WorldWideScience

Sample records for policy interventions specifically

  1. 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

  2. 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 ...

  3. 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 ...

  4. 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.

  5. 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.

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

    Science.gov (United States)

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

    2016-03-01

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

  7. 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

  8. 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 ...

  9. 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

  10. 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

  11. 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.

  12. 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

  13. Analyzing Security-Enhanced Linux Policy Specifications

    National Research Council Canada - National Science Library

    Archer, Myla

    2003-01-01

    NSA's Security-Enhanced (SE) Linux enhances Linux by providing a specification language for security policies and a Flask-like architecture with a security server for enforcing policies defined in the language...

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. Health Policy as a Specific Area of Social Policy

    Directory of Open Access Journals (Sweden)

    Dominika Pekarová

    2017-08-01

    Full Text Available Purpose and Originality: The aim of the article was to analyse the work of the health policy which is a very specific part of social policy. In the work we focus on its financing, which is a very important issue in the health care. We try to show, what is the role of the state in the health care system as well as the creation of resources and control costs in the health sector. The work is finding such as financing health care in Slovakia and in other selected countries, and which could be changed for the best operation. Method: The analysis was carried out on the basis of the information which I drew from books and Internet resources. The work is divided into two parts. Contains 9 tables and 3 charts. The first chapter is devoted to a general description of social policy, its funding, with a focus on health policy than its specific area. The second chapter analyses the financing systems of health policy in Slovakia and in selected countries. Results: The results showed that the Slovak health care makes is trying hard to catch up with the level of the best health care systems. However, there are countries, which are doing much worse than us, in terms of funding. Society: It is important to properly invest money but also communication between states. To get help on health and to ensure that citizens know states the best conditions of health care. Limitations / further research: This work is focused on how to bring closer health care and its financing in several different countries economically. IN doing so some other aspects such as what is best level of services, etc. were put aside.

  6. 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.

  7. 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.

  8. 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

  9. 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

    Antimicrobial resistance (AMR) is a recognized threat to global public health. Increasing AMR and a dry pipeline of novel antimicrobial drugs have put AMR in the international spotlight. One strategy to combat AMR is to reduce antimicrobial drug consumption. Governments around the world have been experimenting with different policy interventions, such as regulating where antimicrobials can be sold, restricting the use of last-resort antimicrobials, funding AMR stewardship programs, and launching public awareness campaigns. To inform future action, governments should have access to synthesized data on the effectiveness of large-scale AMR interventions. This planned systematic review will (1) identify and describe previously evaluated government policy interventions to reduce human antimicrobial use and (2) estimate the effectiveness of these different strategies. An electronic search strategy has been developed in consultation with two research librarians. Seven databases (MEDLINE, CINAHL, EMBASE, CENTRAL, PAIS Index, Web of Science, and PubMed excluding MEDLINE) will be searched, and additional studies will be identified using several gray literature search strategies. To be included, a study must (1) clearly describe the government policy and (2) use a rigorous design to quantitatively measure the impact of the policy on human antibiotic use. The intervention of interest is any policy intervention enacted by a government or government agency in any country to change human antimicrobial use. Two independent reviewers will screen for eligibility using criteria defined a priori. Data will be extracted with Covidence software using a customized extraction form. If sufficient data exists, a meta-analysis by intervention type will be conducted as part of the effectiveness review. However, if there are too few studies or if the interventions are too heterogeneous, data will be tabulated and a narrative synthesis strategy will be used. This evidence synthesis is intended

  10. 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.

  11. 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

  12. 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

  13. 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.

  14. 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

  15. 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,

  16. 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

  17. 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.

  18. 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…

  19. 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

  20. A controlled community-based trial to promote smoke-free policy in rural communities.

    Science.gov (United States)

    Hahn, Ellen J; Rayens, Mary Kay; Adkins, Sarah; Begley, Kathy; York, Nancy

    2015-01-01

    Rural, tobacco-growing areas are disproportionately affected by tobacco use, secondhand smoke, and weak tobacco control policies. The purpose was to test the effects of a stage-specific, tailored policy-focused intervention on readiness for smoke-free policy, and policy outcomes in rural underserved communities. A controlled community-based trial including 37 rural counties. Data were collected annually with community advocates (n = 330) and elected officials (n = 158) in 19 intervention counties and 18 comparison counties over 5 years (average response rate = 68%). Intervention communities received policy development strategies from community advisors tailored to their stage of readiness and designed to build capacity, build demand, and translate and disseminate science. Policy outcomes were tracked over 5 years. Communities receiving the stage-specific, tailored intervention had higher overall community readiness scores and better policy outcomes than the comparison counties, controlling for county-level smoking rate, population size, and education. Nearly one-third of the intervention counties adopted smoke-free laws covering restaurants, bars, and all workplaces compared to none of the comparison counties. The stage-specific, tailored policy-focused intervention acted as a value-added resource to local smoke-free campaigns by promoting readiness for policy, as well as actual policy change in rural communities. Although actual policy change and percent covered by the policies were modest, these areas need additional resources and efforts to build capacity, build demand, and translate and disseminate science in order to accelerate smoke-free policy change and reduce the enormous toll from tobacco in these high-risk communities. © 2014 National Rural Health Association.

  1. 32 CFR 292.4 - Specific policy.

    Science.gov (United States)

    2010-07-01

    ... INFORMATION ACT PROGRAM DEFENSE INTELLIGENCE AGENCY (DIA) FREEDOM OF INFORMATION ACT § 292.4 Specific policy... of source and object codes, regardless of medium are not agency records. (This does not include the... existing computer program or printout for retrieval of the requested information. (c) The prior application...

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. Effectiveness and specificity of a classroom-based group intervention in children and adolescents exposed to war in Lebanon.

    Science.gov (United States)

    Karam, Elie G; Fayyad, John; Nasser Karam, Aimee; Cordahi Tabet, Caroline; Melhem, Nadine; Mneimneh, Zeina; Dimassi, Hani

    2008-01-01

    The purpose of this study was to examine the effectiveness and specificity of a classroom-based psychosocial intervention after war. All students (n=2500) of six villages in Southern Lebanon designated as most heavily exposed to war received a classroom-based intervention delivered by teachers, consisting of cognitive-behavioural and stress inoculation training strategies. A random sample of treated students (n=101) and a matched control group (n=93) were assessed one month post-war and one year later. Mental disorders and psychosocial stressors were assessed using the Diagnostic Interview for Children and Adolescents - Revised with children and parents. War exposure was measured using the War Events Questionnaire. The prevalence of major depressive disorder (MDD), separation anxiety disorder (SAD) and post-traumatic stress disorder (PTSD) was examined pre-war, one month post-war (pre-intervention), and one year post-war. Specificity of treatment was determined by rating teachers' therapy diaries. The rates of disorders peaked one month post-war and decreased over one year. There was no significant effect of the intervention on the rates of MDD, SAD or PTSD. Post-war MDD, SAD and PTSD were associated with pre-war SAD and PTSD, family violence parameters, financial problems and witnessing war events. These findings have significant policy and public health implications, given current practices of delivering universal interventions immediately post-war.

  10. 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

  11. Importance of baseline specification in evaluating conservation interventions and achieving no net loss of biodiversity.

    Science.gov (United States)

    Bull, J W; Gordon, A; Law, E A; Suttle, K B; Milner-Gulland, E J

    2014-06-01

    There is an urgent need to improve the evaluation of conservation interventions. This requires specifying an objective and a frame of reference from which to measure performance. Reference frames can be baselines (i.e., known biodiversity at a fixed point in history) or counterfactuals (i.e., a scenario that would have occurred without the intervention). Biodiversity offsets are interventions with the objective of no net loss of biodiversity (NNL). We used biodiversity offsets to analyze the effects of the choice of reference frame on whether interventions met stated objectives. We developed 2 models to investigate the implications of setting different frames of reference in regions subject to various biodiversity trends and anthropogenic impacts. First, a general analytic model evaluated offsets against a range of baseline and counterfactual specifications. Second, a simulation model then replicated these results with a complex real world case study: native grassland offsets in Melbourne, Australia. Both models showed that achieving NNL depended upon the interaction between reference frame and background biodiversity trends. With a baseline, offsets were less likely to achieve NNL where biodiversity was decreasing than where biodiversity was stable or increasing. With a no-development counterfactual, however, NNL was achievable only where biodiversity was declining. Otherwise, preventing development was better for biodiversity. Uncertainty about compliance was a stronger determinant of success than uncertainty in underlying biodiversity trends. When only development and offset locations were considered, offsets sometimes resulted in NNL, but not across an entire region. Choice of reference frame determined feasibility and effort required to attain objectives when designing and evaluating biodiversity offset schemes. We argue the choice is thus of fundamental importance for conservation policy. Our results shed light on situations in which biodiversity offsets may

  12. 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

  13. 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...

  14. The ORSEC arrangement and the 'nuclear' intervention specific plan

    International Nuclear Information System (INIS)

    Guenon, C.

    2010-01-01

    In order to take the specific character of a nuclear emergency situation into account, France has developed planning tools within the so-called Crisis National Organisation (ONC, organisation nationale de crise). This organisation involves public bodies, agencies and companies. Thus, intervention specific plans (PPI, plans particuliers d'intervention) are included in the ORSEC general arrangement. The assessment of geographical and chronological consequences of a nuclear accident has lead to the definition of two main categories of measures, depending on the fact they are immediately or progressively applied. They involve the intervention of specialised means. This report also indicates how new measures have been introduced in the ORSEC arrangement to manage the post-accident phase. The author also outlines that crisis communication must also be prepared and tested

  15. 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

  16. Rationales for technology-specific RES support and their relevance for German policy

    International Nuclear Information System (INIS)

    Gawel, Erik; Lehmann, Paul; Purkus, Alexandra; Söderholm, Patrik; Witte, Katherina

    2017-01-01

    In order to achieve cost-effective RES-E deployment it is often argued that technology-neutral support schemes for renewables are indispensable. Against this background, RES-E support policies making widely use of technology differentiation in remuneration settings, e.g. across the EU, are frequently criticized from a theoretical point of view. However, in this paper we provide a systematic critique of the technology neutrality concept as a foundation for designing policy support schemes in the RES-E technology field. Specifically, the main objective of the paper is to scrutinize the arguments for technology-neutrality, and discuss three conceptual arguments for why technology-specific support schemes could in fact help minimize the societal costs of reaching future RES-E targets. We also briefly address different political economy concerns, which could constrain the choice of cost-effective policy support schemes, and that have to be taken into account for economic policy advice. For empirical illustration of the key arguments we refer to the case of German RES-E policy-making. The central conclusion from this paper is that technology-specific RES-E support schemes may generate significant economic benefits, particularly if technology markets work imperfectly and in second-best policy settings with additional non-internalized market failures. - Highlights: • Three theoretical cost-effectiveness reasons for technology-specific RES-E support. • German case study to show relevance of theoretical arguments for policy-making. • Political economy constraints to technology-neutral support are demonstrated. • Technology-specific RES-E support may generate significant economic benefits.

  17. 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…

  18. 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.

  19. 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.

  20. 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...

  1. 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.

  2. Importance of Baseline Specification in Evaluating Conservation Interventions and Achieving No Net Loss of Biodiversity

    Science.gov (United States)

    Bull, J W; Gordon, A; Law, E A; Suttle, K B; Milner-Gulland, E J

    2014-01-01

    There is an urgent need to improve the evaluation of conservation interventions. This requires specifying an objective and a frame of reference from which to measure performance. Reference frames can be baselines (i.e., known biodiversity at a fixed point in history) or counterfactuals (i.e., a scenario that would have occurred without the intervention). Biodiversity offsets are interventions with the objective of no net loss of biodiversity (NNL). We used biodiversity offsets to analyze the effects of the choice of reference frame on whether interventions met stated objectives. We developed 2 models to investigate the implications of setting different frames of reference in regions subject to various biodiversity trends and anthropogenic impacts. First, a general analytic model evaluated offsets against a range of baseline and counterfactual specifications. Second, a simulation model then replicated these results with a complex real world case study: native grassland offsets in Melbourne, Australia. Both models showed that achieving NNL depended upon the interaction between reference frame and background biodiversity trends. With a baseline, offsets were less likely to achieve NNL where biodiversity was decreasing than where biodiversity was stable or increasing. With a no-development counterfactual, however, NNL was achievable only where biodiversity was declining. Otherwise, preventing development was better for biodiversity. Uncertainty about compliance was a stronger determinant of success than uncertainty in underlying biodiversity trends. When only development and offset locations were considered, offsets sometimes resulted in NNL, but not across an entire region. Choice of reference frame determined feasibility and effort required to attain objectives when designing and evaluating biodiversity offset schemes. We argue the choice is thus of fundamental importance for conservation policy. Our results shed light on situations in which biodiversity offsets may

  3. 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.

  4. Transnational issue-specific expert networking: A pathway to local policy change.

    Science.gov (United States)

    O'Brien, Cheryl

    2015-12-01

    This article reports on key findings from a study of subnational governments in Mexico and Nigeria (O'Brien, 2013). With empirical richness of the case study method and small-n statistical analysis across the subnational units for each country, this study asks: How can we push the needle toward more progressive policy change on violence against women in developing and democratizing contexts? This study finds that issue-specific expert networking is a civic pathway to subnational policy responsiveness in Mexico and Nigeria. The dynamics of this pathway illuminate local-global political connections, and this study shows how issue-specific expert networking is important for the diffusion of an international norm and policies on violence against women. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Engaging Gatekeepers, Optimizing Decision Making, and Mitigating Bias: Design Specifications for Systemic Diversity Interventions.

    Science.gov (United States)

    Vinkenburg, Claartje J

    2017-06-01

    In this contribution to the Journal of Applied Behavioral Science Special Issue on Understanding Diversity Dynamics in Systems: Social Equality as an Organization Change Issue, I develop and describe design specifications for systemic diversity interventions in upward mobility career systems, aimed at optimizing decision making through mitigating bias by engaging gatekeepers. These interventions address the paradox of meritocracy that underlies the surprising lack of diversity at the top of the career pyramid in these systems. I ground the design specifications in the limited empirical evidence on "what works" in systemic interventions. Specifically, I describe examples from interventions in academic settings, including a bias literacy program, participatory modeling, and participant observation. The design specifications, paired with inspirational examples of successful interventions, should assist diversity officers and consultants in designing and implementing interventions to promote the advancement to and representation of nondominant group members at the top of the organizational hierarchy.

  6. Optimization guidance to post-accident intervention: a specific case

    International Nuclear Information System (INIS)

    Garcia-Ramirez, J.E.; Reyes-Sanchez, M.A.

    1996-01-01

    ICRP recommends the application of the system of protection to intervention situations, i.e. those in which exposure pathways are already present; e.g the public exposure following an accident. This implies that intervention must be justified and optimized, being the optimization the process of deciding the nature of protective action in order to obtain the maximum net benefit. This paper provides an example of one optimization model to guide a decision making process in a specific case of post-accident intervention. The involved scenario postulates the contamination of big quantities of reinforcing steel bars used in construction industry, and a lot of them present in the structure of several dwellings. Inhabitants of these dwellings must be protected and the proposed action is to demolish those homes exceeding some intervention criterion. The objective of this study is to reach such intervention level trough an optimization process economically focused. (author)

  7. 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

  8. 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.

  9. The role of migration-specific and migration-relevant policies in migrant decision-making in transit

    NARCIS (Netherlands)

    Kuschminder - de Guerre, Katie; Koser, Khalid

    2017-01-01

    This paper examines the role of migration-specific and migration-relevant policies in migrant decision-making factors for onwards migration or stay in Greece and Turkey. In this paper we distinguish migration-specific policies from migration-relevant policies in transit and destination countries,

  10. 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...

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

    Science.gov (United States)

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

    2016-02-01

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

  12. 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.

  13. Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

    Science.gov (United States)

    Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

    2016-08-01

    Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.

  14. 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

  15. 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

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

    OpenAIRE

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

    2016-01-01

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

  17. Learning from games : Stakeholders’ experiences involved in local health policy

    NARCIS (Netherlands)

    Spitters, H.P.E.M.; van de Goor, L.A.M.; Juel Lau, C.; Sandu, P.; Eklund Karlsson, L.; Jansen, J.; van Oers, J.A.M.

    2018-01-01

    Since public health problems are complex and the related policies need to address a wide range of sectors, cross-sectoral collaboration is beneficial. One intervention focusing on stimulating collaboration is a 'policy game'. The focus on specific problems facilitates relationships between the

  18. 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.

  19. The Specifics of Post-War Canadian Immigration Policy (1945–1957

    Directory of Open Access Journals (Sweden)

    Mariia Burtseva

    2017-12-01

    Full Text Available Immigration plays a significant role in various areas of the society’s life and the international policy. Investigating the Canadian experience of immigration is one of the major elements for understanding different aspects of actual mass relocation. The principal objective of this study is to investigate the specifics of Canadian immigration policy following the Second World War. The research is based on analyzing legislation regulations that established Canadian immigration policy from 1945 to 1957. The findings indicated that there were multilateral causes for the after-war immigration changes. And that in reality, Canadian immigration policy in the post-war decade was quite ambiguous because of enacting liberal and discriminatory legislation at the same time.

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

    CSIR Research Space (South Africa)

    Stafford, WHL

    2010-08-01

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

  1. 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...

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Brief Report: An Evaluation of an Australian Autism-Specific, Early Intervention Programme

    Science.gov (United States)

    Paynter, Jessica M.; Riley, Emma P.; Beamish, Wendi; Scott, James G.; Heussler, Helen S.

    2015-01-01

    There is a relative paucity of evidence examining the effectiveness of early intervention for young children with Autism Spectrum Disorder, in particular those delivered through educationally-based programmes. This study aimed to evaluate the real world effectiveness of a community-based autism-specific early learning and intervention programme in…

  8. A Case Study with an Identified Bully: Policy and Practice Implications

    Directory of Open Access Journals (Sweden)

    Huddleston, Lillie

    2011-07-01

    Full Text Available Objective: Bullying is a serious public health problem that may include verbal or physical injury as well as social isolation or exclusion. As a result, research is needed to establish a database for policies and interventions designed to prevent bullying and its negative effects. This paper presented a case study that contributed to the literature by describing an intervention for bullies that has implications for research, practice and related policies regarding bullying.Methods: An individualized intervention for an identified bully was implemented using the Participatory Culture-Specific Intervention Model (PCSIM; Nastasi, Moore, & Varjas, 2004 with a seventh-grade middle school student. Ecological and culture-specific perspectives were used to develop and implement the intervention that included psychoeducational sessions with the student and consultation with the parent and school personnel. A mixed methods intervention design was used with the following informants: the target student, the mother of the student, a teacher and the school counselor. Qualitative data included semi-structured interviews with the parent, teacher and student, narrative classroom observations and evaluation/feedback forms filled out by the student and interventionist. Quantitative data included the following quantitative surveys (i.e., Child Posttraumatic Stress Reaction Index [CPTS-RI] and the Behavior Assessment Scale for Children, 2nd Edition. Both qualitative and quantitative data were used to evaluate the acceptability, integrity and efficacy of this intervention.Results: The process of intervention design, implementation and evaluation are described through an illustrative case study. Qualitative and quantitative findings indicated a decrease in internalizing, externalizing and bullying behaviors as reported by the teacher and the mother, and a high degree of acceptability and treatment integrity as reported by multiple stakeholders.Conclusion: This case

  9. 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.

  10. 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

  11. National-Level Wetland Policy Specificity and Goals Vary According to Political and Economic Indicators

    Science.gov (United States)

    Peimer, Alex W.; Krzywicka, Adrianna E.; Cohen, Dora B.; Van den Bosch, Kyle; Buxton, Valerie L.; Stevenson, Natalie A.; Matthews, Jeffrey W.

    2017-01-01

    Growing recognition of the importance of wetlands to human and ecosystem well-being has led countries worldwide to implement wetland protection policies. Different countries have taken different approaches to wetland protection by implementing various policies, including territorial exclusion, market-based offsetting, and incentive programs for land users. Our objective was to describe the relationship between components of national-level wetland protection policies and national characteristics, including natural resource, economic, social, and political factors. We compiled data on the wetland policies of all 193 countries recognized by the U.N. and described the relationships among wetland policy goals and wetland protection mechanisms using non-metric multidimensional scaling. The first non-metric multidimensional scaling axis strongly correlated with whether a country had a wetland-specific environmental policy in place. Adoption of a comprehensive, wetland-specific policy was positively associated with degree of democracy and a commitment to establishing protected areas. The second non-metric multidimensional scaling axis defined a continuum of policy goals and mechanisms by which wetlands are protected, with goals to protect wetland ecosystem services on one end of the spectrum and goals to protect biodiversity on the other. Goals for protecting ecosystem services were frequently cited in policy documents of countries with agriculture-based economies, whereas goals associated with wetland biodiversity tended to be associated with tourism-based economies. We argue that the components of a country's wetland policies reflect national-level resource and economic characteristics. Understanding the relationship between the type of wetland policy countries adopt and national-level characteristics is critical for international efforts to protect wetlands.

  12. Responsive Feeding: Implications for Policy and Program Implementation12

    Science.gov (United States)

    Engle, Patrice L.; Pelto, Gretel H.

    2011-01-01

    In this article, we examine responsive feeding as a nutrition intervention, with an emphasis on the development and incorporation of responsive feeding into policies and programs over the last 2 decades and recommendations for increasing the effectiveness of responsive feeding interventions. A review of policy documents from international agencies and high-income countries reveals that responsive feeding has been incorporated into nutrition policies. Official guidelines from international agencies, nongovernmental organizations, and professional organizations often include best practice recommendations for responsive feeding. Four potential explanations are offered for the rapid development of policies related to responsive feeding that have occurred despite the relatively recent recognition that responsive feeding plays a critical role in child nutrition and growth and the paucity of effectiveness trials to determine strategies to promote responsive feeding. Looking to the future, 3 issues related to program implementation are highlighted: 1) improving intervention specificity relative to responsive feeding; 2) developing protocols that facilitate efficient adaptation of generic guidelines to national contexts and local conditions; and 3) development of program support materials, including training, monitoring, and operational evaluation. PMID:21270361

  13. 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

  14. WHO policy development processes for a new vaccine: case study of malaria vaccines

    Directory of Open Access Journals (Sweden)

    Cheyne James

    2010-06-01

    Full Text Available Abstract Background Recommendations from the World Health Organization (WHO are crucial to inform developing country decisions to use, or not, a new intervention. This article analysed the WHO policy development process to predict its course for a malaria vaccine. Methods The decision-making processes for one malaria intervention and four vaccines were classified through (1 consultations with staff and expert advisors to WHO's Global Malaria Programme (GMP and Immunization, Vaccines and Biologicals Department (IVB; (2 analysis of the procedures and recommendations of the major policy-making bodies of these groups; (3 interviews with staff of partnerships working toward new vaccine availability; and (4 review and analyses of evidence informing key policy decisions. Case description WHO policy formulation related to use of intermittent preventive treatment in infancy (IPTi and the following vaccine interventions: Haemophilus influenzae type b conjugate vaccine (Hib, pneumococcal conjugate vaccine (PCV, rotavirus vaccine (RV, and human papillomavirus vaccine (HPV, five interventions which had relatively recently been through systematic WHO policy development processes as currently constituted, was analysed. Required information was categorized in three areas defined by a recent WHO publication on development of guidelines: safety and efficacy in relevant populations, implications for costs and population health, and localization of data to specific epidemiological situations. Discussion and evaluation Data needs for a malaria vaccine include safety; the demonstration of efficacy in a range of epidemiological settings in the context of other malaria prevention interventions; and information on potential rebound in which disease increases subsequent to the intervention. In addition, a malaria vaccine would require attention to additional factors, such as costs and cost-effectiveness, supply and demand, impact of use on other interventions, and

  15. 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.

  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. 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...

  19. 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

  20. Windscale inquiry and policy-making procedures

    Energy Technology Data Exchange (ETDEWEB)

    Von Moltke, K

    1978-07-01

    Policy decisions on the development and installation of nuclear facilities often strain both the time and human resources of a country, some countries having taken steps to involve the national government in specific siting decisions and shifting the constitutional balance in response to popular dissent. Challenges to nuclear facilities could be met by limiting the scope of intervenors and the use of judicial review. The 100-day Windscale Inquiry in the United Kingdom represents the most costly review any country has had of a specific nuclear policy and has international implications. A chronology of the inquiry illustrates how the debate evolved into a vote on whether nuclear energy should be developed at all and effectively cut off other avenues of recourse. The traditional procedures for planning are shown to be inadequate for setting nuclear energy policy without the intervention of Parliament. 18 references.

  1. The ORSEC arrangement and the 'nuclear' intervention specific plan; Dispositif orsec and plan particulier d'intervention -nucleaire-

    Energy Technology Data Exchange (ETDEWEB)

    Guenon, C. [Ministere de l' interieur, de l' outre mer et des collectivites territoriales, Direction de la Securite Civile, 92 - Asnieres sur Seine (France)

    2010-07-01

    In order to take the specific character of a nuclear emergency situation into account, France has developed planning tools within the so-called Crisis National Organisation (ONC, organisation nationale de crise). This organisation involves public bodies, agencies and companies. Thus, intervention specific plans (PPI, plans particuliers d'intervention) are included in the ORSEC general arrangement. The assessment of geographical and chronological consequences of a nuclear accident has lead to the definition of two main categories of measures, depending on the fact they are immediately or progressively applied. They involve the intervention of specialised means. This report also indicates how new measures have been introduced in the ORSEC arrangement to manage the post-accident phase. The author also outlines that crisis communication must also be prepared and tested

  2. 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...

  3. Using Argumentation Logic for Firewall Policy Specification and Analysis

    OpenAIRE

    Bandara, Arosha K.; Kakas, Antonis; Lupu, Emil C.; Russo, Alessandra

    2006-01-01

    Firewalls are important perimeter security mechanisms that imple-ment an organisation's network security requirements and can be notoriously difficult to configure correctly. Given their widespread use, it is crucial that network administrators have tools to translate their security requirements into firewall configuration rules and ensure that these rules are consistent with each other. In this paper we propose an approach to firewall policy specification and analysis that uses a formal fram...

  4. 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.

  5. 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.

  6. Sri Lankan FRAX model and country-specific intervention thresholds.

    Science.gov (United States)

    Lekamwasam, Sarath

    2013-01-01

    There is a wide variation in fracture probabilities estimated by Asian FRAX models, although the outputs of South Asian models are concordant. Clinicians can choose either fixed or age-specific intervention thresholds when making treatment decisions in postmenopausal women. Cost-effectiveness of such approach, however, needs to be addressed. This study examined suitable fracture probability intervention thresholds (ITs) for Sri Lanka, based on the Sri Lankan FRAX model. Fracture probabilities were estimated using all Asian FRAX models for a postmenopausal woman of BMI 25 kg/m² and has no clinical risk factors apart from a fragility fracture, and they were compared. Age-specific ITs were estimated based on the Sri Lankan FRAX model using the method followed by the National Osteoporosis Guideline Group in the UK. Using the age-specific ITs as the reference standard, suitable fixed ITs were also estimated. Fracture probabilities estimated by different Asian FRAX models varied widely. Japanese and Taiwan models showed higher fracture probabilities while Chinese, Philippine, and Indonesian models gave lower fracture probabilities. Output of remaining FRAX models were generally similar. Age-specific ITs of major osteoporotic fracture probabilities (MOFP) based on the Sri Lankan FRAX model varied from 2.6 to 18% between 50 and 90 years. ITs of hip fracture probabilities (HFP) varied from 0.4 to 6.5% between 50 and 90 years. In finding fixed ITs, MOFP of 11% and HFP of 3.5% gave the lowest misclassification and highest agreement. Sri Lankan FRAX model behaves similar to other Asian FRAX models such as Indian, Singapore-Indian, Thai, and South Korean. Clinicians may use either the fixed or age-specific ITs in making therapeutic decisions in postmenopausal women. The economical aspects of such decisions, however, need to be considered.

  7. 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

  8. 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

  9. Communication Policies in Knowledge Networks

    Science.gov (United States)

    Ioannidis, Evangelos; Varsakelis, Nikos; Antoniou, Ioannis

    2018-02-01

    Faster knowledge attainment within organizations leads to improved innovation, and therefore competitive advantage. Interventions on the organizational network may be risky or costly or time-demanding. We investigate several communication policies in knowledge networks, which reduce the knowledge attainment time without interventions. We examine the resulting knowledge dynamics for real organizational networks, as well as for artificial networks. More specifically, we investigate the dependence of knowledge dynamics on: (1) the Selection Rule of agents for knowledge acquisition, and (2) the Order of implementation of "Selection" and "Filtering". Significant decrease of the knowledge attainment time (up to -74%) can be achieved by: (1) selecting agents of both high knowledge level and high knowledge transfer efficiency, and (2) implementing "Selection" after "Filtering" in contrast to the converse, implicitly assumed, conventional prioritization. The Non-Commutativity of "Selection" and "Filtering", reveals a Non-Boolean Logic of the Network Operations. The results demonstrate that significant improvement of knowledge dynamics can be achieved by implementing "fruitful" communication policies, by raising the awareness of agents, without any intervention on the network structure.

  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. 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…

  12. Policy for Promotion of Women's Mental Health: Insight from Analysis of Policy on Postnatal Depression in Mexico.

    Science.gov (United States)

    Place, Jean Marie S; Billings, Deborah L; Frongillo, Edward A; Blake, Christine E; Mann, Joshua R; deCastro, Filipa

    2016-03-01

    This article critically examines federal, state and facility-level policies, as well as clinical practice guidelines regarding postnatal depression in Mexico. Thirteen documents including national health plans, national action plans, federal and state laws and regulations, clinical practice guidelines, and public-sector healthcare facility policies were collected and evaluated according to whether they included a statement of intent and/or actions related to the care of women at risk for or experiencing postnatal depression. While postnatal depression is included in several policies in Mexico, it is not addressed in ways that guide actions to manage postnatal depression. Specific direction on postnatal depression in policies would bridge a gap in maternal mental healthcare given that medication, treatment, and timing of interventions is unique in the postpartum context.

  13. AN INVESTIGATIVE STUDY REGARDING SMES SPECIFIC ACCOUNTING POLICIES

    Directory of Open Access Journals (Sweden)

    Mester Ioana Teodora

    2011-07-01

    Full Text Available In this paper we intend to continue the research regarding the enterprise accounting policies and the manner in which these are perceived by the practitioner accountants, preparers of financial statements. This time, in order to carry out the research, we made up a new questionnaire applied to the same sample, containing a number of 100 SMEs in Bihor County, selected according to the criterion of the average number of employees and that of the level of net turnover at the end of 2008. Continuing previous conducted research we have investigated this time the specific accounting policies of the sampled SMEs from Bihor County and the way these policies are understood by practitioners and implemented in order to prepare financial statements. Surprisingly, we have found that only 93.33% of the respondents agree that the elements presented in the annual financial statements of the entity are evaluated in accordance with the general accounting principles stipulated in Order 3055/2009, according to the accrual accounting. Half of the people interviewed had in view all four qualities of accounting information (intelligibility, relevance, credibility, comparability in drawing up the annual financial statements, and most of them (56.67% are not aware of the possibility to use a significance threshold (10%-15% of the total value of that particular category of assets, liabilities, expenditure, income and results for an as faithful as possible presentation of information in the balance sheet and in the profit and loss account.

  14. SPECIFICS OF GERMAN FOREIGN POLICY IN THE MIDDLE EAST AND NORTH AFRICA

    Directory of Open Access Journals (Sweden)

    Г А Ханнанова

    2017-12-01

    Full Text Available The article is devoted to an analysis of the main factors, determining German policy in the Middle East and North Africa (MENA. More active German military-technical engagement in the settlement of the crises in the region on the modern stage determines relevance of this article’s topic. Based on historical method, author considers the development of German foreign policy in the Arab world, examining the main aspects of the colonial policy of German empire on the threshold of the First and Second World Wars, as well as the prerequisites of the intensification of German-Arabic contacts in the period of Cold War. In accordance with the principals of system analysis Germany’s Middle East policy was investigated in complex, given geopolitical, economic and military aspects. Special emphasis is put on the problem of transformation of Middle East regional order as a factor of political instability. Notwithstanding the rea-sonableness of Germany’s standing for stable and predictable regional order, these goals were challenged owing to the fact that Germany benefits from the regional disorder in terms of increase of its influence. In reliance on the German goals in the Middle East and North Africa, mentioned in the Coalition Agreement of 2013, the author points out the priority of crisis management. At the same time the ethno-confessional conflict potential of the region meets the interests of German military-industrial complex. Increase of Germany’s export of weapons to the Arab states as well as neglecting the restrictions on export go to prove that Germany backs the armaments race in the Middle East. In this regard, German policy is characterized by “double standards” and inconsistency. These specifics can be explained by the ongoing process of Middle East policy shift and searching for new priorities on a long-term horizon. In the conclusion, the author analyzes the specifics and prospects of German policy in MENA region.

  15. The Specificity Principle in Acculturation Science

    Science.gov (United States)

    Bornstein, Marc H.

    2016-01-01

    The Specificity Principle in Acculturation Science asserts that specific setting conditions of specific people at specific times moderate specific domains in acculturation by specific processes. Our understanding of acculturation depends critically on what is studied where, in whom, how, and when. This article defines, explains, and illustrates the Specificity Principle in Acculturation Science. Research hypotheses about acculturation can be more adequately tested, inconsistencies and discrepancies in the acculturation literature can be satisfactorily resolved, acculturation interventions can be tailored to be more successful, and acculturation policies can be brought to new levels of effectiveness if the specificity principle that governs acculturation science is more widely recognized. PMID:28073331

  16. Classification schemes for knowledge translation interventions: a practical resource for researchers.

    Science.gov (United States)

    Slaughter, Susan E; Zimmermann, Gabrielle L; Nuspl, Megan; Hanson, Heather M; Albrecht, Lauren; Esmail, Rosmin; Sauro, Khara; Newton, Amanda S; Donald, Maoliosa; Dyson, Michele P; Thomson, Denise; Hartling, Lisa

    2017-12-06

    As implementation science advances, the number of interventions to promote the translation of evidence into healthcare, health systems, or health policy is growing. Accordingly, classification schemes for these knowledge translation (KT) interventions have emerged. A recent scoping review identified 51 classification schemes of KT interventions to integrate evidence into healthcare practice; however, the review did not evaluate the quality of the classification schemes or provide detailed information to assist researchers in selecting a scheme for their context and purpose. This study aimed to further examine and assess the quality of these classification schemes of KT interventions, and provide information to aid researchers when selecting a classification scheme. We abstracted the following information from each of the original 51 classification scheme articles: authors' objectives; purpose of the scheme and field of application; socioecologic level (individual, organizational, community, system); adaptability (broad versus specific); target group (patients, providers, policy-makers), intent (policy, education, practice), and purpose (dissemination versus implementation). Two reviewers independently evaluated the methodological quality of the development of each classification scheme using an adapted version of the AGREE II tool. Based on these assessments, two independent reviewers reached consensus about whether to recommend each scheme for researcher use, or not. Of the 51 original classification schemes, we excluded seven that were not specific classification schemes, not accessible or duplicates. Of the remaining 44 classification schemes, nine were not recommended. Of the 35 recommended classification schemes, ten focused on behaviour change and six focused on population health. Many schemes (n = 29) addressed practice considerations. Fewer schemes addressed educational or policy objectives. Twenty-five classification schemes had broad applicability

  17. 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.

  18. Patient-Specific Tailored Intervention Improves INR Time in Therapeutic Range and INR Variability in Heart Failure Patients.

    Science.gov (United States)

    Gotsman, Israel; Ezra, Orly; Hirsh Raccah, Bruria; Admon, Dan; Lotan, Chaim; Dekeyser Ganz, Freda

    2017-08-01

    Many patients with heart failure need anticoagulants, including warfarin. Good control is particularly challenging in heart failure patients, with range, thereby increasing the risk of complications. This study aimed to evaluate the effect of a patient-specific tailored intervention on anticoagulation control in patients with heart failure. Patients with heart failure taking warfarin therapy (n = 145) were randomized to either standard care or a 1-time intervention assessing potential risk factors for lability of INR, in which they received patient-specific instructions. Time in therapeutic range (TTR) using Rosendaal's linear model was assessed 3 months before and after the intervention. The patient-tailored intervention significantly increased anticoagulation control. The median TTR levels before intervention were suboptimal in the interventional and control groups (53% vs 45%, P = .14). After intervention the median TTR increased significantly in the interventional group compared with the control group (80% [interquartile range, 62%-93%] vs 44% [29%-61%], P <.0001). The intervention resulted in a significant improvement in the interventional group before versus after intervention (53% vs 80%, P <.0001) but not in the control group (45% vs 44%, P = .95). The percentage of patients with a TTR ≥60%, considered therapeutic, was substantially higher in the interventional group: 79% versus 25% (P <.0001). The INR variability (standard deviation of each patient's INR measurements) decreased significantly in the interventional group, from 0.53 to 0.32 (P <.0001) after intervention but not in the control group. Patient-specific tailored intervention significantly improves anticoagulation therapy in patients with heart failure. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-12-01

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

  20. 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

  1. Sport-specific fitness testing and intervention for an adolescent with cerebral palsy: a case report.

    Science.gov (United States)

    Kenyon, Lisa K; Sleeper, Mark D; Tovin, Melissa M

    2010-01-01

    This case report describes the development, implementation, and outcomes of a fitness-related intervention program that addressed the sport-specific goals of an adolescent with cerebral palsy. The participant in this case was a 16-year-old African American male with spastic diplegia. The participant joined his high school wrestling team and asked to focus his physical therapy on interventions that would improve his wrestling performance. An examination was performed using the muscle power sprint test, the 10 x 5-m sprint test, strength tests, the 10-m shuttle run test, and the Gross Motor Function Measure. The intervention consisted of interval training, which focused on the demands of wrestling. Scores on all tests and measures were higher after the intervention. The outcomes of this case report seem to support the use of a fitness-related intervention program for addressing the sport-specific goals of an adolescent with cerebral palsy.

  2. 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.

  3. Development and preliminary evaluation of culturally specific web-based intervention for parents of adolescents.

    Science.gov (United States)

    Choi, H; Kim, S; Ko, H; Kim, Y; Park, C G

    2016-10-01

    WHAT IS KNOWN ON THE SUBJECT?: Problematic parent-child relationships have been identified as one of the main predictors of adolescents' mental health problems, but there are few existing interventions that address this issue. The format and delivery method of existing interventions for parents are relatively inaccessible for parents with full-time jobs and families living in rural areas. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: The newly developed 'Stepping Stone' culturally specific web-based intervention, which is intended to help Korean parents of adolescents to acquire both knowledge and communication and conflict management skills, was found to be feasible and well-accepted by parents. This study enabled us to identify areas for improvement in the content and format of the intervention and strategies. This will potentially increase effect sizes for the outcome variables of parents' perception and behaviours. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This web-based intervention could be delivered across diverse settings, such as schools and community mental health centers, to increase parents' knowledge of adolescent's mental health and allow for early detection of mental health problems. Mental health nurses working in schools may spend a significant amount of time addressing students' mental health issues; thus, this web-based intervention could be a useful resource to share with parents and children. In this way, the mental health nurses could facilitate parental engagement in the intervention and then help them to continue to apply and practice the knowledge and skills obtained through the program. Introduction There is a need for accessible, culturally specific web-based interventions to address parent-child relationships and adolescents' mental health. Aims This study developed and conducted a preliminary evaluation of a 4-week web-based intervention for parents of adolescents aged 11 to 16 years in Korea. Methods We used a two-group, repeated

  4. 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

  5. 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.

  6. 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

  7. External factors affecting decision-making and use of evidence in an Australian public health policy environment.

    Science.gov (United States)

    Zardo, Pauline; Collie, Alex; Livingstone, Charles

    2014-05-01

    This study examined external factors affecting policy and program decision-making in a specific public health policy context: injury prevention and rehabilitation compensation in the Australian state of Victoria. The aim was twofold: identify external factors that affect policy and program decision-making in this specific context; use this evidence to inform targeting of interventions aimed at increasing research use in this context. Qualitative interviews were undertaken from June 2011 to January 2012 with 33 employees from two state government agencies. Key factors identified were stakeholder feedback and action, government and ministerial input, legal feedback and action, injured persons and the media. The identified external factors were able to significantly influence policy and program decision-making processes: acting as both barriers and facilitators, depending on the particular issue at hand. The factors with the most influence were the Minister and government, lawyers, and agency stakeholders, particularly health providers, trade unions and employer groups. This research revealed that interventions aimed at increasing use of research in this context must target and harness the influence of these groups. This research provides critical insights for researchers seeking to design interventions to increase use of research in policy environments and influence decision-making in Victorian injury prevention and rehabilitation compensation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. 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.

