an intervention conducted as part of a randomised trial in policy organisations. We identify strengths and weaknesses, and discuss how the methods are functioning during early implementation. Using 'insider' consultation to develop methods is enabling us to optimise data collection while minimising discomfort and burden for

  15. Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents.

    NARCIS (Netherlands)

    Singh, A.S.; Chin A Paw, M.J.M.; Kremers, S.P.J.; Visscher, T.L.S.; Brug, J.; van Mechelen, W.

    2006-01-01

    Background: Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. Methods: Applying the

  16. Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT) : Systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents

    NARCIS (Netherlands)

    A. Singh (Amika); M.J.M. Chin A Paw (Marijke); S.P.J. Kremers (Stef); T.L.S. Visscher (Tommy); J. Brug (Hans); W. van Mechelen (Willem)

    2006-01-01

    textabstractBackground: Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. Methods:

  17. Joint force opportunities: Policy Aims And Adaptations

    Science.gov (United States)

    2016-05-26

    temporal proximity to recounting what happened. 19 Antoine Bousquet and Simon Curtis, ‘Beyond Models and Metaphors: Complexity Theory, Systems Thinking and...Bousquet, Antoine And Simon Curtis. "Beyond Models And Metaphors: Complexity

  18. A randomised controlled trial of an intervention to increase the implementation of a healthy canteen policy in Australian primary schools: study protocol.

    Science.gov (United States)

    Wolfenden, Luke; Nathan, Nicole; Williams, Christopher M; Delaney, Tessa; Reilly, Kathryn L; Freund, Megan; Gillham, Karen; Sutherland, Rachel; Bell, Andrew C; Campbell, Libby; Yoong, Serene; Wyse, Rebecca; Janssen, Lisa M; Preece, Sarah; Asmar, Melanie; Wiggers, John

    2014-10-11

    The implementation of healthy school canteen policies has been recommended as a strategy to help prevent unhealthy eating and excessive weight gain. Internationally, research suggests that schools often fail to implement practices consistent with healthy school canteen policies. Without a population wide implementation, the potential benefits of these policies will not be realised. The aim of this trial is to assess the effectiveness of an implementation intervention in increasing school canteen practices consistent with a healthy canteen policy of the New South Wales (NSW), Australia, government known as the 'Fresh Tastes @ School NSW Healthy School Canteen Strategy'. The parallel randomised trial will be conducted in 70 primary schools located in the Hunter region of New South Wales, Australia. Schools will be eligible to participate if they are not currently meeting key components of the healthy canteen policy. Schools will be randomly allocated after baseline data collection in a 1:1 ratio to either an intervention or control group using a computerised random number function in Microsoft Excel. Thirty-five schools will be selected to receive a multi-component intervention including implementation support from research staff, staff training, resources, recognition and incentives, consensus and leadership strategies, follow-up support and implementation feedback. The 35 schools allocated to the control group will not receive any intervention support as part of the research trial. The primary outcome measures will be i) the proportion of schools with a canteen menu that does not contain foods or beverages restricted from regular sale ('red' and 'banned' items) and ii) the proportion of schools where healthy canteen items ('green' items) represent the majority (>50%) of products listed on the menu. Outcome data will be collected via a comprehensive menu audit, conducted by dietitians blind to group allocation. Intervention effectiveness will be assessed using

  19. Developing a holistic policy and intervention framework for global mental health.

    Science.gov (United States)

    Khenti, Akwatu; Fréel, Stéfanie; Trainor, Ruth; Mohamoud, Sirad; Diaz, Pablo; Suh, Erica; Bobbili, Sireesha J; Sapag, Jaime C

    2016-02-01

    There are significant gaps in the accessibility and quality of mental health services around the globe. A wide range of institutions are addressing the challenges, but there is limited reflection and evaluation on the various approaches, how they compare with each other, and conclusions regarding the most effective approach for particular settings. This article presents a framework for global mental health capacity building that could potentially serve as a promising or best practice in the field. The framework is the outcome of a decade of collaborative global health work at the Centre for Addiction and Mental Health (CAMH) (Ontario, Canada). The framework is grounded in scientific evidence, relevant learning and behavioural theories and the underlying principles of health equity and human rights. Grounded in CAMH's research, programme evaluation and practical experience in developing and implementing mental health capacity building interventions, this article presents the iterative learning process and impetus that formed the basis of the framework. A developmental evaluation (Patton M.2010. Developmental Evaluation: Applying Complexity Concepts to Enhance Innovation and Use. New York: Guilford Press.) approach was used to build the framework, as global mental health collaboration occurs in complex or uncertain environments and evolving learning systems. A multilevel framework consists of five central components: (1) holistic health, (2) cultural and socioeconomic relevance, (3) partnerships, (4) collaborative action-based education and learning and (5) sustainability. The framework's practical application is illustrated through the presentation of three international case studies and four policy implications. Lessons learned, limitations and future opportunities are also discussed. The holistic policy and intervention framework for global mental health reflects an iterative learning process that can be applied and scaled up across different settings through

  20. Mechanisms of change for interventions aimed at improving the wellbeing, mental health and resilience of children and adolescents affected by war and armed conflict: a systematic review of reviews.

    Science.gov (United States)

    Bosqui, Tania Josiane; Marshoud, Bassam

    2018-01-01

    Despite increasing research and clinical interest in delivering psychosocial interventions for children affected by war, little research has been conducted on the underlying mechanisms of change associated with these interventions. This review aimed to identify these processes in order to inform existing interventions and highlight research gaps. A systematic review of reviews was conducted drawing from academic databases (PubMed, PILOTS, Cochrane Library for Systematic Reviews) and field resources (e.g. Médecins Sans Frontières and the Psychosocial Centre of the International Federation of Red Cross and Red Crescent Societies), with extracted data analysed using Thematic Content Analysis. Thirteen reviews of psychosocial or psychological interventions for children and adolescents (< 25 years old) affected by war, armed conflict or political violence were identified, covering over 30 countries worldwide. Qualitative analysis identified 16 mechanisms of change, one of which was an adverse mechanism. Themes included protection from harm, play, community and family capacity building, strengthening relationships with caregivers, improved emotional regulation, therapeutic rapport, trauma processing, and cognitive restructuring; with the adverse mechanism relating to the pathologising of normal reactions. However, only 4 mechanisms were supported by strong empirical evidence, with only moderate or poor quality evidence supporting the other mechanisms. The poor quality of supporting evidence limits what can be inferred from this review's findings, but serves to highlight clinically informed mechanisms of change for existing and widely used non-specialist interventions in the field, which urgently need rigorous scientific testing to inform their continued practice.

  1. Did Government Intervention on Firm’s Employment Policies Have an Effect on the Employment of Elderly Workers?

    OpenAIRE

    Nishimura, Yoshinori

    2016-01-01

    This paper analyzes whether government intervention on firms’ employment policies have an effect on the employment of the elderly. As a result of the pensionable age increasing in Japan, this policy makes a di↵erence between the mandatory retirement age and the pensionable age. The Japanese government has obliged firms to employ elderly workers until they reach the pensionable age. According to literature, the labor force participation rate of elderly male workers increased after the implemen...

  2. Best practices for using natural experiments to evaluate retail food and beverage policies and interventions.

    Science.gov (United States)

    Taillie, Lindsey Smith; Grummon, Anna H; Fleischhacker, Sheila; Grigsby-Toussaint, Diana S; Leone, Lucia; Caspi, Caitlin Eicher

    2017-12-01

    Policy and programmatic change in the food retail setting, including excise taxes on beverages with added-caloric sweeteners, new supermarkets in food deserts, and voluntary corporate pledges, often require the use of natural experimental evaluation for impact evaluation when randomized controlled trials are not possible. Although natural experimental studies in the food retail setting provide important opportunities to test how nonrandomized interventions affect behavioral and health outcomes, researchers face several key challenges to maintaining strong internal and external validity when conducting these studies. Broadly, these challenges include 1) study design and analysis; 2) selection of participants, selection of measures, and obtainment of data; and 3) real-world considerations. This article addresses these challenges and different approaches to meeting them. Case studies are used to illustrate these approaches and to highlight advantages and disadvantages of each approach. If the trade-offs required to address these challenges are carefully considered, thoughtful natural experimental evaluations can minimize bias and provide critical information about the impacts of food retail interventions to a variety of stakeholders, including the affected population, policymakers, and food retailers. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. CAFÉ: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: protocol of a randomised controlled trial

    Science.gov (United States)

    Williams, Christopher M; Nathan, Nicole; Delaney, Tessa; Yoong, Sze Lin; Wiggers, John; Preece, Sarah; Lubans, Nicole; Sutherland, Rachel; Pinfold, Jessica; Smith, Kay; Small, Tameka; Reilly, Kathryn L; Butler, Peter; Wyse, Rebecca J; Wolfenden, Luke

    2015-01-01

    Introduction A number of jurisdictions internationally have policies requiring schools to implement healthy canteens. However, many schools have not implemented such policies. One reason for this is that current support interventions cannot feasibly be delivered to large numbers of schools. A promising solution to support population-wide implementation of healthy canteen practices is audit and feedback. The effectiveness of this strategy has, however, not previously been assessed in school canteens. This study aims to assess the effectiveness and cost-effectiveness of an audit and feedback intervention, delivered by telephone and email, in increasing the number of school canteens that have menus complying with a government healthy-canteen policy. Methods and analysis Seventy-two schools, across the Hunter New England Local Health District in New South Wales Australia, will be randomised to receive the multicomponent audit and feedback implementation intervention or usual support. The intervention will consist of between two and four canteen menu audits over 12 months. Each menu audit will be followed by two modes of feedback: a written feedback report and a verbal feedback/support via telephone. Primary outcomes, assessed by dieticians blind to group status and as recommended by the Fresh Tastes @ School policy, are: (1) the proportion of schools with a canteen menu containing foods or beverages restricted for sale, and; (2) the proportion of schools that have a menu which contains more than 50% of foods classified as healthy canteen items. Secondary outcomes are: the proportion of menu items in each category (‘red’, ‘amber’ and ‘green’), canteen profitability and cost-effectiveness. Ethics and dissemination Ethical approval has been obtained by from the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee. The findings will be disseminated in usual forums, including peer

  4. Mechanisms blocking the dynamics of the European offshore wind energy innovation system – Challenges for policy intervention

    International Nuclear Information System (INIS)

    Jacobsson, Staffan; Karltorp, Kersti

    2013-01-01

    Decarbonizing electricity production in the EU may necessitate building new “low-carbon” capacity (excluding nuclear investments) to deliver 3500 TWh by 2050. Offshore wind power has the potential to contribute substantially to fill this gap. Realizing this potential is, however, difficult since deployment offshore does not constitute a simple diversification by the onshore wind turbine industry to a new segment. This paper identifies factors obstructing the development of the northern European innovation system centered on offshore wind power, specifies a set of associated policy challenges and discusses various policy responses. - Highlights: • Offshore wind power has a strategic role in decarbonizing EU's supply of electricity. • There are numerous obstacles to deployment of offshore wind turbines. • We specify seven major policy challenges in diverse policy domains. • Managing these requires coordination of interventions across policy domains and national boundaries

  5. The Pivotal Position of 'Liaison People': Facilitating a Research Utilisation Intervention in Policy Agencies

    Science.gov (United States)

    Haynes, Abby; Butow, Phyllis; Brennan, Sue; Williamson, Anna; Redman, Sally; Carter, Stacy; Gallego, Gisselle; Rudge, Sian

    2018-01-01

    This paper explores the enormous variation in views, championing behaviours and impacts of liaison people: staff nominated to facilitate, tailor and promote SPIRIT (a research utilisation intervention trial in six Australian health policy agencies). Liaison people made cost/benefit analyses: they weighed the value of participation against its…

  6. Can Legal Interventions Change Beliefs? The Effect of Exposure to Sexual Harassment Policy on Men's Gender Beliefs

    Science.gov (United States)

    Tinkler, Justine Eatenson; Li, Yan E.; Mollborn, Stefanie

    2007-01-01

    In spite of the relative success of equal opportunity laws on women's status in the workplace, we know little about the influence of such legal interventions on people's attitudes and beliefs. This paper focuses, in particular, on how sexual harassment policy affects men's beliefs about the gender hierarchy. We employ an experimental design in…

  7. Use of population exposure frequency distributions to simulate effects of policy interventions on NO2 exposure

    Science.gov (United States)

    Dimitroulopoulou, C.; Ashmore, M. R.; Terry, A. C.

    2017-02-01

    of policy interventions are to be accurately assessed.

  8. Using frameworks to diagram value in complex policy and environmental interventions to prevent childhood obesity.

    Science.gov (United States)

    Swank, Melissa Farrell; Brennan, Laura K; Gentry, Daniel; Kemner, Allison L

    2015-01-01

    To date, few tools assist policy makers and practitioners in understanding and conveying the implementation costs, potential impacts, and value of policy and environmental changes to address healthy eating, active living, and childhood obesity. For the Evaluation of Healthy Kids, Healthy Communities (HKHC), evaluators considered inputs (resources and investments) that generate costs and savings as well as benefits and harms related to social, economic, environmental, and health-related outcomes in their assessment of 49 HKHC community partnerships funded from 2009 to 2014. Using data collected through individual and group interviews and an online performance monitoring system, evaluators created a socioecological framework to assess investments, resources, costs, savings, benefits, and harms at the individual, organizational, community, and societal levels. Evaluators customized frameworks for 6 focal strategies: active transportation, parks and play spaces, child care physical activity standards, corner stores, farmers' markets, and child care nutrition standards. To illustrate the Value Frameworks, this brief highlights the 38 HKHC communities implementing at least 1 active transportation strategy. Evaluators populated this conceptual Value Framework with themes from the strategy-specific inputs and outputs. The range of factors corresponding to the implementation and impact of the HKHC community partnerships are highlighted along with the inputs and outputs. The Value Frameworks helped evaluators identify gaps in current analysis models (ie, benefit-cost analysis, cost-effectiveness analysis) as well as paint a more complete picture of value for potential obesity prevention strategies. These frameworks provide a comprehensive understanding of investments needed, proposed costs and savings, and potential benefits and harms associated with economic, social, environmental, and health outcomes. This framing also allowed evaluators to demonstrate the interdependence

  9. Men perpetrators of violence against women: public policy challenges and possible interventions in Latin America and Portugal

    Directory of Open Access Journals (Sweden)

    Maria Juracy F. Toneli

    2017-06-01

    Full Text Available From exploratory researches done in Latin America and Portugal that have mapped programs for men perpetrators of violence against women, this paper intends to problematize how these men have been regarded by public policies. As to the methodology, visits were made to each program, along with routine observations and access to the materials produced by them, as well as coordinators interviews. The majority of initiatives have been developed by NGOs, however, in Brazil, governmental interventions are growing since the Maria da Penha Law was enacted. In Portugal, four programs were visited, three of which were linked to universities and the other to a hospital. While some difficulties are identified to give support to the male demand, it is important to emphasize the success of programs that propose educational and reflexive interventions. Thus, through reinforcement of public policies and interventions to give visibility for men perpetrators of violence, the possibility to promote changes in this context can be widely expanded.

  10. Evaluation of caregiver-friendly workplace policy (CFWPs interventions on the health of full-time caregiver employees (CEs: implementation and cost-benefit analysis

    Directory of Open Access Journals (Sweden)

    Allison M. Williams

    2017-09-01

    Full Text Available Abstract Background Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (economic and workers (health of caregiver-friendly workplace policy intervention(s for full-time caregiver-employees? What are the impacts for employers, workers and society of the caregiver-friendly workplace policy intervention(s in each participating workplace? What contextual factors impact the successful implementation of caregiver-friendly workplace policy intervention(s? Methods Using a pre-post-test comparative case study design, Study A will determine the effectiveness of newly implemented caregiver-friendly workplace policy intervention(s across two workplaces to determine impacts on caregiver-employee health. A quasi-experimental pre-post design will allow the caregiver-friendly workplace policy intervention(s to be tested with respect to potential impacts on health, and specifically on caregiver employee mental, psychosocial, and physical health. Framed within a comparative case study design, Study B will utilize cost-benefit and cost-effectiveness analysis approaches to evaluate the economic impacts of the caregiver-friendly workplace policy intervention(s for each of the two participating workplaces. Framed within a comparative case study design, Study C will undertake an implementation analysis of the caregiver-friendly workplace policy intervention(s in each participating workplace in order to determine: the degree of support for the intervention(s (reflected in the workplace culture; how sex and gender are implicated; co

  11. Evaluation of caregiver-friendly workplace policy (CFWPs) interventions on the health of full-time caregiver employees (CEs): implementation and cost-benefit analysis.

    Science.gov (United States)

    Williams, Allison M; Tompa, Emile; Lero, Donna S; Fast, Janet; Yazdani, Amin; Zeytinoglu, Isik U

    2017-09-20

    Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (economic) and workers (health) of caregiver-friendly workplace policy intervention(s) for full-time caregiver-employees? What are the impacts for employers, workers and society of the caregiver-friendly workplace policy intervention(s) in each participating workplace? What contextual factors impact the successful implementation of caregiver-friendly workplace policy intervention(s)? Using a pre-post-test comparative case study design, Study A will determine the effectiveness of newly implemented caregiver-friendly workplace policy intervention(s) across two workplaces to determine impacts on caregiver-employee health. A quasi-experimental pre-post design will allow the caregiver-friendly workplace policy intervention(s) to be tested with respect to potential impacts on health, and specifically on caregiver employee mental, psychosocial, and physical health. Framed within a comparative case study design, Study B will utilize cost-benefit and cost-effectiveness analysis approaches to evaluate the economic impacts of the caregiver-friendly workplace policy intervention(s) for each of the two participating workplaces. Framed within a comparative case study design, Study C will undertake an implementation analysis of the caregiver-friendly workplace policy intervention(s) in each participating workplace in order to determine: the degree of support for the intervention(s) (reflected in the workplace culture); how sex and gender are implicated; co-workers' responses to the chosen intervention(s), and

  12. [Determinants of health and health policy. Part 3. From intervention of quality of life].

    Science.gov (United States)

    Zácek, A

    2000-03-29

    Effectiveness of outputs of a qualified intervention can be valued by several positive criteria corresponding to the "quality of life" conception, which is based on the feeling of the health and contentment. The finding that great differences in the income among different social groups in conditions of the liberal market society correlate with several health and social problems brought about to the hypothesis that the decrease of the differences in the income, accompanied by strengthening of various forms of the social cohesion, civic solidarity, legitimate equality, and ethical justice may substantially improve the health status of the population. The hypothesis has been verified in many epidemiological studies and found to be valid enough for the health policy and far-seeing economy. Analytics of the World Bank recommend to governments primary invest into the health of socially week groups in order to decrease their poverty and to keep social conciliation. World Health Organization (WHO) sets in its new program for Europe called "21 Goals for the 21st Century" that differences in the health status among the European states should diminish till 2020 by one third and within the countries by one quarter at least. Both goals should be achieved by a substantial improvement of the health status of the ill-adapted social groups and by significant improvement of those socioeconomical conditions which may have adverse effects namely on the differences in incomes, education and opportunities for employment.

  13. The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms.

    Science.gov (United States)

    Elder, Randy W; Lawrence, Briana; Ferguson, Aneeqah; Naimi, Timothy S; Brewer, Robert D; Chattopadhyay, Sajal K; Toomey, Traci L; Fielding, Jonathan E

    2010-02-01

    A systematic review of the literature to assess the effectiveness of alcohol tax policy interventions for reducing excessive alcohol consumption and related harms was conducted for the Guide to Community Preventive Services (Community Guide). Seventy-two papers or technical reports, which were published prior to July 2005, met specified quality criteria, and included evaluation outcomes relevant to public health (e.g., binge drinking, alcohol-related crash fatalities), were included in the final review. Nearly all studies, including those with different study designs, found that there was an inverse relationship between the tax or price of alcohol and indices of excessive drinking or alcohol-related health outcomes. Among studies restricted to underage populations, most found that increased taxes were also significantly associated with reduced consumption and alcohol-related harms. According to Community Guide rules of evidence, these results constitute strong evidence that raising alcohol excise taxes is an effective strategy for reducing excessive alcohol consumption and related harms. The impact of a potential tax increase is expected to be proportional to its magnitude and to be modified by such factors as disposable income and the demand elasticity for alcohol among various population groups. Published by Elsevier Inc.

  14. Human trafficking and health: a conceptual model to inform policy, intervention and research.

    Science.gov (United States)

    Zimmerman, Cathy; Hossain, Mazeda; Watts, Charlotte

    2011-07-01

    Human trafficking is an international crime renowned for extreme forms of violence against women, men and children. Although trafficking-related violence has been well-documented, the health of trafficked persons has been a largely neglected topic. For people who are trafficked, health risks and consequences may begin before they are recruited into the trafficking process, continue throughout the period of exploitation and persist even after individuals are released. Policy-making, service provision and research often focus narrowly on criminal violations that occur during the period of exploitation, regularly overlooking the health implications of trafficking. Similarly, the public health sector has not yet incorporated human trafficking as a health concern. We present a conceptual model that highlights the migratory and exploitative nature of a multi-staged trafficking process, which includes: 'recruitment', travel-transit', 'exploitation' and 'integration' or 'reintegration', and for some trafficked persons, 'detention' and 're-trafficking' stages. Trafficked persons may suffer from physical, sexual and psychological harm, occupational hazards, legal restrictions and difficulties associated with being marginalised or stigmatised. Researchers and decision-makers will benefit from a theoretical approach that conceptualizes trafficking and health as a multi-staged process of cumulative harm. To address a health risk such as trafficking, which spans geographical boundaries and involves multiple sectors, including immigration and law enforcement, labour, social and health services, interventions must be coordinated between nations and across sectors to promote the protection and recovery of people who are trafficked. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps

    Science.gov (United States)

    Khosla, Rajat; Krishnan, Suneeta; George, Asha; Gruskin, Sofia; Amin, Avni

    2016-01-01

    The importance of promoting gender equality and human rights in sexual and reproductive health (SRH) programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994–2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader set of SRH topics

  16. How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps.

    Directory of Open Access Journals (Sweden)

    Miriam Hartmann

    Full Text Available The importance of promoting gender equality and human rights in sexual and reproductive health (SRH programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994-2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader

  17. How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps.

    Science.gov (United States)

    Hartmann, Miriam; Khosla, Rajat; Krishnan, Suneeta; George, Asha; Gruskin, Sofia; Amin, Avni

    2016-01-01

    The importance of promoting gender equality and human rights in sexual and reproductive health (SRH) programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994-2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader set of SRH topics

  18. The Post-Discharge Network Coordination Programme (PDNC-P: A randomised controlled trial to evaluate the efficacy of an intervention aimed at reducing rehospitalisations and improving mental health

    Directory of Open Access Journals (Sweden)

    Michael Pascal Hengartner

    2016-03-01

    Full Text Available Purpose: To evaluate the efficacy of a post-discharge intervention for psychiatric inpatients aimed at preventing hospital readmissions and at improving patients’ mental health and psychosocial functioning. Methods: RCT using parallel group block randomisation including 151 patients with ≤3 hospitalisations within the last three years, a GAF score ≤60, and aged 18–64 years, assessed at two psychiatric hospitals from the canton of Zurich, Switzerland, between September 2011 and February 2014. Primary outcomes were rate and duration of rehospitalisation; secondary outcomes were mental health and functioning. Outcome measures were assessed before discharge from the index hospitalisation (t0, 3 months after discharge when the intervention terminated (t1, and 12 months after discharge (t2. Participants received either a brief case management post-discharge intervention or treatment as usual.Results: In the short-term (i.e., t0-t1 no significant effect emerged in any outcome. In the long-term (i.e., t0-t2 the two groups did not differ significantly with respect to the rate and duration of rehospitalisation. Also, the intervention did not reduce psychiatric symptoms, did not improve social support and did not improve quality of life. However, it did slightly increase assessor-rated general (d=0.30 and social functioning (d=0.42, although self-reports revealed a deteriorative effect on symptom remission (d=-0.44.Conclusions: This psychosocial post-discharge intervention showed no efficacy in the primary outcome of rehospitalisation. With respect to secondary outcomes, in the long-term it might lead to slightly increased social functioning but revealed no significant effect on psychopathology, social support and quality of life. In contrast, with respect to self-reported symptom remission, it was revealed to have a negative effect. In this high-resource catchment area with comprehensive community psychiatric and social services the intervention

  19. The Sydney playground project--levelling the playing field: a cluster trial of a primary school-based intervention aiming to promote manageable risk-taking in children with disability.

    Science.gov (United States)

    Bundy, Anita C; Wyver, Shirley; Beetham, Kassia S; Ragen, Jo; Naughton, Geraldine; Tranter, Paul; Norman, Richard; Villeneuve, Michelle; Spencer, Grace; Honey, Anne; Simpson, Judith; Baur, Louise; Sterman, Julia

    2015-11-14

    Providing children and adults with opportunities to engage in manageable risk taking may be a stepping stone toward closing the gap in life conditions currently experienced by young people with disabilities. We aim to demonstrate the effectiveness of a simple, innovative program for 1) changing the way parents and teachers view manageable risk-taking for children with disabilities and 2) increasing the level of responsibility that children take for their own actions, as seen on the school playground. We will employ a cluster repeated measures trial with six Sydney-area primary-school-based programs for children with disabilities. The intervention comprises two arms. 1) Risk-reframing--teachers and parents will participate together in small group intervention sessions focusing on the benefits of manageable risk-taking; 2) Introduction of play materials--materials without a defined purpose and facilitative of social cooperation will be introduced to the school playground for children to use at all break times. A control period will be undertaken first for two school terms, followed by two terms of the intervention period. Outcome measures will include playground observations, The Coping Inventory, qualitative field notes, and The Tolerance of Risk in Play Scale. New national programs, such as Australia's National Disability Insurance Scheme, will place increasing demands on young people with disabilities to assume responsibility for difficult decisions regarding procuring services. Innovative approaches, commencing early in life, are required to prepare young people and their carers for this level of responsibility. This research offers innovative intervention strategies for promoting autonomy in children with disabilities and their carers. Australian and New Zealand Clinical Trials Registration Number ACTRN12614000549628 (registered 22/5/2014).

  20. Consumer behavior and energy conservation. A policy-oriented field experimental study on the effectiveness of behavioral interventions promoting residential energy conservation

    Energy Technology Data Exchange (ETDEWEB)

    Ester, P

    1984-01-01

    The primary goal of this study is to investigate the effectiveness of behavioral interventions aimed at promoting energy conservation by consumers. It is argued that energy conservation has many advantages over other energy policy options, especially with respect to sociopolitical, economic, technical, safety and environmental considerations. Theories are discussed which deal with micromotives behind individual energy consumption and their macroconsequences. Antecedent and consequence behavioral interventions (information/education, prompting, modeling, feedback, self-monitoring, reinforcement/punishment) for promoting energy conservation by consumers are analyzed, and an extensive review is presented of behavioral experiments conducted in this area. Discussed is how the field experiment, which was conducted in five cities in the Netherlands with appr. 400 subjects, has been implemented. Hypotheses are tested regarding belief structures with respect to energy conservation. Provided are data about the absolute and relative effectiveness of energy conservation information, biweekly and monthly feedback, and self-monitoring in encouraging consumers to conserve energy. Hypotheses are tested about cognitive aspects related to responsiveness to behavioral interventions and attitude change toward energy conservation. Conclusions are presented and some energy policy recommendations and directions for future research are formulated. (J.C.R.)

  1. Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

    Science.gov (United States)

    Hurlimann, Thierry; Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo; Godard, Béatrice

    2017-01-01

    The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues

  2. Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

    Directory of Open Access Journals (Sweden)

    Thierry Hurlimann

    Full Text Available The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc. contexts.The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise.A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications.The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented.The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these

  3. The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: a systematic review.

    Science.gov (United States)

    Bee, Penny; Bower, Peter; Byford, Sarah; Churchill, Rachel; Calam, Rachel; Stallard, Paul; Pryjmachuk, Steven; Berzins, Kathryn; Cary, Maria; Wan, Ming; Abel, Kathryn

    2014-02-01

    Serious parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents. Improving the lives of these children is a political and public health concern. To conduct an evidence synthesis of the clinical effectiveness, cost-effectiveness and acceptability of community-based interventions for improving QoL in children of parents with serious mental illness (SMI). Nineteen health, allied health and educational databases, searched from database inception to May 2012, and supplemented with hand searches, reference checking, searches of grey literature, dissertations, ongoing research registers, forward citation tracking and key author contact. Inclusion criteria required≥50% of parents to have SMI or severe depression confirmed by clinical diagnosis or baseline symptoms. Children were ≤18 years of age. Community-based interventions included any non-residential psychological/psychosocial intervention involving parents or children for the purposes of improving health or well-being. Intervention comparators were not predefined and primary outcomes were validated measures of children's QoL and emotional health. Secondary outcomes were derived from UK policy and stakeholder consultation. Data were extracted independently by two reviewers and the study quality was assessed via Cochrane criteria for randomised/non-randomised designs, Critical Appraisal Skills Programme (CASP) qualitative criteria or a standard checklist for economic evaluations. Separate syntheses were conducted for SMI and severe depression. Standardised effect size (ES) trials were pooled using random-effects modelling for which sufficient data were available. Economic data were summarised and acceptability data were synthesised via a textual narrative approach. Three trials targeted mothers/the children of mothers with psychotic symptoms. Children were ≤12 years of age and no primary QoL or emotional health outcomes were reported. Insufficient

  4. 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.

  5. Animal-assisted interventions: A national survey of health and safety policies in hospitals, eldercare facilities, and therapy animal organizations.

    Science.gov (United States)

    Linder, Deborah E; Siebens, Hannah C; Mueller, Megan K; Gibbs, Debra M; Freeman, Lisa M

    2017-08-01

    Animal-assisted intervention (AAI) programs are increasing in popularity, but it is unknown to what extent therapy animal organizations that provide AAI and the hospitals and eldercare facilities they work with implement effective animal health and safety policies to ensure safety of both animals and humans. Our study objective was to survey hospitals, eldercare facilities, and therapy animal organizations on their AAI policies and procedures. A survey of United States hospitals, eldercare facilities, and therapy animal organizations was administered to assess existing health and safety policies related to AAI programs. Forty-five eldercare facilities, 45 hospitals, and 27 therapy animal organizations were surveyed. Health and safety policies varied widely and potentially compromised human and animal safety. For example, 70% of therapy animal organizations potentially put patients at risk by allowing therapy animals eating raw meat diets to visit facilities. In general, hospitals had stricter requirements than eldercare facilities. This information suggests that there are gaps between the policies of facilities and therapy animal organizations compared with recent guidelines for animal visitation in hospitals. Facilities with AAI programs need to review their policies to address recent AAI guidelines to ensure the safety of animals and humans involved. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Environmental policy performance revisited

    DEFF Research Database (Denmark)

    Daugbjerg, Carsten; Sønderskov, Kim Mannemar

    2012-01-01

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

  7. Effectiveness of a virtual intervention for primary healthcare professionals aimed at improving attitudes towards the empowerment of patients with chronic diseases: study protocol for a cluster randomized controlled trial (e-MPODERA project).

