Sample records for change policy analysis

  1. Can policy analysis theories predict and inform policy change? Reflections on the battle for legal abortion in Indonesia

    PubMed Central

    Surjadjaja, Claudia; Mayhew, Susannah H

    2011-01-01

    The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools to identify power relations between key actors and what strategic approaches should be employed to manage these to enhance the possibility of policy change. The findings show how the moves to legalize abortion have been supported or constrained according to the balance of political and religious powers operating in a macro-political context defined increasingly by a polarized Islamic-authoritarian—Western-liberal agenda. The issue of reproductive health constituted a battlefield where these two ideologies met and the debate on the current health law amendment became a contest, which still continues, for the larger future of Indonesia. The findings confirm the utility of policy analysis theories and stakeholder mapping tools for predicting the likelihood of policy change and informing the strategic approaches for achieving such change. They also highlight opportunities and dilemmas in prospective policy analysis and raise questions about whether research on policy processes and actors can or should be used to inform, or even influence, policies in ‘real-time’. PMID:21183461

  2. Can policy analysis theories predict and inform policy change? Reflections on the battle for legal abortion in Indonesia.

    PubMed

    Surjadjaja, Claudia; Mayhew, Susannah H

    2011-09-01

    The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools to identify power relations between key actors and what strategic approaches should be employed to manage these to enhance the possibility of policy change. The findings show how the moves to legalize abortion have been supported or constrained according to the balance of political and religious powers operating in a macro-political context defined increasingly by a polarized Islamic-authoritarian-Western-liberal agenda. The issue of reproductive health constituted a battlefield where these two ideologies met and the debate on the current health law amendment became a contest, which still continues, for the larger future of Indonesia. The findings confirm the utility of policy analysis theories and stakeholder mapping tools for predicting the likelihood of policy change and informing the strategic approaches for achieving such change. They also highlight opportunities and dilemmas in prospective policy analysis and raise questions about whether research on policy processes and actors can or should be used to inform, or even influence, policies in 'real-time'.

  3. Optimal climate change: economics and climate science policy histories (from heuristic to normative).

    PubMed

    Randalls, Samuel

    2011-01-01

    Historical accounts of climate change science and policy have reflected rather infrequently upon the debates, discussions, and policy advice proffered by economists in the 1980s. While there are many forms of economic analysis, this article focuses upon cost-benefit analysis, especially as adopted in the work of William Nordhaus. The article addresses the way in which climate change economics subtly altered debates about climate policy from the late 1970s through the 1990s. These debates are often technical and complex, but the argument in this article is that the development of a philosophy of climate change as an issue for cost-benefit analysis has had consequences for how climate policy is made today.

  4. Moving towards an Integrated Theory of Policy Networks: A Multi-Theoretical Approach for Examining State-Level Policy Change in U.S. Subsystems. Working Paper #45

    ERIC Educational Resources Information Center

    Galey, Sarah; Youngs, Peter

    2014-01-01

    Scholars have developed a wide range of theories to explain both stability and change in policy subsystems. In recent years, a burgeoning literature has emerged that focuses on the application of network analysis in policy research, more formally known as Policy Network Analysis (PNA). This approach, while still developing, has great potential as…

  5. Adaptive Governance, Uncertainty, and Risk: Policy Framing and Responses to Climate Change, Drought, and Flood.

    PubMed

    Hurlbert, Margot; Gupta, Joyeeta

    2016-02-01

    As climate change impacts result in more extreme events (such as droughts and floods), the need to understand which policies facilitate effective climate change adaptation becomes crucial. Hence, this article answers the question: How do governments and policymakers frame policy in relation to climate change, droughts, and floods and what governance structures facilitate adaptation? This research interrogates and analyzes through content analysis, supplemented by semi-structured qualitative interviews, the policy response to climate change, drought, and flood in relation to agricultural producers in four case studies in river basins in Chile, Argentina, and Canada. First, an epistemological explanation of risk and uncertainty underscores a brief literature review of adaptive governance, followed by policy framing in relation to risk and uncertainty, and an analytical model is developed. Pertinent findings of the four cases are recounted, followed by a comparative analysis. In conclusion, recommendations are made to improve policies and expand adaptive governance to better account for uncertainty and risk. This article is innovative in that it proposes an expanded model of adaptive governance in relation to "risk" that can help bridge the barrier of uncertainty in science and policy. © 2015 Society for Risk Analysis.

  6. Identifying state-level policy and provision domains for physical education and physical activity in high school

    PubMed Central

    2013-01-01

    Background It is important to quickly and efficiently identify policies that are effective at changing behavior; therefore, we must be able to quantify and evaluate the effect of those policies and of changes to those policies. The purpose of this study was to develop state-level physical education (PE) and physical activity (PA) policy domain scores at the high-school level. Policy domain scores were developed with a focus on measuring policy change. Methods Exploratory factor analysis was used to group items from the state-level School Health Policies and Programs Study (SHPPS) into policy domains. Items that related to PA or PE at the High School level were identified from the 7 SHPPS health program surveys. Data from 2000 and 2006 were used in the factor analysis. RESULTS: From the 98 items identified, 17 policy domains were extracted. Average policy domain change scores were positive for 12 policy domains, with the largest increases for “Discouraging PA as Punishment”, “Collaboration”, and “Staff Development Opportunities”. On average, states increased scores in 4.94 ± 2.76 policy domains, decreased in 3.53 ± 2.03, and had no change in 7.69 ± 2.09 policy domains. Significant correlations were found between several policy domain scores. Conclusions Quantifying policy change and its impact is integral to the policy making and revision process. Our results build on previous research offering a way to examine changes in state-level policies related to PE and PA of high-school students and the faculty and staff who serve them. This work provides methods for combining state-level policies relevant to PE or PA in youth for studies of their impact. PMID:23815860

  7. Climate Change and the Canadian Higher Education System: An Institutional Policy Analysis

    ERIC Educational Resources Information Center

    Henderson, Joseph; Bieler, Andrew; McKenzie, Marcia

    2017-01-01

    Climate change is a pressing concern. Higher education can address the challenge, but systematic analyses of climate change in education policy are sparse. This paper addresses this gap in the literature by reporting on how Canadian postsecondary educational institutions have engaged with climate change through policy actions. We used descriptive…

  8. Workshop: Improving the Assessment and Valuation of Climate Change Impacts for Policy and Regulatory Analysis: Modeling Climate Change Impacts and Associated Economic Damages (2010 - part 1)

    EPA Pesticide Factsheets

    The purpose of this workshop Improving the Assessment and Valuation of Climate Change Impacts for Policy and Regulatory Analysis. focused on conceptual and methodological issues - integrated assessment modeling and valuation.

  9. Competing actors in the climate change arena in Mexico: A network analysis.

    PubMed

    Ortega Díaz, Araceli; Gutiérrez, Erika Casamadrid

    2018-06-01

    This paper analyzes the actors in the climate change arena and their influence in directing Mexico toward policies that decrease greenhouse gas emissions, such as the carbon tax and climate change law. The network analysis of the agreement of these laws and public policies in Mexico is a lesson for any country that is in the process of designing and adopting environmental laws. The research is performed using a network analysis that is derived from interviews with various main actors and a discourse analysis of the media. Results show that actors do not coordinate their efforts-they meet frequently but in different inter-ministerial commissions-and do not enforce the same policies. The actors in the industry have formed strong coalitions against the carbon tax and the General Law on Climate Change, whereas international institutions have formed coalitions that support these policies and laws. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Why do policies change? Institutions, interests, ideas and networks in three cases of policy reform

    PubMed Central

    Shearer, Jessica C; Abelson, Julia; Kouyaté, Bocar; Lavis, John N; Walt, Gill

    2016-01-01

    Abstract Policy researchers have used various categories of variables to explain why policies change, including those related to institutions, interests and ideas. Recent research has paid growing attention to the role of policy networks—the actors involved in policy-making, their relationships with each other, and the structure formed by those relationships—in policy reform across settings and issues; however, this literature has largely ignored the theoretical integration of networks with other policy theories, including the ‘3Is’ of institutions, interests and ideas. This article proposes a conceptual framework integrating these variables and tests it on three cases of policy change in Burkina Faso, addressing the need for theoretical integration with networks as well as the broader aim of theory-driven health policy analysis research in low- and middle-income countries. We use historical process tracing, a type of comparative case study, to interpret and compare documents and in-depth interview data within and between cases. We found that while network changes were indeed associated with policy reform, this relationship was mediated by one or more of institutions, interests and ideas. In a context of high donor dependency, new donor rules affected the composition and structure of actors in the networks, which enabled the entry and dissemination of new ideas and shifts in the overall balance of interest power ultimately leading to policy change. The case of strategic networking occurred in only one case, by civil society actors, suggesting that network change is rarely the spark that initiates the process towards policy change. This analysis highlights the important role of changes in institutions and ideas to drive policymaking, but hints that network change is a necessary intermediate step in these processes. PMID:27233927

  11. Accounting for health in climate change policies: a case study of Fiji.

    PubMed

    Morrow, Georgina; Bowen, Kathryn

    2014-01-01

    Climate change is expected to affect the health of most populations in the coming decades, having the greatest impact on the poorest and most disadvantaged people in the world. The Pacific islands, including Fiji, are particularly vulnerable to the effects of climate change. The three major health impacts of climate change in Fiji explored in this study were dengue fever, diarrhoeal disease, and malnutrition, as they each pose a significant threat to human health. The aim of this study was to investigate to what extent the Fiji National Climate Change Policy, and a selection of relevant sectoral policies, account for these human health effects of climate change. The study employed a three-pronged policy analysis to evaluate: 1) the content of the Fijian National Climate Change Policy and to what extent health was incorporated within this; 2) the context within which the policy was developed; 3) the relevant processes; and 4) the actors involved. A selection of relevant sectoral policies were also analysed to assess the extent to which these included climate change and health considerations. The policy analysis showed that these three health impacts of climate change were only considered to a minor extent, and often indirectly, in both the Fiji National Climate Change Policy and the corresponding National Climate Change Adaptation Strategy, as well as the Public Health Act. Furthermore, supporting documents in relevant sectors including water and agriculture made no mention of climate change and health impacts. The projected health impacts of climate change should be considered as part of reviewing the Fiji National Climate Change Policy and National Climate Change Adaptation Strategy, and the Public Health Act. In the interest of public health, this should include strategies for combating dengue fever, malnutrition, and water-borne disease. Related sectoral policies in water and agriculture should also be revised to consider climate change and its impact on human health. Approaches to include health aspects of climate change within sectoral and climate change specific policies should be encouraged, via a number of mechanisms, such as the Health in All Policies approach. Future research could support the Fiji health sector in developing climate change and health programmes.

  12. Workshop: Improving the Assessment and Valuation of Climate Change Impacts for Policy and Regulatory Analysis: Modeling Climate Change Impacts and Associated Economic Damages (2011 - part 2)

    EPA Pesticide Factsheets

    The purpose of this workshop Improving the Assessment and Valuation of Climate Change Impacts for Policy and Regulatory Analysis. focused on conceptual and methodological issues - estimating impacts and valuing damages on a sectoral basis.

  13. An Analysis of States' Policies Regarding Social Media Use in Education

    ERIC Educational Resources Information Center

    Miller, Janette K.

    2016-01-01

    This policy analysis project focused on states' policies regarding social media use in education. Currently, policies, practices and laws are not keeping pace with the rapidly changing nature of technology. As a result of the quick advancement of social media practices, the need exists for organic policies and practices within the educational…

  14. A retrospective analysis of the change in anti-malarial treatment policy: Peru.

    PubMed

    Williams, Holly Ann; Vincent-Mark, Arlene; Herrera, Yenni; Chang, O Jaime

    2009-04-28

    National malaria control programmes must deal with the complex process of changing national malaria treatment guidelines, often without guidance on the process of change. Selecting a replacement drug is only one issue in this process. There is a paucity of literature describing successful malaria treatment policy changes to help guide control programs through this process. To understand the wider context in which national malaria treatment guidelines were formulated in a specific country (Peru). Using qualitative methods (individual and focus group interviews, stakeholder analysis and a review of documents), a retrospective analysis of the process of change in Peru's anti-malarial treatment policy from the early 1990's to 2003 was completed. The decision to change Peru's policies resulted from increasing levels of anti-malarial drug resistance, as well as complaints from providers that the drugs were no longer working. The context of the change occurred in a time in which Peru was changing national governments, which created extreme challenges in moving the change process forward. Peru utilized a number of key strategies successfully to ensure that policy change would occur. This included a) having the process directed by a group who shared a common interest in malaria and who had long-established social and professional networks among themselves, b) engaging in collaborative teamwork among nationals and between nationals and international collaborators, c) respect for and inclusion of district-level staff in all phases of the process, d) reliance on high levels of technical and scientific knowledge, e) use of standardized protocols to collect data, and f) transparency. Although not perfectly or fully implemented by 2003, the change in malaria treatment policy in Peru occurred very quickly, as compared to other countries. They identified a problem, collected the data necessary to justify the change, utilized political will to their favor, approved the policy, and moved to improve malaria control in their country. As such, they offer an excellent example for other countries as they contemplate or embark on policy changes.

  15. Transfer of Health for All policy – What, how and in which direction? A two-case study

    PubMed Central

    Tervonen-Gonçalves, Leena; Lehto, Juhani

    2004-01-01

    Background This article explores the transfer of World Health Organization's (WHO) policy initiative Health for All by the Year 2000 (HFA2000) into national contexts by using the changes in the public health policies of Finland and Portugal from the 1970's onward and the relationship of these changes to WHO policy development as test cases. Finland and Portugal were chosen to be compared as they represent different welfare state types and as the paradigmatic transition from the old to new public health is assumed to be related to the wider welfare state development. Methods The policy transfer approach is used as a conceptual tool to analyze the possible policy changes related to the adaptation of HFA into the national context. To be able to analyze not only the content but also the contextual conditions of policy transfer Kingdon's analytical framework of policy analysis is applied. Conclusions Our analysis suggests that no significant change of health promotion policy resulted from the launch of HFA program neither in Finland nor in Portugal. Instead the changes that occurred in both countries were of incremental nature, in accordance with the earlier policy choices, and the adaptation of HFA program was mainly applied to the areas where there were national traditions. PMID:15585064

  16. Changing Hot Pursuit Policy: An Empirical Assessment of the Impact on Pursuit Behavior.

    ERIC Educational Resources Information Center

    Crew, Robert E., Jr.; And Others

    1994-01-01

    Using a two-year time series, the impact on law enforcement pursuit behavior of two changes in pursuit policy in a police department was studied using the ARIMA computer program and Tobit analysis. Each policy change produced significant reductions in pursuits engaged in by police officers. (SLD)

  17. Moving Communities Toward Policy Change: APPEAL’s 4-Prong Policy Change Model

    PubMed Central

    Tong, Elisa K.; Lew, Rod

    2014-01-01

    Policy change is recognized for underlying much of the success of tobacco control. However, there is little evidence and attention on how Asian American and Native Hawaiian and Pacific Islander (AA and NHPI) communities may engage in policy change. Challenges for AA and NHPI communities include the racial/ethnic and geographic diversity, and tobacco data accurately representing the communities. Over the past decade, the Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL) has worked to develop and implement policy change for AA and NHPI communities. This article describes APPEAL’s 4-prong policy change model, in the context of its overall strategic framework for policy change with communities that accounts for varying levels of readiness and leadership capacity, and targets four different levels of policy change (community, mainstream institution, legislative, and corporate). The health promotion implication of this framework for tobacco control policy engagement is for improving understanding of effective pathways to policy change, promoting innovative methods for policy analysis, and translating them into effective implementation and sustainability of policy initiatives. The APPEAL strategic framework can transcend into other communities and health topics that ultimately may contribute to the elimination of health disparities. PMID:23707962

  18. Framing Literacy Policy: Power and Policy Drivers in Primary Schools

    ERIC Educational Resources Information Center

    Mills, Colin

    2011-01-01

    This article is linked to the theme of the special issue through its focus on micropolitical analysis of the changing role of "policy drivers", mediating national policy through interactions with primary school heads and teachers. The central arguments draw on case studies undertaken in two primary schools where changes related to…

  19. Venezuela’s Changing Foreign Policy Towards the United States: A Holistic Analysis

    DTIC Science & Technology

    2001-12-01

    explanations for this change: 1) A new post -Cold War international system. 2) Antagonism produced by unpopular U.S. policies towards Venezuela. 3...States. The thesis hypothesizes four possible explanations for this change: 1) A new post - Cold War international system. 2) Unpopular U.S. policies...These include, the new post -Cold War international system, unpopular U.S. policies towards Venezuela, domestic issues within Venezuela, and

  20. Accounting for health in climate change policies: a case study of Fiji

    PubMed Central

    Morrow, Georgina; Bowen, Kathryn

    2014-01-01

    Background Climate change is expected to affect the health of most populations in the coming decades, having the greatest impact on the poorest and most disadvantaged people in the world. The Pacific islands, including Fiji, are particularly vulnerable to the effects of climate change. Objective The three major health impacts of climate change in Fiji explored in this study were dengue fever, diarrhoeal disease, and malnutrition, as they each pose a significant threat to human health. The aim of this study was to investigate to what extent the Fiji National Climate Change Policy, and a selection of relevant sectoral policies, account for these human health effects of climate change. Design The study employed a three-pronged policy analysis to evaluate: 1) the content of the Fijian National Climate Change Policy and to what extent health was incorporated within this; 2) the context within which the policy was developed; 3) the relevant processes; and 4) the actors involved. A selection of relevant sectoral policies were also analysed to assess the extent to which these included climate change and health considerations. Results The policy analysis showed that these three health impacts of climate change were only considered to a minor extent, and often indirectly, in both the Fiji National Climate Change Policy and the corresponding National Climate Change Adaptation Strategy, as well as the Public Health Act. Furthermore, supporting documents in relevant sectors including water and agriculture made no mention of climate change and health impacts. Conclusions The projected health impacts of climate change should be considered as part of reviewing the Fiji National Climate Change Policy and National Climate Change Adaptation Strategy, and the Public Health Act. In the interest of public health, this should include strategies for combating dengue fever, malnutrition, and water-borne disease. Related sectoral policies in water and agriculture should also be revised to consider climate change and its impact on human health. Approaches to include health aspects of climate change within sectoral and climate change specific policies should be encouraged, via a number of mechanisms, such as the Health in All Policies approach. Future research could support the Fiji health sector in developing climate change and health programmes. PMID:24836442

  1. Shaping Policy Change in Population Health: Policy Entrepreneurs, Ideas, and Institutions

    PubMed Central

    Béland, Daniel; Katapally, Tarun R.

    2018-01-01

    Political realities and institutional structures are often ignored when gathering evidence to influence population health policies. If these policies are to be successful, social science literature on policy change should be integrated into the population health approach. In this contribution, drawing on the work of John W. Kingdon and related scholarship, we set out to examine how key components of the policy change literature could contribute towards the effective development of population health policies. Shaping policy change would require a realignment of the existing school of thought, where the contribution of population health seems to end at knowledge translation. Through our critical analysis of selected literature, we extend recommendations to advance a burgeoning discussion in adopting new approaches to successfully implement evidence-informed population health policies. PMID:29764101

  2. Why do policies change? Institutions, interests, ideas and networks in three cases of policy reform.

    PubMed

    Shearer, Jessica C; Abelson, Julia; Kouyaté, Bocar; Lavis, John N; Walt, Gill

    2016-11-01

    Policy researchers have used various categories of variables to explain why policies change, including those related to institutions, interests and ideas. Recent research has paid growing attention to the role of policy networks-the actors involved in policy-making, their relationships with each other, and the structure formed by those relationships-in policy reform across settings and issues; however, this literature has largely ignored the theoretical integration of networks with other policy theories, including the '3Is' of institutions, interests and ideas. This article proposes a conceptual framework integrating these variables and tests it on three cases of policy change in Burkina Faso, addressing the need for theoretical integration with networks as well as the broader aim of theory-driven health policy analysis research in low- and middle-income countries. We use historical process tracing, a type of comparative case study, to interpret and compare documents and in-depth interview data within and between cases. We found that while network changes were indeed associated with policy reform, this relationship was mediated by one or more of institutions, interests and ideas. In a context of high donor dependency, new donor rules affected the composition and structure of actors in the networks, which enabled the entry and dissemination of new ideas and shifts in the overall balance of interest power ultimately leading to policy change. The case of strategic networking occurred in only one case, by civil society actors, suggesting that network change is rarely the spark that initiates the process towards policy change. This analysis highlights the important role of changes in institutions and ideas to drive policymaking, but hints that network change is a necessary intermediate step in these processes. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Understanding policy persistence-The case of police drug detection dog policy in NSW, Australia.

    PubMed

    Hughes, Caitlin E; Ritter, Alison; Lancaster, Kari; Hoppe, Robert

    2017-06-01

    Significant research attention has been given to understanding the processes of drug policy reform. However, there has been surprisingly little analysis of the persistence of policy in the face of opposition and evidence of ineffectiveness. In this article we analysed just such a case - police drug detection dog policy in NSW, Australia. We sought to identify factors which may account for the continuation of this policy, in spite of counter-evidence and concerted advocacy. The analysis was conducted using the Advocacy Coalition Framework (ACF). We collated documents relating to NSW drug detection dog policy from 1995 to 2016, including parliamentary records (NSW Parliament Hansard), government and institutional reports, legislation, police procedures, books, media, and academic publications. Texts were then read, coded and classified against the core dimensions of the ACF, including subsystem actors and coalitions, their belief systems and resources and venues employed for policy debate. Three coalitions were identified as competing in the policy subsystem: security/law and order, civil liberties and harm reduction. Factors that aided policy stability were the continued dominance of the security/law and order coalition since they introduced the drug dog policy; a power imbalance enabling the ruling coalition to limit when and where the policy was discussed; and a highly adversarial policy subsystem. In this context even technical knowledge that dogs infringed civil liberties and increased risks of overdose were readily downplayed, leading to only incremental changes in implementation rather than policy cessation or wholesale revision. The analysis provides new insights into why the accumulation of new evidence and advocacy efforts can be insufficient to drive significant policy change. It poses a challenge for the evidence-based paradigm suggesting that in highly adversarial policy subsystems new evidence is unlikely to generate policy change without broader subsystem change, such as reducing the adversarial nature and/or providing new avenues for cross-coalition learning. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. The terrain of health policy analysis in low and middle income countries: a review of published literature 1994–2007

    PubMed Central

    Gilson, Lucy; Raphaely, Nika

    2008-01-01

    This article provides the first ever review of literature analysing the health policy processes of low and middle income countries (LMICs). Based on a systematic search of published literature using two leading international databases, the article maps the terrain of work published between 1994 and 2007, in terms of policy topics, lines of inquiry and geographical base, as well as critically evaluating its strengths and weaknesses. The overall objective of the review is to provide a platform for the further development of this field of work. From an initial set of several thousand articles, only 391 were identified as relevant to the focus of inquiry. Of these, 164 were selected for detailed review because they present empirical analyses of health policy change processes within LMIC settings. Examination of these articles clearly shows that LMIC health policy analysis is still in its infancy. There are only small numbers of such analyses, whilst the diversity of policy areas, topics and analytical issues that have been addressed across a large number of country settings results in a limited depth of coverage within this body of work. In addition, the majority of articles are largely descriptive in nature, limiting understanding of policy change processes within or across countries. Nonetheless, the broad features of experience that can be identified from these articles clearly confirm the importance of integrating concern for politics, process and power into the study of health policy. By generating understanding of the factors influencing the experience and results of policy change, such analysis can inform action to strengthen future policy development and implementation. This article, finally, outlines five key actions needed to strengthen the field of health policy analysis within LMICs, including capacity development and efforts to generate systematic and coherent bodies of work underpinned by both the intent to undertake rigorous analytical work and concern to support policy change. PMID:18650209

  5. Social Justice in Australian Higher Education Policy: An Historical and Conceptual Account of Student Participation

    ERIC Educational Resources Information Center

    Gale, Trevor; Tranter, Deborah

    2011-01-01

    This article provides a synoptic account of historically changing conceptions and practices of social justice in Australian higher education policy. It maps the changes in this policy arena, beginning with the period following the Second World War and concluding with an analysis of the most recent policy proposals of the Bradley Review.…

  6. Modeling energy/economy interactions for conservation and renewable energy-policy analysis

    NASA Astrophysics Data System (ADS)

    Groncki, P. J.

    Energy policy and the implications for policy analysis and the methodological tools are discussed. The evolution of one methodological approach and the combined modeling system of the component models, their evolution in response to changing analytic needs, and the development of the integrated framework are reported. The analyses performed over the past several years are summarized. The current philosophy behind energy policy is discussed and compared to recent history. Implications for current policy analysis and methodological approaches are drawn.

  7. Challenging Fundraising, Challenging Inequity: Contextual Constraints on Advocacy Groups' Policy Influence

    ERIC Educational Resources Information Center

    Winton, Sue

    2018-01-01

    School fundraising is known to reproduce inequities in schools, yet it remains common practice in Ontario, Canada; findings from a critical policy analysis of an advocacy group's efforts to change fundraising policy help explain why this is the case. Adopting a discursive understanding of policy, the study used rhetorical analysis to identify how…

  8. Blueprint for Change in Ohio: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  9. Neoliberalism, Policy Reforms and Higher Education in Bangladesh

    ERIC Educational Resources Information Center

    Kabir, Ariful Haq

    2013-01-01

    Bangladesh has introduced neoliberal policies since the 1970s. Military regimes, since the dramatic political changes in 1975, accelerated the process. A succession of military rulers made rigorous changes in policy-making in various sectors. This article uses a critical approach to document analysis and examines the perceptions of key…

  10. Blueprint for Change in Utah: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  11. Blueprint for Change in Mississippi: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  12. Blueprint for Change in Florida: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  13. Blueprint for Change in Maryland: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  14. Blueprint for Change in Louisiana: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  15. Blueprint for Change in South Dakota: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  16. Blueprint for Change in Massachusetts: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  17. Blueprint for Change in Illinois: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  18. Blueprint for Change in Nevada: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  19. Blueprint for Change in Iowa: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  20. Blueprint for Change in Washington: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  1. Blueprint for Change in Alabama: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  2. Blueprint for Change in North Dakota: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  3. Blueprint for Change in Michigan: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  4. Blueprint for Change in North Carolina: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  5. Blueprint for Change in Minnesota: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  6. Blueprint for Change in Pennsylvania: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  7. Blueprint for Change in Hawaii: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  8. Blueprint for Change in Texas: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  9. Blueprint for Change in Idaho: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  10. Blueprint for Change in New Hampshire: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  11. Blueprint for Change in Arizona: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  12. Blueprint for Change in New Mexico: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  13. Blueprint for Change in Wisconsin: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  14. Blueprint for Change in Montana: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  15. Blueprint for Change in Arkansas: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  16. Blueprint for Change in Kansas: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  17. Blueprint for Change in West Virginia: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  18. Blueprint for Change in Vermont: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  19. Blueprint for Change in Oregon: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  20. Blueprint for Change in South Carolina: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  1. Blueprint for Change in Alaska: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  2. Blueprint for Change in Wyoming: State Teacher Policy Yearbook, 2010

    ERIC Educational Resources Information Center

    National Council on Teacher Quality, 2010

    2010-01-01

    The 2009 "State Teacher Policy Yearbook" provided a comprehensive review of states' policies that impact the teaching profession. As a companion to last year's comprehensive state-by-state analysis, the 2010 edition provides each state with an individualized "Blueprint for Change," building off last year's "Yearbook"…

  3. Education Policy Analysis Archives, 2000.

    ERIC Educational Resources Information Center

    Glass, Gene V., Ed.

    2000-01-01

    This document consists of the 2000 edition of the "Education Policy Analysis Archives." The papers include: (1) "Teacher Quality and Student Achievement: A Review of State Policy Evidence" (Linda Darling-Hammond); (2) "America Y2K: The Obsolescence of Educational Reforms" (Sherman Dorn); (3) "Forces for Change in…

  4. Mucking through the Swamp: Changing the Pedagogy of a Social Welfare Policy Course

    ERIC Educational Resources Information Center

    Anderson, Debra K.