  9. 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.

  10. [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.

  11. 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.

  12. 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.

  13. 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…

  14. 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.

  15. 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.

  16. Effective intervention for expressive grammar in children with specific language impairment.

    Science.gov (United States)

    Smith-Lock, Karen M; Leitao, Suze; Lambert, Lara; Nickels, Lyndsey

    2013-01-01

    Children with specific language impairment are known to struggle with expressive grammar. While some studies have shown successful intervention under laboratory conditions, there is a paucity of evidence for the effectiveness of grammar treatment in young children in community settings. To evaluate the effectiveness of a school-based intervention programme for expressive grammar in 5-year-olds with specific language impairment. Thirty-four 5-year-old children attending a specialized school for children with language impairment participated in the study. Nineteen children received treatment for expressive grammar (experimental group) and 15 children received a control treatment. Treatment consisted of weekly 1-h sessions of small group activities in a classroom setting for 8 weeks. Techniques included direct instruction, focused stimulation, recasting and imitation. Results were analysed at the group level and as a case series with each child as their own control in a single-subject design. There was a significant difference in grammatical performance pre- and post-treatment for children who received grammar treatment (Cohen's d = 1.24), but not for a group of children who received a control treatment. Further, no difference in performance was found in the equivalent time period prior to treatment, nor for an untreated target. Treatment success was more pronounced in children without articulation difficulties which interfered with their ability to produce the grammatical targets (Cohen's d = 1.66). Individual analyses indicated the treatment effect was significant for the majority of children. Individually targeted intervention delivered in small groups in a classroom setting was effective in improving production of expressive grammatical targets in 5-year-old children with specific language impairment. © 2013 Royal College of Speech and Language Therapists.

  17. 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 ...

  18. 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

  19. 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

  20. Analysis of Foreign Exchange Interventions by Intervention Agent with an Artificial Market Approach

    Science.gov (United States)

    Matsui, Hiroki; Tojo, Satoshi

    We propose a multi-agent system which learns intervention policies and evaluates the effect of interventions in an artificial foreign exchange market. Izumi et al. had presented a system called AGEDASI TOF to simulate artificial market, together with a support system for the government to decide foreign exchange policies. However, the system needed to fix the amount of governmental intervention prior to the simulation, and was not realistic. In addition, the interventions in the system did not affect supply and demand of currencies; thus we could not discuss the effect of intervention correctly. First, we improve the system so as to make much of the weights of influential factors. Thereafter, we introduce an intervention agent that has the role of the central bank to stabilize the market. We could show that the agent learned the effective intervention policies through the reinforcement learning, and that the exchange rate converged to a certain extent in the expected range. We could also estimate the amount of intervention, showing the efficacy of signaling. In this model, in order to investigate the aliasing of the perception of the intervention agent, we introduced a pseudo-agent who was supposed to be able to observe all the behaviors of dealer agents; with this super-agent, we discussed the adequate granularity for a market state description.

  1. Policies to promote healthy eating in Europe

    DEFF Research Database (Denmark)

    Capacci, Sara; Mazzocchi, Mario; Macias, José Brambila

    2012-01-01

    This review provides a classification of public policies to promote healthier eating and a structured mapping of existing measures in Europe. Complete coverage of alternative policy types was ensured by complementing the review with a selection of major interventions from outside Europe. Within...... with policy-makers. This work led to a list of 129 policy interventions (of which 121 in Europe). For each policy type, a critical review of the available evidence basis on its effectiveness is provided. The review has emphasised the need for a more systematic and accurate evaluation of government......-level interventions, and a stronger focus on actual behavioural change rather than on attitude change or intentions only. The amount of evidence is very heterogeneous across policy types and often incomplete...

  2. Prevention of mental and behavioural disorders: implications for policy and practice.

    Science.gov (United States)

    Saxena, Shekhar; Jané-Llopis, Eva; Hosman, Clemens

    2006-02-01

    There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice.

  3. Prevention of mental and behavioural disorders: implications for policy and practice

    Science.gov (United States)

    SAXENA, SHEKHAR; JANÉ-LLOPIS, EVA; HOSMAN, CLEMENS

    2006-01-01

    There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice. PMID:16757984

  4. Recommendations for international gambling harm-minimisation guidelines: comparison with effective public health policy.

    Science.gov (United States)

    Gainsbury, Sally M; Blankers, Matthijs; Wilkinson, Claire; Schelleman-Offermans, Karen; Cousijn, Janna

    2014-12-01

    Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of basing policy on empirical evidence, international conventions exist for policy on alcohol, tobacco, and illegal substances. This paper examines the evidence of best practice policies to provide recommendations for international guidelines for harm-minimisation policy for gambling, including specific consideration of the specific requirements for policies on Internet gambling. Evidence indicates that many of the public health policies implemented for addictive substances can be adapted to address gambling-related harms. Specifically, a minimum legal age of at least 18 for gambling participation, licensing of gambling venues and activities with responsible gambling and consumer protection strategies mandated, and brief interventions should be available for those at-risk for and experiencing gambling-related problems. However, there is mixed evidence on the effectiveness of limits on opening hours and gambling venue density and increased taxation to minimise harms. Given increases in trade globalisation and particularly the global nature of Internet gambling, it is recommended that jurisdictions take actions to harmonise gambling public health policies.

  5. Green electricity in the market place: the policy challenge

    International Nuclear Information System (INIS)

    Fuchs, D.A.

    2002-01-01

    The paper explores the implications of the liberalization of electricity markets in Europe and North America for policy means and mechanisms to enhance the market penetration of renewables. Applying a (co-) evolutionary approach, the argument highlights the need for policy intervention to help producers and consumers move out of technological trajectories favoring non-renewable electricity. On the production side, energy generation is locked into the central power station system deriving from more than a hundred years of technological developments along a specific system trajectory. On the consumption side, the locked-in effect results from a similarly long experience with electricity provision by monopoly suppliers and the associated lack of consumer choice and responsibility for product differentiation. As the analysis shows, policy strategies targeting both the production and consumption sides of the electricity market are needed for effective intervention. Furthermore, policy strategies should draw on a clear analysis of the inertia and dynamism underlying the production and consumption of electricity. In the light of such evolutionary dynamics, the analysis demonstrates the insufficiency of the policy approaches currently employed to foster the market share of renewables based electricity. Instead, the authors suggest a reflexive policy approach to initiate and support a reorientation towards green electricity, emphasizing the need for learning and communication between and among societal sectors. (author)

  6. Green electricity in the market place: the policy challenge

    Energy Technology Data Exchange (ETDEWEB)

    Fuchs, D.A. [Ludwig-Maximilians-University, Munich (Germany). Faculty of International Relations; Arentsen, M.J. [University of Twente, Enschede (Netherlands)

    2002-05-01

    The paper explores the implications of the liberalization of electricity markets in Europe and North America for policy means and mechanisms to enhance the market penetration of renewables. Applying a (co-) evolutionary approach, the argument highlights the need for policy intervention to help producers and consumers move out of technological trajectories favoring non-renewable electricity. On the production side, energy generation is locked into the central power station system deriving from more than a hundred years of technological developments along a specific system trajectory. On the consumption side, the locked-in effect results from a similarly long experience with electricity provision by monopoly suppliers and the associated lack of consumer choice and responsibility for product differentiation. As the analysis shows, policy strategies targeting both the production and consumption sides of the electricity market are needed for effective intervention. Furthermore, policy strategies should draw on a clear analysis of the inertia and dynamism underlying the production and consumption of electricity. In the light of such evolutionary dynamics, the analysis demonstrates the insufficiency of the policy approaches currently employed to foster the market share of renewables based electricity. Instead, the authors suggest a reflexive policy approach to initiate and support a reorientation towards green electricity, emphasizing the need for learning and communication between and among societal sectors. (author)

  7. 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

  8. Now is the time to advocate for interventions designed specifically to prevent and control waterpipe tobacco smoking.

    Science.gov (United States)

    Lopez, A A; Eissenberg, T; Jaafar, M; Afifi, R

    2017-03-01

    Waterpipe tobacco usage is spreading rapidly worldwide, with reports of more youth being waterpipe users compared to adults. In many areas of the world, waterpipe usage surpasses cigarette smoking. Waterpipes and cigarettes are both mechanisms for inhalation of tobacco smoke and therefore have serious health consequences. However, because of the many differences between the two products, prevention and control strategies that have proven effective for cigarettes may not transfer readily to waterpipe. This report highlights the differences between waterpipes and cigarettes in toxicant exposure and physiologic effects, patterns of use, social norms, the extent of evidence, and the policy environment. There is little evidence to date around effective interventions for waterpipe prevention and control. The current state of evidence for intervention to curb or control waterpipe is at ground zero and critically needs attention from both scientists and policy makers. National and global efforts aimed at cigarette prevention have succeeded, particularly in developed countries. We suggest the time has come to harness what we know works for cigarette prevention and control and adapt it to tackle the growing epidemic of waterpipe tobacco use. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2009-04-01

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

  10. Decrease in shigellosis-related deaths without Shigella spp.-specific interventions, Asia.

    Science.gov (United States)

    Bardhan, Pradip; Faruque, A S G; Naheed, Aliya; Sack, David A

    2010-11-01

    In 1999, a review of the literature for 1966-1997 suggested that ≈1.1 million persons die annually of shigellosis, including ≈880,000 in Asia. Our recent review of the literature for 1990-2009 indicates that ≈125 million shigellosis cases occur annually in Asia, of which ≈14,000 are fatal. This estimate for illnesses is similar to the earlier estimate, but the number of deaths is 98% lower; that is, the lower estimate of deaths is associated with markedly reduced case-fatality rates rather than fewer cases. Shigella spp.-related deaths decreased substantially during a period without Shigella spp.-specific interventions. We speculate that nonspecific interventions, e.g., measles vaccination, vitamin A supplementation, and improved nutrition, may have led to the reduced number of shigellosis-related deaths.

  11. 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.

  12. 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

  13. Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis

    Science.gov (United States)

    Davies, Cathy; Cipriani, Andrea; Ioannidis, John P.A.; Radua, Joaquim; Stahl, Daniel; Provenzani, Umberto; McGuire, Philip; Fusar‐Poli, Paolo

    2018-01-01

    Preventing psychosis in patients at clinical high risk may be a promising avenue for pre‐emptively ameliorating outcomes of the most severe psychiatric disorder. However, information on how each preventive intervention fares against other currently available treatment options remains unavailable. The aim of the current study was to quantify the consistency and magnitude of effects of specific preventive interventions for psychosis, comparing different treatments in a network meta‐analysis. PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials, and unpublished/grey literature were searched up to July 18, 2017, to identify randomized controlled trials conducted in individuals at clinical high risk for psychosis, comparing different types of intervention and reporting transition to psychosis. Two reviewers independently extracted data. Data were synthesized using network meta‐analyses. The primary outcome was transition to psychosis at different time points and the secondary outcome was treatment acceptability (dropout due to any cause). Effect sizes were reported as odds ratios and 95% confidence intervals (CIs). Sixteen studies (2,035 patients, 57% male, mean age 20.1 years) reported on risk of transition. The treatments tested were needs‐based interventions (NBI); omega‐3 + NBI; ziprasidone + NBI; olanzapine + NBI; aripiprazole + NBI; integrated psychological interventions; family therapy + NBI; D‐serine + NBI; cognitive behavioural therapy, French & Morrison protocol (CBT‐F) + NBI; CBT‐F + risperidone + NBI; and cognitive behavioural therapy, van der Gaag protocol (CBT‐V) + CBT‐F + NBI. The network meta‐analysis showed no evidence of significantly superior efficacy of any one intervention over the others at 6 and 12 months (insufficient data were available after 12 months). Similarly, there was no evidence for intervention differences in acceptability at either time point. Tests

  14. 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.

  15. 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'.

  16. 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

  17. Using public policy to improve outcomes for asthmatic children in schools.

    Science.gov (United States)

    Lynn, Jewlya; Oppenheimer, Sophie; Zimmer, Lorena

    2014-12-01

    School-based services to improve asthma management need to be accompanied by public policies that can help sustain services, scale effective interventions, create greater equity across schools, and improve outcomes for children. Several national organizations, including the Centers for Disease Control and Prevention, have recommended specific public policies the adoption of which in school settings can improve asthma outcomes for children. Although many states and school districts have adopted some of these policies, adoption is not universal, and implementation is not always successful, leaving inequities in children's access to asthma services and supports. These issues can be addressed by changing public policy. Policy change is a complex process, but it is one that will benefit from greater involvement by asthma experts, including the researchers who generate the knowledge base on what services, supports, and policies have the best outcomes for children. Asthma experts can participate in the policy process by helping to build awareness of the need for school-based asthma policy, estimating the costs associated with policy options and with inaction, advocating for the selection of specific policies, assisting in implementation (including providing feedback), conducting the research that can evaluate the effectiveness of implementation, and ultimately providing information back into the policy process to allow for improvements to the policies. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  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. Evidence Synthesis and Translation for Nutrition Interventions to Combat Micronutrient Deficiencies with Particular Focus on Food Fortification

    Directory of Open Access Journals (Sweden)

    Mark Lawrence

    2016-09-01

    Full Text Available Over two billion people suffer from micronutrient deficiencies. Food fortification is a prominent nutrition intervention to combat such deficiencies; however, its effectiveness, risks, and ethical implications vary depending on the contexts associated with the deficiency it is addressing and the circumstances with its implementation. The aim of this research was to analyse the profile of nutrition interventions for combating micronutrient deficiency with particular focus on food fortification reported in existing systematic reviews (SRs, guidelines and policy statements, and implementation actions for nutrition. A review of secondary data available from online databases of SRs, guidelines and policy statements, and implementation actions, categorised as either “nutrition-specific interventions” (NSpI or “nutrition-sensitive interventions” (NSeI, was conducted. Currently, there is evidence available for a diversity of food fortification topics, and there has been much translation into action. Indeed, food fortification and micronutrient supplementation interventions and NSpI more broadly dominate the profile of interventions for which there were SRs, guidelines, and policy statements available. The findings demonstrate that, although there is a rational linear relationship between evidence synthesis and translation in formulating policy and actions to combat micronutrient deficiencies, the various nutrition interventions available to help combat micronutrient deficiencies are not equally represented in the evidence synthesis and translation processes. Effective and safe policies and actions to combat micronutrient deficiencies require decisions to be informed from a body of evidence that consists of evidence from a variety of interventions. Into the future, investment in making available a higher number of SRs, guidelines and policy statements, and actions of NSeI is indicated.

  20. Decreasing Shigellosis-related Deaths without Shigella spp.–specific Interventions, Asia

    Science.gov (United States)

    Bardhan, Pradip; Faruque, A.S.G.; Naheed, Aliya

    2010-01-01

    In 1999, a review of the literature for 1966–1997 suggested that ≈1.1 million persons die annually of shigellosis, including ≈880,000 in Asia. Our recent review of the literature for 1990–2009 indicates that ≈125 million shigellosis cases occur annually in Asia, of which ≈14,000 are fatal. This estimate for illnesses is similar to the earlier estimate, but the number of deaths is 98% lower; that is, the lower estimate of deaths is associated with markedly reduced case-fatality rates rather than fewer cases. Shigella spp.–related deaths decreased substantially during a period without Shigella spp.–specific interventions. We speculate that nonspecific interventions, e.g., measles vaccination, vitamin A supplementation, and improved nutrition, may have led to the reduced number of shigellosis-related deaths. PMID:21029529

  1. A Country Specific Approach To IFRS Accounting Policy Choice In The European, Australian And Turkish Context

    Directory of Open Access Journals (Sweden)

    Nalan Akdogan

    2015-02-01

    Full Text Available IAS 8 defines the concept of accounting policy as "the specific principles, bases, conventions, rules and practices applied by an entity in preparing and presenting financial statements". Within the framework of this concept, this research that is derived from International Financial Reporting Standards (IFRS contributes to the accounting literature by focusing on the alternative accounting policies' debate related to presentation and recognition issues in the European, Australian and Turkish context and concludes that there is an influence of local accounting policies over IFRS practice in Turkey and this influence still exists in Europe and Australia. This shows that as long as diversity in accounting policies of IFRS is present, entities are expected to be inclined to select their local accounting policies by leading to comparability of financial statements within the country rather than between countries in the IFRS context.

  2. 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.)

  3. Near-term technology policies for long-term climate targets--economy wide versus technology specific approaches

    International Nuclear Information System (INIS)

    Sanden, B.A.; Azar, Christian

    2005-01-01

    The aim of this paper is to offer suggestions when it comes to near-term technology policies for long-term climate targets based on some insights into the nature of technical change. We make a distinction between economy wide and technology specific policy instruments and put forward two key hypotheses: (i) Near-term carbon targets such as the Kyoto protocol can be met by economy wide price instruments (carbon taxes, or a cap-and-trade system) changing the technologies we pick from the shelf (higher energy efficiency in cars, buildings and industry, wind, biomass for heat and electricity, natural gas instead of coal, solar thermal, etc.). (ii) Technology specific policies are needed to bring new technologies to the shelf. Without these new technologies, stricter emission reduction targets may be considered impossible to meet by the government, industry and the general public, and therefore not adopted. The policies required to bring these more advanced technologies to the shelf are more complex and include increased public research and development, demonstration, niche market creation, support for networks within the new industries, standard settings and infrastructure policies (e.g., when it comes to hydrogen distribution). There is a risk that the society in its quest for cost-efficiency in meeting near-term emissions targets, becomes blindfolded when it comes to the more difficult, but equally important issue of bringing more advanced technologies to the shelf. The paper presents mechanisms that cause technology look in, how these very mechanisms can be used to get out of the current 'carbon lock-in' and the risk with premature lock-ins into new technologies that do not deliver what they currently promise. We then review certain climate policy proposals with regards to their expected technology impact, and finally we present a let-a-hundred-flowers-bloom strategy for the next couple of decades

  4. 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

  5. Changes in Consumer Attitudes toward Broad-Based and Environment-Specific Sodium Policies-SummerStyles 2012 and 2015.

    Science.gov (United States)

    Odom, Erika C; Whittick, Corine; Tong, Xin; John, Katherine A; Cogswell, Mary E

    2017-08-04

    We examined temporal changes in consumer attitudes toward broad-based actions and environment-specific policies to limit sodium in restaurants, manufactured foods, and school and workplace cafeterias from the 2012 and 2015 SummerStyle surveys. We used two online, national research panel surveys to conduct a cross-sectional analysis of 7845 U.S. adults. Measures included self-reported agreement with broad-based actions and environment-specific policies to limit sodium in restaurants, manufactured foods, school cafeterias, workplace cafeterias, and quick-serve restaurants. Wald Chi-square tests were used to examine the difference between the two survey years and multivariate logistic regression was used to obtain odds ratios. Agreement with broad-based actions to limit sodium in restaurants (45.9% agreed in 2015) and manufactured foods (56.5% agreed in 2015) did not change between 2012 and 2015. From 2012 to 2015, there was a significant increase in respondents that supported environment-specific policies to lower sodium in school cafeterias (80.0% to 84.9%; p consumers ready for actions to lower sodium in foods served in schools, workplaces, and quick-serve restaurants.

  6. Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews.

    Science.gov (United States)

    Das, Jai K; Salam, Rehana A; Arshad, Ahmed; Finkelstein, Yaron; Bhutta, Zulfiqar A

    2016-10-01

    Many unhealthy behaviors often begin during adolescence and represent major public health challenges. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, and mental health problems. We conducted an overview of systematic reviews to evaluate the effectiveness of interventions to prevent substance abuse among adolescents. We report findings from a total of 46 systematic reviews focusing on interventions for smoking/tobacco use, alcohol use, drug use, and combined substance abuse. Our overview findings suggest that among smoking/tobacco interventions, school-based prevention programs and family-based intensive interventions typically addressing family functioning are effective in reducing smoking. Mass media campaigns are also effective given that these were of reasonable intensity over extensive periods of time. Among interventions for alcohol use, school-based alcohol prevention interventions have been associated with reduced frequency of drinking, while family-based interventions have a small but persistent effect on alcohol misuse among adolescents. For drug abuse, school-based interventions based on a combination of social competence and social influence approaches have shown protective effects against drugs and cannabis use. Among the interventions targeting combined substance abuse, school-based primary prevention programs are effective. Evidence from Internet-based interventions, policy initiatives, and incentives appears to be mixed and needs further research. Future research should focus on evaluating the effectiveness of specific interventions components with standardized intervention and outcome measures. Various delivery platforms, including digital platforms and policy initiative, have the potential to improve substance abuse outcomes among adolescents; however, these require further research. Copyright © 2016 Society for Adolescent Health and Medicine

  7. Improving Early Identification and Intervention for Children at Risk for Autism Spectrum Disorder.

    Science.gov (United States)

    Rotholz, David A; Kinsman, Anne M; Lacy, Kathi K; Charles, Jane

    2017-02-01

    To provide an example of a successful, novel statewide effort to increase early identification of young children at risk for autism spectrum disorder (ASD) using a 2-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination. The South Carolina Act Early Team (SCAET) provided focused collaboration among leaders representing state agencies, universities, health care systems, private organizations, and families to improve quality of life for children with ASD. Specific focus was on implementing policy changes and training to result in earlier identification and home-based behavioral intervention for young children at risk for ASD. Policy changes, training, and modified state agency practices were accomplished. Presumptive eligibility, on the basis of a 2-tiered screening process was implemented by BabyNet (South Carolina's Early Intervention Program) in collaboration with the lead agency for developmental disability services. There was a fivefold increase in children eligible for early intensive behavioral intervention without waiting for a diagnosis of ASD, avoiding long waits for diagnostic evaluations. Only 16 children (2.5%) were later found not to have ASD from a comprehensive evaluation. Improvements in early identification and intervention are feasible through collaborative policy change. The South Carolina Act Early Team and its key stakeholders committed to improving outcomes for this population used existing tools and methods in new ways to improve early identification of children with ASD and to make available evidence-based intervention services. This example should be replicable in other states with key stakeholders working collaboratively for the benefit of young children with ASD. Copyright © 2017 by the American Academy of Pediatrics.

  8. 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

  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. 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.

  11. Learning from games: Stakeholders’ experiences involved in local health policy

    DEFF Research Database (Denmark)

    Spitters, Hilde; van de Goor, Ien; Juel Lau, Cathrine

    2018-01-01

    Since public health problems are complex and the related policies need to address a wide range of sectors, cross-sectoral collaboration is beneficial. One intervention focusing on stimulating collaboration is a ‘policy game’. The focus on specific problems facilitates relationships between...... the stakeholders and stimulates cross-sectoral policymaking. The present study explores stakeholders’ learning experiences with respect to the collaboration process in public health policymaking. This was achieved via their game participation, carried out in real-life stakeholder networks in the Netherlands...... the collaboration processes in local policymaking. Specific learning experiences were related to: (i) the stakeholder network, (ii) interaction and (iii) relationships. The game also increased participant’s understanding of group dynamics and need for a coordinator in policymaking. This exploratory study shows...

  12. 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.

  13. Intervention complexity--a conceptual framework to inform priority-setting in health.

    Science.gov (United States)

    Gericke, Christian A; Kurowski, Christoph; Ranson, M Kent; Mills, Anne

    2005-04-01

    Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals.

  14. Intervention complexity--a conceptual framework to inform priority-setting in health.

    Science.gov (United States)

    Gericke, Christian A.; Kurowski, Christoph; Ranson, M. Kent; Mills, Anne

    2005-01-01

    Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals. PMID:15868020

  15. 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

  16. Policy Dialogue and Engagement between Non-Governmental Organizations and Government: A Survey of Processes and Instruments of Canadian Policy Workers

    Directory of Open Access Journals (Sweden)

    Bryan Mitchell Evans

    2013-07-01

    Full Text Available Various analysts have raised concerns respecting declining research, evaluation and analytical capacities within public services. Typically, the decline is attributed to reforms associated with neoliberal restructuring of the state and its concomitant managerial expression in New Public Management (NPM.  This has given rise to a conceptual shift now commonly captured as a movement from ‘government’ to ‘governance’. Policy advising from a new governance perspective entails an image of a more distributed policy advisory system where a plurality of actors, including non-state actors, engages with government in deliberating policy interventions to address collective problems.The original research presented here suggests that those responsible for policy work across four policy communities in the three Canadian provinces surveyed differ in terms of their capacities, depth of commitment to a specific policy file/field, roles and functions, as well as perceptions of the policy work that they undertake. Over the past several years, a number of primarily quantitative analyses examining the processes, tools and perspectives of Canadian federal and provincial government policy analysts have been published.  Consequently, a significant knowledge-base has been acquired respecting what government policy analysts do and their attitudes toward their work but very little is known about external interactions with non-governmental organizations (NGOs.

  17. Competition policies on the electricity markets

    International Nuclear Information System (INIS)

    Dubois, U.

    2008-01-01

    This article puts forward a critical analysis of European competition instruments and practices in terms of market power on the electricity wholesale markets. Due to the speck nature of electrical activities, competition policies come up against difficulties of market power identification at first, since there is no model for detecting perfectly the potential or real exertion of market power in this sector. What is more, since competition authorities rely on specific intervention methods, their ability to limit the exertion of market power is relatively low. For a large number of their interventions involves controlling concentrations. In the light of this double phenomenon, this article discusses some recent developments of European competition policies on the electricity wholesale markets. The sector inquiry of 2007 seems to mark the start of a new competition policy practice in the electricity sector. The initiative and decision-making power now seem to be nesting mainly at a European level where action is not only to be found in terms of controlling mergers and acquisitions, but also stretches to involve an in-depth evaluation of the way the different markets work. This action is manifested in decisions to investigate some companies as well as legislative proposals in the framework of the third package. Thus we are moving towards a greater monitoring of electricity markets using more formal supervision instruments and on a more continuous basis. (author)

  18. Sectoral job training as an intervention to improve health equity.

    Science.gov (United States)

    Tsui, Emma K

    2010-04-01

    A growing literature on the social determinants of health strongly suggests the value of examining social policy interventions for their potential links to health equity. I investigate how sectoral job training, an intervention favored by the Obama administration, might be conceptualized as an intervention to improve health equity. Sectoral job training programs ideally train workers, who are typically low income, for upwardly mobile job opportunities within specific industries. I first explore the relationships between resource redistribution and health equity. Next, I discuss how sectoral job training theoretically redistributes resources and the ways in which these resources might translate into improved health. Finally, I make recommendations for strengthening the link between sectoral job training and improved health equity.

  19. Specificity of the Best Possible Self intervention for increasing optimism: Comparison with a gratitude intervention

    OpenAIRE

    Peters, Madelon L; Meevissen, Yvo M. C; Hanssen, Marjolein M

    2013-01-01

    The present study compared the effects of a one week best possible self intervention and a one week gratitude intervention on life satisfaction and optimism. We hypothesized that both interventions would lead to similar increases in life satisfaction, but that only the best possible self intervention would increase optimism. The results partly confirmed the hypotheses: only the best possible self intervention led to increased optimism immediately after the intervention period, which further i...

  20. 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.

  1. Phonological Awareness and Rapid Automatized Naming Are Independent Phonological Competencies With Specific Impacts on Word Reading and Spelling: An Intervention Study.

    Science.gov (United States)

    Vander Stappen, Caroline; Reybroeck, Marie Van

    2018-01-01

    Phonological awareness (PA) and rapid automatized naming (RAN) have been shown to be powerful predictors of reading achievement across many languages. However, literature remains unclear: (a) whether RAN is independent of PA, (b) about the specific influences of PA and RAN on reading and spelling, and (c) about the efficacy of a RAN intervention. This study aims to address these issues by means of an intervention design. Precisely, the objectives are (a) to determine whether training one competence involves or not an effect on the other, (b) to examine whether each intervention based on oral abilities (PA vs. RAN) could improve word reading and word spelling performances, and (c) to assess the efficacy of a RAN-objects' intervention. Thirty-six French-speaking second graders, from two Belgian elementary schools, were divided into two groups, and received either a PA- or a RAN-objects' intervention. Twenty-five-minute lessons took place at school twice a week over a period of 2 months. Both groups were compared on multiple experimental measures (PA, RAN, word reading, and word spelling), before and immediately after the intervention, and 6 months later. Results showed specific efficacy of the two interventions, with participants trained in one ability outperforming those from the other group on this specific ability at post-test. Moreover, the PA intervention revealed transfer effects on the sub-lexical processes of spelling, while the RAN intervention enhanced word reading speed. Finally, the results demonstrated the efficacy of a RAN-objects' intervention for the first time. These findings provide a new piece of evidence showing the independence of PA and RAN, each process influencing the acquisition of literacy skills in a different way. The efficacy and the specific transfer effects of both interventions open up new perspectives for prevention and targeted remediation of reading disabilities.

  2. The impact of policies regulating alcohol trading hours and days on specific alcohol-related harms: a systematic review.

    Science.gov (United States)

    Sanchez-Ramirez, Diana C; Voaklander, Donald

    2018-02-01

    Evidence supports the expectation that changes in time of alcohol sales associate with changes in alcohol-related harm in both directions. However, to the best of our knowledge, no comprehensive systematic reviews had examined the effect of policies restricting time of alcohol trading on specific alcohol-related harms. To compile existing evidence related to the impact of policies regulating alcohol trading hours/days of on specific harm outcomes such as: assault/violence, motor vehicle crashes/fatalities, injury, visits to the emergency department/hospital, murder/homicides and crime. Systematic review of literature studying the impact of policies regulation alcohol trading times in alcohol-related harm, published between January 2000 and October 2016 in English language. Results support the premise that policies regulating times of alcohol trading and consumption can contribute to reduce injuries, alcohol-related hospitalisations/emergency department visits, homicides and crime. Although the impact of alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is also positive, these associations seem to be more complex and require further study. Evidence suggests a potential direct effect of policies that regulate alcohol trading times in the prevention of injuries, alcohol-related hospitalisations, homicides and crime. The impact of these alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is less compelling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. The use and utility of specific nonpharmacological interventions for behavioral symptoms in dementia: an exploratory study.

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Marx, Marcia S; Dakheel-Ali, Maha; Thein, Khin

    2015-02-01

    This study compares different nonpharmacological interventions for persons with behavioral symptoms and dementia on frequency of use and perceived efficacy in terms of change in behavior and interest. Participants were 89 nursing home residents from six Maryland nursing homes with a mean age of 85.9 years (SD: 8.6 years). Research assistants presented interventions tailored to the participants' needs and preferences in a pre-intervention trial phase and in an intervention phase. The impact of each intervention on behavioral symptoms and on the person's interest was rated immediately after the intervention by a research assistant. The most utilized interventions in both trial and treatment phases were the social intervention of one-on-one interaction, simulated social interventions such as a lifelike doll and respite video, the theme intervention of magazine, and the sensory stimulation intervention of music. In contrast, the least utilized interventions in both phases were sewing, fabric book, and flower arrangement. Interventions with the highest impact on behavioral symptoms included one-on-one social interaction, hand massage, music, video, care, and folding towels. Other high impact interventions included walking, going outside, flower arranging, food or drink, sewing, group activity, book presentation, ball toss, coloring or painting, walking, and family video. The results provide initial directions for choosing specific interventions for persons with dementia and also demonstrate a methodology for increasing knowledge through ongoing monitoring of practice. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. 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.

  5. The ethics of public policy RCTs: The principle of policy equipoise.

    Science.gov (United States)

    MacKay, Douglas

    2018-01-01

    In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For all arms of a policy RCT, policy experts must either (1) reasonably disagree about whether the trial arms are more effective than this policy, or (2) know that they are. © 2017 John Wiley & Sons Ltd.

  6. Piloting a Sex-Specific, Technology-Enhanced, Active Learning Intervention for Stroke Prevention in Women.

    Science.gov (United States)

    Dirickson, Amanda; Stutzman, Sonja E; Alberts, Mark J; Novakovic, Roberta L; Stowe, Ann M; Beal, Claudia C; Goldberg, Mark P; Olson, DaiWai M

    2017-12-01

    Recent studies reveal deficiencies in stroke awareness and knowledge of risk factors among women. Existing stroke education interventions may not address common and sex-specific risk factors in the population with the highest stroke-related rate of mortality. This pilot study assessed the efficacy of a technology-enhanced, sex-specific educational program ("SISTERS") for women's knowledge of stroke. This was an experimental pretest-posttest design. The sample consisted of 150 women (mean age, 55 years) with at least 1 stroke risk factor. Participants were randomized to either the intervention (n = 75) or control (n = 75) group. Data were collected at baseline and at a 2-week posttest. There was no statistically significant difference in mean knowledge score (P = .67), mean confidence score (P = .77), or mean accuracy score (P = .75) between the intervention and control groups at posttest. Regression analysis revealed that older age was associated with lower knowledge scores (P < .001) and lower confidence scores (P < .001). After controlling for age, the SISTERS program was associated with a statistically significant difference in knowledge (P < .001) and confidence (P < .001). Although no change occurred overall, after controlling for age, there was a statistically significant benefit. Older women may have less comfort with technology and require consideration for cognitive differences.

  7. Recommendations for equipment requirements and specifications for digital and interventional radiology: Dosimetric aspects

    International Nuclear Information System (INIS)

    Suliman, I.I.; Zoetelief, J.

    2002-01-01

    The recognition of radiation induced injuries from fluoroscopically guided interventional procedures has resulted in the current demand for development of recommendations and standards to limit dose to both patients and staff. This paper outlines the recommendations drafted within the framework of European Project DIMOND III. The actual work involves survey and review of national and international documents as well as scientific publications in areas relevant to the digital and/or interventional radiology with an aim of developing recommendations for equipment requirements and specifications for digital and interventional radiology. A pilot study of experimental investigations in at least three hospitals will be conducted to test the requirements and the specifications, the result of which will be presented. The recommendations are expected to provide an effective means of dose reduction to both patients and staff while maintaining image quality adequate for the specific diagnosis or interventional procedure. Different components of x-ray systems that have direct impact on patient and staff doses have been considered. Where necessary a compromise between patient dose and image quality has been made. The dosimetric aspects of the recommendations propose detailed descriptions and limits to dosimetric information relevant to patient and staff doses. International recommendations on maximum patient entrance surface dose rate vary in the range from 25 to 65 mGy.min -1 for normal mode fluoroscopy. Maximum image intensifier or image receptor input dose rate around 0.1 Gy min -1 at a distance 30 cm from the image intensifier input surface has been generally recommended. Maximum fluoroscopic dose rate in air must not exceed 50 mGy.min -1 at a location depending on the configuration e.g. for undertable x-ray tube at 10 mm from the patient support on the patient side of the support. The use of pulsed fluoroscopy or low dose fluoroscopy is proposed as good options to minimize

  8. Nutrition labelling is a trade policy issue: lessons from an analysis of specific trade concerns at the World Trade Organization.

    Science.gov (United States)

    Thow, Anne Marie; Jones, Alexandra; Hawkes, Corinna; Ali, Iqra; Labonté, Ronald

    2017-01-12

    Interpretive nutrition labels provide simplified nutrient-specific text and/or symbols on the front of pre-packaged foods, to encourage and enable consumers to make healthier choices. This type of labelling has been proposed as part of a comprehensive policy response to the global epidemic of non-communicable diseases. However, regulation of nutrition labelling falls under the remit of not just the health sector but also trade. Specific Trade Concerns have been raised at the World Trade Organization's Technical Barriers to Trade Committee regarding interpretive nutrition labelling initiatives in Thailand, Chile, Indonesia, Peru and Ecuador. This paper presents an analysis of the discussions of these concerns. Although nutrition labelling was identified as a legitimate policy objective, queries were raised regarding the justification of the specific labelling measures proposed, and the scientific evidence for effectiveness of such measures. Concerns were also raised regarding the consistency of the measures with international standards. Drawing on policy learning theory, we identified four lessons for public health policy makers, including: strategic framing of nutrition labelling policy objectives; pro-active policy engagement between trade and health to identify potential trade issues; identifying ways to minimize potential 'practical' trade concerns; and engagement with the Codex Alimentarius Commission to develop international guidance on interpretative labelling. This analysis indicates that while there is potential for trade sector concerns to stifle innovation in nutrition labelling policy, care in how interpretive nutrition labelling measures are crafted in light of trade commitments can minimize such a risk and help ensure that trade policy is coherent with nutrition action. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Correlates and predictors of obesity-specific quality of life of former participants of a residential intensive lifestyle intervention

    DEFF Research Database (Denmark)

    Elbe, A-M; Elsborg, P; Dandanell, S

    2018-01-01

    Introduction: The aim of this study was to investigate the relationship between weight loss during and after a unique type of weight loss intervention, namely, a residential intensive lifestyle intervention (ILI), and participants' obesity-specific health-related quality of life (HRQOL) several...

  10. The effects of public health policies on population health and health inequalities in European welfare states: protocol for an umbrella review.

    Science.gov (United States)

    Thomson, Katie; Bambra, Clare; McNamara, Courtney; Huijts, Tim; Todd, Adam

    2016-04-08

    The welfare state is potentially an important macro-level determinant of health that also moderates the extent, and impact, of socio-economic inequalities in exposure to the social determinants of health. The welfare state has three main policy domains: health care, social policy (e.g. social transfers and education) and public health policy. This is the protocol for an umbrella review to examine the latter; its aim is to assess how European welfare states influence the social determinants of health inequalities institutionally through public health policies. A systematic review methodology will be used to identify systematic reviews from high-income countries (including additional EU-28 members) that describe the health and health equity effects of upstream public health interventions. Interventions will focus on primary and secondary prevention policies including fiscal measures, regulation, education, preventative treatment and screening across ten public health domains (tobacco; alcohol; food and nutrition; reproductive health services; the control of infectious diseases; screening; mental health; road traffic injuries; air, land and water pollution; and workplace regulations). Twenty databases will be searched using a pre-determined search strategy to evaluate population-level public health interventions. Understanding the impact of specific public health policy interventions will help to establish causality in terms of the effects of welfare states on population health and health inequalities. The review will document contextual information on how population-level public health interventions are organised, implemented and delivered. This information can be used to identify effective interventions that could be implemented to reduce health inequalities between and within European countries. PROSPERO CRD42016025283.

  11. Smoker-free workplace policies: developing a model of public health consequences of workplace policies barring employment to smokers.

    Science.gov (United States)

    Houle, B; Siegel, M

    2009-02-01

    A marked shift in tobacco-related workplace health promotion intervention involves the adoption of policies barring employment to smokers. We discuss the potential public health consequences of these policies on those affected-smokers, their families, the surrounding community and society at large. We find a lack of published evidence evaluating the effectiveness and consequences of these policies. By developing a model of policy effects, we outline possible unintended consequences. With such large gaps in the evidence base and the potential for deleterious consequences, we argue for increased discussion about the use of smoker-free employment policies as a public health intervention and for increased engagement of employers by the public health community in worksite health promotion.

  12. 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...

  13. The role of reported tobacco-specific media exposure on adult attitudes towards proposed policies to limit the portrayal of smoking in movies.

    Science.gov (United States)

    Blake, Kelly D; Viswanath, K; Blendon, Robert J; Vallone, Donna

    2010-06-01

    To assess the relative, independent contribution of reported tobacco-specific media exposure (pro-tobacco advertising, anti-tobacco advertising, and news coverage of tobacco issues) to US adults' support for policy efforts that aim to regulate the portrayal of smoking in movies. Using the American Legacy Foundation's 2003 American Smoking and Health Survey (ASHES-2), multivariable logistic regression was used to model the predicted probability that US adults support movie-specific tobacco control policies, by reported exposure to tobacco-specific media messages, controlling for smoking status, education, income, race/ethnicity, age, sex, knowledge of the negative effects of tobacco and state. Across most outcome variables under study, findings reveal that reported exposure to tobacco-specific media messages is associated with adult attitudes towards movie-specific policy measures. Most exposure to tobacco information in the media (with the exception of pro-tobacco advertising on the internet) contributes independently to the prediction of adult support for movie-specific policies. The direction of effect follows an expected pattern, with reported exposure to anti-tobacco advertising and news coverage of tobacco predicting supportive attitudes towards movie policies, and reported exposure to pro-tobacco advertising lessening support for some movie policies, though the medium of delivery makes a difference. Media campaigns to prevent tobacco use and exposure to secondhand smoke have had value beyond the intended impact of single-issue campaigns; exposure to anti-tobacco campaigns and public dialogue about the dangers of tobacco seem also to be associated with shaping perceptions of the social world related to norms about tobacco, and ideas about regulating the portrayal of smoking in movies.