    Science.gov (United States)

    González-González, Ana Isabel; Orrego, Carola; Perestelo-Perez, Lilisbeth; Bermejo-Caja, Carlos Jesús; Mora, Nuria; Koatz, Débora; Ballester, Marta; Del Pino, Tasmania; Pérez-Ramos, Jeannet; Toledo-Chavarri, Ana; Robles, Noemí; Pérez-Rivas, Francisco Javier; Ramírez-Puerta, Ana Belén; Canellas-Criado, Yolanda; Del Rey-Granado, Yolanda; Muñoz-Balsa, Marcos José; Becerril-Rojas, Beatriz; Rodríguez-Morales, David; Sánchez-Perruca, Luis; Vázquez, José Ramón; Aguirre, Armando

    2017-10-30

    Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases. This paper describes the protocol for a cluster randomized controlled trial. We will randomly assign 18 primary-care practices per participating region of Spain (Catalonia, Madrid and Canary Islands) to a virtual community of practice or to usual training. The primary-care practice will be the randomization unit and the primary healthcare professional will be the unit of analysis. We will need a sample of 270 primary healthcare professionals (general practitioners and nurses) and 1382 patients. We will perform randomization after professionals and patients are selected. We will ask the intervention group to participate for 12 months in a virtual community of practice based on a web 2.0 platform. We will measure the primary outcome using the Patient-Provider Orientation Scale questionnaire administered at baseline and after 12 months. Secondary outcomes will be the sociodemographic characteristics of health professionals, sociodemographic and clinical characteristics of patients, the Patient Activation Measure questionnaire for patient activation and outcomes regarding use of the virtual community of practice. We will calculate a linear mixed-effects regression to estimate the effect of participating in the virtual community of practice. This cluster randomized controlled trial will show whether a virtual intervention for primary healthcare professionals improves attitudes to the empowerment of patients with chronic diseases. ClicalTrials.gov, NCT02757781 . Registered on 25 April 2016. Protocol Version. PI15.01 22 January 2016.

  8. [Promoting a balanced diet and physical activity among children : Conditions for the successful implementation and maintenance of multi-level interventions and policies: Results of two qualitative case studies].

    Science.gov (United States)

    Steenbock, Berit; Muellmann, Saskia; Zeeb, Hajo; Pischke, Claudia R

    2017-10-01

    To date, conditions for successfully implementing and maintaining multi-level interventions and policies for the promotion of a balanced diet and physical activity are not well understood from the perspective of stakeholders. The aim of this article is to examine which factors are regarded as facilitating or impeding introduction, implementation and maintenance of multi-level interventions and policies from the standpoint of stakeholders. Semi-structured face-to-face interviews with stakeholders of one multi-level intervention (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS [IDEFICS] for the prevention of childhood obesity, n = 4) and one policy (Federal state offices coordinating networks for the provision of healthy food options in schools, n = 3) were analysed using qualitative content analysis. In both cases, the use of existing structures facilitated introduction, implementation and maintenance. Additionally, training of staff for implementation according to standardised protocols or concepts and taking structures and work conditions of settings into account during implementation were considered essential. In both cases, conflicting interests in interdisciplinary stakeholder teams regarding intervention content and implementation were identified as a barrier. A lack of political support and insecure long-term funding only played a role in regard to the implementation and maintenance of policies. On the other hand, target groups of the multi-level intervention were not sufficiently involved in the development of intervention materials which resulted in a lack of tailoring and acceptance in the target groups. The results provide important insights into the long-term implementation of multi-level interventions and policies in different settings.

  9. Estudios de intervención dirigidos a disminuir el riesgo de padecer diabetes mellitus tipo 2 Intervention studies aimed at lowering the risk of type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    José Luis Valenciaga Rodríguez

    2003-12-01

    Full Text Available Los estudios de intervención en población de riesgo, dirigidos a disminuir la frecuencia de la aparición de la diabetes mellitus tipo 2 (DM 2, son considerados orientadores para el enfoque del trabajo con esos pacientes. El objetivo del presente estudio es revisar los resultados de investigaciones dirigidas a disminuir el riesgo de padecer DM 2. Los sujetos estudiados presentaban alguna de las siguientes condiciones: glucosa alterada en ayunas (GAA o tolerancia a la glucosa alterada (TGA, antecedente personal de diabetes gestacional y síndrome metabólico. Se citan, entre otros, DPP (diabetes prevention program, DPS (diabetes prevention study, STOP-NIDDM (study to prevent non-insulin-dependent diabetes mellitus, Hiperglucemia en ayunas, DAISI (dutch acarbose intervention trial, Da Quing (estudio chino, TRIPOD (troglitazone In the prevention of diabetes, intervención, XENDOS (xenical in the prevention of diabetes in obese subjects, WOSCOPS (west of scotland coronary prevention study, EDIT (early diabetes intervención trial, NAVIGATOR (nateglinide and valsartan in impaired glucose tolerance outcomes research, DREAM (diabetes reduction assessment with ramipril and rosiglitazone medication. Estos consistían en cambios de estilo de vida (fundamentalmente ejercicios físicos sistemáticos y orientaciones nutricionales y/o intervenciones terapéuticas. Se concluye que en personas con 25 o más años de edad de ambos sexos, con riesgo de padecer DM 2, la adopción de un estilo de vida saludable logra disminuir el riesgo de padecer el síndrome diabético. En sujetos con alto riesgo de DM 2, los fármacos que reportan mejores y más consistentes resultados son el metformin y la acarbosa. Otros como la nateglidina, rosiglitazona, ramipril y valsartan, se están investigando actualmente.Intervention studies on population at risk aimed at lowering the frequency of occurrence of type 2 diabetes mellitus(DM2 are considered as guiding lines for the work

  10. AIMES Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Katz, Daniel S [Univ. of Illinois, Urbana-Champaign, IL (United States). National Center for Supercomputing Applications (NCSA); Jha, Shantenu [Rutgers Univ., New Brunswick, NJ (United States); Weissman, Jon [Univ. of Minnesota, Minneapolis, MN (United States); Turilli, Matteo [Rutgers Univ., New Brunswick, NJ (United States)

    2017-01-31

    This is the final technical report for the AIMES project. Many important advances in science and engineering are due to large-scale distributed computing. Notwithstanding this reliance, we are still learning how to design and deploy large-scale production Distributed Computing Infrastructures (DCI). This is evidenced by missing design principles for DCI, and an absence of generally acceptable and usable distributed computing abstractions. The AIMES project was conceived against this backdrop, following on the heels of a comprehensive survey of scientific distributed applications. AIMES laid the foundations to address the tripartite challenge of dynamic resource management, integrating information, and portable and interoperable distributed applications. Four abstractions were defined and implemented: skeleton, resource bundle, pilot, and execution strategy. The four abstractions were implemented into software modules and then aggregated into the AIMES middleware. This middleware successfully integrates information across the application layer (skeletons) and resource layer (Bundles), derives a suitable execution strategy for the given skeleton and enacts its execution by means of pilots on one or more resources, depending on the application requirements, and resource availabilities and capabilities.

  11. A Training Intervention for Supervisors to Support a Work-Life Policy Implementation

    Directory of Open Access Journals (Sweden)

    Naima Laharnar

    2013-09-01

    Conclusion: CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA.

  12. 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.

  13. Program, policy, and price interventions for tobacco control: quantifying the return on investment of a state tobacco control program.

    Science.gov (United States)

    Dilley, Julia A; Harris, Jeffrey R; Boysun, Michael J; Reid, Terry R

    2012-02-01

    We examined health effects associated with 3 tobacco control interventions in Washington State: a comprehensive state program, a state policy banning smoking in public places, and price increases. We used linear regression models to predict changes in smoking prevalence and specific tobacco-related health conditions associated with the interventions. We estimated dollars saved over 10 years (2000-2009) by the value of hospitalizations prevented, discounting for national trends. Smoking declines in the state exceeded declines in the nation. Of the interventions, the state program had the most consistent and largest effect on trends for heart disease, cerebrovascular disease, respiratory disease, and cancer. Over 10 years, implementation of the program was associated with prevention of nearly 36,000 hospitalizations, at a value of about $1.5 billion. The return on investment for the state program was more than $5 to $1. The combined program, policy, and price interventions resulted in reductions in smoking and related health effects, while saving money. Public health and other leaders should continue to invest in tobacco control, including comprehensive programs.

  14. Cluster randomised controlled trial of a multicomponent intervention to support the implementation of policies and practices that promote healthier environments at junior sports clubs: study protocol.

    Science.gov (United States)

    Milner, Sharin; Sherker, Shauna; Clinton-McHarg, Tara; Dray, Julia; Zukowski, Nadya; Gonzalez, Sharleen; Kingsland, Melanie; Ooi, Jia Ying; Murphy, Allan; Brooke, Daisy; Wiggers, John; Wolfenden, Luke

    2018-01-23

    A large proportion of children and adolescents participate in organised sport, making community sports clubs a promising setting to support healthy behaviours. To date, however, there have been few interventions conducted in junior sports clubs that have targeted health-promoting practices. The primary aim of this pilot study is to assess the potential effectiveness of an intervention to implement health-promoting policies and practices in junior sporting clubs targeting alcohol and tobacco practices, healthy food and beverage availability, and physical activity via participation in sport. A secondary outcome is to assess the impact of such strategies on child exposure to alcohol and tobacco use at the club, purchasing behaviours by/for children at the club canteen and child sports participation opportunities. The study will employ a cluster randomised controlled trial design and be conducted in metropolitan and regional areas of two Australian states. Randomisation will occur at the level of the football league. Community football clubs with over 40 junior players (players under 18 years) within each league will be eligible to participate. The intervention will be developed based on frameworks that consider the social, cultural and environmental factors that influence health behaviours. Intervention clubs will be supported to implement 16 practices targeting alcohol management, tobacco use, nutrition practices, new player recruitment activity, equal participation for players and the development of policies to support these practices. Trained research staff will collect outcome data via telephone interviews at baseline and follow-up. Interviews will be conducted with both club representatives and parents of junior players. The study has been approved by the University of Newcastle Human Research Ethics Committee (H-2013-0429). The results of the study will be disseminated via peer-reviewed publications and presentations at conferences. ACTRN12617001044314; Pre

  15. Cluster randomised controlled trial of a multicomponent intervention to support the implementation of policies and practices that promote healthier environments at junior sports clubs: study protocol

    Science.gov (United States)

    Milner, Sharin; Sherker, Shauna; Clinton-McHarg, Tara; Dray, Julia; Zukowski, Nadya; Gonzalez, Sharleen; Kingsland, Melanie; Ooi, Jia Ying; Murphy, Allan; Brooke, Daisy; Wiggers, John

    2018-01-01

    Introduction A large proportion of children and adolescents participate in organised sport, making community sports clubs a promising setting to support healthy behaviours. To date, however, there have been few interventions conducted in junior sports clubs that have targeted health-promoting practices. The primary aim of this pilot study is to assess the potential effectiveness of an intervention to implement health-promoting policies and practices in junior sporting clubs targeting alcohol and tobacco practices, healthy food and beverage availability, and physical activity via participation in sport. A secondary outcome is to assess the impact of such strategies on child exposure to alcohol and tobacco use at the club, purchasing behaviours by/for children at the club canteen and child sports participation opportunities. Methods and analysis The study will employ a cluster randomised controlled trial design and be conducted in metropolitan and regional areas of two Australian states. Randomisation will occur at the level of the football league. Community football clubs with over 40 junior players (players under 18 years) within each league will be eligible to participate. The intervention will be developed based on frameworks that consider the social, cultural and environmental factors that influence health behaviours. Intervention clubs will be supported to implement 16 practices targeting alcohol management, tobacco use, nutrition practices, new player recruitment activity, equal participation for players and the development of policies to support these practices. Trained research staff will collect outcome data via telephone interviews at baseline and follow-up. Interviews will be conducted with both club representatives and parents of junior players. Ethics and dissemination The study has been approved by the University of Newcastle Human Research Ethics Committee (H-2013-0429). The results of the study will be disseminated via peer-reviewed publications and

  16. AIM Data Services

    Directory of Open Access Journals (Sweden)

    Michael Scholz

    2016-05-01

    Full Text Available AIM Data Services as a virtual facility provides virtual 3D reference tracks for simulation applications in the domain of automotive and railway systems. It offers tools for management and analysis of experiment data and a platform for survey and processing of vehicle data in the public transport domain. Collected spatial data is bundled in a database cluster and published through common web mapping interfaces.

  17. HEALTH POLICY INTERVENTION IN SCHOOLS PROMOTE PHYSICAL ACTIVITIES AMONG THE PUPILS

    DEFF Research Database (Denmark)

    He, Chen; Mikkelsen, Bent Egberg

    setting. For instance schools are expected to have food and nutrition policy (FNP), physical activity policy (PAP) and a health policy. However instead of seeing these policies as separate entities this paper speculate that there is a possible interrelatedness between the policies. In other words could......Today, more and more children are overweight or obese than ever before. Schools can play a prominent role in easing the situation. Schools have a great potential through the curriculum, health promoting programming and transportation to preventing children from becoming obese and overweight....... However schools are complex social systems that does not necessarily by themselves adapt to this new health promoting role and thus committed management support is needed. Since schools are complex organizational structures convenient organizational structure are needed to formalize the praxis...

  18. Low-carbon transition of iron and steel industry in China: carbon intensity, economic growth and policy intervention.

    Science.gov (United States)

    Yu, Bing; Li, Xiao; Qiao, Yuanbo; Shi, Lei

    2015-02-01

    As the biggest iron and steel producer in the world and one of the highest CO2 emission sectors, China's iron and steel industry is undergoing a low-carbon transition accompanied by remarkable technological progress and investment adjustment, in response to the macroeconomic climate and policy intervention. Many drivers of the CO2 emissions of the iron and steel industry have been explored, but the relationships between CO2 abatement, investment and technological expenditure, and their connections with the economic growth and governmental policies in China, have not been conjointly and empirically examined. We proposed a concise conceptual model and an econometric model to investigate this crucial question. The results of regression, Granger causality test and impulse response analysis indicated that technological expenditure can significantly reduce CO2 emissions, and that investment expansion showed a negative impact on CO2 emission reduction. It was also argued with empirical evidence that a good economic situation favored CO2 abatement in China's iron and steel industry, while achieving CO2 emission reduction in this industrial sector did not necessarily threaten economic growth. This shed light on the dispute over balancing emission cutting and economic growth. Regarding the policy aspects, the year 2000 was found to be an important turning point for policy evolution and the development of the iron and steel industry in China. The subsequent command and control policies had a significant, positive effect on CO2 abatement. Copyright © 2014. Published by Elsevier B.V.

  19. Does health intervention research have real world policy and practice impacts: testing a new impact assessment tool.

    Science.gov (United States)

    Cohen, Gillian; Schroeder, Jacqueline; Newson, Robyn; King, Lesley; Rychetnik, Lucie; Milat, Andrew J; Bauman, Adrian E; Redman, Sally; Chapman, Simon

    2015-01-01

    There is a growing emphasis on the importance of research having demonstrable public benefit. Measurements of the impacts of research are therefore needed. We applied a modified impact assessment process that builds on best practice to 5 years (2003-2007) of intervention research funded by Australia's National Health and Medical Research Council to determine if these studies had post-research real-world policy and practice impacts. We used a mixed method sequential methodology whereby chief investigators of eligible intervention studies who completed two surveys and an interview were included in our final sample (n = 50), on which we conducted post-research impact assessments. Data from the surveys and interviews were triangulated with additional information obtained from documentary analysis to develop comprehensive case studies. These case studies were then summarized and the reported impacts were scored by an expert panel using criteria for four impact dimensions: corroboration; attribution, reach, and importance. Nineteen (38%) of the cases in our final sample were found to have had policy and practice impacts, with an even distribution of high, medium, and low impact scores. While the tool facilitated a rigorous and explicit criterion-based assessment of post-research impacts, it was not always possible to obtain evidence using documentary analysis to corroborate the impacts reported in chief investigator interviews. While policy and practice is ideally informed by reviews of evidence, some intervention research can and does have real world impacts that can be attributed to single studies. We recommend impact assessments apply explicit criteria to consider the corroboration, attribution, reach, and importance of reported impacts on policy and practice. Impact assessments should also allow sufficient time between impact data collection and completion of the original research and include mechanisms to obtain end-user input to corroborate claims and reduce biases

  20. AIMES Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Jha, Shantenu [Rutgers Univ., New Brunswick, NJ (United States)

    2017-01-31

    Many important advances in science and engineering are due to large-scale distributed computing. Notwithstanding this reliance, we are still learning how to design and deploy large-scale production Distributed Computing Infrastructures (DCI). The AIMES project was conceived against this backdrop, following on the heels of a comprehensive survey of scienti c distributed applications [1]. The survey established, arguably for the rst time, the relationship between infrastructure and scienti c distributed applications. It examined well known contributors to the complexity associated with infrastructure, such as inconsistent internal and external interfaces, and demonstrated the correlation with application brittleness. It discussed how infrastructure complexity reinforces the challenges inherent in developing distributed applications.

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

    Science.gov (United States)

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

    2012-01-01

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

  2. Education on tick bite and Lyme borreliosis prevention, aimed at schoolchildren in the Netherlands: comparing the effects of an online educational video game versus a leaflet or no intervention.

    Science.gov (United States)

    Beaujean, D J M A; Gassner, F; Wong, A; Steenbergen, J E; Crutzen, R; Ruwaard, D

    2016-11-16

    Lyme disease or Lyme borreliosis (LB) is the most common tick-borne disease both in the United States and Europe. Children, in particular, are at high risk of contracting LB. Since child-specific educational tools on ticks, tick bites and LB are lacking, we developed an online educational video game. In this study, we compared the effectiveness of an online educational video game versus a newly developed leaflet aimed to improve prevention of tick bites and LB among Dutch schoolchildren. A total of 887 children, aged 9-13 years and attending the two final years of primary schooling, were recruited from 25 primary schools in June and July 2012. They were assigned through cluster randomization to one of three intervention groups: 'game' (22.4%), 'leaflet' (35.6%) or 'control' (41.9%). Prior to and directly following intervention, the children were asked to complete a short questionnaire. The main outcome measures were knowledge, perception (perceived susceptibility and importance) and preventive behavior in relation to tick bites and LB. Generalized linear mixed models were used to analyze the data. In the game group, the leaflet group and the control group, knowledge about ticks and tick bites improved significantly. The game was also an effective tool for improving preventive behavior; the frequency of checking for ticks increased significantly. However, there were no significant differences in knowledge improvement between the interventions. The game outperformed the leaflet in terms of improving preventive behavior, whereas the frequency of tick checks increased significantly. But this frequency didn't increase more than in the control group. The positive knowledge effects observed in the control group suggests the presence of a mere measurement effect related to completion of the questionnaire. The game did not outperform the leaflet or control group on all outcome measures. Therefore, the game may be of value as a complementary role, in addition to other media

  3. Education on tick bite and Lyme borreliosis prevention, aimed at schoolchildren in the Netherlands: comparing the effects of an online educational video game versus a leaflet or no intervention

    Directory of Open Access Journals (Sweden)

    D. J. M. A. Beaujean

    2016-11-01

    Full Text Available Abstract Background Lyme disease or Lyme borreliosis (LB is the most common tick-borne disease both in the United States and Europe. Children, in particular, are at high risk of contracting LB. Since child-specific educational tools on ticks, tick bites and LB are lacking, we developed an online educational video game. In this study, we compared the effectiveness of an online educational video game versus a newly developed leaflet aimed to improve prevention of tick bites and LB among Dutch schoolchildren. Methods A total of 887 children, aged 9–13 years and attending the two final years of primary schooling, were recruited from 25 primary schools in June and July 2012. They were assigned through cluster randomization to one of three intervention groups: ‘game’ (22.4%, ‘leaflet’ (35.6% or ‘control’ (41.9%. Prior to and directly following intervention, the children were asked to complete a short questionnaire. The main outcome measures were knowledge, perception (perceived susceptibility and importance and preventive behavior in relation to tick bites and LB. Generalized linear mixed models were used to analyze the data. Results In the game group, the leaflet group and the control group, knowledge about ticks and tick bites improved significantly. The game was also an effective tool for improving preventive behavior; the frequency of checking for ticks increased significantly. However, there were no significant differences in knowledge improvement between the interventions. The game outperformed the leaflet in terms of improving preventive behavior, whereas the frequency of tick checks increased significantly. But this frequency didn’t increase more than in the control group. Conclusions The positive knowledge effects observed in the control group suggests the presence of a mere measurement effect related to completion of the questionnaire. The game did not outperform the leaflet or control group on all outcome measures. Therefore

  4. Studying complex interventions: reflections from the FEMHealth project on evaluating fee exemption policies in West Africa and Morocco.

    Science.gov (United States)

    Marchal, Bruno; Van Belle, Sara; De Brouwere, Vincent; Witter, Sophie

    2013-11-08

    The importance of complexity in health care policy-making and interventions, as well as research and evaluation is now widely acknowledged, but conceptual confusion reigns and few applications of complexity concepts in research design have been published. Taking user fee exemption policies as an entry point, we explore the methodological consequences of 'complexity' for health policy research and evaluation. We first discuss the difference between simple, complicated and complex and introduce key concepts of complex adaptive systems theory. We then apply these to fee exemption policies. We describe how the FEMHealth research project attempts to address the challenges of complexity in its evaluation of fee exemption policies for maternal care. We present how the development of a programme theory for fee exemption policies was used to structure the overall design. This allowed for structured discussions on the hypotheses held by the researchers and helped to structure, integrate and monitor the sub-studies. We then show how the choice of data collection methods and tools for each sub-study was informed by the overall design. Applying key concepts from complexity theory proved useful in broadening our view on fee exemption policies and in developing the overall research design. However, we encountered a number of challenges, including maintaining adaptiveness of the design during the evaluation, and ensuring cohesion in the disciplinary diversity of the research teams. Whether the programme theory can fulfil its claimed potential to help making sense of the findings is yet to be tested. Experience from other studies allows for some moderate optimism. However, the biggest challenge complexity throws at health system researchers may be to deal with the unknown unknowns and the consequence that complex issues can only be understood in retrospect. From a complexity theory point of view, only plausible explanations can be developed, not predictive theories. Yet here

  5. Aiming for the ordinary

    DEFF Research Database (Denmark)

    Offersen, Sara Marie Hebsgaard

    that the Danes are encouraged to be alert to still earlier and vaguer bodily signs of potential cancer and seek care ‘in time’. With biomedical constructions such as ‘cancer awareness’ and ‘alarm symptoms of cancer’ and the retrospectively oriented definition of life before symptoms-based healthcare seeking...... and articulation of bodily sensations, and how decisions about healthcare seeking are established in this context. This dissertation aims to explore these matters from the perspective of the Danish middle class, mainly focusing on how sensations are ascribed meaning as symptoms and how they are evoked...... on a continuum between what is locally considered ordinary and extraordinary. Overall, the dissertation argues that inquiries into morality and potentiality provide valuable insights into healthcare seeking practices and the making and management of symptoms in everyday life. The dissertation is based on 18...

  6. Selecting interventions to promote fruit and vegetable consumption: from policy to action, a planning framework case study in Western Australia.

    Science.gov (United States)

    Pollard, Christina M; Lewis, Janette M; Binns, Colin W

    2008-12-24

    The Department of Health in Western Australia identified access to, and daily consumption of recommended amounts of fruit and vegetables, as priority health determinants. The numerous factors that influence supply and consumption of fruit and vegetables indicated that a comprehensive approach would be required.A government and non-government sector steering group was set up to select priority interventions using the National Public Health Partnership's Framework for Implementing Public Health Strategies. This structured framework was used for developing strategies to improve fruit and vegetable consumption and supply, and to identify implementation priorities.After one year a desktop audit of progress on framework interventions was undertaken. The structured framework led to a plan for defined actions, partners, costs, and performance indicators for strategies to improve fruit and vegetable consumption and supply. Lead agency custodians for management of the selected interventions were identified.After one year there was significant progress in the implementation of a number of the high-ranking interventions. The exception was interventions that provide the infrastructure support such as research and development capacity, information systems. A structured framework and stakeholder participation assisted in developing a fruit and vegetable implementation strategy. Engagement and commitment of influential and diverse stakeholders is needed, not just for program support, but particularly in the areas of food and nutrition policy development and providing the infrastructure support required. Further work is required to develop performance outcomes and cost effectiveness measures for many of the strategies that have been proposed to address portfolio objectives.

  7. Controlling, Modeling, Consensus, and Substance Use(r) Policy Intervention: Unfinished Business.

    Science.gov (United States)

    Ferguson, Brian

    2015-01-01

    This article looks at certain aspects of unfinished business in substance use policy from the economist's perspective. It takes the view that in tackling a policy issue such as cigarette smoking, it is likely to be necessary to use a portfolio of policy tools, rather than on just one tool, and that it is likely to be necessary to accept that complete elimination of the activity being considered will almost certainly cost more than it is worth-we will probably always have to live with some nonzero level of such activities.

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

    Science.gov (United States)

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

    2018-03-01

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

  9. Reductions in non-medical prescription opioid use among adults in Ontario, Canada: are recent policy interventions working?

    Science.gov (United States)

    Fischer, Benedikt; Ialomiteanu, Anca; Kurdyak, Paul; Mann, Robert E; Rehm, Jürgen

    2013-02-14

    Non-medical prescription opioid use (NMPOU) and prescription opioid (PO) related harms have become major substance use and public health problems in North America, the region with the world's highest PO use levels. In Ontario, Canada's most populous province, NMPOU rates, PO-related treatment admissions and accidental mortality have risen sharply in recent years. A series of recent policy interventions from governmental and non-governmental entities to stem PO-related problems have been implemented since 2010. We compared the prevalence of NMPOU in the Ontario general adult population (18 years+) in 2010 and 2011 based on data from the 'Centre for Addiction and Mental Health (CAMH) Monitor' (CM), a long-standing annual telephone interview-based representative population survey of substance use and health indicators. While 'any PO use' (in past year) changed non-significantly from 26.6% to 23.9% (Chi2 = 2.511; df = 1; p =  0.113), NMPOU decreased significantly from 7.7% to 4.0% (Chi2 = 14.786; df = 1; p policy interventions, alongside extensive media reporting, focusing on NMPOU and PO-related harms, and may mean that these interventions have shown initial effects. However, other casual factors could have been involved. Thus, it is necessary to systematically examine whether the observed changes will be sustained, and whether other key PO-related harm indicators (e.g., treatment admissions, accidental mortality) change correspondingly in order to more systematically assess the impact of the policy measures.

  10. Illicit drug use and harms, and related interventions and policy in Canada: A narrative review of select key indicators and developments since 2000.

    Science.gov (United States)

    Fischer, Benedikt; Murphy, Yoko; Rudzinski, Katherine; MacPherson, Donald

    2016-01-01

    By the year 2000, Canada faced high levels of illicit drug use and related harms. Simultaneously, a fundamental tension had raisen between continuing a mainly repression-based versus shifting to a more health-oriented drug policy approach. Despite a wealth of new data and numerous individual studies that have emerged since then, no comprehensive review of key indicators and developments of illicit drug use/harm epidemiology, interventions and law/policy exist; this paper seeks to fill this gap. We searched and reviewed journal publications, as well as key reports, government publications, surveys, etc. reporting on data and information since 2000. Relevant data were selected and extracted for review inclusion, and subsequently grouped and narratively summarized in major topical sub-theme categories. Cannabis use has remained the principal form of illicit drug use; prescription opioid misuse has arisen as a new and extensive phenomenon. While new drug-related blood-borne-virus transmissions declined, overdose deaths increased in recent years. Acceptance and proliferation of - mainly local/community-based - health measures (e.g., needle exchange, crack paraphernalia or naloxone distribution) aiming at high-risk drug users has evolved, though reach and access limitations have persisted; Vancouver's 'supervised injection site' has attracted continued attention yet remains un-replicated elsewhere in Canada. While opioid maintenance treatment utilization increased, access to treatment for key (e.g., infectious disease, psychiatric) co-morbidities among drug users remained limited. Law enforcement continued to principally focus on cannabis and specifically cannabis users. 'Drug treatment courts' were introduced but have shown limited effectiveness; several attempts cannabis control law reform have failed, except for the recent establishment of 'medical cannabis' access provisions. While recent federal governments introduced several law and policy measures reinforcing a

  11. [Aiming for zero blindness].

    Science.gov (United States)

    Nakazawa, Toru

    2015-03-01

    -independent factors, as well as our investigation of ways to improve the clinical evaluation of the disease. Our research was prompted by the multifactorial nature of glaucoma. There is a high degree of variability in the pattern and speed of the progression of visual field defects in individual patients, presenting a major obstacle for successful clinical trials. To overcome this, we classified the eyes of glaucoma patients into 4 types, corresponding to the 4 patterns of glaucomatous optic nerve head morphology described: by Nicolela et al. and then tested the validity of this method by assessing the uniformity of clinical features in each group. We found that in normal tension glaucoma (NTG) eyes, each disc morphology group had a characteristic location in which the loss of circumpapillary retinal nerve fiber layer thickness (cpRNFLT; measured with optical coherence tomography: OCT) was most likely to occur. Furthermore, the incidence of reductions in visual acuity differed between the groups, as did the speed of visual field loss, the distribution of defective visual field test points, and the location of test points that were most susceptible to progressive damage, measured by Humphrey static perimetry. These results indicate that Nicolela's method of classifying eyes with glaucoma was able to overcome the difficulties caused by the diverse nature of the disease, at least to a certain extent. Building on these findings, we then set out to identify sectors of the visual field that correspond to the distribution of retinal nerve fibers, with the aim of detecting glaucoma progression with improved sensitivity. We first mapped the statistical correlation between visual field test points and cpRNFLT in each temporal clock-hour sector (from 6 to 12 o'clock), using OCT data from NTG patients. The resulting series of maps allowed us to identify areas containing visual field test points that were prone to be affected together as a group. We also used a similar method to identify visual

  12. [Aids in Madagascar. II. Intervention policy for maintaining low HIV infection prevalence].

    Science.gov (United States)

    Ravaoarimalala, C; Andriamahenina, R; Ravelojaona, B; Rabeson, D; Andriamiadana, J; May, J F; Behets, F; Rasamindrakotroka, A

    1998-01-01

    The HIV seroprevalence per 100,000 adults Malagasy rose from 20 in 1989, to 30 in 1992, and to 70 in 1995. In that year, the total number of HIV infected people in the Big Island was estimated at 5,000, the number of people sick with AIDS at 130, and the people at risk at more than 1,000,000. The latter are the persons infected with other STDs and individuals (or their partners) with risky sexual behaviour (e.g. numerous sexual partners, occasional sexual partners, and/or sexual contacts with commercial sex workers). The HIV prevalence rate is low as compared with those of other countries. Nevertheless, the spread of the HIV infection is alarming in some parts of the country and the risk factors are also present, namely: the high prevalence of STDs, numerous sexual partners, the low use of condoms in all groups, the development of tourism, the development of prostitution associated with social and economical problems, and internal and international migrations (with risky sexual contacts). Therefore, the still low but rising HIV prevalence in 1995 does not warrant complacency. To estimate the trend of HIV prevalence within the population, it is useful to know two different assumptions, as follows: firstly, a controlled evolution of the epidemic (low epidemic) and secondly, a very fast spread of the epidemic (high epidemic). If we consider the 5,000 individuals seropositive in July 1995, the Aids Impact Model (AIM) projection model shows that HIV seroprevalence rates among adults in 2015 might be between 3% (when the progression course of HIV epidemic is low) and 15% (when the progression course of HIV epidemic is high). By 2015 AIDS could have severe demographic, social, and economic impacts. Then, it is necessary to take measures to prevent contamination. Five major interventions are required: public information about AIDS, HIV transmission mechanism, and its prevention, communities education via the respected people and the notabilities to promote moral values

  13. Moving towards a new vision: implementation of a public health policy intervention

    Directory of Open Access Journals (Sweden)

    Ruta Valaitis

    2016-05-01

    Full Text Available Abstract Background Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public’s health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced their implementation. This paper explores policy implementation in two exemplar public health programs -chronic disease prevention and sexually-transmitted infection prevention - in Ontario, Canada. It examines public health service providers’, managers’ and senior managements’ perspectives on the process of implementation of the Ontario Public Health Standards 2008 and factors influencing implementation. Methods Public health staff from six health units representing rural, remote, large and small urban settings were included. We conducted 21 focus groups and 18 interviews between 2010 (manager and staff focus groups and 2011 (senior management interviews involving 133 participants. Research assistants coded transcripts and researchers reviewed these; the research team discussed and resolved discrepancies. To facilitate a breadth of perspectives, several team members helped interpret the findings. An integrated knowledge translation approach was used, reflected by the inclusion of academics as well as decision-makers on the team and as co-authors. Results Front line service providers often were unaware of the new policies but managers and senior management incorporated them in operational and program planning. Some participants were involved in policy development or provided feedback prior to their launch. Implementation was influenced by many factors that aligned with Greenhalgh and colleagues’ empirically-based Diffusion of Innovations in Service Organizations Framework. Factors and related components that were most clearly linked to the OPHS policy implementation were: attributes of the innovation itself; adoption by individuals

  14. Consumer Food Security and Labeling Intervention on Food Products through Public Policies in Romania

    Directory of Open Access Journals (Sweden)

    Dacinia Crina Petrescu

    2018-02-01

    Full Text Available The correct understanding of consumers’ food labeling knowledge and perceptions is a prerequisite to develop and implement coherent and appropriate food safety policies. One objective of the paper was to discover how often consumers access and use specific food label information. Another objective was to explore stakeholders’ preferences for several public policy options relevant for food safety. In this respect, a survey on a sample of 312 Romanian consumers and the evaluation of several public policy options by four stakeholder groups (food producers and sellers, doctors, fitness trainers, and consumers were carried out. The results revealed that the most frequently read types of information on the label were “expiration date” and “price”, closely followed by “quantity” and “brand”. Among tested public policies, those related to the traffic light labels and to the social interest messages with health claims were rewarded with high scores by investigated stakeholders. Although nutrition has a decisive impact on health state, nutrition information was not frequently read by people, thus justifying the implementation of a public policy meant to enhance consumers’ interest in and reading frequency of nutrition information on food label.