    2006-01-01

    Despite the fact that social welfare problems do not lend themselves to rational definition and analysis, most undergraduate social welfare policy courses use technical rational approaches to teach policy analysis. This article argues that analysts need to descend from the high ground of rational analysis to the "swampy lowlands of human concern"…

  5. Science priorities for the human dimensions of global change

    NASA Technical Reports Server (NTRS)

    1994-01-01

    The topics covered include the following: defining research needs; understanding land use change; improving policy analysis -- research on the decision-making process; designing policy instruments and institutions to address energy-related environmental problems; assessing impacts, vulnerability, and adaptation to global changes; and understanding population dynamics and global change.

  6. 7 CFR 2.29 - Chief Economist.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Energy Act of 2008 (Pub. L. 110-246). (12) Related to climate change. (i) Coordinate policy analysis, long-range planning, research, and response strategies relating to climate change issues. (ii) Provide... climate change issues. (iii) Inform the Department of scientific developments and policy issues relating...

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

    PubMed

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

    2015-01-01

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

  8. National Renewable Energy Policy in a Global World

    NASA Astrophysics Data System (ADS)

    Jeong, Minji

    Increasing trade of renewable energy products has significantly contributed to reducing the costs of renewable energy sources, but at the same time, it has generated protectionist policies, which may negatively affect the trend of the cost reduction. Although a few recent studies examined the rise of renewable energy protectionism and trade disputes, they are limited in addressing the conflict between the original goal of traditional renewable energy policies and the new protectionist policies under the globalized renewable energy industry. To fill this gap, this dissertation explores how the globalized renewable energy industry has changed national renewable energy policies. Through three analyses, three aspects of the globalized renewable energy industry are examined: the rise of multinational corporations, international interactions among actors, and the changes of the global and domestic market conditions. First analysis investigates how multinational renewable energy corporations have affected national policies. A content analysis of the annual reports of 15 solar photovoltaic multinational corporation shows that solar multinationals have been influenced by national policies and have adapted to the changes rather than having attempted to change national policies. Second analysis examines how diverse actors have framed renewable energy trade issues through a network analysis of the Chinese solar panel issue in the United States. The result shows that the Chinese solar panel issue was framed differently from the traditional environmental frame of renewable energy, being dominated by multinational corporations headquartered in other countries. Third analysis explores what has caused the increasing diversity in national renewable energy policies through the case studies of the U.S. and South Korea. The result reveals that the globalization of solar industry has affected the diversification of solar policies in two countries by generating both challenges, which needed to be addressed by new and additional policies, and opportunities, which strengthened the political power of domestic solar industries. The three analyses show that the globalized renewable energy industry has led to the diversification of national renewable energy policies by increasing international interactions between actors and by introducing both challenges and opportunities to domestic renewable energy industries. This research contributes to the literature on trade and the environment by analyzing a new pattern of the conflicts between traditional environmental policies and "green" protectionist policies. It also contributes to the literature on protectionism by adding an empirical case of green protectionism, one of the forms of "murky" protectionism that has risen after the global financial crisis.

  9. Policy Change and Private Higher Education Development: A Case Study

    ERIC Educational Resources Information Center

    Zhao, Xiantong

    2014-01-01

    This research aims to explore the development of private higher education and related policy changes in China in the light of Foucault's notion of governmentality in neoliberal China. Essentially it is a synthesis of macro-level and micro-level analysis. The researcher examines policy development in combination with wide social, political and…

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

    PubMed

    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.

  11. Planning, climate change, and transportation : thoughts on policy analysis

    DOT National Transportation Integrated Search

    2010-10-01

    Ideally, policy should be informed by social welfare analyses that carefully assess costs and benefits. In the context of : GHG policies, such analyses face particular challenges. The decades-long span of GHG policy-making will require introduction :...

  12. The Media Got It Wrong! A Critical Discourse Analysis of Changes to the Educational Policy Making Arena

    ERIC Educational Resources Information Center

    Piazza, Peter

    2014-01-01

    The context for education policy making has changed dramatically in recent years. Policymaking at the state-level has become characterized by near-unprecedented enactment of neo-liberal education policies, increased influence of so-called Education Reform Advocacy Organizations (ERAOs) and increased challenges to unions' political influence. In…

  13. Carrying out a Language Policy Change: Advocacy Coalitions and the Management of Linguistic Landscape

    ERIC Educational Resources Information Center

    Sloboda, Marian; Szabo-Gilinger, Eszter; Vigers, Dick; Simicic, Lucija

    2010-01-01

    This paper focuses on agency in language policy change. The object of the analysis is the processes of bilingualization of signage in three European towns. Located in the Czech Republic, Hungary and Wales, the towns differ in various respects, including the extent to which signage language policies have faced opposition and threatened social…

  14. Education and Social Policy: Report on a Doctoral Training Program.

    ERIC Educational Resources Information Center

    Browning, Jane; Cohen, David

    This report seeks to (a) explain the origins and development of a research and teaching program in social policy analysis; (b) give a broad view of curricular problems in teaching social policy analysis; (c) explore changing academic priorities, away from the traditional concerns of teacher training, curricular development, and disciplinary…

  15. Introduction of male circumcision for HIV prevention in Uganda: analysis of the policy process.

    PubMed

    Odoch, Walter Denis; Kabali, Kenneth; Ankunda, Racheal; Zulu, Joseph Mumba; Tetui, Moses

    2015-06-20

    Health policy analysis is important for all health policies especially in fields with ever changing evidence-based interventions such as HIV prevention. However, there are few published reports of health policy analysis in sub-Saharan Africa in this field. This study explored the policy process of the introduction of male circumcision (MC) for HIV prevention in Uganda in order to inform the development processes of similar health policies. Desk review of relevant documents was conducted between March and May 2012. Thematic analysis was used to analyse the data. Conceptual frameworks that demonstrate the interrelationship within the policy development processes and influence of actors in the policy development processes guided the analysis. Following the introduction of MC on the national policy agenda in 2007, negotiation and policy formulation preceded its communication and implementation. Policy proponents included academic researchers in the early 2000s and development partners around 2007. Favourable contextual factors that supported the development of the policy included the rising HIV prevalence, adoption of MC for HIV prevention in other sub-Saharan African countries, and expertise on MC. Additionally, the networking capability of proponents facilitated the change in position of non-supportive or neutral actors. Non-supportive and neutral actors in the initial stages of the policy development process included the Ministry of Health, traditional and Muslim leaders, and the Republican President. Using political authority, legitimacy, and charisma, actors who opposed the policy tried to block the policy development process. Researchers' initial disregard of the Ministry of Health in the research process of MC and the missing civil society advocacy arm contributed to delays in the policy development process. This study underscores the importance of securing top political leadership as well as key implementing partners' support in policy development processes. Equally important is the appreciation of the various forms of actors' power and how such power shapes the policy agenda, development process, and content.

  16. Initiating policy, systems, and environmental changes for childhood obesity prevention by engaging six faith-based organizations.

    PubMed

    Boutain, Doris M; McNees, Molly

    2013-01-01

    Little is known about how to engage faith-organizations, especially churches, when using policy, systems, and environmental (PSE) change approaches for prevention. This article documents the PSE changes implemented by engaging 6 faith organizations, with an estimated reach of 3500 members, for 18 months. Timeline (n = 6), focus group (n = 6), report (n = 18), and observational meeting (n = 16) and event (n = 5) summaries were analyzed using content analysis. Early changes were usually environmental changes. Mid and later changes focused on policy and systems change. Churches structured for process and outcome accountability and person-centered accountability can accomplish PSE changes.

  17. Thinking Outside the Box: Policy Strategies for Readiness, Access, and Success. Changing Direction: Integrating Higher Education Financial Aid and Financing Policy

    ERIC Educational Resources Information Center

    Blanco, Cheryl D.; Jones, Dennis P.; Longanecker, David A.; Michelau, Demaree K.

    2007-01-01

    In partnership with the American Council on Education's Center for Policy Analysis, the National Conference of State Legislatures, and the State Higher Education Executive Officers, the Western Interstate Commission for Higher Education (WICHE) has been working to advance the overarching goal of the Changing Direction project, which was to examine…

  18. Assessment of environmental impacts following alternative agricultural policy scenarios.

    PubMed

    Bárlund, I; Lehtonen, H; Tattari, S

    2005-01-01

    Abstract Finnish agriculture is likely to undergo major changes in the near and intermediate future. The ifuture policy context can be examined at a general level by strategic scenario building. Computer-based modelling in combination with agricultural policy scenarios can in turn create a basis for the assessments of changes in environmental quality following possible changes in Finnish agriculture. The analysis of economic consequences is based on the DREMFIA model, which is applied to study effects of various agricultural policies on land use, animal production, and farmers' income. The model is suitable for an impact analysis covering an extended time span--here up to the year 2015. The changes in land use, obtained with the DREMFIA model assuming rational economic behaviour, form the basis when evaluating environmental impacts of different agricultural policies. The environmental impact assessment is performed using the field scale nutrient transport model ICECREAM. The modelled variables are nitrogen and phosphorus losses in surface runoff and percolation. In this paper the modelling strategy will be presented and highlighted using two case study catchments with varying environmental conditions and land use as an example. In addition, the paper identifies issues arising when connecting policy scenarios with impact modelling.

  19. A Multiple Streams analysis of the decisions to fund gender-neutral HPV vaccination in Canada.

    PubMed

    Shapiro, Gilla K; Guichon, Juliet; Prue, Gillian; Perez, Samara; Rosberger, Zeev

    2017-07-01

    In Canada, the human papillomavirus (HPV) vaccine is licensed and recommended for females and males. Although all Canadian jurisdictions fund school-based HPV vaccine programs for girls, only six jurisdictions fund school-based HPV vaccination for boys. The research aimed to analyze the factors that underpin government decisions to fund HPV vaccine for boys using a theoretical policy model, Kingdon's Multiple Streams framework. This approach assesses policy development by examining three concurrent, but independent, streams that guide analysis: Problem Stream, Policy Stream, and Politics Stream. Analysis from the Problem Stream highlights that males are affected by HPV-related diseases and are involved in transmitting HPV infection to their sexual partners. Policy Stream analysis makes clear that while the inclusion of males in HPV vaccine programs is suitable, equitable, and acceptable; there is debate regarding cost-effectiveness. Politics Stream analysis identifies the perspectives of six different stakeholder groups and highlights the contribution of government officials at the provincial and territorial level. Kingdon's Multiple Streams framework helps clarify the opportunities and barriers for HPV vaccine policy change. This analysis identified that the interpretation of cost-effectiveness models and advocacy of stakeholders such as citizen-advocates and HPV-affected politicians have been particularly important in galvanizing policy change. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. I PASS: an interactive policy analysis simulation system.

    Treesearch

    Doug Olson; Con Schallau; Wilbur Maki

    1984-01-01

    This paper describes an interactive policy analysis simulation system(IPASS) that can be used to analyze the long-term economic and demographic effects of alternative forest resource management policies. The IPASS model is a dynamic analytical tool that forecasts growth and development of an economy. It allows the user to introduce changes in selected parameters based...

  1. Policy Space and the Governance of Education: Transnational Influences on Institutions and Identities in the Netherlands and the UK

    ERIC Educational Resources Information Center

    Alexiadou, Nafsika; van de Bunt-Kokhuis, Sylvia

    2013-01-01

    This article presents a comparative analysis of two country-specific cases. The comparative analysis is situated within the broad domain of the changing knowledge economy landscape for educational policy. The two cases examine the transfer, embedding and enactment of policies during the interactions between supranational, national, institutional…

  2. Costing for Policy Analysis.

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers, Washington, DC.

    Cost behavior analysis, a costing process that can assist managers in estimating how certain institutional costs change in response to volume, policy, and environmental factors, is described. The five steps of this approach are examined, and the application of cost behavior analysis at four college-level settings is documented. The institutions…

  3. Efficacy Trade-Offs in Individuals' Support for Climate Change Policies

    ERIC Educational Resources Information Center

    Rosentrater, Lynn D.; Saelensminde, Ingrid; Ekström, Frida; Böhm, Gisela; Bostrom, Ann; Hanss, Daniel; O'Connor, Robert E.

    2013-01-01

    Using survey data, the authors developed an architecture of climate change beliefs in Norway and their correlation with support for policies aimed at reducing greenhouse gas emissions. A strong majority of respondents believe that anthropogenic climate change is occurring and identify carbon dioxide emissions as a cause. Regression analysis shows…

  4. Research in geosciences policy

    NASA Technical Reports Server (NTRS)

    Brunner, Ronald D.

    1992-01-01

    The general task was to look beyond the adverse physical impacts and to defining the policy problem. In order for policy actions to be effective, they must address the right policy problems, which will be different from and broader than the physical problems. We will work on defining the policy problems with a view to indicating how practical solutions might be implemented. In particular, public officials need advice on what should be said, and done, and for what purposes. That advice needs to be based on systematic analysis of: (1) the scholarly literature in the social sciences, and related disciplines; (2) the charging content of the policy debate at the center of attention; and (3) how citizens perceive and understand issues related to global change. We will conduct this analysis. Chapter 1 and 2 each reports work on defining the policy problem and analyzing the scholarly literature. Chapters 3 and 4, respectively, address the policy debate and citizen viewpoints in issues related to global change.

  5. Introduction: Greening the countryside? Changing frameworks of EU agricultural policy.

    PubMed

    Lowe, Philip; Feindt, Peter H; Vihinen, Hilkka

    2010-01-01

    In response to wide-ranging criticism of agricultural policy, especially within Western industrialized countries, new frameworks of justification are emerging and new hybrid policy fields have been established to tackle some of the ‘externalities’ of agricultural support. However, institutional frameworks are proving slower to change, partly because this would require coordinated action across different levels of governance. Nevertheless, previously marginalized environmental concerns have successfully gained entrance to agricultural policy networks, while the intersection of trade liberalization and rural diversification have undermined the dominance of the productivist mindset in government. This gives rise to a plurality of policy actors and actions which defy the conventional categories of analysis of agricultural policy, calling for changing frameworks on the polity of agriculture too.

  6. Bethany Speer | NREL

    Science.gov Websites

    Strategic Energy Analysis Center. Areas of Expertise International economic policy Climate change mitigation Markets Climate change mitigation policies Education M.A. in global finance, trade and economic Keyser, Suzanne Tegen. 2016. Floating Offshore Wind in California: Gross Potential for Jobs and Economic

  7. Policy Coherence and Interplay between Climate Change Adaptation Policies and the Forestry Sector in Nepal.

    PubMed

    Ranabhat, Sunita; Ghate, Rucha; Bhatta, Laxmi Dutt; Agrawal, Nand Kishor; Tankha, Sunil

    2018-06-01

    Least Developed Countries are likely to be hit the hardest by climate change and need focused efforts towards adaptation. Nepal recognizes that it needs to integrate climate change adaptation into various policies, but limited understanding of how to make these policies coherent is among the factors that hinder effective adaptation action. This can lead to wasted resources and lost opportunities. This paper applies concepts from policy coherence for development frameworks and policy content analysis to examine coherence in Nepal's climate and forest policies-and discusses the factors hindering effective implementation. The policies are analyzed at the horizontal/external level at three layers-motivation, measures, and planned implementation process. The paper finds that policies are more consistent on motivation level and adaptation measures, but are less coherent on implementation. The National Adaptation Programme of Action (NAPA) is more explicit in identifying institutions, organizations, roles and responsibilities, resource allocation (financial), and a monitoring and evaluation plan for climate change adaptation while other policies such as Climate Change Policy 2011, National Biodiversity Strategy and Action Plan 2014-2020, Forest Policy 2015, and Forest Sector Strategy 2016 have critical gaps in this area. This paper conclude that formulation of a policy, articulating targets, and mobilizing financial resources are in themselves not sufficient to effectively address climate change adaptation. Policy-based legislation is required, together with development of a supportive collaborative multi-stakeholder approach at different levels of governance, backed up by effective, collaborative monitoring and enforcement.

  8. Policy challenges facing integrated community case management in Sub-Saharan Africa.

    PubMed

    Bennett, Sara; George, Asha; Rodriguez, Daniela; Shearer, Jessica; Diallo, Brahima; Konate, Mamadou; Dalglish, Sarah; Juma, Pamela; Namakhoma, Ireen; Banda, Hastings; Chilundo, Baltazar; Mariano, Alda; Cliff, Julie

    2014-07-01

    To report an in-depth analysis of policy change for integrated community case management of childhood illness (iCCM) in six sub-Saharan African countries. We analysed how iCCM policies developed and the barriers and facilitators to policy change. Qualitative retrospective case studies drawing from document reviews, semi-structured interviews and in-country validation workshops were conducted in Burkina Faso, Kenya, Malawi, Mali, Mozambique and Niger. These countries were selected to maximise variation in iCCM policy status, community health worker (CHW) models and different African regions. Country iCCM policies evolved in an ad hoc fashion, but were substantially influenced by the history of primary health care and the nature of CHW programmes. Technical officers within Ministries of Health led iCCM policy change with support from international donors, but neither communities nor political leadership was mobilised. Concerns about achieving the Millennium Development Goals, together with recognition of the shortcomings of existing child health programmes, led to the adoption of iCCM policies. Availability of external financing played a critical role in facilitating policy change. iCCM policy change has been promoted by international agencies, but national governments have struggled to align iCCM with country health systems. Greater investment is needed in tailoring global policy initiatives to match country needs. High-level, political ownership of iCCM policies could facilitate policy change, as could clearer strategies for ensuring the long-term sustainability of such policies. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  9. Policy challenges facing integrated community case management in Sub-Saharan Africa

    PubMed Central

    Bennett, Sara; George, Asha; Rodriguez, Daniela; Shearer, Jessica; Diallo, Brahima; Konate, Mamadou; Dalglish, Sarah; Juma, Pamela; Namakhoma, Ireen; Banda, Hastings; Chilundo, Baltazar; Mariano, Alda; Cliff, Julie

    2014-01-01

    Objective To report an in-depth analysis of policy change for integrated community case management of childhood illness (iCCM) in six sub-Saharan African countries. We analysed how iCCM policies developed and the barriers and facilitators to policy change. Methods Qualitative retrospective case studies drawing from document reviews, semi-structured interviews and in-country validation workshops were conducted in Burkina Faso, Kenya, Malawi, Mali, Mozambique and Niger. These countries were selected to maximise variation in iCCM policy status, community health worker (CHW) models and different African regions. Results Country iCCM policies evolved in an ad hoc fashion, but were substantially influenced by the history of primary health care and the nature of CHW programmes. Technical officers within Ministries of Health led iCCM policy change with support from international donors, but neither communities nor political leadership was mobilised. Concerns about achieving the Millennium Development Goals, together with recognition of the shortcomings of existing child health programmes, led to the adoption of iCCM policies. Availability of external financing played a critical role in facilitating policy change. Conclusions iCCM policy change has been promoted by international agencies, but national governments have struggled to align iCCM with country health systems. Greater investment is needed in tailoring global policy initiatives to match country needs. High-level, political ownership of iCCM policies could facilitate policy change, as could clearer strategies for ensuring the long-term sustainability of such policies. PMID:24750516

  10. The State of Social Media Policies in Higher Education

    PubMed Central

    Pomerantz, Jeffrey; Hank, Carolyn; Sugimoto, Cassidy R.

    2015-01-01

    This paper presents an analysis of the current state of development of social media policies at institution of higher education. Content analysis of social media policies for all institutions listed in the Carnegie Classification Data File revealed that less than one-quarter of institutions had an accessible social media policy. Analysis was done by institution and campus unit, finding that social media policies were most likely to appear at doctorate-granting institutions and health, athletics, and library units. Policies required that those affiliated with the institution post appropriate content, represent the unit appropriately, and moderate conversations with coworkers and external agencies. This analysis may inform the development and revision of social media policies across the field of higher education, taking into consideration the rapidly changing landscape of social media, issues of academic freedom, and notions of interoperability with policies at the unit and campus levels. PMID:26017549

  11. The state of social media policies in higher education.

    PubMed

    Pomerantz, Jeffrey; Hank, Carolyn; Sugimoto, Cassidy R

    2015-01-01

    This paper presents an analysis of the current state of development of social media policies at institution of higher education. Content analysis of social media policies for all institutions listed in the Carnegie Classification Data File revealed that less than one-quarter of institutions had an accessible social media policy. Analysis was done by institution and campus unit, finding that social media policies were most likely to appear at doctorate-granting institutions and health, athletics, and library units. Policies required that those affiliated with the institution post appropriate content, represent the unit appropriately, and moderate conversations with coworkers and external agencies. This analysis may inform the development and revision of social media policies across the field of higher education, taking into consideration the rapidly changing landscape of social media, issues of academic freedom, and notions of interoperability with policies at the unit and campus levels.

  12. A Policy Analysis of Adult Literacy Education in India: Across the Two National Policy Reviews of 1968 and 1986.

    ERIC Educational Resources Information Center

    Bhola, H. S.

    There have been few, if any, significant changes in educational policy regarding the provision of adult literacy education in India over the past two decades. The changes that have taken place in India's adult literacy programs have occurred in the realm of technology rather than ideology, thereby supporting a continuity in the existing…

  13. Spatial Microsimulation for Rural Policy Analysis in Ireland: The Implications of CAP Reforms for the National Spatial Strategy

    ERIC Educational Resources Information Center

    Ballas, D.; Clarke, G. P.; Wiemers, E.

    2006-01-01

    Microsimulation attempts to describe economic and social events by modelling the behaviour of individual agents. These models have proved useful in evaluating the impact of policy changes at the micro level. Spatial microsimulation models contain geographic information and allow for a regional or local approach to policy analysis. This paper…

  14. Towards an empowerment approach in tuberculosis treatment in Cape Town, South Africa: a qualitative analysis of programmatic change

    PubMed Central

    Atkins, Salla; Lewin, Simon; Ringsberg, Karin C.; Thorson, Anna

    2012-01-01

    Background Tuberculosis rates in the world remain high, especially in low- and middle-income countries. International tuberculosis (TB) policy generally recommends the use of directly observed therapy (DOT) to ensure treatment adherence. Objective This article examines a change in TB treatment support that occurred in 2005 in South Africa, from DOT to the enhanced TB adherence programme (ETA). Design Seven key individuals representing academics, policy makers and service providers involved in the development of the ETA programme or knowledgeable about the issue were purposively sampled and interviewed, and participant observation was conducted at ETA programme steering group meetings. Qualitative content analysis was used to analyse the data, drawing on the Kingdon model of agenda setting. This model suggests that three independent streams – problem, policy and politics – come together at a certain point, often facilitated by policy entrepreneurs, to provide an opportunity for an issue to enter the policy agenda. Results The results suggest the empowerment-oriented programme emerged through the presence of policy entrepreneurs with access to resources. Policy entrepreneurs were influenced by a number of simultaneously occurring challenges including problems within the existing programme; a perceived mismatch between patient needs and the existing TB treatment model; and the TB-HIV co-epidemic. Policy entrepreneurs saw the ART approach as a possible solution to these challenges. Conclusions The Kingdon model contributed to describing the process of policy change. Research evidence seemed to influence this change diffusely, through the interaction of policy entrepreneurs and academics. PMID:22902052

  15. Policy Coherence and Interplay between Climate Change Adaptation Policies and the Forestry Sector in Nepal

    NASA Astrophysics Data System (ADS)

    Ranabhat, Sunita; Ghate, Rucha; Bhatta, Laxmi Dutt; Agrawal, Nand Kishor; Tankha, Sunil

    2018-06-01

    Least Developed Countries are likely to be hit the hardest by climate change and need focused efforts towards adaptation. Nepal recognizes that it needs to integrate climate change adaptation into various policies, but limited understanding of how to make these policies coherent is among the factors that hinder effective adaptation action. This can lead to wasted resources and lost opportunities. This paper applies concepts from policy coherence for development frameworks and policy content analysis to examine coherence in Nepal's climate and forest policies—and discusses the factors hindering effective implementation. The policies are analyzed at the horizontal/external level at three layers—motivation, measures, and planned implementation process. The paper finds that policies are more consistent on motivation level and adaptation measures, but are less coherent on implementation. The National Adaptation Programme of Action (NAPA) is more explicit in identifying institutions, organizations, roles and responsibilities, resource allocation (financial), and a monitoring and evaluation plan for climate change adaptation while other policies such as Climate Change Policy 2011, National Biodiversity Strategy and Action Plan 2014-2020, Forest Policy 2015, and Forest Sector Strategy 2016 have critical gaps in this area. This paper conclude that formulation of a policy, articulating targets, and mobilizing financial resources are in themselves not sufficient to effectively address climate change adaptation. Policy-based legislation is required, together with development of a supportive collaborative multi-stakeholder approach at different levels of governance, backed up by effective, collaborative monitoring and enforcement.

  16. An In-Depth Analysis of Adult Learning Policies and Their Effectiveness in Europe

    ERIC Educational Resources Information Center

    European Union, 2015

    2015-01-01

    Adult learning policies, like any other policies, need to be effective: they need to reach their objectives and attain the desired impacts, which should be carefully defined. Understanding the performance of policies allows policy makers to change and improve them. A growing body of research and statistics provides important insights into how…

  17. Using Evaluation Research as a Means for Policy Analysis in a "New" Mission-Oriented Policy Context

    ERIC Educational Resources Information Center

    Amanatidou, Effie; Cunningham, Paul; Gök, Abdullah; Garefi, Ioanna

    2014-01-01

    Grand challenges stress the importance of multi-disciplinary research, a multi-actor approach in examining the current state of affairs and exploring possible solutions, multi-level governance and policy coordination across geographical boundaries and policy areas, and a policy environment for enabling change both in science and technology and in…

  18. Teacher Change in an Era of Neo-Liberal Policies: A Neoinstitutional Analysis of Teachers' Perceptions of Their Professional Change

    ERIC Educational Resources Information Center

    Ramberg, Magnus Rye

    2014-01-01

    The aim of this article is to explore how neo-institutional theory may be applied as an analytical framework to investigate the relationships between teachers' perceptions on their professional change on the one hand, and the numerous change efforts embedded in recent neo-liberal educational policies in Norway on the other. Based on biographical…

  19. Shaping Policy Change in Population Health: Policy Entrepreneurs, Ideas, and Institutions.

    PubMed

    Béland, Daniel; Katapally, Tarun R

    2018-01-14

    Political realities and institutional structures are often ignored when gathering evidence to influence population health policies. If these policies are to be successful, social science literature on policy change should be integrated into the population health approach. In this contribution, drawing on the work of John W. Kingdon and related scholarship, we set out to examine how key components of the policy change literature could contribute towards the effective development of population health policies. Shaping policy change would require a realignment of the existing school of thought, where the contribution of population health seems to end at knowledge translation. Through our critical analysis of selected literature, we extend recommendations to advance a burgeoning discussion in adopting new approaches to successfully implement evidence-informed population health policies. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  20. Radioactive Reversal? The Fukushima Accident as a Focusing Event for Comparative Policy Change on Nuclear Energy

    NASA Astrophysics Data System (ADS)

    Sanchez, Victoria Justine

    This dissertation project examines the 2011 Fukushima nuclear accident as a focusing event for policy change on nuclear energy. For example, following the accident, Germany (and much of Europe) experienced a reversal of policy on nuclear energy. Conversely, many others such as China, Russia, and France, did not exhibit such a retraction against nuclear power, albeit with public debate about the risks and consequences of accidents. Why has there been dramatic policy change in some cases but not others? The political and literal fallout of Fukushima has provoked a wave of policy change towards nuclear energy at the national level. Through qualitative and quantitative measures, we can view Fukushima as an impetus for comparing the dynamics of nuclear policy change. Quantitatively, this project employs logistic regression to explore variables such as regime type, energy security, trade supply and demand, climate change concerns, and public acceptance are related to policy outcomes and change on nuclear energy in the post-Fukushima context of 49 different countries. Qualitatively, country cases (Russia, Germany, and Canada) are assessed into three categories based on the outcome of policy decisions on nuclear energy following Fukushima for a richer analysis. Beyond the Fukushima example, we can hope to better understand how political focusing events can gain influence in an international context.