  14. Children's parasympathetic reactivity to specific emotions moderates response to intervention for early-onset aggression.

    Science.gov (United States)

    Gatzke-Kopp, Lisa M; Greenberg, Mark; Bierman, Karen

    2015-01-01

    Following theories that individual differences in respiratory sinus arrhythmia (RSA) denote differential sensitivity to environmental influences, this study examines whether differences in RSA reactivity to specific emotional challenges predict differential response to intervention. We present data from a randomized clinical trial of a targeted intervention for early onset aggression. In collaboration with a high-risk urban school district, 207 kindergarten children (73% African American, 66% male), identified by their teachers as having high levels of aggressive and disruptive behavior, were recruited. All children received a universal social-emotional curriculum. One hundred children were randomly assigned to an additional intervention consisting of weekly peer-based social skills training. Complete RSA data were available for 139 of the children. Teacher-reported externalizing symptoms and emotion regulation in 1st grade (post intervention) were examined controlling for baseline levels. First-grade peer nominations of aggressive behavior, controlling for baseline nominations, were also examined as outcomes. No effect of resting RSA was found. However, greater reactivity to anger was associated with higher externalizing symptoms and lower emotion regulation skills in 1st grade relative to low reactive children. Lower reactivity to fear was associated with greater improvement over time, an effect that was enhanced in the targeted intervention condition. Results suggest that measures of affective reactivity may provide insight into children's capacity to benefit from different types of interventions.

  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. The politics of surveillance policy: UK regulatory dynamics after Snowden

    Directory of Open Access Journals (Sweden)

    Arne Hintz

    2016-09-01

    Full Text Available The revelations by NSA whistleblower Edward Snowden have illustrated the scale and extent of digital surveillance carried out by different security and intelligence agencies. The publications have led to a variety of concerns, public debate, and some diplomatic fallout regarding the legality of the surveillance, the extent of state interference in civic life, and the protection of civil rights in the context of security. Debates about the policy environment of surveillance emerged quickly after the leaks began, but actual policy change is only starting. In the UK, a draft law (Investigatory Powers Bill has been proposed and is currently discussed. In this paper, we will trace the forces and dynamics that have shaped this particular policy response. Addressing surveillance policy as a site of struggle between different social forces and drawing on different fields across communication policy research, we suggest eight dynamics that, often in conflicting ways, have shaped the regulatory framework of surveillance policy in the UK since the Snowden leaks. These include the governmental context; national and international norms; court rulings; civil society advocacy; technical standards; private sector interventions; media coverage; and public opinion. We investigate how state surveillance has been met with criticism by parts of the technology industry and civil society, and that policy change was required as a result of legal challenges, review commissions and normative interventions. However a combination of specific government compositions, the strong role of security agendas and discourses, media justification and a muted reaction by the public have hindered a more fundamental review of surveillance practices so far and have moved policy debate towards the expansion, rather than the restriction, of surveillance in the aftermath of Snowden.

  17. Tuberculosis in Canada: Detection, Intervention and Compliance

    Directory of Open Access Journals (Sweden)

    Katya Richardson

    2014-11-01

    Full Text Available This paper provides an overview of the current state of TB in Canada by referencing information presented at the workshop, “Tuberculosis: Detection, Prevention, and Compliance.” The workshop took place on November 14 and 15, 2012 in Ottawa. The workshop was organized by the Centre for Disease Modeling and the Public Health Agency of Canada as a two-day knowledge translation event that was comprised of scientific and policy focused presentations designed to address four key objectives: (1 Evaluate the success of current tuberculosis (TB health policies and control strategies in Canada and for specific Canadian sub-populations; (2 Determine the impact of detection, intervention, compliance, and education strategies in terms of TB incidence and prevalence; (3 Develop targets for future interventions by identifying key characteristics of TB epidemics that impact the success of TB health policies and control strategies; (4 Leverage our existing ties with public health decision makers, aboriginal health organizations, and organizations serving the homeless to develop a research community that is based on close collaboration, and will foster national TB control efforts. The workshop elicited robust discussions between experts from a variety of academic disciplines and government officials. A summary of the information presented, comments shared, and questions posed, will provide a comprehensive understanding of the status of TB in Canada and future directions to be taken for improved control of the disease.

  18. Environmental Interventions for Obesity and Chronic Disease Prevention.

    Science.gov (United States)

    Gittelsohn, Joel; Trude, Angela

    2015-01-01

    Innovative approaches are needed to impact obesity and other diet-related chronic diseases, including tested interventions at the environmental and policy levels. We have conducted multi-level community trials in low-income minority settings in the United States and other countries that test interventions to improve the food environment, support policy, and reduce the risk for developing obesity and other diet-related chronic diseases. All studies have examined change from pre- to post-study, comparing an intervention with a comparison group. Our results have shown consistent positive effects of these trials on consumer psychosocial factors, food purchasing, food preparation and diet, and, in some instances, obesity. We have recently implemented a systems science model to support programs and policies to improve urban food environments. Environmental interventions are a promising approach for addressing the global obesity epidemic due to their wide reach. Further work is needed to disseminate, expand and sustain these initiatives through policy at the city, state and federal levels.

  19. Adolescent suicide prevention. Current research and social policy implications.

    Science.gov (United States)

    Garland, A F; Zigler, E

    1993-02-01

    The rate of adolescent suicide has increased dramatically in the past few decades, prompting several interventions to curb the increase. Unfortunately, many of the intervention efforts have not benefited from current research findings because the communication between researchers and those who develop the interventions is inadequate. Of specific concern are the increasingly popular curriculum-based suicide prevention programs, which have not demonstrated effectiveness and may contain potentially deleterious components. This article reviews the current epidemiological research in adolescent suicide and suggests how this knowledge could be used more effectively to reduce the rate of adolescent suicide. Recommendations include support for integrated primary prevention efforts; suicide prevention education for professionals; education and policies on firearm management; education for the media about adolescent suicide; more efficient identification and treatment of at-risk youth, including those exposed to suicidal behavior; crisis intervention; and treatment for suicide attempters.

  20. Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases.

    Science.gov (United States)

    Peters, D T J M; Raab, J; Grêaux, K M; Stronks, K; Harting, J

    2017-12-01

    Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as addressing environmental determinants of health. This study examines these relations in different phases of the policy process. A multiple-case study was performed on four public health-related policy networks. Using a snowball method among network actors, overall and sub-networks per policy phase were identified and the policy sector of each actor was assigned. To operationalise the outcome variable, interventions were classified by the proportion of environmental determinants they addressed. In the overall networks, no relation was found between structural network characteristics and network performance. In most effective cases, the policy development sub-networks were characterised by integration with less interrelations between actors (low cohesion), more equally distributed distances between the actors (low closeness centralisation), and horizontal integration in inter-sectoral cliques. The most effective case had non-public health central actors with less connections in all sub-networks. The results suggest that, to address environmental determinants of health, sub-networks should be inter-sectorally composed in the policy development rather than in the intervention development and implementation phases, and that policy development actors should have the opportunity to connect with other actors, without strong direction from a central actor. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. 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,…

  2. Childhood obesity policy: implications for African American girls and a nursing ecological model.

    Science.gov (United States)

    Reed, Monique

    2013-01-01

    In the United States there is a prevalence of obesity among ethnic groups, especially African American girls. The author in this column examines through an ecological lens selected American federal, state, and city policies and program interventions aimed at reducing obesity. Specifically, the eating behavior of African American girls is discussed as a population subset for which significant gaps are present in current obesity policy and implementation. Policy recommendations should include parents as research has shown a significant relationship in the eating behaviors of African American girls and their parents. Opportunities for nurses in practice and research to test the effectiveness of family and community level policy and program initiatives that address the ecological perspectives of the adolescent environment are discussed.

  3. How countries link REDD+ interventions to drivers in their readiness plans: implications for monitoring systems

    International Nuclear Information System (INIS)

    Salvini, G; Herold, M; De Sy, V; Kissinger, G; Brockhaus, 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 address. Moreover it is crucial to design systems that monitor the effectiveness of the planned interventions. In this article we provide a comprehensive and comparative assessment of interventions proposed by 43 REDD+ countries in 98 readiness documents. We summarize the types of interventions and assess if they are formulated referring to the drivers of DD that they are aiming to address. Based on this assessment we consider the implications for systems for monitoring effectiveness of proposed interventions. Most countries reviewed link proposed interventions to specific drivers of DD. The majority of the countries making this link have better driver data quality, in particularly those that present their data in ratio or ordinal terms. Proposed interventions focus not only on activities to reduce deforestation, but also on other forest related REDD+ activities such as sustainable forest management, which reduce forest degradation and enhance forest stocks. Moreover, driver-specific interventions often relate to drivers not only inside but also outside the forest sector. Hence we suggest that monitoring systems need to assess not only deforestation rates through remote sensing, but also degradation and other carbon stock changes within the forest, using more detailed ground level surveys and measurements. In addition, the performance of interventions outside the forest need to be monitored, even if the impacts of these cannot be linked to specific changes in forest carbon stock in specific locations. (paper)

  4. A Qualitative Study of HR/OHS Stress Interventions in Australian Universities

    Science.gov (United States)

    Winefield, Anthony H.; Boyd, Carolyn M.

    2018-01-01

    To enhance the understanding of psychosocial factors and extend research on work stress interventions, we investigated the key human resource (HR)/occupational health and safety (OHS) stress interventions implemented at five Australian universities over a three-year period. Five senior HR Directors completed an online survey to identify the intervention strategies taken at their university in order to reduce stress and enhance employee well-being and morale. We also explored the types of individual-, organization-, and individual/organization-directed interventions that were implemented, and the strategies that were prioritized at each university. Across universities, the dominant interventions were strategies that aimed to balance the social exchange in the work contract between employee-organization with an emphasis on initiatives to: enhance training, career development and promotional opportunities; improve remuneration and recognition practices; and to enhance the fairness of organizational policies and procedures. Strategies to improve work-life balance were also prominent. The interventions implemented were predominantly proactive (primary) strategies focused at the organizational level and aimed at eliminating or reducing or altering work stressors. The findings contribute to the improved management of people at work by identifying university-specific HR/OHS initiatives, specifically leadership development and management skills programs which were identified as priorities at three universities. PMID:29315278

  5. A Qualitative Study of HR/OHS Stress Interventions in Australian Universities.

    Science.gov (United States)

    Pignata, Silvia; Winefield, Anthony H; Boyd, Carolyn M; Provis, Chris

    2018-01-09

    To enhance the understanding of psychosocial factors and extend research on work stress interventions, we investigated the key human resource (HR)/occupational health and safety (OHS) stress interventions implemented at five Australian universities over a three-year period. Five senior HR Directors completed an online survey to identify the intervention strategies taken at their university in order to reduce stress and enhance employee well-being and morale. We also explored the types of individual-, organization-, and individual/organization-directed interventions that were implemented, and the strategies that were prioritized at each university. Across universities, the dominant interventions were strategies that aimed to balance the social exchange in the work contract between employee-organization with an emphasis on initiatives to: enhance training, career development and promotional opportunities; improve remuneration and recognition practices; and to enhance the fairness of organizational policies and procedures. Strategies to improve work-life balance were also prominent. The interventions implemented were predominantly proactive (primary) strategies focused at the organizational level and aimed at eliminating or reducing or altering work stressors. The findings contribute to the improved management of people at work by identifying university-specific HR/OHS initiatives, specifically leadership development and management skills programs which were identified as priorities at three universities.

  6. A Qualitative Study of HR/OHS Stress Interventions in Australian Universities

    Directory of Open Access Journals (Sweden)

    Silvia Pignata

    2018-01-01

    Full Text Available To enhance the understanding of psychosocial factors and extend research on work stress interventions, we investigated the key human resource (HR/occupational health and safety (OHS stress interventions implemented at five Australian universities over a three-year period. Five senior HR Directors completed an online survey to identify the intervention strategies taken at their university in order to reduce stress and enhance employee well-being and morale. We also explored the types of individual-, organization-, and individual/organization-directed interventions that were implemented, and the strategies that were prioritized at each university. Across universities, the dominant interventions were strategies that aimed to balance the social exchange in the work contract between employee-organization with an emphasis on initiatives to: enhance training, career development and promotional opportunities; improve remuneration and recognition practices; and to enhance the fairness of organizational policies and procedures. Strategies to improve work-life balance were also prominent. The interventions implemented were predominantly proactive (primary strategies focused at the organizational level and aimed at eliminating or reducing or altering work stressors. The findings contribute to the improved management of people at work by identifying university-specific HR/OHS initiatives, specifically leadership development and management skills programs which were identified as priorities at three universities.

  7. 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

  8. Intervention development in occupational research: an example from the printing industry.

    Science.gov (United States)

    Brown, T P; Rushton, L; Williams, H C; English, J S C

    2006-04-01

    Intervention development research is an essential prerequisite of any study that attempts to determine whether specific interventions work to prevent work related injury and illness. Focus groups (n = 5) and direct observational studies (n = 21) of printers were used to elicit key issues that would aid the development of subsequent interventions. Transcripts from these were analysed by standard qualitative methods to identify common and related themes. The views of managers differed significantly from those of print workers in a number of areas, and working practices did not always follow policy. The majority of printers did not perceive dermatitis to be a major problem, although many complained of dry hands. Other key results included: the lack of skin care policy in most companies; poor understanding of the nature, causes, and treatment of dermatitis; low priority of dermatitis within health and safety concerns; little or no provision of occupational health services, particularly skin checks; variability in provision of and access to appropriate skin protection; and lack of accessible washing facilities. As a result it was decided to evaluate the implementation of four provision of (1) skin checks and treatment advice; (2) gloves of the correct type and size, and use of an after-work cream; (3) information on dermatitis within the printing industry; and (4) development of best practice skin care policy.

  9. The One-Child Policy, Elder Care, and LGB Chinese: A Social Policy Explanation for Family Pressure.

    Science.gov (United States)

    Hildebrandt, Timothy

    2018-01-03

    Lesbian, gay, and bisexual (LGB) people in China consistently report family pressure as the greatest challenge they face in their daily lives. This problem has been explained primarily by highlighting sociocultural factors. While such explanations are important to understanding family pressure, they do not easily lead to actionable policy interventions to relieve it. This article suggests a new way of looking at family pressure by positing a social policy explanation. In particular, it reveals how both the one-child policy and elder care reforms have strong heteronormative biases that negatively and disproportionately affect LGB people, and it explores social policy interventions that may help address them. Beyond the China case, the article seeks to open up new avenues for research into how sexuality could be better accounted for in analyses of social policies and considered in broader discussions on defamilization and welfare state reform.

  10. Façade insulation retrofitting policy implementation process and its effects on health equity determinants: A realist review

    International Nuclear Information System (INIS)

    Camprubí, Lluís; Malmusi, Davide; Mehdipanah, Roshanak

    2016-01-01

    Fuel poverty and cold housing constitute a significant public health problem. Energy efficiency interventions, such as façade retrofitting, address the problem from a structural and long-term perspective. Despite evidence of the health benefits of insulation, little is known about the political and social contexts that contribute to social inequalities in receiving and experiencing health benefits from these interventions. We used a realist review methodology to better understand the mechanisms that explain how and why variations across different social groups appear in receiving energy efficiency façade retrofitting interventions and in their impact on health determinants. We considered the four stages of the policy implementation framework: public policy approach; policy; receiving intervention and impact on health determinants. We found strong evidence that certain social groups (low-income, renters, elderly) suffering most from fuel poverty, experience more barriers for undertaking a building retrofitting (due to factors such as upfront costs, “presentism” thinking, split incentives, disruption and lack of control), and that some public policies on housing energy efficiency may exacerbate these inequalities. This can be avoided if such policies specifically aim at tackling fuel poverty or social inequities, are completely free to users, target the most affected groups and are adapted to their needs. - Highlights: •Health benefits of housing façade insulation more pronounced in fuel poor groups. •Social groups suffering most from fuel poverty least likely to undergo insulation. •Energy efficiency policies focused solely on CO_2 reduction may increase inequalities. •Split Incentives and “Take-Back” effect show socioeconomic and contextual variability. •Universal policies without targeting increase inequalities in retrofitting uptake.

  11. The Human Factor: Training and Professional Development as a Policy Tool

    Directory of Open Access Journals (Sweden)

    Lucian CIOLAN

    2014-11-01

    Full Text Available In this paper, we try to make a case for the risky approach of many decision-makers and pol- icy specialists to overuse authority and regula- tion-based tools, while neglecting the ones more focused on human capacity and persuasion. Especially in fields like education, we consider that the human factor should be at the core of any policy mix, and a tool like training and pro- fessional development should gain a more visible and persistent role in policy interventions. Firstly, we try to analyze the distribution of policy tools on the authority-complexity axes. The value we see in the mapping of policy tools is that it can be used for investigating and positioning the activity of a specific governing body or central gover- nance. Thus, a fundamental question remains as to what really influences the choice of policy tools or instruments, as a basis for better understand- ing the rationales behind a specific policy mix. We argue that policy failure could be ex- plained in many cases by the incapacity to ad- dress in a consistent and professional way the human capacities needed for implementation. Thus, training and professional development are, at least, poorly used from the perspective of the potential they have. As an argument, we tried to look at training and professional development in the specific area of teachers in pre-university education in Romania, situating it in the broader context of European policies in lifelong learning and participation of adults in continuing educa- tion and training, but also in the local policy en- vironment. The results of the research led us to the conclusion that educational policies should be among the first in the broader spectrum of public policies valuing and emphasizing learning, through training and professional development of the stakeholders involved in policy change together with adding more value to the Human Factor in educational policies

  12. 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…

  13. Participatory planning of interventions to mitigate human-wildlife conflicts.

    Science.gov (United States)

    Treves, Adrian; Wallace, R B; White, S

    2009-12-01

    Conservation of wildlife is especially challenging when the targeted species damage crops or livestock, attack humans, or take fish or game. Affected communities may retaliate and destroy wildlife or their habitats. We summarize recommendations from the literature for 13 distinct types of interventions to mitigate these human-wildlife conflicts. We classified eight types as direct (reducing the severity or frequency of encounters with wildlife) and five as indirect (raising human tolerance for encounters with wildlife) interventions. We analyzed general cause-and-effect relationships underlying human-wildlife conflicts to clarify the focal point of intervention for each type. To organize the recommendations on interventions we used three standard criteria for feasibility: cost-effective design, wildlife specificity and selectivity, and sociopolitical acceptability. The literature review and the feasibility criteria were integrated as decision support tools in three multistakeholder workshops. The workshops validated and refined our criteria and helped the participants select interventions. Our approach to planning interventions is systematic, uses standard criteria, and optimizes the participation of experts, policy makers, and affected communities. We argue that conservation action generally will be more effective if the relative merits of alternative interventions are evaluated in an explicit, systematic, and participatory manner.

  14. 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.

  15. 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.

  16. Intervention for children exposed to interparental violence : A randomized controlled trial of effectiveness of specific factors, moderators and mediators in community-based intervention

    NARCIS (Netherlands)

    Overbeek, M.M.

    2014-01-01

    The main aim of this thesis was to evaluate the added benefit of applying specific factors in community-based intervention for child witnesses of interparental violence (IPV) and their parents, by means of a randomized controlled trial (RCT). The results of this RCT showed no additional benefits of

  17. 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...

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

    Science.gov (United States)

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

    2015-01-01

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

  19. Settings for Physical Activity – Developing a Site-specific Physical Activity Behavior Model based on Multi-level Intervention Studies

    DEFF Research Database (Denmark)

    Troelsen, Jens; Klinker, Charlotte Demant; Breum, Lars

    Settings for Physical Activity – Developing a Site-specific Physical Activity Behavior Model based on Multi-level Intervention Studies Introduction: Ecological models of health behavior have potential as theoretical framework to comprehend the multiple levels of factors influencing physical...... to be taken into consideration. A theoretical implication of this finding is to develop a site-specific physical activity behavior model adding a layered structure to the ecological model representing the determinants related to the specific site. Support: This study was supported by TrygFonden, Realdania...... activity (PA). The potential is shown by the fact that there has been a dramatic increase in application of ecological models in research and practice. One proposed core principle is that an ecological model is most powerful if the model is behavior-specific. However, based on multi-level interventions...

  20. 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

  1. 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.

  2. From Policy to Practice: A South-African Perspective on Implementing Inclusive Education Policy

    Science.gov (United States)

    Naicker, Sigamoney

    2007-01-01

    The advent of a democracy in South Africa ushered in refreshing changes within the South African context. Given South Africa's dark apartheid history, every policy intervention had to ensure a human rights ethos prevails. Inclusive Education, through the publication of the policy document Education White Paper 6 on Special Needs Education:…

  3. Healthy Food Procurement Policies and Their Impact

    Science.gov (United States)

    Niebylski, Mark L.; Lu, Tammy; Campbell, Norm R. C.; Arcand, Joanne; Schermel, Alyssa; Hua, Diane; Yeates, Karen E.; Tobe, Sheldon W.; Twohig, Patrick A.; L’Abbé, Mary R.; Liu, Peter P.

    2014-01-01

    Unhealthy eating is the leading risk for death and disability globally. As a result, the World Health Organization (WHO) has called for population health interventions. One of the proposed interventions is to ensure healthy foods are available by implementing healthy food procurement policies. The objective of this systematic review was to evaluate the evidence base assessing the impact of such policies. A comprehensive review was conducted by searching PubMed and Medline for policies that had been implemented and evaluated the impact of food purchases, food consumption, and behaviors towards healthy foods. Thirty-four studies were identified and found to be effective at increasing the availability and purchases of healthy food and decreasing purchases of unhealthy food. Most policies also had other components such as education, price reductions, and health interventions. The multiple gaps in research identified by this review suggest that additional research and ongoing evaluation of food procurement programs is required. Implementation of healthy food procurement policies in schools, worksites, hospitals, care homes, correctional facilities, government institutions, and remote communities increase markers of healthy eating. Prior or simultaneous implementation of ancillary education about healthy eating, and rationale for the policy may be critical success factors and additional research is needed. PMID:24595213

  4. 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

  5. A methodology for evaluating organizational change in community-based chronic disease interventions.

    Science.gov (United States)

    Hanni, Krista D; Mendoza, Elsa; Snider, John; Winkleby, Marilyn A

    2007-10-01

    In 2003, the Monterey County Health Department, serving Salinas, California, was awarded one of 12 grants from the Steps to a HealthierUS Program to implement a 5-year, multiple-intervention community approach to reduce diabetes, asthma, and obesity. National adult and youth surveys to assess long-term outcomes are required by all Steps sites; however, site-specific surveys to assess intermediate outcomes are not required. Salinas is a medically underserved community of primarily Mexican American residents with high obesity rates and other poor health outcomes. The health department's Steps program has partnered with traditional organizations such as schools, senior centers, clinics, and faith-based organizations as well as novel organizations such as employers of agricultural workers and owners of taquerias. The health department and the Stanford Prevention Research Center developed new site-specific, community-focused partner surveys to assess intermediate outcomes to augment the nationally mandated surveys. These site-specific surveys will evaluate changes in organizational practices, policies, or both following the socioecological model, specifically the Spectrum of Prevention. Our site-specific partner surveys helped to 1) identify promising new partners, select initial partners from neighborhoods with the greatest financial need, and identify potentially successful community approaches; and 2) provide data for evaluating intermediate outcomes matched to national long-term outcomes so that policy and organizational level changes could be assessed. These quantitative surveys also provide important context-specific qualitative data, identifying opportunities for strengthening community partnerships. Developing site-specific partner surveys in multisite intervention studies can provide important data to guide local program efforts and assess progress toward intermediate outcomes matched to long-term outcomes from nationally mandated surveys.

  6. Interventions to mitigate the effects of poverty and inequality on mental health.

    Science.gov (United States)

    Wahlbeck, Kristian; Cresswell-Smith, Johanna; Haaramo, Peija; Parkkonen, Johannes

    2017-05-01

    To review psychosocial and policy interventions which mitigate the effects of poverty and inequality on mental health. Systematic reviews, controlled trials and realist evaluations of the last 10 years are reviewed, without age or geographical restrictions. Effective psychosocial interventions on individual and family level, such as parenting support programmes, exist. The evidence for mental health impact of broader community-based interventions, e.g. community outreach workers, or service-based interventions, e.g. social prescribing and debt advice is scarce. Likewise, the availability of evidence for the mental health impact of policy level interventions, such as poverty alleviation or youth guarantee, is quite restricted. The social, economic, and physical environments in which people live shape mental health and many common mental disorders. There are effective early interventions to promote mental health in vulnerable groups, but it is necessary to both initiate and facilitate a cross-sectoral approach, and to form partnerships between different government departments, civic society organisations and other stakeholders. This approach is referred to as Mental Health in All Policies and it can be applied to all public policy levels from local policies to supranational.

  7. 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.

  8. Label, nudge or tax? A review of health policies for risky behaviours.

    Science.gov (United States)

    Galizzi, Matteo M

    2012-02-17

    This work proposes a critical, non systematic, review of the three main lines of health policy interventions to deal with risky behaviours, such as over-eating, smoking, sedentary lives, and excess alcohol drinking, namely: i) the release of information on health risks and consequences; ii) the use of incentives; and iii) direct policy intervention in markets, through regulation and taxation. First, the health and economic impact of the risky behaviours epidemics are briefly described. Then a critical review follows on the evidence existing on the effectiveness of each type of intervention. The review will also highlight the public health approach staying beyond each type of policy on risky behaviours and critically consider them within the context of more general health and social policy interventions.

  9. Implementation research evidence uptake and use for policy-making

    Directory of Open Access Journals (Sweden)

    Panisset Ulysses

    2012-07-01

    Full Text Available Abstract A major obstacle to the progress of the Millennium Development Goals has been the inability of health systems in many low- and middle-income countries to effectively implement evidence-informed interventions. This article discusses the relationships between implementation research and knowledge translation and identifies the role of implementation research in the design and execution of evidence-informed policy. After a discussion of the benefits and synergies needed to translate implementation research into action, the article discusses how implementation research can be used along the entire continuum of the use of evidence to inform policy. It provides specific examples of the use of implementation research in national level programmes by looking at the scale up of zinc for the treatment of childhood diarrhoea in Bangladesh and the scaling up of malaria treatment in Burkina Faso. A number of tested strategies to support the transfer of implementation research results into policy-making are provided to help meet the standards that are increasingly expected from evidence-informed policy-making practices.

  10. 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

  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)

    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

  12. Are Alcohol Taxation and Pricing Policies Regressive? Product-Level Effects of a Specific Tax and a Minimum Unit Price for Alcohol.

    Science.gov (United States)

    Vandenberg, Brian; Sharma, Anurag

    2016-07-01

    To compare estimated effects of two policy alternatives, (i) a minimum unit price (MUP) for alcohol and (ii) specific (per-unit) taxation, upon current product prices, per capita spending (A$), and per capita consumption by income quintile, consumption quintile and product type. Estimation of baseline spending and consumption, and modelling policy-to-price and price-to-consumption effects of policy changes using scanner data from a panel of demographically representative Australian households that includes product-level details of their off-trade alcohol spending (n = 885; total observations = 12,505). Robustness checks include alternative price elasticities, tax rates, minimum price thresholds and tax pass-through rates. Current alcohol taxes and alternative taxation and pricing policies are not highly regressive. Any regressive effects are small and concentrated among heavy consumers. The lowest-income consumers currently spend a larger proportion of income (2.3%) on alcohol taxes than the highest-income consumers (0.3%), but the mean amount is small in magnitude [A$5.50 per week (95%CI: 5.18-5.88)]. Both a MUP and specific taxation will have some regressive effects, but the effects are limited, as they are greatest for the heaviest consumers, irrespective of income. Among the policy alternatives, a MUP is more effective in reducing consumption than specific taxation, especially for consumers in the lowest-income quintile: an estimated mean per capita reduction of 11.9 standard drinks per week (95%CI: 11.3-12.6). Policies that increase the cost of the cheapest alcohol can be effective in reducing alcohol consumption, without having highly regressive effects. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  13. Paradigmatic obstacles to improving the health of populations: implications for health policy

    Directory of Open Access Journals (Sweden)

    McKinlay John B.

    1998-01-01

    Full Text Available While there are promising developments in public health, most interventions (both at the individual and community levels remain focused on "downstream" tertiary treatments or one-on-one interventions. These efforts have their origins in the biomedical paradigm and risk factor epidemiology and the behavioral science research methods that serve as their handmaidens. This paper argues for a more appropriate balance of "downstream" efforts with a more appropriate whole population public health approach to health policy -what may be termed a social policy approach to healthy lifestyles rather than the current lifestyle approach to health policy. New, more appropriate research methods must be developed and applied to match these emerging levels of whole population intervention. We must avoid any disjunction between new upstream policy level interventions and the methods used to measure their effect -appropriate unto the intervention level must be the evaluation method thereof.

  14. 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.

  15. Policy integration, coherence and governance in Dutch climate policy : a multi-level analysis of mitigation and adoption policy

    NARCIS (Netherlands)

    Bommel, van S.; Kuindersma, W.

    2008-01-01

    This report assesses the integration of climate policy in Dutch public policy at the national, regional, local and area level. The national analysis focuses on the horizontal integration of climate policy in national government programmes, adaptation and mitigation strategies and specific policy

  16. Herd-specific interventions to reduce antimicrobial usage in pig production without jeopardising technical and economic performance.

    Science.gov (United States)

    Collineau, L; Rojo-Gimeno, C; Léger, A; Backhans, A; Loesken, S; Nielsen, E Okholm; Postma, M; Emanuelson, U; Beilage, E Grosse; Sjölund, M; Wauters, E; Stärk, K D C; Dewulf, J; Belloc, C; Krebs, S

    2017-09-01

    Pig farmers are strongly encouraged to reduce their antimicrobial usage in order to reduce the risk of antimicrobial resistance. Herd-level intervention is needed to achieve national and European reduction targets. Alternative, especially preventive measures, have to be implemented to reduce the need for antimicrobial treatments. However, little is known about the feasibility, effectiveness and return on investment of such measures. The objective of this study was to assess, across four countries, the technical and economic impact of herd-specific interventions aiming at reducing antimicrobial usage in pig production while implementing alternative measures. An intervention study was conducted between February 2014 and August 2015 in 70 farrow-to-finish pig farms located in Belgium, France, Germany and Sweden. Herd-specific interventions were defined together with the farmer and the herd veterinarian. Farms were followed over one year and their antimicrobial usage and technical performance were compared with values from the year before intervention. Compliance with the intervention plan was also monitored. Changes in margin over feed cost and net farm profit were estimated in a subset of 33 Belgian and French farms with sufficient data, using deterministic and stochastic modeling. Following interventions, a substantial reduction in antimicrobial use was achieved without negative impact the overall farm technical performance. A median reduction of 47.0% of antimicrobial usage was achieved across four countries when expressed in terms of treatment incidence from birth to slaughter, corresponding to a 30.5% median reduction of antimicrobial expenditures. Farm compliance with intervention plans was high (median: 93%; min-max: 20; 100) and farms with higher compliance tended to achieve bigger reduction (ρ=-0.18, p=0.162). No association was found between achieved reduction and type or number of alternative measures implemented. Mortality in suckling piglets, weaners and

  17. 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.

  18. Increased Adoption of Quality Improvement Interventions to Implement Evidence-Based Practices for Pressure Ulcer Prevention in U.S. Academic Medical Centers.

    Science.gov (United States)

    Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Wald, Heidi L; Campbell, Jonathan D; Nair, Kavita V; Valuck, Robert J

    2015-12-01

    In 2008, the U.S. Centers for Medicare and Medicaid Services enacted a nonpayment policy for stage III and IV hospital-acquired pressure ulcers (HAPUs), which incentivized hospitals to improve prevention efforts. In response, hospitals looked for ways to support implementation of evidence-based practices for HAPU prevention, such as adoption of quality improvement (QI) interventions. The objective of this study was to quantify adoption patterns of QI interventions for supporting evidence-based practices for HAPU prevention. This study surveyed wound care specialists working at hospitals within the University HealthSystem Consortium. A questionnaire was used to retrospectively describe QI adoption patterns according to 25 HAPU-specific QI interventions into four domains: leadership, staff, information technology (IT), and performance and improvement. Respondents indicated QI interventions implemented between 2007 and 2012 to the nearest quarter and year. Descriptive statistics defined patterns of QI adoption. A t-test and statistical process control chart established statistically significant increase in adoption following nonpayment policy enactment in October 2008. Increase are described in terms of scope (number of QI domains employed) and scale (number of QI interventions within domains). Fifty-three of the 55 hospitals surveyed reported implementing QI interventions for HAPU prevention. Leadership interventions were most frequent, increasing in scope from 40% to 63% between 2008 and 2012; "annual programs to promote pressure ulcer prevention" showed the greatest increase in scale. Staff interventions increased in scope from 32% to 53%; "frequent consult driven huddles" showed the greatest increase in scale. IT interventions increased in scope from 31% to 55%. Performance and improvement interventions increased in scope from 18% to 40%, with "new skin care products . . ." increasing the most. Academic medical centers increased adoption of QI interventions

  19. Evidence-based policy versus morality policy: the case of syringe access programs.

    Science.gov (United States)

    de Saxe Zerden, Lisa; O'Quinn, Erin; Davis, Corey

    2015-01-01

    Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

  20. A systematic approach to injury policy assessment: introducing the assessment of child injury prevention policies (A-CHIPP).

    Science.gov (United States)

    Alonge, Olakunle; Agrawal, Priyanka; Meddings, David; Hyder, Adnan A

    2017-11-03

    This study presents a systematic approach-assessment of child injury prevention policies (A-CHIPP)-to assess and track policies on effective child injury interventions at the national level. Results from an initial pilot test of the approach in selected countries are presented. A literature review was conducted to identify conceptual models for injury policy assessment, and domains and indicators were proposed for assessing national injury policies for children aged 1-9 years. The indicators focused on current evidence-supported interventions targeting the leading external causes of child injury mortality globally, and were organised into a self-administered A-CHIPP questionnaire comprising 22 questions. The questionnaire was modified based on reviews by experts in child injury prevention. For an initial test of the approach, 13 countries from all six WHO regions were selected to examine the accuracy, usefulness and ease of understanding of the A-CHIPP questionnaire. Data on the A-CHIPP questionnaire were received from nine countries. Drowning and road traffic injuries were reported as the leading causes of child injury deaths in seven of these countries. Most of the countries lacked national policies on interventions that address child injuries; supportive factors such as finance and leadership for injury prevention were also lacking. All countries rated the questionnaire highly on its relevance for assessment of injury prevention policies. The A-CHIPP questionnaire is useful for national assessment of child injury policies, and such an assessment could draw attention of stakeholders to policy gaps and progress in child injury prevention in all countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Integration of fall prevention into state policy in Connecticut.

    Science.gov (United States)

    Murphy, Terrence E; Baker, Dorothy I; Leo-Summers, Linda S; Bianco, Luann; Gottschalk, Margaret; Acampora, Denise; King, Mary B

    2013-06-01

    To describe the ongoing efforts of the Connecticut Collaboration for Fall Prevention (CCFP) to move evidence regarding fall prevention into clinical practice and state policy. A university-based team developed methods of networking with existing statewide organizations to influence clinical practice and state policy. We describe steps taken that led to funding and legislation of fall prevention efforts in the state of Connecticut. We summarize CCFP's direct outreach by tabulating the educational sessions delivered and the numbers and types of clinical care providers that were trained. Community organizations that had sustained clinical practices incorporating evidence-based fall prevention were subsequently funded through mini-grants to develop innovative interventional activities. These mini-grants targeted specific subpopulations of older persons at high risk for falls. Building collaborative relationships with existing stakeholders and care providers throughout the state, CCFP continues to facilitate the integration of evidence-based fall prevention into clinical practice and state-funded policy using strategies that may be useful to others.

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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

  7. Label, nudge or tax? A review of health policies for risky behaviours

    Directory of Open Access Journals (Sweden)

    Matteo M. Galizzi

    2012-02-01

    Full Text Available This work proposes a critical, non systematic, review of the three main lines of health policy interventions to deal with risky behaviours, such as over-eating, smoking, sedentary lives, and excess alcohol drinking, namely: i the release of information on health risks and consequences; ii the use of financial incentives; and iii direct policy intervention in markets, through regulation and taxation. First, the health and economic impact of the risky behaviours epidemics are briefly described. Then a critical review follows on the evidence existing on the effectiveness of each type of intervention. The review will also highlight the public health approach staying beyond each type of policy on risky behaviours and critically consider them within the context of more general health and social policy interventions.

  8. Determinants of evidence use in Public Health Policy making

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  9. 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...

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

    Science.gov (United States)

    Room, Graham

    2013-01-01

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

  11. Communication and marketing as climate change-intervention assets a public health perspective.

    Science.gov (United States)

    Maibach, Edward W; Roser-Renouf, Connie; Leiserowitz, Anthony

    2008-11-01

    The understanding that global climate change represents a profound threat to the health and well-being of human and nonhuman species worldwide is growing. This article examines the potential of communication and marketing interventions to influence population behavior in ways consistent with climate change prevention and adaptation objectives. Specifically, using a framework based on an ecologic model of public health, the paper examines: (1) the potential of communication and marketing interventions to influence population behaviors of concern, including support for appropriate public policies; (2) potential target audiences for such programs; and (3) the attributes of effective climate change messages. Communication and marketing interventions appear to have considerable potential to promote important population behavior change objectives, but there is an urgent need for additional translational research to effectively harvest this potential to combat climate change.

  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. Museums and art galleries as partners for public health interventions.

    Science.gov (United States)

    Camic, Paul M; Chatterjee, Helen J

    2013-01-01

    The majority of public health programmes are based in schools, places of employment and in community settings. Likewise, nearly all health-care interventions occur in clinics and hospitals. An underdeveloped area for public health-related planning that carries international implications is the cultural heritage sector, and specifically museums and art galleries. This paper presents a rationale for the use of museums and art galleries as sites for public health interventions and health promotion programmes through discussing the social role of these organisations in the health and well-being of the communities they serve. Recent research from several countries is reviewed and integrated into a proposed framework for future collaboration between cultural heritage, health-care and university sectors to further advance research, policy development and evidence-based practice.

  14. Interventions for suspected placenta praevia.

    Science.gov (United States)

    Neilson, J P

    2003-01-01

    Because placenta praevia is implanted unusually low in the uterus, it may cause major, and/or repeated, antepartum haemorrhage. The traditional policy of care of women with symptomatic placenta praevia includes prolonged stay in hospital and delivery by caesarean section. To assess the impact of any clinical intervention applied specifically because of a perceived likelihood that a pregnant woman might have placenta praevia. A comprehensive electronic search was performed to identify relevant literature. Searched databases included the Trials Register maintained by the Cochrane Pregnancy and Childbirth Group (August 2002), and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2002). Any controlled clinical trial that has assessed the impact of an intervention in women diagnosed as having, or being likely to have, placenta praevia. Data were extracted, unblinded, by the author without consideration of results. Three trials were included, involving a total of 114 women. Both tested interventions (home versus hospitalisation and cervical cerclage versus no cerclage) were associated with reduced lengths of stay in hospital antenatally: weighted mean difference (WMD) respectively -18.50 days (95% confidence interval (CI) -26.83 to -10.17), -4.80 days (95% CI -6.37 to -3.23). Otherwise, there was little evidence of any clear advantage or disadvantage to a policy of home versus hospital care. The one woman who had a haemorrhage severe enough to require immediate transfusion and delivery was in the home care group. Cervical cerclage may reduce the risk of delivery before 34 weeks: relative risk (RR) 0.45 (95% CI 0.23 to 0.87), or the birth of a baby weighing less than two kilograms RR 0.34 (0.14 to 0.83) or having a low five minute Apgar score RR 0.19 (0.04 to 1.00). In general, these possible benefits were more evident in the trial of lower methodological quality. There are insufficient data from trials to recommend any change in clinical practice

  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. Are pro-welfare state and full-employment policies possible in the era of globalization?