  15. Solution scanning as a key policy tool: identifying management interventions to help maintain and enhance regulating ecosystem services

    Directory of Open Access Journals (Sweden)

    William J. Sutherland

    2014-06-01

    Full Text Available The major task of policy makers and practitioners when confronted with a resource management problem is to decide on the potential solution(s to adopt from a range of available options. However, this process is unlikely to be successful and cost effective without access to an independently verified and comprehensive available list of options. There is currently burgeoning interest in ecosystem services and quantitative assessments of their importance and value. Recognition of the value of ecosystem services to human well-being represents an increasingly important argument for protecting and restoring the natural environment, alongside the moral and ethical justifications for conservation. As well as understanding the benefits of ecosystem services, it is also important to synthesize the practical interventions that are capable of maintaining and/or enhancing these services. Apart from pest regulation, pollination, and global climate regulation, this type of exercise has attracted relatively little attention. Through a systematic consultation exercise, we identify a candidate list of 296 possible interventions across the main regulating services of air quality regulation, climate regulation, water flow regulation, erosion regulation, water purification and waste treatment, disease regulation, pest regulation, pollination and natural hazard regulation. The range of interventions differs greatly between habitats and services depending upon the ease of manipulation and the level of research intensity. Some interventions have the potential to deliver benefits across a range of regulating services, especially those that reduce soil loss and maintain forest cover. Synthesis and applications: Solution scanning is important for questioning existing knowledge and identifying the range of options available to researchers and practitioners, as well as serving as the necessary basis for assessing cost effectiveness and guiding implementation strategies. We

  16. Evidence-based obesity prevention in childhood and adolescence: critique of recent etiological studies, preventive interventions, and policies.

    Science.gov (United States)

    Reilly, John J

    2012-07-01

    Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the "energy gap" that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers.

  17. Evidence-Based Obesity Prevention in Childhood and Adolescence: Critique of Recent Etiological Studies, Preventive Interventions, and Policies123

    Science.gov (United States)

    Reilly, John J.

    2012-01-01

    Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the “energy gap” that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers. PMID:22798005

  18. Cost effectiveness of tobacco control policies in Vietnam: the case of population-level interventions.

    Science.gov (United States)

    Higashi, Hideki; Truong, Khoa D; Barendregt, Jan J; Nguyen, Phuong K; Vuong, Mai L; Nguyen, Thuy T; Hoang, Phuong T; Wallace, Angela L; Tran, Tien V; Le, Cuong Q; Doran, Christopher M

    2011-05-01

    Tobacco smoking is one of the leading public health problems in the world. It is also possible to prevent and/or reduce the harm from tobacco use through the use of cost-effective tobacco control measures. However, most of this evidence comes from developed countries and little research has been conducted on this issue in developing countries. The objective of this study was to analyse the cost effectiveness of four population-level tobacco control interventions in Vietnam. Four tobacco control interventions were evaluated: excise tax increase; graphic warning labels on cigarette packs; mass media campaigns; and smoking bans (in public or in work places). A multi-state life table model was constructed in Microsoft® Excel to examine the cost effectiveness of the tobacco control intervention options. A government perspective was adopted, with costing conducted using a bottom-up approach. Health improvement was considered in terms of disability-adjusted life-years (DALYs) averted. All assumptions were subject to sensitivity and uncertainty analysis. All the interventions fell within the definition of being very cost effective according to the threshold level suggested by the WHO (i.e. place smoking bans. If the cost offset was included in the analysis, all interventions would provide cost savings to the government health sector. All four interventions to reduce the harm from tobacco use appear to be highly cost effective and should be considered as priorities in the context of Vietnam. The government may initially consider graphic warning labels and tax increase, followed by other interventions.

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

    Science.gov (United States)

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

    2004-10-01

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

  20. Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness.

    Science.gov (United States)

    Reilly, Kathryn L; Reeves, Penny; Deeming, Simon; Yoong, Sze Lin; Wolfenden, Luke; Nathan, Nicole; Wiggers, John

    2018-03-20

    No evaluations of the cost or cost effectiveness of interventions to increase school implementation of food availability policies have been reported. Government and non-government agency decisions regarding the extent of investment required to enhance school implementation of such policies are unsupported by such evidence. This study sought to i) Determine cost and cost-effectiveness of three interventions in improving school implementation of an Australian government healthy canteen policy and; ii) Determine the relative cost-effectiveness of the interventions in improving school implementation of such a policy. An analysis of the cost and cost-effectiveness of three implementation interventions of varying support intensity, relative to usual implementation support conducted during 2013-2015 was undertaken. Secondly, an indirect comparison of the trials was undertaken to determine the most cost-effective of the three strategies. The economic analysis was based on the cost of delivering the interventions by health service delivery staff to increase the proportion of schools 'adherent' with the policy. The total costs per school were $166,971, $70,926 and $75,682 for the high, medium and low intensity interventions respectively. Compared to usual support, the cost effectiveness ratios for each of the three interventions were: A$2982 (high intensity), A$2627 (medium intensity) and A$4730 (low intensity) per percent increase in proportion of schools reporting 'adherence'). Indirect comparison between the 'high' and 'medium intensity' interventions showed no statistically significant difference in cost-effectiveness. The results indicate that while the cost profiles of the interventions varied substantially, the cost-effectiveness did not. This result is valuable to policy makers seeking cost-effective solutions that can be delivered within budget.

  1. Impact of a School Health Coordinator Intervention on Health-Related School Policies and Student Behavior

    Science.gov (United States)

    O'Brien, Liam M.; Polacsek, Michele; MacDonald, Pamela B.; Ellis, Jacqueline; Berry, Susan; Martin, Maurice

    2010-01-01

    Background: Health-related, school-based interventions may serve to prevent disease and improve academic performance. The Healthy Maine Partnerships (HMP) initiative funded local school health coordinators (SHCs) as a part of Maine's Coordinated School Health Program (CSHP) beginning in January 2001. SHCs established school health leadership teams…

  2. Integrated assessment of policy interventions for promoting sustainable irrigation in semi-arid environments: a hydro-economic modeling approach.

    Science.gov (United States)

    Blanco-Gutiérrez, Irene; Varela-Ortega, Consuelo; Purkey, David R

    2013-10-15

    Sustaining irrigated agriculture to meet food production needs while maintaining aquatic ecosystems is at the heart of many policy debates in various parts of the world, especially in arid and semi-arid areas. Researchers and practitioners are increasingly calling for integrated approaches, and policy-makers are progressively supporting the inclusion of ecological and social aspects in water management programs. This paper contributes to this policy debate by providing an integrated economic-hydrologic modeling framework that captures the socio-economic and environmental effects of various policy initiatives and climate variability. This modeling integration includes a risk-based economic optimization model and a hydrologic water management simulation model that have been specified for the Middle Guadiana basin, a vulnerable drought-prone agro-ecological area with highly regulated river systems in southwest Spain. Namely, two key water policy interventions were investigated: the implementation of minimum environmental flows (supported by the European Water Framework Directive, EU WFD), and a reduction in the legal amount of water delivered for irrigation (planned measure included in the new Guadiana River Basin Management Plan, GRBMP, still under discussion). Results indicate that current patterns of excessive water use for irrigation in the basin may put environmental flow demands at risk, jeopardizing the WFD's goal of restoring the 'good ecological status' of water bodies by 2015. Conflicts between environmental and agricultural water uses will be stressed during prolonged dry episodes, and particularly in summer low-flow periods, when there is an important increase of crop irrigation water requirements. Securing minimum stream flows would entail a substantial reduction in irrigation water use for rice cultivation, which might affect the profitability and economic viability of small rice-growing farms located upstream in the river. The new GRBMP could contribute

  3. A mixed methods study of the factors that influence whether intervention research has policy and practice impacts: perceptions of Australian researchers.

    Science.gov (United States)

    Newson, Robyn; King, Lesley; Rychetnik, Lucie; Bauman, Adrian E; Redman, Sally; Milat, Andrew J; Schroeder, Jacqueline; Cohen, Gillian; Chapman, Simon

    2015-07-21

    To investigate researchers' perceptions about the factors that influenced the policy and practice impacts (or lack of impact) of one of their own funded intervention research studies. Mixed method, cross-sectional study. Intervention research conducted in Australia and funded by Australia's National Health and Medical Research Council between 2003 and 2007. The chief investigators from 50 funded intervention research studies were interviewed to determine if their study had achieved policy and practice impacts, how and why these impacts had (or had not) occurred and the approach to dissemination they had employed. We found that statistically significant intervention effects and publication of results influenced whether there were policy and practice impacts, along with factors related to the nature of the intervention itself, the researchers' experience and connections, their dissemination and translation efforts, and the postresearch context. This study indicates that sophisticated approaches to intervention development, dissemination actions and translational efforts are actually widespread among experienced researches, and can achieve policy and practice impacts. However, it was the links between the intervention results, further dissemination actions by researchers and a variety of postresearch contextual factors that ultimately determined whether a study had policy and practice impacts. Given the complicated interplay between the various factors, there appears to be no simple formula for determining which intervention studies should be funded in order to achieve optimal policy and practice impacts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Restricting marketing to children: consensus on policy interventions to address obesity.

    Science.gov (United States)

    Raine, Kim D; Lobstein, Tim; Landon, Jane; Kent, Monique Potvin; Pellerin, Suzie; Caulfield, Timothy; Finegood, Diane; Mongeau, Lyne; Neary, Neil; Spence, John C

    2013-05-01

    Obesity presents major challenges for public health and the evidence is strong. Lessons from tobacco control indicate a need for changing the policy and environments to make healthy choices easier and to create more opportunities for children to achieve healthy weights. In April 2011, the Alberta Policy Coalition for Chronic Disease Prevention convened a consensus conference on environmental determinants of obesity such as marketing of unhealthy foods and beverages to children. We examine the political environment, evidence, issues, and challenges of placing restrictions on marketing of unhealthy foods and beverages within Canada. We recommend a national regulatory system prohibiting commercial marketing of foods and beverages to children and suggest that effective regulations must set minimum standards, monitor compliance, and enact penalties for non-compliance.

  5. Policy intervention for arsenic mitigation in drinking water in rural habitations in India: achievements and challenges.

    Science.gov (United States)

    Shrivastava, Brajesh K

    2016-10-01

    This article provides updated status of the arsenic affected rural habitations in India, summarizes the policy initiatives of the Ministry of Drinking Water & Sanitation (Government of India), reviews the technologies for arsenic treatment and analyses the progress made by states in tackling arsenic problems in rural habitations. It also provides a list of constraints based on experiences and recommends suggested measures to tackle arsenic problems in an holistic manner. It is expected that the paper would be useful for policy formulators in states, non-government organizations, researchers of academic and scientific institutions and programme managers working in the area of arsenic mitigation in drinking water, especially in developing countries, as it provides better insights compared to other available information in India on mitigating arsenic problems in drinking water in rural areas.

  6. HEALTH POLICY INTERVENTION IN SCHOOLS PROMOTE PHYSICAL ACTIVITIES AMONG THE PUPILS

    OpenAIRE

    He, Chen; Mikkelsen, Bent Egberg

    2009-01-01

    Now, more than ever, there are serious health concerns for obese and overweight children. Schools are the perfect setting for children to learn, and this influence can play an important role in preventing children from becoming obese and overweight. The study concerns the behaviors of Health Promoting School (HPS) according to a broad definition of HPS in World Health Organization (WHO), or dependent on schools own health promoting policies. The purpose of study research is to examine whether...

  7. Policy framework on energy access and key development indicators: ECOWAS interventions and the case of Ghana

    International Nuclear Information System (INIS)

    Aglina, Moses Kwame; Agbejule, Adebayo; Nyamuame, Godwin Yao

    2016-01-01

    Energy has become the main driver for development as industries grow, agricultural sectors become more modernized, economies boom and countries become wealthy. There are still vast majority of people living under the poverty line especially in the ECOWAS region. The purpose of this study is to explore how improvements in energy access can be a key driver in economic development and progress in the ECOWAS region. Data for the study was obtained from the database of the World Bank. A regression analysis was carried out to establish the relationships between energy access and development indicators. The paper suggests the need for policy makers in the ECOWAS region to focus on targets, such as household access, consumption of electricity, and ease of use instead on supply targets that focus merely on physical coverage. A case on how Ghana is improving energy access is presented. - Highlights: • Energy policies in the ECOWAS region must focus on demand side targets. • Energy policies should target rural and peri-urban areas of the ECOWAS region. • Improved energy access requires a new supply chain energy model.

  8. Limits of policy intervention in a world of neoliberal mechanism designs: Paradoxes of the global crisis

    Directory of Open Access Journals (Sweden)

    Dymski Gary A.

    2011-01-01

    Full Text Available The current global context poses several paradoxes: the recovery from the 2009 recession was not a recovery; investment, normally driven by profit rates, is lagging and not leading economic activity; the crisis is global but debate involves sub-global levels; and public safety-nets, which have helped to stabilize national income, are being cut. These paradoxes can be traced, in part, to the impact of the “truce” that followed the Keynesian-Monetarist controversy on economists’ ideas about policy activism. This implicit “truce” has removed activist macro policy from discussion, and shifted attention toward institutions as mechanisms for solving game-theoretic coordination problems. Policy activism then centers on how the “agents” (nations can achieve optimal use of their available resources (or optimal access to resources at the global level; and this involves creating and fine-tuning compacts - neoliberal mechanism designs - that can capture rents and attract globally mobile capital. This approach leads economists to see the key problem in the current global crisis as fixing broken neoliberal mechanisms. However, a global economy dominated by mechanisms that feed on aggregate demand without generating it faces the prospect of stagnation or collapse.

  9. Attracting and retaining health workers in rural areas: investigating nurses’ views on rural posts and policy interventions

    Directory of Open Access Journals (Sweden)

    Goodman Catherine

    2010-07-01

    Full Text Available Abstract Background Kenya has bold plans for scaling up priority interventions nationwide, but faces major human resource challenges, with a lack of skilled workers especially in the most disadvantaged rural areas. Methods We investigated reasons for poor recruitment and retention in rural areas and potential policy interventions through quantitative and qualitative data collection with nursing trainees. We interviewed 345 trainees from four purposively selected Medical Training Colleges (MTCs (166 pre-service and 179 upgrading trainees with prior work experience. Each interviewee completed a self-administered questionnaire including likert scale responses to statements about rural areas and interventions, and focus group discussions (FGDs were conducted at each MTC. Results Likert scale responses indicated mixed perceptions of both living and working in rural areas, with a range of positive, negative and indifferent views expressed on average across different statements. The analysis showed that attitudes to working in rural areas were significantly positively affected by being older, but negatively affected by being an upgrading student. Attitudes to living in rural areas were significantly positively affected by being a student at the MTC furthest from Nairobi. During FGDs trainees raised both positive and negative aspects of rural life. Positive aspects included lower costs of living and more autonomy at work. Negative issues included poor infrastructure, inadequate education facilities and opportunities, higher workloads, and inadequate supplies and supervision. Particular concern was expressed about working in communities dominated by other tribes, reflecting Kenya’s recent election-related violence. Quantitative and qualitative data indicated that students believed several strategies could improve rural recruitment and retention, with particular emphasis on substantial rural allowances and the ability to choose their rural location

  10. The impact of micro financing on poverty levels of rural women farm households in Abia state, Nigeria; implication for policy intervention

    Directory of Open Access Journals (Sweden)

    EZEH Innocent

    2013-06-01

    Full Text Available This study determined the impact of micro-finance on poverty level of rural women farm households in Abia State, Nigeria: Implication for policy intervention. A multi-stage random sampling technique was used to +select the local government areas, communities and respondents in the three (Aba, Ohafia and Umuahia agricultural zones of the State. The sample size was 240 (120 a piece for rural women farmer borrowers and non borrowers. Instrument of data collection was a set of structured and pre-tested questionnaire administered on both groups of rural women farmers. The result indicated that incidence of poverty or head count ratio was 0.558 for the rural women farmers borrowers and 0.933 for the rural women farmer non borrowers; poverty gap otherwise known as income short fall was 0.4547 for the rural women farmer borrowers and 0.6995 for the rural women farmer non borrowers. The result of the paired t-test showed that micro-finance impacted significantly on annual farm income, farm size and fertilizer use level of rural women farmer borrowers at given levels of significance. It was however, recommended that increased subsidy policy on agro-inputs and increased funding by the micro-finance will significantly aim at reducing the poverty levels of these women.

  11. Translating evidence to policy: urban interventions and physical activity promotion in Bogotá, Colombia and Curitiba, Brazil.

    Science.gov (United States)

    Díaz Del Castillo, Adriana; Sarmiento, Olga L; Reis, Rodrigo S; Brownson, Ross C

    2011-06-01

    The growing evidence of the influence of urban environment on physical activity (PA) underscore the need for novel policy solutions to address the inequality, lack of space, and limited PA resources in rapidly growing Latin American cities. This study aims to better understand the PA policy process by conducting two case studies of Bogotá's Ciclovía and Curitiba's CuritibAtiva. Literature review of peer- and non-peer-reviewed documents and semi-structured interviews with stakeholders was conducted. In the cases of Ciclovía and CuritibAtiva, most policies conducive to program development and sustainability were developed outside the health sector in sports and recreation, urban planning, environment, and transportation. Both programs were developed by governments as initiatives to overcome inequalities and provide quality of life. In both programs, multisectoral policies mainly from recreation and urban planning created a window of opportunity for the development and sustainability of the programs and environments supportive of PA.

  12. Urban vs. rural differences in prescription opioid misuse among adults in the United States: informing region specific drug policies and interventions.

    Science.gov (United States)

    Rigg, Khary K; Monnat, Shannon M

    2015-05-01

    In the United States, prescription opioid misuse (POM) has increased dramatically over the past two decades. However, there are still questions regarding whether rural/urban differences in adult POM exist, and more important, which factors might be driving these differences. Using data from the 2011 and 2012 National Survey on Drug Use and Health, we conducted unadjusted and adjusted binary logistic regression analyses to determine the association between metropolitan status and POM. We found that urban adults were more likely to engage in POM compared to rural adults because of their higher use of other substances, including alcohol, cannabis, and other illicit and prescription drugs, and because of their greater use of these substances as children. This study fills an important gap in the literature by not only identifying urban/rural differences in POM, but by also pointing out factors that mediate those differences. Because patterns and predictors of POM can be unique to geographic region, this research is critical to informing tailored interventions and drug policy decisions. Specifically, these findings suggest that interventions should be aimed at urban illicit drug users and adults in manual labor occupations. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Evaluation of physical activity interventions in youth via the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework: A systematic review of randomised and non-randomised trials.

    Science.gov (United States)

    McGoey, Tara; Root, Zach; Bruner, Mark W; Law, Barbi

    2015-07-01

    An identified limitation of existing reviews of physical activity interventions in school-aged youth is the lack of reporting on issues related to the translatability of the research into health promotion practice. This review used the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance framework to determine the extent to which intervention studies promoting physical activity in youth report on factors that inform generalizability across settings and populations. A systematic search for controlled interventions conducted within the last ten years identified 50 studies that met the selection criteria. Based on Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance criteria, most of these studies focused on statistically significant findings and internal validity rather than on issues of external validity. Due to this lack of information, it is difficult to determine whether or not reportedly successful interventions are feasible and sustainable in an uncontrolled, real-world setting. Areas requiring further research include costs associated with recruitment and implementation, adoption rate, and representativeness of participants and settings. This review adds data to support recommendations that interventions promoting physical activity in youth should include assessment of adoption and implementation issues. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession: interrupted time series analyses.

    Science.gov (United States)

    Leopold, Christine; Zhang, Fang; Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; Ross-Degnan, Dennis; Wagner, Anita K

    2014-07-25

    To analyze the impacts of pharmaceutical sector policies implemented to contain country spending during the economic recession--a reference price system in Finland and a mix of policies including changes in reimbursement rates, a generic promotion campaign and discounts granted to the public payer in Portugal - on utilization of, as a proxy for access to, antipsychotic medicines. We obtained monthly IMS Health sales data in standard units of antipsychotic medicines in Portugal and Finland for the period January 2007 to December 2011. We used an interrupted time series design to estimate changes in overall use and generic market shares by comparing pre-policy and post-policy levels and trends. Both countries' policy approaches were associated with slight, likely unintended, decreases in overall use of antipsychotic medicines and with increases in generic market shares of major antipsychotic products. In Finland, quetiapine and risperidone generic market shares increased substantially (estimates one year post-policy compared to before, quetiapine: 6.80% [3.92%, 9.68%]; risperidone: 11.13% [6.79%, 15.48%]. The policy interventions in Portugal resulted in a substantially increased generic market share for amisulpride (estimate one year post-policy compared to before: 22.95% [21.01%, 24.90%]; generic risperidone already dominated the market prior to the policy interventions. Different policy approaches to contain pharmaceutical expenditures in times of the economic recession in Finland and Portugal had intended--increased use of generics--and likely unintended--slightly decreased overall sales, possibly consistent with decreased access to needed medicines--impacts. These findings highlight the importance of monitoring and evaluating the effects of pharmaceutical policy interventions on use of medicines and health outcomes.

  15. Improving knowledge, awareness, and use of flexible career policies through an accelerator intervention at the University of California, Davis, School of Medicine.

    Science.gov (United States)

    Villablanca, Amparo C; Beckett, Laurel; Nettiksimmons, Jasmine; Howell, Lydia P

    2013-06-01

    The challenges of balancing a career and family life disproportionately affect women in academic health sciences and medicine, contributing to their slower career advancement and/or their attrition from academia. In this article, the authors first describe their experiences at the University of California, Davis, School of Medicine developing and implementing an innovative accelerator intervention designed to promote faculty work-life balance by improving knowledge, awareness, and access to comprehensive flexible career policies. They then summarize the results of two faculty surveys--one conducted before the implementation of their intervention and the second conducted one year into their three-year intervention--designed to assess faculty's use and intention to use the flexible career policies, their awareness of available options, barriers to their use of the policies, and their career satisfaction. The authors found that the intervention significantly increased awareness of the policies and attendance at related educational activities, improved attitudes toward the policies, and decreased perceived barriers to use. These results, however, were most pronounced for female faculty and faculty under the age of 50. The authors next discuss areas for future research on faculty use of flexible career policies and offer recommendations for other institutions of higher education--not just those in academic medicine--interested in implementing a similar intervention. They conclude that having flexible career policies alone is not enough to stem the attrition of female faculty. Such policies must be fully integrated into an institution's culture such that faculty are both aware of them and willing to use them.

  16. Improving Knowledge, Awareness, and Use of Flexible Career Policies through an Accelerator Intervention at the University of California, Davis, School of Medicine

    Science.gov (United States)

    Villablanca, Amparo C.; Beckett, Laurel; Nettiksimmons, Jasmine; Howell, Lydia P.

    2013-01-01

    The challenges of balancing a career and family life disproportionately affect women in academic health sciences and medicine, contributing to their slower career advancement and/or their attrition from academia. In this article, the authors first describe their experiences at the University of California, Davis, School of Medicine developing and implementing an innovative accelerator intervention designed to promote faculty work-life balance by improving knowledge, awareness, and access to comprehensive flexible career policies. They then summarize the results of two faculty surveys--one conducted before the implementation of their intervention and the second conducted one year into their three-year intervention--designed to assess faculty’s use and intention to use the flexible career policies, their awareness of available options, barriers to their use of the policies, and their career satisfaction. The authors found that the intervention significantly increased awareness of the policies and attendance at related educational activities, improved attitudes toward the policies, and decreased perceived barriers to use. These results however were most pronounced for female faculty and faculty under the age of 50. The authors next discuss areas for future research on faculty use of flexible career policies and offer recommendations for other institutions of higher education, not just those in academic medicine, interested in implementing a similar intervention. They conclude that having flexible career policies alone is not enough to stem the attrition of female faculty. Such policies must be fully integrated into an institution’s culture such that faculty are both aware of them and willing to use them. PMID:23619063

  17. Educational intervention on medication reviews aiming to reduce acute healthcare consumption in elderly patients with potentially inappropriate medicines-A pragmatic open-label cluster-randomized controlled trial in primary care

    DEFF Research Database (Denmark)

    Schmidt-Mende, K; Andersen, M; Wettermark, B

    2017-01-01

    consisted of educational outreach visits with feedback on prescribing and the development of a working procedure on MRs. Follow-up was 9 months. Outcomes were assessed in an administrative health care database. The combined primary outcome was unplanned hospital admission and/or emergency department visit...... after an educational intervention in primary care. The reasons for the lack of effect could be a suboptimal intervention, limitations in outcome measures, and the use of administrative data to monitor outcomes.......PURPOSE: Potentially inappropriate medicines (PIMs) may cause 10% of unplanned admissions in elderly people. We performed an educational intervention in primary care to reduce acute health care consumption and PIMs through the promotion of medication reviews (MRs) in elderly patients. METHODS...

  18. Effectiveness of an implementation optimisation intervention aimed at increasing parent engagement in HENRY, a childhood obesity prevention programme - the Optimising Family Engagement in HENRY (OFTEN) trial: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Bryant, Maria; Burton, Wendy; Cundill, Bonnie; Farrin, Amanda J; Nixon, Jane; Stevens, June; Roberts, Kim; Foy, Robbie; Rutter, Harry; Hartley, Suzanne; Tubeuf, Sandy; Collinson, Michelle; Brown, Julia

    2017-01-24

    Family-based interventions to prevent childhood obesity depend upon parents' taking action to improve diet and other lifestyle behaviours in their families. Programmes that attract and retain high numbers of parents provide an enhanced opportunity to improve public health and are also likely to be more cost-effective than those that do not. We have developed a theory-informed optimisation intervention to promote parent engagement within an existing childhood obesity prevention group programme, HENRY (Health Exercise Nutrition for the Really Young). Here, we describe a proposal to evaluate the effectiveness of this optimisation intervention in regard to the engagement of parents and cost-effectiveness. The Optimising Family Engagement in HENRY (OFTEN) trial is a cluster randomised controlled trial being conducted across 24 local authorities (approximately 144 children's centres) which currently deliver HENRY programmes. The primary outcome will be parental enrolment and attendance at the HENRY programme, assessed using routinely collected process data. Cost-effectiveness will be presented in terms of primary outcomes using acceptability curves and through eliciting the willingness to pay for the optimisation from HENRY commissioners. Secondary outcomes include the longitudinal impact of the optimisation, parent-reported infant intake of fruits and vegetables (as a proxy to compliance) and other parent-reported family habits and lifestyle. This innovative trial will provide evidence on the implementation of a theory-informed optimisation intervention to promote parent engagement in HENRY, a community-based childhood obesity prevention programme. The findings will be generalisable to other interventions delivered to parents in other community-based environments. This research meets the expressed needs of commissioners, children's centres and parents to optimise the potential impact that HENRY has on obesity prevention. A subsequent cluster randomised controlled pilot

  19. A matched pair cluster randomized implementation trail to measure the effectiveness of an intervention package aiming to decrease perinatal mortality and increase institution-based obstetric care among indigenous women in Guatemala: study protocol.

    Science.gov (United States)

    Kestler, Edgar; Walker, Dilys; Bonvecchio, Anabelle; de Tejada, Sandra Sáenz; Donner, Allan

    2013-03-21

    Maternal and perinatal mortality continue to be a high priority problem on the health agendas of less developed countries. Despite the progress made in the last decade to quantify the magnitude of maternal mortality, few interventions have been implemented with the intent to measure impact directly on maternal or perinatal deaths. The success of interventions implemented in less developed countries to reduce mortality has been questioned, in terms of the tendency to maintain a clinical perspective with a focus on purely medical care separate from community-based approaches that take cultural and social aspects of maternal and perinatal deaths into account. Our innovative approach utilizes both the clinical and community perspectives; moreover, our study will report the weight that each of these components may have had on reducing perinatal mortality and increasing institution-based deliveries. A matched pair cluster-randomized trial will be conducted in clinics in four rural indigenous districts with the highest maternal mortality ratios in Guatemala. The individual clinic will serve as the unit of randomization, with 15 matched pairs of control and intervention clinics composing the final sample. Three interventions will be implemented in indigenous, rural and poor populations: a simulation training program for emergency obstetric and perinatal care, increased participation of the professional midwife in strengthening the link between traditional birth attendants (TBA) and the formal health care system, and a social marketing campaign to promote institution-based deliveries. No external intervention is planned for control clinics, although enhanced monitoring, surveillance and data collection will occur throughout the study in all clinics throughout the four districts. All obstetric events occurring in any of the participating health facilities and districts during the 18 months implementation period will be included in the analysis, controlling for the cluster

  20. Cambios en el uso de la terapia hormonal sustitutiva tras una intervención informativa dirigida a mujeres y prescriptores Changes in the use of hormone replacement therapy after an educational intervention aimed at women and prescribers

    Directory of Open Access Journals (Sweden)

    Carmen Mosquera Tenreiro

    2009-04-01

    from 1996 to 2003 (preintervention period. In 2004 and 2005, annual sales of HRT products and the percentage of women using HRT among the population aged 50-59 years were analyzed. To analyze trends in costs, we used the price of each product in pesetas until 2001 and in euros thereafter. Results: Sales of HRT increased until 2001. Total sales declined by 73.6% between 2001 and 2005. The decrease between 2004 and 2005 (49.1% was twice that observed between 2002 and 2003 (24.5%. An estimated 17.2% of women aged 50-59 years old were using HRT in 1996 compared with 4.1% in 2005. The total pharmaceutical cost related to HRT showed a similar decrease, although sales of Boltin® (tibolone increased by two-fold. Conclusions: Systematic and independent educational interventions aimed at women in the general population and prescribers are both effective and necessary. The HRT epidemic and its health costs, as well as the shift to tibolone prescription and the adverse effects of this drug, should be investigated nationwide.

  1. How did Japanese rural dwellers become rapidly healthier in the two decades following World War II?: Examining the diverse policy interventions that improved the population's health.