  1. Policy-Making Theory as an Analytical Framework in Policy Analysis: Implications for Research Design and Professional Advocacy.

    PubMed

    Sheldon, Michael R

    2016-01-01

    Policy studies are a recent addition to the American Physical Therapy Association's Research Agenda and are critical to our understanding of various federal, state, local, and organizational policies on the provision of physical therapist services across the continuum of care. Policy analyses that help to advance the profession's various policy agendas will require relevant theoretical frameworks to be credible. The purpose of this perspective article is to: (1) demonstrate the use of a policy-making theory as an analytical framework in a policy analysis and (2) discuss how sound policy analysis can assist physical therapists in becoming more effective change agents, policy advocates, and partners with other relevant stakeholder groups. An exploratory study of state agency policy responses to address work-related musculoskeletal disorders is provided as a contemporary example to illustrate key points and to demonstrate the importance of selecting a relevant analytical framework based on the context of the policy issue under investigation. © 2016 American Physical Therapy Association.

  2. Policy entrepreneurship and policy networks in healthcare systems - the case of Israel's pediatric dentistry reform.

    PubMed

    Cohen, Nissim; Horev, Tuvia

    2017-01-01

    Can the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel's dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel. We demonstrate how a policy entrepreneur navigated within a policy network and managed to promote a reform that, until his appearance, no one else in that network had succeeded in enacting. Our goals are advanced through a case study of a reform in pediatric dentistry implemented in Israel in 2010. It rests on textual analyses of the literature, reports, committee minutes, parliamentary proceedings, print and online media, and updates in relevant legislation and case law between 2009 and 2015. In addition, the case study draws on the insights of one of the authors (TH), who played a role in the reform process. Historical circumstances and the Israeli public's longstanding lack of interest in changing the existing model as well as interest groups that preferred the dominance of the private sector in the dental healthcare system kept that area out of the services supplied, universally, under the National Health Insurance Law. This situation changed significantly following the publication in 2007 of a policy analysis that contributed to shifts in the motivations and balance of power within the policy network, which in turn prepared the ground for a policy change. In this environment a determined policy entrepreneur, who identified a window of opportunity, took the lead and instituted an innovative and far-reaching reform. A policy entrepreneur can leverage external factors as well as the previous activities of a policy network that has already matured to create a policy change. Such entrepreneurial activity includes maneuvering around opponents and overcoming resistance from various stakeholders.

  3. The Changing Status of School Sport and Physical Education: Explaining Policy Change

    ERIC Educational Resources Information Center

    Houlihan, Barrie; Green, Mick

    2006-01-01

    This paper examines the changing political salience of school sport and physical education (PE) over the last 15 years. A brief survey of the recent history of school sport and PE based on an analysis of a range of policy documents published by professional bodies and government departments and agencies is followed by a discussion of two…

  4. From Product to Process. The Reform of Doctoral Education in Europe and China

    ERIC Educational Resources Information Center

    Bao, Yanhua; Kehm, Barbara M.; Ma, Yonghong

    2018-01-01

    This contribution is based on an analysis of recent changes in doctoral education that can be observed in Europe and China. It traces the policies having led to these changes and discusses related policy transfer. The contribution is divided into five parts. It begins by sketching recent changes in doctoral education in the framework of the…

  5. Classical linear-control analysis applied to business-cycle dynamics and stability

    NASA Technical Reports Server (NTRS)

    Wingrove, R. C.

    1983-01-01

    Linear control analysis is applied as an aid in understanding the fluctuations of business cycles in the past, and to examine monetary policies that might improve stabilization. The analysis shows how different policies change the frequency and damping of the economic system dynamics, and how they modify the amplitude of the fluctuations that are caused by random disturbances. Examples are used to show how policy feedbacks and policy lags can be incorporated, and how different monetary strategies for stabilization can be analytically compared. Representative numerical results are used to illustrate the main points.

  6. The Role of Health Co-Benefits in the Development of Australian Climate Change Mitigation Policies

    PubMed Central

    Workman, Annabelle; Blashki, Grant; Karoly, David; Wiseman, John

    2016-01-01

    Reducing domestic carbon dioxide and other associated emissions can lead to short-term, localized health benefits. Quantifying and incorporating these health co-benefits into the development of national climate change mitigation policies may facilitate the adoption of stronger policies. There is, however, a dearth of research exploring the role of health co-benefits on the development of such policies. To address this knowledge gap, research was conducted in Australia involving the analysis of several data sources, including interviews carried out with Australian federal government employees directly involved in the development of mitigation policies. The resulting case study determined that, in Australia, health co-benefits play a minimal role in the development of climate change mitigation policies. Several factors influence the extent to which health co-benefits inform the development of mitigation policies. Understanding these factors may help to increase the political utility of future health co-benefits studies. PMID:27657098

  7. Determinants of change in Medicaid pharmaceutical cost sharing: does evidence affect policy?

    PubMed

    Soumerai, S B; Ross-Degnan, D; Fortess, E E; Walser, B L

    1997-01-01

    Since 1980, many Medicaid programs have instituted, adjusted, or abolished pharmaceutical copayments or limitations on the number of prescriptions per patient (caps). Studies indicate that prescription caps can harm patients and increase Medicaid costs. However, because there is little information on how state policy makers select and evaluate such policies, in-depth telephone interviews were conducted with key informants in Medicaid programs that had recently made changes in cost-sharing policies. Among the barriers to evidence-based policy making were lack of political power, skills, and infrastructure; crisis-oriented decisions; compartmentalized budgeting; lack of advocates for disadvantaged patients; and the absence of timely research. Research was applied successfully when the interests of patient advocates and the drug industry were aligned and when Medicaid analysis were able to identify and communicate relevant research to policy makers at the time, or "teachable moment," that policy was being changed.

  8. The Role of Health Co-Benefits in the Development of Australian Climate Change Mitigation Policies.

    PubMed

    Workman, Annabelle; Blashki, Grant; Karoly, David; Wiseman, John

    2016-09-20

    Reducing domestic carbon dioxide and other associated emissions can lead to short-term, localized health benefits. Quantifying and incorporating these health co-benefits into the development of national climate change mitigation policies may facilitate the adoption of stronger policies. There is, however, a dearth of research exploring the role of health co-benefits on the development of such policies. To address this knowledge gap, research was conducted in Australia involving the analysis of several data sources, including interviews carried out with Australian federal government employees directly involved in the development of mitigation policies. The resulting case study determined that, in Australia, health co-benefits play a minimal role in the development of climate change mitigation policies. Several factors influence the extent to which health co-benefits inform the development of mitigation policies. Understanding these factors may help to increase the political utility of future health co-benefits studies.

  9. Realizing the Potential of Ecosystem Services: A Framework for Relating Ecological Changes to Economic Benefits

    EPA Science Inventory

    An analysis framework to link ecological change to economic benefits for multiple stakeholders requires several key components. First, since we aim to support policy decisions, the framework should link a factor that can be controlled or influenced by policy (discharge limit, ca...

  10. A critical analysis of Child and Adolescent Mental Health Services policy in England.

    PubMed

    Callaghan, Jane Em; Fellin, Lisa Chiara; Warner-Gale, Fiona

    2017-01-01

    Policy on Child and Adolescent Mental Health Services (CAMHS) in England has undergone radical changes in the last 15 years, with far reaching implications for funding models, access to services and service delivery. Using corpus analysis and critical discourse analysis, we explore how childhood, mental health and CAMHS are constituted in 15 policy documents, 9 pre-2010 and 6 post-2010. We trace how these constructions have changed over time and consider the practice implications of these changes. We identify how children's distress is individualised, through medicalising discourses and shifting understandings of the relationship between socio-economic context and mental health. This is evidenced in a shift from seeing children's mental health challenges as produced by social and economic inequities to a view that children's mental health must be addressed early to prevent future socio-economic burden. We consider the implications of CAMHS policies for the relationship between children, families, mental health services and the state. The article concludes by exploring how concepts of 'parity of esteem' and 'stigma reduction' may inadvertently exacerbate the individualisation of children's mental health.

  11. Reasons for and challenges of recent increases in teen birth rates: a study of family planning service policies and demographic changes at the state level.

    PubMed

    Yang, Zhou; Gaydos, Laura M

    2010-06-01

    After declining for over a decade, the birth rate in the United States for adolescents aged 15-19 years increased by 3% in 2006 and 1% again in 2007. We examined demographic and policy reasons for this trend at state level. With data merged from multiple sources, descriptive analysis was used to detect state-level trends in birth rate and policy changes from 2000 to 2006, and variations in the distribution of teen birth rates, sex education, and family planning service policies, and demographic features across each state in 2006. Regression analysis was then conducted to estimate the effect of several reproductive health policies and demographic features on teen birth rates at the state level. Instrument variable was used to correct possible bias in the regression analysis. Medicaid family planning waivers were found to reduce teen birth rates across all ages and races. Abstinence-only education programs were found to cause an increase in teen birth rates among white and black teens. The increasing Hispanic population is another driving force for high teen birth rates. Both demographic factors and policy changes contributed to the increase in teen birth rates between 2000 and 2006. Future policy and behavioral interventions should focus on promoting and increasing access to contraceptive use. Family planning policies should be crafted to address the special needs of teens from different cultural backgrounds, especially Hispanics. Copyright 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Language Planning and Policy in a School Site: A Diachronic Analysis

    ERIC Educational Resources Information Center

    Kemp, Shaun

    2017-01-01

    This article engages with diachronic analysis, an analysis of changes over time, as it relates to the field of language planning and policy (LPP) through a case study of a local language problem: the introduction of Chinese language into an established government school over a 10-year period. Using cultural-historical activity theory, expanding…

  13. The inter-section of political history and health policy in Asia--the historical foundations for health policy analysis.

    PubMed

    Grundy, John; Hoban, Elizabeth; Allender, Steve; Annear, Peter

    2014-09-01

    One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own historical pathways. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. An Actor-Network Theory Analysis of Policy Innovation for Smoke-Free Places: Understanding Change in Complex Systems

    PubMed Central

    Borland, Ron; Coghill, Ken

    2010-01-01

    Complex, transnational issues like the tobacco epidemic are major challenges that defy analysis and management by conventional methods, as are other public health issues, such as those associated with global food distribution and climate change. We examined the evolution of indoor smoke-free regulations, a tobacco control policy innovation, and identified the key attributes of those jurisdictions that successfully pursued this innovation and those that to date have not. In doing so, we employed the actor-network theory, a comprehensive framework for the analysis of fundamental system change. Through our analysis, we identified approaches to help overcome some systemic barriers to the solution of the tobacco problem and comment on other complex transnational problems. PMID:20466949

  15. An actor-network theory analysis of policy innovation for smoke-free places: understanding change in complex systems.

    PubMed

    Young, David; Borland, Ron; Coghill, Ken

    2010-07-01

    Complex, transnational issues like the tobacco epidemic are major challenges that defy analysis and management by conventional methods, as are other public health issues, such as those associated with global food distribution and climate change. We examined the evolution of indoor smoke-free regulations, a tobacco control policy innovation, and identified the key attributes of those jurisdictions that successfully pursued this innovation and those that to date have not. In doing so, we employed the actor-network theory, a comprehensive framework for the analysis of fundamental system change. Through our analysis, we identified approaches to help overcome some systemic barriers to the solution of the tobacco problem and comment on other complex transnational problems.

  16. The International Alcohol Control (IAC) study-evaluating the impact of alcohol policies.

    PubMed

    Casswell, Sally; Meier, Petra; MacKintosh, Anne M; Brown, Abraham; Hastings, Gerard; Thamarangsi, Thaksaphon; Chaiyasong, Surasak; Chun, Sungsoo; Huckle, Taisia; Wall, Martin; You, Ru Q

    2012-08-01

    This paper describes a new multicountry collaborative project to assess the impact of alcohol control policy. Longitudinal surveys of drinkers in a number of participating countries and analysis of the policy context allow for the assessment of change over time within countries and comparison between countries. The design of the study is modeled on the International Tobacco Control study and aims to assess the impact of alcohol policies in different cultural contexts on policy-related behaviors and alcohol consumption. A survey instrument and protocol for policy analysis have been developed by the initial participating countries: England, Scotland, Thailand, South Korea, and New Zealand. The first round of data collection is scheduled for 2011-2012. The survey instrument (International Alcohol Control [IAC] survey) measures key policy relevant behaviors: place and time of purchase, amounts purchased and price paid; ease of access to alcohol purchase; alcohol marketing measures; social supply; perceptions of alcohol affordability and availability and salience of price; perceptions of enforcement; people's experiences with specific alcohol restrictions; support for policy and consumption (typical quantity, frequency using beverage and location-specific measures). The Policy Analysis Protocol (PoLAP) assesses relevant aspects of the policy environment including regulation and implementation. It has proved feasible to design instruments to collect detailed data on behaviors relevant to alcohol policy change and to assess the policy environment in different cultural settings. In a policy arena in which the interest groups and stakeholders have different perceptions of appropriate policy responses to alcohol-related harm, a robust methodology to assess the impact of policy will contribute to the debate. Copyright © 2012 by the Research Society on Alcoholism.

  17. A Policy Analysis of Missouri Community College Residence Hall Discipline Policies with an Analysis of Changes in the State Fair Community College Residence Hall Policy

    ERIC Educational Resources Information Center

    Gilgour, Joseph G.

    2012-01-01

    Community colleges in the United States have long been known as institutions of equal opportunity and affordable education. One facet of student life appearing at more and more community colleges is the addition of residence halls. Still, the number of community colleges with on-campus living is relatively small, and for the campuses with…

  18. Framing the ecosystem concept through a longitudinal study of developments in science and policy.

    PubMed

    Aggestam, Filip

    2015-08-01

    This paper examines how scientific literature and policy documents frame the ecosystem concept and how these frames have shaped scientific dialogue and policy making over time. This was achieved by developing a frame typology, as a basis for organizing relevant value expressions, to assess how different frames have altered perspectives of the ecosystem concept. The frame typology and analysis is based on a semi-grounded and longitudinal document analysis of scientific literature and policy documents using the ecosystem concept. Despite changing discourses and public priorities (e.g., cultural constructs of biodiversity) both science and policy documents are characterized by stable value systems that have not changed substantially since the 1930s. These value systems were defined based on ethical principles that delineate 6 core frames: humans first, dual systems, eco-science, eco-holism, animals first, and multicentrism. Specific crises (e.g., climate change) and cross-disciplinary uptake and re-uptake of, for example, the ecosystem services concept, have brought new perspectives to the forefront of public discourse. These developments triggered changes in the core frames that, rather than being value based, are based on how the ecosystem is conceptualized under fixed value systems and over time. Fourteen subframes were developed to reflect these longitudinal changes. There are as such clear framing effects in both scientific literature and in policy. Ecosystem research is for instance often characterized by unstated value judgments even though the scientific community does not make these explicit. In contrast, policy documents are characterized by clear value expressions but are principally management driven and human centered. © 2015 Society for Conservation Biology.

  19. Does research through Structured Operational Research and Training (SORT IT) courses impact policy and practice?

    PubMed Central

    Shewade, H. D.; Tripathy, J. P.; Guillerm, N.; Tayler-Smith, K.; Berger, S. Dar; Bissell, K.; Reid, A. J.; Zachariah, R.; Harries, A. D.

    2016-01-01

    Setting: Structured Operational Research and Training Initiative (SORT IT) courses are well known for their output, with nearly 90% of participants completing the course and publishing in scientific journals. Objective: We assessed the impact of research papers on policy and practice that resulted from six SORT IT courses initiated between July 2012 and March 2013. Design: This was a cross-sectional study involving e-mail-based, self-administered questionnaires and telephone/skype/in-person responses from first and/or senior co-authors of course papers. A descriptive content analysis of the responses was performed and categorised into themes. Results: Of 72 participants, 63 (88%) completed the course. Course output included 81 submitted papers, of which 76 (94%) were published. Of the 81 papers assessed, 45 (55%) contributed to a change in policy and/or practice: 29 contributed to government policy/practice change (20 at national, 4 at subnational and 5 at hospital level), 11 to non-government organisational policy change and 5 to reinforcing existing policy. The changes ranged from modifications of monitoring and evaluation tools, to redrafting of national guidelines, to scaling up existing policies. Conclusion: More than half of the SORT IT course papers contributed to a change in policy and/or practice. Future assessments should include more robust and independent verification of the reported change(s) with all stakeholders. PMID:27051612

  20. Multiple Adaptation Types with Mitigation: A Framework for Policy Analysis

    EPA Science Inventory

    Effective climate policy will consist of mitigation and adaptation implemented simultaneously in a policy portfolio to reduce the risks of climate change. The relative share of these responses will vary over time and will be adjusted in response to new information. Furthermore,...

  1. Anticipating cascading change in land use: Exploring the implications of a major trend in US northern forests

    Treesearch

    David N. Bengston; Michael J. Dockry; Stephen R. Shifley

    2018-01-01

    Land managers, planners, and policy makers need to proactively consider the potential effects of change in order to prepare for it. But the direct consequences of social and ecological change are often not thoroughly identified and explored in policy analysis, and possible higher-order implications are rarely considered. This study used a structured group process...

  2. Locations of Racism in Education: A Speech Act Analysis of a Policy Chain

    ERIC Educational Resources Information Center

    Arneback, Emma; Quennerstedt, Ann

    2016-01-01

    This article explores how racism is located in an educational policy chain and identifies how its interpretation changes throughout the chain. A basic assumption is that the policy formation process can be seen as a chain in which international, national and local policies are "links"--separate entities yet joined. With Sweden as the…

  3. Neo-Democracy in Educational Policy-Making: A Critical Case Study of Neoliberal Reform in Massachusetts

    ERIC Educational Resources Information Center

    Piazza, Peter

    2017-01-01

    This paper explores changes to the educational policy-making arena through case study analysis of a Massachusetts law passed in 2012 that limits seniority-based job protections for public K-12 teachers. I use data from interviews with policy stakeholders, observations of public meetings, and policy artifacts to explore struggles over democratic…

  4. The nursing profession in Sri Lanka: time for policy changes.

    PubMed

    Aluwihare-Samaranayake, D; Ogilvie, L; Cummings, G G; Gellatly, Ian R

    2017-09-01

    We address issues and challenges in nursing in Sri Lanka with the aim of identifying where and how policy changes need to be made. Increased global interconnectivity calls for professional leadership, research, education, and policy reform in nursing as these are identified as enhancing health workforce performance and professionalization, thereby improving health systems. We draw on first-hand knowledge of health care and nursing in Sri Lanka and a recent survey of nurses at a large urban government hospital in Sri Lanka, followed by discussion and proposed action on themes identified through analysis of published and unpublished literature about the nursing profession. Policy and action are needed to: (a) establish mandatory nurse licensure in the public and private healthcare sectors; (b) implement realistic policies to further develop nursing education; (c) develop a professionalization process to support nursing autonomy and voice; and (d) promote systematic processes for educational accreditation, curriculum revision, continuing professional development, evidence-based practice, research, leadership, and information systems. There is a policy vacuum that requires careful analysis and strategic planning by formal nurse leaders. Implementing change will require political and professional power and strategic, innovative, and evolutionary policy initiatives as well as organizational infrastructure modifications best achieved through committed multidisciplinary collaboration, augmented research capacity, bolstered nursing leadership, and promotion of partnerships with policy makers. © 2017 International Council of Nurses.

  5. Community Health Workers Promote Civic Engagement and Organizational Capacity to Impact Policy.

    PubMed

    Sabo, Samantha; Flores, Melissa; Wennerstrom, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia

    2017-12-01

    Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.

  6. Measuring the progress of capacity building in the Alberta Policy Coalition for Cancer Prevention.

    PubMed

    Raine, Kim D; Sosa Hernandez, Cristabel; Nykiforuk, Candace I J; Reed, Shandy; Montemurro, Genevieve; Lytvyak, Ellina; MacLellan-Wright, Mary-Frances

    2014-07-01

    The Alberta Policy Coalition for Cancer Prevention (APCCP) represents practitioners, policy makers, researchers, and community organizations working together to coordinate efforts and advocate for policy change to reduce chronic diseases. The aim of this research was to capture changes in the APCCP's capacity to advance its goals over the course of its operation. We adapted the Public Health Agency of Canada's validated Community Capacity-Building Tool to capture policy work. All members of the APCCP were invited to complete the tool in 2010 and 2011. Responses were analyzed using descriptive statistics and t tests. Qualitative comments were analyzed using thematic content analysis. A group process for reaching consensus provided context to the survey responses and contributed to a participatory analysis. Significant improvement was observed in eight out of nine capacity domains. Lessons learned highlight the importance of balancing volume and diversity of intersectoral representation to ensure effective participation, as well as aligning professional and economic resources. Defining involvement and roles within a coalition can be a challenging activity contingent on the interests of each sector represented. The participatory analysis enabled the group to reflect on progress made and future directions for policy advocacy. © 2013 Society for Public Health Education.

  7. Implementation strategies to promote community-engaged efforts to counter tobacco marketing at the point of sale.

    PubMed

    Leeman, Jennifer; Myers, Allison; Grant, Jennifer C; Wangen, Mary; Queen, Tara L

    2017-09-01

    The US tobacco industry spends $8.2 billion annually on marketing at the point of sale (POS), a practice known to increase tobacco use. Evidence-based policy interventions (EBPIs) are available to reduce exposure to POS marketing, and nationwide, states are funding community-based tobacco control partnerships to promote local enactment of these EBPIs. Little is known, however, about what implementation strategies best support community partnerships' success enacting EBPI. Guided by Kingdon's theory of policy change, Counter Tools provides tools, training, and other implementation strategies to support community partnerships' performance of five core policy change processes: document local problem, formulate policy solutions, engage partners, raise awareness of problems and solutions, and persuade decision makers to enact new policy. We assessed Counter Tools' impact at 1 year on (1) partnership coordinators' self-efficacy, (2) partnerships' performance of core policy change processes, (3) community progress toward EBPI enactment, and (4) salient contextual factors. Counter Tools provided implementation strategies to 30 partnerships. Data on self-efficacy were collected using a pre-post survey. Structured interviews assessed performance of core policy change processes. Data also were collected on progress toward EBPI enactment and contextual factors. Analysis included descriptive and bivariate statistics and content analysis. Following 1-year exposure to implementation strategies, coordinators' self-efficacy increased significantly. Partnerships completed the greatest proportion of activities within the "engage partners" and "document local problem" core processes. Communities made only limited progress toward policy enactment. Findings can inform delivery of implementation strategies and tests of their effects on community-level efforts to enact EBPIs.

  8. Adaptation strategies to climate change in the Arctic: a global patchwork of reactive community-scale initiatives

    NASA Astrophysics Data System (ADS)

    Loboda, Tatiana V.

    2014-11-01

    Arctic regions have experienced and will continue to experience the greatest rates of warming compared to any other region of the world. The people living in the Arctic are considered among most vulnerable to the impacts of environmental change ranging from decline in natural resources to increasing mental health concerns (IPCC 2014 Climate Change 2014: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change (Cambridge: Cambridge University Press)). A meta-analysis study by Ford et al (2014 Environ. Res. Lett. 9 104005) has assessed the volume, scope and geographic distribution of reported in the English language peer-reviewed literature initiatives for adaptation to climate change in the Arctic. Their analysis highlights the reactive nature of the adopted policies with a strong emphasis on local and community-level policies mostly targeting indigenous population in Canada and Alaska. The study raises concerns about the lack of monitoring and evaluation mechanism to track the success rate of the existing policies and the need for long-term strategic planning in adaption policies spanning international boundaries and including all groups of population.

  9. A frame-critical policy analysis of Canada's response to the World Food Summit 1998-2008.

    PubMed

    Mah, Catherine L; Hamill, Catherine; Rondeau, Krista; McIntyre, Lynn

    2014-01-01

    The 2012 visit to Canada of Olivier De Schutter, the United Nations Special Rapporteur on the Right to Food, led to a public rebuff by Canadian governmental officials. This paper adapts the frame-critical policy analysis of Schön and Rein (1994), to explore the rhetorical basis for this conflict. This examination is offered as an illustrative example of how food insecurity is framed as a public policy problem in a high-income nation and how this framing has changed over time. We analyze Canada's decade of sequential responses to the 1996 World Food Summit, spanning 1998-2008, in the form of Canada's Action Plan on Food Security, and its subsequent Progress Reports. We conducted a qualitative policy analysis, adapting the frame-critical approach first delineated by Schön and Rein (1994). This analysis uses a social constructionist approach to map out the relationships between tacit understanding of policy by particular actors, explicit rhetoric in the public domain, and action in this policy area over time. We identify three key ways in which competing rhetorical frames arise over time: frame shifts (e.g., a shift away from language highlighting the right to food and health); frame blending (e.g., discussion about poverty becomes obscured by complexity discourse); and within-frame incongruence (e.g., monitoring for health indicators that are unrelated to policy solutions). Together, these frames illustrate how the conflict embodied in the UN Special Rapporteur's visit has been deeply woven into the policy discourse on food insecurity in Canada over time. Frame-critical analysis is instructive for exposing and also predicting tensions that impede forward progress on difficult policy issues. Accordingly, such analyses may be helpful in not only dissecting how policy can become 'stuck' in the process of change but in active reframing towards new policy solutions.

  10. Effects of Conservation Policies on Forest Cover Change in Giant Panda Habitat Regions, China

    PubMed Central

    Li, Yu; Viña, Andrés; Yang, Wu; Chen, Xiaodong; Zhang, Jindong; Ouyang, Zhiyun; Liang, Zai; Liu, Jianguo

    2014-01-01

    After long periods of deforestation, forest transition has occurred globally, but the causes of forest transition in different countries are highly variable. Conservation policies may play important roles in facilitating forest transition around the world, including China. To restore forests and protect the remaining natural forests, the Chinese government initiated two nationwide conservation policies in the late 1990s -- the Natural Forest Conservation Program (NFCP) and the Grain-To-Green Program (GTGP). While some studies have discussed the environmental and socioeconomic effects of each of these policies independently and others have attributed forest recovery to both policies without rigorous and quantitative analysis, it is necessary to rigorously quantify the outcomes of these two conservation policies simultaneously because the two policies have been implemented at the same time. To fill the knowledge gap, this study quantitatively evaluated the effects of the two conservation policies on forest cover change between 2001 and 2008 in 108 townships located in two important giant panda habitat regions -- the Qinling Mountains region in Shaanxi Province and the Sichuan Giant Panda Sanctuary in Sichuan Province. Forest cover change was evaluated using a land-cover product (MCD12Q1) derived from the Moderate Resolution Imaging Spectroradiometer (MODIS). This product proved to be highly accurate in the study region (overall accuracy was ca. 87%, using 425 ground truth points collected in the field), thus suitable for the forest change analysis performed. Results showed that within the timeframe evaluated, most townships in both regions exhibited either increases or no changes in forest cover. After accounting for a variety of socioeconomic and biophysical attributes, an Ordinary Least Square (OLS) regression model suggests that the two policies had statistically significant positive effects on forest cover change after seven years of implementation, while population density, percent agricultural population, road density, and initial forest cover (i.e. in 2001) had significant negative effects. The methods and results from this study will be useful for continuing the implementation of these conservation policies, for the development of future giant panda habitat conservation projects, and for achieving forest sustainability in China and elsewhere. PMID:26146431

  11. Effects of Conservation Policies on Forest Cover Change in Giant Panda Habitat Regions, China.

    PubMed

    Li, Yu; Viña, Andrés; Yang, Wu; Chen, Xiaodong; Zhang, Jindong; Ouyang, Zhiyun; Liang, Zai; Liu, Jianguo

    2013-07-01

    After long periods of deforestation, forest transition has occurred globally, but the causes of forest transition in different countries are highly variable. Conservation policies may play important roles in facilitating forest transition around the world, including China. To restore forests and protect the remaining natural forests, the Chinese government initiated two nationwide conservation policies in the late 1990s -- the Natural Forest Conservation Program (NFCP) and the Grain-To-Green Program (GTGP). While some studies have discussed the environmental and socioeconomic effects of each of these policies independently and others have attributed forest recovery to both policies without rigorous and quantitative analysis, it is necessary to rigorously quantify the outcomes of these two conservation policies simultaneously because the two policies have been implemented at the same time. To fill the knowledge gap, this study quantitatively evaluated the effects of the two conservation policies on forest cover change between 2001 and 2008 in 108 townships located in two important giant panda habitat regions -- the Qinling Mountains region in Shaanxi Province and the Sichuan Giant Panda Sanctuary in Sichuan Province. Forest cover change was evaluated using a land-cover product (MCD12Q1) derived from the Moderate Resolution Imaging Spectroradiometer (MODIS). This product proved to be highly accurate in the study region (overall accuracy was ca. 87%, using 425 ground truth points collected in the field), thus suitable for the forest change analysis performed. Results showed that within the timeframe evaluated, most townships in both regions exhibited either increases or no changes in forest cover. After accounting for a variety of socioeconomic and biophysical attributes, an Ordinary Least Square (OLS) regression model suggests that the two policies had statistically significant positive effects on forest cover change after seven years of implementation, while population density, percent agricultural population, road density, and initial forest cover (i.e. in 2001) had significant negative effects. The methods and results from this study will be useful for continuing the implementation of these conservation policies, for the development of future giant panda habitat conservation projects, and for achieving forest sustainability in China and elsewhere.