    Science.gov (United States)

    Navarro, V

    2000-01-01

    There is a widely held belief in U.S. and European economic, political, and academic circles that economic globalization has considerably diminished states' power to follow public policies identified with the social democratic tradition, such as full-employment policies, comprehensive and universal provision of welfare state services, and state regulatory interventions in labor markets and economic policies. And large sectors of the European center-left and left parties believe that European monetary integration made expansionist and full-employment policies practically impossible, except when realized at the European continental level. This article presents empirical information that questions these positions. It documents how specific governments in Europe have been able to carry out such public policies during these years of economic globalization and monetary integration. Some countries (such as Sweden and Finland) that had carried out these policies then later weakened their implementation did so in response to political changes mostly unrelated to globalization of the economy or monetary integration. The article also analyzes and documents how countries that had followed expansionist and full-employment policies have responded to the globalization of financial markets.

  17. Making the most of natural experiments: What can studies of the withdrawal of public health interventions offer?

    Science.gov (United States)

    Craig, Peter; Gibson, Marcia; Campbell, Mhairi; Popham, Frank; Katikireddi, Srinivasa Vittal

    2018-03-01

    Many interventions that may have large impacts on health and health inequalities, such as social and public health policies and health system reforms, are not amenable to evaluation using randomised controlled trials. The United Kingdom Medical Research Council's guidance on the evaluation of natural experiments draws attention to the need for ingenuity to identify interventions which can be robustly studied as they occur, and without experimental manipulation. Studies of intervention withdrawal may usefully widen the range of interventions that can be evaluated, allowing some interventions and policies, such as those that have developed piecemeal over a long period, to be evaluated for the first time. In particular, sudden removal may allow a more robust assessment of an intervention's long-term impact by minimising 'learning effects'. Interpreting changes that follow withdrawal as evidence of the impact of an intervention assumes that the effect is reversible and this assumption must be carefully justified. Otherwise, withdrawal-based studies suffer similar threats to validity as intervention studies. These threats should be addressed using recognised approaches, including appropriate choice of comparators, detailed understanding of the change processes at work, careful specification of research questions, and the use of falsification tests and other methods for strengthening causal attribution. Evaluating intervention withdrawal provides opportunities to answer important questions about effectiveness of population health interventions, and to study the social determinants of health. Researchers, policymakers and practitioners should be alert to the opportunities provided by the withdrawal of interventions, but also aware of the pitfalls. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  18. The effectiveness of adolescent-specific prenatal interventions on improving attendance and reducing harm during and after birth: a systematic review.

    Science.gov (United States)

    Tibingana-Ahimbisibwe, Brenda; Katabira, Catherine; Mpalampa, Lena; Harrison, Roger A

    2016-08-18

    Adolescent pregnancy has been associated with poor pregnancy outcomes including pre-term birth (PTB), low birth weight (LBW) and perinatal death. To systematically review the effect of adolescent-specific interventions on reducing PTB, LBW, and perinatal death and increasing prenatal care attendance. Possible studies for inclusion were identified by a comprehensive search of OvidSP MEDLINE (limits: humans, 1990-present), EMBASE (limits: humans, 1990-2015), Popline and Global Health Database from the World Health Organisation (WHO) and PubMed International scientific databases, and references of identified articles were searched from 1990 to present. All types of controlled studies of prenatal interventions were exclusive to adolescents and at least one of the outcomes of interest. Investigators identified relevant studies and entered the data in a pro forma. Data were summarised as forest plots and narrative synthesis. Twenty-two studies (three randomised controlled trials (RCTs), four prospective cohort studies, nine retrospective cohort studies, five case controls and one natural experiment) were included with all but one study being carried out in higher-income countries. Seven of the 16 studies reporting on PTB found a statistically significant reduction in PTB rates between adolescent-specific prenatal care (intervention) and non-age specific prenatal care odds ratio (OR) and 95% confidence intervals (CIs) ranged from OR: 0.15 (95% CI: 0.03-0.83) to OR: 0.59 (95% CI: 0.45-0.78). Nine of the 12 studies reported statistically significant higher mean prenatal attendance rates among the intervention group compared to controls (ranging from a mean number of visits of 14.3 vs. 10.7 pbirth rate but their effect on perinatal death is uncertain. There is a distinct lack of evidence of the effectiveness of these interventions for adolescents living in low-middle income countries, despite having the majority of adolescent pregnancies, and associated risk of harm. No high

  19. Specific collaborative group intervention for patients with medically unexplained symptoms in general practice: a cluster randomized controlled trial.

    Science.gov (United States)

    Schaefert, R; Kaufmann, C; Wild, B; Schellberg, D; Boelter, R; Faber, R; Szecsenyi, J; Sauer, N; Guthrie, E; Herzog, W

    2013-01-01

    Patients with medically unexplained symptoms (MUS) are frequent in primary care and substantially impaired in their quality of life (QoL). Specific training of general practitioners (GPs) alone did not demonstrate sustained improvement at later follow-up in current reviews. We evaluated a collaborative group intervention. We conducted a cluster randomized controlled trial. Thirty-five GPs recruited 304 MUS patients (intervention group: 170; control group: 134). All GPs were trained in diagnosis and management of MUS (control condition). Eighteen randomly selected intervention GPs participated in training for a specific collaborative group intervention. They conducted 10 weekly group sessions and 2 booster meetings in their practices, together with a psychosomatic specialist. Six and 12 months after baseline, QoL was assessed with the Short-Form 36. The primary outcome was the physical composite score (PCS), and the secondary outcome was the mental composite score (MCS). At 12 months, intention-to-treat analyses showed a significant between-group effect for the MCS (p = 0.023) but not for the PCS (p = 0.674). This effect was preceded by a significant reduction of somatic symptom severity (15-item somatic symptom severity scale of the Patient Health Questionnaire, PHQ-15) at 6 months (p = 0.008) that lacked significance at 12 months (p = 0.078). As additional between-group effects at 12 months, per-protocol analyses showed less health anxiety (Whiteley-7; p = 0.038) and less psychosocial distress (PHQ; p = 0.024); GP visits were significantly (p = 0.042) reduced in the intervention group. Compared to pure GP training, collaborative group intervention achieved a progressive, clinically meaningful improvement in mental but not physical QoL. It could bridge gaps between general practice and mental health care. Copyright © 2012 S. Karger AG, Basel.

  20. 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

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

    Science.gov (United States)

    Grove, Jeffrey

    2014-01-01

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

  2. Lessons from photovoltaic policies in China for future development

    International Nuclear Information System (INIS)

    Huo, Mo-lin; Zhang, Dan-wei

    2012-01-01

    The paper first provides an overview of the current status of PV industry development in China, including the penetration speed, the market segments and the value chain. Further, it reviews the experience of governmental interventions composed of the legal framework, market incentives and manufacturing policies for lessons learning. After the Renewable Energy Law took effect in 2006, PV penetration was accelerated. Capital subsidies and feed-in tariffs, which were still in a trial stage, public bidding and the cooperation among relevant Ministries played important roles. A series of public R and D projects provided elemental technologies and meanwhile the preferential tax policies encouraged PV R and D nationwide. Then the paper looks into the future prospects, based on the technical potential, the national indicative targets in 2020, and the energy planning considering the governmental targets of energy transition and CO 2 mitigation. Consequently we analyze problems impeding the future development based on evidences. For instance, there was no predetermined degression of the capital subsidy to push cost reduction; the budget and the organization of public PV R and D were insufficient. Finally, we propose some recommendations on improving policy interventions. - Highlights: ► Surveys the current status of PV industry in China, including the market trend, the installation distribution and the value chain. ► Reviews the experience of governmental interventions composed of the legal framework, market policies and manufacturing policies. ► Looks into future prospects, based on the technical potential, the national targets of 2020, policies of energy transition and CO 2 mitigation. ► Analyzes barriers of future development, and proposes some recommendations on improving policy interventions.

  3. The Evaluation of the Effectiveness of Counterterrorism Policies on the PKK-inflicted Violence during the Democratization Process of Turkey

    OpenAIRE

    Irfan Ciftci; Sedat Kula

    2015-01-01

    This study tries to explore the relationship between soft-line governmental policy interventions of Turkey and the responses of the PKK (The Kurdistan Workers’ Party) by using time series data from 1995 to 2010. The negative binomial specifications for two models, the number of incidents and the number casualties are used. The aggregated impact of soft-line policies on the level of violence is found to be positive and significant. In one hand, Turkey’s EU accession process had a decreasing im...

  4. Disability Policy Evaluation: Combining Logic Models and Systems Thinking

    Science.gov (United States)

    Claes, Claudia; Ferket, Neelke; Vandevelde, Stijn; Verlet, Dries; De Maeyer, Jessica

    2017-01-01

    Policy evaluation focuses on the assessment of policy-related personal, family, and societal changes or benefits that follow as a result of the interventions, services, and supports provided to those persons to whom the policy is directed. This article describes a systematic approach to policy evaluation based on an evaluation framework and an…

  5. 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.

  6. 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 ...

  7. Access to Justice 4 Known or Potential Extremists? : Local Professionals on Legal Remedies Against Person-Specific Interventions

    NARCIS (Netherlands)

    Quirine Eijkman; Josien Roodnat

    2016-01-01

    This article discusses, from the local professional perspective, access to justice for person-specific interventions to prevent or counter (violent) extremism in Europe. Using a Dutch case study it focusses on legal protection for hand-tailored interferences that are part of a wider-ranging

  8. State health agencies and the legislative policy process.

    Science.gov (United States)

    Williams-Crowe, S M; Aultman, T V

    1994-01-01

    A new era of health care reform places increasing pressure on public health leaders and agencies to participate in the public policy arena. Public health professionals have long been comfortable in providing the scientific knowledge base required in policy development. What has been more recent in its evolution, however, is recognition that they must also play an active role in leading and shaping the debate over policy. A profile of effective State legislative policy "entrepreneurs" and their strategies has been developed to assist health agencies in developing such a leadership position. Based on the experiences of State legislative liaison officers, specific strategies for dealing with State legislatures have been identified and are organized into five key areas--agency organization, staff skills, communications, negotiation, and active ongoing involvement. A public health agency must be organized effectively to participate in the legislative policy process. Typically, effective agencies centralize responsibility for policy activities and promote broad and coordinated participation throughout the organization. Playing a key role in the agency's political interventions, the legislative liaison office should be staffed with persons possessing excellent interpersonal skills and a high degree of technical competence. Of central importance to effective legislative policy entrepreneurship is the ability to communicate the agency's position clearly. This includes setting forward a focused policy agenda, documenting policy issues in a meaningful manner, and reaching legislators with the proper information. Once a matter is on the legislative agenda, the agency must be prepared to negotiate and build broad support for the measure. Finally, public health agencies must be active policy players. To take advantage of new opportunities for action, the public health (policy) leader must monitor the political environment continually.By working to anticipate and formulate

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

    Science.gov (United States)

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

    2014-09-23

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

  10. Mitigating pharmaceutical waste exposures: policy and program considerations.

    Science.gov (United States)

    Amster, Eric D

    2016-01-01

    Pharmaceutical disposal and the environmental fate of medication metabolites directly impacts the public's health in two significant ways: accidental medication ingestion of pharmaceuticals that were not disposed of properly results in inadvertent toxicity; and environmental health consequences of pharmaceuticals that were inappropriately disposed and which contaminate municipal water supply. In reviewing the effectiveness of medication disposal policy globally, it is crucial to not only determine which policies are effective but also to assess why they are effective. By assessing the root causes for a specific policy's effectiveness it can be determined if those successes could be translated to another country with a different health care system, unique culture and divergent policy ecosystem. Any intervention regarding pharmaceutical disposal would require a multifaceted approach beyond raising awareness and coordinating pharmaceutical disposal on a national level. While consumer participation is important, effective primary prevention would also include research on drug development that is designed to biodegrade in the environment as opposed to medications that persist and accumulate in the natural environment even when properly disposed. Countries that lack a nationalized disposal policy should leverage the resources and infrastructure already in place in the national health care system to implement a unified policy to address medication disposal in the short-term. In tandem, efforts should be made to recruit the biotechnology sector in high-tech and academia to develop new technologies in medication design and water filtration to decrease exposures in the long-term.

  11. Screenplays: From knowledge to devicing policies

    Directory of Open Access Journals (Sweden)

    Damjana Gantar

    2006-01-01

    Full Text Available Public policies and related interventions cause diverse territorial impacts; intended and wanted as well as lateral, indirect and unwanted ones. Strategic impact assessments are commonly used to identify and assess these impacts. Besides, the main intention of impact assessments is to influence and optimize the policy actions in terms of their impacts. Forecasting of future development and identification of impacts is a complex task, charged with uncertainties, which requires resourceful use and combination of different tools. Scenarios are among the most effective forecasting, communication and policy design tools. The paper presents the use of scenarios in a strategic environmental impact assessment for a high speed rail in Slovenia. Scenarios were used as an input for environmental vulnerability modelling. Acceptability of environmental costs brought about by planned intervention can only be assessed based on knowledge about the changes/benefits.

  12. 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

  13. Landscape Analysis of Nutrition-sensitive Agriculture Policy Development in Senegal.

    Science.gov (United States)

    Lachat, Carl; Nago, Eunice; Ka, Abdoulaye; Vermeylen, Harm; Fanzo, Jessica; Mahy, Lina; Wüstefeld, Marzella; Kolsteren, Patrick

    2015-06-01

    Unlocking the agricultural potential of Africa offers a genuine opportunity to address malnutrition and drive development of the continent. Using Senegal as a case study, to identify gaps and opportunities to strengthen agricultural policies with nutrition-sensitive approaches. We carried out a systematic analysis of 13 policy documents that related to food production, agriculture, food security, or nutrition. Next, we collected data during a participatory analysis with 32 national stakeholders and in-depth interviews with 15 national experts of technical directorates of the different ministries that deal with agriculture and food production. The current agricultural context has various elements that are considered to enhance its nutrition sensitivity. On average, 8.3 of the 17 Food and Agriculture Organization guiding principles for agriculture programming for nutrition were included in the policies reviewed. Ensuring food security and increasing dietary diversity were considered to be the principal objectives of agricultural policies. Although there was considerable agreement that agriculture can contribute to nutrition, current agricultural programs generally do not target communities on the basis of their nutritional vulnerability. Agricultural programs were reported to have specific components to target female beneficiaries but were generally not used as delivery platforms for nutritional interventions. The findings of this study indicate the need for a coherent policy environment across the food system that aligns recommendations at the national level with local action on the ground. In addition, specific activities are needed to develop a shared understanding of nutrition and public health nutrition within the agricultural community in Senegal. © The Author(s) 2015.

  14. 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.

  15. 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...

  16. Cooperative learning in science: intervention in the secondary school

    Science.gov (United States)

    Topping, K. J.; Thurston, A.; Tolmie, A.; Christie, D.; Murray, P.; Karagiannidou, E.

    2011-04-01

    The use of cooperative learning in secondary school is reported - an area of considerable concern given attempts to make secondary schools more interactive and gain higher recruitment to university science courses. In this study the intervention group was 259 pupils aged 12-14 years in nine secondary schools, taught by 12 self-selected teachers. Comparison pupils came from both intervention and comparison schools (n = 385). Intervention teachers attended three continuing professional development days, in which they received information, engaged with resource packs and involved themselves in cooperative learning. Measures included both general and specific tests of science, attitudes to science, sociometry, self-esteem, attitudes to cooperative learning and transferable skills (all for pupils) and observation of implementation fidelity. There were increases during cooperative learning in pupil formulation of propositions, explanations and disagreements. Intervened pupils gained in attainment, but comparison pupils gained even more. Pupils who had experienced cooperative learning in primary school had higher pre-test scores in secondary education irrespective of being in the intervention or comparison group. On sociometry, comparison pupils showed greater affiliation to science work groups for work, but intervention pupils greater affiliation to these groups at break and out of school. Other measures were not significant. The results are discussed in relation to practice and policy implications.

  17. Fiscal policy and the global financial crisis

    DEFF Research Database (Denmark)

    Andersen, Torben M.

     The financial crisis raises demands for fiscal policy interventions. While a fall in aggregate demand is an important consequence of the crisis, it also reflects more underlying structural problems and changes. Hence, appropriate policy designs have to take account of the nature of the crisis......-run objectives are discussed. Past experience shows that deep recessions become persistent due to marginalization of unemployed, and therefore labour market policies have to be considered as an integral part of policy packages. Finally the question of international policy coordination is addressed....

  18. 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

  19. 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

  20. 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.

  1. The immediate effect of a brief energy psychology intervention (Emotional Freedom Techniques) on specific phobias: a pilot study.

    Science.gov (United States)

    Salas, Martha M; Brooks, Audrey J; Rowe, Jack E

    2011-01-01

    Specific phobia is one of the most prevalent anxiety disorders. Emotional Freedom Techniques (EFT) has been shown to improve anxiety symptoms; however, their application to specific phobias has received limited attention. This pilot study examined whether EFT, a brief exposure therapy that combines cognitive and somatic elements, had an immediate effect on the reduction of anxiety and behavior associated with specific phobias. The study utilized a crossover design with participants randomly assigned to either diaphragmatic breathing or EFT as the first treatment. The study was conducted at a regional university in the Southwestern United States. Twenty-two students meeting criteria for a phobic response to a specific stimulus (≥8 on an 11-point subjective units of distress scale). Participants completed a total of five two-minute rounds in each treatment intervention. Study measures included a behavioral approach test (BAT), Subjective Units of Distress Scale (SUDS), and Beck Anxiety Inventory (BAI). Emotional Freedom Techniques significantly reduced phobia-related anxiety (BAI P = .042; SUDS P = .002) and ability to approach the feared stimulus (BAT P = .046) whether presented as an initial treatment or following diaphragmatic breathing. When presented as the initial treatment, the effects of EFT remained through the presentation of the comparison intervention. The efficacy of EFT in treating specific phobias demonstrated in several earlier studies is corroborated by the current investigation. Comparison studies between EFT and the most effective established therapies for treating specific phobias are recommended. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. 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.

  3. 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.

  4. Education and Equality in Portugal: The Role of Priority Education Policies

    Directory of Open Access Journals (Sweden)

    Maria Dias

    2013-03-01

    Full Text Available This article addresses priority education policies developed in Portugal and focuses on the latest intervention trends in this regard. Firstly, the contexts in which these policies emerged are described with respect to the country’s specificity concerning the universalization of basic education and compulsory schooling, as well as social and educational equity. Secondly, the main current governmental initiative in the field, Priority Intervention Education Territories (TEIP2, is analyzed. It aims to reduce school failure and school dropout in deprived areas and attempts to fulfill the goals set for Europe in terms of education and training. We analyze TEIP2 program’s impact on students’ school achievement, dropout and on the possibilities of innovating pedagogical practices. We argue that significant changes have occurred in the conceptions and goals of priority education in Portugal, especially in what concerns the need for schools to acknowledge the sociological and cultural diversity of their students and families. However, it cannot be neglected that current policies show an important vulnerability in what concerns their ambitious goals, as they simultaneously try to achieve system modernization, social cohesion and reduction of social inequalities. In our opinion, the question of knowing if these principles and logics of action are compatible or can coexist is remaining, especially in the context of a deep economic and financial crisis that is nowadays prevailing in Portugal.

  5. Development and application of dynamic hybrid multi-region inventory analysis for macro-level environmental policy analysis: a case study on climate policy in Taiwan.

    Science.gov (United States)

    Chao, Chia-Wei; Heijungs, Reinout; Ma, Hwong-wen

    2013-03-19

    We develop a novel inventory method called Dynamic Hybrid Multi-Region Inventory analysis (DHMRI), which integrates the EEMRIOA and Integrated Hybrid LCA and applies time-dependent environmental intervention information for inventory analysis. Consequently, DHMRI is able to quantify the change in the environmental footprint caused by a specific policy while taking structural changes and technological dynamics into consideration. DHMRI is applied to assess the change in the total CO2 emissions associated with the total final demand caused by the climate policy in Taiwan to demonstrate the practicality of this novel method. The evaluation reveals that the implementation of mitigation measures included in the existing climate policy, such as an enhancement in energy efficiency, promotion of renewable energy, and limitation of the growth of energy-intensive industries, will lead to a 28% increase in the total CO2 emissions and that the main driver is the export-oriented electronics industry. Moreover, a major increase in the total emissions is predicted to occur in Southeast Asia and China. The observations from the case study reveal that DHMRI is capable of overcoming the limitations of existing assessment tools at macro-level evaluation of environmental policies.

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

    Science.gov (United States)

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

    2016-10-01

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

  7. HIV risk inside U.S. prisons: a systematic review of risk reduction interventions conducted in U.S. prisons.

    Science.gov (United States)

    Valera, Pamela; Chang, Yvonne; Lian, Zi

    2017-08-01

    HIV prevalence in correctional populations is approximately five times that of the general adult population. This systematic review examines the broad question of HIV prevention and interventions to reduce inmate HIV-related risk behaviors in U.S. federal and state prisons. We conducted a systematic review of multiple databases and Google Scholar to identify behavioral, biomedical, social, and policy studies related to HIV among U.S. prison populations from 1980-2014. Studies were excluded if they did not focus on HIV, prison inmates, if they were conducted outside of the U.S., if they involved juvenile offenders, or if they included post-release outcomes. Twenty-seven articles met the study criteria. Evidence suggests that research related to the HIV care continuum, risk behaviors, gender, prevention (e.g., peer education), and policy are key topics to enhance HIV prevention interventions in the criminal justice system. This review provides a prison-specific overview of HIV in U.S. correctional populations and highlight effective interventions, including inmate peer education. There is an urgent need to continue to implement HIV prevention interventions across all prisons and improve the quality of life among those at heightened risk of HIV infection.

  8. HIV risk and preventive interventions in transgender women sex workers

    Science.gov (United States)

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-01

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  9. National ownership in the implementation of global climate policy in Uganda

    DEFF Research Database (Denmark)

    Olsen, K.H.

    2006-01-01

    This article explores the history, from a developing country perspective, of how external interventions to implement global policies on the Climate Convention and the Clean Development Mechanism (CDM) have been integrated into national development policy frameworks in the period 1990-2005. The main...... question asked is to what extent external interventions have formed part of a country-driven approach in Uganda. The conflicting national and global priorities concerning the need for adaptation to the impacts of climate change versus the need for global mitigation of greenhouse gases (GHGs) are explored...... first. Against this background, Uganda's policy response to climate change is reviewed. National climate policies are found not to exist, and the implementation of global policies is not integrated into national policy frameworks, partly due to conflicting national and global priorities. Given limited...

  10. Policy Learning and Organizational Capacities in Innovation Policies

    DEFF Research Database (Denmark)

    Borrás, Susana

    2011-01-01

    Bengt-Åke Lundvall’s work has underlined the importance of policy learning for inducing innovation systems’ adaptability. In spite of his efforts and of the general interest in this topic, studies of policy learning in innovation policy continue to be scarce. Elaborating from recent theoretical...... advances, the paper identifies three levels of policy learning and argues that their effects on innovation systems are related to specific capacities of the relevant organizations implementing change. This analytical framework is used in the study of trans-national policy learning in Europe in the area...... of science–industry relations, showing the importance of capacities (or lack thereof). This calls for the practical need of addressing organizational capacity-building, in particular of analytical capacity, for truly strategic innovation policy-making....

  11. Constructing public oral health policies in Brazil: issues for reflection.

    Science.gov (United States)

    Soares, Catharina Leite Matos

    2012-01-01

    This paper addresses the construction of public oral health policies in Brazil by reviewing the available literature. It includes a discussion of the social responses given by the Brazilian State to oral health policies and the relationship of these responses with the ideological oral health movements that have developed globally, and that have specifically influenced oral health policies in Brazil. The influence of these movements has affected a series of hegemonic practices originating from both Market Dentistry and Preventive and Social Dentistry in Brazil. Among the state activities that have been set into motion, the following stand out: the drafting of a law to regulate the fluoridation of the public water supply, and the fluoridation of commercial toothpaste in Brazil; epidemiological surveys to analyze the status of the Brazilian population's oral health; the inclusion of oral health in the Family Health Strategy (Estratégia de Saúde da Família - ESF); the drawing up of the National Oral Health Policy, Smiling Brazil (Brasil Sorridente). From the literature consulted, the progressive expansion of state intervention in oral health policies is observed. However, there remains a preponderance of hegemonic "dental" practices reproduced in the Unified Public Health Service (Sistema Único de Saúde - SUS) and the Family Health Strategy.

  12. Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case?control study

    OpenAIRE

    Omlin, Aurelius; Blum, David; Wierecky, Jan; Haile, Sarah R.; Ottery, Faith D.; Strasser, Florian

    2013-01-01

    Background Involuntary weight loss (IWL) is frequent in advanced cancer patients causing compromised anticancer treatment outcomes and function. Cancer cachexia is influenced by nutrition impact symptoms (NIS). The aim of this study was to explore the frequency of NIS in advanced patients and to assess specific interventions guided by a 12-item NIS checklist. Methods Consecutive patients from an outpatient nutrition-fatigue clinic completed the NIS checklist. The NIS checklist was developed b...

  13. Identifying Priorities for Aging Policies in Two Portuguese Communities.

    Science.gov (United States)

    Bárrios, Maria João; Fernandes, Ana Alexandre; Fonseca, António Manuel

    2018-02-20

    The aging population has an impact on health, social, and economic issues in regard to individuals, communities, and organizations. The challenge for local policies in response to aging is to create sufficient resources to meet the population's needs, wishes, and rights as people age. Active aging constitutes one of the guiding perspectives on policies. Taking into account the local governance perspective, the Model for Aging Local Policies Analysis (MALPA) was created in order to convert the active aging paradigm into a practical approach, as a technique to evaluate and analyze local aging policies. In this research, the MALPA instrument was applied in two Portuguese communities (Coruche and Oeiras). The objective was to identify the intervention priorities of aging policies in both communities, determining whether the instrument can facilitate the development of proposals for the improvement of local aging policies. It was possible to evaluate the communities and programs, identifying the least appropriate policy actions regarding the intervention priorities. The results allowed us to identify 10 priorities about collaborative governance, involvement of the elderly in the policy-making process, lifelong learning, economic hardship, policies for all ages, isolated vulnerable and fragile groups, intergenerational contacts, safety in all policies, labor opportunities, and conditions and transport network improvement.

  14. Targeting brains, producing responsibilities: the use of neuroscience within British social policy.

    Science.gov (United States)

    Broer, Tineke; Pickersgill, Martyn

    2015-05-01

    Concepts and findings 'translated' from neuroscientific research are finding their way into UK health and social policy discourse. Critical scholars have begun to analyse how policies tend to 'misuse' the neurosciences and, further, how these discourses produce unwarranted and individualizing effects, rooted in middle-class values and inducing guilt and anxiety. In this article, we extend such work while simultaneously departing from the normative assumptions implied in the concept of 'misuse'. Through a documentary analysis of UK policy reports focused on the early years, adolescence and older adults, we examine how these employ neuroscientific concepts and consequently (re)define responsibility. In the documents analysed, responsibility was produced in three different but intersecting ways: through a focus on optimisation, self-governance, and vulnerability. Our work thereby adds to social scientific examinations of neuroscience in society that show how neurobiological terms and concepts can be used to construct and support a particular imaginary of citizenship and the role of the state. Neuroscience may be leveraged by policy makers in ways that (potentially) reduce the target of their intervention to the soma, but do so in order to expand the outcome of the intervention to include the enhancement of society writ large. By attending as well to more critical engagements with neuroscience in policy documents, our analysis demonstrates the importance of being mindful of the limits to the deployment of a neurobiological idiom within policy settings. Accordingly, we contribute to increased empirical specificity concerning the impacts and translation of neuroscientific knowledge in contemporary society whilst refusing to take for granted the idea that the neurosciences necessarily have a dominant role (to play). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. THE FORMATION OF ENVIRONMENTAL AND ECONOMIC POLICY IN UKRAINE: REGIONAL SPECIFICITY

    Directory of Open Access Journals (Sweden)

    Volodymyr Korol’

    2016-03-01

    state in ore mining areas and industrial urban agglomerations, ensuring its sustainable improvement and ecologically balanced condition; - execution of environmentally sound assessments of population specific provision by different types of natural resources, including life-supporting; - improving the economic levers of environmental control. Ukraine is one of the countries whose development largely depends on balancing the use of available natural resource base, primarily life-supporting (land, water, mineral and raw material.  Research and analysis confirm that, despite the inherited problems of development, Ukraine has its  own opportunities of problems solving, especially through the effective using of all kinds natural resources. Assuming that the industrial structure is the core national economy, its dynamics, natural and  resource input, the priority objective is the improvement of industry structure in the direction of  increasing its technology and providing benefits to those sectors and industries that produce the final ecologically not capacious and environmentally friendly products. This is a problem of great strategic goal, to which the public policy must focus. Thus, the most active level of ecological and economic systems is regional one, as the region (area is also the governance subject, at this level environmental problems of society are emerging, the requirements for the production greening and environmental management are nominated. The region combines specific area points of productive forces distribution, polluting enterprises and natural resources using enterprises, which are parts of its economic structure. The structure and scale of regional production determine the character and volume of pollution, the intensity of the impact on the environment. Thus, the development of the national economy requires considering for at least three factors: first, the natural resource potential of the national territory, which in Ukraine, as in each country

  16. Innovation and Integrity in Intervention Research: Conceptual Issues, Methodology, and Knowledge Translation.

    Science.gov (United States)

    Malti, Tina; Beelmann, Andreas; Noam, Gil G; Sommer, Simon

    2018-04-01

    In this article, we introduce the special issue entitled Innovation and Integrity in Intervention Science. Its focus is on essential problems and prospects for intervention research examining two related topics, i.e., methodological issues and research integrity, and challenges in the transfer of research knowledge into practice and policy. The main aims are to identify how to advance methodology in order to improve research quality, examine scientific integrity in the field of intervention science, and discuss future steps to enhance the transfer of knowledge about evidence-based intervention principles into sustained practice, routine activities, and policy decisions. Themes of the special issue are twofold. The first includes questions about research methodology in intervention science, both in terms of research design and methods, as well as data analyses and the reporting of findings. Second, the issue tackles questions surrounding the types of knowledge translation frameworks that might be beneficial to mobilize the transfer of research-based knowledge into practice and public policies. The issue argues that innovations in methodology and thoughtful approaches to knowledge translation can enable transparency, quality, and sustainability of intervention research.

  17. Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case-control study.

    Science.gov (United States)

    Omlin, Aurelius; Blum, David; Wierecky, Jan; Haile, Sarah R; Ottery, Faith D; Strasser, Florian

    2013-03-01

    Involuntary weight loss (IWL) is frequent in advanced cancer patients causing compromised anticancer treatment outcomes and function. Cancer cachexia is influenced by nutrition impact symptoms (NIS). The aim of this study was to explore the frequency of NIS in advanced patients and to assess specific interventions guided by a 12-item NIS checklist. Consecutive patients from an outpatient nutrition-fatigue clinic completed the NIS checklist. The NIS checklist was developed based on literature review and multiprofessional clinical expert consensus. Chart review was performed to detect defined NIS typical interventions. Oncology outpatients not seen in the nutrition-fatigue clinic were matched for age, sex, and tumor to serve as controls. In 52 nutrition-fatigue clinic patients, a mixed cancer population [IWL in 2 months 5.96 % (mean)], the five most frequent NIS were taste and smell alterations 27 %, constipation 19 %, abdominal pain 14 %, dysphagia 12 %, and epigastric pain 10 %. A statistically significant difference for NIS typical interventions in patients with taste and smell alterations (p = 0.04), constipation (p = 0.01), pain (p = 0.0001), and fatigue (p = 0.0004) were found compared to the control population [mixed cancer, 3.53 % IWL in 2 months (mean)]. NIS are common in advanced cancer patients. The NIS checklist can guide therapeutic nutrition-targeted interventions. The awareness for NIS will likely evoke more research in assessment, impact, and treatment.

  18. 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

  19. Brief alcohol interventions for mandated college students: comparison of face-to-face counseling and computer-delivered interventions.

    Science.gov (United States)

    Carey, Kate B; Carey, Michael P; Henson, James M; Maisto, Stephen A; DeMartini, Kelly S

    2011-03-01

    College students who violate alcohol policies are often mandated to participate in alcohol-related interventions. This study investigated (i) whether such interventions reduced drinking beyond the sanction alone, (ii) whether a brief motivational intervention (BMI) was more efficacious than two computer-delivered interventions (CDIs) and (iii) whether intervention response differed by gender. Randomized controlled trial with four conditions [brief motivation interventions (BMI), Alcohol 101 Plus™, Alcohol Edu for Sanctions(®), delayed control] and four assessments (baseline, 1, 6 and 12 months). Private residential university in the United States. Students (n = 677; 64% male) who had violated campus alcohol policies and were sanctioned to participate in a risk reduction program. Consumption (drinks per heaviest and typical week, heavy drinking frequency, peak and typical blood alcohol concentration), alcohol problems and recidivism. Piecewise latent growth models characterized short-term (1-month) and longer-term (1-12 months) change. Female but not male students reduced drinking and problems in the control condition. Males reduced drinking and problems after all interventions relative to control, but did not maintain these gains. Females reduced drinking to a greater extent after a BMI than after either CDI, and maintained reductions relative to baseline across the follow-up year. No differences in recidivism were found. Male and female students responded differently to sanctions for alcohol violations and to risk reduction interventions. BMIs optimized outcomes for both genders. Male students improved after all interventions, but female students improved less after CDIs than after BMI. Intervention effects decayed over time, especially for males. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  20. Italian energy policy

    International Nuclear Information System (INIS)

    1988-01-01

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

  1. Corporate Language Policies

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum

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

  2. Corporate Language Policies

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum

    2015-01-01

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

  3. 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.

  4. Correlates and predictors of obesity-specific quality of life of former participants of a residential intensive lifestyle intervention.

    Science.gov (United States)

    Elbe, A-M; Elsborg, P; Dandanell, S; Helge, J W

    2018-04-01

    The aim of this study was to investigate the relationship between weight loss during and after a unique type of weight loss intervention, namely, a residential intensive lifestyle intervention (ILI), and participants' obesity-specific health-related quality of life (HRQOL) several years after the intervention. In the residential ILI under investigation, participants attended a 10- to 12-week long course away from their daily living environment, namely, at Ubberup Folk High School located in Denmark. A total of 79 former participants (31 male, mean age 36.6; SD = 12.7 years) who had participated in the intervention on average 5.3 (SD = 3.2) years ago were recruited for this study. They completed a questionnaire on weight-related quality of life (IWQOL-lite) and physical activity, as well as measurements of VO 2 max, blood pressure, Homeostatic Model Assessment for Insulin Resistance, waist circumference and hand grip strength. The study results showed that weight change after the end of the intervention could predict HRQOL whereas how much weight they lost during the intervention could not. Furthermore, almost all of the investigated physiological factors were related to participants' current HRQOL. Waist circumference showed relationships with four of the five aspects of HRQOL. Focusing on behavioural change, adhering to improved lifestyle and maintaining weight loss after the end of the intervention seem to be the key not only for cardio-metabolic risk factors but also for sustainable HRQOL.

  5. UK energy policy – Stuck in ideological limbo?

    International Nuclear Information System (INIS)

    Keay, Malcolm

    2016-01-01

    Energy policy in the UK has undergone a paradigm change over recent decades – from the free market stance of the 1990s to the more interventionist measures of the 21st century. However, the two approaches have not been reconciled – even as the Government intervenes, it reaffirms its goal of creating more competitive markets. The contradictions are most apparent with electricity, which has been the main focus of intervention to date, in line with decarbonisation strategy. Investment is dependent on Government support, which changes in response to circumstances, creating uncertainty and undermining the basis of market operation – so leading to the need for more intervention. The future for other sources – natural gas, nuclear power and carbon capture and storage in particular – remains unclear. The Government risks getting the worst of both worlds – without the coordination and direction which could come from a centralised approach or the efficiencies and innovation which might emerge from a more consistent market based policy. Unless a fuller policy statement, expected later this year, can clarify matters, UK energy policy will not be fit for purpose and will fail to meet its key goals, of economic effectiveness, environmental protection and energy security. - Highlights: •UK energy policy has undergone a partial paradigm change. •Electricity has been the main focus of intervention to date, leading to distortions. •The way forward in other sectors is uncertain. •Key energy policy goals are at risk. •The Government needs to develop a clearer strategy.

  6. Decision Analysis and Policy Formulation for Technology-Specific Renewable Energy Targets

    Science.gov (United States)

    Okioga, Irene Teshamulwa

    This study establishes a decision making procedure using Analytic Hierarchy Process (AHP) for a U.S. national renewable portfolio standard, and proposes technology-specific targets for renewable electricity generation for the country. The study prioritizes renewable energy alternatives based on a multi-perspective view: from the public, policy makers, and investors' points-of-view, and uses multiple criteria for ranking the alternatives to generate a unified prioritization scheme. During this process, it considers a 'quadruple bottom-line' approach (4P), i.e. reflecting technical "progress", social "people", economic 'profits", and environmental "planet" factors. The AHP results indicated that electricity generation from solar PV ranked highest, and biomass energy ranked lowest. A "Benefits/Cost Incentives/Mandates" (BCIM) model was developed to identify where mandates are needed, and where incentives would instead be required to bring down costs for technologies that have potential for profitable deployment. The BCIM model balances the development of less mature renewable energy technologies, without the potential for rising near-term electricity rates for consumers. It also ensures that recommended policies do not lead to growth of just one type of technology--the "highest-benefit, least-cost" technology. The model indicated that mandates would be suited for solar PV, and incentives generally for geothermal and concentrated solar power. Development for biomass energy, as a "low-cost, low-benefits" alternative was recommended at a local rather than national level, mainly due to its low resource potential values. Further, biomass energy generated from wastewater treatment plants (WWTPs) had the least resource potential compared to other biomass sources. The research developed methodologies and recommendations for biogas electricity targets at WWTPs, to take advantage of the waste-to-energy opportunities.

  7. Drinking and its burden in a global perspective: policy considerations and options.

    Science.gov (United States)

    Room, Robin; Graham, Kathryn; Rehm, Jürgen; Jernigan, David; Monteiro, Maristela

    2003-10-01

    To identify the policy implications of the magnitude and characteristics of alcohol consumption and problems, viewed globally, and to summarize conclusions on the effectiveness of the strategies available to policymakers concerned with reducing rates of alcohol problems. This summative article draws on the findings of the articles preceding it and of reviews of the literature. Overall volume of consumption is the major factor in the prevalence of harms from drinking. Since consumption and associated problems tend to increase with economic development, policymakers in developing economies should be especially aware of the need to develop policies to minimize overall increases in alcohol consumption. Unrecorded consumption is also an important consideration for policy in many parts of the world, and poses difficulties for alcohol control policies. Drinking pattern is also an important contributing factor toward alcohol-related harm. Although some drinking patterns have been shown to produce beneficial health effects, because the net effect of alcohol on coronary disease is negative in most parts of the world, policies that promote abstinence or lower drinking overall may be the safest options. Moreover, sporadic intoxication is common in many parts of the world, and policies are unlikely to change this drinking pattern at least in the short to medium term. At the same time, because injuries comprise a large proportion of the burden of alcohol, it is appropriate to enhance these policies with targeted harm reduction strategies such as drinking and driving countermeasures and interventions focused on reducing alcohol-related violence in specific high-risk settings. Alcohol consumption is a major factor for the global burden of disease and should be considered a public health priority globally, regionally, and nationally for the vast majority of countries in the world. The need for alcohol policy is even stronger when it is taken into consideration that the burden of

  8. THE PSYCHOLOGICAL TREATMENT OF CHILDREN AND ADOLESCENTS IN RESIDENTIAL CARE. CONTRIBUTIONS TO A SPECIFIC FIELD OF INTERVENTION

    Directory of Open Access Journals (Sweden)

    Antonio Galán Rodríguez

    2014-09-01

    Full Text Available Psychological treatment is provided to a great number of minors fostered in residential centres of the child protection system; however, a deep and systematic analysis regarding the specific topics of this field has not yet been carried out. We analyse the ways of organizing units to attend children, taking into account three different options (general practice, specific practice in common settings, and specialized programs, and their advantages and disadvantages. We consider the role of the theoretical models, underlining the need for complexity and critical analysis, illustrated by reviewing three common models (the psychopathological, trauma-informed, and attachment models. Finally, we pay attention to the specificity of the technical interventions, calling for modified adaptations based on the characteristics of the minors, specific topics in this field, and some particular aspects of the context.