    Science.gov (United States)

    Yuasa, Motoyuki

    2017-01-01

    Objective During the two decades following Japan's World War II surrender in 1945, tremendous improvement in the population's health was observed, particularly in infant mortality and life expectancy. How did Japanese rural dwellers achieve such remarkable health improvement during this relatively short time span while its economy remained heavily damaged following the war? While the efforts from government-driven public health strategies and programs are well known, relatively little is known about the contributions of policies in non-health sectors. Therefore, the main aim is to verify, using literature based sources, whether non-health sectors contributed to the betterment of the population's health in addition to the public health sector policies.Hypotheses Synergistic efforts of diverse interventions from different policies and programs likely catalyzed the drastic health improvement observed in the Japanese population in the two decades after World War II. The Ministry of Health and Welfare, for example, implemented programs to provide health care services. These are thought to have contributed directly to reducing maternal and child mortality, as well as tuberculosis-related mortality. Additionally, the Ministry of Agriculture and Forestry carried out a nationwide livelihood improvement program to enhance individual and family lifestyles, improve indoor and outdoor environments, and strengthen social solidarity. The ministry also attempted to generate income stability for farmers through an agricultural improvement program to ensure allocation of household income to family health. The Ministry of Education also had an initiative to disseminate the concepts of democracy and rational thought to the Japanese population through a social education program. Through these efforts, superstition and pre-modern customs were reduced, and subsequently health awareness increased, leading to an improvement in the population's health.Conclusion The public health

  2. Living both well and sustainably: a review of the literature, with some reflections on future research, interventions and policy

    Science.gov (United States)

    Kasser, Tim

    2017-05-01

    The idea that human well-being (WB) can be supported and even enhanced by using, producing, buying, selling and consuming less `stuff' is anathema to many living under consumer capitalism. Yet a growing research literature actually finds that frequent engagement in pro-ecological behaviours (PEBs) is positively correlated with personal WB. This paper reviews data relevant to three possible explanations for the apparent compatibility of PEBs and WB: (i) engaging in PEBs leads to psychological need satisfaction, which in turn causes WB; (ii) being in a good mood causes people to engage in more prosocial behaviours, including PEBs; and (iii) personal characteristics and lifestyles such as intrinsic values, mindfulness and voluntary simplicity cause both PEBs and WB. Because each explanation has some empirical support, I close by reflecting on some relevant interventions and policies that could strengthen each of these three pathways and thereby promote living both well and sustainably. This article is part of the themed issue 'Material demand reduction'.

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

    Science.gov (United States)

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

    2015-02-01

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

  4. Review of solar PV policies, interventions and diffusion in East Africa

    DEFF Research Database (Denmark)

    Hansen, Ulrich Elmer; Pedersen, Mathilde Brix; Nygaard, Ivan

    2015-01-01

    from donor and government-based support to market-driven diffusion of solar PV; and (ii) a transition from small-scale, off-grid systems towards mini-grids and large-scale, grid-connected solar power plants. The paper points out three generic factors that have contributed to encouraging SHS diffusion......Previous research on the diffusion of solar PV in Africa has mainly focused on solar home systems (SHS) in individual countries and thus overlooked developments in other PV market segments that have recently emerged. In contrast this paper adopts a regional perspective by reviewing developments...... in supportive policies, donor programs and diffusion status in all PV market segments in Kenya, Tanzania and Uganda, as well as identifying the key factors put forward in the literature to explain differences in the diffusion of SHS in these three countries. The paper finds two emerging trends: (i) a movement...

  5. Health policy in interwar Greece: the intervention by the League of Nations Health Organisation.

    Science.gov (United States)

    Theodorou, Vassiliki; Karakatsani, Despina

    2008-01-01

    The first serious attempts to deal with public health problems in Greece were undertaken between 1925 and 1935. This period also witnessed setbacks to developments in public health, caused by the lack of welfare infrastructure for social relief, as well as extensive health problems brought about by the settlement in Greece of 1,300,000 refugees from Asia Minor. In 1928 following the example set by other European countries, the Liberal Government appealed to international health organisations for support in order to effectively deal with these problems. This contribution constitutes a case study addressing the following issues: a) the impact the League of Nations Health Organisation intervention had on the establishment of public health services; b) the framework for a collaboration of the Rockefeller Foundation and the League of Nations Health Organisation; and c) the factors that led to the failure of the health care reorganisation.

  6. The vending and à la carte policy intervention in Maine public high schools.

    Science.gov (United States)

    Davee, Anne-Marie; Blum, Janet E Whatley; Devore, Rachel L; Beaudoin, Christina M; Kaley, Lori A; Leiter, Janet L; Wigand, Debra A

    2005-11-01

    A healthy school nutrition environment may be important for decreasing childhood overweight. This article describes a project to make healthier snacks and beverages available in vending machines and à la carte programs in Maine public high schools. Seven public high schools in Maine volunteered to participate in this project. Four schools made changes to the nutrition environment, and three schools that served as controls did not. The nutrition guidelines were to offer only low-fat (not more than 30% of total calories from fat) and low-sugar (not more than 35% by weight of sugar) items in vending machines and à la carte programs. Strategies to implement the project included early communications with school officials, monetary stipends for participation, identification of a school liaison, and a committee at each school to promote the healthy changes. Baseline nutrient content and sales of all competitive foods and beverages were assessed to develop the guidelines for changes in the four schools. Student volunteers at all seven schools were measured for height, weight, diet quality, and physical activity level to assess the impact of the change to the nutrition environment. Baseline measures were taken in the spring semester of 2004. Nutrition changes were made to the à la carte programs and vending machines in the four intervention schools at the start of the fall semester of 2004. Follow-up nutrition assessment and student data collection occurred in the spring semester of 2005. Healthy changes in vending machines were more easily achieved than those made in the à la carte programs. Technical assistance and ongoing support were essential for successful implementation of this intervention. It is possible to improve the nutrition environment of Maine public high schools. Stakeholder support is essential to sustain healthy changes.

  7. Effective Evidence-Based Interventions for Emotional Well-Being: Lessons for Policy and Practice

    Science.gov (United States)

    Bywater, Tracey; Sharples, Jonathan

    2012-01-01

    School-based programmes developed to promote social and emotional well-being aims to reduce the risk of academic failure and other negative outcomes, such as antisocial behaviour and mental health problems. This article maps the British political trajectory from understanding the importance of social and emotional well-being, to delivering…

  8. Sustainable Soil Management: Its perception and the need for policy intervention

    Science.gov (United States)

    Basch, Gottlieb; Kassam, Amir; González-Sánchez, Emilio

    2017-04-01

    As stated in the strategic objectives of the Global Soil Partnership "healthy soils and sustainable soil management are the precondition for human well-being and economic welfare and therefore play the key role for sustainable development". Although the functional properties of a healthy soil are well understood, in practice it is easily overlooked what is necessary to achieve and sustain healthy agricultural soils. This contribution intends: to discuss the concept of sustainable soil management in agricultural production with regard to soil health, and to highlight its importance in the achievement of both Sustainable Development Goals and the 4 per mille objectives, as well as for the Common Agricultural Policy (CAP). In Europe, soil and the need for its conservation and stewardship gained visibility at the beginning of this century during the discussions related to the Soil Thematic Strategy. This higher level of awareness concerning the status of Europe's soils led to the introduction of soil conservation standards into the cross-compliance mechanism within the 1st Pillar of CAP. These standards were applied through the definition of Good Agricultural and Environmental Conditions (GAECs) which are compulsory for all farmers receiving direct payments, and in the last CAP reform in 2014, through the introduction of additional Greening Measures in Pilar 1. Despite these measures and the claim of some writers that they already contributed to significantly reducing soil erosion, the EC Joint Research Centre still reports water erosion in Europe amounting to almost one billion tonnes annually. Regarding soil conservation, soil carbon stocks or the provision of additional ecosystem services, measures called for in GAEC 4 (Minimum soil cover), in GAEC 5 (Minimum land management reflecting site specific conditions to limit soil erosion), and in GAEC 6 (Maintenance of soil organic matter level through appropriate practices, …), give the impression that a lot is being

  9. Measuring food availability and access in African-American communities: implications for intervention and policy.

    Science.gov (United States)

    Odoms-Young, Angela M; Zenk, Shannon; Mason, Maryann

    2009-04-01

    Obesity is a major public health concern in the U.S. As compared to whites, minority populations are disproportionately at risk, with the highest prevalence rates of overweight and obesity occurring among African American women. Although researchers and policymakers argue that environmental approaches have the greatest potential to reverse the rising prevalence of obesity, critical gaps remain in our understanding of the complex mechanisms that underlie the associations between neighborhood food environments and weight status. A major challenge has been the need for reliable and valid measures to assess aspects of the neighborhood food environment that encourage or inhibit healthful eating behaviors and weight management. Investigators have made considerable gains in the development of tools and approaches to measure neighborhood food environments overall, but few studies focus on the specific challenges and issues associated with characterizing neighborhood food environments in communities of color. This paper highlights important considerations for measuring food environments in African-American neighborhoods and their implications for developing programmatic and policy solutions to reduce racial disparities in overweight.

  10. Health policies for the reduction of obstetric interventions in singleton full-term births in Catalonia.

    Science.gov (United States)

    Pueyo, Maria-Jesus; Escuriet, Ramon; Pérez-Botella, M; de Molina, I; Ruíz-Berdun, D; Albert, S; Díaz, S; Torres-Capcha, P; Ortún, V

    2018-04-01

    To explore the effect of hospital's characteristics in the proportion of obstetric interventions (OI) performed in singleton fullterm births (SFTB) in Catalonia (2010-2014), while incentives were employed to reduce C-sections. Data about SFTB assisted at 42 public hospitals were extracted from the dataset of hospital discharges. Hospitals were classified according to the level of complexity, the volume of births attended, and the adoption of a non-medicalized delivery (NMD) strategy. The annual average change in the percentage for OI was calculated based on Poisson regression models. The rate of OI (35% of all SFTB) including C-sections (20.6%) remained stable through the period. Hospitals attending less complex cases had a lower average of OI, while hospitals attending lower volumes had the highest average. Higher levels of complexity increased the use of C-sections (+4% yearly) and forceps (+16%). The adoption of the NMD strategy decreased the rate of C-sections. The proportion of OI, including C-sections, remained stable in spite of public incentives to reduce them. The adoption of the NMD strategy could help in decreasing the rate of OI. To reduce the OI rate, new strategies should be launched as the development of low-risk pregnancies units, alignment of incentives and hospital payment, increased value of incentives and encouragement of a cultural shift towards non-medicalized births. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Female labour force status and fertility behaviour in Bangladesh: search for policy interventions.

    Science.gov (United States)

    Chaudhury, R H

    1983-09-01

    This paper examines the effect of female labor force participation on fertility behavior because of its immediate relevance to the formulation of small family norm policies. The hypothesis that female employment is inversely related to fertility and positively related to contraceptive use is based on the following assumptions: 1) the satisfactions of outside employment can substitute for those of child rearing; 2) employment delays marriage and increases the probability of women remaining single, thus reducing fertility; 3) every additional child increases the "opportunity cost" (income lost) of a working mother; 4) a working wife has more status with her husband, and the resultant improved spousal communication leads to more contraceptive use; and 5) working women do not have to rely on their children for support in their old age. Using data from various rural and urban surveys of women in Bangladesh (mostly in Dhaka) and data from the 1961 Bangladesh Population Census, the author finds that fertility is reduced and contraceptive use increases for poor and illiterate women if they work outside the home, but employment has no effect on fertility for higher educated women, who have comparatively fewer children to begin with. In Java, Indonesia, it was found that poor working women have the lowest fertility compared to any other higher socioeconomic group. In Thailand, too, it was found that women who worked outside the home and who had modern values had significantly fewer children than other women. Evaluations of income generating programs for women in Bangladesh attest to the fertility lowering success of integrating family planning and health services with employment programs. Employment through these cooperatives has also indirectly lowered fertility by leading to longer birth spacing and marriage delays. The author recommends such integrated programs and cooperatives because they enhance the social and economic status of women, and by doing so, modernize the

  12. Exploring individual cognitions, self-regulation skills, and environmental-level factors as mediating variables of two versions of a Web-based computer-tailored nutrition education intervention aimed at adults: A randomized controlled trial.

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; Candel, Math J J M; de Vries, Hein; Oenema, Anke

    2016-03-01

    This study explored whether the determinants that were targeted in two versions of a Web-based computer-tailored nutrition education intervention mediated the effects on fruit, high-energy snack, and saturated fat intake among adults who did not comply with dietary guidelines. A RCT was conducted with a basic (tailored intervention targeting individual cognitions and self-regulation), plus (additionally targeting environmental-level factors), and control group (generic nutrition information). Participants were recruited from the general Dutch adult population and randomly assigned to one of the study groups. Online self-reported questionnaires assessed dietary intake and potential mediating variables (behavior-specific cognitions, action- and coping planning, environmental-level factors) at baseline and one (T1) and four (T2) months post-intervention (i.e. four and seven months after baseline). The joint-significance test was used to establish mediating variables at different time points (T1-mediating variables - T2-intake; T1-mediating variables - T1-intake; T2-mediating variables - T2-intake). Educational differences were examined by testing interaction terms. The effect of the plus version on fruit intake was mediated (T2-T2) by intention and fruit availability at home and for high-educated participants also by attitude. Among low/moderate-educated participants, high-energy snack availability at home mediated (T1-T1) the effect of the basic version on high-energy snack intake. Subjective norm mediated (T1-T1) the effect of the basic version on fat intake among high-educated participants. Only some of the targeted determinants mediated the effects of both intervention versions on fruit, high-energy snack, and saturated fat intake. A possible reason for not finding a more pronounced pattern of mediating variables is that the educational content was tailored to individual characteristics and that participants only received feedback for relevant and not for all

  13. Gender and HIV/AIDS: Exploring Men and Vulnerability Towards Effective HIV/AIDS Policy Interventions and Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Ogochukwu Nzewi

    2012-06-01

    Full Text Available This article examines the dynamics between HIV/Aids gender policy strategies and the socio-political demands on HIV/Aids interventions in sub-Saharan Africa. Gender in HIV/Aids intervention seems inescapable. Nowhere else is this more marked than in the social dimensions of HIV/Aids prevention in sub-Saharan Africa. This has resulted in prevention strategies, which are encumbered by the reality of poverty, gender, access, power and the various debates on behavioural change. The social constructions of gender roles and power relations play a significant role in the region’s HIV /Aids dynamic. To this end, the mainstreaming of gender issues into national political, social and economic agenda and policies has been championed by international development and economic institutions. In developing HIV/Aids intervention policies, gender has also been mainstreamed, especially where epidemiological data show the disparity in infection rates between men and women, where women are seen as more susceptible to infection. The gendered approach to HIV/Aids appears to typecast women as the vulnerable and suffering face of HIV/Aids, while men, as ‘the other’, are generally regarded as the perpetuators and spreaders of the virus. While there is no doubt that women’s vulnerability in this milieu has been proven within known research evidence to exist, the neglect of institutional (social, cultural and economic and historical vulnerabilities of African men’s realities are sometimes overlooked. Recently, greater focus has shifted to curbing infection rates in men based on new scientific evidence that shows that risk of transmission in circumcised men is reduced. The article argues that such movement towards showing areas of men’s vulnerability as a focus in HIV/Aids policy interventions may have the potential to shift the observed burden that current HIV/Aids policy thrusts inadvertently place on African women. The article will put forward an argument for

  14. Energy for Rhineland-Palatinate. Safety and sustainability as aim for economy, science and policy. 2. rev. ed.; Energie fuer Rheinland-Pfalz. Sicherheit und Nachhaltigkeit als Ziele fuer Wirtschaft, Wissenschaft und Politik

    Energy Technology Data Exchange (ETDEWEB)

    Schaumann, Gunter; Weingarten, Joe (eds.)

    2009-07-01

    The book under consideration reports on the conclusions and results of the ZIRP project 'Future radar 2030 - On the way to the energy country Rhineland-Palatinate. The book contains the following contributions: (1) Energy as a central question of survival of our industrial society (Kurt Beck); (2) Energy policy and climate protection - Decisive factors for the competitiveness of the industry (Harald Schwager); (3) Further increase of the worldwide energy consumption at limited reserves - one of the central challenges for the next decades. (Dieter Schmitt); (4) Safe energy in the future with energy efficiency and innovation (Gunter Schaumann); (5) Decentralized power supply and cooperative legal form (Walter Weinkauf); (6) Policy of energy and climatic protection in Rhineland-Palatinate - Energy mix of the future (Margit Conrad); (7) Energy supply and climatic protection as a market for companies in Rhineland-Palatinate (Hendrik Hering); (8) The Pfalz companies: Regional strength in the European power market (Guenther Koch); (9) Energy country Rhineland-Palatinate - Scope of possible action and experiences of municipal power supplier (Karl-Heinz Koch); (10) Power supply as a task of the regional planning and planning in Rhineland-Palatinate (Karl Peter Bruch); (11) Power generation and agriculture (Andrea Adams); (12) The implementation of energy as a main theme in the education at schools (Doris Ahnen); (13) Energy management in companies (Dietmar Kohn, Klaus-Werner Linneweber); (14) Hot thing. Geothermal power in Rhineland-Palatinate (Joerg Baumgaertner, Peter Hauffe, Walter Kirsch); (15) Friendly Energy - Friendly World. Sustainability with clean wind power and education (Joachim Fuhrlaender); (16) Rhineland-Palatinate as a region with imports of electricity - Are climate targets available without nuclear power? (Konrad Kleinknecht); (17) Regional material stream management in the energy sector (Peter Heck); (18) The utilization of renewable energies

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

    Science.gov (United States)

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

    2016-07-01

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

  16. Effect of the Uniform Accident and Sickness Policy Provision Law on alcohol screening and intervention in trauma centers.

    Science.gov (United States)

    Gentilello, Larry M; Donato, Anthony; Nolan, Susan; Mackin, Robert E; Liebich, Franesa; Hoyt, David B; LaBrie, Richard A

    2005-09-01

    Alcohol screening and intervention in trauma centers are widely recommended. The Uniform Accident and Sickness Policy Provision Law (UPPL) exists in most states, and allows insurers to refuse payment for treatment of injuries in patients with a positive alcohol or drug test. This article analyzed the UPPL's impact on screening and reimbursement, measured the knowledge of legislators about substance use problems in trauma centers, and determined their opinions about substance use-related exclusions in insurance contracts for trauma care. A nationwide survey of members of the American Association for the Surgery of Trauma was conducted. A separate survey of legislators who are members of the Senate, House, or Assembly and serve in some leadership role on committees responsible for insurance in their state was also performed. Ninety-eight trauma surgeon and 56 legislator questionnaires were analyzed. Surgeons' familiarity with the UPPL was limited; only 13% believed they practiced in a UPPL state, but 70% actually did. Despite lack of knowledge of the statute, 24% reported an alcohol- or drug-related insurance denial in the past 6 months. This appeared to affect screening practices; the majority of surgeons (51.5%) do not routinely measure blood alcohol concentration, even though over 91% believe blood alcohol concentration testing is important. Most (82%) indicated that if there were no insurance barriers, they would be willing to establish a brief alcohol intervention program in their center. Legislators were aware of the impact of substance use on trauma centers. They overwhelmingly agreed (89%) that alcohol problems are treatable, and 80% believed it is a good idea to offer counseling in trauma centers. As with surgeons, the majority (53%) were not sure whether the UPPL existed in their state, but they favored prohibiting alcohol-related exclusions by a 2:1 ratio, with strong bipartisan support. The study documents strong support for screening and intervention

  17. Living both well and sustainably: a review of the literature, with some reflections on future research, interventions and policy.

    Science.gov (United States)

    Kasser, Tim

    2017-06-13

    The idea that human well-being (WB) can be supported and even enhanced by using, producing, buying, selling and consuming less 'stuff' is anathema to many living under consumer capitalism. Yet a growing research literature actually finds that frequent engagement in pro-ecological behaviours (PEBs) is positively correlated with personal WB. This paper reviews data relevant to three possible explanations for the apparent compatibility of PEBs and WB: (i) engaging in PEBs leads to psychological need satisfaction, which in turn causes WB; (ii) being in a good mood causes people to engage in more prosocial behaviours, including PEBs; and (iii) personal characteristics and lifestyles such as intrinsic values, mindfulness and voluntary simplicity cause both PEBs and WB. Because each explanation has some empirical support, I close by reflecting on some relevant interventions and policies that could strengthen each of these three pathways and thereby promote living both well and sustainably.This article is part of the themed issue 'Material demand reduction'. © 2017 The Author(s).

  18. The role of imaging specialists as authors of systematic reviews on diagnostic and interventional imaging and its impact on scientific quality: report from the EuroAIM Evidence-based Radiology Working Group.

    Science.gov (United States)

    Sardanelli, Francesco; Bashir, Humayun; Berzaczy, Dominik; Cannella, Guglielmo; Espeland, Ansgar; Flor, Nicola; Helbich, Thomas; Hunink, Myriam; Malone, Dermot E; Mann, Ritse; Muzzupappa, Claudia; Petersen, Lars J; Riklund, Katrine; Sconfienza, Luca M; Serafin, Zbigniew; Spronk, Sandra; Stoker, Jaap; van Beek, Edwin J R; Vorwerk, Dierk; Di Leo, Giovanni

    2014-08-01

    To evaluate the inclusion of radiologists or nuclear medicine physicians (imaging specialists) as authors of systematic reviews (SRs) on imaging and imaging-guided diagnostic procedures and to determine the impact of imaging specialists' presence as authors on the overall quality of the reviews. A MEDLINE and EMBASE search was performed for SRs of diagnostic and interventional image-guided procedures that were published from January 2001 to December 2010. SRs about procedures primarily performed by nonimaging specialists were excluded. The inclusion of imaging specialists among the SR authors and the frequency of publication in imaging journals were evaluated. The quality of a subset of 200 SRs (100 most recent SRs with imaging specialists as authors and 100 most recent SRs without imaging specialists as authors) was rated by using a 12-item modified assessment of multiple SRs (AMSTAR) evaluation tool. Spearman, χ(2), and Mann-Whitney statistics were used. From among 3258 retrieved citations, 867 SRs were included in the study. Neuroimaging had the largest number of SRs (28% [241 of 867]), 41% (354 of 867) of SRs concerned diagnostic performance, and 26% (228 of 867) of SRs were published in imaging journals. Imaging specialists were authors (in any position) in 330 (38%) of 867 SRs; they were first authors of 176 SRs and last authors of 161 SRs. SRs with imaging specialists as authors were more often published in imaging journals than in nonimaging journals (54% [179 of 330] vs 9% [49 of 537]; P < .001). The median number of modified AMSTAR quality indicators was nine in SRs with imaging specialists as authors, while that in SRs without imaging specialists as authors was seven (P = .003). Only 38% (330 of 867) of SRs on radiology or nuclear medicine-related imaging published from January 2001 to December 2010 included imaging specialists as authors. However, the inclusion of imaging specialists as authors was associated with a significant increase in the

  19. Barreiras às intervenções relacionadas à saúde do trabalhador do setor saúde no Brasil Barriers to interventions aimed at promoting the health of health care workers in Brazil

    Directory of Open Access Journals (Sweden)

    Érica Lui Reinhardt

    2009-05-01

    following key words were used to identify articles in English, Portuguese, and Spanish: work, health personnel, occupational, risks, diseases, ergonomics, work ability, quality of life, organization, accidents, work conditions, intervention, and administration. Articles on injury and disease prevention and occupational health in a health care setting in Latin America were selected, along with articles focused on health promotion in the health sector. RESULTS: The following shortcomings were identified: activities lacked a sound theoretical foundation and were not integrated with the health services management; a failure to evaluate the effectiveness of the activity; health surveillance focused solely on a specific disease or injury; management not committed to the proposed activity; miscommunication; inability of workers to participate, or control the work environment; and, programs or efforts that were limited to changing the workers' behaviors. CONCLUSIONS: The literature shows that all the barriers identified by this study affect both the health care workers' health as well as their productivity.

  20. Public health interventions to protect against falsified medicines: a systematic review of international, national and local policies.

    Science.gov (United States)

    Hamilton, William L; Doyle, Cormac; Halliwell-Ewen, Mycroft; Lambert, Gabriel

    2016-12-01

    Falsified medicines are deliberately fraudulent drugs that pose a direct risk to patient health and undermine healthcare systems, causing global morbidity and mortality. To produce an overview of anti-falsifying public health interventions deployed at international, national and local scales in low and middle income countries (LMIC). We conducted a systematic search of the PubMed, Web of Science, Embase and Cochrane Central Register of Controlled Trials databases for healthcare or pharmaceutical policies relevant to reducing the burden of falsified medicines in LMIC. Our initial search identified 660 unique studies, of which 203 met title/abstract inclusion criteria and were categorised according to their primary focus: international; national; local pharmacy; internet pharmacy; drug analysis tools. Eighty-four were included in the qualitative synthesis, along with 108 articles and website links retrieved through secondary searches. On the international stage, we discuss the need for accessible pharmacovigilance (PV) global reporting systems, international leadership and funding incorporating multiple stakeholders (healthcare, pharmaceutical, law enforcement) and multilateral trade agreements that emphasise public health. On the national level, we explore the importance of establishing adequate medicine regulatory authorities and PV capacity, with drug screening along the supply chain. This requires interdepartmental coordination, drug certification and criminal justice legislation and enforcement that recognise the severity of medicine falsification. Local healthcare professionals can receive training on medicine quality assessments, drug registration and pharmacological testing equipment. Finally, we discuss novel technologies for drug analysis which allow rapid identification of fake medicines in low-resource settings. Innovative point-of-purchase systems like mobile phone verification allow consumers to check the authenticity of their medicines. Combining anti

  1. Active Early: one-year policy intervention to increase physical activity among early care and education programs in Wisconsin

    Directory of Open Access Journals (Sweden)

    Tara L. LaRowe

    2016-07-01

    the EPAO; scores showing the greatest increases were the Training and Education (14.5 ± 6.5 at 12-months vs. 2.4 ± 3.8 at baseline, p < 0.01 and Physical Activity Policy (18.6 ± 4.6 at 12-months vs. 2.0 ± 4.1 at baseline, p < 0.01. Conclusions Active Early promoted improvements in providing structured (i.e. teacher-led physical activity beyond the recommended 60 daily minutes using low- to no-cost strategies along with training and environmental changes. Furthermore, it was observed that Active Early positively impacted child physical activity levels by the end of the intervention. However, resources, training, and technical assistance may be necessary for ECE programs to be successful beyond the use of the Active Early guide. Implementing local-level physical activity policies combined with support from local and statewide partners has the potential to influence higher standards for regulated ECE programs.

  2. Applications of isotopes in the development of nutrition policies and evaluation of interventions. Report of a contractual service agreement

    International Nuclear Information System (INIS)

    Vio, F.; Uauy, R.

    2000-01-01

    health level; other international- national- and non-governmental-organizations have mandates for that. Nevertheless, IAEA is playing an enormously important role in facilitating the use of isotopic and nuclear related methods to improve the cost effectiveness of nutrition and health interventions. The aim of this document is therefore to describe the the nuclear techniques that are available to apply in evaluations of interventions in the current epidemiological and nutrition situation of the developing countries and in those with emerging economies

  3. Applications of isotopes in the development of nutrition policies and evaluation of interventions. Report of a contractual service agreement

    Energy Technology Data Exchange (ETDEWEB)

    Vio, F; Uauy, R [Instituto de Nutricion y Tecnologia de los Alimentos, Universidad de Chile, Santiago (Chile)

    2000-07-01

    health level; other international- national- and non-governmental-organizations have mandates for that. Nevertheless, IAEA is playing an enormously important role in facilitating the use of isotopic and nuclear related methods to improve the cost effectiveness of nutrition and health interventions. The aim of this document is therefore to describe the the nuclear techniques that are available to apply in evaluations of interventions in the current epidemiological and nutrition situation of the developing countries and in those with emerging economies.

  4. ENTERPRISE RESTRUCTURING AIM AND TYPES

    Directory of Open Access Journals (Sweden)

    S. P. Baranenko

    2011-01-01

    Full Text Available Enterprise restructuring is aimed at adapting it to market conditions and improving its competitiveness through selection of most effective model of using material, technical, technological, organizational, commercial, economical, financial, tax-related and other resources with due account of the demand. Restructuring classification signs and types as well as restructuring aims specific for industrial enterprises are provided for.

  5. Implementing Health Policy: Lessons from the Scottish Well Men's Policy Initiative.

    Science.gov (United States)

    Douglas, Flora; van Teijlingen, Edwin; Smith, Cairns; Moffat, Mandy

    2015-01-01

    Little is known about how health professionals translate national government health policy directives into action. This paper examines that process using the so-called Well Men's Services (WMS) policy initiative as a 'real world' case study. The WMS were launched by the Scottish Government to address men's health inequalities. Our analysis aimed to develop a deeper understanding of policy implementation as it naturally occurred, used an analytical framework that was developed to reflect the 'rational planning' principles health professionals are commonly encouraged to use for implementation purposes. A mixed-methods qualitative enquiry using a data archive generated during the WMS policy evaluation was used to critically analyze (post hoc) the perspectives of national policy makers, and local health and social care professionals about the: (a) 'policy problem', (b) interventions intended to address the problem, and (c) anticipated policy outcomes. This analysis revealed four key themes: (1) ambiguity regarding the policy problem and means of intervention; (2) behavioral framing of the policy problem and intervention; (3) uncertainty about the policy evidence base and outcomes, and; (4) a focus on intervention as outcome . This study found that mechanistic planning heuristics (as a means of supporting implementation) fails to grapple with the indeterminate nature of population health problems. A new approach to planning and implementing public health interventions is required that recognises the complex and political nature of health problems; the inevitability of imperfect and contested evidence regarding intervention, and, future associated uncertainties.

  6. Effect of educational interventions and medical school policies on medical students' attitudes toward pharmaceutical marketing practices: a multi-institutional study.

    Science.gov (United States)

    Kao, Audiey C; Braddock, Clarence; Clay, Maria; Elliott, Donna; Epstein, Scott K; Filstead, William; Hotze, Tim; May, Win; Reenan, Jennifer

    2011-11-01

    To determine the effect of educational interventions on medical students' attitudes toward pharmaceutical industry marketing practices and whether restrictive medical school policies governing medicine-industry interactions are associated with student support for banning such interactions. Prospective cohort study involving the graduating classes of 2009 (intervention, n=474) and 2010 (control, n=459) at four U.S. medical schools. Intervention students experienced a former pharmaceutical representative's presentation, faculty debate, and a Web-based course. Both groups completed baseline and follow-up attitude surveys about pharmaceutical marketing. A total of 482 students (51.6%) completed both surveys. In regression analyses, intervention students were more likely than control students to think that physicians are strongly or moderately influenced by pharmaceutical marketing (OR, 2.29; 95% CI, 1.46-3.59) and believed they would be more likely to prescribe a company's drug if they accepted that company's gifts and food (OR, 1.68; 95% CI, 1.12-2.52). Intervention students were more likely to support banning interactions between pharmaceutical representatives and students (OR, 4.82; 95% CI, 3.02-7.68) and with physicians (OR, 6.88; 95% CI, 4.04-11.70). Students from schools with more restrictive policies were more likely to support banning interactions between pharmaceutical representatives and students (OR, 1.99; 95% CI, 1.26-3.16) and with physicians (OR, 3.44; 95% CI, 2.05-5.79). Education about pharmaceutical marketing practices and more restrictive policies governing medicine-industry interactions seem to increase medical students' skepticism about the appropriateness of such marketing practices and disapproval of pharmaceutical representatives in the learning environment.

  7. Preconception care: from policy to practice and back

    NARCIS (Netherlands)

    S.F. van Voorst (Sabine)

    2017-01-01

    markdownabstractAIMS OF THIS THESIS • To evaluate the policy process and to review the evidence which led to selection of PCC as an intervention to reduce perinatal mortality (Part I - Agenda setting and intervention selection). • To develop a programmatic PCC intervention strategy in high

  8. Interventions Aimed at Improving Child Language by Improving Maternal Responsivity

    OpenAIRE

    Brady, Nancy; Warren, Steven F.; Sterling, Audra

    2009-01-01

    Maternal responsivity, or the ways in which mothers provide for, interact with, and respond to their children, helps to shape their children’s development, including language development. In this chapter, we describe maternal responsivity as a multilevel construct with different measures appropriate for each level. Molar responsivity refers to aspects of interaction style such as affect that can best be measured with rating scales. Molecular responsivity refers to contingent maternal behavior...