  12. Adapting to Uncertainty: Comparing Methodological Approaches to Climate Adaptation and Mitigation Policy

    NASA Astrophysics Data System (ADS)

    Huda, J.; Kauneckis, D. L.

    2013-12-01

    Climate change adaptation represents a number of unique policy-making challenges. Foremost among these is dealing with the range of future climate impacts to a wide scope of inter-related natural systems, their interaction with social and economic systems, and uncertainty resulting from the variety of downscaled climate model scenarios and climate science projections. These cascades of uncertainty have led to a number of new approaches as well as a reexamination of traditional methods for evaluating risk and uncertainty in policy-making. Policy makers are required to make decisions and formulate policy irrespective of the level of uncertainty involved and while a debate continues regarding the level of scientific certainty required in order to make a decision, incremental change in the climate policy continues at multiple governance levels. This project conducts a comparative analysis of the range of methodological approaches that are evolving to address uncertainty in climate change policy. It defines 'methodologies' to include a variety of quantitative and qualitative approaches involving both top-down and bottom-up policy processes that attempt to enable policymakers to synthesize climate information into the policy process. The analysis examines methodological approaches to decision-making in climate policy based on criteria such as sources of policy choice information, sectors to which the methodology has been applied, sources from which climate projections were derived, quantitative and qualitative methods used to deal with uncertainty, and the benefits and limitations of each. A typology is developed to better categorize the variety of approaches and methods, examine the scope of policy activities they are best suited for, and highlight areas for future research and development.

  13. Sustainability and power in health promotion: community-based participatory research in a reproductive health policy case study in New Mexico.

    PubMed

    Mendes, Rosilda; Plaza, Veronica; Wallerstein, Nina

    2016-03-01

    Health promotion programs are commonly viewed as value-free initiatives which seek to improve health, often through behavior change. An opposing view has begun to emerge that health promotion efforts, especially ones seeking to impact health policy and social determinants of health, are vulnerable to political contexts and may depend on who is in power at the time. This community-based participatory research study attempts to understand these interactions by applying a conceptual model focused on the power context, diverse stakeholder roles within this context, and the relationship of political levers and other change strategies to the sustainability of health promotion interventions aimed at health policy change. We present a case study of a health promotion coalition, New Mexico for Responsible Sex Education (NMRSE), as an example of power dynamics and change processes. Formed in 2005 in response to federal policies mandating abstinence-only education, NMRSE includes community activists, health promotion staff from the New Mexico Department of Health, and policy-maker allies. Applying an adapted Mayer's 'power analysis' instrument, we conducted semi-structured stakeholder interviews and triangulated political-context analyses from the perspective of the stakeholders.We identified multiple understandings of sustainability and health promotion policy change, including: the importance of diverse stakeholders working together in coalition and social networks; their distinct positions of power within their political contexts; the role of science versus advocacy in change processes; the particular challenges for public sector health promotion professionals; and other facilitators versus barriers to action. One problem that emerged consisted of the challenges for state employees to engage in health promotion advocacy due to limitations imposed on their activities by state and federal policies. This investigation's results include a refined conceptual model, a power-analysis instrument, and new understandings of the intersection of power and stakeholder strategies in the sustainability of health promotion and health in all policies. © The Author(s) 2014.

  14. Changing Tertiary Education in Modern European Society.

    ERIC Educational Resources Information Center

    Council for Cultural Cooperation, Strasbourg (France).

    Reports on recent developments and problems in the diversification of tertiary education in seven Western European countries are presented by members of the Working Party on the Diversification of Tertiary Education. Policy analysis and evaluation and recommendations for future policy are also provided. As a policy, diversification refers to the…

  15. Educational Quality, Outcomes Assessment, and Policy Change: The Virginia Example

    ERIC Educational Resources Information Center

    Culver, Steve

    2010-01-01

    The higher education system in the Commonwealth of Virginia in the United States provides a case model for how discussions regarding educational quality and assessment of that quality have affected institutions' policy decisions and implementation. Using Levin's (1998) policy analysis framework, this essay explores how assessment of student…

  16. Energy loss, range, and bremsstrahlung yield for 10-keV to 100-MeV electrons in various elements and chemical compounds

    NASA Astrophysics Data System (ADS)

    Pages, Lucien; Bertel, Evelyne; Joffre, Henri; Sklavenitis, Laodamas

    2012-12-01

    Even though the United States lacks a national climate policy, significant action has occurred at the local and regional levels. Some of the most aggressive climate change policies have occurred at the state and local levels and in interagency cooperation on specific management issues. While there is a long history of partnerships in dealing with a wide variety of policy issues, the uncertainty and the political debate surrounding climate change has generated new challenges to establishing effective policy networks. This paper investigates the formation of climate policy networks in the State of Nevada. It presents a methodology based on social network analysis for assessing the structure and function of local policy networks across a range of substantive climate impacted resources (water, landscape management, conservation, forestry and others). It draws from an emerging literature on federalism and climate policy, public sector innovation, and institutional analysis in socio-ecological systems. Comparisons across different policy issue networks in the state are used to highlight the influence of network structure, connectivity, bridging across vertical and horizontal organizational units, organizational diversity, and flows between organizational nodes.

  17. What about Us? Economic and Policy Changes Affecting Rural HIV/AIDS Services and Care.

    PubMed

    Albritton, Tashuna; Martinez, Isabel; Gibson, Crystal; Angley, Meghan; Grandelski, Valen R

    2017-01-01

    Health care budgets and policies are chief drivers in the delivery and access to health services. Place is also a factor that affects patient and provider experiences within the health care system. We examine the impact of policy changes and subsequent budget cuts on rural HIV/AIDS care, support services, and prevention. We interviewed 11 social workers, case managers, and outreach workers who serve rural people living with HIV/AIDS. We conducted telephone interviews inquiring about the effect of economics and policies on direct practice with rural clients. We analyzed data using a content analysis approach. We found several themes from the data. Ryan White funding and policy changes shifted direct practice to a medical case management model. Changes in federal and state poverty levels affected client eligibility for the AIDS Drugs Assistance Program. Policy banning financial support for syringe service programs hindered prevention efforts to reduce HIV/AIDS transmission. Ancillary services were reduced, such as housing assistance, transportation, and emergency financial assistance. In conclusion, we highlight the importance of place-based policies to improve access to healthcare and services. We also provide recommendations for greater inclusion in HIV/AIDS-related policy development, care, and service planning for rural workers.

  18. Media advocacy, tobacco control policy change and teen smoking in Florida

    PubMed Central

    Niederdeppe, Jeff; Farrelly, Matthew C; Wenter, Dana

    2007-01-01

    Objective To assess whether media advocacy activities implemented by the Florida Tobacco Control Program contributed to increased news coverage, policy changes and reductions in youth smoking. Methods A content analysis of news coverage appearing in Florida newspapers between 22 April 1998 and 31 December 2001 was conducted, and patterns of coverage before and after the implementation of media advocacy efforts to promote tobacco product placement ordinances were compared. Event history analysis was used to assess whether news coverage increased the probability of enacting these ordinances in 23 of 67 Florida counties and ordinary least square (OLS) regression was used to gauge the effect of these policies on changes in youth smoking prevalence. Results The volume of programme‐related news coverage decreased after the onset of media advocacy efforts, but the ratio of coverage about Students Working Against Tobacco (the Florida Tobacco Control Program's youth advocacy organisation) relative to other topics increased. News coverage contributed to the passage of tobacco product placement ordinances in Florida counties, but these ordinances did not lead to reduced youth smoking. Conclusion This study adds to the growing literature supporting the use of media advocacy as a tool to change health‐related policies. However, results suggest caution in choosing policy goals that may or may not influence health behaviour. PMID:17297073

  19. Funding Formula and the Fiscal Provisions for Part B: A Policy Analysis.

    ERIC Educational Resources Information Center

    Tschantz, Jennifer

    This policy analysis examines how states are implementing the substantially changed requirements relating to the distribution of federal IDEA (Individuals with Disabilities Education Act) Part B funds (Sections 611 and 619) as set forth in regulations issued in 1999. Interviews were conducted with nine state education agencies (SEAs) on the effect…

  20. Testing Peer Effects among College Students: Evidence from an Unusual Admission Policy Change in China

    ERIC Educational Resources Information Center

    Lu, Fangwen

    2014-01-01

    This paper studies a natural experiment due to an unusual change in the college admission policy at a Chinese university, which brought a large number of low-score students into several academic departments in the university. Exploiting large variations in peer characteristics and strong interactions among peer groups, the analysis finds that…

  1. Bachelor's Degree Productivity X-Inefficiency: The Role of State Higher Education Policy

    ERIC Educational Resources Information Center

    Titus, Marvin A.

    2010-01-01

    Using stochastic frontier analysis and dynamic fixed-effects panel modeling, this study examines how changes in the x-inefficiency of bachelor's degree production are influenced by changes in state higher education policy. The findings from this research show that increases in need-based state financial aid help to mitigate the convergence among…

  2. Advances in risk assessment for climate change adaptation policy.

    PubMed

    Adger, W Neil; Brown, Iain; Surminski, Swenja

    2018-06-13

    Climate change risk assessment involves formal analysis of the consequences, likelihoods and responses to the impacts of climate change and the options for addressing these under societal constraints. Conventional approaches to risk assessment are challenged by the significant temporal and spatial dynamics of climate change; by the amplification of risks through societal preferences and values; and through the interaction of multiple risk factors. This paper introduces the theme issue by reviewing the current practice and frontiers of climate change risk assessment, with specific emphasis on the development of adaptation policy that aims to manage those risks. These frontiers include integrated assessments, dealing with climate risks across borders and scales, addressing systemic risks, and innovative co-production methods to prioritize solutions to climate challenges with decision-makers. By reviewing recent developments in the use of large-scale risk assessment for adaptation policy-making, we suggest a forward-looking research agenda to meet ongoing strategic policy requirements in local, national and international contexts.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Author(s).

  3. Advances in risk assessment for climate change adaptation policy

    NASA Astrophysics Data System (ADS)

    Adger, W. Neil; Brown, Iain; Surminski, Swenja

    2018-06-01

    Climate change risk assessment involves formal analysis of the consequences, likelihoods and responses to the impacts of climate change and the options for addressing these under societal constraints. Conventional approaches to risk assessment are challenged by the significant temporal and spatial dynamics of climate change; by the amplification of risks through societal preferences and values; and through the interaction of multiple risk factors. This paper introduces the theme issue by reviewing the current practice and frontiers of climate change risk assessment, with specific emphasis on the development of adaptation policy that aims to manage those risks. These frontiers include integrated assessments, dealing with climate risks across borders and scales, addressing systemic risks, and innovative co-production methods to prioritize solutions to climate challenges with decision-makers. By reviewing recent developments in the use of large-scale risk assessment for adaptation policy-making, we suggest a forward-looking research agenda to meet ongoing strategic policy requirements in local, national and international contexts. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  4. 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.

    PubMed

    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 identify neglected aspects in current policy, and to develop interventions based on recommendations, thus helping to increase the impact of policy papers.

  5. Climate Change: Integrating Science and Economics

    NASA Astrophysics Data System (ADS)

    Prinn, R. G.

    2008-12-01

    The world is facing an ever-growing conflict between environment and development. Climate change is a century-scale threat requiring a century-long effort in science, technology and policy analysis, and institutions that can sustain this effort over generations. To inform policy development and implementation there is urgent need for better integration of the diverse components of the problem. Motivated by this challenge, we have developed the Integrated Global System Model (IGSM) at MIT. It comprises coupled sub- models of economic development, atmospheric chemistry, climate dynamics and ecosystems. The results of a recent uncertainty analysis involving hundreds of runs of the IGSM imply that, without mitigation policies, the global average surface temperature may rise much faster than previously estimated. Polar temperatures are projected to rise even faster than the average rate with obvious great risks for high latitude ecosystems and ice sheets at the high end of this range. Analysis of policies for climate mitigation, show that the greatest effect of these policies is to lower the probability of extreme changes as opposed to lowering the medians. Faced with the above estimated impacts, the long lifetimes of most greenhouse gases in the atmosphere, the long delay in ultimate warming due to ocean heat uptake, and the capital-intensive global energy infrastructure, the case is strong for concerted action now. Results of runs of the IGSM indicate the need for transformation of the global energy industry on a very large scale to mitigate climate change. Carbon sequestration, renewable energy sources, and nuclear present new economic, technological, and environmental challenges when implemented at the needed scales. Economic analyses using the IGSM indicate that global implementation of efficient policies could allow the needed transformations at bearable costs.

  6. International Experiences with Quantifying the Co-Benefits of Energy-Efficiency and Greenhouse-Gas Mitigation Programs and Policies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Williams, Christopher; Hasanbeigi, Ali; Price, Lynn

    Improving the efficiency of energy production and consumption and switching to lower carbon energy sources can significantly decrease carbon dioxide (CO2) emissions and reduce climate change impacts. A growing body of research has found that these measures can also directly mitigate many non-climate change related human health hazards and environmental damage. Positive impacts of policies and programs that occur in addition to the intended primary policy goal are called co-benefits. Policy analysis relies on forecasting and comparing the costs of policy and program implementation and the benefits that accrue to society from implementation. GHG reduction and energy efficiency policies andmore » programs face political resistance in part because of the difficulty of quantifying their benefits. On the one hand, climate change mitigation policy benefits are often global, long-term, and subject to large uncertainties, and subsidized energy pricing can reduce the direct monetary benefits of energy efficiency policies to below their cost. On the other hand, the co-benefits that accrue from these efforts’ resultant reductions in conventional air pollution (such as improved health, agricultural productivity, reduced damage to infrastructure, and local ecosystem improvements) are generally near term, local, and more certain than climate change mitigation benefits and larger than the monetary value of energy savings. The incorporation of co-benefits into energy efficiency and climate mitigation policy and program analysis therefore might significantly increase the uptake of these policies. Faster policy uptake is especially important in developing countries because ongoing development efforts that do not consider co-benefits may lock in suboptimal technologies and infrastructure and result in high costs in future years. Over the past two decades, studies have repeatedly documented that non-climate change related benefits of energy efficiency and fuel conversion efforts, as a part of GHG mitigation strategies, can be from between 30% to over 100% of the costs of such policies and programs strategies. Policy makers around the world are increasingly interested in including both GHG and non-GHG impacts in analyses of energy efficiency and fuel switching policies and programs and a set of methodologies has matured from the efforts of early moving jurisdictions such as the European Union, the United States, and Japan.« less

  7. The changing economic structure of the maritime industry and its adverse effects on seafarers' health care rights.

    PubMed

    Guillot-Wright, Shannon

    2017-01-01

    This review seeks to understand whether and how seafarers can exercise their human right to health care and the factors that facilitate or impede that exercise. The general focus is on a critical policy analysis of labour policies from the mid-twentieth century through today, with a specific focus on how Filipino seafarers access their health care rights. The methodology includes a critical policy analysis of seafaring, focusing on mid-twentieth century political shifts in the recognition and regulation of health care rights. The analysis of international and United States policy provides the backbone for understanding the health care experiences of seafarers by laying the ideological, theoretical, and political foundations of labour rights and precarious employment. Policy analysis shows that there are numerous laws, regulations, and human rights norms that have been established to protect seafarers, but uncertain and limited recourse to lay claim to such laws, regulations, and norms while at sea. Lack of recourse to policies and regulations, taken together with the changed conditions of labour and worker protections through technology and neoliberal policies, create the conditions that may increase the health inequity among seafarers'. Health policy discussions in the United States and internationally must not solely focus on the health of seafarers as an interruption to travel and trade, but policy makers should consider that their decisions may contribute to how seafarers can exercise their rights to health care. In this context, health is more than disease and access to care - economic and governance structures come to not only matter, but play an integral role in the facilitation or impediment of health care and to the health arrangements/conditions of workers.

  8. The impact of drug policy liberalisation on willingness to seek help for problem drug use: A comparison of 20 countries.

    PubMed

    Benfer, Isabella; Zahnow, Renee; Barratt, Monica J; Maier, Larissa; Winstock, Adam; Ferris, Jason

    2018-06-01

    While the impact of changing drug policies on rates of drug use has been investigated, research into how help-seeking behaviour changes as drug policies become more public-health focused is limited. This paper investigates reported changes in confidence to utilise drug services following hypothetical changes in national drug policy among a sample of individuals who report recent illicit drug use. We predict that liberalising national drug policy will increase the propensity for people who take illegal drugs to utilise health services. The data were drawn from a sample of self-reported responses to the 2014 Global Drug Survey. Respondents were asked if they would be more confident seeking help if each of the following policy changes were made in their country; a) drugs were legalised; b) penalties for possession of small amounts of drugs were reduced to a fine only; c) drugs were legally available through governments outlets. Multiple correspondence analysis and multinomial logistic regression with post-estimation linear hypothesis testing were conducted. Individuals residing in countries with relatively liberal drug policy regimes report their help-seeking behaviour is unlikely to change given the hypothetical policy amendments. Individuals from countries with prohibition-based drug policies reported a far greater propensity for changing their help-seeking behaviour in the event of hypothetical policy amendments, citing reduced fear of criminal sanctions as the major reason. Age and sex differences were also found. The current study demonstrates the capacity for national drug policy reform to influence drug use risk by facilitating or impeding health service engagement among individuals who use illicit substances. We suggest national drug policy requires careful consideration of both prevention goals and the needs of individuals already engaged in illicit substance use; more liberal drug policies may actually encourage the adoption of harm reduction strategies such as health service engagement. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Health policy in times of austerity-A conceptual framework for evaluating effects of policy on efficiency and equity illustrated with examples from Europe since 2008.

    PubMed

    Wenzl, Martin; Naci, Huseyin; Mossialos, Elias

    2017-09-01

    The objective of this paper is to provide a framework for evaluation of changes in health policy against overarching health system goals. We propose a categorisation of policies into seven distinct health system domains. We then develop existing analytical concepts of insurance coverage and cost-effectiveness further to evaluate the effects of policies in each domain on equity and efficiency. The framework is illustrated with likely effects of policy changes implemented in a sample of European countries since 2008. Our illustrative analysis suggests that cost containment has been the main focus and that countries have implemented a mix of measures that are efficient or efficiency neutral. Similarly, policies are likely to have mixed effects on equity. Additional user charges were a common theme but these were frequently accompanied by additional exemptions, making their likely effects on equity difficult to evaluate. We provide a framework for future, and more detailed, evaluations of changes in health policy. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  10. An Inquiry of How Art Education Policies Are Reflected in Art Teacher Preparation: Examining the Standards for Visual Arts and Art Teacher Certification

    ERIC Educational Resources Information Center

    Lim, Kyungeun

    2017-01-01

    Policy changes influence various aspects of art education such as K-12 art education curricula, state licensure systems, and contexts of art teacher preparation. Despite strong relationships between art education policy and practical fields, few studies have attempted to understand art education from the perspective of policy analysis. This study…

  11. School District Leave Policies, Teacher Absenteeism, and Student Achievement.

    ERIC Educational Resources Information Center

    Ehrenberg, Ronald G.; And Others

    1991-01-01

    Econometric analysis of data from over 700 New York state school districts found that (1) policies governing use of teacher leave days clearly influence their use; (2) higher student absenteeism correlated with poorer test performance; and (3) teacher absence was not largely associated with student test performance. Changes in leave policy were…

  12. Policy Advocacy, Inequity, and School Fees and Fundraising in Ontario, Canada

    ERIC Educational Resources Information Center

    Winton, Sue; Milani, Michelle

    2017-01-01

    Fundraising and collecting fees are ubiquitous in Ontario, Canada's public schools. Critics assert that these practices perpetuate and exacerbate inequities between schools and communities. In this article we present findings from a critical policy analysis of an advocacy group's efforts to change Ontario's fees and fundraising policies over the…

  13. Health adaptation policy for climate vulnerable groups: a 'critical computational linguistics' analysis.

    PubMed

    Seidel, Bastian M; Bell, Erica

    2014-11-28

    Many countries are developing or reviewing national adaptation policy for climate change but the extent to which these meet the health needs of vulnerable groups has not been assessed. This study examines the adequacy of such policies for nine known climate-vulnerable groups: people with mental health conditions, Aboriginal people, culturally and linguistically diverse groups, aged people, people with disabilities, rural communities, children, women, and socioeconomically disadvantaged people. The study analyses an exhaustive sample of national adaptation policy documents from Annex 1 ('developed') countries of the United Nations Framework Convention on Climate Change: 20 documents from 12 countries. A 'critical computational linguistics' method was used involving novel software-driven quantitative mapping and traditional critical discourse analysis. The study finds that references to vulnerable groups are relatively little present or non-existent, as well as poorly connected to language about practical strategies and socio-economic contexts, both also little present. The conclusions offer strategies for developing policy that is better informed by a 'social determinants of health' definition of climate vulnerability, consistent with best practice in the literature and global policy prescriptions.

  14. Towards understanding the drivers of policy change: a case study of infection control policies for multi-drug resistant tuberculosis in South Africa.

    PubMed

    Saidi, Trust; Salie, Faatiema; Douglas, Tania S

    2017-05-30

    Explaining policy change is one of the central tasks of contemporary policy analysis. In this article, we examine the changes in infection control policies for multi-drug resistant tuberculosis (MDR-TB) in South Africa from the time the country made the transition to democracy in 1994, until 2015. We focus on MDR-TB infection control and refer to decentralised management as a form of infection control. Using Kingdon's theoretical framework of policy streams, we explore the temporal ordering of policy framework changes. We also consider the role of research in motivating policy changes. Policy documents addressing MDR-TB in South Africa over the period 1994 to 2014 were extracted. Literature on MDR-TB infection control in South Africa was extracted from PubMed using key search terms. The documents were analysed to identify the changes that occurred and the factors driving them. During the period under study, five different policy frameworks were implemented. The policies were meant to address the overwhelming challenge of MDR-TB in South Africa, contextualised by high prevalence of HIV infection, that threatened to undermine public health programmes and the success of antiretroviral therapy rollouts. Policy changes in MDR-TB infection control were supported by research evidence and driven by the high incidence and complexity of the disease, increasing levels of dissatisfaction among patients, challenges of physical, human and financial resources in public hospitals, and the ideologies of the political leadership. Activists and people living with HIV played an important role in highlighting the importance of MDR-TB as well as exerting pressure on policymakers, while the mass media drew public attention to infection control as both a cause of and a solution to MDR-TB. The critical factors for policy change for infection control of MDR-TB in South Africa were rooted in the socioeconomic and political environment, were supported by extensive research, and can be framed using Kingdon's policy streams approach as an interplay of the problem of the disease, political forces that prevailed and alternative proposals.

  15. The effects of country-level population policy for enhancing adaptation to climate change

    NASA Astrophysics Data System (ADS)

    Gunasekara, N. K.; Kazama, S.; Yamazaki, D.; Oki, T.

    2012-08-01

    The effectiveness of population policy scenarios in reducing the combined impacts of population change and climate change on water resources is explored. One no-policy scenario and two scenarios with population policy assumptions are employed in combination with water availability under the SRES scenarios A1b, B1 and A2 for the impact analysis. The population data used are from the World Bank. The river discharges per grid of horizontal resolution 0.5° are obtained from the Total Runoff Integrating Pathways (TRIP) of the University of Tokyo, Japan. Unlike the population scenarios utilized in the SRES emission scenarios and the newest Representative Concentration Pathways, the scenarios employed in this research are based, even after 2050, on country-level rather than regional growth assumptions. Our analysis implies that in combination with a more heterogeneous pattern of population changes across the world, a more convergent, environmentally friendly emissions scenario, such as B1, can result in a high-impact climate scenario, similar to A2, for the already water-stressed low latitudes. However, the effect of population change supersedes the changes in the climate scenarios. In 2100, Africa, Middle-East and parts of Asia are in extreme water-stress under all scenarios. For countries with high population momentum, the population policy scenario with fertility-reduction assumptions gained a maximum of 6.1 times the water availability in Niger and 5.3 times that in Uganda compared with the no-policy scenario. Most of these countries are in Sub-Saharan Africa. These countries represent 24.5% of the global population in the no-policy scenario and the scenario with fertility- reduction assumptions reduces it to 8.7% by 2100. This scenario is also effective at reducing the area under extreme water stress in these countries. However, the policy scenario with assumptions of population stabilization at the replacement fertility rate increases the water stress in high-latitude countries. Nevertheless, the impact is low due to the high per capita water availability in the region. This research is expected to widen the understanding of the combined impacts of climate change in the future and of the strategies needed to enhance the space for adaptation.

  16. Modeling of materials supply, demand and prices

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The societal, economic, and policy tradeoffs associated with materials processing and utilization, are discussed. The materials system provides the materials engineer with the system analysis required for formulate sound materials processing, utilization, and resource development policies and strategies. Materials system simulation and modeling research program including assessments of materials substitution dynamics, public policy implications, and materials process economics was expanded. This effort includes several collaborative programs with materials engineers, economists, and policy analysts. The technical and socioeconomic issues of materials recycling, input-output analysis, and technological change and productivity are examined. The major thrust areas in materials systems research are outlined.