  9. The development, feasibility and acceptability of an Internet-based STI–HIV prevention intervention for young Chilean women

    Science.gov (United States)

    Villegas, N.; Santisteban, D.; Cianelli, R.; Ferrer, L.; Ambrosia, T.; Peragallo, N.; Lara, L.

    2014-01-01

    Background Young Chilean women between 18 and 24 years of age are at high risk of contracting sexually transmitted infection (STI) and human immunodeficiency virus (HIV). The literature shows a shortage of STI–HIV prevention interventions focused on this specific high-risk population and a unique set of barriers to receiving prevention messages. Internet-based interventions are promising for delivering STI–HIV prevention interventions and avoiding barriers to services. Aims The study aimed to develop a culturally informed Internet-based STI–HIV prevention intervention for Chilean women between 18 and 24 years of age, to investigate its feasibility and acceptability, and to compile recommendations on what would make the intervention more acceptable and feasible for these women. Methods The development of the Internet intervention was facilitated by a process that featured consultation with content and technology experts. A pre-post test design was used to test the acceptability and feasibility of the intervention with 40 young Chilean women between 18 and 24 years of age. Results The intervention website consisted of four modules of content and activities that support learning. The intervention was feasible and acceptable for young Chilean women between 18 and 24 years of age. Discussion and conclusion This study demonstrated the value of engaging multiple expert panels to develop culturally informed and technology-based interventions. The results of this study support the feasibility and acceptability of conducting an Internet-based intervention with multiple sessions, yielding high participation rates in a population in which there are barriers to discussion of STI–HIV prevention and sex-related content. Implications for nursing and health policy The outcomes have implications for nursing education and clinical practice and they can be used for the legal and judicial systems to promote or reinforce policies that encourage STI–HIV prevention strategies

  10. Evaluating EU Regional Policy: Many Empirical Specifications, One (Unpleasant) Result

    DEFF Research Database (Denmark)

    Breidenbach, Philipp; Mitze, Timo; Schmidt, Christoph

    Numerous studies have focused on the role of EU regional policy in fostering growth and convergence among European regions, why conducting another one? We argue that two facts are still lacking in the actual academic debate in order to get a sound empirical identification strategy and reliable...... regions with a GDP p.c. of less than 75% of the EU average. These payments shall represent the main instrument to fulfill the central aim of European regional policy, the boost of convergence and harmonic growth over the EU. They represent about two third of the whole European cohesion policy. In our...... results: First, one should take the theoretical underpinnings of regional growth models more serious, and second, a likewise careful account of the role of spatial dependence in the underlying data is needed. Though research has increasingly become aware of the latter point as important control factor...

  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. Impact of nutrition environmental interventions on point-of-purchase behavior in adults: a review.

    Science.gov (United States)

    Seymour, Jennifer D; Yaroch, Amy Lazarus; Serdula, Mary; Blanck, Heidi Michels; Khan, Laura Kettel

    2004-09-01

    Nutrition interventions targeted to individuals are unlikely to significantly shift US dietary patterns as a whole. Environmental and policy interventions are more promising for shifting these patterns. We review interventions that influenced the environment through food availability, access, pricing, or information at the point-of-purchase in worksites, universities, grocery stores, and restaurants. Thirty-eight nutrition environmental intervention studies in adult populations, published between 1970 and June 2003, were reviewed and evaluated on quality of intervention design, methods, and description (e.g., sample size, randomization). No policy interventions that met inclusion criteria were found. Many interventions were not thoroughly evaluated or lacked important evaluation information. Direct comparison of studies across settings was not possible, but available data suggest that worksite and university interventions have the most potential for success. Interventions in grocery stores appear to be the least effective. The dual concerns of health and taste of foods promoted were rarely considered. Sustainability of environmental change was never addressed. Interventions in "limited access" sites (i.e., where few other choices were available) had the greatest effect on food choices. Research is needed using consistent methods, better assessment tools, and longer durations; targeting diverse populations; and examining sustainability. Future interventions should influence access and availability, policies, and macroenvironments.

  13. Intervention levels for protective measures in nuclear accidents

    International Nuclear Information System (INIS)

    Hedemann Jensen, P.

    1992-12-01

    A radiation protection philosophy for exposure situations following an accident has been developed by international organisations such as the ICRP, IAEA, NES/OECD, FAO/WHO, and the CEC during the last decade. After the Chernobyl accident, the application of radiation protection principles for intervention situations such as exposure from accidental contamination or radon in dwellings were further developed and this work is still in progress. The present intervention policy recommended by the international organisations as well as by the Nordic radiation protection authorities is reviewed. The Nordic Intervention levels for foodstuff restrictions, both for the Chernobyl and post-Chernobyl periods, have been based on dose limits and they are therefore in conflict with international intervention policy. Illustrative examples on intervention level setting for relocation and foodstuff restrictions are derived for Nordic conditions from the optimisation principle recommended by the international organisations. Optimised Generic Intervention Levels have been determined to be about 10 mSv x month -1 for relocation/return and 5,000-30,000 Bqxkg -1 for restrictions on various foodstuffs contaminated with 137 Cs and 131 I. (au) (14 tabs., 1 ill., 16 refs.)

  14. 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.

  15. 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.

  16. 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

  17. Petroleum and international policy

    International Nuclear Information System (INIS)

    Pertuzio, A.

    2002-01-01

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

  18. Response to Intervention for Specific Learning Disabilities Identification: The Impact of Graduate Preparation and Experience on Identification Consistency

    Science.gov (United States)

    Maki, Kathrin E.

    2018-01-01

    Response to intervention (RTI) is increasingly being implemented in schools as a means to identify students with specific learning disabilities (SLD). Despite its wide use, there is limited research regarding school psychologists' graduate preparation in and familiarity with RTI for SLD identification. This study examined how school psychologists'…

  19. Data Policy

    Directory of Open Access Journals (Sweden)

    Mark A Parsons

    2013-07-01

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

  20. 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...

  1. How sustainable is government-sponsored desertification rehabilitation in China? Behavior of households to changes in environmental policies.

    Science.gov (United States)

    Liu, Ning; Zhou, Lihua; Hauger, J Scott

    2013-01-01

    This paper undertakes a direct, comprehensive assessment of the long-term sustainability of desertification rehabilitation in China under a plausible but worst case scenario where governmental interventions, in the form of payments for environmental services (PES), will cease. The analysis is based on household behavior as well as experimental data. Our econometric results highlight the main obstacles to the sustainability of rehabilitation programs subsequent to cessation of government intervention, including specific shortfalls in households' preference for a free ride, budget constraints, attitudes, tolerance of and responsibility for desertification, and dissatisfaction with governmental actions. We conclude that desertification rehabilitation is not sustainable in China without continued governmental intervention. The results of this study are intended to support policy makers as they consider future directions for rehabilitation sustainability.

  2. Tourism revenue sharing policy at Bwindi Impenetrable National Park, Uganda: a policy arrangements approach

    NARCIS (Netherlands)

    Ahebwa, W.M.; Duim, van der V.R.; Sandbrook, C.

    2012-01-01

    Debates on how to deliver conservation benefits to communities living close to protected high-biodiversity areas have preoccupied conservationists for over 20 years. Tourism revenue sharing (TRS) has become a widespread policy intervention in Africa and elsewhere where charismatic populations of

  3. Smorgasbord or symphony? Assessing public health nutrition policies across 30 European countries using a novel framework.

    Science.gov (United States)

    Lloyd-Williams, Ffion; Bromley, Helen; Orton, Lois; Hawkes, Corinna; Taylor-Robinson, David; O'Flaherty, Martin; McGill, Rory; Anwar, Elspeth; Hyseni, Lirije; Moonan, May; Rayner, Mike; Capewell, Simon

    2014-11-21

    Countries across Europe have introduced a wide variety of policies to improve nutrition. However, the sheer diversity of interventions represents a potentially bewildering smorgasbord. We aimed to map existing public health nutrition policies, and examine their perceived effectiveness, in order to inform future evidence-based diet strategies. We created a public health nutrition policy database for 30 European countries. National nutrition policies were classified and assigned using the marketing "4 Ps" approach Product (reformulation, elimination, new healthier products); Price (taxes, subsidies); Promotion (advertising, food labelling, health education) and Place (schools, workplaces, etc.). We interviewed 71 senior policy-makers, public health nutrition policy experts and academics from 14 of the 30 countries, eliciting their views on diverse current and possible nutrition strategies. Product Voluntary reformulation of foods is widespread but has variable and often modest impact. Twelve countries regulate maximum salt content in specific foods. Denmark, Austria, Iceland and Switzerland have effective trans fats bans. Price EU School Fruit Scheme subsidies are almost universal, but with variable implementation.Taxes are uncommon. However, Finland, France, Hungary and Latvia have implemented 'sugar taxes' on sugary foods and sugar-sweetened beverages. Finland, Hungary and Portugal also tax salty products. Promotion Dialogue, recommendations, nutrition guidelines, labelling, information and education campaigns are widespread. Restrictions on marketing to children are widespread but mostly voluntary. Place Interventions reducing the availability of unhealthy foods were most commonly found in schools and workplace canteens. Interviewees generally considered mandatory reformulation more effective than voluntary, and regulation and fiscal interventions much more effective than information strategies, but also politically more challenging. Public health nutrition

  4. 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...

  5. Real-Time Effects of Central Bank Interventions in the Euro Market

    DEFF Research Database (Denmark)

    Fatum, Rasmus; Pedersen, Jesper

    This paper investigates the real-time effects of foreign exchange intervention using official intraday intervention data provided by the Danish central bank. Denmark is currently pursuing an active intervention policy under the provisions of the Exchange Rate Mechanism (ERM II) and intervenes...

  6. Energy efficiency and the liberalized market - new approaches in national climate protection policy

    International Nuclear Information System (INIS)

    Hennicke, P.

    2000-01-01

    The paper initially explains the rationale of energy policy-based governmental intervention in the liberalized electricity market ('the need for political governance'). It is shown why there is a 'demand for intelligent regulatory policy' in Germany's energy sector, despite, or rather as a consequence of the deregulation of the energy markets, and refers e.g. to a parliamentary paper of the Bundestag, (BTDrs. 14/2656, p. 9). The author continues with selecting and defining, from the stock of conceivable appropriate action and regulatory instruments, the corner stones of action plans and the range of instruments, specifically designed for the sector and the target groups, that will accelerate market penetration of the energy efficiency policies ('governance functions'). The author also shows that, due to the significance of regulatory and structurizing impacts, as well as resulting consequences to the leading paradigms of policy of this Government (opting out of nuclear power, global climate change), the electricity industry is just the right branch of industry to serve as a ''national demonstration project'' on the way towards sustainable development. (orig./CB) [de

  7. 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...

  8. [Individual, community, regulatory, and systemic approaches to tobacco control interventions].

    Science.gov (United States)

    Gorini, Giuseppe

    2011-01-01

    During the 60s and the 70s strategies for decreasing initiation or quitting have been developed, in order to find those with high success rates. Unfortunately, interventions with an individual approach involved few smokers, so their impact in decreasing smoking prevalence was limited. The socio-ecological model offers a theoretical framework to community interventions for smoking cessation developed during the 80s, in which smoking was considered not only an individual, but also a social problem. In the 80s and the 90s smoking cessation community trials were developed, such as the Community Intervention Trial for Smoking Cessation (COMMIT). Afterwards, policy interventions (price policy; smoking bans in public places; advertising bans; bans of sales to minors) were developed, such as the American Stop Smoking Intervention Study for Cancer Prevention (ASSIST). California has been the first State all over the world to develop a comprehensive Tobacco Control Program in 1988, becoming the place for an ever-conducted natural experiment. All policy interventions in tobacco control have been finally grouped together in the World Health Organization - Framework Convention on Tobacco Control (WHO-FCTC), the first Public Health Treaty. Study designs have changed, according to the individual, community, or regulatory approaches: the classical randomized controlled trials (RCTs), in which the sampling unit is the individual, have been carried out for the evaluation of smoking cessation treatments, whereas cluster RCTs, in which the sampling unit is the community, have been conducted for evaluating community interventions, such as COMMIT. Finally, quasi-experimental studies (before/after study; prospective cohorts, both with a control group), in which the observational unit is a State, have been used for evaluating tobacco control policies, such as ASSIST and the International Tobacco Control Policy Evaluation Project. Although the successes of the last 20 years, tobacco

  9. Modeling Security-Enhanced Linux Policy Specifications for Analysis (Preprint)

    National Research Council Canada - National Science Library

    Archer, Myla; Leonard, Elizabeth; Pradella, Matteo

    2003-01-01

    Security-Enhanced (SE) Linux is a modification of Linux initially released by NSA in January 2001 that provides a language for specifying Linux security policies and, as in the Flask architecture, a security server...

  10. 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

  11. From Tobacco to Obesity Prevention Policies: A Framework for Implementing Community-Driven Policy Change.

    Science.gov (United States)

    Walter, Lauren; Dumke, Kelly; Oliva, Ariana; Caesar, Emily; Phillips, Zoë; Lehman, Nathan; Aragon, Linda; Simon, Paul; Kuo, Tony

    2018-04-01

    Efforts to reverse the obesity epidemic require policy, systems, and environmental (PSE) change strategies. Despite the availability of evidence-based and other promising PSE interventions, limited evidence exists on the "how-to" of transitioning them into practice. For the past 13 years, the Los Angeles County Department of Public Health has been building capacity among community residents and other stakeholders to create effective community coalitions and to implement well-designed policy strategy campaigns using an evidence-based approach to policy change, the policy adoption model (PAM). Implementing a phase-based approach to policy change, the PAM was initially used to support the passage of over 140 tobacco control and prevention policies in Los Angeles County. Following these successes, Los Angeles County Department of Public Health applied the PAM to obesity prevention, operationalizing the policy process by training community residents and other stakeholders on the use of the model. The PAM has shown to be helpful in promoting PSE change in tobacco control and obesity prevention, suggesting a local-level model potentially applicable to other fields of public health seeking sustainable, community-driven policy change.

  12. POLE.VAULT: A Semantic Framework for Health Policy Evaluation and Logical Testing.

    Science.gov (United States)

    Shaban-Nejad, Arash; Okhmatovskaia, Anya; Shin, Eun Kyong; Davis, Robert L; Buckeridge, David L

    2017-01-01

    The major goal of our study is to provide an automatic evaluation framework that aligns the results generated through semantic reasoning with the best available evidence regarding effective interventions to support the logical evaluation of public health policies. To this end, we have designed the POLicy EVAlUation & Logical Testing (POLE.VAULT) Framework to assist different stakeholders and decision-makers in making informed decisions about different health-related interventions, programs and ultimately policies, based on the contextual knowledge and the best available evidence at both individual and aggregate levels.

  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. Process and impact evaluation of the Romp & Chomp obesity prevention intervention in early childhood settings: lessons learned from implementation in preschools and long day care settings.

    Science.gov (United States)

    de Silva-Sanigorski, Andrea M; Bell, Andrew C; Kremer, Peter; Park, Janet; Demajo, Lisa; Smith, Michael; Sharp, Sharon; Nichols, Melanie; Carpenter, Lauren; Boak, Rachel; Swinburn, Boyd

    2012-06-01

    The Romp & Chomp controlled trial, which aimed to prevent obesity in preschool Australian children, was recently found to reduce the prevalence of childhood overweight and obesity and improve children's dietary patterns. The intervention focused on capacity building and policy implementation within various early childhood settings. This paper reports on the process and impact evaluation of this trial and the lessons learned from this complex community intervention. Process data was collected throughout and audits capturing nutrition and physical activity-related environments and practices were completed postintervention by directors of Long Day Care (LDC) centers (n = 10) and preschools (n = 41) in intervention and comparison (n = 161 LDC and n = 347 preschool) groups. The environmental audits demonstrated positive impacts in both settings on policy, nutrition, physical activity opportunities, and staff capacity and practices, although results varied across settings and were more substantial in the preschool settings. Important lessons were learned in relation to implementation of such community-based interventions, including the significant barriers to implementing health-promotion interventions in early childhood settings, lack of engagement of for-profit LDC centers in the evaluation, and an inability to attribute direct intervention impacts when the intervention components were delivered as part of a health-promotion package integrated with other programs. These results provide confidence that obesity prevention interventions in children's settings can be effective; however, significant efforts must be directed toward developing context-specific strategies that invest in policies, capacity building, staff support, and parent engagement. Recognition by funders and reviewers of the difficulties involved in implementing and evaluating such complex interventions is also critical to strengthening the evidence base on the effectiveness of such public health

  15. In the name of human rights: the problematics of EU ethical foreign policy in Africa and elsewhere

    Directory of Open Access Journals (Sweden)

    Olivia Umurerwa Rutazibwa

    2014-02-01

    Full Text Available This doctoral research project explores avenues to research ethically defined foreign policy differently, i.e. in ways that more systematically account for its counterproductive elements. Building on the specific case of the European Union’s foreign policy in sub-Saharan Africa, embodied by the 2000 Cotonou Agreement and the 2007 Joint Africa-EU Strategy, through four papers and one books review, the study firstly develops the Ethical Intervener Europe analytical framework to account for the embedded problematics in the EU’s ethical foreign policy. Secondly, through an eclectic theoretical approach, the study seeks to theoretically pin-point some alternatives to think about ethical foreign policy and finally, looks to concretize it through its application on the case of relative autonomous peace- and state-building in Somaliland. This research report briefly introduces the different findings and addresses the need for further research in view of a decolonial approach to the study of ethical foreign policy in a context of structural inequality. Key words: ethical foreign policy, (humanitarian interventions, EU, sub-Saharan Africa, Somaliland, decoloniality, democratization, state-building

  16. What drives forex interventions? Evidence from the Brazilian Central Bank interventions on the BRL/USD market

    Directory of Open Access Journals (Sweden)

    Felipe Wolk Teixeira

    2013-07-01

    Full Text Available In this paper we study what drives buy-side and sell-side probabilities of intervention by the Brazilian Central Bank (BCB on the USD/BRL spot market between 1999 and 2010. BCB’s forex interventions seem to be related to the exchange rate returns and volatility as well as to the spread between domestic and foreign interest rates. Lagged interventions also appear to have an effect on current interventions. Our findings suggest that the operation of the policymaker in the forex market may serve as a signaling of a possible coordination between BCB’s foreign and monetary policies along with the possibility of an unofficial adoption of an exchange rate band.

  17. A comparative analysis of the costs of onshore wind energy: Is there a case for community-specific policy support?

    International Nuclear Information System (INIS)

    Berka, Anna L.; Harnmeijer, Jelte; Roberts, Deborah; Phimister, Euan; Msika, Joshua

    2017-01-01

    There is growing policy interest in increasing the share of community-owned renewable energy generation. This study explores why and how the costs of community-owned projects differ from commercially-owned projects by examining the case of onshore wind in the UK. Based on cross-sectoral literature on the challenges of community ownership, cost differences are attributed to six facets of an organisation or project: internal processes, internal knowledge and skills, perceived local legitimacy of the project, perceived external legitimacy of the organisation, investor motivation and expectations, and finally, project scale. These facets impact not only development costs but also project development times and the probability that projects pass certain critical stages in the development process. Using survey-based and secondary cost data on community and commercial projects in the UK, a model is developed to show the overall impact of cost, time and risk differences on the value of a hypothetical 500 kW onshore wind project. The results show that the main factors accounting for differences are higher pre-planning costs and additional risks born by community projects, and suggest that policy interventions may be required to place community- owned projects on a level playing field with commercial projects. - Highlights: • Policy support for community energy projects should be targeted at reducing early costs and risk factors. • Hurdle rates are critical in determining the financial viability of projects. • Shared ownership arrangements may help remove some of key challenges to community-only projects.

  18. Skin cancer interventions across the cancer control continuum: Review of technology, environment, and theory.

    Science.gov (United States)

    Taber, Jennifer M; Dickerman, Barbra A; Okhovat, Jean-Phillip; Geller, Alan C; Dwyer, Laura A; Hartman, Anne M; Perna, Frank M

    2018-06-01

    The National Cancer Institute's Skin Cancer Intervention across the Cancer Control Continuum model was developed to summarize research and identify gaps concerning skin cancer interventions. We conducted a mapping review to characterize whether behavioral interventions addressing skin cancer prevention and control from 2000 to 2015 included (1) technology, (2) environmental manipulations (policy and/or built environment), and (3) a theoretical basis. We included 86 studies with a randomized controlled or quasi-experimental design that targeted behavioral intervention in skin cancer for children and/or adults; seven of these were dissemination or implementation studies. Of the interventions described in the remaining 79 articles, 57 promoted only prevention behaviors (e.g., ultraviolet radiation protection), five promoted only detection (e.g., skin examinations), 10 promoted both prevention and detection, and seven focused on survivorship. Of the 79 non-dissemination studies, two-thirds used some type of technology (n=52; 65.8%). Technology specific to skin cancer was infrequently used: UVR photography was used in 15.2% of studies (n=12), reflectance spectroscopy was used in 12.7% (n=10), and dermatoscopes (n=1) and dosimeters (n=2) were each used in less than 3%. Ten studies (12.7%) targeted the built environment. Fifty-two (65.8%) of the studies included theory-based interventions. The most common theories were Social Cognitive Theory (n=20; 25.3%), Health Belief Model (n=17; 21.5%), and the Theory of Planned Behavior/Reasoned Action (n=12; 15.2%). Results suggest that skin cancer specific technology and environmental manipulations are underutilized in skin cancer behavioral interventions. We discuss implications of these results for researchers developing skin cancer behavioral interventions. Copyright © 2017. Published by Elsevier Inc.

  19. A review of UK housing policy: ideology and public health.

    Science.gov (United States)

    Stewart, J

    2005-06-01

    The aim of this paper is to review UK public health policy, with a specific reference to housing as a key health determinant, since its inception in the Victorian era to contemporary times. This paper reviews the role of social and private housing policy in the development of the UK public health movement, tracing its initial medical routes through to the current socio-economic model of public health. The paper establishes five distinct ideologically and philosophically driven eras, placing public health and housing within liberal (Victorian era), state interventionist (post World War 1; post World War 2), neoliberal (post 1979) and "Third Way" (post 1997) models, showing the political perspective of policy interventions and overviewing their impact on public health. The paper particularly focuses on the contemporary model of public health since the Acheson Report, and how its recommendations have found their way into policy, also the impact on housing practice. Public health is closely related to political ideology, whether driven by the State, individual or partnership arrangements. The current political system, the Third Way, seeks to promote a sustainable "social contract" between citizens and the State, public, private and voluntary organizations in delivering community-based change in areas where health inequalities can be most progressively and successfully addressed.

  20. Renewable energies and public policies

    International Nuclear Information System (INIS)

    Cochet, Y.; Pierret, Ch.; Lienemann, M.N.

    2002-04-01

    This document presents the interventions of political personalities on the topic of the renewable energies development policies and the necessity of financial incentives which have been discussed during the colloquium of thursday 4 april 2002 at Paris. (A.L.B.)

  1. Energy efficiency interventions in UK higher education institutions

    International Nuclear Information System (INIS)

    Altan, Hasim

    2010-01-01

    This paper provides an insight into energy efficiency interventions studies, focusing on issues arising in UK higher education institutions (HEIs) in particular. Based on a review of the context for energy efficiency and carbon reduction programmes in the UK and the trends in higher education sector, existing external and internal policies and initiatives and their relevant issues are extensively discussed. To explore the efficacy of some internal intervention strategies, such as technical, non-technical and management interventions, a survey was conducted among UK higher education institutions between February and April 2008. Consultation responses show that there are a relatively high percentage of institutions (83%) that have embarked on both technical and non-technical initiatives, which is a demonstration to the joined-up approach in such area. Major barriers for intervention studies are also identified, including lack of methodology, non-clarity of energy demand and consumption issues, difficulty in establishing assessment boundaries, problems with regards to indices and their effectiveness and so on. Besides establishing clear targets for carbon reductions within the sector, it is concluded that it is important to develop systems for effectively measuring and evaluating the impact of different policies, regulations and schemes in the future as the first step to explore. - Research Highlights: → The research provides an insight into energy efficiency interventions studies, focusing particularly on issues arising in UK higher education institutions (HEIs). → Based on a review of the context for energy efficiency and carbon reduction programmes in the UK and the trends in higher education sector, existing external and internal policies and initiatives, and their relevant issues are extensively discussed. → To explore the efficacy of some internal intervention strategies, such as technical, non-technical and management interventions, a survey was conducted

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

    Science.gov (United States)

    Hawkes, Corinna

    2007-06-01

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

  3. 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.

  4. Interventions for preventing abuse in the elderly.

    Science.gov (United States)

    Baker, Philip R A; Francis, Daniel P; Hairi, Noran N; Othman, Sajaratulnisah; Choo, Wan Yuen

    2016-08-16

    independently extracted data and assessed the studies' risk of bias. Studies were categorised as: 1) education on elder abuse, 2) programmes to reduce factors influencing elder abuse, 3) specific policies for elder abuse, 4) legislation on elder abuse, 5) programmes to increase detection rate on elder abuse, 6) programmes targeted to victims of elder abuse, and 7) rehabilitation programmes for perpetrators of elder abuse. All studies were assessed for study methodology, intervention type, setting, targeted audience, intervention components and intervention intensity. The search and selection process produced seven eligible studies which included a total of 1924 elderly participants and 740 other people. Four of the above seven categories of interventions were evaluated by included studies that varied in study design. Eligible studies of rehabilitation programmes, specific policies for elder abuse and legislation on elder abuse were not found. All included studies contained a control group, with five of the seven studies describing the method of allocation as randomised. We used the Cochrane 'Risk of bias' tool and EPOC assessment criteria to assess risk of bias. The results suggest that risk of bias across the included body of research was high, with at least 40% of the included studies judged as being at high risk of bias. Only one study was judged as having no domains at high risk of bias, with two studies having two of 11 domains at high risk. One study was judged as being at high risk of bias across eight of 11 domains.All included studies were set in high-income countries, as determined by the World Bank economic classification (USA four, Taiwan one, UK two). None of the studies provided specific information or analysis on equity considerations, including by socio-economic disadvantage, although one study was described as being set in a housing project. One study performed some form of cost-effectiveness analysis on the implementation of their intervention programmes

  5. Policy silences: why Canada needs a National First Nations, Inuit and Métis health policy.

    Science.gov (United States)

    Lavoie, Josée G

    2013-12-27

    Despite attempts, policy silences continue to create barriers to addressing the healthcare needs of First Nations, Inuit and Métis. The purpose of this article is to answer the question, if what we have in Canada is an Aboriginal health policy patchwork that fails to address inequities, then what would a Healthy Aboriginal Health Policy framework look like? The data collected included federal, provincial and territorial health policies and legislation that contain Aboriginal, First Nation, Inuit and/or Métis-specific provisions available on the internet. Key websites included the Parliamentary Library, federal, provincial and territorial health and Aboriginal websites, as well as the Department of Justice Canada, Statistics Canada and the Aboriginal Canada Portal. The Indian Act gives the Governor in Council the authority to make health regulations. The First Nations and Inuit Health Branch (FNIHB) of Health Canada historically provided health services to First Nations and Inuit, as a matter of policy. FNIHB's policies are few, and apply only to Status Indians and Inuit. Health legislation in 2 territories and 4 provinces contain no provision to clarify their responsibilities. In provinces where provisions exist, they broadly focus on jurisdiction. Few Aboriginal-specific policies and policy frameworks exist. Generally, these apply to some Aboriginal peoples and exclude others. Although some Aboriginal-specific provisions exist in some legislation, and some policies are in place, significant gaps and jurisdictional ambiguities remain. This policy patchwork perpetuates confusion. A national First Nation, Inuit and Métis policy framework is needed to address this issue.

  6. Patient-specific prescriber feedback can increase the rate of osteoporosis screening and treatment: results from two national interventions.

    Science.gov (United States)

    Kalisch Ellett, Lisa M; Pratt, N L; Sluggett, J K; Ramsay, E N; Kerr, M; LeBlanc, V T; Barratt, J D; Roughead, E E

    2017-12-01

    Osteoporosis interventions targeting older Australians and clinicians were conducted in 2008 and 2011 as part of a national quality improvement program underpinned by behavioural theory and stakeholder engagement. Uptake of bone mineral density (BMD) tests among targeted men and women increased after both interventions and sustained increases in osteoporosis treatment were observed among men targeted in 2008. Educational interventions incorporating patient-specific prescriber feedback have improved osteoporosis screening and treatment among at-risk patients in clinical trials but have not been evaluated nationally. This study assessed uptake of BMD testing and osteoporosis medicines following two national Australian quality improvement initiatives targeting women (70-79 years) and men (75-85 years) at risk of osteoporosis. Administrative health claims data were used to determine monthly rates of BMD testing and initiation of osteoporosis medicines in the 9-months post-intervention among targeted men and women compared to older cohorts of men and women. Log binomial regression models were used to assess differences between groups. In 2008 91,794 patients were targeted and 52,427 were targeted in 2011. There was a twofold increase in BMD testing after each intervention among targeted patients compared to controls (p theory and stakeholder engagement that target both primary care clinicians and patients can improve osteoporosis screening and management at the national level.

  7. China's Industrial Policy in Relation to Electronics Manufacturing

    Institute of Scientific and Technical Information of China (English)

    Zhongxiu Zhao; Xiaoling Huang; Dongya Ye; Paul Gentle

    2007-01-01

    China has become the biggest exporter of electronic products in the world. Government policy intervention has contributed significantly to the rapid expansion of the electronics industry. The present paper examines the evolutionary development of industrial policies related to the electronics industry in China and the impacts of such policies on the shaping of the industry. In particular, the relationship between foreign funded enterprises and domestic firms are examined in detail. The future trend of the industry is also discussed in the paper, and the policy focus of the Chinese Government is predicted.

  8. Tracing the French Policy PISA Debate: A Policy Configuration Approach

    Science.gov (United States)

    Pons, Xavier

    2016-01-01

    This article traces the evolution of the French policy PISA debate from 2001 to 2014 by analysing the results of two original qualitative researches. Theoretically, this debate is the outcome of specific policy configurations, which predetermine its scope, content and effectiveness. These configurations are themselves described through their…

  9. Determinants of State Intervention: Evidence for the EU

    Directory of Open Access Journals (Sweden)

    Simona-Gabriela MAŞCA

    2011-06-01

    Full Text Available The purpose of the paper is to analyze the determinants of State intervention upon the social and economic life, and to grasp their implications in terms of public policy. The problem of State interventionism is a current one, and over time it has been under the influence of certain factors such as interstate differences, economic and social crises, political governance of the country, regional policy and globalization. The challenges that the current economic crisis brings in terms of State interventionism, are also presented. Some indicators that quantify the extent of State intervention through public expenditures are analyzed for the EU member countries (1995- 2010 in order to capture the general trends in their evolution and the peculiarities of their structure. The empirical analysis, based on a panel econometric model, aims to establish the relevance held by the main determinants for the degree of State intervention in budgetary expenditure, for the EU countries. The possibilities for an increasing State interference during the crisis, related with the withdrawal of the State once the crisis would be overcome, are valued with reference to the significant determinants of the interference policy derived from empirical analysis.

  10. Policy implementation and financial incentives for nurses in South Africa: a case study on the occupation-specific dispensation

    Directory of Open Access Journals (Sweden)

    Duane Blaauw

    2013-01-01

    Full Text Available Background: In 2007, the South African government introduced the occupation-specific dispensation (OSD, a financial incentive strategy, to attract, motivate, and retain health professionals in the public sector. Implementation commenced with the nursing sector, but there have been unintended negative consequences. Objective: First, to examine implementation of the OSD for nurses using Hogwood and Gunn's framework that outlines ‘perfect implementation’ pre-conditions. Second, to highlight the conditions for the successful implementation of financial incentives. Methods: A qualitative case study design using a combination of a document review and in-depth interviews with 42 key informants. Results: The study found that there were several implementation weaknesses. Only a few of the pre-conditions were met for OSD policy implementation. The information systems required for successful policy implementation, such as the public sector human resource data base and the South African Nursing Council register of specialised nurses were incomplete and inaccurate, thus undermining the process. Insufficient attention was paid to time and resources, dependency relationships, task specification, and communication and coordination. Conclusion: The implementation of financial incentives requires careful planning and management in order to avoid loss of morale and staff grievances.

  11. Developing Guidelines for the Use of Nontraditional Educational Interventions.

    Science.gov (United States)

    Wood, Frank

    The paper outlines guidelines for developing policy on use of nontraditional educational interventions (such as timeout, aversive stimulation, biofeedback, behavior modification, relaxation therapy, and group meetings) with behavior disordered students. A model policy statement on the use of isolation rooms is presented. Such a statement should…

  12. 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.

  13. How ‘Fake News’ Affects Autism Policy

    Directory of Open Access Journals (Sweden)

    Mickey Keenan

    2018-05-01

    Full Text Available Since autism was first recognised, prevalence has increased rapidly. The growing economic as well as social cost to families and society can only be mitigated by effective interventions and supports. It is, therefore, not surprising that there is much heated debate and most governments have developed public policies to address the management of autism. This paper describes how well-known ‘propaganda’ techniques, that have become prevalent in the helping professions have been used to influence autism policies by spreading ‘fake news’ about the scientific discipline of Applied Behaviour Analysis (ABA. Over the past 40–50 years, meaningful evidence has accrued showing that interventions based on ABA can help people with autism reach their potential. In view of this, nearly all of North America has laws to mandate that ABA-based interventions are available through their health care systems. In contrast, across Europe there are no such laws. In fact, the National Institute for Health and Care Excellence (NICE, the body guiding health and social policy in the UK, concluded that it could not find any evidence to support ABA, and therefore could not recommend it. This paper addresses the reasons for these diametrically opposed perspectives.

  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

    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

  15. Nudging for Prevention in Occupational Health and Safety in South Africa Using Fiscal Policies.

    Science.gov (United States)

    de Jager, Pieter; Rees, David; Kisting, Sophia; Kgalamono, Spo; Ndaba, Mpume; Stacey, Nicolas; Tugendhaft, Aviva; Hofman, Karen

    2017-08-01

    Currently, in some countries occupational health and safety policy and practice have a bias toward secondary prevention and workers' compensation rather than primary prevention. Particularly, in emerging economies, research has not adequately contributed to effective interventions and improvements in workers' health. This article, using South Africa as a case study, describes a methodology for identifying candidate fiscal policy interventions and describes the policy interventions selected for occupational health and safety. It is argued that fiscal policies are well placed to deal with complex intersectoral health problems and to focus efforts on primary prevention. A major challenge is the lack of empirical evidence to support the effectiveness of fiscal policies in improving workers' health. A second challenge is the underprioritization of occupational health and safety partly due to the relatively small burden of disease attributed to occupational exposures. Both challenges can and should be overcome by (i) conducting policy-relevant research to fill the empirical gaps and (ii) reconceptualizing, both for policy and research purposes, the role of work as a determinant of population health. Fiscal policies to prevent exposure to hazards at work have face validity and are thus appealing, not as a replacement for other efforts to improve health, but as part of a comprehensive effort toward prevention.

  16. Interventions to Improve Safe Sleep Among Hospitalized Infants at Eight Children's Hospitals.

    Science.gov (United States)

    Kuhlmann, Stephanie; Ahlers-Schmidt, Carolyn R; Lukasiewicz, Gloria; Truong, Therese Macasiray

    2016-02-01

    Within hospital pediatric units, there is a lack of consistent application or modeling of the American Academy of Pediatrics recommendations for safe infant sleep. The purpose of this study was to improve safe sleep practices for infants in nonneonatal pediatric units with implementation of specific interventions. This multi-institutional study was conducted by using baseline observations collected for sleep location, position, and environment (collectively, "safe sleep") of infants admitted to pediatric units. Interventions consisted of: (1) staff education, including a commitment to promote safe sleep; (2) implementing site-generated safe sleep policies; (3) designating supply storage in patient rooms; and/or (4) caregiver education. Postintervention observations of safe sleep were collected. Eight hospitals participated from the Inpatient FOCUS Group of the Children's Hospital Association. Each site received institutional review board approval/exemption. Safe sleep was observed for 4.9% of 264 infants at baseline and 31.2% of 234 infants postintervention (Ppresent in 77% of cribs at baseline and 44% postintervention. However, the mean number of unsafe items observed in each sleeping environment was reduced by >50% (P=.001). Implementation of site-specific interventions seems to improve overall safe sleep in inpatient pediatric units, although continued improvement is needed. Specifically, extra items are persistently left in the sleeping environment. Moving forward, hospitals should evaluate their compliance with American Academy of Pediatrics recommendations and embrace initiatives to improve modeling of safe sleep. Copyright © 2016 by the American Academy of Pediatrics.

  17. The trade-off between monetary policy and bank stability

    NARCIS (Netherlands)

    Lamers, Martien; Mergaerts, Frederik; Meuleman, Elien; Vennet, Rudi Vander

    2016-01-01

    This paper investigates how monetary policy interventions by the European Central Bank and the Federal Reserve affect the stock market perception of bank systemic risk. In a first step, we identify monetary policy shocks using a structural VAR approach by exploiting the changes of the volatility of

  18. Policy content and stakeholder network analysis for infant and young child feeding in Bangladesh

    Directory of Open Access Journals (Sweden)

    Sabrina Rasheed

    2017-06-01

    Full Text Available Abstract Background Appropriate infant and young child feeding (IYCF practices are essential for nutrition of infants and young children. Bangladesh has one of the highest levels of malnutrition globally along with sub-optimal IYCF practices. A supportive policy environment is essential to ensure that effective IYCF interventions are scaled up. The objectives of our study were to assess the support for IYCF in the national policy environment through policy analysis and stakeholder analysis and in so doing identify opportunities to strengthen the policy environment. Methods We used a matrix developed by SAIFRN (the South Asian Infant Feeding Research Network to systematically identify supportive national policies, plans and guidelines for IYCF. We adapted narrative synthesis and descriptive approaches to analyze policy content, based on four themes with a focus on support for mothers. We conducted three Net-Map interviews to identify stakeholders who influenced the policies and programs related to IYCF. Results We identified 19 national policy documents relevant to IYCF. Overall, there was good level of support for IYCF practices at policy level – particularly regarding general support for IYCF and provision of information to mothers – but these were not consistently supported at implementation level, particularly regarding specificity and population coverage. We identified gaps regarding the training of health workers, capacity building, the monitoring and targeting of vulnerable mothers and providing an enabling environment to mothers, specifically with respect to maternity leave for working women. Urban populations and providers outside the public sector remained uncovered by policy. Our stakeholder analysis identified government entities such as the National Nutrition Service, as the most influential in terms of both technical and funding support as they had the mandate for formulation and implementation of policies and national programs

  19. Policy content and stakeholder network analysis for infant and young child feeding in Bangladesh.

    Science.gov (United States)

    Rasheed, Sabrina; Roy, Swapan Kumar; Das, Susmita; Chowdhury, Syeda Nafisa; Iqbal, Mohammad; Akter, Syeda Mahsina; Jahan, Khurshid; Uddin, Shahadat; Thow, Anne Marie

    2017-06-13

    Appropriate infant and young child feeding (IYCF) practices are essential for nutrition of infants and young children. Bangladesh has one of the highest levels of malnutrition globally along with sub-optimal IYCF practices. A supportive policy environment is essential to ensure that effective IYCF interventions are scaled up. The objectives of our study were to assess the support for IYCF in the national policy environment through policy analysis and stakeholder analysis and in so doing identify opportunities to strengthen the policy environment. We used a matrix developed by SAIFRN (the South Asian Infant Feeding Research Network) to systematically identify supportive national policies, plans and guidelines for IYCF. We adapted narrative synthesis and descriptive approaches to analyze policy content, based on four themes with a focus on support for mothers. We conducted three Net-Map interviews to identify stakeholders who influenced the policies and programs related to IYCF. We identified 19 national policy documents relevant to IYCF. Overall, there was good level of support for IYCF practices at policy level - particularly regarding general support for IYCF and provision of information to mothers - but these were not consistently supported at implementation level, particularly regarding specificity and population coverage. We identified gaps regarding the training of health workers, capacity building, the monitoring and targeting of vulnerable mothers and providing an enabling environment to mothers, specifically with respect to maternity leave for working women. Urban populations and providers outside the public sector remained uncovered by policy. Our stakeholder analysis identified government entities such as the National Nutrition Service, as the most influential in terms of both technical and funding support as they had the mandate for formulation and implementation of policies and national programs. Stakeholders from different sectors played important

  20. The impact of environmental policy on economic indicators. Moving from global to sectoral and regional perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Voigt, Sebastian

    2013-07-01

    In recent times, environmental, energy and climate policies have gained tremendously in importance. Not least, this is due to the latest research findings related to climate change and the resulting growing environmental awareness among people. However, policy approaches to combat environmental pollution and climate change differ both in their intention and in their economic impacts. For instance, command-and-control instruments such as performance or technology standards have different implications than market-based mechanisms such as permit trading of greenhouse gas emissions. Furthermore, sectoral and regional characteristics play an important role when implementing and assessing policy measures. This applies both to the attainability of the targets and to the available instruments. The present doctoral thesis addresses this point and analyzes in several essays different policy instruments and their economic effects from global, regional and sectoral perspectives. In this respect, it deals with various, often very heterogeneous question: How are specific policy types implemented in different countries? What is the CO2 abatement potential in specific regions and sectors? What policy measures can be plausibly used to exploit this potential? How can technological developments and technology-directed policy interventions contribute to improve energy efficiency? Does the promotion of certain energy sources necessarily create positive production and employment effects? To answer these and further questions, different economic methods are applied that accommodate the particular problem, where special emphasis is put on computable general equilibrium modeling. The aim of this work is to contribute to the academic and political debate on measures to combat environmental and climate problems.