  9. The diverse aims of science.

    Science.gov (United States)

    Potochnik, Angela

    2015-10-01

    There is increasing attention to the centrality of idealization in science. One common view is that models and other idealized representations are important to science, but that they fall short in one or more ways. On this view, there must be an intermediary step between idealized representation and the traditional aims of science, including truth, explanation, and prediction. Here I develop an alternative interpretation of the relationship between idealized representation and the aims of science. I suggest that continuing, widespread idealization calls into question the idea that science aims for truth. If instead science aims to produce understanding, this would enable idealizations to directly contribute to science's epistemic success. I also use the fact of widespread idealization to motivate the idea that science's wide variety aims, epistemic and non-epistemic, are best served by different kinds of scientific products. Finally, I show how these diverse aims—most rather distant from truth—result in the expanded influence of social values on science. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Aim For a Healthy Weight

    Science.gov (United States)

    ... out of your control, you can make positive lifestyle changes to lose weight and to maintain a healthy weight. These include a healthy eating plan and being more physically active. Take the Challenge When it comes to aiming for a healthy ...

  11. Politicians learned to request more research knowledge - intervention results from Denmark

    DEFF Research Database (Denmark)

    Loncarevic, Natasa; Radl-Karimi, Christina Mathilde; Bertram, Maja

    2015-01-01

    The interventions were on physical activity policies at initiation phase; Kolding eight-month workshop and guidance intervention (n = 21 team members) aimed to promote inter-sector collaboration; Varde 10-month working group and guidance intervention (n = 11) aimed to facilitate systematic strate...

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

    Science.gov (United States)

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

    2015-01-01

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

  13. Aims, assessments and workplace needs

    Science.gov (United States)

    Black, Paul

    1997-03-01

    This paper attempts to consider the aims that undergraduate physics degree courses actually reflect and serve in the light of the employment patterns of graduates and of the expressed needs of employers. Calling on evidence mainly from the UK, it reviews analyses of what degree examinations actually test, and goes on to quote criticisms of their courses and radical proposals to change them adopted by the senior physics professors in the UK. The discussion is then broadened by discussion of evidence, about the employment of graduates and about the priorities that some industrialists now give in the qualities that they look for when recruiting new graduates. The evidence leads to a view that radical changes are needed, both in courses and examinations, and that there is a need for university departments to work more closely with employers in re-formulating the aims and priorities in their teaching.

  14. 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.

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

    Science.gov (United States)

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

    2017-12-16

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

  16. Filling the gaps: Policy supports and interventions for scaling up renewable energy development in Small Island Developing States

    International Nuclear Information System (INIS)

    Timilsina, Govinda R.; Shah, Kalim U.

    2016-01-01

    SIDS have both opportunities and challenges – economic, social and environmental vulnerability – for low carbon development. Economically, they are highly dependent on international trade; they have limited domestic markets, too small to provide significant scale economies; their exports are constraint by their isolation and remote location. We provide an overview of current energy situation in SIDS, their goals to adopt low carbon economic development paths, policies already in place or required to achieve the goals and challenges to implement their plans and strategies. The focus is on energy policy landscape that needs to be addressed in order to scale-up renewable energy technologies needed to stimulate low carbon economic growth. We find that SIDS face four key barriers to renewable energy development: information to improve the energy information network by strengthening existing information systems and building awareness of renewable energy; financing mechanisms for renewable energy projects, including regional loan structures and technical assistance to banks; policy supports to implement regulatory frameworks that enable renewable energy development; and building technical capacity among players in the renewable energy field. We recommend “policy enablers” that underlie what could positively impact on renewable energy goals and more broadly energy efficiency and climate change. - Highlights: • Incentive based policies are required to stimulate investment and reduce transaction costs. • Sustained, consistent long term policy outlooks to support achieving targets are often absent. • Gaps in technical data, resource assessments and local capacity hinders strong policy decisions. • Coordination by public and private actors across the value chain increases renewables deployment.

  17. The appropriation and dismembering of development intervention : policy, discourse and practice in the field of rural development in Benin

    OpenAIRE

    Mongbo, R.L.

    1995-01-01

    This book concerns a Community Development Programme which provides a vehicle for a theoretical discussion of the reproduction of the discourse and practice of development intervention in general, and the concept of rural development as a field of social interaction in particular. The actions on which the theoretical discussion is based took place in various settings: in ministry offices, within the development intervention institution (the CARDER) and at village level. The Community...

  18. Towards Behaviorally Informed Public Interventions

    Directory of Open Access Journals (Sweden)

    Karol Olejniczak

    2015-06-01

    Full Text Available Purpose: This article informs readers about the theoretical and practical origins of the behaviorally informed interventions (BIPI, analyzes examples of the BIPI from different policy sectors and strategies they offer for policy and regulatory design, and discusses applications and implications of BIPI for public interventions Methodology: This paper is based on a review of literature, as well as an inspection of administrative practices in OECD countries. It encompasses a systematic analysis of scientific papers fromthe SCOPUS database and a query carried out at the library of George Washington University. Findings: The traditional approach to public policy research is based on rational choice theory. It offers limited support, because by assuming perfect rationality of policy decisions, it overlooks existence of systematic errors and biases of human decision-making. The authors argue that behaviorally informed public interventions (BIPI might contribute to improving the effectiveness of a number of public measures – regulation, projects, programs, and even entire policies. Practical implications: The behavioral approach allows decision-makers to better understand the decisions and behaviors of citizens, as well as to design more effective interventions with minimum effort by adapting the existing solutions to real decision mechanisms of citizens. Originality: By combining the concepts of traditional approach with the growing behavioral approach, the authors aim to propose a new theoretical framework (BIPI to be used as a tool for policy design, delivery and evaluation.

  19. The Teacher Is a Learner: Dewey on Aims in Education

    Science.gov (United States)

    Harðarson, Atli

    2018-01-01

    In Chapter VIII of "Democracy and Education", Dewey objects to all three of the following propositions: (1) education serves predefined aims; (2) Education serves aims that are external to the process of education; and (3) Education serves aims that are imposed by authority. From the vantage point of policy-makers and authors of…

  20. Special Education and Juvenile Justice: An Overview and Analysis of Prevention and Intervention Policy and Program Developments

    Science.gov (United States)

    Ohio Coalition for the Education of Children with Disabilities, 2006

    2006-01-01

    There is a serious overpopulation of special needs youth in Ohio's juvenile justice system. This study raises policy questions relating to gaining a deeper understanding of the reasons why there is an overpopulation of children with disabilities in youth correctional facilities and what can be done to reduce the need for future incarcerations.…

  1. Teacher Strategies for Effective Intervention with Students Presenting Social, Emotional and Behavioural Difficulties: Implications for Policy and Practice

    Science.gov (United States)

    Cooper, Paul

    2011-01-01

    In this paper some key practice and policy implications emerging from a review of literature on effective teacher strategies for social, emotional and behavioural difficulties are set out. Particular attention is given to implications in relation to the development of teachers' skills.

  2. How to motivate adults with low literacy and numeracy skills to engage and persist in learning: A literature review of policy interventions

    Science.gov (United States)

    Windisch, Hendrickje Catriona

    2016-06-01

    Low basic skills levels of adults are a complex policy problem which has neither straightforward causes nor solutions, and successful interventions are still relatively rare. Tackling serious literacy and numeracy weaknesses among adults is challenging, partly because the task itself is difficult, and partly because even if accomplished successfully, the returns on the investment (of expertise, time and money) are uncertain. The Survey of Adult Skills, an international investigation conducted in 22 member and two partner countries of the Organisation for Economic Co-operation and Development (OECD) as part of the Programme for the International Assessment of Adult Competencies (PIAAC), has revealed that a considerable number of adults possess only limited literacy and numeracy skills. Governments now recognise the need to upskill these adults in order to maintain national prosperity. This literature review examines current evidence on policy interventions for adults with low literacy and numeracy proficiencies to pinpoint what has so far proven to motivate adults to join and persist in basic literacy and numeracy learning. The author identifies three approaches which seem promising in helping to address individual learners' needs: (1) adapting instruction to learners' needs by means of regular assessment (formative assessment); (2) complementary e-learning (blended learning); and (3) contextualisation of basic skills provision both at work and at home (workplace learning and family literacy). The central challenge is to put the evidence to work.

  3. The appropriation and dismembering of development intervention : policy, discourse and practice in the field of rural development in Benin

    NARCIS (Netherlands)

    Mongbo, R.L.

    1995-01-01

    This book concerns a Community Development Programme which provides a vehicle for a theoretical discussion of the reproduction of the discourse and practice of development intervention in general, and the concept of rural development as a field of social interaction in particular. The

  4. A Policy Intervention Study to Identify High-Risk Groups to Prevent Industrial Accidents in Republic of Korea

    Directory of Open Access Journals (Sweden)

    Kwan Hyung Yi

    2016-09-01

    Conclusion: The manufacturing industry, age over 50 years and workplaces with more than 50 employees showed a high severity level of occupational accidents. Male workers showed a higher severity level of occupational accidents than female workers. The employment period of < 3 years and newly hired workers with a relatively shorter working period are likely to have more occupational accidents than others. Overall, an industrial accident prevention policy must be established by concentrating all available resources and capacities of these high-risk groups.

  5. Mindfulness Interventions.

    Science.gov (United States)

    Creswell, J David

    2017-01-03

    Mindfulness interventions aim to foster greater attention to and awareness of present moment experience. There has been a dramatic increase in randomized controlled trials (RCTs) of mindfulness interventions over the past two decades. This article evaluates the growing evidence of mindfulness intervention RCTs by reviewing and discussing (a) the effects of mindfulness interventions on health, cognitive, affective, and interpersonal outcomes; (b) evidence-based applications of mindfulness interventions to new settings and populations (e.g., the workplace, military, schools); (c) psychological and neurobiological mechanisms of mindfulness interventions; (d) mindfulness intervention dosing considerations; and (e) potential risks of mindfulness interventions. Methodologically rigorous RCTs have demonstrated that mindfulness interventions improve outcomes in multiple domains (e.g., chronic pain, depression relapse, addiction). Discussion focuses on opportunities and challenges for mindfulness intervention research and on community applications.

  6. A Policy-into-Practice Intervention to Increase the Uptake of Evidence-Based Management of Low Back Pain in Primary Care: A Prospective Cohort Study

    Science.gov (United States)

    Slater, Helen; Davies, Stephanie Joy; Parsons, Richard; Quintner, John Louis; Schug, Stephan Alexander

    2012-01-01

    Background Persistent non-specific low back pain (nsLBP) is poorly understood by the general community, by educators, researchers and health professionals, making effective care problematic. This study evaluated the effectiveness of a policy-into-practice intervention developed for primary care physicians (PCPs). Methods To encourage PCPs to adopt practical evidence-based approaches and facilitate time-efficient, integrated management of patients with nsLBP, we developed an interdisciplinary evidence-based, practical pain education program (gPEP) based on a contemporary biopsychosocial framework. One hundred and twenty six PCPs from primary care settings in Western Australia were recruited. PCPs participated in a 6.5-hour gPEP. Self-report measures recorded at baseline and at 2 months post-intervention included PCPs' attitudes, beliefs (modified Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS), evidence-based clinical practices (knowledge and skills regarding nsLBP management: 5-point Likert scale with 1 =  nil and 5 =  excellent) and practice behaviours (recommendations based on a patient vignette; 5-point Likert scale). Results Ninety one PCPs participated (attendance rate of 72%; post-intervention response rate 88%). PCP-responders adopted more positive, guideline-consistent beliefs, evidenced by clinically significant HC-PAIRS score differences (mean change  = −5.6±8.2, ppain education program set within a framework that aligns health policy and practice, encourages PCPs to adopt more self-reported evidence-based attitudes, beliefs and clinical behaviours in their management of patients with nsLBP. However, further research is required to determine cost effectiveness of this approach when compared with other modes of educational delivery and to examine PCP behaviours in actual clinical practice. PMID:22662264

  7. 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

  8. Beliefs Underlying the Decision to Eat Breakfast: The Role of Theory-based Behavioral Analysis in the Development of Policy, Communication and Educational Interventions for Healthy Eating.

    Science.gov (United States)

    Middlestadt, Susan E; Stevenson, Laurel D; Hung, Chia-Ling; Roditis, Maria Leia; Fly, Alyce D; Sheats, Jylana L

    2011-01-01

    Policy, communication, and education efforts to influence any social or health outcome are more effective if based on an understanding of the underlying behaviors and their determinants. This conceptual paper outlines how behavioral theory can help design interventions for one healthy eating behavior, eating breakfast. More specifically, the paper illustrates how a prominent health behavior theory, the Reasoned Action Approach, can be used to guide formative research to identify factors underlying people's decisions. Select findings are presented from three studies of beliefs underlying eating breakfast: online surveys with 1185 undergraduates from a large university in Indiana; in-depth interviews with 61 adults from four Indiana worksites; and 63 in-depth interviews with students from three middle schools in rural Indiana. Analyses of data from the undergraduates demonstrated the role of self-efficacy. Analyses of data from the working adults revealed the importance of normative beliefs about what employers believed. Analyses comparing consequences perceived by adults with those perceived by middle school students found that both groups believed that eating breakfast would provide energy but only middle school students believed that eating breakfast would improve alertness. For each finding, the theory is presented, the finding is described, implications for interventions are suggested, and the need for additional research is outlined. In sum, theory-based behavioral research can help develop interventions at intrapersonal, interpersonal, and environmental levels that are warranted to encourage healthy eating.

  9. Transition of chaotic motion to a limit cycle by intervention of economic policy: an empirical analysis in agriculture.

    Science.gov (United States)

    Sakai, Kenshi; Managi, Shunsuke; Vitanov, Nikolay K; Demura, Katsuhiko

    2007-04-01

    This paper investigates the transition of dynamics observed in an actual real agricultural economic dataset. Lyapunov spectrum analysis is conducted on the data to distinguish deterministic chaos and the limit cycle. Chaotic and periodic oscillation were identified before and after the second oil crisis, respectively. The statitonarity of the time series is investigated using recurrence plots. This shows that government intervention might reduce market instability by removing a chaotic market's long-term unpredictability.

  10. Propuesta de políticas e intervenciones para reducir las desigualdades sociales en salud en España A proposal of policies and interventions to reduce social inequalities in health in Spain

    Directory of Open Access Journals (Sweden)

    2012-04-01

    Full Text Available En noviembre de 2008, a petición de la Dirección General de Salud Pública y Sanidad Exterior del Ministerio de Sanidad y Política Social, se constituyó la Comisión para Reducir las Desigualdades Sociales en Salud en España con el cometido de elaborar una propuesta de medidas de intervención para disminuir las desigualdades en salud. El objetivo de este artículo es exponer el trabajo realizado y los documentos elaborados por la Comisión. Los 18 profesionales que la formaban realizaron un análisis de situación sobre las desigualdades en salud y las políticas para reducirlas, revisaron documentos internacionales y consultaron a 56 expertos de distintos ámbitos para elaborar una propuesta de recomendaciones para disminuir las desigualdades en salud. En mayo de 2010, la Comisión presentó el documento «Avanzando hacia la equidad: Propuesta de políticas e intervenciones para reducir las desigualdades sociales en salud en España». En el documento se detallan 166 recomendaciones, divididas en 14 áreas y ordenadas por prioridad. Las recomendaciones evidencian que la reducción de las desigualdades sociales en salud no es posible sin un compromiso para impulsar la salud y la equidad en todas las políticas y para avanzar hacia una sociedad más justa.In November 2008, at the request of the Directorate General of Public Health of the Ministry of Health and Social Policy, the Commission to Reduce Social Inequalities in Health in Spain was established with a mandate to develop a proposal for interventions to reduce health inequalities. This article aims to present the work carried out and the documents prepared by the Commission. The Commission, consisting of 18 members, conducted a situational analysis of health inequalities and of the policies to reduce them, reviewed international documents and consulted 56 experts from distinct fields to develop a proposal for recommendations to reduce health inequalities. In May 2010, the Commission

  11. The SMART Study, a Mobile Health and Citizen Science Methodological Platform for Active Living Surveillance, Integrated Knowledge Translation, and Policy Interventions: Longitudinal Study.

    Science.gov (United States)

    Katapally, Tarun Reddy; Bhawra, Jasmin; Leatherdale, Scott T; Ferguson, Leah; Longo, Justin; Rainham, Daniel; Larouche, Richard; Osgood, Nathaniel

    2018-03-27

    Physical inactivity is the fourth leading cause of death worldwide, costing approximately US $67.5 billion per year to health care systems. To curb the physical inactivity pandemic, it is time to move beyond traditional approaches and engage citizens by repurposing sedentary behavior (SB)-enabling ubiquitous tools (eg, smartphones). The primary objective of the Saskatchewan, let's move and map our activity (SMART) Study was to develop a mobile and citizen science methodological platform for active living surveillance, knowledge translation, and policy interventions. This methodology paper enumerates the SMART Study platform's conceptualization, design, implementation, data collection procedures, analytical strategies, and potential for informing policy interventions. This longitudinal investigation was designed to engage participants (ie, citizen scientists) in Regina and Saskatoon, Saskatchewan, Canada, in four different seasons across 3 years. In spring 2017, pilot data collection was conducted, where 317 adult citizen scientists (≥18 years) were recruited in person and online. Citizen scientists used a custom-built smartphone app, Ethica (Ethica Data Services Inc), for 8 consecutive days to provide a complex series of objective and subjective data. Citizen scientists answered a succession of validated surveys that were assigned different smartphone triggering mechanisms (eg, user-triggered and schedule-triggered). The validated surveys captured physical activity (PA), SB, motivation, perception of outdoor and indoor environment, and eudaimonic well-being. Ecological momentary assessments were employed on each day to capture not only PA but also physical and social contexts along with barriers and facilitators of PA, as relayed by citizen scientists using geo-coded pictures and audio files. To obtain a comprehensive objective picture of participant location, motion, and compliance, 6 types of sensor-based (eg, global positioning system and accelerometer) data

  12. The SMART Study, a Mobile Health and Citizen Science Methodological Platform for Active Living Surveillance, Integrated Knowledge Translation, and Policy Interventions: Longitudinal Study

    Science.gov (United States)

    Bhawra, Jasmin; Leatherdale, Scott T; Ferguson, Leah; Longo, Justin; Rainham, Daniel; Larouche, Richard; Osgood, Nathaniel

    2018-01-01

    Background Physical inactivity is the fourth leading cause of death worldwide, costing approximately US $67.5 billion per year to health care systems. To curb the physical inactivity pandemic, it is time to move beyond traditional approaches and engage citizens by repurposing sedentary behavior (SB)–enabling ubiquitous tools (eg, smartphones). Objective The primary objective of the Saskatchewan, let’s move and map our activity (SMART) Study was to develop a mobile and citizen science methodological platform for active living surveillance, knowledge translation, and policy interventions. This methodology paper enumerates the SMART Study platform’s conceptualization, design, implementation, data collection procedures, analytical strategies, and potential for informing policy interventions. Methods This longitudinal investigation was designed to engage participants (ie, citizen scientists) in Regina and Saskatoon, Saskatchewan, Canada, in four different seasons across 3 years. In spring 2017, pilot data collection was conducted, where 317 adult citizen scientists (≥18 years) were recruited in person and online. Citizen scientists used a custom-built smartphone app, Ethica (Ethica Data Services Inc), for 8 consecutive days to provide a complex series of objective and subjective data. Citizen scientists answered a succession of validated surveys that were assigned different smartphone triggering mechanisms (eg, user-triggered and schedule-triggered). The validated surveys captured physical activity (PA), SB, motivation, perception of outdoor and indoor environment, and eudaimonic well-being. Ecological momentary assessments were employed on each day to capture not only PA but also physical and social contexts along with barriers and facilitators of PA, as relayed by citizen scientists using geo-coded pictures and audio files. To obtain a comprehensive objective picture of participant location, motion, and compliance, 6 types of sensor-based (eg, global

  13. Conceptual Underpinnings for Innovation Policy Design

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    of innovation policy. This serves two important purposes. Firstly, it allows the identification of problems in an innovation system that require public policy intervention through the choice of appropriate policy instruments. Secondly, it allows a theoretically based identification of input indicators......In cases where innovation indicators and data fail to serve properly as a (necessary) basis for the design of innovation policies, it often has its roots in conceptual unclarities in the underlying concepts. The aim of this paper is to provide a theoretical and conceptual basis for the design...

  14. Assessing the effectiveness of policy interventions to reduce the use of agency or temporary social workers in England.

    Science.gov (United States)

    Cornes, Michelle; Manthorpe, Jill; Moriarty, Jo; Blendi-Mahota, Saidah; Hussein, Shereen

    2013-05-01

    There has been growing concern that English local authorities are over reliant on temporary staff to meet the shortage of social workers. This has been criticised as inefficient and costly while leading to problems of continuity and consistency for people using social work services. Focussing on recent policy and the implementation of new administrative procedures for the procurement and management of temporary or agency staff, this article explores progress being made towards achieving the previous government's policy goal that by 2020 local authorities will no longer need to rely on agency workers to carry out tasks that would normally be carried out by a permanent social worker. The article draws on the findings of an exploratory study (2007-2010) commissioned by the Department of Health which comprised of the following: a survey of local councils in England with adult social services responsibilities; case studies in three different localities; and qualitative interviews with stakeholders (n = 93). The findings suggest that while local authorities have reduced the costs of employing temporary staff through the setting up of intermediary control mechanisms, agency social workers continue to play important roles in teams and services. © 2013 Blackwell Publishing Ltd.

  15. Evaluating the effect of policies and interventions to address inequalities in health: lessons from a Dutch programme

    NARCIS (Netherlands)

    Stronks, Karien; Mackenbach, Johan P.

    2006-01-01

    OBJECTIVES: Many initiatives have been taken in European countries that are designed to reduce inequalities in health. However, the effects of only a very few of these initiatives have been assessed. The main aim of a Dutch research and development programme was to systematically investigate and

  16. Early intervention in psychosis

    DEFF Research Database (Denmark)

    Csillag, Claudio; Nordentoft, Merete; Mizuno, Masafumi

    2017-01-01

    AIM: Early intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges to their implementa......AIM: Early intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges...... benefits alone is not enough to promote implementation, as economic arguments and political and social pressure have shown to be important elements in efforts to achieve implementation. CONCLUSIONS: Users' narratives, close collaboration with community organizations and support from policy-makers and known...

  17. China’s Evolving Foreign Policy in Africa: A New Direction for China’s Non-Intervention Strategy?

    Science.gov (United States)

    2014-09-01

    Xiaoping instituted economic reforms aimed at opening up China’s economy to international trade and China began on its path towards double- digit growth.99...rebellion by the nomadic Tuaregs in the north paved the way for Al Qaeda in the Lands of the Islamic Maghreb (AQIM)’s takeover of Northern Mali. The...marginalization through the creation of a formal state with formal, defined borders. The nomadic lifestyle of the Tuaregs was no longer accepted under

  18. A Policy Intervention Study to Identify High-Risk Groups to Prevent Industrial Accidents in Republic of Korea.

    Science.gov (United States)

    Yi, Kwan Hyung; Lee, Seung Soo

    2016-09-01

    The objective of this study is to identify high-risk groups for industrial accidents by setting up 2003 as the base year and conducting an in-depth analysis of the trends of major industrial accident indexes the index of industrial accident rate, the index of occupational injury rate, the index of occupational illness and disease rate per 10,000 people, and the index of occupational injury fatality rate per 10,000 people for the past 10 years. This study selected industrial accident victims, who died or received more than 4 days of medical care benefits, due to occupational accidents and diseases occurring at workplaces, subject to the Industrial Accident Compensation Insurance Act, as the study population. According to the trends of four major indexes by workplace characteristics, the whole industry has shown a decreasing tendency in all four major indexes since the base year (2003); as of 2012, the index of industrial accident rate was 67, while the index of occupational injury fatality rate per 10,000 people was 59. The manufacturing industry, age over 50 years and workplaces with more than 50 employees showed a high severity level of occupational accidents. Male workers showed a higher severity level of occupational accidents than female workers. The employment period of working period are likely to have more occupational accidents than others. Overall, an industrial accident prevention policy must be established by concentrating all available resources and capacities of these high-risk groups.

  19. Mapping the role of structural and interpersonal violence in the lives of women: implications for public health interventions and policy.

    Science.gov (United States)

    Montesanti, Stephanie Rose; Thurston, Wilfreda E

    2015-11-11

    Research on interpersonal violence towards women has commonly focused on individual or proximate-level determinants associated with violent acts ignores the roles of larger structural systems that shape interpersonal violence. Though this research has contributed to an understanding of the prevalence and consequences of violence towards women, it ignores how patterns of violence are connected to social systems and social institutions. In this paper, we discuss the findings from a scoping review that examined: 1) how structural and symbolic violence contributes to interpersonal violence against women; and 2) the relationships between the social determinants of health and interpersonal violence against women. We used concept mapping to identify what was reported on the relationships among individual-level characteristics and population-level influence on gender-based violence against women and the consequences for women's health. Institutional ethics review was not required for this scoping review since there was no involvement or contact with human subjects. The different forms of violence-symbolic, structural and interpersonal-are not mutually exclusive, rather they relate to one another as they manifest in the lives of women. Structural violence is marked by deeply unequal access to the determinants of health (e.g., housing, good quality health care, and unemployment), which then create conditions where interpersonal violence can happen and which shape gendered forms of violence for women in vulnerable social positions. Our web of causation illustrates how structural factors can have negative impacts on the social determinants of health and increases the risk for interpersonal violence among women. Public health policy responses to violence against women should move beyond individual-level approaches to violence, to consider how structural and interpersonal level violence and power relations shape the 'lived experiences' of violence for women.

  20. Lamps recycling aiming at the environment preservation

    International Nuclear Information System (INIS)

    Yamachita, Roberto Akira; Gama, Paulo Henrique R. Pereira; Haddad, Jamil; Santos, Afonso H. Moreira; Guardia, Eduardo C.

    1999-01-01

    The article discusses the following issues of lamps recycling in Brazil: mercury lamps recycling, recycling potential, energy conservation and environmental impacts, enterprises lamps recycling, and incentives policy

  1. Resolution proposition aiming to create an inquiry commission on the capacities and the financial results of the Total Group, on the resources use, the industrial policy and on the employment, wages and country planing policy, as on the social and environmental liabilities. (refer to the economical, environmental and country affairs commission, for lack of special commission in due time by the articles 30 and 31 of the regulation)

    International Nuclear Information System (INIS)

    2005-03-01

    This document denounces the Total Group policy oriented to the profit and reveals the resulting environmental and social negative effects. It proposes the creation of an inquiry commission on the Group policy activities. (A.L.B.)

  2. Fiscal policy in energy sector. Synthesis of talks at 22 March 1999 Session of DGEMP/CGP energy policy workshops; Fiscalite energetique. Synthese des interventions. Cycle de conferences de politique energetique DGEMP/CGP - Session du 22 mars 1999

    Energy Technology Data Exchange (ETDEWEB)

    Godard, Olivier [Directeur de Recherche, Centre National de la Recherche Scientifique CNRS, 75 - Paris (France)

    2000-02-18

    problems. Hence, this is the political significance of the so-called 'double-return' policy which links the long-term preoccupations (planet climate) to more immediate preoccupations of our society (struggle against unemployment, sustainable growth, etc). In the talk by Dominique Bureau, concerning the struggle against greenhouse effect, one stresses that France is interested in taxing the energy as a tool for minimizing the costs. In presenting its policy to other European countries one should dismantle the concept that France is solely driven by its interest in protecting its exportation of electricity of nuclear origin. Finally, introduction of a CO{sub 2} or CO{sub 2} energy taxation should be approached by implying the externalities and avoiding any competition distortion. So, a fiscal approach should reflect in a general manner but moderately and progressively the taxation on fossil fuels aiming at the same time at lowering charges on low salaries. Hence, a integrated tax policy should be conducted both by preoccupation for climatic changes and avoidance of a over-taxation of non-qualified laborers.

  3. A novel method for feasibility testing urban sustainable development policies

    Directory of Open Access Journals (Sweden)

    O’Doherty Travis

    2013-01-01

    Full Text Available Policy making to promote more sustainable development is a complex task due in part to the large number of both stakeholders and potential policies. Policy feasibility testing provides a guide to the viability and practicality of policy implementation and forms an important part of an evidence based policy making process. An extensive literature review has identified no standardized approach to feasibility testing. This paper addresses this knowledge gap by describing a novel method using Multi-Criteria Decision Analysis (MCDA for feasibility testing of policies aimed at increasing the sustainability of towns and villages in Ireland. Feasibility results are provided for 40 frequently cited policy interventions tested for 18 settlements in Ireland. Policies were selected in the arenas of transport, food, housing and urban form, energy, waste and water. Policies are feasibility tested through analysis of operational evidence from both quantitative and qualitative data sources. Following testing, policies are ranked in terms of feasibility. This research examines the effectiveness of local and national level policies and the importance of both local community involvement and central government regulation in policy success. The inter-settlement variation in feasibility testing scores prioritises policy selection and aims to reduce cherry-picking of policies to support the viewpoints of the decision maker. Although developed for an Irish urban context the methods described here may have applicability elsewhere.

  4. Nordic cultural policies

    DEFF Research Database (Denmark)

    Duelund, Peter

    2008-01-01

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

  5. Organisational Factors Affecting Policy and Programme Decision Making in a Public Health Policy Environment

    Science.gov (United States)

    Zardo, Pauline; Collie, Alex; Livingstone, Charles

    2015-01-01

    Organisational factors can affect the success of interventions aimed at increasing research use. Research is needed to identify organisational factors affecting research use in specific public health policy contexts. Qualitative interviews with decision makers from a specific public health context identified a range of organisational factors that…

  6. Social capital and Regional Policy in the EU

    DEFF Research Database (Denmark)

    Svendsen, Gert Tinggaard

    2009-01-01

    There needs to be a clear and explicit distinction between policy interventions aimed at increasing income and growth (“efficiency” objectives in the terminology of the Report) and those aimed at reducing inequalities (“social inclusion” objectives in the Report), not least in order to be able...... to monitor and evaluate the results. There needs to be a greater coherence with the place-based or territorial policy concept. And a true concentration on a few issues of key importance for the EU and its people. This would create a Europe-wide critical mass of interventions on commonly agreed priorities...

  7. Journal of Contemporary European Research User You are logged in as... jcer_editor My Profile Log Out Subscribe... Sign up for issue alerts Follow JCER on Twitter Font Size Make font size smaller Make font size default Make font size larger Journal Content Search Search Scope Browse By Issue By Author By Title Information For Readers For Authors For Librarians Journal Help Keywords CFSP Communication ESDP EU EU enlargement EU trade policy Energy, EU, External Policy Europe European Commission European Parliament European Union European integration Europeanisation Euroscepticism First Enlargement Germany Liberty Lisbon Treaty Poland Russia Security The UACES Blog Power shift? The EU’s pivot to Asia 100 Books on Europe to be Remembered For a Global European Studies? EU Member State Building in the... Same aims, different approaches?... Open Journal Systems Home About User Home Search Current Archives Announcements UACES Home > Vol 9, No 4 (2013 > De Ville The Promise of Critical Historical Institutionalism for EU Trade Policy Analysis

    Directory of Open Access Journals (Sweden)

    Ferdi de Ville

    2013-10-01

    Full Text Available This paper aims to convince the reader of the potential of a critical version of historical institutionalism (HI as a theoretical perspective for EU trade policy analysis. It argues that critical HI sensitises the analyst to important but hitherto often neglected factors including: the influence of the past on EU trade policy; the complex, multiarena and multilevel nature of contemporary trade policy; and issues of distributional conflict. The core concept in critical HI is ‘reactive sequencing’, conceiving of policy evolution as a chain of events produced by reactions and counter-reactions. This paper demonstrates that this is invaluable to understand contemporary EU trade politics. Some examples of EU trade policy decisions and its general strategic evolution since the conclusion of the Uruguay Round are given to show the value of critical HI. Finally, the external dimension of “Europe 2020” as the latest trade policy strategy is analysed from a critical historical institutionalist angle.