  17. Soft Power as a Policy Rationale for International Education in the UK: A Critical Analysis

    ERIC Educational Resources Information Center

    Lomer, Sylvie

    2017-01-01

    This article presents the results of a textual analysis conducted on policy discourses on international students in the UK between 1999 and 2013. A number of rationales for and against increasing their numbers have been made, which have largely remained consistent over changing political administrations. One key rationale is that international…

  18. Marketisation and Widening Participation in English Higher Education: A Critical Discourse Analysis of Institutional Access Policy Documents

    ERIC Educational Resources Information Center

    McCaig, Colin

    2015-01-01

    This paper uses critical discourse analysis of English higher education institutions' policy statements about access to explore the changing ways that institutions have used language to shift their market positionality away from widening participation for all and the process of higher education to "fair access" (i.e. social mobility for…

  19. Access and Equity and South African Higher Education: A Review of Policies after 20 Years of Democracy

    ERIC Educational Resources Information Center

    Mabokela, Reitumetse Obakeng; Mlambo, Yeukai Angela

    2017-01-01

    The demise of apartheid in 1994 introduced many changes to the social, political, and economic sectors of South Africa with similar changes in the higher education sector. This article offers an integrative review and analysis of higher education policies implemented and legislation passed that significantly impacted the nature of the South…

  20. Towards a "Post-Public Era"? Shifting Frames in German and Australian Higher Education Policy

    ERIC Educational Resources Information Center

    Pick, David

    2008-01-01

    Higher education in Germany and Australia is being subject to pressures of market forces, internationalisation and financial constraints. This had led to both systems experiencing significant crisis and change over the past 20 years. In this paper, frame analysis is used to compare the changing policies in each nation and examine the extent to…

  1. Social Media as a Catalyst for Policy Action and Social Change for Health and Well-Being: Viewpoint.

    PubMed

    Yeung, Douglas

    2018-03-19

    This viewpoint paper argues that policy interventions can benefit from the continued use of social media analytics, which can serve as an important complement to traditional social science data collection and analysis. Efforts to improve well-being should provide an opportunity to explore these areas more deeply, and encourage the efforts of those conducting national and local data collection on health to incorporate more of these emerging data sources. Social media remains a relatively untapped source of information to catalyze policy action and social change. However, the diversity of social media platforms and available analysis techniques provides multiple ways to offer insight for policy making and decision making. For instance, social media content can provide timely information about the impact of policy interventions. Social media location information can inform where to deploy resources or disseminate public messaging. Network analysis of social media connections can reveal underserved populations who may be disconnected from public services. Machine learning can help recognize important patterns for disease surveillance or to model population sentiment. To fully realize these potential policy uses, limitations to social media data will need to be overcome, including data reliability and validity, and potential privacy risks. Traditional data collection may not fully capture the upstream factors and systemic relationships that influence health and well-being. Policy actions and social change efforts, such as the Robert Wood Johnson Foundation's effort to advance a culture of health, which are intended to drive change in a network of upstream health drivers, will need to incorporate a broad range of behavioral information, such as health attitudes or physical activity levels. Applying innovative techniques to emerging data has the potential to extract insight from unstructured data or fuse disparate sources of data, such as linking health attitudes that are expressed to health behaviors or broader health and well-being outcomes. ©Douglas Yeung. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.03.2018.

  2. Social Media as a Catalyst for Policy Action and Social Change for Health and Well-Being: Viewpoint

    PubMed Central

    2018-01-01

    This viewpoint paper argues that policy interventions can benefit from the continued use of social media analytics, which can serve as an important complement to traditional social science data collection and analysis. Efforts to improve well-being should provide an opportunity to explore these areas more deeply, and encourage the efforts of those conducting national and local data collection on health to incorporate more of these emerging data sources. Social media remains a relatively untapped source of information to catalyze policy action and social change. However, the diversity of social media platforms and available analysis techniques provides multiple ways to offer insight for policy making and decision making. For instance, social media content can provide timely information about the impact of policy interventions. Social media location information can inform where to deploy resources or disseminate public messaging. Network analysis of social media connections can reveal underserved populations who may be disconnected from public services. Machine learning can help recognize important patterns for disease surveillance or to model population sentiment. To fully realize these potential policy uses, limitations to social media data will need to be overcome, including data reliability and validity, and potential privacy risks. Traditional data collection may not fully capture the upstream factors and systemic relationships that influence health and well-being. Policy actions and social change efforts, such as the Robert Wood Johnson Foundation’s effort to advance a culture of health, which are intended to drive change in a network of upstream health drivers, will need to incorporate a broad range of behavioral information, such as health attitudes or physical activity levels. Applying innovative techniques to emerging data has the potential to extract insight from unstructured data or fuse disparate sources of data, such as linking health attitudes that are expressed to health behaviors or broader health and well-being outcomes. PMID:29555624

  3. Influencing policy change: the experience of health think tanks in low- and middle-income countries

    PubMed Central

    Bennett, Sara; Corluka, Adrijana; Doherty, Jane; Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Jesani, Amar; Kyabaggu, Joseph; Namaganda, Grace; Hussain, A M Zakir; de-Graft Aikins, Ama

    2012-01-01

    In recent years there has been a growth in the number of independent health policy analysis institutes in low- and middle-income countries which has occurred in response to the limitation of government analytical capacity and pressures associated with democratization. This study aimed to: (i) investigate the contribution made by health policy analysis institutes in low- and middle-income countries to health policy agenda setting, formulation, implementation and monitoring and evaluation; and (ii) assess which factors, including organizational form and structure, support the role of health policy analysis institutes in low- and middle-income countries in terms of positively contributing to health policy. Six case studies of health policy analysis institutes in Bangladesh, Ghana, India, South Africa, Uganda and Vietnam were conducted including two NGOs, two university and two government-owned policy analysis institutes. Case studies drew on document review, analysis of financial information, semi-structured interviews with staff and other stakeholders, and iterative feedback of draft findings. Some of the institutes had made major contributions to policy development in their respective countries. All of the institutes were actively engaged in providing policy advice and most undertook policy-relevant research. Relatively few were engaged in conducting policy dialogues, or systematic reviews, or commissioning research. Much of the work undertaken by institutes was driven by requests from government or donors, and the primary outputs for most institutes were research reports, frequently combined with verbal briefings. Several factors were critical in supporting effective policy engagement. These included a supportive policy environment, some degree of independence in governance and financing, and strong links to policy makers that facilitate trust and influence. While the formal relationship of the institute to government was not found to be critical, units within government faced considerable difficulties. PMID:21558320

  4. Influencing policy change: the experience of health think tanks in low- and middle-income countries.

    PubMed

    Bennett, Sara; Corluka, Adrijana; Doherty, Jane; Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Jesani, Amar; Kyabaggu, Joseph; Namaganda, Grace; Hussain, A M Zakir; de-Graft Aikins, Ama

    2012-05-01

    In recent years there has been a growth in the number of independent health policy analysis institutes in low- and middle-income countries which has occurred in response to the limitation of government analytical capacity and pressures associated with democratization. This study aimed to: (i) investigate the contribution made by health policy analysis institutes in low- and middle-income countries to health policy agenda setting, formulation, implementation and monitoring and evaluation; and (ii) assess which factors, including organizational form and structure, support the role of health policy analysis institutes in low- and middle-income countries in terms of positively contributing to health policy. Six case studies of health policy analysis institutes in Bangladesh, Ghana, India, South Africa, Uganda and Vietnam were conducted including two NGOs, two university and two government-owned policy analysis institutes. Case studies drew on document review, analysis of financial information, semi-structured interviews with staff and other stakeholders, and iterative feedback of draft findings. Some of the institutes had made major contributions to policy development in their respective countries. All of the institutes were actively engaged in providing policy advice and most undertook policy-relevant research. Relatively few were engaged in conducting policy dialogues, or systematic reviews, or commissioning research. Much of the work undertaken by institutes was driven by requests from government or donors, and the primary outputs for most institutes were research reports, frequently combined with verbal briefings. Several factors were critical in supporting effective policy engagement. These included a supportive policy environment, some degree of independence in governance and financing, and strong links to policy makers that facilitate trust and influence. While the formal relationship of the institute to government was not found to be critical, units within government faced considerable difficulties.

  5. Climate change risk perception and communication: addressing a critical moment?

    PubMed

    Pidgeon, Nick

    2012-06-01

    Climate change is an increasingly salient issue for societies and policy-makers worldwide. It now raises fundamental interdisciplinary issues of risk and uncertainty analysis and communication. The growing scientific consensus over the anthropogenic causes of climate change appears to sit at odds with the increasing use of risk discourses in policy: for example, to aid in climate adaptation decision making. All of this points to a need for a fundamental revision of our conceptualization of what it is to do climate risk communication. This Special Collection comprises seven papers stimulated by a workshop on "Climate Risk Perceptions and Communication" held at Cumberland Lodge Windsor in 2010. Topics addressed include climate uncertainties, images and the media, communication and public engagement, uncertainty transfer in climate communication, the role of emotions, localization of hazard impacts, and longitudinal analyses of climate perceptions. Climate change risk perceptions and communication work is critical for future climate policy and decisions. © 2012 Society for Risk Analysis.

  6. Assessing the environmental impacts of aircraft noise and emissions

    NASA Astrophysics Data System (ADS)

    Mahashabde, Anuja; Wolfe, Philip; Ashok, Akshay; Dorbian, Christopher; He, Qinxian; Fan, Alice; Lukachko, Stephen; Mozdzanowska, Aleksandra; Wollersheim, Christoph; Barrett, Steven R. H.; Locke, Maryalice; Waitz, Ian A.

    2011-01-01

    With the projected growth in demand for commercial aviation, many anticipate increased environmental impacts associated with noise, air quality, and climate change. Therefore, decision-makers and stakeholders are seeking policies, technologies, and operational procedures that balance environmental and economic interests. The main objective of this paper is to address shortcomings in current decision-making practices for aviation environmental policies. We review knowledge of the noise, air quality, and climate impacts of aviation, and demonstrate how including environmental impact assessment and quantifying uncertainties can enable a more comprehensive evaluation of aviation environmental policies. A comparison is presented between the cost-effectiveness analysis currently used for aviation environmental policy decision-making and an illustrative cost-benefit analysis. We focus on assessing a subset of the engine NO X emissions certification stringency options considered at the eighth meeting of the International Civil Aviation Organization’s Committee on Aviation Environmental Protection. The FAA Aviation environmental Portfolio Management Tool (APMT) is employed to conduct the policy assessments. We show that different conclusions may be drawn about the same policy options depending on whether benefits and interdependencies are estimated in terms of health and welfare impacts versus changes in NO X emissions inventories as is the typical practice. We also show that these conclusions are sensitive to a variety of modeling uncertainties. While our more comprehensive analysis makes the best policy option less clear, it represents a more accurate characterization of the scientific and economic uncertainties underlying impacts and the policy choices.

  7. Exploring perceptions of community health policy in Kenya and identifying implications for policy change.

    PubMed

    McCollum, Rosalind; Otiso, Lilian; Mireku, Maryline; Theobald, Sally; de Koning, Korrie; Hussein, Salim; Taegtmeyer, Miriam

    2016-02-01

    Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change. We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those who will influence or be influenced by CHS policy change in Kenya (policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members) in two purposively selected counties: Nairobi and Kitui. Qualitative data were digitally recorded, transcribed, translated and coded before framework analysis. There is widespread community appreciation for the existing strategy. High attrition, lack of accountability for voluntary CHWs and lack of funds to pay CHW salaries, combined with high CHEW workload were seen as main drivers for strategy change. Areas for change identified include: lack of clear supervisory structure including provision of adequate travel resources, current uneven coverage and equity of community health services, limited community knowledge about the strategy revision and demand for home-based HIV testing and counselling. This in-depth analysis which captures multiple perspectives results in robust recommendations for strategy revision informed by the Five Wonders of Change Framework. These recommendations point towards a more people-centred health system for improved equity and effectiveness and indicate priority areas for action if success of policy change through the roll-out of the revised strategy is to be realized. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

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

    PubMed

    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.

  9. Impact of policy changes on infant feeding decisions among low-income women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children.

    PubMed

    Whaley, Shannon E; Koleilat, Maria; Whaley, Mike; Gomez, Judy; Meehan, Karen; Saluja, Kiran

    2012-12-01

    We present infant feeding data before and after the 2009 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package change that supported and incentivized breastfeeding. We describe the key role of California WIC staff in supporting these policy changes. We analyzed WIC data on more than 180,000 infants in Southern California. We employed the analysis of variance and Tukey (honestly significant difference) tests to compare issuance rates of postpartum and infant food packages before and after the changes. We used analysis of covariance to adjust for poverty status changes as a potential confounder. Issuance rates of the "fully breastfeeding" package at infant WIC enrollment increased by 86% with the package changes. Rates also increased significantly for 2- and 6-month-old infants. Issuance rates of packages that included formula decreased significantly. All outcomes remained highly significant in the adjusted model. Policy changes, training of front-line WIC staff, and participant education influenced issuance rates of WIC food packages. In California, the issuance rates of packages that include formula have significantly decreased and the rate for those that include no formula has significantly increased.

  10. Irrigation water policy analysis using a business simulation game

    NASA Astrophysics Data System (ADS)

    Buchholz, M.; Holst, G.; Musshoff, O.

    2016-10-01

    Despite numerous studies on farmers' responses to changing irrigation water policies, uncertainties remain about the potential of water pricing schemes and water quotas to reduce irrigation. Thus far, policy impact analysis is predominantly based upon rational choice models that assume behavioral assumptions, such as a perfectly rational profit-maximizing decision maker. Also, econometric techniques are applied which could lack internal validity due to uncontrolled field data. Furthermore, such techniques are not capable of identifying ill-designed policies prior to their implementation. With this in mind, we apply a business simulation game for ex ante policy impact analysis of irrigation water policies at the farm level. Our approach has the potential to reveal the policy-induced behavioral change of the participants in a controlled environment. To do so, we investigate how real farmers from Germany, in an economic experiment, respond to a water pricing scheme and a water quota intending to reduce irrigation. In the business simulation game, the participants manage a "virtual" cash-crop farm for which they make crop allocation and irrigation decisions during several production periods, while facing uncertain product prices and weather conditions. The results reveal that a water quota is able to reduce mean irrigation applications, while a water pricing scheme does not have an impact, even though both policies exhibit equal income effects for the farmers. However, both policies appear to increase the variation of irrigation applications. Compared to a perfectly rational profit-maximizing decision maker, the participants apply less irrigation on average, both when irrigation is not restricted and when a water pricing scheme applies. Moreover, the participants' risk attitude affects the irrigation decisions.

  11. Setting performance-based financing in the health sector agenda: a case study in Cameroon.

    PubMed

    Sieleunou, Isidore; Turcotte-Tremblay, Anne-Marie; Fotso, Jean-Claude Taptué; Tamga, Denise Magne; Yumo, Habakkuk Azinyui; Kouokam, Estelle; Ridde, Valery

    2017-08-01

    More than 30 countries in sub-Saharan Africa have introduced performance-based financing (PBF) in their healthcare systems. Yet, there has been little research on the process by which PBF was put on the national policy agenda in Africa. This study examines the policy process behind the introduction of PBF program in Cameroon. The research is an explanatory case study using the Kingdon multiple streams framework. We conducted a document review and 25 interviews with various types of actors involved in the policy process. We conducted thematic analysis using a hybrid deductive-inductive approach for data analysis. By 2004, several reports and events had provided evidence on the state of the poor health outcomes and health financing in the country, thereby raising awareness of the situation. As a result, decision-makers identified the lack of a suitable health financing policy as an important issue that needed to be addressed. The change in the political discourse toward more accountability made room to test new mechanisms. A group of policy entrepreneurs from the World Bank, through numerous forms of influence (financial, ideational, network and knowledge-based) and building on several ongoing reforms, collaborated with senior government officials to place the PBF program on the agenda. The policy changes occurred as the result of two open policy windows (i.e. national and international), and in both instances, policy entrepreneurs were able to couple the policy streams to effect change. The policy agenda of PBF in Cameroon underlined the importance of a perceived crisis in the policy reform process and the advantage of building a team to carry forward the policy process. It also highlighted the role of other sources of information alongside scientific evidence (eg.: workshop and study tour), as well as the role of previous policies and experiences, in shaping or influencing respectively the way issues are framed and reformers' actions and choices.

  12. Researching Early Childhood Policy and Practice. A Critical Ecology

    ERIC Educational Resources Information Center

    Urban, Mathias

    2012-01-01

    This article examines the renewed interest in early childhood education and care in European politics, and the implications for research in changing policy contexts. Based on the policy analysis, it argues for a radical reconceptualisation of how, with and for whom, and to what end we design, conduct and interpret research in early childhood in…

  13. The Effect of Mitigation Policy on Regional Climate Impacts on the U.S. Electric Sector

    NASA Astrophysics Data System (ADS)

    Cohen, S. M.; Sun, Y.; Strzepek, K.; McFarland, J.; Boehlert, B.; Fant, C.

    2017-12-01

    Climate change can influence the U.S. electricity sector in many ways, the nature of which can be shaped by energy and environmental policy choices. Changing temperatures affect electricity demand largely through heating and cooling needs, and temperatures also affect generation and transmission system performance. Altered precipitation patterns affect the regional and seasonal distribution of surface water runoff, which changes hydropower operation and thermal cooling water availability. The extent to which these stimuli influence U.S. power sector operation and planning will depend to some extent on whether or not proactive policies are enacted to mitigate these impacts. Mitigation policies such as CO2 emissions limits or technology restrictions can change the makeup of the electricity system while reducing the extent of climate change itself. We use the National Renewable Energy Laboratory's Regional Energy Deployment System (ReEDS), a U.S. electric sector capacity expansion model, to explore electric sector evolution through 2050 under alternative climate and policy assumptions. The model endogenously represents climate impacts on load, power system performance, cooling water availability, and hydropower, allowing internally consistent system responses to climate change along with projected technology, market, and policy conditions. We compare climate impacts across 5 global circulation models for a 8.5 W/m2 representative concentration pathway (RCP) without a climate mitigation policy and a 4.5 W/m2 RCP with climate mitigation. Climate drivers affect the capacity and generation mix at the national and regional levels, with relative growth of wind, solar, and natural gas-based technologies depending on local electricity system characteristics. These differences affect regional economic impacts, measured here as changes to electricity price and system costs. Mitigation policy reduces the economic and system impacts of climate change largely by moderating temperature-induced load but also by lessening water- and temperature-based performance constraints. Policy impacts are nuanced and region-specific, and this analysis underscores the importance of climate mitigation policy to regional electricity system planning decisions.

  14. Thirty Years of Education in China: Between Change and No Change--A Comparative Analysis of Four Key Documents on Education Policy

    ERIC Educational Resources Information Center

    Wenbin, Hu

    2012-01-01

    This article reviews the education reform and development footprints in China by analyzing four key education policy documents in the past three decades. The conclusion is that the reform and development of China's educational establishment have provided excellent support for the operations of China's political and economic systems. The reality is…

  15. Ten Years of LibQual: A Study of Qualitative and Quantitative Survey Results at the University of Mississippi 2001-2010

    ERIC Educational Resources Information Center

    Greenwood, Judy T.; Watson, Alex P.; Dennis, Melissa

    2011-01-01

    This article analyzes quantitative adequacy gap scores and coded qualitative comments from LibQual surveys at the University of Mississippi from 2001 to 2010, looking for relationships between library policy changes and LibQual results and any other trends that emerged. Analysis found no relationship between changes in policy and survey results…

  16. DYNARIP: A technique for regional forest inventory projection and policy analysis

    Treesearch

    William A. Bechtold

    1984-01-01

    DYNARIP is a policy-oriented model capable of tracking all of the treatments and disturbances experienced by the forest resources of an entire State or regional area. It can also isolate the impact of any one of the 27 man-caused or natural disturbances (including natural succession and forest land-base changes). The model is driven by empirical rates of change as...

  17. The Timber Resource Inventory Model (TRIM): a projection model for timber supply and policy analysis.

    Treesearch

    P.L. Tedder; R.N. La Mont; J.C. Kincaid

    1987-01-01

    TRIM (Timber Resource Inventory Model) is a yield table projection system developed for timber supply projections and policy analysis. TRIM simulates timber growth, inventories, management and area changes, and removals over the projection period. Programs in the TRIM system, card-by-card descriptions of required inputs, table formats, and sample results are presented...

  18. What's Missing from No Child Left Behind? A Policy Analysis from a Social Work Perspective

    ERIC Educational Resources Information Center

    Lagana-Riordan, Christine; Aguilar, Jemel P.

    2009-01-01

    The No Child Left Behind Act of 2001 (NCLB) initiated sweeping changes to the U.S. educational system. However, many have argued that NCLB is not accomplishing its stated purposes of improving education for disadvantaged students and closing the achievement gap. This policy analysis sheds light on the social and emotional risk factors that prevent…

  19. ACA-mandated elimination of cost sharing for preventive screening has had limited early impact.

    PubMed

    Mehta, Shivan J; Polsky, Daniel; Zhu, Jingsan; Lewis, James D; Kolstad, Jonathan T; Loewenstein, George; Volpp, Kevin G

    2015-07-01

    The Affordable Care Act eliminated patient cost sharing for evidence-based preventive care, yet the impact of this policy on colonoscopy and mammography rates is unclear. We examined the elimination of cost sharing among small business beneficiaries of Humana, a large national insurer. This was a retrospective interrupted time series analysis of whether the change in cost-sharing policy was associated with a change in screening utilization, using grandfathered plans as a comparison group. We compared beneficiaries in small business nongrandfathered plans that were required to eliminate cost sharing (intervention) with those in grandfathered plans that did not have to change cost sharing (control). There were 63,246 men and women aged 50 to 64 years eligible for colorectal cancer screening, and 30,802 women aged 50 to 64 years eligible for breast cancer screening. The primary outcome variables were rates of colonoscopy and mammography per person-month, with secondary analysis of colonoscopy rates coded as preventive only. There was no significant change in the level or slope of colonoscopy and mammography utilization for intervention plans relative to the control plans. There was also no significant relevant change among those colonoscopies coded as preventive. The results suggest that the implementation of the policy is not having its intended effects, as cost sharing rates for colonoscopy and mammography did not change substantially, and utilization of colonoscopy and mammography changed little, following this new policy approach.

  20. Strengthening the research to policy and practice interface: exploring strategies used by research organisations working on sexual and reproductive health and HIV/AIDS

    PubMed Central

    2011-01-01

    This commentary introduces the HARPS supplement on getting research into policy and practice in sexual and reproductive health (SRH). The papers in this supplement have been produced by the Sexual Health and HIV Evidence into Practice (SHHEP) collaboration of international research, practitioner and advocacy organizations based in research programmes funded by the UK Department for International Development. The commentary describes the increasing interest from research and communication practitioners, policy makers and funders in expanding the impact of research on policy and practice. It notes the need for contextually embedded understanding of ways to engage multiple stakeholders in the politicized, sensitive and often contested arenas of sexual and reproductive health. The commentary then introduces the papers under their respective themes: (1) The theory and practice of research engagement (two global papers); (2) Applying policy analysis to explore the role of research evidence in SRH and HIV/AIDS policy (two papers with examples from Ghana, Malawi, Uganda and Zambia); (3) Strategies and methodologies for engagement (five papers on Kenya, South Africa, Ghana, Tanzania and Swaziland respectively); (4) Advocacy and engagement to influence attitudes on controversial elements of sexual health (two papers, Bangladesh and global); and (5) Institutional approaches to inter-sectoral engagement for action and strengthening research communications (two papers, Ghana and global). The papers illustrate the many forms research impact can take in the field of sexual and reproductive health. This includes discursive changes through carving out legitimate spaces for public debate; content changes such as contributing to changing laws and practices, procedural changes such as influencing how data on SRH are collected, and behavioural changes through partnerships with civil society actors such as advocacy groups and journalists. The contributions to this supplement provide a body of critical analysis of communication and engagement strategies across the spectrum of SRH and HIV/AIDS research through the testing of different models for the research-to-policy interface. They provide new insights on how researchers and communication specialists can respond to changing policy climates to create windows of opportunity for influence. PMID:21679383

  1. Comments on "Women, Development Planning and Government Policies in Pakistan".

    PubMed

    Hafeez, S

    1992-01-01

    Commentary on Shahnaz and Bilquees Raza's paper on women in development in Pakistan is supportive of the content analysis of the Sixth and Seventh 5-Year Plans and policies, but critical of the methods used n the analysis. The parallel to survey research methods was made in that there was a specification of 1) the unit of analysis (reference to each policy measure, each chapter, each page of the plan), 2) the rationale for the plan, 3) specific objectives of the examination, and 4) the criteria for analysis. Missing also was the identification of policy trends from the Fourth and Fifth 5-Year Plans. The question is never answered as to why gender issues were not directed to the agricultural sector. The conclusion that there was a hugh gap between intentions and implementation was an issue not unique to women's issues, and a deeper analysis may have been required in order to understand the nature and magnitude of the gaps for women's policies and their productive roles. Questions should have been directed to the issues of the root causes of gaps in planning and implementation of policies and programs for women in development, and the identification of quantitative and qualitative indicators of gaps. Questions arise as to whether the gaps have changed with changes in the strength of political and social will in various decades. Recognition was given by the authors to the low budget allocations between 1955 and 1970 to education and health which affected both men and women, but there was scant mention of the strong social, not political, will to enhance women's welfare prevalent at this time. Information was lacking on the differences between the Sixth and Seventh sectoral plans for agricultural employment and women and the working groups plans that did include women in agricultural employment; the question is why the working plans were not incorporated into the final plans, and why the working groups did not protest this omission. The lack of political and social will was one of the most significant gaps between policy and implementation that was the article's focus. Has the Ministry of Women in Development really been given administrative authority to promote social change?

  2. The smoking ban next door: do hospitality businesses in border areas have reduced sales after a statewide smoke-free policy?

    PubMed

    Klein, Elizabeth G; Hood, Nancy E

    2015-01-01

    Despite numerous studies demonstrating no significant economic effects on hospitality businesses following a statewide smoke-free (SF) policy, regional concerns suggest that areas near states without SF policies may experience a loss of hospitality sales across the border. The present study evaluated the impact of Ohio's statewide SF policy on taxable restaurant and bar sales in border and non-border areas. Spline regression analysis was used to assess changes in monthly taxable sales at the county level in full-service restaurants and bars in Ohio. Data were analyzed from four years prior to policy implementation to three years post-policy. Change in the differences in the slope of taxable sales for border (n = 21) and non-border (n = 67) counties were evaluated for changes following the statewide SF policy enforcement, adjusted for unemployment rates, general trends in the hospitality sector, and seasonality. After adjusting for covariates, there was no statistically significant change in the difference in slope for taxable sales for either restaurants (β = 0.9, p = 0.09) or bars (β = 0.2, p = 0.07) following the SF policy for border areas compared to non-border areas of Ohio. Border regions in Ohio did not experience a significant change in bar and restaurant sales compared to non-border areas following a statewide SF policy. Results support that Ohio's statewide SF policy did not impact these two areas differently, and provide additional evidence for the continued use of SF policies to provide protection from exposure to secondhand smoke for both workers and the general public. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Health, energy vulnerability and climate change: a retrospective thematic analysis of primary care trust policies and practices.

    PubMed

    Richardson, J; Kagawa, F; Nichols, A

    2009-12-01

    To review publicly available documents produced by primary care trusts (PCTs) to assess the extent to which local activity and planning consider energy vulnerability, climate change and sustainability. Retrospective thematic content analysis of publicly available materials located on PCT websites. Thematic content analysis of publicly available materials was undertaken by two researchers over a 6-month period in 2008. These materials were obtained from the websites of 30 PCTs in England. Materials included annual reports, plans, policies and strategy documents. Of the 30 PCT websites studied, four were found to have an absence of content related to climate change, energy vulnerability and sustainability. Of the remaining 26 PCT websites, consistent themes were found: strategic initiatives, joint working with other agencies, promoting sustainable communities, and targeted actions. Evidence of good examples in sustainable development was predominantly limited to policy statements and strategic aims; evidence of action was limited. As champions of the public health agenda, PCT action on sustainability should be integral to all aspects of organizational governance.

  4. Applied Dynamic Analysis of the Global Economy (ADAGE)

    EPA Science Inventory

    ADAGE is a dynamic computable general equilibrium (CGE) model capable of examining many types of economic, energy, environmental, climate change mitigation, and trade policies at the international, national, U.S. regional, and U.S. state levels. To investigate proposed policy eff...

  5. The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions in Youth Ice Hockey Players.

    PubMed

    Krolikowski, Maciej P; Black, Amanda M; Palacios-Derflingher, Luz; Blake, Tracy A; Schneider, Kathryn J; Emery, Carolyn A

    2017-02-01

    Ice hockey is a popular winter sport in Canada. Concussions account for the greatest proportion of all injuries in youth ice hockey. In 2011, a policy change enforcing "zero tolerance for head contact" was implemented in all leagues in Canada. To determine if the risk of game-related concussions and more severe concussions (ie, resulting in >10 days of time loss) and the mechanisms of a concussion differed for Pee Wee class (ages 11-12 years) and Bantam class (ages 13-14 years) players after the 2011 "zero tolerance for head contact" policy change compared with players in similar divisions before the policy change. Cohort study; Level of evidence, 3. The retrospective cohort included Pee Wee (most elite 70%, 2007-2008; n = 891) and Bantam (most elite 30%, 2008-2009; n = 378) players before the rule change and Pee Wee (2011-2012; n = 588) and Bantam (2011-2012; n = 242) players in the same levels of play after the policy change. Suspected concussions were identified by a team designate and referred to a sport medicine physician for diagnosis. Incidence rate ratios (IRRs) were estimated based on multiple Poisson regression analysis, controlling for clustering by team and other important covariates and offset by game-exposure hours. Incidence rates based on the mechanisms of a concussion were estimated based on univariate Poisson regression analysis. The risk of game-related concussions increased after the head contact rule in Pee Wee (IRR, 1.85; 95% CI, 1.20-2.86) and Bantam (IRR, 2.48; 95% CI, 1.17-5.24) players. The risk of more severe concussions increased after the head contact rule in Pee Wee (IRR, 4.12; 95% CI, 2.00-8.50) and Bantam (IRR, 7.91; 95% CI, 3.13-19.94) players. The rates of concussions due to body checking and direct head contact increased after the rule change. The "zero tolerance for head contact" policy change did not reduce the risk of game-related concussions in Pee Wee or Bantam class ice hockey players. Increased concussion awareness and education after the policy change may have contributed to the increased risk of concussions found after the policy change.