  1. The impact of environmental policy on economic indicators. Moving from global to sectoral and regional perspectives

    International Nuclear Information System (INIS)

    Voigt, Sebastian

    2013-01-01

    In recent times, environmental, energy and climate policies have gained tremendously in importance. Not least, this is due to the latest research findings related to climate change and the resulting growing environmental awareness among people. However, policy approaches to combat environmental pollution and climate change differ both in their intention and in their economic impacts. For instance, command-and-control instruments such as performance or technology standards have different implications than market-based mechanisms such as permit trading of greenhouse gas emissions. Furthermore, sectoral and regional characteristics play an important role when implementing and assessing policy measures. This applies both to the attainability of the targets and to the available instruments. The present doctoral thesis addresses this point and analyzes in several essays different policy instruments and their economic effects from global, regional and sectoral perspectives. In this respect, it deals with various, often very heterogeneous question: How are specific policy types implemented in different countries? What is the CO2 abatement potential in specific regions and sectors? What policy measures can be plausibly used to exploit this potential? How can technological developments and technology-directed policy interventions contribute to improve energy efficiency? Does the promotion of certain energy sources necessarily create positive production and employment effects? To answer these and further questions, different economic methods are applied that accommodate the particular problem, where special emphasis is put on computable general equilibrium modeling. The aim of this work is to contribute to the academic and political debate on measures to combat environmental and climate problems.

  2. Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

    Science.gov (United States)

    Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

    2017-02-01

    The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

  3. Steps to Ensure a Successful Implementation of Occupational Health and Safety Interventions at an Organizational Level

    Science.gov (United States)

    Herrera-Sánchez, Isabel M.; León-Pérez, José M.; León-Rubio, José M.

    2017-01-01

    There is increasing meta-analytic evidence that addresses the positive impact of evidence-based occupational health and safety interventions on employee health and well-being. However, such evidence is less clear when interventions are approached at an organizational level and are aimed at changing organizational policies and processes. Given that occupational health and safety interventions are usually tailored to specific organizational contexts, generalizing and transferring such interventions to other organizations is a complex endeavor. In response, several authors have argued that an evaluation of the implementation process is crucial for assessing the intervention’s effectiveness and for understanding how and why the intervention has been (un)successful. Thus, this paper focuses on the implementation process and attempts to move this field forward by identifying the main factors that contribute toward ensuring a greater success of occupational health and safety interventions conducted at the organizational level. In doing so, we propose some steps that can guide a successful implementation. These implementation steps are illustrated using examples of evidence-based best practices reported in the literature that have described and systematically evaluated the implementation process behind their interventions during the last decade. PMID:29375413

  4. Steps to Ensure a Successful Implementation of Occupational Health and Safety Interventions at an Organizational Level

    Directory of Open Access Journals (Sweden)

    Isabel M. Herrera-Sánchez

    2017-12-01

    Full Text Available There is increasing meta-analytic evidence that addresses the positive impact of evidence-based occupational health and safety interventions on employee health and well-being. However, such evidence is less clear when interventions are approached at an organizational level and are aimed at changing organizational policies and processes. Given that occupational health and safety interventions are usually tailored to specific organizational contexts, generalizing and transferring such interventions to other organizations is a complex endeavor. In response, several authors have argued that an evaluation of the implementation process is crucial for assessing the intervention’s effectiveness and for understanding how and why the intervention has been (unsuccessful. Thus, this paper focuses on the implementation process and attempts to move this field forward by identifying the main factors that contribute toward ensuring a greater success of occupational health and safety interventions conducted at the organizational level. In doing so, we propose some steps that can guide a successful implementation. These implementation steps are illustrated using examples of evidence-based best practices reported in the literature that have described and systematically evaluated the implementation process behind their interventions during the last decade.

  5. The economics of interventional radiology

    International Nuclear Information System (INIS)

    Price, G.W.

    1988-01-01

    At a time when policy makers and regulators are scheming to reduce the costs and utilization of medical services, interventional radiology is poised for growth. Part of this potential for growth is based on wider acceptance of the procedures performed by interventional radiologists. A second factor in the growth potential is the relative value in cost of these procedures compared with alternative therapies. The author presents a discussion of the differences in the relative value of these procedures when performed by physicians of different specialties. This paper reviews the status of the economic climate in the health care delivery system and the role and potential growth of interventional radiology. This includes a review of current data on the utilization of interventional radiology procedures in the Medicare program. This overview includes a discussion of the initiatives of the federal government which directly impact interventional radiology

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

    National Research Council Canada - National Science Library

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

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chigozie Jesse Uneke

    2015-09-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  9. Temporal trends in childhood mortality in Ghana: impacts and challenges of health policies and programs

    Directory of Open Access Journals (Sweden)

    Gbenga A. Kayode

    2016-08-01

    Full Text Available Background: Following the adoption of the Millennium Development Goal 4 (MDG 4 in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2 that seeks to end preventable deaths of newborns and children aged under-five. Thus, this study aimed to compare trends in neonatal, infant, and under-five mortality over two decades and to highlight the impacts and challenges of health policies and intervention programs implemented. Design: Ghana Demographic and Health Survey data (1988–2008 were analyzed using trend analysis. Poisson regression analysis was applied to quantify the incidence rate ratio of the trends. Implemented health policies and intervention programs to reduce childhood mortality in Ghana were reviewed to identify their impact and challenges. Results: Since 1988, the annual average rate of decline in neonatal, infant, and under-five mortality in Ghana was 0.6, 1.0, and 1.2%, respectively. From 1988 to 1989, neonatal, infant, and under-five mortality declined from 48 to 33 per 1,000, 72 to 58 per 1,000, and 108 to 83 per 1,000, respectively, whereas from 1989 to 2008, neonatal mortality increased by 2 per 1,000 while infant and under-five mortality further declined by 6 per 1,000 and 17 per 1,000, respectively. However, the observed declines were not statistically significant except for under-five mortality; thus, the proportion of infant and under-five mortality attributed to neonatal death has increased. Most intervention programs implemented to address childhood mortality seem not to have been implemented comprehensively. Conclusion: Progress towards attaining MDG 4 in Ghana was below the targeted rate, particularly for neonatal mortality as most health policies and programs targeted infant and under-five mortality

  10. Randomised controlled trial of site specific advice on school travel patterns.

    Science.gov (United States)

    Rowland, D; DiGuiseppi, C; Gross, M; Afolabi, E; Roberts, I

    2003-01-01

    To evaluate the effect of site specific advice from a school travel coordinator on school travel patterns. Cluster randomised controlled trial of children attending 21 primary schools in the London boroughs of Camden and Islington. A post-intervention survey measured the proportion of children walking, cycling, or using public transport for travel to school, and the proportion of parents/carers very or quite worried about traffic and abduction. The proportion of schools that developed and implemented travel plans was assessed. One year post-intervention, nine of 11 intervention schools and none of 10 control schools had travel plans. Proportions of children walking, cycling, or using public transport on the school journey were similar in intervention and control schools. The proportion of parents who were very or quite worried about traffic danger was similar in the intervention (85%) and control groups (87%). However, after adjusting for baseline and other potential confounding factors we could not exclude the possibility of a modest reduction in parental concern about traffic danger as a result of the intervention. Having a school travel coordinator increased the production of school travel plans but there was no evidence that this changed travel patterns or reduced parental fears. Given the uncertainty about effectiveness, the policy of providing school travel coordinators should only be implemented within the context of a randomised controlled trial.

  11. Healthcare Policy in Romania. Frameworks and Challenges

    Directory of Open Access Journals (Sweden)

    Buţiu Călina Ana

    2016-07-01

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

  12. The cost of crime to society: new crime-specific estimates for policy and program evaluation.

    Science.gov (United States)

    McCollister, Kathryn E; French, Michael T; Fang, Hai

    2010-04-01

    Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than 10 years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost to society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Representations of women and drug use in policy: A critical policy analysis.

    Science.gov (United States)

    Thomas, Natalie; Bull, Melissa

    2018-06-01

    Contemporary research in the drugs field has demonstrated a number of gender differences in patterns and experiences of substance use, and the design and provision of gender-responsive interventions has been identified as an important policy issue. Consequently, whether and how domestic drug policies attend to women and gender issues is an important question for investigation. This article presents a policy audit and critical analysis of Australian national and state and territory policy documents. It identifies and discusses two key styles of problematisation of women's drug use in policy: 1) drug use and its effect on women's reproductive role (including a focus on pregnant women and women who are mothers), and 2) drug use and its relationship to women's vulnerability to harm (including violent and sexual victimisation, trauma, and mental health issues). Whilst these are important areas for policy to address, we argue that such representations of women who use drugs tend to reinforce particular understandings of women and drug use, while at the same time contributing to areas of 'policy silence' or neglect. In particular, the policy documents analysed are largely silent about the harm reduction needs of all women, as well as the needs of women who are not mothers, young women, older women, transwomen or other women deemed to be outside of dominant normative reproductive discourse. This analysis is important because understanding how women's drug use is problematised and identifying areas of policy silence provides a foundation for redressing gaps in policy, and for assessing the likely effectiveness of current and future policy approaches. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. 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.

  15. Integration of targeted health interventions into health systems: a conceptual framework for analysis.

    Science.gov (United States)

    Atun, Rifat; de Jongh, Thyra; Secci, Federica; Ohiri, Kelechi; Adeyi, Olusoji

    2010-03-01

    The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated (horizontal) versus non-integrated (vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated and non-integrated programmes in many countries suggests benefits to each approach. While the terms 'vertical' and 'integrated' are widely used, they each describe a range of phenomena. In practice the dichotomy between vertical and horizontal is not rigid and the extent of verticality or integration varies between programmes. However, systematic analysis of the relative merits of integration in various contexts and for different interventions is complicated as there is no commonly accepted definition of 'integration'-a term loosely used to describe a variety of organizational arrangements for a range of programmes in different settings. We present an analytical framework which enables deconstruction of the term integration into multiple facets, each corresponding to a critical health system function. Our conceptual framework builds on theoretical propositions and empirical research in innovation studies, and in particular adoption and diffusion of innovations within health systems, and builds on our own earlier empirical research. It brings together the critical elements that affect adoption, diffusion and assimilation of a health intervention, and in doing so enables systematic and holistic exploration of the extent to which different interventions are integrated in varied settings and the reasons for the variation. The conceptual framework and the analytical approach we propose are intended to facilitate analysis in evaluative and formative studies of-and policies on-integration, for use in systematically comparing and

  16. Countering school bullying: An analysis of policy content in Ontario and Saskatchewan

    Directory of Open Access Journals (Sweden)

    Ginette Diane Roberge

    2011-08-01

    Full Text Available The incidence of extreme school violence as a direct consequence of bullying among peers, exacerbated by vast media attention, has caused educational institutions worldwide to put bullying intervention and prevention strategies into operation. This study focused on an overview of two provincewide antibullying incentives in the Canadian provinces of Ontario and Saskatchewan, and an analysis of the quality of their respective antibullying policies. An itemized list of beneficial practices for bullying intervention and prevention originated from Smith, Smith, Osborn and Samara (2008’s scoring scheme. The scoring scheme was adapted to the current study by linking research-based program elements that have been found to be effective in reducing school bullying to a content analysis of both provincial frameworks. The final scoring scheme comprised a total of 39 criterions, divided into five categories: Defining Bullying Behaviors, Establishing a Positive School Climate, Disseminating, Monitoring and Reviewing Policy, Reporting and Responding to Bullying, and Involving the Broader Community. Results showed that policies contained a total average of 60% of the criterions in Ontario, and 59% in Saskatchewan. The conclusion of this study observes from policy lenses key essentials of bullying intervention and prevention initiatives in elementary and secondary educational settings. Recommendations are proposed to bridge the gap between areas that have received extensive attention and areas that have received less treatment in bullying intervention and prevention endeavors, using the content of Ontario and Saskatchewan policies as a basis for discussion.

  17. Modeling malaria control intervention effect in KwaZulu-Natal, South Africa using intervention time series analysis.

    Science.gov (United States)

    Ebhuoma, Osadolor; Gebreslasie, Michael; Magubane, Lethumusa

    The change of the malaria control intervention policy in South Africa (SA), re-introduction of dichlorodiphenyltrichloroethane (DDT), may be responsible for the low and sustained malaria transmission in KwaZulu-Natal (KZN). We evaluated the effect of the re-introduction of DDT on malaria in KZN and suggested practical ways the province can strengthen her already existing malaria control and elimination efforts, to achieve zero malaria transmission. We obtained confirmed monthly malaria cases in KZN from the malaria control program of KZN from 1998 to 2014. The seasonal autoregressive integrated moving average (SARIMA) intervention time series analysis (ITSA) was employed to model the effect of the re-introduction of DDT on confirmed monthly malaria cases. The result is an abrupt and permanent decline of monthly malaria cases (w 0 =-1174.781, p-value=0.003) following the implementation of the intervention policy. The sustained low malaria cases observed over a long period suggests that the continued usage of DDT did not result in insecticide resistance as earlier anticipated. It may be due to exophagic malaria vectors, which renders the indoor residual spraying not totally effective. Therefore, the feasibility of reducing malaria transmission to zero in KZN requires other reliable and complementary intervention resources to optimize the existing ones. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

    Science.gov (United States)

    Corrigan, Patrick W; Watson, Amy C

    2003-04-01

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

  19. Policy Brief: Enhancing water-use efficiency of thermal power plants in India: need for mandatory water audits

    Energy Technology Data Exchange (ETDEWEB)

    Batra, R.K. (ed.)

    2012-12-15

    This policy brief discusses the challenges of water availability and opportunity to improve the water use efficiency in industries specially the thermal power plants. It presents TERI’s experience from comprehensive water audits conducted for thermal power plants in India. The findings indicate that there is a significant scope for saving water in the waste water discharge, cooling towers, ash handling systems, and the township water supply. Interventions like recycling wastewater, curbing leakages, increasing CoC (Cycles of concentration) in cooling towers, using dry ash handling etc., can significantly reduce the specific water consumption in power plants. However, the first step towards this is undertaking regular water audits. The policy brief highlights the need of mandatory water audits necessary to understand the current water use and losses as well as identify opportunities for water conservation, reduction in specific water consumption, and an overall improvement in water use efficiency in industries.

  20. Cyber security policy guidebook

    CERN Document Server

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

    2012-01-01

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

  1. Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases

    NARCIS (Netherlands)

    Peters, D. T. J. M.; Raab, J.; Grêaux, K. M.; Stronks, K.; Harting, J.

    2017-01-01

    Background: Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as

  2. Structural integration and performance of inter-sectoral public health-related policy networks : An analysis across policy phases

    NARCIS (Netherlands)

    Peters, Dorothee; Raab, J.; Grêaux, Kimberley M.; Stronks, Karien; Harting, Janneke

    2017-01-01

    Background: Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structure and network characteristics (i.e., composition and integration) and network performance, such

  3. Explaining trends in addictive behaviour policy--the role of policy coherence.

    Science.gov (United States)

    Adam, Christian; Raschzok, Andreas

    2014-05-01

    This article analyses addictive behaviour policy regimes - focusing on illegal drugs and gambling - in 19 countries over a period of 50 years. It compares how these countries have combined rules on the consumption and possession of cannabis and on the participation in sports betting with sanctions for violations of these rules. While theories of policy convergence can explain dominant trends in the way the combination of these policy instruments have changed, they cannot account for all of the empirical variation observed. Turning to Portugal, a case which deviates in both illegal drug and gambling policy from the expected trend, we show that explanations of policy change improve substantially when taking the concept of policy coherence into account. Specifically, we argue that changes of the policy status quo are facilitated when policy entrepreneurs succeed in shaping a perception of policy incoherence. In turn, when relevant actors are able to maintain a perception of policy coherence, the policy status quo is stabilized. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Effectiveness of school food environment policies on children's dietary behaviors: A systematic review and meta-analysis.

    Science.gov (United States)

    Micha, Renata; Karageorgou, Dimitra; Bakogianni, Ioanna; Trichia, Eirini; Whitsel, Laurie P; Story, Mary; Peñalvo, Jose L; Mozaffarian, Dariush

    2018-01-01

    School food environment policies may be a critical tool to promote healthy diets in children, yet their effectiveness remains unclear. To systematically review and quantify the impact of school food environment policies on dietary habits, adiposity, and metabolic risk in children. We systematically searched online databases for randomized or quasi-experimental interventions assessing effects of school food environment policies on children's dietary habits, adiposity, or metabolic risk factors. Data were extracted independently and in duplicate, and pooled using inverse-variance random-effects meta-analysis. Habitual (within+outside school) dietary intakes were the primary outcome. Heterogeneity was explored using meta-regression and subgroup analysis. Funnel plots, Begg's and Egger's test evaluated potential publication bias. From 6,636 abstracts, 91 interventions (55 in US/Canada, 36 in Europe/New Zealand) were included, on direct provision of healthful foods/beverages (N = 39 studies), competitive food/beverage standards (N = 29), and school meal standards (N = 39) (some interventions assessed multiple policies). Direct provision policies, which largely targeted fruits and vegetables, increased consumption of fruits by 0.27 servings/d (n = 15 estimates (95%CI: 0.17, 0.36)) and combined fruits and vegetables by 0.28 servings/d (n = 16 (0.17, 0.40)); with a slight impact on vegetables (n = 11; 0.04 (0.01, 0.08)), and no effects on total calories (n = 6; -56 kcal/d (-174, 62)). In interventions targeting water, habitual intake was unchanged (n = 3; 0.33 glasses/d (-0.27, 0.93)). Competitive food/beverage standards reduced sugar-sweetened beverage intake by 0.18 servings/d (n = 3 (-0.31, -0.05)); and unhealthy snacks by 0.17 servings/d (n = 2 (-0.22, -0.13)), without effects on total calories (n = 5; -79 kcal/d (-179, 21)). School meal standards (mainly lunch) increased fruit intake (n = 2; 0.76 servings/d (0.37, 1.16)) and reduced total fat (-1.49%energy; n = 6 (-2

  5. Identifying structural barriers to an effective HIV response: using the National Composite Policy Index data to evaluate the human rights, legal and policy environment

    Science.gov (United States)

    Gruskin, Sofia; Ferguson, Laura; Alfven, Tobias; Rugg, Deborah; Peersman, Greet

    2013-01-01

    Introduction Attention to the negative effects of structural barriers on HIV efforts is increasing. Reviewing national legal and policy environments with attention to the international human rights commitments of states is a means of assessing and providing focus for addressing these barriers to effective HIV responses. Methods Law and policy data from the 171 countries reporting under the Declaration of Commitment from the 2001 United Nations General Assembly Special Session on HIV/AIDS were analyzed to assess attention to human rights in national legal and policy environments as relevant to the health and rights of key populations such as people who inject drugs, men who have sex with men and sex workers. Results Seventy-eight governments and civil society in 106 countries report the existence of laws and policies which present obstacles to accessing HIV services for key populations. Laws and policies which positively affect access to HIV-related services, in and of themselves constituting structural interventions, were also reported. The dissonance between laws and how this impacts the availability and use of HIV-related services deserve greater attention. Conclusions Recognition of the harms inherent in laws that constitute structural barriers to effective HIV responses and the potential positive role that a supportive legal environment can play suggests the need for legal reform to ensure an enabling regulatory framework within which HIV services can be effectively delivered and used by the populations who need them. Moving beyond laws and policies, further efforts are required to determine how to capture information on the range of structural barriers. Teasing apart the impact of different barriers, as well as the structural interventions put in place to address them, remains complicated. Capturing the impact of policy and legal interventions can ultimately support governments and civil society to ensure the human rights of key populations are protected in

  6. Utilization of Facet Joint and Sacroiliac Joint Interventions in Medicare Population from 2000 to 2014: Explosive Growth Continues!

    Science.gov (United States)

    Manchikanti, Laxmaiah; Hirsch, Joshua A; Pampati, Vidyasagar; Boswell, Mark V

    2016-10-01

    Increasing utilization of interventional techniques in managing chronic spinal pain, specifically facet joint interventions and sacroiliac joint injections, is a major concern of healthcare policy makers. We analyzed the patterns of utilization of facet and sacroiliac joint interventions in managing chronic spinal pain. The results showed significant increase of facet joint interventions and sacroiliac joint injections from 2000 to 2014 in Medicare FFS service beneficiaries. Overall, the Medicare population increased 35 %, whereas facet joint and sacroiliac joint interventions increased 313.3 % per 100,000 Medicare population with an annual increase of 10.7 %. While the increases were uniform from 2000 to 2014, there were some decreases noted for facet joint interventions in 2007, 2010, and 2013, whereas for sacroiliac joint injections, the decreases were noted in 2007 and 2013. The increases were for cervical and thoracic facet neurolysis at 911.5 % compared to lumbosacral facet neurolysis of 567.8 %, 362.9 % of cervical and thoracic facet joint blocks, 316.9 % of sacroiliac joints injections, and finally 227.3 % of lumbosacral facet joint blocks.

  7. Predictive Feature Selection for Genetic Policy Search

    Science.gov (United States)

    2014-05-22

    limited manual intervention are becoming increasingly desirable as more complex tasks in dynamic and high- tempo environments are explored. Reinforcement...states in many domains causes features relevant to the reward variations to be overlooked, which hinders the policy search. 3.4 Parameter Selection PFS...the current feature subset. This local minimum may be “deceptive,” meaning that it does not clearly lead to the global optimal policy ( Goldberg and

  8. Policies for Renewable Heat

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

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

  9. Community interventions for cardiovascular disease.

    Science.gov (United States)

    Parker, Donna R; Assaf, Annlouise R

    2005-12-01

    Review of the community-based CVD intervention programs suggests that a number of components have been successful using varying methods and materials for CVD risk reduction. It should be noted, however, that in multi-intervention programs it is often difficult to determine which components of the intervention were responsible for the overall success of the study. The community-based approach to CVD prevention is generalizable, cost-effective (because of the use of mass communication methods), and has the potential for modifying the environment and influencing health policies. Based on the experiences and successes of a number of community projects, recommendations have been proposed for developing future programs. Although they are not totally comprehensive, it has been suggested that a community-based intervention program should consider the following recommendations: 1) An understanding of the community: the needs and priorities of the community should be assessed, and close collaboration with individuals from the community, including community leaders, opinion leaders, community health care providers, and community organizations from various sectors of the community, should be consulted. Efforts should be focused on underserved and vulnerable populations. 2) Inclusion of community activities: these activities should be integrated within the context of the community environment, including primary health care services, voluntary organizations, grocery stores, restaurants, work sites, schools, and local media. 3) Inclusion mass media messages: the mass media can provide information and reinforcement of the behavior change. 4) Develop cost-effective interventions to assure that the community is exposed to an effective dose of the intervention. 5) Work with community organizations to help change social and physical environments to make them more conducive to health and healthy life-styles changes. 6) Develop a reliable monitoring and evaluation system: monitor the

  10. Frailty Intervention Trial (FIT

    Directory of Open Access Journals (Sweden)

    Lockwood Keri

    2008-10-01

    Full Text Available Abstract Background Frailty is a term commonly used to describe the condition of an older person who has chronic health problems, has lost functional abilities and is likely to deteriorate further. However, despite its common use, only a small number of studies have attempted to define the syndrome of frailty and measure its prevalence. The criteria Fried and colleagues used to define the frailty syndrome will be used in this study (i.e. weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. Previous studies have shown that clinical outcomes for frail older people can be improved using multi-factorial interventions such as comprehensive geriatric assessment, and single interventions such as exercise programs or nutritional supplementation, but no interventions have been developed to specifically reverse the syndrome of frailty. We have developed a multidisciplinary intervention that specifically targets frailty as defined by Fried et al. We aim to establish the effects of this intervention on frailty, mobility, hospitalisation and institutionalisation in frail older people. Methods and Design A single centre randomised controlled trial comparing a multidisciplinary intervention with usual care. The intervention will target identified characteristics of frailty, functional limitations, nutritional status, falls risk, psychological issues and management of chronic health conditions. Two hundred and thirty people aged 70 and over who meet the Fried definition of frailty will be recruited from clients of the aged care service of a metropolitan hospital. Participants will be followed for a 12-month period. Discussion This research is an important step in the examination of specifically targeted frailty interventions. This project will assess whether an intervention specifically targeting frailty can be implemented, and whether it is effective when compared to usual care. If successful, the study will establish a

  11. Systems Thinking and Simulation Modeling to Inform Childhood Obesity Policy and Practice.

    Science.gov (United States)

    Powell, Kenneth E; Kibbe, Debra L; Ferencik, Rachel; Soderquist, Chris; Phillips, Mary Ann; Vall, Emily Anne; Minyard, Karen J

    In 2007, 31.7% of Georgia adolescents in grades 9-12 were overweight or obese. Understanding the impact of policies and interventions on obesity prevalence among young people can help determine statewide public health and policy strategies. This article describes a systems model, originally launched in 2008 and updated in 2014, that simulates the impact of policy interventions on the prevalence of childhood obesity in Georgia through 2034. In 2008, using information from peer-reviewed reports and quantitative estimates by experts in childhood obesity, physical activity, nutrition, and health economics and policy, a group of legislators, legislative staff members, and experts trained in systems thinking and system dynamics modeling constructed a model simulating the impact of policy interventions on the prevalence of childhood obesity in Georgia through 2034. Use of the 2008 model contributed to passage of a bill requiring annual fitness testing of schoolchildren and stricter enforcement of physical education requirements. We updated the model in 2014. With no policy change, the updated model projects that the prevalence of obesity among children and adolescents aged ≤18 in Georgia would hold at 18% from 2014 through 2034. Mandating daily school physical education (which would reduce prevalence to 12%) and integrating moderate to vigorous physical activity into elementary classrooms (which would reduce prevalence to 10%) would have the largest projected impact. Enacting all policies simultaneously would lower the prevalence of childhood obesity from 18% to 3%. Systems thinking, especially with simulation models, facilitates understanding of complex health policy problems. Using a simulation model to educate legislators, educators, and health experts about the policies that have the greatest short- and long-term impact should encourage strategic investment in low-cost, high-return policies.

  12. 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.

  13. 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.

  14. Counterterrorism: Policy of Preemptive Action

    National Research Council Canada - National Science Library

    Westphal, Stephen

    2003-01-01

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

  15. Analysis of Ethiopia's national ICT policy and strategy: insights into ...

    African Journals Online (AJOL)

    The trend shows that the national ICT policy need to focus broadly on core and emerging issues that are crucial for ICT ecosystem such as infrastructure, services, applications, universal access, cyber security, social media, and users. Broadband infrastructure development is considered as key intervention in the policy.

  16. From policy to practice: implementation of physical activity and food policies in schools

    Science.gov (United States)

    2013-01-01

    Purpose Public policies targeting the school setting are increasingly being used to address childhood obesity; however, their effectiveness depends on their implementation. This study explores the factors which impeded or facilitated the implementation of publicly mandated school-based physical activity and nutrition guidelines in the province of British Columbia (BC), Canada. Methods Semi-structured interviews were conducted with 50 school informants (17 principals - 33 teacher/school informants) to examine the factors associated with the implementation of the mandated Daily Physical Activity (DPA) and Food and Beverage Sales in Schools (FBSS) guidelines. Coding used a constructivist grounded theory approach. The first five transcripts and every fifth transcript thereafter were coded by two independent coders with discrepancies reconciled by a third coder. Data was coded and analysed in the NVivo 9 software. Concept maps were developed and current theoretical perspectives were integrated in the later stages of analysis. Results The Diffusion of Innovations Model provided an organizing framework to present emergent themes. With the exception of triability (not relevant in the context of mandated guidelines/policies), the key attributes of the Diffusion of Innovations Model (relative advantage, compatibility, complexity, and observability) provided a robust framework for understanding themes associated with implementation of mandated guidelines. Specifically, implementation of the DPA and FBSS guidelines was facilitated by perceptions that they: were relatively advantageous compared to status quo; were compatible with school mandates and teaching philosophies; had observable positive impacts and impeded when perceived as complex to understand and implement. In addition, a number of contextual factors including availability of resources facilitated implementation. Conclusions The enactment of mandated policies/guidelines for schools is considered an essential step in

  17. Prevention of mental and behavioral disorders : implications for policy and practice

    NARCIS (Netherlands)

    Saxena, S.; Llopis, E.J.; Hosman, C.M.H.

    2006-01-01

    There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity

  18. Stem cell policy exceptionalism: proceed with caution.

    Science.gov (United States)

    Lomax, Geoffrey P; Peckman, Steven R

    2012-06-01

    The term "stem cell exceptionalism" has been used to characterize the policy response to controversies surrounding human embryonic stem cell research. For example, governments and funding agencies have adopted policies governing the derivation and use of human embryonic stem cell lines. These policies have effectively served to fill gaps in existing guidelines and regulations and signal that scientists are committed to a responsible framework for the conduct of research involving human embryos. Recent publications discuss whether ethical and policy issues associated with induced pluripotent cells (iPSCs) from non-embryonic sources create a need for further policy intervention. We suggest many of the issues identified by commentators may be addressed through the application of established policy frameworks governing the use of tissue, human stem cells, and research participation by human research subjects. To the extent, iPSC research intersects with hESC research (e.g. the creation of human gametes and/or embryos), the policy framework governing hESC appears sufficiently robust at this time.

  19. Improving Intervention Decisions to Prevent Genocide: Less Muddle, More Structure

    Directory of Open Access Journals (Sweden)

    Robin Gregory

    2018-03-01

    Full Text Available Decisions to intervene in a foreign country to prevent genocide and mass atrocities are among the most challenging and controversial choices facing national leaders. Drawing on techniques from decision analysis, psychology, and negotiation analysis, we propose a structured approach to these difficult choices that can provide policy makers with additional insight, consistency, efficiency, and defensibility. We propose the use of a values-based framework to clarify the key elements of these complex choices and to provide a consistent structure for comparison of the likely benefits, risks, and tradeoffs associated with alternative intervention strategies. Results from a workshop involving Ambassadors and experienced policy makers provide a first test of this new method for clarifying intervention choices. A decision-aiding framework is shown to improve the clarity and relevance of intervention deliberations, laying the groundwork for a more comprehensive and clearer understanding of the threats and opportunities associated with various intervention options.

  20. Provider-associated factors in obstetric interventions

    NARCIS (Netherlands)

    Pel, M.; Heres, M. H.; Hart, A. A.; van der Veen, F.; Treffers, P. E.

    1995-01-01

    OBJECTIVE: To assess which factors influence provider-associated differences in obstetric interventions. STUDY DESIGN: A survey of obstetricians and co-workers in a sample consisting of 38 Dutch hospitals was taken, using a questionnaire that contained questions about personal and hospital-policy

  1. Vested interests in addiction research and policy alcohol policies out of context: drinks industry supplanting government role in alcohol policies in sub-Saharan Africa.

    Science.gov (United States)

    Bakke, Øystein; Endal, Dag

    2010-01-01

    In this paper, we describe an analysis of alcohol policy initiatives sponsored by alcohol producer SABMiller and the International Center on Alcohol Policies, an alcohol industry-funded organization. In a number of sub-Saharan countries these bodies have promoted a 'partnership' role with governments to design national alcohol policies. A comparison was conducted of four draft National Alcohol Policy documents from Lesotho, Malawi, Uganda and Botswana using case study methods. The comparison indicated that the four drafts are almost identical in wording and structure and that they are likely to originate from the same source. The processes and the draft policy documents reviewed provide insights into the methods, as well as the strategic and political objectives of the multi-national drinks industry. This initiative reflects the industry's preferred version of a national alcohol policy. The industry policy vision ignores, or chooses selectively from, the international evidence base on alcohol prevention developed by independent alcohol researchers and disregards or minimizes a public health approach to alcohol problems. The policies reviewed maintain a narrow focus on the economic benefits from the trade in alcohol. In terms of alcohol problems (and their remediation) the documents focus upon individual drinkers, ignoring effective environmental interventions. The proposed policies serve the industry's interests at the expense of public health by attempting to enshrine 'active participation of all levels of the beverage alcohol industry as a key partner in the policy formulation and implementation process'.

  2. Interventional neuroradiology techniques in interventional radiology

    CERN Document Server

    Murphy, Kieran; Robertson, Fergus; Watkinson, Anthony

    2013-01-01

    This book provides accessible technique-specific information on interventional radiology procedures, in a format suitable for reference in the IR treatment room or as a carry-around guide. Offers step-by-step points, key point summaries and illustrations.

  3. OPEN MARKETING - A SPECIFIC FORM OF MONETARY POLICY IN ORDER TO MONETARY VOLUME ADJUSTMENT

    Directory of Open Access Journals (Sweden)

    CHIRTOC IRINA- ELENA

    2013-02-01

    Full Text Available : Applying a uniform monetary policy by all European Union member states also require harmonization of monetary policy instruments and national interbank market integration also. Monetary policy instruments used by NBR (National Bank of Romania have evolved over time as a result of alignment with the instruments used by the European Central Bank. Money market operations in Romania have appeared for the first time in 1997. Starting from the wishing of Central Bank to reduce excess liquidity in 2001 they became the most important monetary policy tool used by the National Bank of Rumania. Open market operations are the instrument of monetary policy, central banking in Eastern Europe to work towards monetary contraction or expansion. Open-market operations in recent years have become the most important monetary policy instrument they play an essential role in promoting monetary policy by the central bank. Through open marketing operations the monetary authorities aim to alter bank reserves and thereby influence the amount of currency in circulation. In Romania, the open marketing operations are initiated by the National Bank of Romania, which determines what type of tools will be used while setting terms and conditions of the implementation. Through the use and control of monetary policy instruments, the central bank as the state bank seeks managing liquidity in the economy.

  4. 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.

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

    Science.gov (United States)

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

    2018-03-01

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

  6. The role of decision analytic modeling in the health economic assessment of spinal intervention.

    Science.gov (United States)

    Edwards, Natalie C; Skelly, Andrea C; Ziewacz, John E; Cahill, Kevin; McGirt, Matthew J

    2014-10-15

    Narrative review. To review the common tenets, strengths, and weaknesses of decision modeling for health economic assessment and to review the use of decision modeling in the spine literature to date. For the majority of spinal interventions, well-designed prospective, randomized, pragmatic cost-effectiveness studies that address the specific decision-in-need are lacking. Decision analytic modeling allows for the estimation of cost-effectiveness based on data available to date. Given the rising demands for proven value in spine care, the use of decision analytic modeling is rapidly increasing by clinicians and policy makers. This narrative review discusses the general components of decision analytic models, how decision analytic models are populated and the trade-offs entailed, makes recommendations for how users of spine intervention decision models might go about appraising the models, and presents an overview of published spine economic models. A proper, integrated, clinical, and economic critical appraisal is necessary in the evaluation of the strength of evidence provided by a modeling evaluation. As is the case with clinical research, all options for collecting health economic or value data are not without their limitations and flaws. There is substantial heterogeneity across the 20 spine intervention health economic modeling studies summarized with respect to study design, models used, reporting, and general quality. There is sparse evidence for populating spine intervention models. Results mostly showed that interventions were cost-effective based on $100,000/quality-adjusted life-year threshold. Spine care providers, as partners with their health economic colleagues, have unique clinical expertise and perspectives that are critical to interpret the strengths and weaknesses of health economic models. Health economic models must be critically appraised for both clinical validity and economic quality before altering health care policy, payment strategies, or

  7. Food Waste Drivers in Europe, from Identification to Possible Interventions

    Directory of Open Access Journals (Sweden)

    Massimo Canali

    2016-12-01

    Full Text Available The growing volumes of food globally lost or wasted and implications for food security and sustainability have raised the concern of researchers, governments, international organizations and grass-root movements. Much research and experiences investigating food waste causes and drivers focus on one specific segment of the food supply chain and limit the analysis to the situation of one or few countries, while the few studies of wider geographical scope also target other relevant and diversified objectives (e.g., food waste definition, quantification, environmental and economic impacts, and recommendations for interventions. This study, carried out by a network of European institutions involved in research and initiatives against food waste, focuses on the analysis of a broad area, Europe, through a wide and systematic literature review and consultation with stakeholders in international focus groups. The food supply chain was divided into seven segments and three main contexts were defined for the examination of food waste sources: Technological, Institutional (related to organisational factors, i.e., business management, economy, legislation, and policy, and Social (related to consumers’ behaviours and lifestyles. Results suggest a wide and multifaceted problem, interconnected across all stages of the food supply chain, from primary production, to final consumption. Within each context, the identified drivers have been grouped according to the possibilities and the type of interventions for food waste reduction. A final cross-contextual prioritization distinguished food waste sources related to (A inherent characteristics of food; (B social and economic factors; (C individual non-readily changeable behaviours; (D other priorities targeted by private and public stakeholders; (E diversified factors, such as mismanagement, inefficient legislation, lack of awareness or information; and sub-optimal use of available technologies, which could be

  8. Financial incentives and psychiatric services in Australia: an empirical analysis of three policy changes.

    Science.gov (United States)

    Doessel, D P; Scheurer, Roman W; Chant, David C; Whiteford, Harvey

    2007-01-01

    Australia has a national, compulsory and universal health insurance scheme, called Medicare. In 1996 the Government changed the Medicare Benefit Schedule Book in such a way as to create different financial incentives for consumers or producers of out-of-hospital private psychiatric services, once an individual consumer had received 50 such services in a 12-month period. The Australian Government introduced a new Item (319) to cover some special cases that were affected by the policy change. At the same time, the Commonwealth introduced a 'fee-freeze' for all medical services. The purpose of this study is two-fold. First, it is necessary to describe the three policy interventions (the constraints on utilization, the operation of the new Item and the general 'fee-freeze'.) The new Item policy was essentially a mechanism to 'dampen' the effect of the 'constraint' policy, and these two policy changes will be consequently analysed as a single intervention. The second objective is to evaluate the policy intervention in terms of the (stated) Australian purpose of reducing utilization of psychiatric services, and thus reducing financial outlays. Thus, it is important to separate out the different effects of the three policies that were introduced at much the same time in November 1996 and January 1997. The econometric results indicate that the composite policy change (constraining services and the new 319 Item) had a statistically significant effect. The analysis of the Medicare Benefit (in constant prices) indicates that the 'fee-freeze' policy also had a statistically significant effect. This enables separate determination of the several policy changes. In fact, the empirical results indicate that the Commonwealth Government underestimated the 'savings' that would arise from the 'constraint' policy.