  8. Making the Most of Obesity Research: Developing Research and Policy Objectives through Evidence Triangulation

    Science.gov (United States)

    Oliver, Kathryn; Aicken, Catherine; Arai, Lisa

    2013-01-01

    Drawing lessons from research can help policy makers make better decisions. If a large and methodologically varied body of research exists, as with childhood obesity, this is challenging. We present new research and policy objectives for child obesity developed by triangulating user involvement data with a mapping study of interventions aimed at…

  9. ECONOMIC EFFECTS OF ENERGY POLICIES

    Directory of Open Access Journals (Sweden)

    Mihaela ȘTEȚ

    2014-12-01

    Full Text Available This paper highlights some of the issues raised by the implementation of energy policies and the fiscal measures in the energy sector and it aims to identify the impact of energy policies at regional level. It is emphasized, along with the environmental impact of the use of renewable resources and economic and social effects on sustainable regional development which can generate state intervention through direct and indirect, financial and non-financial instruments. Given the complex energy profile of Romania, the paper reveals also, the problems that have had to face in the last two decades and the impact of energy policies of Romanian governments. The research is based on an analysis of statistics, publications in energy sector, as well as primary and specific legislation.

  10. How countries link REDD+ interventions to drivers in their readiness plans: implications for monitoring systems

    NARCIS (Netherlands)

    Salvini, G.; Herold, M.; Sy, de V.; Kissinger, G.M.; Brockhouse, M.; Skutsch, M.

    2014-01-01

    Countries participating in the REDD+ scheme are in the readiness phase, designing policy interventions to address drivers of deforestation and forest degradation (DD). In order for REDD+ interventions to be effective, it is essential that they take into account the specific drivers that they aim to

  11. Take AIM and Keep Your Students Engaged

    Science.gov (United States)

    Nash, Catherine

    2014-01-01

    This paper outlines the benefits to distance education teachers of formatting a weekly online newsletter in accordance with motivational learning theory. It reflects on the delivery of weekly AIM newsletters to undergraduate economics students at the Open Polytechnic of New Zealand via Moodle. The acronym, AIM, stands for Academic content,…

  12. Discrimination and the aim of proportional representation

    DEFF Research Database (Denmark)

    Lippert-Rasmussen, Kasper

    2008-01-01

    Many organizations, companies, and so on are committed to certain representational aims as regards the composition of their workforce. One motivation for such aims is the assumption that numerical underrepresentation of groups manifests discrimination against them. In this article, I articulate r...

  13. British Society of Paediatric Dentistry: a policy document on consent and the use of physical intervention in the dental care of children.

    Science.gov (United States)

    Nunn, June; Foster, Martin; Master, Selina; Greening, Sue

    2008-11-01

    This policy document was prepared by J Nunn, M Foster, S Master and S Greening on behalf of the British Society of Paediatric Dentistry (BSPD). Policy documents produced by the BSPD represent a majority view, based on a consideration of currently available evidence. They are produced to provide guidance with the intention that the policy be regularly reviewed and updated to take account of changing views and developments.

  14. Therapeutic intervention in violence against women in Colombia

    Directory of Open Access Journals (Sweden)

    Lina María Martínez González

    2018-01-01

    Full Text Available The article presents some reflections regarding the unspecified place of therapeutic intervention in the Colombian State’s strategies to address violence against women in the context of couple relationships. It focuses on professional intervention, concretely, therapeutic intervention, and states that despite its significant role in the potential transformation of the imaginaries and subjectivities that support that violence, this type of intervention occupies an unspecified place in the measures stipulated by the law, as well as in Colombian public policies aimed at countering that violence. The article also highlights some of the perspectives that therapists consider useful in the construction of non-violent functional conditions for couples.

  15. Qualitative approaches to use of the RE-AIM framework: rationale and methods.

    Science.gov (United States)

    Holtrop, Jodi Summers; Rabin, Borsika A; Glasgow, Russell E

    2018-03-13

    There have been over 430 publications using the RE-AIM model for planning and evaluation of health programs and policies, as well as numerous applications of the model in grant proposals and national programs. Full use of the model includes use of qualitative methods to understand why and how results were obtained on different RE-AIM dimensions, however, recent reviews have revealed that qualitative methods have been used infrequently. Having quantitative and qualitative methods and results iteratively inform each other should enhance understanding and lessons learned. Because there have been few published examples of qualitative approaches and methods using RE-AIM for planning or assessment and no guidance on how qualitative approaches can inform these processes, we provide guidance on qualitative methods to address the RE-AIM model and its various dimensions. The intended audience is researchers interested in applying RE-AIM or similar implementation models, but the methods discussed should also be relevant to those in community or clinical settings. We present directions for, examples of, and guidance on how qualitative methods can be used to address each of the five RE-AIM dimensions. Formative qualitative methods can be helpful in planning interventions and designing for dissemination. Summative qualitative methods are useful when used in an iterative, mixed methods approach for understanding how and why different patterns of results occur. In summary, qualitative and mixed methods approaches to RE-AIM help understand complex situations and results, why and how outcomes were obtained, and contextual factors not easily assessed using quantitative measures.

  16. Discrimination and the aim of proportional representation

    DEFF Research Database (Denmark)

    Lippert-Rasmussen, Kasper

    2008-01-01

    Many organizations, companies, and so on are committed to certain representational aims as regards the composition of their workforce. One motivation for such aims is the assumption that numerical underrepresentation of groups manifests discrimination against them. In this article, I articulate...... representational aims in a way that best captures this rationale. My main claim is that the achievement of such representational aims is reducible to the elimination of the effects of wrongful discrimination on individuals and that this very important concern is, in principle, compatible with the representation...... of discrimination against numerically overrepresented groups, or overlook the innocently different ambitions of some numerically underrepresented groups. In relation to the latter point, I appeal to the fact that many luck egalitarians think justice should be ambition sensitive (but endowment insensitive). Also...

  17. AIM: An Integrated Approach to Organizational Improvement

    Directory of Open Access Journals (Sweden)

    Ronald A. Styron, Jr.

    2016-02-01

    Full Text Available This concept paper is based on the new problem-solving model of Blended Leadership called Alloy Improvement Model (AIM. This model consists of an integration of change theory, leadership theory, and democratic principles and practices to form a comprehensive problem-solving strategy for organizational leaders. The utilization of AIM will assist leaders in moving from problems to solutions while engaging stakeholders in a comprehensive, efficient, inclusive, informative, integrated and transparent process.

  18. Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession : interrupted time series analyses

    NARCIS (Netherlands)

    Leopold, Christine; Zhang, Fang; Mantel-Teeuwisse, Aukje K|info:eu-repo/dai/nl/266775098; Vogler, Sabine; Valkova, Silvia; Ross-Degnan, Dennis; Wagner, Anita K

    2014-01-01

    OBJECTIVES: To analyze the impacts of pharmaceutical sector policies implemented to contain country spending during the economic recession--a reference price system in Finland and a mix of policies including changes in reimbursement rates, a generic promotion campaign and discounts granted to the

  19. Healthy public policy in poor countries: tackling macro-economic policies.

    Science.gov (United States)

    Mohindra, K S

    2007-06-01

    Large segments of the population in poor countries continue to suffer from a high level of unmet health needs, requiring macro-level, broad-based interventions. Healthy public policy, a key health promotion strategy, aims to put health on the agenda of policy makers across sectors and levels of government. Macro-economic policy in developing countries has thus far not adequately captured the attention of health promotion researchers. This paper argues that healthy public policy should not only be an objective in rich countries, but also in poor countries. This paper takes up this issue by reviewing the main macro-economic aid programs offered by international financial institutions as a response to economic crises and unmanageable debt burdens. Although health promotion researchers were largely absent during a key debate on structural adjustment programs and health during the 1980s and 1990s, the international macro-economic policy tool currently in play offers a new opportunity to participate in assessing these policies, ensuring new forms of macro-economic policy interventions do not simply reproduce patterns of (neoliberal) economics-dominated development policy.

  20. Interventions to Promote Cancer Awareness and Early Presentation: Systematic Review

    OpenAIRE

    J Austoker; C Bankhead; Lindsay J. L. Forbes; L Atkins; F Martin; K Robb; J Wardle; A J. Ramirez

    2009-01-01

    Background: Low cancer awareness contributes to delay in presentation for cancer symptoms and may lead to delay in cancer diagnosis. The aim of this study was to review the evidence for the effectiveness of interventions to raise cancer awareness and promote early presentation in cancer to inform policy and future research. Methods: We searched bibliographic databases and reference lists for randomised controlled trials of interventions delivered to individuals, and controlled or uncontrolled...

  1. Practice to Policy: Clinical psychologists' experiences of macro-level work

    OpenAIRE

    Browne, N.

    2017-01-01

    Many clinical psychologists are venturing beyond their traditional therapeutic roles to undertake macro-level work, engaging with social change, policy and public health. However, no research has systematically examined clinical psychologists’ roles in policy work and the implications for the profession. Part 1 of the thesis is a literature review of one area of macro-level policy aimed at improving the social determinants of mental health. It reviews nine intervention studies of housing impr...

  2. Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.

    Directory of Open Access Journals (Sweden)

    T Déirdre Hollingsworth

    Full Text Available Mitigation of a severe influenza pandemic can be achieved using a range of interventions to reduce transmission. Interventions can reduce the impact of an outbreak and buy time until vaccines are developed, but they may have high social and economic costs. The non-linear effect on the epidemic dynamics means that suitable strategies crucially depend on the precise aim of the intervention. National pandemic influenza plans rarely contain clear statements of policy objectives or prioritization of potentially conflicting aims, such as minimizing mortality (depending on the severity of a pandemic or peak prevalence or limiting the socio-economic burden of contact-reducing interventions. We use epidemiological models of influenza A to investigate how contact-reducing interventions and availability of antiviral drugs or pre-pandemic vaccines contribute to achieving particular policy objectives. Our analyses show that the ideal strategy depends on the aim of an intervention and that the achievement of one policy objective may preclude success with others, e.g., constraining peak demand for public health resources may lengthen the duration of the epidemic and hence its economic and social impact. Constraining total case numbers can be achieved by a range of strategies, whereas strategies which additionally constrain peak demand for services require a more sophisticated intervention. If, for example, there are multiple objectives which must be achieved prior to the availability of a pandemic vaccine (i.e., a time-limited intervention, our analysis shows that interventions should be implemented several weeks into the epidemic, not at the very start. This observation is shown to be robust across a range of constraints and for uncertainty in estimates of both R(0 and the timing of vaccine availability. These analyses highlight the need for more precise statements of policy objectives and their assumed consequences when planning and implementing strategies

  3. Is Fitts' law continuous in discrete aiming?

    Directory of Open Access Journals (Sweden)

    Rita Sleimen-Malkoun

    Full Text Available The lawful continuous linear relation between movement time and task difficulty (i.e., index of difficulty; ID in a goal-directed rapid aiming task (Fitts' law has been recently challenged in reciprocal performance. Specifically, a discontinuity was observed at critical ID and was attributed to a transition between two distinct dynamic regimes that occurs with increasing difficulty. In the present paper, we show that such a discontinuity is also present in discrete aiming when ID is manipulated via target width (experiment 1 but not via target distance (experiment 2. Fitts' law's discontinuity appears, therefore, to be a suitable indicator of the underlying functional adaptations of the neuro-muscular-skeletal system to task properties/requirements, independently of reciprocal or discrete nature of the task. These findings open new perspectives to the study of dynamic regimes involved in discrete aiming and sensori-motor mechanisms underlying the speed-accuracy trade-off.

  4. Car ownership, car use and status. A consideration of policy aimed at efficient cars on the basis of happiness theories and the welfare economy; Autobezit, autogebruik en status. Een beschouwing van beleid gericht op zuiniger auto`s vanuit gelukstheorieen en de welvaartseconomie

    Energy Technology Data Exchange (ETDEWEB)

    Van Wee, G.P. [Rijksinstituut voor Volksgezondheid en Milieuhygiene RIVM, Bilthoven (Netherlands); Verhoef, E.T. [Vakgroep Ruimtelijke Economie, Vrije Universiteit, Amsterdam (Netherlands)

    1999-11-01

    After a certain ceiling has been reached (i.e. around $ 10,000), an increase in average income in any one country will not lead to increased personal happiness. Such additional earnings are, in all probability, expended rather on satisfying relative needs. Cars with a low fuel efficiency (big cars, and cars with powerful engines) possibly satisfy more relative needs than absolute needs. This is why a general trend towards more economical vehicles does not or hardly leads to a reduction in contentment: relative needs satisfaction, coupled with the status aspect, does not need to suffer from this. lt is the satisfying of relative needs and the emergence of status effects in consumption that is responsible for inefficient market functioning because of the occurrence of consumption externalities. There is therefore a welfare economic argument for adhering to a regulatory policy in which the consumption of relatively low status goods is encouraged while the consumption of relatively high status goods is discouraged. In view of the sharp price increases required to make the national car volume substantially more economical and in order to survive the considerable resistance that will be put up to such price rises, it might be preferable to introduce policies like `fee-bates` or negotiable rights rather than to wield price policies directed at effecting a trend in the direction of more economical car usage. 24 refs.

  5. Society of Interventional Radiology

    Science.gov (United States)

    ... Picture yourself in L.A. Register now SIR Essentials Purchase/register Search SIR's entire catalog for educational ... Quality Improvement Clinical practice MACRA Matters Health Policy, Economics, Coding Toolkits Society of Interventional Radiology 3975 Fair ...

  6. To Conclude: India can aim big

    Indian Academy of Sciences (India)

    ... Transmission and Distribution Losses. If 100 million middle class homes deploy 1 kW on rooftops. 100 GW peak power capacity added at homes alone; 40% of current peak power installed in India today. India must aim by 2030. To have 50% of its electric power from SOLAR; To have 50% of vehicles as Electric Vehicles ...

  7. Aims and harvest of moral case deliberation.

    Science.gov (United States)

    Weidema, Froukje C; Molewijk, Bert A C; Kamsteeg, Frans; Widdershoven, Guy A M

    2013-09-01

    Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.

  8. Pragmatics and the aims of language evolution.

    Science.gov (United States)

    Scott-Phillips, Thomas C

    2017-02-01

    Pragmatics has historically played a relatively peripheral role in language evolution research. This is a profound mistake. Here I describe how a pragmatic perspective can inform language evolution in the most fundamental way: by making clear what the natural objects of study are, and hence what the aims of the field should be.

  9. From Head Start to Sure Start: Reflections on Policy Transfer

    Science.gov (United States)

    Welshman, John

    2010-01-01

    This article uses the history of debates over the US Head Start programme (1965), Early Head Start (1994) and the UK Sure Start initiative (1998), as a window on to policy transfer. In all the three, the aim was that early intervention could offer a means of boosting children's educational attainment and of countering the wider effects of poverty…

  10. Participatory policy development for integrated watershed management in Uganda's highlands

    NARCIS (Netherlands)

    Mutekanga, F.P.

    2012-01-01

    Soil erosion is a serious problem in the densely populated Uganda highlands and previous interventions were ineffective. This study, on the Ngenge watershed, Mount Elgon, was aimed at developing policy for the implementation of a new strategy for solving the problem, Integrated Watershed

  11. Welfare effects of governmental interventions with a liberalized natural gas market. The Dutch natural gas exploitation policy. Report of an introduction and a reaction

    International Nuclear Information System (INIS)

    Verschoor, M.

    2006-01-01

    A report is given of a meeting of the Netherlands Association for Energy Legislation (NEVER), which was held in Amsterdam, Netherlands, April 2006. After the meeting a presentation was made about the report 'Government involvement in liberalised gas markets. A welfare-economic analysis of the Dutch gas-depletion policy' of the Netherlands Bureau for Economic Policy Analysis (CPB). This report analyses the welfare effects of two major components of the Dutch gas-depletion policy: the offtake guarantee for small-fields gas and the cap on production from the Groningen field. After the presentation a reaction was given to the report. Both presentations give an overview of the governmental policy and insight in the effects [nl

  12. Evaluation of caregiver-friendly workplace policy (CFWPs) interventions on the health of full-time caregiver employees (CEs): implementation and cost-benefit analysis

    OpenAIRE

    Williams, Allison M.; Tompa, Emile; Lero, Donna S.; Fast, Janet; Yazdani, Amin; Zeytinoglu, Isik U.

    2017-01-01

    Background Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (econom...

  13. Tutorial: Asteroseismic Stellar Modelling with AIMS

    Science.gov (United States)

    Lund, Mikkel N.; Reese, Daniel R.

    The goal of aims (Asteroseismic Inference on a Massive Scale) is to estimate stellar parameters and credible intervals/error bars in a Bayesian manner from a set of asteroseismic frequency data and so-called classical constraints. To achieve reliable parameter estimates and computational efficiency, it searches through a grid of pre-computed models using an MCMC algorithm—interpolation within the grid of models is performed by first tessellating the grid using a Delaunay triangulation and then doing a linear barycentric interpolation on matching simplexes. Inputs for the modelling consist of individual frequencies from peak-bagging, which can be complemented with classical spectroscopic constraints. aims is mostly written in Python with a modular structure to facilitate contributions from the community. Only a few computationally intensive parts have been rewritten in Fortran in order to speed up calculations.

  14. CURRICULUM MATTERS: Aims assessments and workplace needs

    Science.gov (United States)

    Black, Paul

    1997-09-01

    This paper attempts to consider the aims that undergraduate physics degree courses actually reflect and serve in the light of the employment patterns of graduates and of the expressed needs of employers. It reviews the results of analyses of what degree examinations actually test, and goes on to quote criticisms of their courses and radical proposals to change them adopted by the UK conference of physics professors. The discussion is then broadened by discussion of evidence, about the employment of graduates and about the priorities that some industrialists now give in the qualities that they look for when recruiting new graduates. The evidence leads to a view that radical changes are needed, both in courses and examinations, and that there is a need for university departments to work more closely with employers in re-formulating the aims and priorities in their teaching.

  15. Aims and methods of nuclear materials management

    International Nuclear Information System (INIS)

    Leven, D.; Schier, H.

    1979-05-01

    Whilst international safeguarding of fissile materials against abuse has been the subject of extensive debate, little public attention has so far been devoted to the internal security of these materials. All countries using nuclear energy for peaceful purposes have laid down appropriate regulations. In the Federal Republic of Germany safeguards are required, for instance, by the Atomic Energy Act, and are therefore a prerequisite for licensing. The aims and methods of national nuclear materials management are contrasted with viewpoints on international safeguards

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

    DEFF Research Database (Denmark)

    Bergenholtz, Henning; Johnsen, Mia

    2006-01-01

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

  17. Population-level interventions to reduce alcohol-related harm: an overview of systematic reviews.

    Science.gov (United States)

    Martineau, Fred; Tyner, Elizabeth; Lorenc, Theo; Petticrew, Mark; Lock, Karen

    2013-10-01

    To analyse available review-level evidence on the effectiveness of population-level interventions in non-clinical settings to reduce alcohol consumption or related health or social harm. Health, social policy and specialist review databases between 2002 and 2012 were searched for systematic reviews of the effectiveness of population-level alcohol interventions on consumption or alcohol-related health or social outcomes. Data were extracted on review research aim, inclusion criteria, outcome indicators, results, conclusions and limitations. Reviews were quality-assessed using AMSTAR criteria. A narrative synthesis was conducted overall and by policy area. Fifty-two reviews were included from ten policy areas. There is good evidence for policies and interventions to limit alcohol sale availability, to reduce drink-driving, to increase alcohol price or taxation. There is mixed evidence for family- and community-level interventions, school-based interventions, and interventions in the alcohol server setting and the mass media. There is weak evidence for workplace interventions and for interventions targeting illicit alcohol sales. There is evidence of the ineffectiveness of interventions in higher education settings. There is a pattern of support from the evidence base for regulatory or statutory enforcement interventions over local non-regulatory approaches targeting specific population groups. © 2013.

  18. Rifkin takes aim at USDA animal research.

    Science.gov (United States)

    Fox, Jeffrey L

    1984-10-19

    Jeremy Rifkin has filed a lawsuit to block U.S. Department of Agriculture (USDA) experiments involving the transfer of human growth hormone genes into sheep and pigs, which he rejects on environmental, economic, and ethical grounds. His real target is the Department's animal breeding program; his ultimate aim is "to establish the principle that there should be no crossing of species barriers in animals." USDA officials have not yet responded to the lawsuit but they intend to continue the experiments, which they consider crucial to the progress of research, until told to stop.

  19. The aims of transfer prices formation

    Directory of Open Access Journals (Sweden)

    Tomašević Stevan

    2013-01-01

    Full Text Available More than two-thirds of today's world trade comprises of transactions between related legal persons. Prices for the above-mentioned transactions within legal person or group of related legal persons are called transfer pricing. The aim of this paper is to present the transfer prices as well as the main objectives of transfer pricing. Also, this paper explains application of transfer pricing in the Republic of Serbia and the normative rules that cover the issue of transfer pricing, their determination and their application in the calculation. Overall, there has been a great deal of attention paid to the transfer pricing in national and international levels.

  20. Intervención por invitación Claves de la política exterior colombiana y de sus debilidades principales / Intervention by Invitation Keys to Colombian Foreign Policy and its Main Shortcomings

    Directory of Open Access Journals (Sweden)

    Arlene B. Tickner

    2007-06-01

    Full Text Available This article develops the thesis that the internationalization of the Colombian armed conflict has been carried out using a strategy denominated “intervention by invitation”, by which the governments of Andrés Pastrana and Álvaro Uribe intensified Colombia’s association with the United States and requested greater involvement by that country in domestic affairs related to counternarcotics and counterinsurgency. The author discusses a series of conceptual frameworks that allow her to situate this strategy, following which she examines the evolution of Colombian foreign policy during the two periods identified.

  1. Aims and methods of education: A recapitulation

    Directory of Open Access Journals (Sweden)

    Pantić Nataša

    2007-01-01

    Full Text Available This paper gives an overview of principal distinction between the aims of the so-called "traditional" and "progressive" education and respective pedagogies associated with each. The term "traditional" education is used to denote the kind of education that prepares people for their role in society as it is, while the term "progressive" is used for education that aspires to equip mankind with capacity to shape the change of society. The paper raises some critical questions about the role of pedagogy in achieving the aims of the progressive model, arguing that the employment of "progressive" methods does not necessarily guarantee the achievement of the commonly professed purposes of progressive education. This is illustrated in the paper by the results of a study in English schools showing how despite the claim of progressive methods, teachers tend to retain traditional attitudes and on the other hand, how even traditional teaching methods can serve the progressive purpose. This is not to advocate for the traditional pedagogy, but to suggest that it might be something other than pedagogy that makes a critical difference in educating liberal-minded citizens of the future. In this sense the paper explores the role of other factors that make a difference towards progressive education, such as democratization of human relations in school ethos and respect for children's freedom.

  2. AIM cryocooler developments for HOT detectors

    Science.gov (United States)

    Rühlich, I.; Mai, M.; Withopf, A.; Rosenhagen, C.

    2014-06-01

    Significantly increased FPA temperatures for both Mid Wave and Long Wave IR detectors, i.e. HOT detectors, which have been developed in recent years are now leaving the development phase and are entering real application. HOT detectors allowing to push size weight and power (SWaP) of Integrated Detectors Cooler Assemblies (IDCA's) to a new level. Key component mainly driving achievable weight, volume and power consumption is the cryocooler. AIM cryocooler developments are focused on compact, lightweight linear cryocoolers driven by compact and high efficient digital cooler drive electronics (DCE) to also achieve highest MTTF targets. This technology is using moving magnet driving mechanisms and dual or single piston compressors. Whereas SX030 which was presented at SPIE in 2012 consuming less 3 WDC to operate a typical IDCA at 140K, next smaller cooler SX020 is designed to provide sufficient cooling power at detector temperature above 160K. The cooler weight of less than 200g and a total compressor length of 60mm makes it an ideal solution for all applications with limited weight and power budget, like in handheld applications. For operating a typical 640x512, 15μm MW IR detector the power consumption will be less than 1.5WDC. MTTF for the cooler will be in excess of 30,000h and thus achieving low maintenance cost also in 24/7 applications. The SX020 compressor is based on a single piston design with integrated passive balancer in a new design achieves very low exported vibration in the order of 100mN in the compressor axis. AIM is using a modular approach, allowing the chose between 5 different compressor types for one common Stirling expander. The 6mm expander with a total length of 74mm is now available in a new design that fits into standard dewar bores originally designed for rotary coolers. Also available is a 9mm coldfinger in both versions. In development is an ultra-short expander with around 35mm total length to achieve highest compactness. Technical

  3. Mapping evidence of interventions and strategies to bridge the gap in the implementation of the prevention of mother-to-child transmission of HIV programme policy in sub-Saharan countries: A scoping review.

    Science.gov (United States)

    Ngidi, Wilbroda H; Naidoo, Joanne R; Ncama, Busisiwe P; Luvuno, Zamasomi P B; Mashamba-Thompson, Tivani P

    2017-05-29

    Prevention of mother-to-child transmission (PMTCT) of HIV is a life-saving public health intervention. Sub-Saharan African (SSA) countries have made significant progress in the programme, but little is known about the strategies used by them to eliminate mother-to-child transmission of HIV. To map evidence of strategies and interventions employed by SSA in bridging the implementation gap in the rapidly changing PMTCT of HIV programme policy. Electronic search of the databases MEDLINE, PubMed and SABINET for articles published in English between 2001 and August 2016. Key words included 'Sub-Saharan African countries', 'implementation strategies', 'interventions to bridge implementation gap', 'prevention of mother-to-child transmission of HIV' and 'closing implementation gap'. Of a total of 743 articles, 25 articles that met the inclusion criteria were included in the study. Manual content analysis resulted in the identification of three categories of strategies: (1) health system (referral systems, integration of services, supportive leadership, systematic quality-improvement approaches that vigorously monitors programme performance); (2) health service delivery (task shifting, networking, shared platform for learning, local capacity building, supportive supervision); as well as (3) community-level strategies (community health workers, technology use - mHealth, family-centred approaches, male involvement, culturally appropriate interventions). There are strategies that exist in SSA countries. Future research should examine multifaceted scientific models to prioritise the highest impact and be evaluated for effectiveness and efficiency.

  4. Plasma health care - Aims, constraints and progress

    International Nuclear Information System (INIS)

    Morfill, G.E.; Zimmerman, J.L.

    2013-01-01

    Health Care covers three areas of interest for cold atmospheric pressure plasmas: Cosmetics, Hygiene and Medicine. These areas can be subdivided into personal and professional care. In this review will concentrate on Hygiene and Medicine. In professional hygiene the most important plasma contribution is sterilization, decontamination and disinfection. The main aim is the prevention of diseases or their containment. Progress in the development of efficient bactericidal plasma sources has been rapid, so that it appears realistic to use plasmas to combat nosocomial infections as well as community associated infections in the not too distant future. The advantages of plasma devices – they use air and electricity only, there are no waste products, they are inexpensive to manufacture and operate, easy to transport and install, and bactericidal effects are fast (seconds). Plasmas can efficiently kill resistant bacteria (e.g. MRSA) and tests have shown no resistance build-up so far. With an estimated 2 Million hospital induced infections each year in the US alone, and about 100.000 resulting deaths, very efficient, safe and fast hospital plasma hygiene devices would appear to be a very important weapon to help contain the spread of infectious diseases. In Medicine there are a number of ambitious ideas and aims. Plasmas can be “designed” to some extent. They can include different active species that can have an effect at the cellular level. There are ionic atoms and molecules, whose medical use need to be evaluated – the vision is that a new area of “plasma pharmacy” could develop. First steps are currently being taken in biological studies. Also the excited atoms in cold atmospheric plasmas may make cell walls more permeable for such species. (author)

  5. Locally specific measures for employment aimed at regional development

    Directory of Open Access Journals (Sweden)

    Vladimir Cini

    2013-12-01

    Full Text Available The oldest and largest sub-region in the world functioning on the principle of economic union is the European Union. The creation of a single market has initiated the process of conditional adjustment of markets in the EU member states, which has a significant impact on the social welfare of its citizens. It is necessary to tackle this issue by joint efforts within the European Union. As globalization processes push for economic integration and development of competitive advantage, the regions will have to make some challenging adjustments. The development tends to concentrate in highly competitive regions, while regions in the periphery lag behind. However, this pertains not only to the economic lag, but also to a potential negative political situation. Locally specific active employment policy measures are a continuation of the effort to make these measures more flexible. They refer to the Joint Assessment of Employment Policy Priorities and the IPA Human Resources Development Operational Programme - a regional policy instrument of the European Union. Both documents highlight the issue of disproportional development of regions, which requires special local measures and active labour market policy programmes. To reduce regional differences in development, it is necessary to invest more resources in the regions that lag behind. In this particular case, this means the counties in Croatia with high unemployment rates, a large number of registered unemployed persons and low employment rate. Consequently, this paper explains the importance of the adoption of locally specific measures for employment, which unfortunately did not take hold in the Republic of Croatia, and highlights the need for further decentralization of public services, with the aim of balancing regional development

  6. Social policies and the pathways to inequalities in health

    DEFF Research Database (Denmark)

    Whitehead, M; Burström, B; Diderichsen, Finn

    2000-01-01

    in relation to the identified policy entry points. Overall, in Britain, around 50% of the health disadvantage of lone mothers is accounted for by the mediating factors of poverty and joblessness, whereas in Sweden these factors only account for between 3% and 13% of the health gap. The final section discusses......The aim of this study is to contribute to the emerging field of health inequalities impact assessment. It develops further a conceptual framework that encompasses the policy context as well as the pathways leading from social position to inequalities in health. It then uses this framework...... the implications of the findings for future policy intervention and research in the two countries....

  7. The Relationship of Students' Awareness on Drug Policy, Procedures, and Intervention Programs to the Drug and Alcohol Use on College Campuses: A Correlational Study

    Science.gov (United States)

    Love-Quick, Sharon J.

    2016-01-01

    One of the most pressing concerns that universities and colleges face today is the drug and alcohol abuse of students. In order to address this, there is a need to strengthen university policies in order to mitigate the increasing rate and cases of drug and alcohol abuse among students. The purpose of this quantitative study was to examine the…

  8. On correlations in IMRT planning aims

    Science.gov (United States)

    Roy, Arkajyoti; Das, Indra J.