  6. Technical change in US industry: A cross-industry analysis

    NASA Technical Reports Server (NTRS)

    Nelson, R. R. (Editor)

    1981-01-01

    The nature of the public policies which have influenced the pace and pattern of technical progress in a number of American industries is studied with the view of assessing the broad effects of these policies. The industries studied are agriculture, pharmaceuticals, semiconductors, computers, civil aircraft, automobiles and residential construction. The policies considered include research and development funding as well as government procurement, education, information dissemination, patent protection, licensing, regulations, and anti-trust policies.

  7. Prevalence and predictors of transitions to and away from syringe exchange use over time in 3 US cities with varied syringe dispensing policies

    PubMed Central

    Green, Traci C.; Bluthenthal, Ricky N.; Singer, Merrill; Beletsky, Leo; Grau, Lauretta E.; Marshall, Patricia; Heimer, Robert

    2010-01-01

    Syringe exchange programs (SEPs) can reduce HIV risk among injecting drug users (IDUs) but their use may depend heavily on contextual factors such as local syringe policies. The frequency and predictors of transitioning over time to and from direct, indirect, and non-use of SEPs are unknown. We sought, over one year, to: (1) quantify and characterize transition probabilities of SEP attendance typologies; (2) identify factors associated with (a) change in typology, and (b) becoming and maintaining direct SEP use; and (3) quantify and characterize transition probabilities of SEP attendance before and after changes in policy designed to increase access. Using data collected from 583 IDUs participating in a three-city cohort study of SEPs, we conducted a latent transition analysis and multinomial regressions. Three typologies were detected: Direct SEP users, Indirect SEP users and Isolated IDUs. Transitions to direct SEP use were most prevalent. Factors associated with becoming or maintaining direct SEP use were female sex, Latino ethnicity, fewer injections per syringe, homelessness, recruitment city, injecting speedballs (cocaine and heroin), and police contact involving drug paraphernalia possession. Similar factors influenced transitions in the syringe policy change analysis. Policy change cities experienced an increase in Indirect SEP users (43% to 51%) with little increased direct use (29% to 31%). We found that, over time, IDUs tended to become Direct SEP users. Policies improving syringe availability influenced SEP use by increasing secondary syringe exchange. Interactions with police around drug paraphernalia may encourage SEP use for some IDUs and may provide opportunities for other health interventions. PMID:20537814

  8. Monitoring Antimicrobial Resistance in the Food Supply Chain and Its Implications for FDA Policy Initiatives

    PubMed Central

    Zawack, Kelson; Li, Min; Booth, James G.; Love, Will; Lanzas, Cristina

    2016-01-01

    In response to concerning increases in antimicrobial resistance (AMR), the Food and Drug Administration (FDA) has decided to increase veterinary oversight requirements for antimicrobials and restrict their use in growth promotion. Given the high stakes of this policy for the food supply, economy, and human and veterinary health, it is important to rigorously assess the effects of this policy. We have undertaken a detailed analysis of data provided by the National Antimicrobial Resistance Monitoring System (NARMS). We examined the trends in both AMR proportion and MIC between 2004 and 2012 at slaughter and retail stages. We investigated the makeup of variation in these data and estimated the sample and effect size requirements necessary to distinguish an effect of the policy change. Finally, we applied our approach to take a detailed look at the 2005 withdrawal of approval for the fluoroquinolone enrofloxacin in poultry water. Slaughter and retail showed similar trends. Both AMR proportion and MIC were valuable in assessing AMR, capturing different information. Most variation was within years, not between years, and accounting for geographic location explained little additional variation. At current rates of data collection, a 1-fold change in MIC should be detectable in 5 years and a 6% decrease in percent resistance could be detected in 6 years following establishment of a new resistance rate. Analysis of the enrofloxacin policy change showed the complexities of the AMR policy with no statistically significant change in resistance of both Campylobacter jejuni and Campylobacter coli to ciprofloxacin, another second-generation fluoroquinolone. PMID:27324772

  9. Monitoring Antimicrobial Resistance in the Food Supply Chain and Its Implications for FDA Policy Initiatives.

    PubMed

    Zawack, Kelson; Li, Min; Booth, James G; Love, Will; Lanzas, Cristina; Gröhn, Yrjö T

    2016-09-01

    In response to concerning increases in antimicrobial resistance (AMR), the Food and Drug Administration (FDA) has decided to increase veterinary oversight requirements for antimicrobials and restrict their use in growth promotion. Given the high stakes of this policy for the food supply, economy, and human and veterinary health, it is important to rigorously assess the effects of this policy. We have undertaken a detailed analysis of data provided by the National Antimicrobial Resistance Monitoring System (NARMS). We examined the trends in both AMR proportion and MIC between 2004 and 2012 at slaughter and retail stages. We investigated the makeup of variation in these data and estimated the sample and effect size requirements necessary to distinguish an effect of the policy change. Finally, we applied our approach to take a detailed look at the 2005 withdrawal of approval for the fluoroquinolone enrofloxacin in poultry water. Slaughter and retail showed similar trends. Both AMR proportion and MIC were valuable in assessing AMR, capturing different information. Most variation was within years, not between years, and accounting for geographic location explained little additional variation. At current rates of data collection, a 1-fold change in MIC should be detectable in 5 years and a 6% decrease in percent resistance could be detected in 6 years following establishment of a new resistance rate. Analysis of the enrofloxacin policy change showed the complexities of the AMR policy with no statistically significant change in resistance of both Campylobacter jejuni and Campylobacter coli to ciprofloxacin, another second-generation fluoroquinolone. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  10. The road to smoke-free legislation in Ireland.

    PubMed

    Currie, Laura M; Clancy, Luke

    2011-01-01

    To describe the process through which Ireland changed its policies towards smoking in work-places and distil lessons for others implementing or extending smoke-free laws. This analysis is informed by a review of secondary sources including a commissioned media analysis, documentary analysis and key informant interviews with policy actors who provide insight into the process of smoke-free policy development. The policy analysis techniques used include the development of a time-line for policy reform, stakeholder analysis, policy mapping techniques, impact analysis through use of secondary data and a review process. The policy analysis triangle, which highlights the importance of examining policy content, context, actors and processes, will be used as an analytical framework. The importance of the political, economic, social and cultural context emerged clearly. The interaction of the context with the policy process both in identification of need for policy and its formulation demonstrated the opportunity for advocates to exert influence at all points of the process. The campaign to support the legislation had the following characteristics: a sustained consistent simple health message, sustained political leadership/commitment, a strong coalition between the Health Alliance, the Office of Tobacco Control and the Department of Health and Children, with cross-party political support and trade union support. The public and the media support clearly defined the benefit of deliberate and consistent planning and organization of a communication strategy. The Irish smoke-free legislation was a success as a policy initiative because of timing, dedication, planning, implementation and the existence of strong leadership and a powerful convinced credible political champion. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  11. Effects of Targeted Subsidies Policy on Health Behavior in Iranian Households: A Qualitative Study

    PubMed Central

    DOSHMANGIR, Leila; DOSHMANGIR, Parinaz; ABOLHASSANI, Nazanin; MOSHIRI, Esmaeil; JAFARI, Mehdi

    2015-01-01

    Background: This study aimed to explore the effects of national targeted subsidies policy on health behavior of Iranian households. Methods: In this qualitative study, data were collected between January 2012 and December 2013 through face-to-face interviews (23 experts in national and provincial levels of health system and 18 household heads) and through a comprehensive and purposive document analysis. The data was analyzed using a thematic analysis method (inductive-deductive) and assisted by Atlas-ti software. Results: Rising health care costs, removing some food subsidies and the increase in price of most goods and services due to the implementation of economic policy of targeted subsidies have led to significant changes in the demand for health services, changes in the consumption trends of goods and services affecting health as well as changes in the health habits of households. Conclusion: Targeted subsidies and the cash subsidy policy have some negative effects on population health behavior especially among poor people. Hence, maintaining or increasing the cash subsidy is not an efficient allocation of resources toward health care system. So, it is necessary to identify appropriate strategies and policies and apply interventions in order to moderate negative effects and enhance positive effects resulted from implementing this economic reform on population health behavior. PMID:26056676

  12. Economic development, climate and values: making policy.

    PubMed

    Stern, Nicholas

    2015-08-07

    The two defining challenges of this century are overcoming poverty and managing the risks of climate change. Over the past 10 years, we have learned much about how to tackle them together from ideas on economic development and public policy. My own work in these areas over four decades as an academic and as a policy adviser in universities and international financial institutions has focused on how the investment environment and the empowerment of people can change lives and livelihoods. The application of insights from economic development and public policy to climate change requires rigorous analysis of issues such as discounting, modelling the risks of unmanaged climate change, climate policy targets and estimates of the costs of mitigation. The latest research and results show that the case for avoiding the risks of dangerous climate change through the transition to low-carbon economic development and growth is still stronger than when the Stern Review was published. This is partly because of evidence that some of the impacts of climate change are happening more quickly than originally expected, and because of remarkable advances in technologies, such as solar power. Nevertheless, significant hurdles remain in securing the international cooperation required to avoid dangerous climate change, not least because of disagreements and misunderstandings about key issues, such as ethics and equity. © 2015 The Author(s).

  13. Economic development, climate and values: making policy

    PubMed Central

    Stern, Nicholas

    2015-01-01

    The two defining challenges of this century are overcoming poverty and managing the risks of climate change. Over the past 10 years, we have learned much about how to tackle them together from ideas on economic development and public policy. My own work in these areas over four decades as an academic and as a policy adviser in universities and international financial institutions has focused on how the investment environment and the empowerment of people can change lives and livelihoods. The application of insights from economic development and public policy to climate change requires rigorous analysis of issues such as discounting, modelling the risks of unmanaged climate change, climate policy targets and estimates of the costs of mitigation. The latest research and results show that the case for avoiding the risks of dangerous climate change through the transition to low-carbon economic development and growth is still stronger than when the Stern Review was published. This is partly because of evidence that some of the impacts of climate change are happening more quickly than originally expected, and because of remarkable advances in technologies, such as solar power. Nevertheless, significant hurdles remain in securing the international cooperation required to avoid dangerous climate change, not least because of disagreements and misunderstandings about key issues, such as ethics and equity. PMID:26203007

  14. Impacts of Climate Policy on Regional Air Quality, Health, and Air Quality Regulatory Procedures

    NASA Astrophysics Data System (ADS)

    Thompson, T. M.; Selin, N. E.

    2011-12-01

    Both the changing climate, and the policy implemented to address climate change can impact regional air quality. We evaluate the impacts of potential selected climate policies on modeled regional air quality with respect to national pollution standards, human health and the sensitivity of health uncertainty ranges. To assess changes in air quality due to climate policy, we couple output from a regional computable general equilibrium economic model (the US Regional Energy Policy [USREP] model), with a regional air quality model (the Comprehensive Air Quality Model with Extensions [CAMx]). USREP uses economic variables to determine how potential future U.S. climate policy would change emissions of regional pollutants (CO, VOC, NOx, SO2, NH3, black carbon, and organic carbon) from ten emissions-heavy sectors of the economy (electricity, coal, gas, crude oil, refined oil, energy intensive industry, other industry, service, agriculture, and transportation [light duty and heavy duty]). Changes in emissions are then modeled using CAMx to determine the impact on air quality in several cities in the Northeast US. We first calculate the impact of climate policy by using regulatory procedures used to show attainment with National Ambient Air Quality Standards (NAAQS) for ozone and particulate matter. Building on previous work, we compare those results with the calculated results and uncertainties associated with human health impacts due to climate policy. This work addresses a potential disconnect between NAAQS regulatory procedures and the cost/benefit analysis required for and by the Clean Air Act.

  15. Alcohol Tax Policy and Related Mortality. An Age-Period-Cohort Analysis of a Rapidly Developed Chinese Population, 1981–2010

    PubMed Central

    Chung, Roger Y.; Kim, Jean H.; Yip, Benjamin H.; Wong, Samuel Y. S.; Wong, Martin C. S.; Chung, Vincent C. H.; Griffiths, Sian M.

    2014-01-01

    To delineate the temporal dynamics between alcohol tax policy changes and related health outcomes, this study examined the age, period and cohort effects on alcohol-related mortality in relation to changes in government alcohol policies. We used the age-period-cohort modeling to analyze retrospective mortality data over 30 years from 1981 to 2010 in a rapidly developed Chinese population, Hong Kong. Alcohol-related mortality from 1) chronic causes, 2) acute causes, 3) all (chronic+acute) causes and 4) causes 100% attributable to alcohol, as defined according to the Alcohol-Related Disease Impact (ARDI) criteria developed by the US Centers for Disease Control and Prevention, were examined. The findings illustrated the possible effects of alcohol policy changes on adult alcohol-related mortality. The age-standardized mortality trends were generally in decline, with fluctuations that coincided with the timing of the alcohol policy changes. The age-period-cohort analyses demonstrated possible temporal dynamics between alcohol policy changes and alcohol-related mortality through the period effects, and also generational impact of alcohol policy changes through the cohort effects. Based on the illustrated association between the dramatic increase of alcohol imports in the mid-1980s and the increased alcohol-related mortality risk of the generations coming of age of majority at that time, attention should be paid to generations coming of drinking age during the 2007–2008 duty reduction. PMID:25153324

  16. The role of emotion in global warming policy support and opposition.

    PubMed

    Smith, Nicholas; Leiserowitz, Anthony

    2014-05-01

    Prior research has found that affect and affective imagery strongly influence public support for global warming. This article extends this literature by exploring the separate influence of discrete emotions. Utilizing a nationally representative survey in the United States, this study found that discrete emotions were stronger predictors of global warming policy support than cultural worldviews, negative affect, image associations, or sociodemographic variables. In particular, worry, interest, and hope were strongly associated with increased policy support. The results contribute to experiential theories of risk information processing and suggest that discrete emotions play a significant role in public support for climate change policy. Implications for climate change communication are also discussed. © 2013 Society for Risk Analysis.

  17. Does Federal Financial Aid Policy Influence the Institutional Aid Policies of Four-Year Colleges and Universities? An Exploratory Analysis

    ERIC Educational Resources Information Center

    Hossler, Don; Kwon, Jihye

    2015-01-01

    There is a dearth of empirical work that examines the relationships between federal financial aid policy and institutional financial aid priorities and expenditures. This study uses Resource Dependency Theory to explore whether changes the amount of financial aid awarded by colleges and universities during the last fifty years are best explained…

  18. Occupation and Industry Sex Segregation, Gender, and Workplace Support: The Use of Flexible Scheduling Policies

    ERIC Educational Resources Information Center

    Minnotte, Krista Lynn; Cook, Alison; Minnotte, Michael C.

    2010-01-01

    This study examines how industry and occupation sex segregation are related to the use of flexible scheduling policies and perceptions of the career repercussions of using such policies. The analysis is performed on data from the 2002 National Study of the Changing Workforce (N = 2,810). Findings suggest that the percentage of women per industry…

  19. STAPOL: A Simulation of the Impact of Policy, Values, and Technological and Societal Developments upon the Quality of Life.

    ERIC Educational Resources Information Center

    Little, Dennis; Feller, Richard

    The Institute for the Future has been conducting research in technological and societal forecasting, social indicators, value change, and simulation gaming. This paper describes an effort to bring together parts of that research into a simulation game ("State Policy," or STAPOL) for analysis of the impact of government policy, social values, and…

  20. The Changing Faces of Adult Literacy, Language and Numeracy: Literacy Policy and Implementation in the UK

    ERIC Educational Resources Information Center

    Hillier, Yvonne

    2009-01-01

    This article draws upon a research project funded by the ESRC (R000239387) that tracked the development of adult literacy, numeracy and English for Speakers of Other Languages (ESOL) from the 1970s to 2000 in England using life-history interviews and documentary policy analysis to compare policy, practitioner and learner perspectives. The article…

  1. Reductions in abortion-related mortality following policy reform: evidence from Romania, South Africa and Bangladesh

    PubMed Central

    2011-01-01

    Unsafe abortion is a significant contributor to worldwide maternal mortality; however, abortion law and policy liberalization could lead to drops in unsafe abortion and related deaths. This review provides an analysis of changes in abortion mortality in three countries where significant policy reform and related service delivery occurred. Drawing on peer-reviewed literature, population data and grey literature on programs and policies, this paper demonstrates the policy and program changes that led to declines in abortion-related mortality in Romania, South Africa and Bangladesh. In all three countries, abortion policy liberalization was followed by implementation of safe abortion services and other reproductive health interventions. South Africa and Bangladesh trained mid-level providers to offer safe abortion and menstrual regulation services, respectively, Romania improved contraceptive policies and services, and Bangladesh made advances in emergency obstetric care and family planning. The findings point to the importance of multi-faceted and complementary reproductive health reforms in successful implementation of abortion policy reform. PMID:22192901

  2. Federal Industrial Innovation Policy : A Review of Congressional and Task Force Activity

    DOT National Transportation Integrated Search

    1980-12-01

    The issue of technological innovation, and the appropriate role of government policy, have been the subjects of many task forces and special committees. A retrospective analysis was carried out to identify changing perspectives of the causes of decli...

  3. Advances in risk assessment for climate change adaptation policy

    PubMed Central

    Adger, W. Neil; Brown, Iain; Surminski, Swenja

    2018-01-01

    Climate change risk assessment involves formal analysis of the consequences, likelihoods and responses to the impacts of climate change and the options for addressing these under societal constraints. Conventional approaches to risk assessment are challenged by the significant temporal and spatial dynamics of climate change; by the amplification of risks through societal preferences and values; and through the interaction of multiple risk factors. This paper introduces the theme issue by reviewing the current practice and frontiers of climate change risk assessment, with specific emphasis on the development of adaptation policy that aims to manage those risks. These frontiers include integrated assessments, dealing with climate risks across borders and scales, addressing systemic risks, and innovative co-production methods to prioritize solutions to climate challenges with decision-makers. By reviewing recent developments in the use of large-scale risk assessment for adaptation policy-making, we suggest a forward-looking research agenda to meet ongoing strategic policy requirements in local, national and international contexts. This article is part of the theme issue ‘Advances in risk assessment for climate change adaptation policy’. PMID:29712800

  4. Local Government Capacity to Respond to Environmental Change: Insights from Towns in New York State.

    PubMed

    Larson, Lincoln R; Lauber, T Bruce; Kay, David L; Cutts, Bethany B

    2017-07-01

    Local governments attempting to respond to environmental change face an array of challenges. To better understand policy responses and factors influencing local government capacity to respond to environmental change, we studied three environmental issues affecting rural or peri-urban towns in different regions of New York State: climate change in the Adirondacks (n = 63 towns), loss of open space due to residential/commercial development in the Hudson Valley (n = 50), and natural gas development in the Southern Tier (n = 62). Our analysis focused on towns' progression through three key stages of the environmental policy process (issue awareness and salience, common goals and agenda setting, policy development and implementation) and the factors that affect this progression and overall capacity for environmental governance. We found that-when compared to towns addressing open space development and natural gas development-towns confronted with climate change were at a much earlier stage in the policy process and were generally less likely to display the essential resources, social support, and political legitimacy needed for an effective policy response. Social capital cultivated through collaboration and networking was strongly associated with towns' policy response across all regions and could help municipalities overcome omnipresent resource constraints. By comparing and contrasting municipal responses to each issue, this study highlights the processes and factors influencing local government capacity to address a range of environmental changes across diverse management contexts.

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

    ERIC Educational Resources Information Center

    Piattoeva, Nelli

    2009-01-01

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

  6. Teacher Evaluation as a Policy Target for Improved Student Learning: A Fifty-State Review of Statute and Regulatory Action since NCLB

    ERIC Educational Resources Information Center

    Hazi, Helen M.; Rucinski, Daisy Arredondo

    2009-01-01

    This paper reports on the analysis of state statutes and department of education regulations in fifty states for changes in teacher evaluation in use since the passage of No Child Left Behind Act of 2001. We asked what the policy activity for teacher evaluation is in state statutes and department of education regulations, how these changes in…

  7. Contextual influence on evaluation capacity building in a rapidly changing environment under new governmental policies.

    PubMed

    Chen, Karen Hui-Jung

    2017-12-01

    Evaluation capacity building (ECB) is a context-dependent process. Contextual factors affecting ECB implementation have been explored theoretically and practically, but their influence within a changing environment has seldom been discussed. This study examined essential context-sensitive parameters, particularly those involved in implementing new governmental policies regarding higher education. Taiwan was used as a case study for exploring the effect of contextual change on ECB attributes from the perspectives of training receivers and providers. Surveys and interviews were used for data collection and importance-performance analysis was applied for data analysis. Four prominent features were identified. First, the ECB attributes perceived as important by receivers were performed adequately, whereas those perceived as less important were performed less well. Second, under new policies, training provider designed training covering a wide range of ECB, whereas receivers focused on those can be directly applied in evaluation process. Third, in a small education system such as Taiwan's, the complexity of peer review is high and ethical issues become important. Fourth, because the evaluation structure has been changed from single- to dual-track, receivers expect more training for institution staff, whereas providers insist on hierarchical training. Aligning ECB supply and needs is paramount for adaptation to new policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Effective Curriculum Policy and Cross-Curricularity: Analysis of the New Curriculum Design of the Hellenic Pedagogical Institute

    ERIC Educational Resources Information Center

    Alahiotis, Stamatis N.; Karatzia-Stavlioti, Eleni

    2006-01-01

    In this paper we perform text analysis on the new Cross Thematic Curriculum Framework Syllabus Design for compulsory education, which was constructed by the Hellenic Pedagogical Institute and is soon going to be applied in Greek schools. This curriculum text is treated as a policy text which introduces important changes in Greek school practice,…

  9. Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland.

    PubMed

    Jones, Catherine M; Clavier, Carole; Potvin, Louise

    2017-01-01

    Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making.

  10. Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland

    PubMed Central

    Clavier, Carole; Potvin, Louise

    2017-01-01

    Background Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Methods Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Results Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Conclusion Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making. PMID:28589007

  11. Advanced nursing training in health policy: designing and implementing a new program.

    PubMed

    Harrington, Charlene; Crider, Mark C; Benner, Patricia E; Malone, Ruth E

    2005-05-01

    Although the nursing profession has a growing role in the health policy arena, the rapidly changing health care environment means that clinicians need a sophisticated understanding of health policy. Nurses are assuming leadership roles in advocacy, research, analysis, and policy development, implementation, and evaluation, contributing to a growing need to educate nurses to specialize in health policy research and analysis. This article provides an overview of a new master's and doctoral educational program specializing in health policy for advanced practice nurses who are culturally diverse and sensitive to issues of diversity. The program, currently in its third year of operation at the University of California San Francisco, School of Nursing, is addressing the gap in nursing education and practice expertise in health policy. The program is supported through funding by the Department of Health and Human Services Health Resources and Services Administration, Advanced Nurse Training program.

  12. Comparative Logic Modeling for Policy Analysis: The Case of HIV Testing Policy Change at the Department of Veterans Affairs

    PubMed Central

    Langer, Erika M; Gifford, Allen L; Chan, Kee

    2011-01-01

    Objective Logic models have been used to evaluate policy programs, plan projects, and allocate resources. Logic Modeling for policy analysis has been used rarely in health services research but can be helpful in evaluating the content and rationale of health policies. Comparative Logic Modeling is used here on human immunodeficiency virus (HIV) policy statements from the Department of Veterans Affairs (VA) and Centers for Disease Control and Prevention (CDC). We created visual representations of proposed HIV screening policy components in order to evaluate their structural logic and research-based justifications. Data Sources and Study Design We performed content analysis of VA and CDC HIV testing policy documents in a retrospective case study. Data Collection Using comparative Logic Modeling, we examined the content and primary sources of policy statements by the VA and CDC. We then quantified evidence-based causal inferences within each statement. Principal Findings VA HIV testing policy structure largely replicated that of the CDC guidelines. Despite similar design choices, chosen research citations did not overlap. The agencies used evidence to emphasize different components of the policies. Conclusion Comparative Logic Modeling can be used by health services researchers and policy analysts more generally to evaluate structural differences in health policies and to analyze research-based rationales used by policy makers. PMID:21689094

  13. Charting the trajectory of domestic violence policy change in the Republic of Ireland since the mid-1990s – a path towards integration?

    PubMed Central

    Kearns, Noreen; Coen, Liam

    2014-01-01

    Introduction This paper assesses the policy developments pertaining to the implementation of an integrated approach to domestic violence over the past 15 years. The contextual setting is outlined in terms of the international policy response to the problem of domestic violence based on an ecological perspective. Description of policy and case Periods of core strategic policy and related structural developments are considered illustrating the Irish experience of domestic violence policy-making and service provision. The value of adopting an integrated approach to domestic violence based on the rationale of improving strategic policy formulation, coordinating service provision and facilitating joined-up governance is set out. The core facilitators and challenges associated with such an approach are described. Analysis and conclusion The policy framework and restructured landscape of domestic violence in Ireland has undergone significant change over the past decade and a half. The paper uses a three-dimensional matrix of domestic violence policy development and service integration as a means of addressing horizontal, vertical and resource aspects of collaboration and integration. While the changes have been characterised by significant phases of fluctuation in terms of coordinated action and the situation currently appears promising, however it is too early to judge the outcomes of the most recent reforms. PMID:25337062

  14. Obesity and climate change mitigation in Australia: overview and analysis of policies with co-benefits.

    PubMed

    Lowe, Melanie

    2014-02-01

    To provide an overview of the shared structural causes of obesity and climate change, and analyse policies that could be implemented in Australia to both equitably reduce obesity rates and contribute to mitigating climate change. Informed by the political economy of health theoretical framework, a review was conducted of the literature on the shared causes of, and solutions to, obesity and climate change. Policies with potential co-benefits for climate change and obesity were then analysed based upon their feasibility and capacity to reduce greenhouse gas emissions and equitably reduce obesity rates in Australia. Policies with potential co-benefits fit within three broad categories: those to replace car use with low-emissions, active modes of transport; those to improve diets and reduce emissions from the food system; and macro-level economic policies to reduce the over-consumption of food and fossil fuel energy. Given the complex causes of both problems, it is argued that a full spectrum of complementary strategies across different sectors should be utilised. Such an approach would have significant public health, social and environmental benefits. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

  15. Electoral reform and public policy outcomes in Thailand: the politics of the 30-Baht health scheme.

    PubMed

    Selway, Joel Sawat

    2011-01-01

    How do changes in electoral rules affect the nature of public policy outcomes? The current evidence supporting institutional theories that answer this question stems almost entirely from quantitative cross-country studies, the data of which contain very little within-unit variation. Indeed, while there are many country-level accounts of how changes in electoral rules affect such phenomena as the number of parties or voter turnout, there are few studies of how electoral reform affects public policy outcomes. This article contributes to this latter endeavor by providing a detailed analysis of electoral reform and the public policy process in Thailand through an examination of the 1997 electoral reforms. Specifically, the author examines four aspects of policy-making: policy formulation, policy platforms, policy content, and policy outcomes. The article finds that candidates in the pre-1997 era campaigned on broad, generic platforms; parties had no independent means of technical policy expertise; the government targeted health resources to narrow geographic areas; and health was underprovided in Thai society. Conversely, candidates in the post-1997 era relied more on a strong, detailed national health policy; parties created mechanisms to formulate health policy independently; the government allocated health resources broadly to the entire nation through the introduction of a universal health care system, and health outcomes improved. The author attributes these changes in the policy process to the 1997 electoral reform, which increased both constituency breadth (the proportion of the population to which politicians were accountable) and majoritarianism.