  9. Effectiveness of school food environment policies on children’s dietary behaviors: A systematic review and meta-analysis

    Science.gov (United States)

    Bakogianni, Ioanna; Trichia, Eirini; Whitsel, Laurie P.; Story, Mary; Peñalvo, Jose L.; Mozaffarian, Dariush

    2018-01-01

    Background School food environment policies may be a critical tool to promote healthy diets in children, yet their effectiveness remains unclear. Objective To systematically review and quantify the impact of school food environment policies on dietary habits, adiposity, and metabolic risk in children. Methods We systematically searched online databases for randomized or quasi-experimental interventions assessing effects of school food environment policies on children’s dietary habits, adiposity, or metabolic risk factors. Data were extracted independently and in duplicate, and pooled using inverse-variance random-effects meta-analysis. Habitual (within+outside school) dietary intakes were the primary outcome. Heterogeneity was explored using meta-regression and subgroup analysis. Funnel plots, Begg’s and Egger’s test evaluated potential publication bias. Results From 6,636 abstracts, 91 interventions (55 in US/Canada, 36 in Europe/New Zealand) were included, on direct provision of healthful foods/beverages (N = 39 studies), competitive food/beverage standards (N = 29), and school meal standards (N = 39) (some interventions assessed multiple policies). Direct provision policies, which largely targeted fruits and vegetables, increased consumption of fruits by 0.27 servings/d (n = 15 estimates (95%CI: 0.17, 0.36)) and combined fruits and vegetables by 0.28 servings/d (n = 16 (0.17, 0.40)); with a slight impact on vegetables (n = 11; 0.04 (0.01, 0.08)), and no effects on total calories (n = 6; -56 kcal/d (-174, 62)). In interventions targeting water, habitual intake was unchanged (n = 3; 0.33 glasses/d (-0.27, 0.93)). Competitive food/beverage standards reduced sugar-sweetened beverage intake by 0.18 servings/d (n = 3 (-0.31, -0.05)); and unhealthy snacks by 0.17 servings/d (n = 2 (-0.22, -0.13)), without effects on total calories (n = 5; -79 kcal/d (-179, 21)). School meal standards (mainly lunch) increased fruit intake (n = 2; 0.76 servings/d (0.37, 1.16)) and

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

    International Nuclear Information System (INIS)

    Bettzuge, Marc Oliver

    2013-11-01

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

  11. Drug and Alcohol Studies (Volume 5: Interventions)

    OpenAIRE

    MacGregor, S; Thom, B

    2014-01-01

    VOLUME FIVE: INTERVENTIONS Natural Recovery from Alcohol Problems Harald Klingemann School-Based Programmes to Prevent Alcohol, Tobacco and Other Drug Use Gilbert Botvin and Kenneth Griffin Community Prevention of Alcohol Problems Harold Holder Can Screening and Brief Intervention Lead to Population-Level Reductions in Alcohol-Related Harm? Nick Heather Sharpening the Focus of Alcohol Policy from Aggregate Consumption to Harm and Risk Reduction Tim Stockwell et al A Review of the Efficacy and...

  12. Domain Specificity between Peer Support and Self-Concept

    Science.gov (United States)

    Leung, Kim Chau; Marsh, Herbert W.; Craven, Rhonda G.; Yeung, Alexander S.; Abduljabbar, Adel S.

    2013-01-01

    Peer support interventions have mostly neglected the domain specificity of intervention effects. In two studies, the present investigation examined the domain specificity of peer support interventions targeting specific domains of self-concept. In Study 1, participants ("n" = 50) who had received an academically oriented peer support…

  13. Translating Neurodevelopmental Care Policies Into Practice: The Experience of Neonatal ICUs in France—The EPIPAGE-2 Cohort Study

    Science.gov (United States)

    Coquelin, Anaëlle; Cuttini, Marina; Khoshnood, Babak; Glorieux, Isabelle; Claris, Olivier; Durox, Mélanie; Kaminski, Monique; Ancel, Pierre-Yves; Arnaud, Catherine

    2016-01-01

    Objectives: To describe the implementation of neurodevelopmental care for newborn preterm infants in neonatal ICUs in France in 2011, analyze changes since 2004, and investigate factors associated with practice. Design: Prospective national cohort study of all births before 32 weeks of gestation. Setting: Twenty-five French regions. Participants: All neonatal ICUs (n = 66); neonates surviving at discharge (n = 3,005). Interventions: None. Measurements and Main Results: Neurodevelopmental care policies and practices were assessed by structured questionnaires. Proportions of neonates initiating kangaroo care during the first week of life and those whose mothers expressed breast milk were measured as neurodevelopmental care practices. Multilevel logistic regression analyses were used to investigate relationships between kangaroo care or breast-feeding practices and unit policies, taking into account potential confounders. Free visiting policies, bed availability for parents, and kangaroo care encouragement significantly improved between 2004 and 2011 but with large variabilities between units. Kangaroo care initiation varied from 39% for neonates in the most restrictive units to 68% in less restrictive ones (p neurodevelopmental care significantly influenced kangaroo care initiation (odds ratio, 3.5; 95% CI, 1.8–7.0 for Newborn Individualized Developmental Care and Assessment Program implementation compared with no training). Breast milk expression by mothers was greater in units with full-time availability professionals trained for breast-feeding support (60% vs 73%; p neurodevelopmental practices occurred between 2004 and 2011, but large variabilities between units persist. Practices increased in units with supportive policies. Specific neurodevelopmental care training with multifaceted interventions strengthened the implementation of policies. PMID:27518584

  14. Priorities and needs for research on urban interventions targeting vector-borne diseases: rapid review of scoping and systematic reviews.

    Science.gov (United States)

    Bermudez-Tamayo, Clara; Mukamana, Olive; Carabali, Mabel; Osorio, Lyda; Fournet, Florence; Dabiré, Kounbobr Roch; Turchi Marteli, Celina; Contreras, Adolfo; Ridde, Valéry

    2016-12-01

    This paper highlights the critical importance of evidence on vector-borne diseases (VBD) prevention and control interventions in urban settings when assessing current and future needs, with a view to setting policy priorities that promote inclusive and equitable urban health services. Research should produce knowledge about policies and interventions that are intended to control and prevent VBDs at the population level and to reduce inequities. Such interventions include policy, program, and resource distribution approaches that address the social determinants of health and exert influence at organizational and system levels.

  15. Allergies And Asthma : Employing Principles Of Social Justice As A Guide In Public Health Policy Development

    Directory of Open Access Journals (Sweden)

    Jason Behrmann

    2010-05-01

    Full Text Available The growing epidemic of allergy and allergy-induced asthma poses a significant challenge to population health. This article, written for a target audience of policy-makers in public health, aims to contribute to the development of policies to counter allergy morbidities by demonstrat- ing how principles of social justice can guide public health initiatives in reducing allergy and asthma triggers. Following a discussion of why theories of social justice have utility in analyzing allergy, a step-wise policy assessment protocol formulated on Rawlsian principles of social jus- tice is presented. This protocol can serve as a tool to aid in prioritizing public health initiatives and identifying ethically problematic policies that necessitate reform. Criteria for policy assess- ment include: 1 whether a tentative public health intervention would provide equal health ben- efit to a range of allergy and asthma sufferers, 2 whether targeting initiatives towards particu- lar societal groups is merited based on the notion of ‘worst-off status’ of certain population seg- ments, and 3 whether targeted policies have the potential for stigmatization. The article con- cludes by analyzing three examples of policies used in reducing allergy and asthma triggers in order to convey the general thought process underlying the use of the assessment protocol, which public health officials could replicate as a guide in actual, region-specific policy development.

  16. The effectiveness of sexual harassment policies and procedures at higher education institutions in South Africa

    Directory of Open Access Journals (Sweden)

    Pierre Joubert

    2011-02-01

    Research purpose: The aim of this study was to investigate the awareness levels of academic staff members at higher education institutions in South Africa of sexual harassment policies and procedures in their institutions. Motivation for the study: A number of high profile court cases emphasised the need for effective policies to reduce the incidence of sexual harassment complaints. Research design, approach and method: A cross-sectional survey design was conducted amongst 161 academic staff members, representing 10 higher education institutions in South Africa. The measuring instrument that was used is the Sexual Harassment Questionnaire (SHQ that was developed specifically for this study. Main findings: The results showed that despite indications that sexual harassment policies do exist and that they are regarded as effective tools in addressing sexual harassment, the implementation of such policies is not effective and few academic staff members received training and/or guidance on the utilisation of the policy. Significant correlation coefficients were found between the elements of an effective policy and between population group and some of the elements. Practical/managerial implications: Employers across the board should regularly conduct an audit to determine the level of awareness of sexual harassment policies and procedures and plan interventions. Contribution: No other study in South Africa attempted to measure the awareness levels of academics and its impact on the management of sexual harassment.

  17. Brain death determination: the imperative for policy and legal initiatives in Sub-Saharan Africa.

    Science.gov (United States)

    Waweru-Siika, Wangari; Clement, Meredith Edwards; Lukoko, Lilian; Nadel, Simon; Rosoff, Philip M; Naanyu, Violet; Kussin, Peter S

    2017-05-01

    The concept of brain death (BD), defined as irreversible loss of function of the brain including the brainstem, is accepted in the medical literature and in legislative policy worldwide. However, in most of Sub-Saharan Africa (SSA) there are no legal guidelines regarding BD. Hypothetical scenarios based on our collective experience are presented which underscore the consequences of the absence of BD policies in resource-limited countries (RLCs). Barriers to the development of BD laws exist in an RLC such as Kenya. Cultural, ethnic, and religious diversity creates a complex perspective about death challenging the development of uniform guidelines for BD. The history of the medical legal process in the USA provides a potential way forward. Uniform guidelines for legislation at the state level included special consideration for ethnic or religious preferences in specific states. In SSA, medical and social consensus on the definition of BD is a prerequisite for the development BD legislation. Legislative policy will (1) limit prolonged and futile interventions; (2) mitigate the suffering of families; (3) standardise clinical practice; and (4) facilitate better allocation of scarce critical care resources in RLCs. There is a clear-cut need for these policies, and previous successful policies can serve to guide these efforts.

  18. Dosha phenotype specific Ayurveda intervention ameliorates asthma symptoms through cytokine modulations: Results of whole system clinical trial.

    Science.gov (United States)

    Joshi, Kalpana S; Nesari, Tanuja M; Dedge, Amrish P; Dhumal, Vikram R; Shengule, Sushant A; Gadgil, Maithili S; Salvi, Sundeep; Valiathan, Marthanda Varma Sankaran

    2017-02-02

    Over the past few decades, there have been significant scientific advances leading to improved understanding of asthma as a disease and treatment providing immediate relief. However, prevention of recurrent attacks, exacerbations and disease cure remains a challenge. Ayurveda refers to bronchial asthma as Tamaka Swasa and it is well explained in Charaka Samhita. Management of asthma in Ayurveda includes removal of vitiated Kapha through Shodhana, Shamana procedures, herbal and herbomineral formulations in addition to advising a healthy lifestyle and diet. Several clinical trials on Ayurvedic formulations for treatment of asthma are reported, however, whole system management of asthma has rarely been studied in the manner in which it is actually being practiced. Ayurveda therapeutics provides Dosha specific approaches, which needs biological investigation. The objective of our study was to investigate lung functions and cytokine changes in Asthmatic individuals in response to Ayurvedic intervention. The study design was approved by the Institutional Ethics Committee of Tilak Ayurveda Mahavidyalaya (TAMV) & Sheth Tarachand Ramnath Charitable Ayurveda Hospital and followed guidelines of the Declaration of Helsinki and Tokyo for humans. It was conducted as a whole system individualized pragmatic clinical trial and written consent of patients was collected before enrollment. One hundred and fifteen patients with mild-to-moderate asthma were divided into 2 sub-groups depending on their disease subsets and administered phenotype specific ayurvedic interventions. Seventy six asthma patients completed the treatment. Serum IgE levels, blood eosinophil counts, spirometry and blood cytokine levels were measured before the start of treatment and six months at the end of treatment. Age and sex matched healthy participants (n=69) were recruited in the study for comparison of cytokines levels. Significant improvements in FEV1(% predicted) (p<0.0001) and FVC (% predicted) (p=0

  19. Maori challenges and crown responsibilities: Maori policymaker ideas on smokefree policy options.

    Science.gov (United States)

    Gifford, Heather; Parata, Kiri; Thomson, George

    2010-11-26

    To determine obstacles/opportunities within policy processes, for smokefree interventions appropriate to Maori. In particular, to explore Maori policymakers' ideas on how to achieve progress on smokefree homes, cars and community property. Documents and interviews with 16 senior Maori officials and Members of Parliament, and nine interviews in two case studies, were used to explore Maori policymakers' ideas for (i) Progress, within relevant policy processes, on smoking in homes, cars and community property; (ii) Particular interventions that the interviewees felt were most and least effective, practical, sustainable, politically feasible or desirable in some way; (iii) The context, and obstacles and opportunities for such interventions. The case studies were of a Maori health service and a group of Maori District Health Board managers. Several key themes emerged from the research including, (i) children as drivers for change, (ii) strong national and local indigenous leadership needed for change, (iii) delivering smokefree messages as part of wider healthy living approaches, (iv) targeting of the messages for greatest impact for Maori, (v) need for a Maori approach, not a general approach, (vi) central and local government having a significant role in the prevention of tobacco harm, (vii) ideas on how tobacco tax revenue should be spent on tobacco control, and (viii) the rights of children to smokefree environments. Results indicate that indigenous specific approaches and indigenous leadership are critical for Maori tobacco-free advances. Harnessing indigenous values and principles related to health, family and children was the preferred method of these Maori policymakers for delivering social marketing messages.

  20. Quality policy at nuclear medicine services

    International Nuclear Information System (INIS)

    Gil Martinez, Eduardo Manuel; Jimenez, Tomas

    2007-01-01

    In the present text we comment about a Quality Policy model to establish in a Nuclear Medicine Service. The need for a strict control in every process that take place in a Nuclear Medicine Service, requires of an exact planification in terms of Quality Policy, specific to the real needs of every Service. Quality Policy must be a live Policy, with capability of changes and must be known for every workers in a Nuclear Medicine Service. Although the 'model' showed in this text is concret for a specific Service type, it must be extrapolated to any Nuclear Medicine Service with the necessary changes (au)

  1. Changing policy and practice: making sense of national guidelines for osteoarthritis.

    Science.gov (United States)

    Ong, Bie Nio; Morden, Andrew; Brooks, Lauren; Porcheret, Mark; Edwards, John J; Sanders, Tom; Jinks, Clare; Dziedzic, Krysia

    2014-04-01

    Understanding uptake of complex interventions is an increasingly prominent area of research. The interplay of macro (such as changing health policy), meso (re-organisation of professional work) and micro (rationalisation of clinical care) factors upon uptake of complex interventions has rarely been explored. This study focuses on how English General Practitioners and practice nurses make sense of a complex intervention for the management of osteoarthritis, using the macro-meso-micro contextual approach and Normalisation Process Theory (NPT), specifically the construct of coherence. It is embedded in a cluster RCT comprising four control practices and four intervention practices. In order to study sense-making by professionals introduction and planning meetings (N = 14) between researchers and the practices were observed. Three group interviews were carried out with 10 GPs and 5 practice nurses after they had received training in the intervention. Transcripts were thematically analysed before comparison with NPT constructs. We found that: first, most GPs and all nurses distinguished the intervention from current ways of working. Second, from the introduction meeting to the completion of the training the purpose of the intervention increased in clarity. Third, GPs varied in their understanding of their remit, while the practice nurses felt that the intervention builds on their holistic care approach. Fourth, the intervention was valued by practice nurses as it strengthened their expert status. GPs saw its value as work substitution, but felt that a positive conceptualisation of OA enhanced the consultation. When introducing new interventions in healthcare settings the interaction between macro, meso and micro factors, as well as the means of engaging new clinical practices and their sense-making by clinicians needs to be considered. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. 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.

  3. 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.

  4. 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

  5. EDUCATIONAL OUTCOMES OF SCHOOL FEEDING INTERVENTION: EVIDENCE FROM RURAL NORTHERN GHANA

    Directory of Open Access Journals (Sweden)

    Oloruntoba Abayomi

    2014-03-01

    Full Text Available The study investigated how policy intervention could have significant impact on beneficiaries. Using quasi-experimental design, 360 pupils from participating and non-participating schools in a feeding program were selected from a rural setting. Instrument for data collection was validated, pre-tested and administered on cross-section of respondents. Data were analyzed using descriptive statistics, t-test and regression analyses. Findings show that significant differences existed in educational outcomes as participating pupils performed better in core subjects of English Language, Mathematics and Integrated Science. In terms of socio-economic determinants, findings show that selected variables such as sex of pupils and number of dependents in the family had directly impacted on the performance of pupils. The study also found causal link between the school feeding intervention and others as one of the multiplier effects was not only an increased enrolments by almost a quarter, but reduced dropout and absenteeism rates. This implied that the policy environments was sufficiently pro-poor and effective since it has strengthened the standard of foundational primary school and completion rate envisaged in the educational policy. It is recommended that further policy options that would facilitate the scaling-up of the program in the entire intervention area be formulated.

  6. On the evolution of U.S. foreign-exchange-market intervention: thesis, theory, and institutions

    OpenAIRE

    Michael D. Bordo; Owen F. Humpage; Anna J. Schwartz

    2011-01-01

    Attitudes about foreign-exchange-market intervention in the United States evolved in tandem with views about monetary policy as policy makers grappled with the perennial problem of having more economic objectives than independent instruments with which to achieve them. This paper—the introductory chapter to our history of U.S. foreign exchange market intervention—explains this thesis and summarizes our conclusion: The Federal Reserve abandoned frequent foreign-exchange-market intervention bec...

  7. 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.

  8. Formulating Public Policy in Croatia and the Problem of Policy Coordination

    Directory of Open Access Journals (Sweden)

    Zdravko Petak

    2008-01-01

    Full Text Available The paper explores the role of politicians and civil servants in the process of horizontal and vertical policy coordination, with a special emphasis on the specific context of Croatia. Starting from Guy Peters’ typology, which distinguishes four distinct types of coordination, ranging from more simple to more complex ones – negative coordination, positive coordination, policy integration and development of strategies for government, the author stresses that the Croatian case is connected with failure in achieving all types of coordination. One of the reasons for such a situation lies in a low level of applying classical policy analysis in the Croatian public administration system. A direct consequence of this is the existence of the system of coordination based on ad hoc assessment of proposed policies, and not on standard policy analysis tools. Therefore, in the lack of central government policy unit the prominent role in such a system belongs to the finance Minister, who serves as some kind of “policy switchman”.

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

    Science.gov (United States)

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

    acute care hospital wards. Finally, delivery rooms were excluded because this review does not evaluate the impact of the outcomes of presence during "delivery" (or other "procedures").Types of interventions Studies were considered for inclusion in this review if they evaluated the effect or impact of visiting policies. This included interventions targeted at limiting or expanding patient visiting. We anticipated a paucity of experimental studies regarding this review question, thus included observational studies where the impact of visiting policy on patients and/or visitors was a focus, but testing intervention(s) may not have been the primary aim. We did not consider observational studies that focused only on the presence of visitors during specific procedures, resuscitation, or childbirth. The reason is that this limited aspect of the presence of a significant other was not considered "visiting" per se, and would be best examined in another systematic review.Types of outcome measures For this review, outcome measures related to both patients and visitors as a result of visiting hour policies were considered, including but not limited to: patient and/or visitor satisfaction; attitudes; beliefs; perceptions; mood; or patient physiological outcomes. These also included health care provider beliefs, perceptions, and attitudes about the impact of visiting policies on patients and/or visitors. Studies were excluded if they examined the trend of current visiting hour policies (with no evaluation of their impact), or if they focused on visitor presence only during emergency procedures, resuscitation, or childbirth.Types of studies Randomized controlled trials (RCTs) or quasi-experimental studies were included. However, given the expected scarcity of these designs relevant to our review question, other quantitative research designs were considered, such as non-randomized controlled trials, before-and-after studies, and descriptive/observational studies. Using a defined search

  10. 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.

  11. Nudges, shoves and budges: Behavioural economic policy frameworks.

    Science.gov (United States)

    Oliver, Adam

    2018-01-01

    Behavioural economics-the study of human decision making and how it sometimes deviates systematically from the assumptions of standard economic theory-has attracted a lot of attention in the health policy discourse over recent years. Many appear to believe that behavioural economic findings can be used only to help inform policies that manipulate the choices made by citizens, ie, the so-called nudge policy. However, these findings can be used to inform several different policy frameworks, from seemingly innocuous liberty-preserving changes to the contexts people operate in, to the outlawing of certain corporate behaviours. This article depicts diagrammatically, with the aid of a "behavioural policy cube" and in relation to smoking cessation interventions, the conceptual parameters of several behavioural economic-informed policy frameworks, which could be easily extended to other areas of health, and indeed broader public, policy. Copyright © 2017 John Wiley & Sons, Ltd.

  12. 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.

  13. 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...

  14. Comparative Analysis of Food Price Policies in the Developed Countries

    Institute of Scientific and Technical Information of China (English)

    Linrong; LI

    2015-01-01

    As the basis for maintenance of national security and global strategic material,food has always captured the attention of governments in the world.After reaching a certain stage of industrialization,most countries will take the food support and protection measures,and the policy objectives and policy tools have evolved into a set of policy systems through continuous adjustment,but the intervention in food price has always been present.The food price intervention only plays a role in regulating food market supply and demand and guaranteeing minimum income for grain producers,and it can not reflect the cost of food production and continuously improve grain producers’ income,but because of its simple operation,low cost and immediate effect,it is suitable for the countries with a large number of grain producers but small operation scale in the short term.

  15. Experiences and lessons learned for planning and supply of micronutrient powders interventions

    Science.gov (United States)

    Schauer, Claudia; Sunley, Nigel; Nyhus Dhillon, Christina; Roca, Claudia; Tapia, Gustavo; Mathema, Pragya; Walton, Shelley; Situma, Ruth; Zlotkin, Stanley; DW Klemm, Rolf

    2017-01-01

    Abstract Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of “The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,” 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale‐up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale‐up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. PMID:28960875

  16. Knowledge brokering between researchers and policymakers in Fiji to develop policies to reduce obesity: a process evaluation.

    Science.gov (United States)

    Waqa, Gade; Mavoa, Helen; Snowdon, Wendy; Moodie, Marj; Schultz, Jimaima; McCabe, Marita; Kremer, Peter; Swinburn, Boyd

    2013-07-01

    The importance of using research evidence in decisionmaking at the policy level has been increasingly recognized. However, knowledge brokering to engage researchers and policymakers in government and non-government organizations is challenging. This paper describes and evaluates the knowledge exchange processes employed by the Translational Research on Obesity Prevention in Communities (TROPIC) project that was conducted from July 2009 to April 2012 in Fiji. TROPIC aimed to enhance: the evidence-informed decisionmaking skills of policy developers; and awareness and utilization of local and other obesity-related evidence to develop policies that could potentially improve the nation's food and physical activity environments. The specific research question was: Can a knowledge brokering approach advance evidence-informed policy development to improve eating and physical activity environments in Fiji. The intervention comprised: recruiting organizations and individuals; mapping policy environments; analyzing organizational capacity and support for evidence-informed policymaking (EIPM); developing EIPM skills; and facilitating development of evidence-informed policy briefs. Flexible timetabling of activities was essential to accommodate multiple competing priorities at both individual and organizational levels. Process diaries captured the duration, frequency and type of each interaction and/or activity between the knowledge brokering team and participants or their organizations. Partnerships were formalized with high-level officers in each of the six participating organization. Participants (n = 49) developed EIPM skills (acquire, assess, adapt and apply evidence) through a series of four workshops and applied this knowledge to formulate briefs with ongoing one-to-one support from TROPIC team members. A total of 55% of participants completed the 12 to18 month intervention, and 63% produced one or more briefs (total = 20) that were presented to higher

  17. Public support for alcohol policies associated with knowledge of cancer risk.

    Science.gov (United States)

    Buykx, Penny; Gilligan, Conor; Ward, Bernadette; Kippen, Rebecca; Chapman, Kathy

    2015-04-01

    Several options are advocated by policy experts to mitigate alcohol-related harms, although the most effective strategies often have the least public support. While knowledge of tobacco-related health risks predicts support for relevant public health measures, it is not known whether knowledge of alcohol health risks is similarly associated with the acceptability of policies intended to reduce alcohol consumption and related harms. This study aims to gauge public support for a range of alcohol policies and to determine whether or not support is associated with knowledge of a long-term health risk of alcohol consumption, specifically cancer. 2482 adults in New South Wales (NSW), Australia, participated in an online survey. Logistic regression analysis was used to examine the association between demographic data, alcohol consumption, smoking status, knowledge of alcohol as a risk factor for cancer and support for alcohol-related policies. Most participants were supportive of health warnings, restricting access to internet alcohol advertising to young people, and requiring information on national drinking guidelines on alcohol containers. Almost half of participants supported a ban on sport sponsorship, while less than 41% supported price increases, volumetric taxation, or reducing the number of retail outlets. Only 47% of participants identified drinking too much alcohol as a risk factor for cancer. Knowledge of alcohol as a risk factor for cancer was a significant predictor of support for all policies, while level of alcohol consumption had a significant inverse relationship with policy support. The finding that support for alcohol management policies is associated with awareness that drinking too much alcohol may contribute to cancer could assist in the planning of future public health interventions. Improving awareness of the long term health risks of alcohol consumption may be one avenue to increasing public support for effective alcohol harm-reduction policies

  18. Policy dialogues - the "bolts and joints" of policy-making: experiences from Cabo Verde, Chad and Mali.

    Science.gov (United States)

    Dovlo, Delanyo; Nabyonga-Orem, Juliet; Estrelli, Yolanda; Mwisongo, Aziza

    2016-07-18

    Policy processes that yield good outcomes are inherently complex, requiring interactions of stakeholders in problem identification, generation of political will and selection of practical solutions. To make policy processes rational, policy dialogues are increasingly being used as a policy-making tool. Despite their increasing use for policy-making in Africa, evidence is limited on how they have evolved and are being used on the continent or in low and middle income countries elsewhere. This was an exploratory study using qualitative methods. It utilised data related to policy dialogues for three specific policies and strategies to understand the interplay between policy dialogue and policy-making in Cabo Verde, Chad and Mali. The specific methods used to gather data were key informant interviews and document review. Data were analysed inductively and deductively using thematic content analysis. Participation in the policy dialogues was inclusive, and in some instances bottom-up participatory approaches were used. The respondents felt that the execution of the policy dialogues had been seamless, and the few divergent views expressed often were resolved in a unanimous manner. The policies and strategies developed were seen by all stakeholders as relating to priority issues. Other specific process factors that contributed to the success of the dialogues included the use of innovative approaches, good facilitation, availability of resources for the dialogues, good communication, and consideration of the different opinions. Among the barriers were contextual issues, delays in decision-making and conflicting coordination roles and mandates. Policy dialogues have proved to be an effective tool in health sector management and could be a crucial component of the governance dynamics of the sector. The policy dialogue process needs to be institutionalised for continuity and maintenance of institutional intelligence. Other essential influencing factors include building

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

    Directory of Open Access Journals (Sweden)

    Jonathan Pearson-Stuttard

    2017-06-01

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

  20. Epidemiology, Policy, and Racial/Ethnic Minority Health Disparities

    Science.gov (United States)

    Carter-Pokras, Olivia; Offutt-Powell, Tabatha; Kaufman, Jay S.; Giles, Wayne; Mays, Vickie

    2013-01-01

    Purpose Epidemiologists have long contributed to policy efforts to address health disparities. Three examples illustrate how epidemiologists have addressed health disparities in the U.S. and abroad through a “social determinants of health” lens. Methods To identify examples of how epidemiologic research has been applied to reduce health disparities, we queried epidemiologists engaged in disparities research in the U.S., Canada, and New Zealand, and drew upon the scientific literature. Results Resulting examples covered a wide range of topic areas. Three areas selected for their contributions to policy were: 1) epidemiology's role in definition and measurement, 2) the study of housing and asthma, and 3) the study of food policy strategies to reduce health disparities. While epidemiologic research has done much to define and quantify health inequalities, it has generally been less successful at producing evidence that would identify targets for health equity intervention. Epidemiologists have a role to play in measurement and basic surveillance, etiologic research, intervention research, and evaluation research. However, our training and funding sources generally place greatest emphasis on surveillance and etiologic research. Conclusions: The complexity of health disparities requires better training for epidemiologists to effectively work in multidisciplinary teams. Together we can evaluate contextual and multilevel contributions to disease and study intervention programs in order to gain better insights into evidenced-based health equity strategies. PMID:22626003

  1. Effect evaluation of a two-year complex intervention to reduce loneliness in non-institutionalised elderly Dutch people

    NARCIS (Netherlands)

    Honigh-de Vlaming, R.; Haveman-Nies, A.; Heinrich, J.; Veer, van 't P.; Groot, de C.P.G.M.

    2013-01-01

    Background: Public health policy calls for intervention programmes to reduce loneliness in the ageing population. So far, numerous loneliness interventions have been developed, with effectiveness demonstrated for few of these interventions. The loneliness intervention described in this manuscript

  2. Environmental law, policy, and economics: reclaiming the environmental agenda

    National Research Council Canada - National Science Library

    Caldart, Charles C; Ashford, Nicholas Askounes

    2008-01-01

    ... of Information Regarding Chemical Risks 771 11 Enforcement: Encouraging Compliance with Environmental Statutes 807 12 Alternative Forms of Government Intervention to Promote Pollution Reduction 879 13 Polici...

  3. Anti-Poverty Policy in Brazil, Concepts and Strategies

    Directory of Open Access Journals (Sweden)

    Darana Carvalho de Azevedo

    2010-01-01

    Full Text Available This article concerns the debate about anti-poverty policy in Brazil and analyzes the relations between concepts of poverty and interventions adopted to address it. The article begins with a review of the principal conceptual approaches to poverty, based upon which it analyzes how policy strategies implemented in the country affect the multiple determinants of the situation. The paper is highlighted by a discussion of the effectiveness of universal and or focused strategies. It demonstrates that the difficulties in implementing policies based on an understanding of poverty as a multidimensional problem weaken the consolidation of criteria of social justice and disregard the potential for integrated policies to achieve these principles.

  4. Examining Policies to Reduce Homelessness Using a General Equilibrium Model of the Housing Market

    OpenAIRE

    Mansur, Erin; Quigley, John M.; Raphael, Steven; Smolensky, Eugene

    2003-01-01

    In this paper, we use a general equilibrium simulation model to assess the potential impacts on homelessness of various housing-market policy interventions. We calibrate the model to the four largest metropolitan areas in California. We explore the welfare con- sequences and the effects on homelessness of three housing-market policy interventions: extending housing vouchers to all low-income households, subsidizing all landlords, and subsidizing those landlords who supply low-income housing. ...

  5. Domestic violence: recognition, intervention, and prevention.

    Science.gov (United States)

    Smith, M; Martin, F

    1995-02-01

    Domestic violence is a significant social and health problem that has received intensive recent publicity in the lay media. Nurses should play a major role in primary, secondary, and tertiary prevention interventions. Intensified health promotion and public policy initiatives can reduce the incidence of domestic violence in the future.

  6. 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.

  7. Using decision pathway surveys to inform climate engineering policy choices.

    Science.gov (United States)

    Gregory, Robin; Satterfield, Terre; Hasell, Ariel

    2016-01-19

    Over the coming decades citizens living in North America and Europe will be asked about a variety of new technological and behavioral initiatives intended to mitigate the worst impacts of climate change. A common approach to public input has been surveys whereby respondents' attitudes about climate change are explained by individuals' demographic background, values, and beliefs. In parallel, recent deliberative research seeks to more fully address the complex value tradeoffs linked to novel technologies and difficult ethical questions that characterize leading climate mitigation alternatives. New methods such as decision pathway surveys may offer important insights for policy makers by capturing much of the depth and reasoning of small-group deliberations while meeting standard survey goals including large-sample stakeholder engagement. Pathway surveys also can help participants to deepen their factual knowledge base and arrive at a more complete understanding of their own values as they apply to proposed policy alternatives. The pathway results indicate more fully the conditional and context-specific nature of support for several "upstream" climate interventions, including solar radiation management techniques and carbon dioxide removal technologies.

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

    Science.gov (United States)

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

    2016-03-05

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

  9. Prostate specific antigen testing policy worldwide varies greatly and seems not to be in accordance with guidelines: a systematic review

    Directory of Open Access Journals (Sweden)

    Van der Meer Saskia

    2012-10-01

    Full Text Available Abstract Background Prostate specific antigen (PSA testing is widely used, but guidelines on follow-up are unclear. Methods We performed a systematic review of the literature to determine follow-up policy after PSA testing by general practitioners (GPs and non-urologic hospitalists, the use of a cut-off value for this policy, the reasons for repeating a PSA test after an initial normal result, the existence of a general cut-off value below which a PSA result is considered normal, and the time frame for repeating a test. Data sources. MEDLINE, Embase, PsychInfo and the Cochrane library from January 1950 until May 2011. Study eligibility criteria. Studies describing follow-up policy by GPs or non-urologic hospitalists after a primary PSA test, excluding urologists and patients with prostate cancer. Studies written in Dutch, English, French, German, Italian or Spanish were included. Excluded were studies describing follow-up policy by urologists and follow-up of patients with prostate cancer. The quality of each study was structurally assessed. Results Fifteen articles met the inclusion criteria. Three studies were of high quality. Follow-up differed greatly both after a normal and an abnormal PSA test result. Only one study described the reasons for not performing follow-up after an abnormal PSA result. Conclusions Based on the available literature, we cannot adequately assess physicians’ follow-up policy after a primary PSA test. Follow-up after a normal or raised PSA test by GPs and non-urologic hospitalists seems to a large extent not in accordance with the guidelines.

  10. 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.

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

    Science.gov (United States)

    Kaplin, Lauren; Thow, Anne Marie

    2013-03-01

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

  12. The energy geo-policy

    International Nuclear Information System (INIS)

    Duval, M.

    2005-01-01

    This analysis updates and develops the analysis of the energy geo-policy proposed by the French Review of geo-policy. In this framework the today policies of the different sate and geographical actors, as suppliers and consumers of petroleum energy, are examined. Then the author analyzes the political problems resulting from, this petroleum energy transfers by earth and sea and the problems resulting specifically from the nuclear energy. The last part brings the author own opinions. (A.L.B.)

  13. The assessment of ongoing community-based interventions to prevent obesity: lessons learned

    NARCIS (Netherlands)

    Gubbels, J.S.; Mathisen, F.K.S.; Samdal, O.; Lobstein, T.; Kohl, L.F.M.; Leversen, I.; Lakerveld, J.; Kremers, S.P.J.; Assema, P.

    2015-01-01

    Background: The assessment of real-life, community-based interventions to tackle obesity is an important step in the development of effective policies. Especially multi-level interventions have a high likely effectiveness and potential reach in counteracting the obesity epidemic. Although much can

  14. 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.

  15. 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.

  16. Socio-Cultural Perspectives on Causes and Intervention Strategies

    African Journals Online (AJOL)

    AJRH Managing Editor

    Ngezi exclusively rely on socio-cultural intervention strategies to solve the problem of male infertility. ... infertility which integrates the socio-cultural perspectives in policy and programming, if ..... out that the concept of using traditional medicine.

  17. Improving Safe Sleep Modeling in the Hospital through Policy Implementation.

    Science.gov (United States)

    Heitmann, Rachel; Nilles, Ester K; Jeans, Ashley; Moreland, Jackie; Clarke, Chris; McDonald, Morgan F; Warren, Michael D

    2017-11-01

    Introduction Sleep-related infant deaths are major contributors to Tennessee's high infant mortality rate. The purpose of this initiative was to evaluate the impact of policy-based efforts to improve modeling of safe sleep practices by health care providers in hospital settings across Tennessee. Methods Safe sleep policies were developed and implemented at 71 hospitals in Tennessee. Policies, at minimum, were required to address staff training on the American Academy of Pediatrics' safe sleep recommendations, correct modeling of infant safe sleep practices, and parent education. Hospital data on process measures related to training and results of crib audits were compiled for analysis. Results The overall observance of infants who were found with any risk factors for unsafe sleep decreased 45.6% (p ≤ 0.001) from the first crib audit to the last crib audit. Significant decreases were noted for specific risk factors, including infants found asleep not on their back, with a toy or object in the crib, and not sleeping in a crib. Significant improvements were observed at hospitals where printed materials or video were utilized for training staff compared to face-to-face training. Discussion Statewide implementation of the hospital policy intervention resulted in significant reductions in infants found in unsafe sleep situations. The most common risk factors for sleep-related infant deaths can be modeled in hospitals. This effort has the potential to reduce sleep-related infant deaths and ultimately infant mortality.

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

    Science.gov (United States)

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

    2012-10-01

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

  19. Too much ‘Dreaming’: Evaluations of the Northern Territory National Emergency Response Intervention 2007–2012

    Directory of Open Access Journals (Sweden)

    Jon Altman

    2012-12-01

    Full Text Available The Northern Territory National Emergency Response Intervention (the Intervention of 2007 was a bold experiment by the Howard Government. The Intervention was developed quickly without comprehensive policy development based on evidence or consultation. During its five-year statutory life (ending August 2012, the absence of coherent policy logic has seen the Intervention fundamentally reframed by the Rudd and Gillard Governments. The unprecedented and controversial nature of the Intervention has seen extraordinary levels of monitoring, review and evaluation, but the absence of an overarching evaluation strategy has resulted in a fragmented and confused approach. In this article, we do not seek to critique the Intervention itself or to assess whether these multiple monitoring and evaluation exercises have been successes or failures. Indeed, our review illustrates that in highly contested policy areas, notions of success, failure and the evaluations themselves become politically charged. Instead we make a series of critical observations regarding this contradictory messiness of evaluations, using political science and anthropological frameworks to draw wider conclusions about the nature and logic of evaluation fetishism. We conclude that evaluations of the Intervention have not led to greater transparency, accountability and monitoring of outcomes and outputs. The Intervention evaluations instead are consistent with the view that they are both obfuscating mechanisms and techniques of governance designed to allay public concern and normalise the governance of marginalised Indigenous Australian spaces.

  20. 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.

  1. 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.

  2. The Role of Conversation Policy in Carrying Out Agent Conversations

    International Nuclear Information System (INIS)

    Link, Hamilton E.; Phillips, Laurence R.

    1999-01-01

    Structured conversation diagrams, or conversation specifications, allow agents to have predictable interactions and achieve predefined information-based goals, but they lack the flexibility needed to function robustly in an unpredictable environment. We propose a mechanism that combines a typical conversation structure with a separately established policy to generate an actual conversation. The word ''policy'' connotes a high-level direction external to a specific planned interaction with the environment. Policies, which describe acceptable procedures and influence decisions, can be applied to broad sets of activity. Based on their observation of issues related to a policy, agents may dynamically adjust their communication patterns. The policy object describes limitations, constraints, and requirements that may affect the conversation in certain circumstances. Using this new mechanism of interaction simplifies the description of individual conversations and allows domain-specific issues to be brought to bear more easily during agent communication. By following the behavior of the conversation specification when possible and deferring to the policy to derive behavior in exceptional circumstances, an agent is able to function predictably under normal situations and still act rationally in abnormal situations. Different conversation policies applied to a given conversation specification can change the nature of the interaction without changing the specification

  3. Development of the Social Network-Based Intervention "Powerful Together with Diabetes" Using Intervention Mapping.

    Science.gov (United States)

    Vissenberg, Charlotte; Nierkens, Vera; Uitewaal, Paul J M; Middelkoop, Barend J C; Nijpels, Giel; Stronks, Karien

    2017-01-01

    This article describes the development of the social network-based intervention Powerful Together with Diabetes which aims to improve diabetes self-management (DSM) among patients with type 2 diabetes living in socioeconomically deprived neighborhoods by stimulating social support for DSM and diminishing social influences hindering DSM (e.g., peer pressure and social norms). The intervention was specifically developed for patients with Dutch, Turkish, Moroccan, and Surinamese backgrounds. The intervention was developed according to Intervention Mapping. This article describes the first four steps of Intervention Mapping: (1) the needs assessment; (2) development of performance and change objectives; (3) selection of theory-based methods and strategies; and (4) the translation of these into an organized program. These four steps resulted in Powerful Together with Diabetes , a 10-month group-based intervention consisting of 24 meetings, 6 meetings for significant others, and 2 meetings for participants and their spouses. The IM method resulted in a tailored approach with a specific focus on the social networks of its participants. This article concludes that the IM method helped our planning team to tailor the intervention to the needs of our target population and facilitated our evaluation design. However, in hindsight, the intervention could have been improved by investing more in participatory planning and community involvement.