    2016-01-01

    The purpose was to study correlations amongst IMRT DVH evaluation points and how their relaxation impacts the overall plan. 100 head‐and‐neck cancer cases, using the Eclipse treatment planning system with the same protocol, are statistically analyzed for PTV, brainstem, and spinal cord. To measure variations amongst the plans, we use (i) interquartile range (IQR) of volume as a function of dose, (ii) interquartile range of dose as a function of volume, and (iii) dose falloff. To determine correlations for institutional and ICRU goals, conditional probabilities and medians are computed. We observe that most plans exceed the median PTV dose (average D50 = 104% prescribed dose). Furthermore, satisfying D50 reduced the probability of also satisfying D98, constituting a negative correlation of these goals. On the other hand, satisfying D50 increased the probability of satisfying D2, suggesting a positive correlation. A positive correlation is also observed between the PTV V105 and V110. Similarly, a positive correlation between the brainstem V45 and V50 is measured by an increase in the conditional median of V45, when V50 is violated. Despite the imposed institutional and international recommendations, significant variations amongst DVH points can occur. Even though DVH aims are evaluated independently, sizable correlations amongst them are possible, indicating that some goals cannot be satisfied concurrently, calling for unbiased plan criteria. PACS number(s): 87.55.dk, 87.53.Bn, 87.55.Qr, 87.55.de. PMID:27929480

  9. Computational Models Used to Assess US Tobacco Control Policies.

    Science.gov (United States)

    Feirman, Shari P; Glasser, Allison M; Rose, Shyanika; Niaura, Ray; Abrams, David B; Teplitskaya, Lyubov; Villanti, Andrea C

    2017-11-01

    Simulation models can be used to evaluate existing and potential tobacco control interventions, including policies. The purpose of this systematic review was to synthesize evidence from computational models used to project population-level effects of tobacco control interventions. We provide recommendations to strengthen simulation models that evaluate tobacco control interventions. Studies were eligible for review if they employed a computational model to predict the expected effects of a non-clinical US-based tobacco control intervention. We searched five electronic databases on July 1, 2013 with no date restrictions and synthesized studies qualitatively. Six primary non-clinical intervention types were examined across the 40 studies: taxation, youth prevention, smoke-free policies, mass media campaigns, marketing/advertising restrictions, and product regulation. Simulation models demonstrated the independent and combined effects of these interventions on decreasing projected future smoking prevalence. Taxation effects were the most robust, as studies examining other interventions exhibited substantial heterogeneity with regard to the outcomes and specific policies examined across models. Models should project the impact of interventions on overall tobacco use, including nicotine delivery product use, to estimate preventable health and cost-saving outcomes. Model validation, transparency, more sophisticated models, and modeling policy interactions are also needed to inform policymakers to make decisions that will minimize harm and maximize health. In this systematic review, evidence from multiple studies demonstrated the independent effect of taxation on decreasing future smoking prevalence, and models for other tobacco control interventions showed that these strategies are expected to decrease smoking, benefit population health, and are reasonable to implement from a cost perspective. Our recommendations aim to help policymakers and researchers minimize harm and

  10. Science and policy on endocrine disrupters must not be mixed: a reply to a “common sense” intervention by toxicology journal editors

    DEFF Research Database (Denmark)

    Bergman, Åke; Andersson, Anna-Maria; Becher, Georg

    2013-01-01

    The “common sense” intervention by toxicology journal editors regarding proposed European Union endocrine disrupter regulations ignores scientific evidence and well-established principles of chemical risk assessment. In this commentary, endocrine disrupter experts express their concerns about a r...

  11. Prevention of Falls Network Europe: a thematic network aimed at introducing good practice in effective falls prevention across Europe.

    Science.gov (United States)

    Skelton, D A; Becker, C; Lamb, S E; Close, J C T; Zijlstra, W; Yardley, L; Todd, C J

    2004-12-01

    The Prevention of Falls Network Europe (ProFaNE) aims to improve quality of life of the ageing population by focussing on a major cause of disability and distress: falls. The thematic network is funded by the European Commission and brings together scientists, clinicians and other health professionals from around Europe to focus on four main themes: taxonomy and coordination of trials, clinical assessment and management of falls, assessment of balance function, and psychological aspects of falling. There are 24 members across Europe as well as network associates who contribute expertise at workshops and meetings. ProFaNE, a 4-year project which started in January 2003, aims to improve and standardise health care processes, introducing and promoting good practice widely across Europe. ProFaNE undertakes workshops that bring together experts and observers around specific topics to exchange knowledge, expertise and resources on interventions that reduce falls. A key document for policy makers around Europe, written by ProFaNE members, was published by the World Health Organisation in March 2004. ProFaNE's website has both public and private areas with resources (web links to falls prevention, useful documents for policy makers, researchers and practitioners) and a discussion board to encourage informal networking between members and the public. The ultimate aim of ProFaNE is to submit a collaborative bid to undertake a multi-centre, randomised controlled trial of a multi-factorial fall prevention intervention with peripheral fracture as the primary outcome. The success of the networking and relationship building in the first year and a half of ProFaNE's work makes this an achievable goal.

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

    Science.gov (United States)

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

    2013-11-01

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

  13. Políticas públicas en la Ciudad de Buenos Aires dirigidas a juventudes vulnerables: Continuidades y transformaciones en la última década Políticas públicas na cidade de Buenos Aires destinadas a jovens vulneráveis: Continuidades e transformações ao longo da última década Public policy in the city of Buenos Aires aimed at vulnerable youth: Continuities and transformations in the last decade

    Directory of Open Access Journals (Sweden)

    Liliana Raggio

    2012-07-01

    íticas recentes e conseqüências socioculturais das políticas neoliberais nos países da região.As part of broader research on public policy aimed at vulnerable youth in the City of Buenos Aires, this article discusses a set of programs based on diagnosis regarding urban "insecurity" in general, and youth at risk in particular. Specifically, it addresses the so-called "Crime Prevention Plan" and various actions of cultural policy, reflecting on their characteristics and possible convergence, which bring into play social representations regarding the relationship between crime, culture and vulnerable youth. Through case studies and considering public policy recommendations aimed at youth from various international agencies and institutions, the emphasis and agendas of our own Latin American region are underlined, in relation to recent political changes and socio-cultural consequences of neoliberal policies in the region.

  14. Improving Knowledge, Awareness, and Use of Flexible Career Policies through an Accelerator Intervention at the University of California, Davis, School of Medicine

    OpenAIRE

    Villablanca, Amparo C.; Beckett, Laurel; Nettiksimmons, Jasmine; Howell, Lydia P.

    2013-01-01

    The challenges of balancing a career and family life disproportionately affect women in academic health sciences and medicine, contributing to their slower career advancement and/or their attrition from academia. In this article, the authors first describe their experiences at the University of California, Davis, School of Medicine developing and implementing an innovative accelerator intervention designed to promote faculty work-life balance by improving knowledge, awareness, and access to c...

  15. Agricultural policy schemes

    DEFF Research Database (Denmark)

    Hansen, Henning Otte

    2016-01-01

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

  16. Ecolabel and ecodesign. Aims impossible for small and medium companies?

    International Nuclear Information System (INIS)

    Luciani, R.; Andriola, L.; Masoni, P.

    2000-01-01

    It is commonly held by now that a policy of sustainable development in the production sector cannot be faced in terms of simply reducing the environmental impact at the end of the production chain but should be imprinted with a preventive approach which, intervening on the production cycles and the products themselves, helps minimize pressure on the environment. To be competitive manufacturing industry must contribute a determinant amount to sustainable development by reducing the material content of products and increasing their use value, through processes and products-services that are innovative, safer, cleaner and based on a low use of natural resources. To be effective and avoid merely shifting the problem, this work should not be aimed at the level of individual plants or industries but be broadly planned, taking into account the entire value chain and hence the product's whole life-cycle. In addition, support should be given to small and medium-sized companies that characterize Italian production, because they find it hard to use the tools of a product policy originally ideated for big business [it

  17. Environment based innovation: policy questions

    Directory of Open Access Journals (Sweden)

    Mario Rui Silva

    2009-12-01

    Full Text Available Natural resources and physical cultural resources, referred to in this paper as “Environmental Resources”, can be important assets for regional competitiveness and innovation. In recent years, these types of assets have been increasingly taken into consideration in the design and implementation of regional development strategies, as a consequence of their potential role as a source of differentiation and of new competitive advantages. However, in contrast to environmental policies, which usually focus on the protection of the environment, innovation policies and their instruments are largely shaped by, and geared towards, knowledge-based innovation.In this paper, we discuss the role played by environmental resources in the context of regional innovation policies. We begin by discussing the relationship between environmental resources and regional development, and by emphasizing some contrasting views with regard to the function of environmental resources in regional development. Then, we address the relationship between regional competitive advantages and innovation strategies. The specific issues and problems that arise whenever the aim is to attain competitive advantages through the valorisation of environmental resources constitute the core of section III. In that section, we highlight the specific characteristics of environmental resources and we discuss the applicability of the “natural resource curse” argument to the dynamics based on the valorisation of environmental resources. The reasons that justify public interventionas well as the difficulties concerning the adequate level of intervention (local / regional / national are also examined. The paper ends with some conclusions and policy implications.

  18. POLÍTICAS PÚBLICAS PARA INCENTIVAR EL ACCESO A LA FINANCIACIÓN DE LAS PYMES EN ESPAÑA: EL MERCADO ALTERNATIVO BURSÁTIL (MAB / PUBLIC POLICY TO PROMOTE ACCESS TO FINANCING OF SMES IN SPAIN: THE ALTERNATIVE INVESTMENT MARKET (AIM

    Directory of Open Access Journals (Sweden)

    Álvaro GONZÁLEZ LORENTE

    2012-09-01

    Full Text Available La crisis económica actual ha afectado a las posibilidades de captación de financiación de las pequeñas y medianas empresas españolas. Al endurecimiento de las condiciones crediticias hay que sumarle también el aumento del riesgo debido, por un lado, al incremento de la morosidad y, por otro, a la caída del volumen de ventas provocado tanto por la notable pérdida de poder adquisitivo de los consumidores como por el aumento de su desconfianza. En este contexto el Mercado Alternativo Bursátil –en adelante MAB-, surge como un mercado de valores creado y destinado a proveer de financiación a empresas de menor capitalización que, no obstante, desean expandirse y poder llegar a más mercados de lo que su propia estructura financiera podría permitir. El principal objetivo del MAB es dotar de recursos financieros, mediante la aportación de recursos propios, a empresas en fase de expansión, tanto nacional como internacional. En el presente trabajo se analizarán las principales características de este novedoso mercado, así como las ventajas fiscales que incorpora tanto para los inversores como para las empresas. / The current economic crisis has affected the chances of attracting financing of small and medium-sized Spanish companies. To the tightening of credit conditions we must add also the increased risk because, on the one hand, the increase in defaults and, secondly, the fall in sales volume caused both by the significant loss of purchasing power of consumers as by increasing distrust. In this context the Alternative Investment Market (AIM, emerges as an alternative stock exchange market to provide financing to smaller companies, that however, want to expand and reach more markets than its own financial structure could afford. The main objective of the AIM is to provide financial resources, by increasing equity to companies undergoing expansion, both nationally and internationally. In this paper we analyze the main characteristics

  19. Interventions to Promote an Integrated Approach to Public Health Problems: An Application to Childhood Obesity

    Directory of Open Access Journals (Sweden)

    Anna-Marie Hendriks

    2012-01-01

    Full Text Available Experts stress the need to bring the childhood obesity epidemic under control by means of an integrated approach. The implementation of such an approach requires the development of integrated enabling policies on public health by local governments. A prerequisite for developing such integrated public health policies is intersectoral collaboration. Since the development of integrated policies is still in its early stages, this study aimed to answer the following research question: “What interventions can promote intersectoral collaboration and the development of integrated health policies for the prevention of childhood obesity?” Data were collected through a literature search and observations of and interviews with stakeholders. Based on a theoretical framework, we categorized potential interventions that could optimize an integrated approach regarding children's physical activity and diet. The intervention categories included education, persuasion, incentivization, coercion, training, restriction, environmental restructuring, modeling, and enablement.

  20. Política Social e Serviço Social: os desafios da intervenção profissional Social Policy and Social Work: the challenges of professional intervention

    Directory of Open Access Journals (Sweden)

    Regina Celia Tamaso Mioto

    2013-01-01

    Full Text Available Este artigo discute política social e Serviço Social e os desafios que esta relação apresenta para a intervenção profissional. Enfatiza o florescimento e o aprofundamento desse debate ao longo das duas últimas décadas do século 20, e a sua consolidação no início do século 21, que se expressam através da consistente produção de conhecimento e da inserção peculiar dos órgãos representativos da categoria profissional no processo de luta pela institucionalização das políticas públicas compatíveis com os valores contidos no Código de Ética Profissional dos assistentes sociais. O enfoque maior recai sobre a questão da intervenção dos assistentes sociais, no campo da política social, ao implementar o projeto profissional, comprometido com a defesa dos direitos sociais de caráter universal. Nessa perspectiva, trata a política social como um campo contraditório, permeado por interesses e projetos societários antagônicos, no qual se reatualizam questões diretamente articuladas à especificidade e à autonomia profissional.This article discusses social policy and Social Work and the challenges that their relationship presents for professional intervention. It emphasizes the flourishing and deepening of the debate about this issue in the past two decades of the 20th century, and its consolidation in the early 21st century, which is expressed through the constant production of knowledge and the peculiar insertion of agencies that represent the professional category in the struggle for the institutionalization of public policies compatible with the values found in the Code of Professional Ethics for social workers. The strongest focus is on the issues of the intervention of social workers in the field of social policy, through implementation of the professional project, committed to defending social rights of a universal character. From this perspective, it involves social policy as a contradictory field that is permeated

  1. A Triple Aim Framework For the Performance Assessment of Disease Management Programs

    NARCIS (Netherlands)

    Verbeek, N.A.; M.G. Franken (Margreet); M.A. Koopmanschap (Marc); M.P.M.H. Rutten-van Mölken (Maureen)

    2015-01-01

    markdownabstractObjectives: A structured and comprehensive assessment of disease management implementations is not straightforward due to the broadness of the interventions and the various evaluation possibilities. The aim of this study was to develop a comprehensive framework for outcome

  2. Public Policy and the Prison System Failure Brazil: Legal Theses 17 and 18 of the Attorney General's Office - Ago, and Immediate Intervention Judicial Power

    Directory of Open Access Journals (Sweden)

    Daniela Carvalho Almeida Da Costa

    2015-12-01

    Full Text Available The purpose of this paper is to analyze the legal feasibility of the judiciary determine the Executive to carry out works in prisons; confronting the reservation of the theory of financially possible and the immediate applicability of explicit fundamental rights in the Constitution, and the latest understanding of our Constitutional Court on the subject. Thus, it was taken as a backdrop the extraordinary appeal object if 592 581 / RS - which resulted in the legal arguments of nos 17 and 18 of the Attorney General - PGR, which concerned about the problem of "judicial control policies public "to ensure the preservation of the fundamental right to physical and moral integrity of prisoners, including renovation, expansion and construction of prisons in the event of failure of state entities. Finally, there was a brief analysis of the structural crisis of the Brazilian prison system, sign flagrant violation of the supreme value of human dignity.

  3. 'Are you still on that stupid diet?': women's experiences of societal pressure and support regarding weight loss, and attitudes towards health policy intervention.

    Science.gov (United States)

    Whale, Katie; Gillison, Fiona B; Smith, Paula C

    2014-12-01

    This study investigated how people's attitudes and motivations towards losing weight are influenced by societal pressures surrounding weight loss, their interaction with the obesogenic environment and individuals' attitudes and motivations towards weight. Semi-structured qualitative interviews were conducted with 10 women currently attending commercial weight-loss programmes. Participants experienced conflicting messages regarding weight norms, with the media portraying powerful social norms relating to thinness and beauty, and changes to the food environment and interactions with family and friends commonly undermining weight-loss activities and promoting increased consumption. Providing social and environmental support for the behaviours needed to produce weight loss may need to be a primary focus for obesity policy. © The Author(s) 2013.

  4. EUROPEAN MARITIME TRANSPORT POLICY

    Directory of Open Access Journals (Sweden)

    Jerzy Kujawa

    2014-03-01

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

  5. Pursuing the Triple Aim: The First 7 Years.

    Science.gov (United States)

    Whittington, John W; Nolan, Kevin; Lewis, Ninon; Torres, Trissa

    2015-06-01

    POLICY POINTS: In 2008, researchers at the Institute for Healthcare Improvement (IHI) proposed the Triple Aim, strategic organizing principles for health care organizations and geographic communities that seek, simultaneously, to improve the individual experience of care and the health of populations and to reduce the per capita costs of care for populations. In 2010, the Triple Aim became part of the US national strategy for tackling health care issues, especially in the implementation of the Patient Protection and Affordable Care Act (ACA) of 2010. Since that time, IHI and others have worked together to determine how the implementation of the Triple Aim has progressed. Drawing on our 7 years of experience, we describe 3 major principles that guided the organizations and communities working on this endeavor: creating the right foundation for population management, managing services at scale for the population, and establishing a learning system to drive and sustain the work over time. In 2008, researchers at the Institute for Healthcare Improvement (IHI) described the Triple Aim as simultaneously "improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations." IHI and its close colleagues had determined that both individual and societal changes were needed. In 2007, IHI began recruiting organizations from around the world to participate in a collaborative to implement what became known as the Triple Aim. The 141 participating organizations included health care systems, hospitals, health care insurance companies, and others closely tied to health care. In addition, key groups outside the health care system were represented, such as public health agencies, social services groups, and community coalitions. This collaborative provided a structure for observational research. By noting the contrasts between the contexts and structures of those sites in the collaborative that progressed and

  6. Using media to impact health policy-making: an integrative systematic review.

    Science.gov (United States)

    Bou-Karroum, Lama; El-Jardali, Fadi; Hemadi, Nour; Faraj, Yasmine; Ojha, Utkarsh; Shahrour, Maher; Darzi, Andrea; Ali, Maha; Doumit, Carine; Langlois, Etienne V; Melki, Jad; AbouHaidar, Gladys Honein; Akl, Elie A

    2017-04-18

    Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media interventions-including social media-on the health policy-making process. Eligible study designs included randomized and non-randomized designs, economic studies, process evaluation studies, stakeholder analyses, qualitative methods, and case studies. We electronically searched Medline, EMBASE, Communication and Mass Media Complete, Cochrane Central Register of Controlled Trials, and the WHO Global Health Library. We followed standard systematic review methodology for study selection, data abstraction, and risk of bias assessment. Twenty-one studies met our eligibility criteria: 10 evaluation studies using either quantitative (n = 7) or qualitative (n = 3) designs and 11 case studies. None of the evaluation studies were on social media. The findings of the evaluation studies suggest that media interventions may have a positive impact when used as accountability tools leading to prioritizing and initiating policy discussions, as tools to increase policymakers' awareness, as tools to influence policy formulation, as awareness tools leading to policy adoption, and as awareness tools to improve compliance with laws and regulations. In one study, media-generated attention had a negative effect on policy advocacy as it mobilized opponents who defeated the passage of the bills that the media intervention advocated for. We judged the confidence in the available evidence as limited due to the risk of bias in the included studies and the indirectness of the evidence. There is currently a lack of reliable evidence to guide decisions on the use of media interventions to influence health policy-making. Additional and better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and

  7. Analysis of the decision-support function of policy assessment in real-world policy making in the field of poverty and social inequalities. Case study on migrant integration policies in the Brussels-Capital Region

    International Nuclear Information System (INIS)

    Feyaerts, Gille; Deguerry, Murielle; Deboosere, Patrick; De Spiegelaere, Myriam

    2017-01-01

    Despite its high potential to support decision-making, the role of policy assessment in real-world policy making in the field of poverty and social inequalities remains largely questioned. In this study, we analyse policy assessment's role in a context of real-world policymaking, by means of a case study on a legislative proposal on integration policy for immigrant newcomers in the Brussels-Capital Region, for which we evaluate the potential effects on poverty and social inequalities. We first analyse the policy process surrounding the policy proposal – a process that is often treated as a black box within policy assessment research. Understanding the factors that influence and determine the decision-making process, enables us to gain insight into the potential decision-support function(s). Second, we develop an approach to policy assessment that aims to fully exploit its potential to contribute to the functions of both instrumental and conceptual learning. For this purpose, we propose to introduce the approach of realist evaluation and to focus on evaluating the underlying policy intervention theory from the perspective of poverty and social inequalities. Finally, we illustrate this new approach and its added value by applying it to the legislative proposal on integration policy and analyse its contribution to policy-oriented learning. - Highlights: •The field of policy assessment should draw on insights from policy studies. •We unpacked the policymaking black-box to identify the mechanisms of policy change. •The policy process is driven by an interaction of ideas, interests and institutions. •Policy assessment's potential lies in both instrumental and conceptual learning. •We propose to integrate realist evaluation's logic of inquiry within policy assessment.

  8. What works in inclusion health: overview of effective interventions for marginalised and excluded populations.

    Science.gov (United States)

    Luchenski, Serena; Maguire, Nick; Aldridge, Robert W; Hayward, Andrew; Story, Alistair; Perri, Patrick; Withers, James; Clint, Sharon; Fitzpatrick, Suzanne; Hewett, Nigel

    2017-11-10

    Inclusion health is a service, research, and policy agenda that aims to prevent and redress health and social inequities among the most vulnerable and excluded populations. We did an evidence synthesis of health and social interventions for inclusion health target populations, including people with experiences of homelessness, drug use, imprisonment, and sex work. These populations often have multiple overlapping risk factors and extreme levels of morbidity and mortality. We identified numerous interventions to improve physical and mental health, and substance use; however, evidence is scarce for structural interventions, including housing, employment, and legal support that can prevent exclusion and promote recovery. Dedicated resources and better collaboration with the affected populations are needed to realise the benefits of existing interventions. Research must inform the benefits of early intervention and implementation of policies to address the upstream causes of exclusion, such as adverse childhood experiences and poverty. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Policy bill of program on the radioactive materials and wastes management. Press conference. Intervention of Francois Loos, Ministry delegate to the Industry

    International Nuclear Information System (INIS)

    2006-01-01

    This document provides the presentation of Francois Loos concerning the policy bill on the program of radioactive materials and wastes. Three axis of researches are decided: the separation and transmutation, the deep underground disposal and long dated storage and conditioning processes. The bill institutes a national radioactive materials and waste management plan and defines a programme and calendar for research and work leading to implementation of this plan, which will comprise three major points: with a view to looking to reduce the quantity of waste, spent nuclear fuels taken from the nuclear power plants will be reprocessed for recycling in the plants; waste which cannot be recycled will be packaged in a robust matrix and then temporarily stored on the surface; after interim storage, waste which cannot be finally disposed of in a surface facility, will be placed in a deep geological reversible repository. In order to monitor each step in this plan, the bill strengthens independent assessment of research and involves greater information of the public. With regard to financing, the bill clarifies the fact that economic development of the departments concerned by research into disposal options and the research itself will be financed by additional taxes on the operators of nuclear installations. (A.L.B.)

  10. Social Marketing Interventions Aiming to Increase Physical Activity among Adults: A Systematic Review

    Science.gov (United States)

    Kubacki, Krzysztof; Ronti, Rimante; Lahtinen, Ville; Pang, Bo; Rundle-Thiele, Sharyn

    2017-01-01

    Purpose: A significant proportion of the world's adult population is insufficiently active. One approach used to overcome barriers and facilitate participation in physical activity is social marketing. The purpose of this paper are twofold: first, this review seeks to provide a contemporary review of social marketing's effectiveness in changing…

  11. Risks and benefits of the interventions aimed at minimizing nuclear damage in the Chernobyl accident

    International Nuclear Information System (INIS)

    Rossiello, L.A.; Failla, L.

    1997-01-01

    The damages that the absorption of ionizing radiation (i.r.) can cause to humans may be classified as 1) nonstochastic (somatic or deterministic) or 2) stochastic (probabilistic) , which result, for example, from high doses of i.r. absorbed after a serious nuclear accident. Though the Chernobyl case involved both kinds of damage, this paper deals only with stochastic damage risk, and confine our considerations to individuals who were directly Affected and received high i.r. doses. The purpose of this paper is to provide elements on which to base future decisions on the evacuation and return of populations affected by serious nuclear accidents. Unlike the abundant literature on the subject, and as a necessary complement thereto within the bounds of a strict synthesis, to identify the most significant parameters applicable to single individuals rather than to the population at large, and referring solely to risks of stochastic damage

  12. Mathematical Literacy in Plant Physiology Undergraduates: Results of Interventions Aimed at Improving Students' Performance

    Science.gov (United States)

    Vila, Francisca; Sanz, Amparo

    2013-01-01

    The importance of mathematical literacy in any scientific career is widely recognized. However, various studies report lack of numeracy and mathematical literacy in students from various countries. In the present work, we present a detailed study of the mathematical literacy of Spanish undergraduate students of Biology enrolled in a Plant…

  13. Realist Review of Programs, Policies, and Interventions to Enhance the Social, Emotional, and Spiritual Well-Being of Aboriginal and Torres Strait Islander Young People Living in Out-of-Home Care

    Directory of Open Access Journals (Sweden)

    Sophie Lindstedt

    2017-07-01

    Full Text Available The child protection system in Australia includes out-of-home care (OoHC for children and young people at risk of harm and neglect. In Australia, Aboriginal and Torres Strait Islander children and young people are 9 times more likely to be placed in care than non-Aboriginal young people (Australian Institute of Health and Welfare, 2015. Australia’s history of colonization and subsequent policies have caused trauma to individuals, families, and communities and resulted in poor physical and mental health and mistrust of services. This review was undertaken to identify programs and policies currently in place that aim to improve the mental health and well-being of this vulnerable population. It provides an analysis of both the strengths of the current system as well as what has been inadequately addressed based on literature in the area.By incorporating an Aboriginal perspective, this review focuses on social, emotional, and spiritual well-being (SESWB and the aspects of a child’s life and community that promote this. A realist review of the academic and grey literature was conducted in 2014. It included an extensive search of government and non-government (NGO publications. The review identified nine programs or policies that are designed to improve the SESWB of Aboriginal young people in OoHC in local and international settings. These are the Aboriginal and Torres Strait Islander Child Placement Principle, cultural support plans, Aboriginal Community Controlled Organisations (ACCOs, family group decision-making, therapeutic care, and Panyappi Mentoring Program. Given that culturally competent service provision is important to SESWB, the review concludes that an increase in monitoring and evaluation is necessary to determine the effectiveness of programs and ensure their implementation and sustainability when warranted. Policy and research work is needed to adapt and devise programs promoting the SESWB of Aboriginal young people (at both the

  14. National Climate Policies: Aiming at the Factor 4 Target by 2050?

    International Nuclear Information System (INIS)

    Godard, Olivier

    2016-01-01

    The paper considers how the governments of midsize developed countries could define national strategies to control greenhouse gas emissions, assuming that such strategies are the product of cognitive and ethical choices relating to global climate scenarios and the rule for allocating shares of expected global climate damage to individual States. After evaluating the carbon value linked to each cognitive-ethical configuration, I identify the configurations that justify the target of dividing national emissions by 4 between 1990 and 2050 - a goal known as 'Factor 4'. Lastly, I examine the resulting constraints on the shape of the control trajectory leading to that target

  15. Theories of the Family and Policy

    OpenAIRE

    Veronica Jacobsen; Lindy Fursman; John Bryant; Megan Claridge; Benedikte Jensen

    2004-01-01

    Policy interventions that affect or are mediated through the family typically assume a behavioural response. Policy analyses proceeding from different disciplinary bases may come to quite different conclusions about the effects of policies on families, depending how individuals within families behave. This paper identifies the implications of five theories of family and individual behaviour for the likely success of policy intervention. Anthropology documents not only the universality of the ...

  16. Implementation of Policy, Systems, and Environmental Community-Based Interventions for Cardiovascular Health Through a National Not-for-Profit: A Multiple Case Study.

    Science.gov (United States)

    Garney, Whitney R; Szucs, Leigh E; Primm, Kristin; King Hahn, Laura; Garcia, Kristen M; Martin, Emily; McLeroy, Kenneth

    2018-05-01

    In 2014, the Centers for Disease Control and Prevention funded the American Heart Association to implement policy, systems, and environment-focused strategies targeting access to healthy food and beverages, physical activity, and smoke-free environments. To understand factors affecting implementation and variations in success across sites, evaluators conducted a multiple case study. Based on past literature, community sites were categorized as capacity-building or implementation-ready, for comparison. A sample of six communities were selected using a systematic selection tool. Through site visits, evaluators conducted interviews with program staff and community partners and assessed action plans. Evaluators identified important implications for nationally coordinated community-based prevention programming. Differences in implementation varied by the communities' readiness, with the most notable differences in how they planned activities and defined success. Existing partner relationships (or lack thereof) played a significant role, regardless of the American Heart Association's existing presence within the communities, in the progression of initiatives and the differences observed among phases. Last, goals in capacity-building sites were tied to organizational goals while goals in implementation-ready sites were more incremental with increased community influence and buy-in. Using national organizations as a mechanism to carry out large-scale community-based prevention work is a viable option that provides coordinated, wide-scale implementation without sacrificing a community's priorities or input. In funding future initiatives, the presence of relationships and the time needed to cultivate such relationships should be accounted for in the planning and implementation processes, as well as both local and national expectations.

  17. Housing, neighbourhoods and interventions

    NARCIS (Netherlands)

    Karin Wittebrood; Matthieu Permentier; with contributions from Fenne Pinkster

    2011-01-01

    Original title: Wonen, wijken en interventies Current Dutch neighbourhood policy is aimed at improving the position of 'priority neighbourhoods'. How successful is the policy proving? Does restructuring and the sale of social housing help? Does increasing the amount of green space and building

  18. Adult population as potential reservoir of NTD infections in rural villages of Kwale district, Coastal Kenya: implications for preventive chemotherapy interventions policy.

    Science.gov (United States)

    Njenga, Sammy M; Mwandawiro, Charles S; Muniu, Erastus; Mwanje, Mariam T; Haji, Fatma M; Bockarie, Moses J

    2011-09-14

    Neglected tropical diseases (NTDs) are major public health problems in developing countries where they contribute to suffering of populations living in poor settings. As part of a research project started in September 2009 in Kwale district, Coast Region, Kenya, a baseline cross-sectional survey was conducted in 5 rural villages to provide information on the status of NTDs, including urinary schistosomiasis, soil-transmitted helminthiasis (STH), and lymphatic filariasis. This paper presents the results of a parasitological investigation among adults in the study villages. A total of 599 adults in the 5 study villages were tested for NTD infections in urine, stool and blood. The presence of Schistosoma haematobium infection was determined by the urine filtration method. The presence of STH in stool was determined by Kato-Katz method while filarial antigenaemia was determined using immunochromatographic (ICT) test. The study revealed high prevalence of hookworm (41.7%) and schistosomiasis (18.2%) infections among adults in the study villages. Of the 599 individuals examined, 50.1% had one or more helminthic infections. There was low level of polyparasitism with helminthic NTDs in the study population with 9.5% and 1.7% of the participants having two and three infections, respectively. In the current study, hookworm and schistosomiasis infections were identified as important infections among adults living in areas of high endemicity for these infections. Thus, if this section of the population is left untreated it may remain an important potential reservoir and a source of re-infection for school-age children treated in school deworming programmes. Therefore, there is a need to design novel strategies for preventive chemotherapy interventions that could allow inclusion of adults in an effort to reduce force of infection in high endemic communities.