  16. Impact of Policy Changes on Infant Feeding Decisions Among Low-Income Women Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children

    PubMed Central

    Koleilat, Maria; Whaley, Mike; Gomez, Judy; Meehan, Karen; Saluja, Kiran

    2012-01-01

    Objectives. We present infant feeding data before and after the 2009 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package change that supported and incentivized breastfeeding. We describe the key role of California WIC staff in supporting these policy changes. Methods. We analyzed WIC data on more than 180 000 infants in Southern California. We employed the analysis of variance and Tukey (honestly significant difference) tests to compare issuance rates of postpartum and infant food packages before and after the changes. We used analysis of covariance to adjust for poverty status changes as a potential confounder. Results. Issuance rates of the “fully breastfeeding” package at infant WIC enrollment increased by 86% with the package changes. Rates also increased significantly for 2- and 6-month-old infants. Issuance rates of packages that included formula decreased significantly. All outcomes remained highly significant in the adjusted model. Conclusions. Policy changes, training of front-line WIC staff, and participant education influenced issuance rates of WIC food packages. In California, the issuance rates of packages that include formula have significantly decreased and the rate for those that include no formula has significantly increased. PMID:23078467

  17. Explaining drug policy: Towards an historical sociology of policy change.

    PubMed

    Seddon, Toby

    2011-11-01

    The goal of seeking to understand the development over time of drug policies is a specific version of the more general intellectual project of finding ways of explaining social change. The latter has been a preoccupation of some of the greatest thinkers within the social sciences of the last 200 years, from Foucault all the way back to the three nineteenth-century pioneers, Marx, Durkheim and Weber. I describe this body of work as 'historical sociology'. In this paper, I outline how a particular approach to historical sociology can be fruitfully drawn upon to understand the development of drug policy, using by way of illustration the example of the analysis of a recent transformation in British drug policy: the rise of the criminal justice agenda. I conclude by arguing that by looking at developments in drug policy in this way, some new insights are opened up. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Oregon's Senate Bill 560: practical policy lessons for nurse advocates.

    PubMed

    Gilson Sistrom, Maria

    2010-02-01

    In response to striking rates of childhood obesity in Oregon, advocates led by a nurse lobbyist proposed legislation in 2005 to regulate junk foods in public schools. Several theories propose to explain the policy-making process, yet Senate Bill 560 (SB 560) followed a twisted course through rule making, legislative and political processes that are not well articulated in policy theory. Three overlapping mechanisms were identified in content analysis of documents and interviews with participants in the SB 560 policy process. Strategically placed legislative "banana peels," proponents' amateur advocacy, and legislative outflanking by professional lobbyists more fully characterize this policy process and better account for the failure of SB 560. Subsequent passage of the Oregon Healthy School Foods bill in the more politically conducive 2007 legislature suggest that advocacy and incremental change frameworks are less predictive of successful passage than is the ability to take advantage of political opportunities to change public health policy.

  19. UNICEF's contribution to the adoption and implementation of option B+ for preventing mother-to-child transmission of HIV: a policy analysis.

    PubMed

    Chersich, M F; Newbatt, E; Ng'oma, K; de Zoysa, I

    2018-06-01

    Between 2011 and 2013, global and national guidelines for preventing mother-to-child transmission (PMTCT) of HIV shifted to recommend Option B+, the provision of lifelong antiretroviral treatment for all HIV-infected pregnant women. We aimed to analyse how Option B+ reached the policy agenda, and unpack the processes, actors and politics that explain its adoption, with a focus on examining UNICEF's contribution to these events. Analysis drew on published articles and other documentation, 30 key informants interviews with staff at UNICEF, partner organisations and government officials, and country case studies. Cameroon, India, South Africa and Zimbabwe were each visited for 5-8 days. Interview transcripts were analysed using Dedoose software, reviewed several times and then coded thematically. A national policy initiative in Malawi in 2011, in which the country adopted Option B+, rather than existing WHO recommended regimens, irrevocably placed the policy on the global agenda. UNICEF and other organisations recognised the policy's potential impact and strategically crafted arguments to support it, framing these around operational considerations, cost-effectiveness and values. As 'policy entrepreneurs', these organisations vigorously promoted the policy through a variety of channels and means, overcoming concerted opposition. WHO, on the basis of scanty evidence, released a series of documents towards the policy's endorsement, paving the way for its widespread adoption. National-level policy transformation was rapid and definitive, distinct from previous incremental policy processes. Many organisations, including UNICEF, facilitated these changes in country, acting individually, or in concert. The adoption of the Option B+ policy marked a departure from established processes for PMTCT policy formulation which had been led by WHO with the support of technical experts, and in which recommendations were developed following shifts in evidence. Rather, changes were spurred by a country-level initiative, and a set of strategically framed arguments that resonated with funders and country-level actors. This bottom-up approach, supported by normative agencies, was transformative. For UNICEF, alignment between the organisation's country focus and the policy's underpinning values, enabled it to work with partners and accelerate widespread policy change.

  20. Regional trade and the nutrition transition: opportunities to strengthen NCD prevention policy in the Southern African Development Community.

    PubMed

    Thow, Anne Marie; Sanders, David; Drury, Eliza; Puoane, Thandi; Chowdhury, Syeda N; Tsolekile, Lungiswa; Negin, Joel

    2015-01-01

    Addressing diet-related non-communicable diseases (NCDs) will require a multisectoral policy approach that includes the food supply and trade, but implementing effective policies has proved challenging. The Southern African Development Community (SADC) has experienced significant trade and economic liberalization over the past decade; at the same time, the nutrition transition has progressed rapidly in the region. This analysis considers the relationship between regional trade liberalization and changes in the food environment associated with poor diets and NCDs, with the aim of identifying feasible and proactive policy responses to support healthy diets. Changes in trade and investment policy for the SADC were documented and compared with time-series graphs of import data for soft drinks and snack foods to assess changes in imports and source country in relation to trade and investment liberalization. Our analysis focuses on regional trade flows. Diets and the burden of disease in the SADC have changed since the 1990s in parallel with trade and investment liberalization. Imports of soft drinks increased by 76% into SADC countries between 1995 and 2010, and processed snack foods by 83%. South Africa acts as a regional trade and investment hub; it is the major source of imports and investment related to these products into other SADC countries. At the same time, imports of processed foods and soft drinks from outside the region - largely from Asia and the Middle East - are increasing at a dramatic rate with soft drink imports growing by almost 1,200% and processed snack foods by 750%. There is significant intra-regional trade in products associated with the nutrition transition; however, growing extra-regional trade means that countries face new pressures in implementing strong policies to prevent the increasing burden of diet-related NCDs. Implementation of a regional nutrition policy framework could complement the SADC's ongoing commitment to regional trade policy.

  1. Regional trade and the nutrition transition: opportunities to strengthen NCD prevention policy in the Southern African Development Community

    PubMed Central

    Thow, Anne Marie; Sanders, David; Drury, Eliza; Puoane, Thandi; Chowdhury, Syeda N.; Tsolekile, Lungiswa; Negin, Joel

    2015-01-01

    Background Addressing diet-related non-communicable diseases (NCDs) will require a multisectoral policy approach that includes the food supply and trade, but implementing effective policies has proved challenging. The Southern African Development Community (SADC) has experienced significant trade and economic liberalization over the past decade; at the same time, the nutrition transition has progressed rapidly in the region. This analysis considers the relationship between regional trade liberalization and changes in the food environment associated with poor diets and NCDs, with the aim of identifying feasible and proactive policy responses to support healthy diets. Design Changes in trade and investment policy for the SADC were documented and compared with time-series graphs of import data for soft drinks and snack foods to assess changes in imports and source country in relation to trade and investment liberalization. Our analysis focuses on regional trade flows. Results Diets and the burden of disease in the SADC have changed since the 1990s in parallel with trade and investment liberalization. Imports of soft drinks increased by 76% into SADC countries between 1995 and 2010, and processed snack foods by 83%. South Africa acts as a regional trade and investment hub; it is the major source of imports and investment related to these products into other SADC countries. At the same time, imports of processed foods and soft drinks from outside the region – largely from Asia and the Middle East – are increasing at a dramatic rate with soft drink imports growing by almost 1,200% and processed snack foods by 750%. Conclusions There is significant intra-regional trade in products associated with the nutrition transition; however, growing extra-regional trade means that countries face new pressures in implementing strong policies to prevent the increasing burden of diet-related NCDs. Implementation of a regional nutrition policy framework could complement the SADC's ongoing commitment to regional trade policy. PMID:26205364

  2. Crisis and Change: The Making of a French FDA.

    PubMed

    Nathanson, Constance A; Bergeron, Henri

    2017-09-01

    Policy Points: Introducing a recent special issue of The Lancet on the health system in France, Horton and Ceschia observe that "the dominance of English as the language of science and, increasingly, global health too often closes the door on the history and experiences of others." 1 In that spirit, this manuscript presents a detailed case study of public health policy transformation in France in the early 1990s. It casts light on processes of policy change in a political and cultural environment very different from that of the United States, showing how the public health policy process is shaped by multiple contingencies of history, ideology, and politics. More specifically, we describe the transformation of a disease catastrophe into a political crisis and the deployment of that crisis to precipitate reform of the French public health system. Until the last decade of the 20th century, France had no equivalent to the US Food and Drug Administration. In this paper we describe and interpret the complex series of events that led to the passage by the French Parliament in December 1992 of a law incorporating such an agency, the Agence du Médicament (literally, "medicines agency"). The broad aim of this project was to learn how public health policy change comes about by detailed analysis of a specific instance. More specifically, we aimed to better understand the circumstances under which public health crisis leads to significant public health policy reform. This paper is based on detailed analysis of primary documents (eg, archived French health ministry papers, recorded parliamentary debates, government reports, newspaper articles) and oral history interviews covering a period from 1988 to 1993. Thematic analysis of these materials was initially grounded in theories of organizational change, moving to constructs that emerged from the data themselves. Policy entrepreneurs positioned to frame adverse events and seize opportunities are key to public health policy reform. However, whether these entrepreneurs will have the requisite institutional power is contingent both on political structure and on the power of competing institutional actors. Health crises may catalyze institutional reform, but our analysis suggests that whether reform occurs, or even whether adverse episodes are labeled as crises, is highly contingent on circumstances of history, political structure, and political ideology and is extremely difficult to predict or control. Actors positioned to shape public health policy need to have a detailed understanding of the circumstances that facilitate or impede policy reform. Health crises are now more often global than not. Comparative, theoretically grounded, cross-national research that looks in detail at how different countries respond to similar health crises would be extremely valuable in informing both policymakers and researchers. © 2017 Milbank Memorial Fund.

  3. Climate change and nutrition: creating a climate for nutrition security.

    PubMed

    Tirado, M C; Crahay, P; Mahy, L; Zanev, C; Neira, M; Msangi, S; Brown, R; Scaramella, C; Costa Coitinho, D; Müller, A

    2013-12-01

    Climate change further exacerbates the enormous existing burden of undernutrition. It affects food and nutrition security and undermines current efforts to reduce hunger and promote nutrition. Undernutrition in turn undermines climate resilience and the coping strategies of vulnerable populations. The objectives of this paper are to identify and undertake a cross-sectoral analysis of the impacts of climate change on nutrition security and the existing mechanisms, strategies, and policies to address them. A cross-sectoral analysis of the impacts of climate change on nutrition security and the mechanisms and policies to address them was guided by an analytical framework focused on the three 'underlying causes' of undernutrition: 1) household food access, 2) maternal and child care and feeding practices, 3) environmental health and health access. The analytical framework includes the interactions of the three underlying causes of undernutrition with climate change,vulnerability, adaptation and mitigation. Within broad efforts on climate change mitigation and adaptation and climate-resilient development, a combination of nutrition-sensitive adaptation and mitigation measures, climate-resilient and nutrition-sensitive agricultural development, social protection, improved maternal and child care and health, nutrition-sensitive risk reduction and management, community development measures, nutrition-smart investments, increased policy coherence, and institutional and cross-sectoral collaboration are proposed as a means to address the impacts of climate change to food and nutrition security. This paper proposes policy directions to address nutrition in the climate change agenda and recommendations for consideration by the UN Framework Convention on Climate Change (UNFCCC). Nutrition and health stakeholders need to be engaged in key climate change adaptation and mitigation initiatives, including science-based assessment by the Intergovernmental Panel on Climate Change (IPCC), and policies and actions formulated by the UN Framework Convention on Climate Change (UNFCCC). Improved multi-sectoral coordination and political will is required to integrate nutrition-sensitive actions into climate-resilient sustainable development efforts in the UNFCCC work and in the post 2015 development agenda. Placing human rights at the center of strategies to mitigate and adapt to the impacts of climate change and international solidarity is essential to advance sustainable development and to create a climate for nutrition security.

  4. News and Comment: Knapp Reinterprets Excellence at NSF.

    ERIC Educational Resources Information Center

    Walsh, John

    1983-01-01

    Examines changes at the National Science Foundation since Edward Knapp was appointed director, including relations with National Science Board, vacancies in deputy directorship and four assistant directorships, relations with Office of Science and Technology Policy, research grant administration, budget control, policy analysis, programs outside…

  5. Pathways to policy: Lessons learned in multisectoral collaboration for physical activity and built environment policy development from the Coalitions Linking Action and Science for Prevention (CLASP) initiative.

    PubMed

    Politis, Christopher E; Mowat, David L; Keen, Deb

    2017-06-16

    The Canadian Partnership Against Cancer funded 12 large-scale knowledge to action cancer and chronic disease prevention projects between 2009 and 2016 through the Coalitions Linking Action and Science for Prevention (CLASP) initiative. Two projects, Healthy Canada by Design (HCBD) and Children's Mobility, Health and Happiness (CMHH), developed policies to address physical activity and the built environment through a multisectoral approach. A qualitative analysis involving a review of 183 knowledge products and 8 key informant interviews was conducted to understand what policy changes occurred, and the underlying critical success factors, through these projects. Both projects worked at the local level to change physical activity and built environment policy in 203 sites, including municipalities and schools. Both projects brought multisectoral expertise (e.g., public health, land use planning, transportation engineering, education, etc.) together to inform the development of local healthy public policy in the areas of land use, transportation and school travel planning. Through the qualitative analysis of the knowledge products and key informant interviews, 163 policies were attributed to HCBD and CMHH work. Fourteen "pathways to policy" were identified as critical success factors facilitating and accelerating the development and implementation of physical activity and built environment policy. Of the 14 pathways to policy, 8 had a focus on multisectoral collaboration. The lessons learned from the CLASP experience could support enhanced multisectoral collaborations to accelerate the development and implementation of physical activity and built environment policy in new jurisdictions across Canada and internationally.

  6. Integrated mixed methods policy analysis for sustainable food systems: trends, challenges and future research.

    PubMed

    Cuevas, Soledad

    Agriculture is a major contributor to greenhouse gas emissions, an important part of which is associated to deforestation and indirect land use change. Appropriate and coherent food policies can play an important role in aligning health, economic and environmental goals. From the point of view of policy analysis, however, this requires multi-sectoral, interdisciplinary approaches which can be highly complex. Important methodological advances in the area are not exempted from limitations and criticism. We argue that there is scope for further developments in integrated quantitative and qualitative policy analysis combining existing methods, including mathematical modelling and stakeholder analysis. We outline methodological trends in the field, briefly characterise integrated mixed methods policy analysis and identify contributions, challenges and opportunities for future research. In particular, this type of approach can help address issues of uncertainty and context-specific validity, incorporate multiple perspectives and help advance meaningful interdisciplinary collaboration in the field. Substantial challenges remain, however, such as the integration of key issues related to non-communicable disease, or the incorporation of a broader range of qualitative approaches that can address important cultural and ethical dimensions of food.

  7. Challenging Representations: Constructing the Adult Literacy Learner over 30 Years of Policy and Practice in the United Kingdom

    ERIC Educational Resources Information Center

    Hamilton, Mary; Pitt, Kathy

    2011-01-01

    This article addresses the question, How do changes in policy discourses shape public representations of literacy learners and the goals of adult literacy education? It examines specifically how the agency of adult literacy learners is constructed. We carry out a critical discourse analysis of two key adult literacy policy documents from the U.K.:…

  8. Education Reform Policy and Early Childhood Teacher Education in Hong Kong before and after the Transfer of Sovereignty to China in 1997

    ERIC Educational Resources Information Center

    Yuen, Gail

    2008-01-01

    Built on a sociocultural framework of policy analysis and Wertsch's concept of mediation, the present study examines how early childhood teacher education has changed as a result of interactions between reform policy and the action of teacher educators. Ten teacher educators participated in the study, along with eight early childhood leaders, 15…

  9. Recovering and Framing the George I. Sanchez Legacy of Chicana/o Student and Policy Advocacy: Utilizing Data for Social Change

    ERIC Educational Resources Information Center

    Rodríguez, Cristóbal

    2014-01-01

    Recovering and critically examining the pioneering scholarship and history of George I. Sanchez provides an interpretation toward a legacy of a Chicana/o student and policy advocacy framework for Chicana/o scholars to consider. The author of this work applies a critical policy theoretical analysis by Frank Fischer to develop a Chicana/o student…

  10. Social cost of carbon pricing of power sector CO2: accounting for leakage and other social implications from subnational policies

    NASA Astrophysics Data System (ADS)

    Bistline, John E.; Rose, Steven K.

    2018-01-01

    In environments where climate policy has partial coverage or unequal participation, carbon dioxide (CO2) emissions or economic activity may shift to locations and sectors where emissions are unregulated. This is referred to as leakage. Leakage can offset or augment emissions reductions associated with a policy, which has important environmental and economic implications. Although leakage has been studied at national levels, analysis of leakage for subnational policies is limited. This is despite greater market integration and many existing state and regional environmental regulations in the US. This study explores leakage potential, net emissions changes, and other social implications in the US energy system with regionally differentiated pricing of power sector CO2 emissions. We undertake an economic analysis using EPRI’s US-REGEN model, where power sector CO2 emissions are priced in individual US regions with a range of social cost of carbon (SCC) values. SCC estimates are being considered by policy-makers for valuing potential societal damages from CO2 emissions. In this study, we evaluate the emissions implications within the SCC pricing region, within the power sector outside the SCC region, and outside the power sector (i.e. in the rest of the energy system). Results indicate that CO2 leakage is possible within and outside the electric sector, ranging from negative 70% to over 80% in our scenarios, with primarily positive leakage outcomes. Typically ignored in policy analysis, leakage would affect CO2 reduction benefits. We also observe other potential societal effects within and across regions, such as higher electricity prices, changes in power sector investments, and overall consumption losses. Efforts to reduce leakage, such as constraining power imports into the SCC pricing region likely reduce leakage, but could also result in lower net emissions reductions, as well as larger price increases. Thus, it is important to look beyond leakage and consider a broader set of environmental and economic metrics. Leakage rates, net emissions outcomes, electricity price changes, fuel market effects, and macroeconomic costs vary by region of the country, time, policy stringency, policy design (e.g. leakage mitigation provisions), policy environment in neighboring regions, and price responsiveness of demand.

  11. Spatially Explicit Landscape-Level Ecological Risks Induced by Land Use and Land Cover Change in a National Ecologically Representative Region in China.

    PubMed

    Gong, Jian; Yang, Jianxin; Tang, Wenwu

    2015-11-09

    Land use and land cover change is driven by multiple influential factors from environmental and social dimensions in a land system. Land use practices of human decision-makers modify the landscape of the land system, possibly leading to landscape fragmentation, biodiversity loss, or environmental pollution-severe environmental or ecological impacts. While landscape-level ecological risk assessment supports the evaluation of these impacts, investigations on how these ecological risks induced by land use practices change over space and time in response to alternative policy intervention remain inadequate. In this article, we conducted spatially explicit landscape ecological risk analysis in Ezhou City, China. Our study area is a national ecologically representative region experiencing drastic land use and land cover change, and is regulated by multiple policies represented by farmland protection, ecological conservation, and urban development. We employed landscape metrics to consider the influence of potential landscape-level disturbance for the evaluation of landscape ecological risks. Using spatiotemporal simulation, we designed scenarios to examine spatiotemporal patterns in landscape ecological risks in response to policy intervention. Our study demonstrated that spatially explicit landscape ecological risk analysis combined with simulation-driven scenario analysis is of particular importance for guiding the sustainable development of ecologically vulnerable land systems.

  12. Spatially Explicit Landscape-Level Ecological Risks Induced by Land Use and Land Cover Change in a National Ecologically Representative Region in China

    PubMed Central

    Gong, Jian; Yang, Jianxin; Tang, Wenwu

    2015-01-01

    Land use and land cover change is driven by multiple influential factors from environmental and social dimensions in a land system. Land use practices of human decision-makers modify the landscape of the land system, possibly leading to landscape fragmentation, biodiversity loss, or environmental pollution—severe environmental or ecological impacts. While landscape-level ecological risk assessment supports the evaluation of these impacts, investigations on how these ecological risks induced by land use practices change over space and time in response to alternative policy intervention remain inadequate. In this article, we conducted spatially explicit landscape ecological risk analysis in Ezhou City, China. Our study area is a national ecologically representative region experiencing drastic land use and land cover change, and is regulated by multiple policies represented by farmland protection, ecological conservation, and urban development. We employed landscape metrics to consider the influence of potential landscape-level disturbance for the evaluation of landscape ecological risks. Using spatiotemporal simulation, we designed scenarios to examine spatiotemporal patterns in landscape ecological risks in response to policy intervention. Our study demonstrated that spatially explicit landscape ecological risk analysis combined with simulation-driven scenario analysis is of particular importance for guiding the sustainable development of ecologically vulnerable land systems. PMID:26569270

  13. A modelling approach for the assessment of the effects of Common Agricultural Policy measures on farmland biodiversity in the EU27.

    PubMed

    Overmars, Koen P; Helming, John; van Zeijts, Henk; Jansson, Torbjörn; Terluin, Ida

    2013-09-15

    In this paper we describe a methodology to model the impacts of policy measures within the Common Agricultural Policy (CAP) on farm production, income and prices, and on farmland biodiversity. Two stylised scenarios are used to illustrate how the method works. The effects of CAP measures, such as subsidies and regulations, are calculated and translated into changes in land use and land-use intensity. These factors are then used to model biodiversity with a species-based indicator on a 1 km scale in the EU27. The Common Agricultural Policy Regionalised Impact Modelling System (CAPRI) is used to conduct the economic analysis and Dyna-CLUE (Conversion of Land Use and its Effects) is used to model land use changes. An indicator that expresses the relative species richness was used as the indicator for biodiversity in agricultural areas. The methodology is illustrated with a baseline scenario and two scenarios that include a specific policy. The strength of the methodology is that impacts of economic policy instruments can be linked to changes in agricultural production, prices and incomes, on the one hand, and to biodiversity effects, on the other - with land use and land-use intensity as the connecting drivers. The method provides an overall assessment, but for detailed impact assessment at landscape, farm or field level, additional analysis would be required. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Geographic variation in opinions on climate change at state and local scales in the USA

    NASA Astrophysics Data System (ADS)

    Howe, Peter D.; Mildenberger, Matto; Marlon, Jennifer R.; Leiserowitz, Anthony

    2015-06-01

    Addressing climate change in the United States requires enactment of national, state and local mitigation and adaptation policies. The success of these initiatives depends on public opinion, policy support and behaviours at appropriate scales. Public opinion, however, is typically measured with national surveys that obscure geographic variability across regions, states and localities. Here we present independently validated high-resolution opinion estimates using a multilevel regression and poststratification model. The model accurately predicts climate change beliefs, risk perceptions and policy preferences at the state, congressional district, metropolitan and county levels, using a concise set of demographic and geographic predictors. The analysis finds substantial variation in public opinion across the nation. Nationally, 63% of Americans believe global warming is happening, but county-level estimates range from 43 to 80%, leading to a diversity of political environments for climate policy. These estimates provide an important new source of information for policymakers, educators and scientists to more effectively address the challenges of climate change.

  15. Is There Any Hope? How Climate Change News Imagery and Text Influence Audience Emotions and Support for Climate Mitigation Policies.

    PubMed

    Feldman, Lauren; Hart, P Sol

    2018-03-01

    Using a national sample, this study experimentally tests the effects of news visuals and texts that emphasize either the causes and impacts of climate change or actions that can be taken to address climate change. We test the effects of variations in text and imagery on discrete emotions (i.e., hope, fear, and anger) and, indirectly, on support for climate mitigation policies. Political ideology is examined as a moderator. The findings indicate that news images and texts that focus on climate-oriented actions can increase hope and, in the case of texts, decrease fear and anger, and these effects generally hold across the ideological spectrum. In turn, the influence of emotions on policy support depends on ideology: Hope and fear increase support for climate policies for all ideological groups but particularly conservatives, whereas anger polarizes the opinions of liberals and conservatives. Implications for climate change communication that appeals to emotions are discussed. © 2017 Society for Risk Analysis.

  16. Adaptation to Climatic Hazards in the Savannah Ecosystem: Improving Adaptation Policy and Action

    NASA Astrophysics Data System (ADS)

    Yiran, Gerald A. B.; Stringer, Lindsay C.

    2017-10-01

    People in Ghana's savannah ecosystem have historically experienced a range of climatic hazards that have affected their livelihoods. In view of current climate variability and change, and projected increases in extreme events, adaptation to climate risks is vital. Policies have been put in place to enhance adaptation across sub-Saharan Africa in accordance with international agreements. At the same time, local people, through experience, have learned to adapt. This paper examines current policy actions and their implementation alongside an assessment of barriers to local adaptation. In doing so it links adaptation policy and practice. Policy documents were analysed that covered key livelihood sectors, which were identified as climate sensitive. These included agriculture, water, housing and health policies, as well as the National Climate Change Policy. In-depth interviews and focus group discussions were also held with key stakeholders in the Upper East Region of Ghana. Analyses were carried using thematic content analysis. Although policies and actions complement each other, their integration is weak. Financial, institutional, social, and technological barriers hinder successful local implementation of some policy actions, while lack of local involvement in policy formulation also hinders adaptation practice. Integration of local perspectives into policy needs to be strengthened in order to enhance adaptation. Coupled with this is a need to consider adaptation to climate change in development policies and to pursue efforts to reduce or remove the key barriers to implementation at the local level.

  17. Exploring the influence of context and policy on health district productivity in Cambodia.

    PubMed

    Ensor, Tim; So, Sovannarith; Witter, Sophie

    2016-01-01

    Cambodia has been reconstructing its economy and health sector since the end of conflict in the 1990s. There have been gains in life expectancy and increased health expenditure, but Cambodia still lags behind neighbours One factor which may contribute is the efficiency of public health services. This article aims to understand variations in efficiency and the extent to which changes in efficiency are associated with key health policies that have been introduced to strengthen access to health services over the past decade. The analysis makes use of data envelopment analysis (DEA) to measure relative efficiency and changes in productivity and regression analysis to assess the association with the implementation of health policies. Data on 28 operational districts were obtained for 2008-11, focussing on the five provinces selected to represent a range of conditions in Cambodia. DEA was used to calculate efficiency scores assuming constant and variable returns to scale and Malmquist indices to measure productivity changes over time. This analysis was combined with qualitative findings from 17 key informant interviews and 19 in-depth interviews with managers and staff in the same provinces. The DEA results suggest great variation in the efficiency scores and trends of scores of public health services in the five provinces. Starting points were significantly different, but three of the five provinces have improved efficiency considerably over the period. Higher efficiency is associated with more densely populated areas. Areas with health equity funds in Special Operating Agency (SOA) and non-SOA areas are associated with higher efficiency. The same effect is not found in areas only operating voucher schemes. We find that the efficiency score increased by 0.12 the year any of the policies was introduced. This is the first study published on health district productivity in Cambodia. It is one of the few studies in the region to consider the impact of health policy changes on health sector efficiency. The results suggest that the recent health financing reforms have been effective, singly and in combination. This analysis could be extended nationwide and used for targeting of new initiatives. The finding of an association between recent policy interventions and improved productivity of public health services is relevant for other countries planning similar health sector reforms.