  4. Intervention principles: Theory and practice

    International Nuclear Information System (INIS)

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

    2000-01-01

    After the Chernobyl accident, it became clear that some clarification of the basic principles for intervention was necessary as well as more internationally recognised numerical guidance on intervention levels. There was in the former USSR and in Europe much confusion over, and lack of recognition of, the very different origins and purposes of dose limits for controlling deliberate increases in radiation exposure for practices and dose levels at which intervention is prompted to decrease existing radiation exposure. In the latest recommendations from ICRP in its Publication 60, a clear distinction is made between the radiation protection systems for a practice and for intervention. According to ICRP, the protective measures forming a program of intervention, which always have some disadvantages, should each be justified on their own merit in the sense that they should do more good than harm, and their form, scale, and duration should be optimised so as to do the most good. Intervention levels for protective actions can be established for many possible accident scenarios. For planning and preparedness purposes, a generic optimisation based on generic accident scenario calculations, should result in optimised generic intervention levels for each protective measure. The factors entering such an optimisation will on the benefit side include avertable doses and avertable risks as well as reassurance. On the harm side the factors include monetary costs, collective and individual risk for the action itself, social disruption and anxiety. More precise optimisation analyses based on real site and accident specific data can be carried out and result in specific intervention levels. It is desirable that values for easily measurable quantities such as dose rate and surface contamination density be developed as surrogates for intervention levels of avertable dose. However, it is important that these quantities should be used carefully and applied taking account of local

  5. Improving health promotion through central rating of interventions: the need for Responsive Guidance.

    Science.gov (United States)

    Kok, Maarten Olivier; Bal, Roland; Roelofs, Caspar David; Schuit, Albertine Jantine

    2017-11-23

    In several countries, attempts are made to improve health promotion by centrally rating the effectiveness of health promotion interventions. The Dutch Effectiveness Rating System (ERS) for health promotion interventions is an improvement-oriented approach in which multi-disciplinary expert committees rate available health promotion interventions as 'theoretically sound', 'probably effective' or 'proven effective'. The aim of this study is to explore the functioning of the ERS and the perspective of researchers, policy-makers and practitioners regarding its contribution to improvement. We interviewed 53 selected key informants from research, policy and practice in the Netherlands and observed the assessment of 12 interventions. Between 2008 and 2012, a total of 94 interventions were submitted to the ERS, of which 23 were rejected, 58 were rated as 'theoretically sound', 10 were rated as 'probably effective' and 3 were rated as 'proven effective'. According to participants, the ERS was intended to facilitate both the improvement of available interventions and the improvement of health promotion in practice. While participants expected that describing and rating interventions promoted learning and enhanced the transferability of interventions, they were concerned that the ERS approach was not suitable for guiding intervention development and improving health promotion in practice. The expert committees that assessed the interventions struggled with a lack of norms for the relevance of effects and questions about how effects should be studied and rated. Health promotion practitioners were concerned that the ERS neglected the local adaptation of interventions and did not encourage the improvement of aspects like applicability and costs. Policy-makers and practitioners were worried that the lack of proven effectiveness legitimised cutbacks rather than learning and advancing health promotion. While measuring and centrally rating the effectiveness of interventions can be

  6. Rethinking immigration policy theory beyond 'Western liberal democracies'.

    Science.gov (United States)

    Natter, Katharina

    2018-01-01

    How do political systems shape immigration policy-making? Explicitly or implicitly, comparative politics and migration policy theories suggest a 'regime effect' that links specific dynamics of immigration policy to liberal democracy. The literature's dominant focus on so-called 'Western liberal democracies', however, has left the 'regime effect' largely untested and research on variations and similarities in immigration policymaking across political systems strikingly undertheorized. This paper challenges the theoretical usefulness of essentialist, dichotomous categories such as Western/non-Western or democratic/autocratic and calls for a more nuanced theorizing of immigration policy-making. It proposes a two-dimensional classification of immigration policy theories, distinguishing between 'issue-specific' theories that capture immigration policy processes regardless of the political system in place and 'regime-specific' theories whose insights are tied to the characteristics of a political system. The paper also advances the 'illiberal paradox' hypothesis to explain why illiberal, autocratic states may enact liberal immigration policies. This theoretical expansion beyond the 'Western' and 'liberal' bubble is illustrated by an analysis of immigration policy-making in 21st century Morocco and Tunisia. Showing how domestic and international institutions, interests, and ideas shape immigration policy-making in Morocco's monarchy and Tunisia's democratic transition, the paper investigates the broader role of political systems in immigration politics and herewith seeks to contribute to a more general and global theorization of immigration policies.

  7. Public management, policy capacity, innovation and development

    Directory of Open Access Journals (Sweden)

    Erkki Karo

    2014-03-01

    Full Text Available In this paper we discuss the question of what factors in development policy create specific forms of policy capacity and under what circumstances developmentoriented complementarities or mismatches between the public and private sectors emerge. We argue that specific forms of policy capacity emerge from three interlinked policy choices, each fundamentally evolutionary in nature: policy choices on understanding the nature and sources of technical change and innovation; on the ways of financing economic growth, in particular technical change; and on the nature of public management to deliver and implement both previous sets of policy choices. Thus, policy capacity is not so much a continuum of abilities (from less to more, but rather a variety of modes of making policy that originate from co-evolutionary processes in capitalist development. To illustrate, we briefly reflect upon how the East Asian developmental states of the 1960s-1980s and Eastern European transition policies since the 1990s led to almost opposite institutional systems for financing, designing and managing development strategies, and how this led, through co-evolutionary processes, to different forms of policy capacity.

  8. Changes in alcohol policies and practices in bars and restaurants after completion of manager-focused responsible service training.

    Science.gov (United States)

    Lenk, Kathleen M; Erickson, Darin J; Nelson, Toben F; Horvath, Keith J; Nederhoff, Dawn M; Hunt, Shanda L; Ecklund, Alexandra M; Toomey, Traci L

    2018-03-01

    Irresponsible and illegal serving practices at bars and restaurants, such as sales to obviously intoxicated patrons, can lead to various public health harms. Training managers of bars and restaurants in the development and promotion of responsible alcohol policies may help prevent risky and illegal alcohol serving practices. We implemented a training program for managers of bars/restaurants designed to establish and promote responsible beverage service policies/practices. The program included online and in-person components. Bars/restaurants were randomised to intervention (n = 171) and control (n = 163) groups. To assess changes in policies/practices, we surveyed managers prior to and at 1 and 6 months post-training. Logistic regression models assessed changes in policies/practices across time points. The proportion in the intervention group that had written alcohol policies increased from 62% to 95% by 6 months post-training while the control group increased from 65% to 79% (P managers in the intervention group reported they had communicated to their staff how to cut off intoxicated patrons, a significant increase from baseline (37%) and from the change observed in the control group (43%-56%). Prevalence of other policies/practices also increased post-training but differences between intervention and control groups were not statistically significant. Our training program appears to have led to implementation of some policies/practices. Additional studies are needed to determine how training can be combined with other strategies to further improve establishment policies and ultimately reduce alcohol-related harms. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  9. Policy Development Fosters Collaborative Practice

    DEFF Research Database (Denmark)

    Meyer, Daniel M; Kaste, Linda M; Lituri, Kathy M

    2016-01-01

    This article provides an example of interprofessional collaboration for policy development regarding environmental global health vis-à-vis the Minamata Convention on Mercury. It presents an overview of mercury and mercury-related environmental health issues; public policy processes and stakeholde...... requiring dental engagement for interprofessional policy development include education, disaster response, HPV vaccination, pain management, research priorities, and antibiotic resistance.......; and specifics including organized dentistry's efforts to create global policy to restrict environmental contamination by mercury. Dentistry must participate in interprofessional collaborations and build on such experiences to be optimally placed for ongoing interprofessional policy development. Current areas...

  10. Scaling up quality care for mothers and newborns around the time of birth: an overview of methods and analyses of intervention-specific bottlenecks and solutions.

    Science.gov (United States)

    Dickson, Kim E; Kinney, Mary V; Moxon, Sarah G; Ashton, Joanne; Zaka, Nabila; Simen-Kapeu, Aline; Sharma, Gaurav; Kerber, Kate J; Daelmans, Bernadette; Gülmezoglu, A; Mathai, Matthews; Nyange, Christabel; Baye, Martina; Lawn, Joy E

    2015-01-01

    The Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortality targets cannot be achieved without high quality, equitable coverage of interventions at and around the time of birth. This paper provides an overview of the methodology and findings of a nine paper series of in-depth analyses which focus on the specific challenges to scaling up high-impact interventions and improving quality of care for mothers and newborns around the time of birth, including babies born small and sick. The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the ENAP process. Country workshops engaged technical experts to complete a tool designed to synthesise "bottlenecks" hindering the scale up of maternal-newborn intervention packages across seven health system building blocks. We used quantitative and qualitative methods and literature review to analyse the data and present priority actions relevant to different health system building blocks for skilled birth attendance, emergency obstetric care, antenatal corticosteroids (ACS), basic newborn care, kangaroo mother care (KMC), treatment of neonatal infections and inpatient care of small and sick newborns. The 12 countries included in our analysis account for the majority of global maternal (48%) and newborn (58%) deaths and stillbirths (57%). Our findings confirm previously published results that the interventions with the most perceived bottlenecks are facility-based where rapid emergency care is needed, notably inpatient care of small and sick newborns, ACS, treatment of neonatal infections and KMC. Health systems building blocks with the highest rated bottlenecks varied for different interventions. Attention needs to be paid to the context specific bottlenecks for each intervention to scale up quality care. Crosscutting findings on health information gaps inform two final papers on a roadmap for improvement of coverage data for newborns and indicate the need for leadership for

  11. Evaluating health effects of transport interventions methodologic case study.

    Science.gov (United States)

    Ogilvie, David; Mitchell, Richard; Mutrie, Nanette; Petticrew, Mark; Platt, Stephen

    2006-08-01

    There is little evidence about the effects of environmental interventions on population levels of physical activity. Major transport projects may promote or discourage physical activity in the form of walking and cycling, but researching the health effects of such "natural experiments" in transport policy or infrastructure is challenging. Case study of attempts in 2004-2005 to evaluate the effects of two major transport projects in Scotland: an urban congestion charging scheme in Edinburgh, and a new urban motorway (freeway) in Glasgow. These interventions are typical of many major transport projects. They are unique to their context. They cannot easily be separated from the other components of the wider policies within which they occur. When, where, and how they are implemented are political decisions over which researchers have no control. Baseline data collection required for longitudinal studies may need to be planned before the intervention is certain to take place. There is no simple way of defining a population or area exposed to the intervention or of defining control groups. Changes in quantitative measures of health-related behavior may be difficult to detect. Major transport projects have clear potential to influence population health, but it is difficult to define the interventions, categorize exposure, or measure outcomes in ways that are likely to be seen as credible in the field of public health intervention research. A final study design is proposed in which multiple methods and spatial levels of analysis are combined in a longitudinal quasi-experimental study.

  12. Monetary policy and regional output in Brazil

    Directory of Open Access Journals (Sweden)

    Rafael Rockenbach da Silva Guimarães

    2014-03-01

    Full Text Available This work presents an analysis of whether the effects of the Brazilian monetary policy on regional outputs are symmetric. The strategy developed combines the techniques of principal component analysis (PCA to decompose the variables that measure regional economic activity into common and region-specific components and vector autoregressions (VAR to observe the behavior of these variables in response to monetary policy shocks. The common component responds to monetary policy as expected. Additionally, the idiosyncratic components of the regions showed no impact of monetary policy. The main finding of this paper is that the monetary policy responses on regional output are symmetrical when the regional output decomposition is performed, and the responses are asymmetrical when this decomposition is not performed. Therefore, performing the regional output decomposition corroborates the economic intuition that monetary policy has no impact on region-specific issues. Once monetary policy affects the common component of the regional economic activity and does not impact its idiosyncratic components, it can be considered symmetrical.

  13. Smoke-free air policies: past, present and future.

    Science.gov (United States)

    Hyland, Andrew; Barnoya, Joaquin; Corral, Juan E

    2012-03-01

    Smoke-free policies have been an important tobacco control intervention. As recently as 20 years ago, few communities required workplaces and hospitality venues to be smoke-free, but today approximately 11% of the world's population live in countries with laws that require these places to be smoke-free. This paper briefly summarises important milestones in the history of indoor smoke-free policies, the role of scientific research in facilitating their adoption, a framework for smoke-free policy evaluation and industry efforts to undermine regulations. At present, smoke-free policies centre on workplaces, restaurants and pubs. In addition, many jurisdictions are now beginning to implement policies in outdoor areas and in shared multiunit housing settings. The future of smoke-free policy development depends on credible scientific data that documents the health risks of secondhand smoke exposure. Over the next 20 years smoke-free policies will very likely extend to outdoor and private areas, and changes in the types of tobacco products that are consumed may also have implications for the nature and scope of the smoke-free policies of the future.

  14. The "Som la Pera" intervention: sustainability capacity evaluation of a peer-led social-marketing intervention to encourage healthy lifestyles among adolescents.

    Science.gov (United States)

    Llauradó, Elisabet; Aceves-Martins, Magaly; Tarro, Lucia; Papell-Garcia, Ignasi; Puiggròs, Francesc; Prades-Tena, Jordi; Kettner, Helle; Arola, Lluis; Giralt, Montse; Solà, Rosa

    2018-02-10

    Sustainability capacity, always considered a challenge, is the ability to maintain effective long-term intervention in a community. The aim of the study was to improve the sustainability capacity of effective "Som la Pera," a school-based, peer-led, social-marketing intervention that encourages healthy diet and physical activity, in low socioeconomic adolescents from Spain. The sustainability capacity was analyzed by a "programme sustainability assessment tool (PSAT)" comprising eight domains: political support, funding stability, partnerships, organizational capacity, programme evaluation, programme adaptation, communications, and strategic planning. Each domain was evaluated from 1 (no or to a small extent) to 7 points (to a great extent). The final score for sustainability capacity was the mean of the eight domain scores. The PSAT was assessed by nine professionals (researchers, staff members, and stakeholders) at two periods during intervention implementation: end of the first year (January 2015) and end of the second year (September 2015). At the end of the first year, strategic planning (4.43 ± 1.98) and funding stability (4.38 ± 1) were considered deficient domains, and at the end of the second year, these domains had improved by 1.67 points (p =.043) and 0.59 points (p = .159), respectively. The funding stability increase was not significant because only one of the five specific items, "policies implemented to ensure sustained funding," improved by 1.08 points (p = .036). The sustainability capacity final score was 5.93 ± 1.13. The sustainability capacity assessment during the intervention allows its improvement before the programme expires, ensuring the long-term implementation of the "Som la Pera" intervention programme to encourage healthy lifestyles in adolescents. © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Efficiency versus fairness: the evaluation of labor market policies by economists and laypeople

    NARCIS (Netherlands)

    Haferkamp, A.; Fetchenhauer, D.; Belschak, F.; Enste, D.

    2009-01-01

    The present study examines the criteria used by economic laypeople (N = 380 German citizens) and economists (N = 80 professors or postgraduates in economics) in judging reform measures as illustrated by policies of governmental labor market intervention policies. Results reveal substantial

  16. The impact of clinical pharmacist and ID intervention in rationalization of antimicrobial use.

    Science.gov (United States)

    Al-Somai, Niaz; Al-Muhur, Mohammed; Quteimat, Osama; Hamzah, Nashaat

    2014-12-01

    There is little research on the impact of implementing and monitoring antimicrobial policy in Saudi hospitals. The purpose of this study is to measure the impact of the clinical pharmacist (CP) and infectious disease consultant (ID) interventions on the use of three antimicrobials (caspofungin, imipenem, meropenem) in hospitalized patients in the King Abdullah Medical City hospital. The study was carried out in the King Abdullah Medical City, in Mekkah, Saudi Arabia. The hospital is a tertiary center that provides CCU, CSICU, Cardiac, Hematology, ICU, Medical, Neuroscience, Oncology, and specialized surgery services. The use of three antimicrobials (caspofungin, imipenem, meropenem) was reviewed by the clinical pharmacist for four periods, pre and post implementation of policy. Relevant data were collected in four periods. In the first period, before policy implementation, data were collected retrospectively to be used as baseline status reference, and in the three remaining periods that followed data were collected prospectively, and compared to baseline data, to evaluate the role of clinical pharmacist and ID interventions in optimizing antimicrobial therapy. Caspofungin duration of therapy was not affected significantly by the intervention. Statistically significant reduction in antimicrobial therapy duration was observed in imipenem (37%) and meropenem (37%) from baseline, which indicate a better control on antimicrobial use and reduction in antimicrobial resistance. The impact of the clinical pharmacist and ID interventions, in reducing antimicrobial therapy duration using imipenem and meropenem, is clear from the result presented above. However, lack of restriction and follow up in the antimicrobial policy in case of negative culture makes antimicrobial use uncontrollable in these cases. Establishing good and accepted policy may help reduce consumption and total cost of therapy.

  17. 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.

  18. Behavior change is not one size fits all: psychosocial phenotypes of childhood obesity prevention intervention participants.

    Science.gov (United States)

    Burgermaster, Marissa; Contento, Isobel; Koch, Pamela; Mamykina, Lena

    2018-01-17

    Variability in individuals' responses to interventions may contribute to small average treatment effects of childhood obesity prevention interventions. But, neither the causes of this individual variability nor the mechanism by which it influences behavior are clear. We used qualitative methods to characterize variability in students' responses to participating in a childhood obesity prevention intervention and psychosocial characteristics related to the behavior change process. We interviewed 18 students participating in a school-based curriculum and policy behavior change intervention. Descriptive coding, summary, and case-ordered descriptive meta-matrices were used to group participants by their psychosocial responses to the intervention and associated behavior changes. Four psychosocial phenotypes of responses emerged: (a) Activated-successful behavior-changers with strong internal supports; (b) Inspired-motivated, but not fully successful behavior-changers with some internal supports, whose taste preferences and food environment overwhelmed their motivation; (c) Reinforced-already practiced target behaviors, were motivated, and had strong family support; and (d) Indifferent-uninterested in behavior change and only did target behaviors if family insisted. Our findings contribute to the field of behavioral medicine by suggesting the presence of specific subgroups of participants who respond differently to behavior change interventions and salient psychosocial characteristics that differentiate among these phenotypes. Future research should examine the utility of prospectively identifying psychosocial phenotypes for improving the tailoring of nutrition behavior change interventions. © Society of Behavioral Medicine 2018.

  19. Secondhand smoke exposure among Hispanics/Latinos living in multiunit housing: exploring barriers to new policies.

    Science.gov (United States)

    Baezconde-Garbanati, Lourdes A; Weich-Reushé, Kimberly; Espinoza, Lilia; Portugal, Cecilia; Barahona, Rosa; Garbanati, James; Seedat, Faatima; Unger, Jennifer B

    2011-01-01

    Despite a high prevalence of voluntary home smoking bans and laws protecting Californians from exposure to secondhand smoke (SHS) in the workplace, many Hispanic/Latino (H/L) residents of multiunit housing (MUH) are potentially exposed to SHS from neighboring apartments. An advocacy/policy intervention was implemented to reduce tobacco-related health disparities by encouraging H/L living in MUH to implement voluntary policies that reduce exposure to SHS. This article presents findings from qualitative and quantitative data collected during development of the intervention, as well as preliminary results of the intervention. MUH residents in Southern California participated in focus groups (n = 48), door-to-door surveys (n = 142), and a telephone survey (n = 409). Exposure to SHS, attitudes toward SHS, and attitudes toward policies restricting SHS in MUH were assessed. H/L MUH residents reported high levels of exposure to SHS and little ability to protect themselves and their families from SHS. Respondents expressed positive attitudes toward adopting antismoking policies in MUH, but they also feared retaliation by smokers. The cultural values of familismo, respeto, simpatía, and personalismo influenced their motivation to protect their families from SHS as well as their reluctance to ask their neighbors to refrain from smoking. Nonsmokers were more likely to favor complete indoor and outdoor smoking bans in MUH, whereas smokers were more likely to favor separate smoking areas. The Regale Salud advocacy/policy intervention, implemented to reduce SHS exposure, prompted the passage of seven voluntary policies in apartment complexes in Southern California to prevent smoking in MUH. H/L in California support voluntary policies, local ordinances, and state laws that prevent exposure to SHS in MUH, especially those that are consistent with H/L cultural values and norms for interpersonal communication.

  20. The State of Intimate Partner Violence Intervention: Progress and Continuing Challenges.

    Science.gov (United States)

    Messing, Jill Theresa; Ward-Lasher, Allison; Thaller, Jonel; Bagwell-Gray, Meredith E

    2015-10-01

    Over the past 40 years, intimate partner violence (IPV) has evolved from an emerging social problem to a socially unacceptable crime. The Violence Against Women Act of 1994 encourages state policies that focus on criminal justice intervention, including mandatory arrest and prosecution. Services offered to victim-survivors of IPV are often tied to criminal justice intervention, or otherwise encourage separation. These interventions have been seen as effectively using the authority of the state to enhance women's power relative to that of abusive men. However, these interventions do not serve the needs of women who, for cultural or personal reasons, want to remain in their relationship, or marginalized women who fear the power of the state due to institutionalized violence, heterosexism, and racism. The one-size-fits-all approach that encourages prosecution and batterer intervention programs for offenders and shelter and advocacy for victim-survivors fails to adhere to the social work value of client self-determination and the practice principle of meeting clients where they are. It is imperative that social workers in all areas of practice are aware of IPV policies, services, and laws. Social workers' challenge moving forward is to develop innovative and evidence-based interventions that serve all victim-survivors of IPV

  1. Early Educational Provision--Emphasised in Education Policy Reforms in Norway? An Analysis of Education Policy Documents

    Science.gov (United States)

    Bjørnsrud, Halvor; Nilsen, Sven

    2014-01-01

    The article analyses how the intentions of early provision in Norwegian schools have been expressed in the education policy reforms in Norway from the 1970s to the present day. The first area deals with the intentions that most explicitly cover early provision; prevention, early detection and intervention. The second area of analysis relates to…

  2. 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.

  3. 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...

  4. Breastfeeding policies and breastfeeding support programs in the mother's workplace.

    Science.gov (United States)

    Bettinelli, Maria Enrica

    2012-10-01

    Women should never be forced to make a choice between mother-work and other work. Many women mistakenly think they cannot breastfeed if they plan to return to work, and thus they may not talk with their employers about their intention to breastfeed or how breastfeeding might be supported at their workplace. All breastfeeding policies and strategies underline the importance of providing support for lactating mothers and highlight the need to promote specific interventions in the workplace. Possible strategies for working mothers include having the mother keep the baby with her while she works, allowing the mother to go to the baby to breastfeed during the workday, telecommuting, offering flexible work schedules, maintaining part-time work schedules, and using on-site or nearby child care centres.

  5. Environmental Policy and Technological Change

    International Nuclear Information System (INIS)

    Jaffe, Adam B.; Newell, Richard G.; Stavins, Robert N.

    2002-01-01

    The relationship between technological change and environmental policy has received increasing attention from scholars and policy makers alike over the past ten years. This is partly because the environmental impacts of social activity are significantly affected by technological change, and partly because environmental policy interventions themselves create new constraints and incentives that affect the process of technological developments. Our central purpose in this article is to provide environmental economists with a useful guide to research on technological change and the analytical tools that can be used to explore further the interaction between technology and the environment. In Part 1 of the article, we provide an overview of analytical frameworks for investigating the economics of technological change, highlighting key issues for the researcher. In Part 2, we turn our attention to theoretical analysis of the effects of environmental policy on technological change, and in Part 3, we focus on issues related to the empirical analysis of technology innovation and diffusion. Finally, we conclude in Part 4 with some additional suggestions for research

  6. Understanding key influencers' attitudes and beliefs about healthy public policy change for obesity prevention.

    Science.gov (United States)

    Raine, Kim D; Nykiforuk, Candace I J; Vu-Nguyen, Karen; Nieuwendyk, Laura M; VanSpronsen, Eric; Reed, Shandy; Wild, T Cameron

    2014-11-01

    As overweight and obesity is a risk factor for chronic diseases, the development of environmental and healthy public policy interventions across multiple sectors has been identified as a key strategy to address this issue. In 2009, a survey was developed to assess the attitudes and beliefs regarding health promotion principles, and the priority and acceptability of policy actions to prevent obesity and chronic diseases, among key policy influencers in Alberta and Manitoba, Canada. Surveys were mailed to 1,765 key influencers from five settings: provincial government, municipal government, school boards, print media companies, and workplaces with greater than 500 employees. A total of 236 surveys were completed with a response rate of 15.0%. Findings indicate nearly unanimous influencer support for individual-focused policy approaches and high support for some environmental policies. Restrictive environmental and economic policies received weakest support. Obesity was comparable to smoking with respect to perceptions as a societal responsibility versus a personal responsibility, boding well for the potential of environmental policy interventions for obesity prevention. This level of influencer support provides a platform for more evidence to be brokered to policy influencers about the effectiveness of environmental policy approaches to obesity prevention. © 2014 The Obesity Society.

  7. 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 ...

  8. Teacher Leadership: Federal Policy Recommendations

    Science.gov (United States)

    Gran, Jackie; Young, Margaret; Broin, Alexandra

    2015-01-01

    This policy brief was developed specifically for federal policymakers, and builds upon the policy recommendations included in "Leading from Every Seat: Empowering Principals to Cultivate Teacher Leadership for School Improvement." The recommendations in this report include the following: (1) Uncover New Leadership Ideas and Seed…

  9. Policy initiatives to promote healthy aging.

    Science.gov (United States)

    Infeld, Donna Lind; Whitelaw, Nancy

    2002-08-01

    An overwhelming array of policies and programs can be used to help older people (and future older people) maintain healthy lifestyles. How can clinicians help ensure that their patients take advantage of these opportunities? How can these broad-scope policies, educational and information initiatives, and direct service programs be turned into tools to help older people maximize health and independence? First, physicians do not need to do it all themselves. They need to know where to send their patients. For example, case managers in local aging service organizations and social workers, nurses, and discharge planners in hospitals can help connect elderly patients to appropriate benefits and services. Physicians play a critical role in creating a bridge between patients and the array of programs and information that can help them change their individual patterns of behavior. A serious lack of integration exists between what is known about healthy behaviors and lifestyles and what is really happening and available to older people today. From the earlier articles in this issue we know that much can be done to prevent many types of age-related disease and disability. This article provides examples of mechanisms that can be used to broadly disseminate knowledge about effective behavior and treatment changes and create mechanisms to turn this knowledge into real and widespread client-level, practice-level, health system, and community-wide interventions. Second, physicians need to understand that they are not merely subject to these policies and initiatives. They can help formulate and shape them. This political involvement includes active participation in policy initiatives of professional associations, involvement in research and demonstration activities, keeping informed about policy proposals at the federal and state levels, and helping advance ideas for improving health behaviors by speaking up and working toward change. These changes go beyond health initiatives to

  10. Comparative Cost Analysis of Four Interventions to Prevent HIV Transmission in Bandung, Indonesia

    Directory of Open Access Journals (Sweden)

    Eveline J.M. Verstraaten

    2017-11-01

    Full Text Available Background: the costs of HIV/AIDS interventions in Indonesia are largely unknown. Knowing these costs is an important input for policy makers in the decision-making of setting priorities among HIV/AIDS interventions. The aim of this analysis is to determine the costs of four HIV/AIDS interventions in Bandung, Indonesia in 2015, to inform the local AIDS commission. Methods: data on utilization and costs of the different interventions were collected in a sexual transmitted infections (STI-clinic and the KPA, the local HIV/AIDS commission, for the period of January 2015-December 2015. The costs were estimated from a societal perspective, using a micro-costing approach. Results: the total annualized costs for condom distribution, mobile voluntary counselling and testing (VCT, religious based information, communication, and education (IEC and STI services equalled US$56,926, US$2,985, US$1,963 and US$5,865, respectively. Conclusion: this analysis has provided cost estimates of four different HIV/AIDS interventions in Bandung, Indonesia. Additionally, it has estimated the costs of scaling up these interventions. Together, this provides important information for policy makers vis-à-vis the implementation of these interventions. However, an evaluation of the effectiveness of these interventions is needed to estimate the cost-effectiveness.

  11. Examining the reaction of monetary policy to exchange rate changes: A nonlinear ARDL approach

    Science.gov (United States)

    Manogaran, Lavaneesvari; Sek, Siok Kun

    2017-04-01

    Previous studies showed the exchange rate changes can have significant impacts on macroeconomic performance. Over fluctuation of exchange rate may lead to economic instability. Hence, monetary policy rule tends to react to exchange rate changes. Especially, in emerging economies where the policy-maker tends to limit the exchange rate movement through interventions. In this study, we seek to investigate how the monetary policy rule reacts to exchange rate changes. The nonlinear autoregressive distributed lag (NARDL) model is applied to capture the asymmetric effect of exchange rate changes on monetary policy reaction function (interest rate). We focus the study in ASEAN5 countries (Indonesia, Malaysia, Philippines, Thailand and Singapore). The results indicated the existence of asymmetric effect of exchange rates changes on the monetary reaction function for all ASEAN5 countries in the long-run. Where, in majority of the cases the monetary policy is reacting to the appreciation and depreciation of exchange rate by raising the policy rate. This affirms the intervention of policymakers with the `fear of floating' behavior.

  12. Areva - Nuclear Safety Policy 2013-2016

    International Nuclear Information System (INIS)

    2013-03-01

    The objectives of Areva's Nuclear Safety Policy cover three areas: 1 - Safety of facilities: - Establish a group wide process to maintain the regulatory compliance of facilities and to ensure the execution of improvements required by periodic reviews of safety. - Put in place proactive measures to reduce source terms present in facilities, and in particular with regard to fire, operational waste and legacy waste on AREVA sites. - Ensure the performance of arrangements and activities central to risk prevention, in particular in the areas of containment, criticality safety and radiological protection through compliance with the associated safety requirements. - Strengthen the emergency planning arrangements to be implemented in case of accidents and test these through regular exercises. 2 - Operational Safety: - Develop and verify the level of safety culture of our staff and subcontractors and increase the presence of operational managers on the ground. - Improve the requirements and responsibilities within documentation associated with operations and interventions on the basis of a significant involvement of our staff and subcontractors. - Implement robust and formal risk prevention processes to manage temporary or transitional situations, uncommon situations, or specific risks, including but not limited to parallel activities, administrative lockout/tag-out, working with naked flames, gamma radiation, work in a radioactive environment. - Integrate human and organizational factors (HOF) in the analysis of safety-related modifications of facilities; undertake detailed reviews of the causes of all significant events inside the group and improve the communication and implementation of operating experience within all group entities. - 3 Safety Management: - Maintain an organization based on clear principles of shared responsibility and delegation of authority, and have in place a robust process to assess the impact on safety of any organizational change. - Strengthen

  13. Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment: Policy Lab Results

    Science.gov (United States)

    Rubin, Jennifer K.; Hesketh, Rachel; Martin, Adam; Herman, William H.; Rubino, Francesco

    2016-01-01

    Despite increasing recognition of the efficacy, safety, and cost-effectiveness of bariatric/metabolic surgery in the treatment of type 2 diabetes, few patients who may be appropriate candidates and may benefit from this type of surgery avail themselves of this treatment option. To identify conceptual and practical barriers to appropriate use of surgical procedures, a Policy Lab was hosted at the 3rd World Congress on Interventional Therapies for Type 2 Diabetes on 29 September 2015. Twenty-six stakeholders participated in the Policy Lab, including academics, clinicians, policy-makers, industry leaders, and patient representatives. Participants were provided with a summary of available evidence about the cost-effectiveness of bariatric/metabolic surgery and the costs of increasing the use of bariatric/metabolic surgery, using U.K. and U.S. scenarios as examples of distinct health care systems. There was widespread agreement among this group of stakeholders that bariatric/metabolic surgery is a legitimate and cost-effective approach to the treatment of type 2 diabetes in obese patients. The following four building blocks were identified to facilitate policy changes: 1) communicating the scale of the costs and harms associated with rising prevalence of type 2 diabetes; 2) properly articulating the role of bariatric/metabolic surgery for certain population groups; 3) identifying new funding sources for bariatric/metabolic surgery; and 4) incorporating bariatric/metabolic surgery into the appropriate clinical pathways. Although more research is needed to identify specific clinical scenarios for the prioritization of bariatric/metabolic surgery, the case appears to be strong enough to engage relevant policy-makers and practitioners in a concerted discussion of how to better use metabolic surgical resources in conjunction with other interventions in good diabetes practice. PMID:27222554

  14. [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.

  15. Perspective on renewable fuels policy April 2002

    International Nuclear Information System (INIS)

    2002-04-01

    Natural Resources Canada (NRCan) has initiated a constructive dialogue on its ethanol policy, and the Canadian Petroleum Products Institute (CPPI) is supportive of the government's efforts in that regard and encourages this dialogue to continue. CPPI believes that it is important to provide sound information to policy makers. Before policy decisions are made, all stakeholders must be fully involved in the process and aware of the implications of the various options open for discussion. In this document, it is stated that significant additional government intervention in the form of higher subsidies and/or mandate is required to increase Canadian demand and push market penetration of fuel ethanol. One of the benefits from the utilization of ethanol fuel resides in the reduction of greenhouse gas emissions. However, the cost effectiveness of ethanol in terms of greenhouse gas emissions reductions indicates that other strategies are less expensive. It was mentioned that ethanol production technology requires a thorough evaluation. The situation in the United States is reviewed. Negotiations recently took place that produced a comprehensive proposal on renewable fuels, and includes: a renewable fuels mandate, funding for leaking underground storage tanks programs, maintenance of the toxic air pollution reductions, and a study of harmonization of Federal, state and local fuel requirements, among others. It was indicated that the Canadian situation is not reflected in this proposal, since most of the policy drivers for the American proposal are not relevant to the Canadian situation. The considerations for Canadian policy makers include two options: investment in production facilities that are widely distributed throughout the country, or transporting ethanol across vast distances at a higher cost. The conclusion calls for further federal and provincial intervention

  16. Tobacco Control in Africa: People, Politics and Policies | IDRC ...

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

    2011-10-15

    Oct 15, 2011 ... Although the policy interventions are well understood, the political economy ... case studies – representing diverse linguistic, geographic, political, legal and ... Addressing Africa's unmet need for family planning by intensifying ...

  17. An eHealth Intervention to Promote Physical Activity and Social Network of Single, Chronically Impaired Older Adults: Adaptation of an Existing Intervention Using Intervention Mapping.

    Science.gov (United States)

    Boekhout, Janet M; Peels, Denise A; Berendsen, Brenda Aj; Bolman, Catherine Aw; Lechner, Lilian

    2017-11-23

    Especially for single older adults with chronic diseases, physical inactivity and a poor social network are regarded as serious threats to their health and independence. The Active Plus intervention is an automated computer-tailored eHealth intervention that has been proven effective to promote physical activity (PA) in the general population of adults older than 50 years. The aim of this study was to report on the methods and results of the systematic adaptation of Active Plus to the wishes and needs of the subgroup of single people older than 65 years who have one or more chronic diseases, as this specific target population may encounter specific challenges regarding PA and social network. The Intervention Mapping (IM) protocol was used to systematically adapt the existing intervention to optimally suit this specific target population. A literature study was performed, and quantitative as well as qualitative data were derived from health care professionals (by questionnaires, n=10) and the target population (by focus group interviews, n=14), which were then systematically integrated into the adapted intervention. As the health problems and the targeted behavior are largely the same in the original and adapted intervention, the outcome of the needs assessment was that the performance objectives remained the same. As found in the literature study and in data derived from health professionals and focus groups, the relative importance and operationalization of the relevant psychosocial determinants related to these objectives are different from the original intervention, resulting in a refinement of the change objectives to optimally fit the specific target population. This refinement also resulted in changes in the practical applications, program components, intervention materials, and the evaluation and implementation strategy for the subgroup of single, chronically impaired older adults. This study demonstrates that the adaptation of an existing intervention is an

  18. Physical inactivity as a policy problem: applying a concept from policy analysis to a public health issue.

    Science.gov (United States)

    Rütten, Alfred; Abu-Omar, Karim; Gelius, Peter; Schow, Diana

    2013-03-07

    Despite the recent rapid development of policies to counteract physical inactivity (PI), only a small number of systematic analyses on the evolution of these policies exists. In this article we analyze how PI, as a public health issue, "translates" into a policy-making issue. First, we discuss why PI has become an increasingly important public health issue during the last two decades. We then follow Guy Peters and conceptualize PI as a "policy problem" that has the potential to be linked to policy instruments and policy impact. Analysis indicates that PI is a policy problem that i) is chronic in nature; ii) involves a high degree of political complexity; iii) can be disaggregated into smaller scales; iv) is addressed through interventions that can be difficult to "sell" to the public when their benefits are not highly divisible; v) cannot be solved by government spending alone; vi) must be addressed through a broad scope of activities; and vii) involves interdependencies among both multiple sectors and levels of government.We conclude that the new perspective on PI proposed in this article might be useful and important for i) describing and mapping policies to counteract PI in different contexts; ii) evaluating whether or not existing policy instruments are appropriate to the policy problem of PI, and iii) explaining the factors and processes that underlie policy development and implementation. More research is warranted in all these areas. In particular, we propose to focus on comparative analyses of how the problem of PI is defined and tackled in different contexts, and on the identification of truly effective policy instruments that are designed to "solve" the PI policy problem.

  19. Development of the Social Network-Based Intervention “Powerful Together with Diabetes” Using Intervention Mapping

    Directory of Open Access Journals (Sweden)

    Charlotte Vissenberg

    2017-12-01

    Full Text Available This article describes the development of the social network-based intervention Powerful Together with Diabetes which aims to improve diabetes self-management (DSM among patients with type 2 diabetes living in socioeconomically deprived neighborhoods by stimulating social support for DSM and diminishing social influences hindering DSM (e.g., peer pressure and social norms. The intervention was specifically developed for patients with Dutch, Turkish, Moroccan, and Surinamese backgrounds. The intervention was developed according to Intervention Mapping. This article describes the first four steps of Intervention Mapping: (1 the needs assessment; (2 development of performance and change objectives; (3 selection of theory-based methods and strategies; and (4 the translation of these into an organized program. These four steps resulted in Powerful Together with Diabetes, a 10-month group-based intervention consisting of 24 meetings, 6 meetings for significant others, and 2 meetings for participants and their spouses. The IM method resulted in a tailored approach with a specific focus on the social networks of its participants. This article concludes that the IM method helped our planning team to tailor the intervention to the needs of our target population and facilitated our evaluation design. However, in hindsight, the intervention could have been improved by investing more in participatory planning and community involvement.

  20. Development of the Social Network-Based Intervention “Powerful Together with Diabetes” Using Intervention Mapping

    Science.gov (United States)

    Vissenberg, Charlotte; Nierkens, Vera; Uitewaal, Paul J. M.; Middelkoop, Barend J. C.; Nijpels, Giel; Stronks, Karien

    2017-01-01

    This article describes the development of the social network-based intervention Powerful Together with Diabetes which aims to improve diabetes self-management (DSM) among patients with type 2 diabetes living in socioeconomically deprived neighborhoods by stimulating social support for DSM and diminishing social influences hindering DSM (e.g., peer pressure and social norms). The intervention was specifically developed for patients with Dutch, Turkish, Moroccan, and Surinamese backgrounds. The intervention was developed according to Intervention Mapping. This article describes the first four steps of Intervention Mapping: (1) the needs assessment; (2) development of performance and change objectives; (3) selection of theory-based methods and strategies; and (4) the translation of these into an organized program. These four steps resulted in Powerful Together with Diabetes, a 10-month group-based intervention consisting of 24 meetings, 6 meetings for significant others, and 2 meetings for participants and their spouses. The IM method resulted in a tailored approach with a specific focus on the social networks of its participants. This article concludes that the IM method helped our planning team to tailor the intervention to the needs of our target population and facilitated our evaluation design. However, in hindsight, the intervention could have been improved by investing more in participatory planning and community involvement. PMID:29326916