  19. Equity-specific effects of 26 Dutch obesity-related lifestyle interventions

    NARCIS (Netherlands)

    Magnée, Tessa; Burdorf, Alex; Brug, Johannes; Kremers, Stef P M; Oenema, Anke; van Assema, Patricia; Ezendam, Nicole P M; van Genugten, Lenneke; Hendriksen, Ingrid Jm; Hopman-Rock, Marijke; Jansen, Wilma; de Jong, Johan; Kocken, Paul L; Kroeze, Willemieke; Kwak, Lydia; Lechner, Lilian; de Nooijer, Jascha; van Poppel, Mireille Nm; Robroek, Suzan J W; Schreurs, Hanneke; van Sluijs, Esther M; Steenhuis, Ingrid J.M.; van Stralen, Maartje M; Tak, Nannah I; te Velde, Saskia J; Vermeer, Willemijn M; Wammes, Birgitte; van Wier, Marieke F; van Lenthe, Frank J

    Context: Reducing health inequalities is a policy priority in many developed countries. Little is known about effective strategies to reduce inequalities in obesity and its underlying behaviors. The goal of the study was to investigate differential effectiveness of interventions aimed at obesity

  20. Equity-specific effects of 26 Dutch obesity-related lifestyle interventions

    NARCIS (Netherlands)

    de Jong, Johan; Kremers, Stef; Assema, Patricia; Schreurs, Hanneke

    2013-01-01

    Reducing health inequalities is a policy priority in many developed countries. Little is known about effective strategies to reduce inequalities in obesity and its underlying behaviors. The goal of the study was to investigate differential effectiveness of interventions aimed at obesity prevention,

  1. Economic and Policy Review

    African Journals Online (AJOL)

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  3. Tendances Carbone no. 94. SUMO policies: smart monetary policies aimed at giving a boost to green investments

    International Nuclear Information System (INIS)

    Ferron, Camille; Morel, Romain

    2014-09-01

    Among the publications of CDC Climat Research, 'Tendances Carbone' bulletin specifically studies the developments of the European market for CO 2 allowances. Beside some statistical figures about energy production/consumption and carbon markets, this issue specifically addresses the following points: - New EU Commissioner: Miguel Arias Canete (Spain) has been appointed as the new energy and climate commissioner. - EU ETS Reform: Denmark, Latvia, Slovenia, and Sweden support Germany's proposal for the mechanism becoming operational ahead of schedule as from 2017. - Climate and Energy package 2030: the European Commission has published a new proposal at the end of July with the goal of improving energy efficiency by 30% in 2030

  4. Assessing sustainable freight policies.

    Science.gov (United States)

    2014-05-01

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

  5. Worship Discourse and White Race-based Policy Attitudes

    Science.gov (United States)

    Brown, R. Khari; Kaiser, Angela; Jackson, James S.

    2014-01-01

    The current study relies upon the 2004 National Politics Study to examine the association between exposure to race-based messages within places of worship and White race-based policy attitudes. The present study challenges the notion that, for White Americans, religiosity inevitably leads to racial prejudice. Rather, we argue, as others have, that religion exists on a continuum that spans from reinforcing to challenging the status quo of social inequality. Our findings suggests that the extent to which Whites discuss race along with the potential need for public policy solutions to address racial inequality within worship spaces, worship attendance contributes to support for public policies aimed at reducing racial inequality. On the other hand, apolitical and non-structural racial discussions within worship settings do seemingly little to move many Whites to challenge dominant idealistic perceptions of race that eschews public policy interventions as solutions to racial inequality. PMID:25324579

  6. Evidence, theory and context: using intervention mapping to develop a worksite physical activity intervention.

    Science.gov (United States)

    McEachan, Rosemary R C; Lawton, Rebecca J; Jackson, Cath; Conner, Mark; Lunt, Jennifer

    2008-09-22

    The workplace is an ideal setting for health promotion. Helping employees to be more physically active can not only improve their physical and mental health, but can also have economic benefits such as reduced sickness absence. The current paper describes the development of a three month theory-based intervention that aims to increase levels of moderate intensity physical activity amongst employees in sedentary occupations. The intervention was developed using an intervention mapping protocol. The intervention was also informed by previous literature, qualitative focus groups, an expert steering group, and feedback from key contacts within a range of organisations. The intervention was designed to target awareness (e.g. provision of information), motivation (e.g. goal setting, social support) and environment (e.g. management support) and to address behavioural (e.g. increasing moderate physical activity in work) and interpersonal outcomes (e.g. encourage colleagues to be more physically active). The intervention can be implemented by local facilitators without the requirement for a large investment of resources. A facilitator manual was developed which listed step by step instructions on how to implement each component along with a suggested timetable. Although time consuming, intervention mapping was found to be a useful tool for developing a theory based intervention. The length of this process has implications for the way in which funding bodies allow for the development of interventions as part of their funding policy. The intervention will be evaluated in a cluster randomised trial involving 1350 employees from 5 different organisations, results available September 2009.

  7. Evidence, Theory and Context: Using intervention mapping to develop a worksite physical activity intervention

    Directory of Open Access Journals (Sweden)

    Conner Mark

    2008-09-01

    Full Text Available Abstract Background The workplace is an ideal setting for health promotion. Helping employees to be more physically active can not only improve their physical and mental health, but can also have economic benefits such as reduced sickness absence. The current paper describes the development of a three month theory-based intervention that aims to increase levels of moderate intensity physical activity amongst employees in sedentary occupations. Methods The intervention was developed using an intervention mapping protocol. The intervention was also informed by previous literature, qualitative focus groups, an expert steering group, and feedback from key contacts within a range of organisations. Results The intervention was designed to target awareness (e.g. provision of information, motivation (e.g. goal setting, social support and environment (e.g. management support and to address behavioural (e.g. increasing moderate physical activity in work and interpersonal outcomes (e.g. encourage colleagues to be more physically active. The intervention can be implemented by local facilitators without the requirement for a large investment of resources. A facilitator manual was developed which listed step by step instructions on how to implement each component along with a suggested timetable. Conclusion Although time consuming, intervention mapping was found to be a useful tool for developing a theory based intervention. The length of this process has implications for the way in which funding bodies allow for the development of interventions as part of their funding policy. The intervention will be evaluated in a cluster randomised trial involving 1350 employees from 5 different organisations, results available September 2009.

  8. How can Saudi Arabia use the Decade of Action for Road Safety to catalyse road traffic injury prevention policy and interventions?

    Science.gov (United States)

    Al Turki, Yousef Abdullah

    2014-01-01

    Motor vehicle accidents are the leading cause of death in adolescents and young adults worldwide. Nearly three-quarters of road deaths occur in developing countries and men comprise a mean 80% of casualties. The rate of road traffic accidents caused by four-wheeled vehicles is the highest globally reported road traffic accidents statistic. In Saudi Arabia, the motor vehicle is the main means of transportation with one person killed and four injured every hour. Over 65% of accidents occur because of vehicles travelling at excess speed and/or drivers disobeying traffic signals. Road traffic injuries cause considerable economic losses to victims, their families, and to nations as a whole. Strategic prevention plans should be implemented soon by various sectors (health, police, transport, and education) to decrease the mortality and morbidity among adolescent and young age group. Strong and effective coordination between ministry of health and other ministries together with World Health Organization and other related organisations will be an important step towards implementing the international Decade of Action for Road Safety (2011-2020). The aim of this review article is to highlight some aspects of the health impacts of road traffic accidents.

  9. Petroleum and international policy

    International Nuclear Information System (INIS)

    Pertuzio, A.

    2002-01-01

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

  10. 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 ...

  11. Evaluation of energy efficiency policy instruments effectiveness : case study Croatia

    International Nuclear Information System (INIS)

    Bukarica, V.

    2007-01-01

    This paper proposed a theoretical basis for evaluating energy efficiency policy in the Republic of Croatia and corroborated it with the analysis of energy efficiency market development and transformation. The current status of the market was evaluated and policy instruments were adapted to achieve optimal results. In particular, the energy efficiency market in Croatia was discussed in terms of micro and macro environment factors that influence policy making processes and the choice of policy instruments. The macro environment for energy efficiency market in Croatia is the process of European Union pre-integration with all related national and international legislation, political and economical factors and potential to use financial funds. The micro environment consists of government institutions, local financing institutions and a range of market players on the supply and demand side. Energy efficiency is the most powerful and cost-effective way for achieving goals of sustainable development. Policy instruments developed to improve energy efficiency are oriented towards a cleaner environment, better standard of living, more competitive industry and improved security of energy supply. Energy efficiency is much harder to implement and requires policy interventions. In response to recent trends in the energy sector, such as deregulation and open competition, policy measures aimed at improving energy efficiency should shift from an end-users oriented approach towards a whole market approach. The optimal policy instruments mix should be designed to meet defined targets. However, market dynamics must be taken into consideration. 9 refs., 4 figs

  12. Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review.

    Science.gov (United States)

    Hoefsmit, Nicole; Houkes, Inge; Nijhuis, Frans J N

    2012-12-01

    In many Western countries, a vast amount of interventions exist that aim to facilitate return to work (RTW) after sickness absence. These interventions are usually focused on specific target populations such as employees with low back pain, stress-related complaints or adjustment disorders. The aim of the present study is to detect and identify characteristics of RTW interventions that generally facilitate return to work (i.e. in multiple target populations and across interventions). This type of knowledge is highly relevant to policy makers and health practitioners who want to deliver evidence based care that supports the employee's health and participation in labour. We performed a keyword search (systematic literature review) in seven databases (period: 1994-2010). In total, 23 articles were included and assessed for their methodological quality. The characteristics of the interventions were evaluated as well. Early interventions, initiated in the first 6 weeks of the RTW process were scarce. These were effective to support RTW though. Multidisciplinary interventions appeared effective to support RTW in multiple target groups (e.g. back pain and adjustment disorders). Time contingent interventions in which activities followed a pre-defined schedule were effective in all physical complaints studied in this review. Activating interventions such as gradual RTW were effective in physical complaints. They have not been studied for people with psychological complaints. Early- and multidisciplinary intervention and time-contingent-, activating interventions appear most effective to support RTW.

  13. National policies for the promotion of physical activity and healthy nutrition in the workplace context: a behaviour change wheel guided content analysis of policy papers in Finland

    Directory of Open Access Journals (Sweden)

    Tuija Seppälä

    2017-08-01

    Full Text Available Abstract Background Health policy papers disseminate recommendations and guidelines for the development and implementation of health promotion interventions. Such documents have rarely been investigated with regard to their assumed mechanisms of action for changing behaviour. The Theoretical Domains Framework (TDF and Behaviour Change Techniques (BCT Taxonomy have been used to code behaviour change intervention descriptions, but to our knowledge such “retrofitting” of policy papers has not previously been reported. This study aims first to identify targets, mediators, and change strategies for physical activity (PA and nutrition behaviour change in Finnish policy papers on workplace health promotion, and second to assess the suitability of the Behaviour Change Wheel (BCW approach for this purpose. Method We searched all national-level health policy papers effectual in Finland in August 2016 focusing on the promotion of PA and/or healthy nutrition in the workplace context (n = 6. Policy recommendations targeting employees’ nutrition and PA including sedentary behaviour (SB were coded using BCW, TDF, and BCT Taxonomy. Results A total of 125 recommendations were coded in the six policy papers, and in two additional documents referenced by them. Psychological capability, physical opportunity, and social opportunity were frequently identified (22%, 31%, and 24%, respectively, whereas physical capability was almost completely absent (1%. Three TDF domains (knowledge, skills, and social influence were observed in all papers. Multiple intervention functions and BCTs were identified in all papers but several recommendations were too vague to be coded reliably. Influencing individuals (46% and changing the physical environment (44% were recommended more frequently than influencing the social environment (10%. Conclusions The BCW approach appeared to be useful for analysing the content of health policy papers. Paying more attention to underlying

  14. National policies for the promotion of physical activity and healthy nutrition in the workplace context: a behaviour change wheel guided content analysis of policy papers in Finland.

    Science.gov (United States)

    Seppälä, Tuija; Hankonen, Nelli; Korkiakangas, Eveliina; Ruusuvuori, Johanna; Laitinen, Jaana

    2017-08-02

    Health policy papers disseminate recommendations and guidelines for the development and implementation of health promotion interventions. Such documents have rarely been investigated with regard to their assumed mechanisms of action for changing behaviour. The Theoretical Domains Framework (TDF) and Behaviour Change Techniques (BCT) Taxonomy have been used to code behaviour change intervention descriptions, but to our knowledge such "retrofitting" of policy papers has not previously been reported. This study aims first to identify targets, mediators, and change strategies for physical activity (PA) and nutrition behaviour change in Finnish policy papers on workplace health promotion, and second to assess the suitability of the Behaviour Change Wheel (BCW) approach for this purpose. We searched all national-level health policy papers effectual in Finland in August 2016 focusing on the promotion of PA and/or healthy nutrition in the workplace context (n = 6). Policy recommendations targeting employees' nutrition and PA including sedentary behaviour (SB) were coded using BCW, TDF, and BCT Taxonomy. A total of 125 recommendations were coded in the six policy papers, and in two additional documents referenced by them. Psychological capability, physical opportunity, and social opportunity were frequently identified (22%, 31%, and 24%, respectively), whereas physical capability was almost completely absent (1%). Three TDF domains (knowledge, skills, and social influence) were observed in all papers. Multiple intervention functions and BCTs were identified in all papers but several recommendations were too vague to be coded reliably. Influencing individuals (46%) and changing the physical environment (44%) were recommended more frequently than influencing the social environment (10%). The BCW approach appeared to be useful for analysing the content of health policy papers. Paying more attention to underlying assumptions regarding behavioural change processes may help to

  15. [Social marketing--seduction with the aim of healthy behavior?].

    Science.gov (United States)

    Loss, J; Nagel, E

    2010-01-01

    SOCIAL MARKETING - SEDUCTION WITH THE AIM OF HEALTHY BEHAVIOR? Social marketing is the use of marketing principles to design and implement programs that promote socially beneficial behaviour change. Contrary to the marketing of consumption goods, social marketing does not deal with material products, but with behaviour, e. g. not smoking. This 'product' has a basic benefit (i. e. reduction of health risks in the long run), which is, however, difficult to convey. Therefore, the intended change in behaviour has to be related to a further reward which consists of symbolic goods, e. g. social appreciation or a better body feeling. The communication policy is essential for information on and motivation for the preventive issue. Social marketing campaigns whose development and management follow the principles of classical marketing can render preventive efforts more effective. In addition, social marketing can lead to a better quality management as compared to conventional preventive activities. These advantages can be explained by a) tailoring the campaign more specifically to the target group's needs and motives, b) presenting health risks more convincingly, and c) continuously analysing and evaluating the campaign and its effects. On the other hand, the marketing of preventive aims through mass media can bear several risks, as exemplified by different national and international public health campaigns. The necessity to communicate briefly and succinctly can lead to misleading simplifications and, in case of cancer screening, to the trivialization of a behaviour's consequences and adverse effects. Also, many campaigns do not intend to educate and inform, but try to persuade target persons of a certain behaviour, using emotions such as fear. This has led to social marketing being criticized as manipulation. Sometimes, social marketing campaigns cause stigma and discrimination of certain population subgroups, e. g. obese or HIV-positive people. Health promoters who plan

  16. Public R&D Policy Impact Evaluation:Propensity Score Matching and Structural Modeling Estimations

    OpenAIRE

    Ilbeigi, Alireza

    2017-01-01

    This dissertation is about public research and development (R&D) subsidies to support private firms doing innovative activities and quantitative impact evaluation of the policy on total factor productivity (TFP) change and additional R&D effort. Public R&D subsidization as a public R&D policy, beside different types of public interventions, has been widely used by governments to stimulate private R&D. These policies aim to fill the gap between the private and social rates of returns by encour...

  17. Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project

    Directory of Open Access Journals (Sweden)

    Anne Marie Thow

    2017-06-01

    Full Text Available Abstract Background South Asian countries experience some of the highest levels of child undernutrition in the world, strongly linked to poor infant and young child feeding (IYCF practices. Strong and responsive policy support is essential for effective interventions to improve IYCF. This study aimed to identify opportunities for strengthening the policy environment in the region to better support appropriate infant and young child feeding. Methods We mapped policies relevant to infant and young child feeding in India, Pakistan, Bangladesh, Sri Lanka and Nepal, based on a common matrix. The matrix described potentially relevant policies ranging from high-level strategic policy documents to implementation-level guidelines. We analyzed the data based on themes focused on caregiver interactions with IYCF interventions: provision of correct information to mothers, training of frontline workers, enabling mothers to engage with service providers and strategic support for IYCF. Results Policy support for IYCF was present in relation to each of the themes assessed. In all countries, there was support for nutrition in National Development Plans, and all countries had some level of maternity protection and restrictions on marketing of breast milk substitutes. Sectoral and implementation-level policy documents contained provisions for system strengthening for IYCF and for training of frontline workers. Conclusions The key opportunities for strengthening IYCF policy support were in relation to translating strategic directives into implementation level documents; improving multi-sectoral support and coordination; and increased clarity regarding roles and responsibilities of frontline workers interacting with mothers. These findings can support efforts to strengthen IYCF policy at the national and regional level.

  18. Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project.

    Science.gov (United States)

    Thow, Anne Marie; Karn, Sumit; Devkota, Madhu Dixit; Rasheed, Sabrina; Roy, S K; Suleman, Yasmeen; Hazir, Tabish; Patel, Archana; Gaidhane, Abhay; Puri, Seema; Godakandage, Sanjeeva; Senarath, Upul; Dibley, Michael J

    2017-06-13

    South Asian countries experience some of the highest levels of child undernutrition in the world, strongly linked to poor infant and young child feeding (IYCF) practices. Strong and responsive policy support is essential for effective interventions to improve IYCF. This study aimed to identify opportunities for strengthening the policy environment in the region to better support appropriate infant and young child feeding. We mapped policies relevant to infant and young child feeding in India, Pakistan, Bangladesh, Sri Lanka and Nepal, based on a common matrix. The matrix described potentially relevant policies ranging from high-level strategic policy documents to implementation-level guidelines. We analyzed the data based on themes focused on caregiver interactions with IYCF interventions: provision of correct information to mothers, training of frontline workers, enabling mothers to engage with service providers and strategic support for IYCF. Policy support for IYCF was present in relation to each of the themes assessed. In all countries, there was support for nutrition in National Development Plans, and all countries had some level of maternity protection and restrictions on marketing of breast milk substitutes. Sectoral and implementation-level policy documents contained provisions for system strengthening for IYCF and for training of frontline workers. The key opportunities for strengthening IYCF policy support were in relation to translating strategic directives into implementation level documents; improving multi-sectoral support and coordination; and increased clarity regarding roles and responsibilities of frontline workers interacting with mothers. These findings can support efforts to strengthen IYCF policy at the national and regional level.

  19. Sustainability Policy and Environmental Policy

    OpenAIRE

    John C. V. Pezzey

    2001-01-01

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

  20. A change in behaviour: getting the balance right for research and policy.

    Science.gov (United States)

    O'Sullivan, Maureen; Ryan, Cristín; Downey, Damian G; Hughes, Carmel M

    2016-10-01

    Behaviour change interventions offer clinical pharmacists many opportunities to optimise the use of medicines. 'MINDSPACE' is a framework used by a Government-affiliated organisation in the United Kingdom to communicate an approach to changing behaviour through policy. The Theoretical Domains Framework (TDF) organises constructs of psychological theories that are most relevant to behaviour change into 14 domains. Both frameworks offer a way of identifying what drives a change in behaviour, providing a target for an intervention. This article aims to compare and contrast MINDSPACE and the TDF, and serves to inform pharmacy practitioners about the potential strengths and weaknesses of using either framework in a clinical pharmacy context. It appears that neither framework can deliver evidence-based interventions that can be developed and implemented with the pace demanded by policy and practice-based settings. A collaborative approach would ensure timely development of acceptable behaviour change interventions that are grounded in evidence.

  1. Influence on working hours among shift workers and effects on sleep quality - An intervention study

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Nabe-Nielsen, Kirsten; Aust, Birgit

    2011-01-01

    in the high intensity group (p effects of interventions on sleep quality were observed. Thus, sleep quality was not improved by increasing work time influence in the present group of Danish elder care workers. This was partly due to program failure (failed intervention), but may also be due......The aim of the present intervention study was to examine if increased influence on working hours among shift workers led to better sleep quality. 391 employees were categorized into groups based on the performed activities: High (self-rostering), moderate (education and/or policy for working hours...

  2. Leveraging Trade Agreements to Meet U.S. Security Aims

    Science.gov (United States)

    2016-04-08

    President George H.W. Bush sought means to influence the policies of Latin American states more effectively. Mexico , particularly in the post-Cold War era...security goals. A review of the U.S. trade policy, and its nesting with the National Security Strategy, demonstrates how President Barack Obama’s... President Barack Obama’s strategic “pivot to Asia,” and the Trans-Pacific Partnership (TPP) trade agreement facilitate U.S. enduring national

  3. Urban Policies and Earthquake Risk Mitigation

    International Nuclear Information System (INIS)

    Sarlo, Antonella

    2008-01-01

    The paper aims at proposing some considerations about some recent experiences of research carried out on the theme of earthquake risk mitigation and combining policies and actions of mitigation with urban development strategies. The objective was to go beyond the classical methodological approach aiming at defining a 'technical' evaluation of the earthquake risk through a procedure which can correlate the three 'components' of danger, exposure and vulnerability. These researches experiment, in terms of methodology and application, with a new category of interpretation and strategy: the so-called Struttura Urbana Minima (Minimum urban structure).Actually, the introduction of the Struttura Urbana Minima establishes a different approach towards the theme of safety in the field of earthquake risk, since it leads to a wider viewpoint, combining the building aspect of the issue with the purely urban one, involving not only town planning, but also social and managerial implications.In this sense the constituent logic of these researches is strengthened by two fundamental issues:- The social awareness of earthquake;- The inclusion of mitigation policies in the ordinary strategies for town and territory management. Three main aspects of the first point, that is of the 'social awareness of earthquake', characterize this issue and demand to be considered within a prevention policy:- The central role of the risk as a social production,- The central role of the local community consent,- The central role of the local community capability to planTherefore, consent, considered not only as acceptance, but above all as participation in the elaboration and implementation of choices, plays a crucial role in the wider issue of prevention policies.As far as the second point is concerned, the inclusion of preventive mitigation policies in ordinary strategies for the town and territory management demands the identification of criteria of choice and priorities of intervention and, as a

  4. Intervention in Vietnam: President Eisenhower's Foreign Policy

    National Research Council Canada - National Science Library

    Slaton, James

    1995-01-01

    For a period of thirty years, from 1945 to 1975, the United States employed countless numbers of financial, material, and human resources toward Vietnam in an effort to shape and control that country's political destiny...

  5. African Journal of Economic Policy: Editorial Policies

    African Journals Online (AJOL)

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

  6. Understanding the Development of Minimum Unit Pricing of Alcohol in Scotland: A Qualitative Study of the Policy Process

    Science.gov (United States)

    Katikireddi, Srinivasa Vittal; Hilton, Shona; Bonell, Chris; Bond, Lyndal

    2014-01-01

    Background Minimum unit pricing of alcohol is a novel public health policy with the potential to improve population health and reduce health inequalities. Theories of the policy process may help to understand the development of policy innovation and in turn identify lessons for future public health research and practice. This study aims to explain minimum unit pricing’s development by taking a ‘multiple-lenses’ approach to understanding the policy process. In particular, we apply three perspectives of the policy process (Kingdon’s multiple streams, Punctuated-Equilibrium Theory, Multi-Level Governance) to understand how and why minimum unit pricing has developed in Scotland and describe implications for efforts to develop evidence-informed policymaking. Methods Semi-structured interviews were conducted with policy actors (politicians, civil servants, academics, advocates, industry representatives) involved in the development of MUP (n = 36). Interviewees were asked about the policy process and the role of evidence in policy development. Data from two other sources (a review of policy documents and an analysis of evidence submission documents to the Scottish Parliament) were used for triangulation. Findings The three perspectives provide complementary understandings of the policy process. Evidence has played an important role in presenting the policy issue of alcohol as a problem requiring action. Scotland-specific data and a change in the policy ‘image’ to a population-based problem contributed to making alcohol-related harms a priority for action. The limited powers of Scottish Government help explain the type of price intervention pursued while distinct aspects of the Scottish political climate favoured the pursuit of price-based interventions. Conclusions Evidence has played a crucial but complex role in the development of an innovative policy. Utilising different political science theories helps explain different aspects of the policy process

  7. Understanding the development of minimum unit pricing of alcohol in Scotland: a qualitative study of the policy process.

    Science.gov (United States)

    Katikireddi, Srinivasa Vittal; Hilton, Shona; Bonell, Chris; Bond, Lyndal

    2014-01-01

    Minimum unit pricing of alcohol is a novel public health policy with the potential to improve population health and reduce health inequalities. Theories of the policy process may help to understand the development of policy innovation and in turn identify lessons for future public health research and practice. This study aims to explain minimum unit pricing's development by taking a 'multiple-lenses' approach to understanding the policy process. In particular, we apply three perspectives of the policy process (Kingdon's multiple streams, Punctuated-Equilibrium Theory, Multi-Level Governance) to understand how and why minimum unit pricing has developed in Scotland and describe implications for efforts to develop evidence-informed policymaking. Semi-structured interviews were conducted with policy actors (politicians, civil servants, academics, advocates, industry representatives) involved in the development of MUP (n = 36). Interviewees were asked about the policy process and the role of evidence in policy development. Data from two other sources (a review of policy documents and an analysis of evidence submission documents to the Scottish Parliament) were used for triangulation. The three perspectives provide complementary understandings of the policy process. Evidence has played an important role in presenting the policy issue of alcohol as a problem requiring action. Scotland-specific data and a change in the policy 'image' to a population-based problem contributed to making alcohol-related harms a priority for action. The limited powers of Scottish Government help explain the type of price intervention pursued while distinct aspects of the Scottish political climate favoured the pursuit of price-based interventions. Evidence has played a crucial but complex role in the development of an innovative policy. Utilising different political science theories helps explain different aspects of the policy process, with Multi-Level Governance particularly useful for

  8. The French electricity policy facing European integration and environmental law

    International Nuclear Information System (INIS)

    Begue, M.C.

    2004-02-01

    The french electricity policy is traditionally defined by public authorities. The preference for nuclear power implies great risk and severe damage to the environment. These features of french electricity policy are however questioned by the increasing influence of european law and the (relatively) recent recognition of the environmental issues of such policy. This thesis intends to study the consequences of two 'new' tendencies that seem to be inevitable in the field of electricity policy: the decreasing role of national public authorities and the diffusion of the concept of sustainable development. The theoretical model which underlies the organization of commercial exchanges is replacing the traditional intervention of the State. regarding of this basic good. The adoption of legal rules to organize the electricity market has involved the development of many economic instruments. Those instruments aim at modifying the electricity policy in accordance with the principle of integration of environmental dimension in sectoral policies. The main object of our work is to analyse the consequences of these changes in the concept of public utility as well as in the importance given to environmental protection in the new forms of electricity policies. (author)

  9. Ultimate Educational Aims, Overridingness, and Personal Well-Being

    Science.gov (United States)

    Haji, Ishtiyaque; Cuypers, Stefaan E.

    2011-01-01

    Discussion regarding education's aims, especially its ultimate aims, is a key topic in the philosophy of education. These aims or values play a pivotal role in regulating and structuring moral and other types of normative education. We outline two plausible strategies to identify and justify education's ultimate aims. The first associates these…

  10. Thailand's Low-Carbon Scenario 2050: The AIM/CGE analyses of CO2 mitigation measures

    International Nuclear Information System (INIS)

    Thepkhun, Panida; Limmeechokchai, Bundit; Fujimori, Shinichiro; Masui, Toshihiko; Shrestha, Ram M.

    2013-01-01

    Climate change and CO 2 mitigation have become increasingly important environmental issues. Recently Thailand has proposed policies on GHG mitigation such as Thailand’s Nationally Appropriate Mitigation Action (NAMA), which aims at GHG mitigation in the energy sector. This study used the computable general equilibrium (CGE) model, called “AIM/CGE” model, to analyse GHG mitigation measures under emission trading and carbon capture and storage (CCS) technology in Thailand. Results show that the international free emission trading policy can drive more GHG reduction by decreasing energy supply and demand, and increasing prices of emissions. The CCS technologies would balance emission reduction but they would reduce energy efficiency improvement and renewable energy utilization. In the energy security aspect, the policy options in this study would improve energy security, energy import dependency, and co-benefits of GHG mitigation in forms of improving local air quality. Results are also helpful to GHG mitigation policy in developing countries. -- Highlights: •A Computable General Equilibrium (CGE) model was used to analyze GHG mitigation policies in Thailand. •The CCS and emission trading will increase GHG mitigation in Thailand. •The 30% GHG mitigation target with 50% emission trading will give the best result in GDP. •The share of biomass resource and energy efficiency will decrease with CCS. •The emission trading will play an important role in decreasing fossil consumption and increasing renewable energy utilization

  11. Privacy Policy

    Science.gov (United States)

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

  12. Towards evidence-based, quality-controlled health promotion: the Dutch recognition system for health promotion interventions.

    NARCIS (Netherlands)

    Brug, J.; Dale, D. van; Lanting, L.; Kremers, S.; Veenhof, C.; Leurs, M.; Yperen, T. van; Kok, G.

    2010-01-01

    Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals

  13. Five-year workplace wellness intervention in the NHS

    OpenAIRE

    Blake, Holly; Zhou, Dingyuan; Batt, Mark E.

    2013-01-01

    aims:\\ud Poor health and well-being has been observed among NHS staff and has become a key focus in current public health policy. The objective of this study was to deliver and evaluate a five-year employee wellness programme aimed at improving the health and well-being of employees in a large NHS workplace.\\ud method:\\ud A theory-driven multi-level ecological workplace wellness intervention was delivered including health campaigns, provision of facilities and health-promotion activities to e...

  14. The policies

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  15. Trade Policy

    OpenAIRE

    Murray Gibbs

    2007-01-01

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

  16. SMART HERITAGE POLICY

    Directory of Open Access Journals (Sweden)

    Bojan Radej

    2018-01-01

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

  17. Random maintenance policies

    CERN Document Server

    Nakagawa, Toshio

    2014-01-01

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

  18. A microeconomic perspective on the role of efficiency and equity criteria in designing natural resource policy

    Directory of Open Access Journals (Sweden)

    Geoff Kaine

    2017-03-01

    Full Text Available Deliberating on policy design to manage natural resources with clarity and precision is a difficult task, even for professional and highly experienced policy practitioners. These difficulties are exacerbated by confounding the crafting of policy instruments to change resource use (a behavioral matter related to resource management with the consequential issue of who bears the cost of changing resource use (an equity matter. The confounding of behavioral and equity issues is not surprising because equity is commonly suggested as a criterion in the literature on policy instrument choice, and inequity in access to resources may also be one of the initial drivers of policy intervention. Here, we restate the microeconomic analysis of "open access" resources and highlight the fundamental difference between efficiency (including allocative inefficiency and equity that emerges from that analysis. We then discuss the implications of this difference for the choice of policy instruments to resolve problems in natural resource management, at least for instruments that entail changing the behavior of primary producers. This discussion is centered on three key decisions for formulating policy: (1 choosing the preferred portfolio of uses for a natural resource, (2 choosing a policy instrument to change that portfolio, and (3 choosing a mechanism to distribute the costs of change fairly. To illustrate how these decisions may play out in a real-world example, we apply the decisions to a freshwater policy process in New Zealand. By articulating the distinction, microeconomics draws distinctions between efficiency and equity as policy objectives. Linking that distinction with the Tinbergen's principle regarding the matching of instruments to objectives, we aim to reduce the conflation of the decision-making criteria employed in policy formulation decisions. In doing so, we hope to assist policy makers to avoid policy failure by reducing the potential for the

  19. From policy to reality

    DEFF Research Database (Denmark)

    Ditlevsen, Kia; Reventlow, Susanne; Nielsen, Annemette Ljungdalh

    2016-01-01

    This qualitative study explores the structural barriers to preventive interventions targeting childhood obesity in the Danish health care system. Based on interviews with relevant health care professionals, the paper reports on the problems which are experienced by general practitioners and health......, and lack of resources together make it difficult for health care professionals to initiate interventions and reach the children in need of support. By analyzing the policy implementation process in a theoretical framework that discloses the discursive allocation of responsibilities, the study is able...

  20. Energy policy in transport and transport policy

    International Nuclear Information System (INIS)

    Van Dender, Kurt

    2009-01-01

    Explanations for, and indirect evidence of, imperfections in the market for private passenger vehicle fuel economy suggest there is a reasonable case for combining fuel economy standards and fuel or carbon taxes to contribute to an energy policy that aims to reduce greenhouse gas emissions and improve energy security. Estimates of key elasticities, including the rebound effect, indicate that the positive and negative side-effects of fuel economy measures on transport activities and external costs are limited. However, an energy policy for transport does not replace a transport policy that aims to manage the main transport externalities including congestion and local pollution. Conventional marginal cost estimates and standard cost-benefit reasoning suggest that policies that address congestion and local