  18. An analysis of forest land use, forest land cover, and change at policy-relevant scales

    Treesearch

    John W. Coulston; Greg Reams; Dave N. Wear; C. Kenneth Brewer

    2014-01-01

    Quantifying the amount of forest and change in the amount of forest are key to ensure that appropriate management practices and policies are in place to maintain the array of ecosystem services provided by forests. There are a range of analytical techniques and data available to estimate these forest parameters, however, not all ‘forest’ is the same and various...

  19. Impact of Technological and Structural Change on Employment. Prospective Analysis 2020. Synthesis Report. Report to the Committee on Employment and Social Affairs of the European Parliament. Technical Report Series.

    ERIC Educational Resources Information Center

    2001

    The possible impact of technological and structural change on employment in the European Union (EU) over the next 20 years was examined through an exploration of the following alternative policy-driven scenarios: (1) business as usual; (2) concentrated technology policy (increases in innovation and research and development [R&D] efforts are…

  20. Trends in public perceptions and preferences on energy and environmental policy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Farhar, B.C.

    1993-02-01

    This report presents selected results from a secondary analysis of public opinion surveys, taken at the national and state/local levels, relevant to energy and environmental policy choices. The data base used in the analysis includes about 2000 items from nearly 600 separate surveys conducted between 1979 and 1992. Answers to word-for-word questions were traced over time, permitting trend analysis. Patterns of response were also identified for findings from similarly worded survey items. The analysis identifies changes in public opinion concerning energy during the past 10 to 15 years.

  1. Advancing team-based primary health care: a comparative analysis of policies in western Canada.

    PubMed

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

    2017-07-17

    We analyzed and compared primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to understand how they inform the design and implementation of team-based primary health care service delivery. The goal was to develop policy imperatives that can advance team-based PHC in Canada. We conducted comparative case studies (n = 3). The policy analysis included: Context review: We reviewed relevant information (2007 to 2014) from databases and websites. Policy review and comparative analysis: We compared and contrasted publically available PHC policies. Key informant interviews: Key informants (n = 30) validated narratives prepared from the comparative analysis by offering contextual information on potential policy imperatives. Advisory group and roundtable: An expert advisory group guided this work and a key stakeholder roundtable event guided prioritization of policy imperatives. The concept of team-based PHC varies widely across and within the three provinces. We noted policy gaps related to team configuration, leadership, scope of practice, role clarity and financing of team-based care; few policies speak explicitly to monitoring and evaluation of team-based PHC. We prioritized four policy imperatives: (1) alignment of goals and policies at different system levels; (2) investment of resources for system change; (3) compensation models for all members of the team; and (4) accountability through collaborative practice metrics. Policies supporting team-based PHC have been slow to emerge, lacking a systematic and coordinated approach. Greater alignment with specific consideration of financing, reimbursement, implementation mechanisms and performance monitoring could accelerate systemic transformation by removing some well-known barriers to team-based care.

  2. Stakeholder analysis: a review.

    PubMed

    Brugha, R; Varvasovszky, Z

    2000-09-01

    The growing popularity of stakeholder analysis reflects an increasing recognition of how the characteristics of stakeholders--individuals, groups and organizations--influence decision-making processes. This paper reviews the origins and uses of stakeholder analysis, as described in the policy, health care management and development literature. Its roots are in the political and policy sciences, and in management theory where it has evolved into a systematic tool with clearly defined steps and applications for scanning the current and future organizational environment. Stakeholder analysis can be used to generate knowledge about the relevant actors so as to understand their behaviour, intentions, interrelations, agendas, interests, and the influence or resources they have brought--or could bring--to bear on decision-making processes. This information can then be used to develop strategies for managing these stakeholders, to facilitate the implementation of specific decisions or organizational objectives, or to understand the policy context and assess the feasibility of future policy directions. Policy development is a complex process which frequently takes place in an unstable and rapidly changing context, subject to unpredictable internal and external factors. As a cross-sectional view of an evolving picture, the utility of stakeholder analysis for predicting and managing the future is time-limited and it should be complemented by other policy analysis approaches.

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

    PubMed

    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.

  4. Energy Management Policies in Distributed Residential Energy Systems

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Duan, Sisi; Sun, Jingtao

    2016-01-01

    In this paper, we study energy management problems in communities with several neighborhood-level Residential Energy Systems (RESs). We consider control problems from both community level and residential level to handle external changes such as restriction on peak demand and restriction on the total demand from the electricity grid. We propose three policies to handle the problems at community level. Based on the collected data from RESs such as predicted energy load, the community controller analyzes the policies, distribute the results to the RES, and each RES can then control and schedule its own energy load based on different coordination functions.more » We utilize a framework to integrate both policy analysis and coordination of functions. With the use of our approach, we show that the policies are useful to resolve the challenges of energy management under external changes.« less

  5. Public Perception of Climate Change: The Importance of Knowledge and Cultural Worldviews.

    PubMed

    Shi, Jing; Visschers, Vivianne H M; Siegrist, Michael

    2015-12-01

    The importance of knowledge for lay people's climate change concerns has been questioned in recent years, as it had been suggested that cultural values are stronger predictors of concern about climate change than knowledge. Studies that simultaneously measured knowledge related to climate change and cultural values have, however, been missing. We conducted a mail survey in the German-speaking part of Switzerland (N = 1,065). Results suggested that cultural worldviews and climate-related knowledge were significantly related with people's concern about climate change. Also, cultural worldviews and climate-relevant knowledge appeared important for people's willingness to change behaviors and to accept climate change policies. In addition, different types of knowledge were found to have different impacts on people's concern about climate change, their willingness to change behaviors, and their acceptance of policies about climate change. Specifically, causal knowledge significantly increased concern about climate change and willingness to support climate-friendly policies. We therefore concluded that risk communication should focus on causal knowledge, provided this knowledge does not threaten cultural values. © 2015 Society for Risk Analysis.

  6. Draft national health policy 2015: A critical appraisal.

    PubMed

    Ahmed, Faruque U

    2016-01-01

    Revising a health policy of any country is a periodic procedure dependent on the change of demographic profile, current health status of the population including epidemiological changes in disease prevalence pattern, and progress made under the earlier policies. Along with it, newer research revelation of the natural history of the existing and emerging health problems, availability of newer technology as well as changing sociopolitical commitment to improve the health status of the population are the driving forces in the change of policy. Draft National Health Policy (NHP) 2015 is an attempt for the same. A review of the draft has been undertaken. The chapter on introduction is crisp and clear. Situation analysis of the draft is sketchy and without any reference of sources. Shifting the health goal is without any basis, and the objectives defined for the policy change are incongruous with the introduction. A detailed description does not give a clear picture but rather confuses the reader as it talks of comprehensive universal health-care services to be provided with a holistic concept but maximum emphasis is made in the implementation of a national program. Private health-care services are an area to reckon but except for mere references on the involvement in private-public mode, nothing concrete is observed, especially in the primary care level. Involvement envisaged in the secondary and tertiary levels is nebulous. The implementation health insurance program as well as regulatory mechanISM with the existing is also not defined exclusively in the context of a newer health policy.

  7. The evolution of HIV policy in Vietnam: from punitive control measures to a more rights-based approach

    PubMed Central

    Nguyen Ha, Pham; Pharris, Anastasia; Huong, Nguyen Thanh; Chuc, Nguyen Thi Kim; Brugha, Ruairi; Thorson, Anna

    2010-01-01

    Aim Policymaking in Vietnam has traditionally been the preserve of the political elite, not open to the scrutiny of those outside the Communist Party. This paper aims to analyse Vietnam's HIV policy development in order to describe and understand the policy content, policy-making processes, actors and obstacles to policy implementation. Methods Nine policy documents on HIV were analysed and 17 key informant interviews were conducted in Hanoi and Quang Ninh Province, based on a predesigned interview guide. Framework analysis, a type of qualitative content analysis, was applied for data analysis. Results Our main finding was that during the last two decades, developments in HIV policy in Vietnam were driven in a top-down way by the state organs, with support and resources coming from international agencies. Four major themes were identified: HIV policy content, the policy-making processes, the actors involved and human resources for policy implementation. Vietnam's HIV policy has evolved from one focused on punitive control measures to a more rights-based approach, encompassing harm reduction and payment of health insurance for medical costs of patients with HIV-related illness. Low salaries and staff reluctance to work with patients, many of whom are drug users and female sex workers, were described as the main barriers to low health staff motivation. Conclusion Health policy analysis approaches can be applied in a traditional one party state and can demonstrate how similar policy changes take place, as those found in pluralistic societies, but through more top-down and somewhat hidden processes. Enhanced participation of other actors, like civil society in the policy process, is likely to contribute to policy formulation and implementation that meets the diverse needs and concerns of its population. PMID:20824159

  8. The evolution of HIV policy in Vietnam: from punitive control measures to a more rights-based approach.

    PubMed

    Nguyen Ha, Pham; Pharris, Anastasia; Huong, Nguyen Thanh; Chuc, Nguyen Thi Kim; Brugha, Ruairi; Thorson, Anna

    2010-08-28

    Policymaking in Vietnam has traditionally been the preserve of the political elite, not open to the scrutiny of those outside the Communist Party. This paper aims to analyse Vietnam's HIV policy development in order to describe and understand the policy content, policy-making processes, actors and obstacles to policy implementation. Nine policy documents on HIV were analysed and 17 key informant interviews were conducted in Hanoi and Quang Ninh Province, based on a predesigned interview guide. Framework analysis, a type of qualitative content analysis, was applied for data analysis. Our main finding was that during the last two decades, developments in HIV policy in Vietnam were driven in a top-down way by the state organs, with support and resources coming from international agencies. Four major themes were identified: HIV policy content, the policy-making processes, the actors involved and human resources for policy implementation. Vietnam's HIV policy has evolved from one focused on punitive control measures to a more rights-based approach, encompassing harm reduction and payment of health insurance for medical costs of patients with HIV-related illness. Low salaries and staff reluctance to work with patients, many of whom are drug users and female sex workers, were described as the main barriers to low health staff motivation. Health policy analysis approaches can be applied in a traditional one party state and can demonstrate how similar policy changes take place, as those found in pluralistic societies, but through more top-down and somewhat hidden processes. Enhanced participation of other actors, like civil society in the policy process, is likely to contribute to policy formulation and implementation that meets the diverse needs and concerns of its population.

  9. The impact of Border policy effect on cross-border ethnic areas

    NASA Astrophysics Data System (ADS)

    Bie, Q. L.; Zhou, S. Y.; Li, C. S.

    2013-11-01

    Boundary effect analysis is related to border policy making in the cross-border ethnic area. The border effect literatures show that geographic boundaries have obvious impacts on economic, social and cultural relations in both sides of a nation border. Particularly in cross-border ethnic areas, each ethnic group has strong internal spatial structure relevance, and the boundary effect is more obvious. However, most of China's border areas are cross-border ethnic areas, each of border issues is unique. Under this perspective, we analyze the border effects of various boundaries can provide basis for formulating border management policies. For small scale of cross-border ethnic minority areas, how to formulate the boundary management policy is a good question to explore. This paper is demonstrated by a study of the impact of border management policies in Dehong Dai and Jingpo Autonomous Prefecture in Yunnan Province at the border area to Burma. The comparative method is used to analysis the border management policies in past 50 decades for the border area of Yunnan Province .This research aims to define trends within border policy and its influences to national security. This paper also examines Wendy Brown's liberal theory of border management policy. We found that it is not suitable for Sino-Burma border area. The conclusion is that the changes or instability of international economic and political situation has more influence to this cross-border ethnic area, and only innovative policy will be effective in cross-border ethnic area. So the border management policies should reflect the change of international context.

  10. Scientific analysis is essential to assess biofuel policy effects: in response to the paper by Kim and Dale on "Indirect land use change for biofuels: Testing predictions and improving analytical methodologies"

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kline, Keith L; Oladosu, Gbadebo A; Dale, Virginia H

    2011-01-01

    Vigorous debate on the effects of biofuels derives largely from the changes in land use estimated using economic models designed mainly for the analysis of agricultural trade and markets. The models referenced for land-use change (LUC) analysis in the U.S. Environmental Protection Agency Final Rule on the Renewable Fuel Standard include GTAP, FAPRI-CARD, and FASOM. To address bioenergy impacts, these models were expanded and modified to facilitate simulations of hypothesized LUC. However, even when models use similar basic assumptions and data, the range of LUC results can vary by ten-fold or more. While the market dynamics simulated in these modelsmore » include processes that are important in estimating effects of biofuel policies, the models have not been validated for estimating land-use changes and employ crucial assumptions and simplifications that contradict empirical evidence.« less

  11. Out of Bounds: Innovation and Change in Law Enforcement Intelligence Analysis

    DTIC Science & Technology

    2006-03-01

    Community capabilities for policy-level and operational consumers Out of Bounds: Innovation and Change in Law Enforcement Intelligence Analysis...31 4. What Works: Relationships and Sharing...will steer or fund these individuals into pursuing its goals.38 The growing need to understand the nature of low-level crime in relationship to terrorist

  12. Graphics; For Regional Policy Making, a Preliminary Study.

    ERIC Educational Resources Information Center

    Ewald, William R., Jr.

    The use of graphics (maps, charts, diagrams, renderings, photographs) for regional policy formulation and decision making is discussed at length. The report identifies the capabilities of a number of tools for analysis/synthesis/communication, especially computer assisted graphics to assist in community self-education and the management of change.…

  13. Recent Policy Developments in Green Education in the Netherlands

    ERIC Educational Resources Information Center

    Kupper, Hendrik; Laurentzen, Ramona; Mulder, Martin

    2012-01-01

    Purpose: To present a description of recent developments in the Dutch green educational system (agriculture, living environment, food). The article builds on a previous 2006 contribution to "JAEE" where different scenarios for changes in green education were suggested. Design/methodology/approach: An analysis of policy documents from…

  14. Using Enrollment Demand Models in Institutional Pricing Decisions.

    ERIC Educational Resources Information Center

    Weiler, William C.

    1984-01-01

    Issues in the application of enrollment demand analysis to institutions' pricing policy are discussed, including price change impact on enrollment, the role of enrollment demand models on long-range financial and personnel planning, use of tuition and financial aid policy in optimizing policymakers' enrollment objectives, and the redistribution…

  15. The College Access Debate: Class Considerations and College Preparation

    ERIC Educational Resources Information Center

    Hodgman, Matthew R.

    2013-01-01

    The college access debate in America remains an important one. Affirmative action policies and practices continue to occupy a significant sub-component of the overall college access discussion. Recent legal debates and policy changes pertaining to affirmative action have encouraged analysis surrounding the overall viability and fairness of these…

  16. Academics and Advocates: Using Participatory Action Research To Influence Welfare Policy.

    ERIC Educational Resources Information Center

    Quoss, Bernita; Cooney, Margaret; Longhurst, Terri

    2000-01-01

    Participatory action research is a useful technique for helping low income groups access postsecondary education. Conducting research involving analysis of the use of surplus welfare funds and federal regulations and advocating policy changes by explaining the benefits of public investment in postsecondary education are two roles for consumer…

  17. In search of robust flood risk management alternatives for the Netherlands

    NASA Astrophysics Data System (ADS)

    Klijn, F.; Knoop, J. M.; Ligtvoet, W.; Mens, M. J. P.

    2012-05-01

    The Netherlands' policy for flood risk management is being revised in view of a sustainable development against a background of climate change, sea level rise and increasing socio-economic vulnerability to floods. This calls for a thorough policy analysis, which can only be adequate when there is agreement about the "framing" of the problem and about the strategic alternatives that should be taken into account. In support of this framing, we performed an exploratory policy analysis, applying future climate and socio-economic scenarios to account for the autonomous development of flood risks, and defined a number of different strategic alternatives for flood risk management at the national level. These alternatives, ranging from flood protection by brute force to reduction of the vulnerability by spatial planning only, were compared with continuation of the current policy on a number of criteria, comprising costs, the reduction of fatality risk and economic risk, and their robustness in relation to uncertainties. We found that a change of policy away from conventional embankments towards gaining control over the flooding process by making the embankments unbreachable is attractive. By thus influencing exposure to flooding, the fatality risk can be effectively reduced at even lower net societal costs than by continuation of the present policy or by raising the protection standards where cost-effective.

  18. Regional variation in acute care length of stay after orthopaedic surgery total joint replacement surgery and hip fracture surgery.

    PubMed

    Fitzgerald, John D; Weng, Haoling H; Soohoo, Nelson F; Ettner, Susan L

    2013-01-01

    To examine change in regional variations in acute care length of stay (LOS) after orthopedic surgery following expiration of the New York (NY) State exemption to the Prospective Payment System and implementation of the Medicare Short Stay Transfer Policy. Time series analyses were conducted to evaluate change in LOS across regions after policy implementations. Small area analyses were conducted to examine residual variation in LOS. The dataset included A 100% sample of fee-for-service Medicare patients undergoing surgical repair for hip fracture or elective joint replacement surgery between 1996 and 2001. Data files from Centers for Medicare and Medicaid Services 1996-2001 Medicare Provider Analysis and Review file, 1999 Provider of Service file, and data from the 2000 United States Census were used for analysis. In 1996, LOS in NY after orthopedic procedures was much longer than the remainder of the country. After policy changes, LOS fell. However, significant residual variation in LOS persisted. This residual variation was likely partly explained by differences variation in regional managed care market penetration, patient management practices and unmeasured characteristics associated with the hospital location. NY hospitals responded to changes in reimbursement policy, reducing variation in LOS. However, even after 5 years of financial pressure to constrain costs, other factors still have a strong impact on delivery of patient care.

  19. Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity--the behavior change ball.

    PubMed

    Hendriks, Anna-Marie; Jansen, Maria W J; Gubbels, Jessica S; De Vries, Nanne K; Paulussen, Theo; Kremers, Stef P J

    2013-04-18

    Childhood obesity is a 'wicked' public health problem that is best tackled by an integrated approach, which is enabled by integrated public health policies. The development and implementation of such policies have in practice proven to be difficult, however, and studying why this is the case requires a tool that may assist local policy-makers and those assisting them. A comprehensive framework that can help to identify options for improvement and to systematically develop solutions may be used to support local policy-makers. We propose the 'Behavior Change Ball' as a tool to study the development and implementation of integrated public health policies within local government. Based on the tenets of the 'Behavior Change Wheel' by Michie and colleagues (2011), the proposed conceptual framework distinguishes organizational behaviors of local policy-makers at the strategic, tactical and operational levels, as well as the determinants (motivation, capability, opportunity) required for these behaviors, and interventions and policy categories that can influence them. To illustrate the difficulty of achieving sustained integrated approaches, we use the metaphor of a ball in our framework: the mountainous landscapes surrounding the ball reflect the system's resistance to change (by making it difficult for the ball to roll). We apply this framework to the problem of childhood obesity prevention. The added value provided by the framework lies in its comprehensiveness, theoretical basis, diagnostic and heuristic nature and face validity. Since integrated public health policies have not been widely developed and implemented in practice, organizational behaviors relevant to the development of these policies remain to be investigated. A conceptual framework that can assist in systematically studying the policy process may facilitate this. Our Behavior Change Ball adds significant value to existing public health policy frameworks by incorporating multiple theoretical perspectives, specifying a set of organizational behaviors and linking the analysis of these behaviors to interventions and policies. We would encourage examination by others of our framework as a tool to explain and guide the development of integrated policies for the prevention of wicked public health problems.

  20. Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behavior change ball

    PubMed Central

    2013-01-01

    Background Childhood obesity is a ‘wicked’ public health problem that is best tackled by an integrated approach, which is enabled by integrated public health policies. The development and implementation of such policies have in practice proven to be difficult, however, and studying why this is the case requires a tool that may assist local policy-makers and those assisting them. A comprehensive framework that can help to identify options for improvement and to systematically develop solutions may be used to support local policy-makers. Discussion We propose the ‘Behavior Change Ball’ as a tool to study the development and implementation of integrated public health policies within local government. Based on the tenets of the ‘Behavior Change Wheel’ by Michie and colleagues (2011), the proposed conceptual framework distinguishes organizational behaviors of local policy-makers at the strategic, tactical and operational levels, as well as the determinants (motivation, capability, opportunity) required for these behaviors, and interventions and policy categories that can influence them. To illustrate the difficulty of achieving sustained integrated approaches, we use the metaphor of a ball in our framework: the mountainous landscapes surrounding the ball reflect the system’s resistance to change (by making it difficult for the ball to roll). We apply this framework to the problem of childhood obesity prevention. The added value provided by the framework lies in its comprehensiveness, theoretical basis, diagnostic and heuristic nature and face validity. Summary Since integrated public health policies have not been widely developed and implemented in practice, organizational behaviors relevant to the development of these policies remain to be investigated. A conceptual framework that can assist in systematically studying the policy process may facilitate this. Our Behavior Change Ball adds significant value to existing public health policy frameworks by incorporating multiple theoretical perspectives, specifying a set of organizational behaviors and linking the analysis of these behaviors to interventions and policies. We would encourage examination by others of our framework as a tool to explain and guide the development of integrated policies for the prevention of wicked public health problems. PMID:23597122

  1. The SAZA study: implementing health financing reform in South Africa and Zambia.

    PubMed

    Gilson, Lucy; Doherty, Jane; Lake, Sally; McIntyre, Di; Mwikisa, Chris; Thomas, Stephen

    2003-03-01

    This paper explores the policy-making process in the 1990s in two countries, South Africa and Zambia, in relation to health care financing reforms. While much of the analysis of health reform programmes has looked at design issues, assuming that a technically sound design is the primary requirement of effective policy change, this paper explores the political and bureaucratic realities shaping the pattern of policy change and its impacts. Through a case study approach, it provides a picture of the policy environment and processes in the two countries, specifically considering the extent to which technical analysts and technical knowledge were able to shape policy change. The two countries' experiences indicate the strong influence of political factors and actors over which health care financing policies were implemented, and which not, as well as over the details of policy design. Moments of political transition in both countries provided political leaders, specifically Ministers of Health, with windows of opportunity in which to introduce new policies. However, these transitions, and the changes in administrative structures introduced with them, also created environments that constrained the processes of reform design and implementation and limited the equity and sustainability gains achieved by the policies. Technical analysts, working either inside or outside government, had varying and often limited influence. In part, this reflected the limits of their own capacity as well as weaknesses in the way they were used in policy development. In addition, the analysts were constrained by the fact that their preferred policies often received only weak political support. Focusing almost exclusively on designing policy reforms, these analysts gave little attention to generating adequate support for the policy options they proposed. Finally, the country experiences showed that front-line health workers, middle level managers and the public had important influences over policy implementation and its impacts. The limited attention given to communicating policy changes to, or consulting with, these actors only heightened the potential for reforms to result in unanticipated and unwanted impacts. The strength of the paper lies in its 'thick description' of the policy process in each country, an empirical case study approach to policy that is under-represented in the literature. While such an approach allows only a cautious drawing of general conclusions, it suggests a number of ways in which to strengthen the implementation of financing policies in each country.

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

    PubMed

    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.

  3. Implementing Health and Safety Policy Changes at the High School Level From a Leadership Perspective

    PubMed Central

    Pagnotta, Kelly D.; Mazerolle, Stephanie M.; Pitney, William A.; Burton, Laura J.; Casa, Douglas J.

    2016-01-01

    Context:  Although consensus statements and recommendations from professional organizations aim to reduce the incidence of injury or sudden death in sport, nothing is mandated at the high school level. This allows states the freedom to create and implement individual policies. An example of a recommended policy is heat acclimatization. Despite its efficacy in reducing sudden death related to heat stroke, very few states follow the recommended guidelines. Objective:  To retroactively examine why and how 3 states were able to facilitate the successful creation and adoption of heat-acclimatization guidelines. Design:  Qualitative study. Setting:  High school athletic associations in Arkansas, Georgia, and New Jersey. Patients or Other Participants:  Eight men and 3 women (n = 11; 6 athletic trainers; 2 members of high school athletic associations; 2 parents; 1 physician) participated. Participant recruitment ceased when data saturation was reached. Data Collection and Analysis:  All phone interviews were digitally recorded and transcribed verbatim. A grounded-theory approach guided analysis and multiple analysts and peer review were used to establish credibility. Results:  Each state had a different catalyst to change (student-athlete death, empirical data, proactivity). Recommendations from national governing bodies guided the policy creation. Once the decision to implement change was made, the states displayed 2 similarities: shared leadership and open communication between medical professionals and members of the high school athletic association helped overcome barriers. Conclusions:  The initiating factor that spurred the change varied, yet shared leadership and communication fundamentally allowed for successful adoption of the policy. Our participants were influenced by the recommendations from national governing bodies, which align with the institutional change theory. As more states begin to examine and improve their health and safety policies, this information could serve as a valuable resource for athletic trainers in other states and for future health and safety initiatives. PMID:27002250

  4. A paradigm analysis of ecological sustainability: The emerging polycentric climate change publics

    NASA Astrophysics Data System (ADS)

    Taminiau, Job B.

    Climate change poses significant complications to the development model employed by modern societies. Using paradigm analysis, the dissertation explains why, after 21 years, policy failure haunts the field: a key impediment is the unquestioned assumption that policy must adhere to an economic optimality principle. This results in policy models which fail to uphold sustainability, justice, and equality due to an emphasis on economic growth, technology, and technical and bureaucratic expertise. Unable to build consensus among low- and high-carbon economies, and searching for what one economist has called an oxymoron -- "sustainable growth" (Daly, 1997) -- the policy process has foundered with its only international convention (the Kyoto Protocol) having lost relevance. In the midst of this policy failure, the dissertation offers and defends the premise that alternative strategies have emerged which signal the prospect of a paradigm shift to ecological sustainability -- a paradigm in which social change takes places through commons-based management and community authorship in the form of network governance and where sustainability serves as governor of growth -- something unavailable in an optimality-guided world. Especially, a strategy of polycentricity is discussed in detail in order to elucidate the potential for a paradigm shift. This discussion is followed by an evaluation of two innovative concepts -- the Sustainable Energy Utility and the Solar City -- that might fit the polycentricity strategy and bring forth transformative change. The dissertation finds considerable potential rests in these two concepts and argues the critical importance of further development of innovative approaches to implement the ecological sustainability paradigm.

  5. Multilevel spatiotemporal change-point models for evaluating the effect of an alcohol outlet control policy on changes in neighborhood assaultive violence rates.

    PubMed

    Xu, Yanjun; Yu, Qingzhao; Scribner, Richard; Theall, Katherine; Scribner, Scott; Simonsen, Neal

    2012-06-01

    Many previous studies have suggested a link between alcohol outlets and assaultive violence rates. In 1997 the City of New Orleans adopted a series of policies, e.g., increased license fee, additional enforcement staff, and expanded powers for the alcohol license board. The policies were specifically enacted to address the proliferation of problem alcohol outlets believed to be the source of a variety of social problems including assaultive violence. In this research, we evaluate the impact of a city level policy in New Orleans to address the problem alcohol outlets and their influence on assaultive violence. The spatial association between rates of assaultive violence at the census tract level (n=170) over a ten year period raises a challenge in statistical analysis. To meet this challenge we developed a hierarchical change-point model that controls for important covariates of assaultive violence and accounts for unexplained spatial and temporal variability. While our model is somewhat complex, its hierarchical Bayesian analysis is accessible via the WinBUGS software program. Keeping other effects fixed, the implementation of the new city level policy was associated with a decrease in the positive association between census tract level rates of assaultive violence and alcohol outlet density. Comparing several candidate change-point models using the DIC criterion, the positive association began decreasing the year of the policy implementation. The magnitude of the association continued to decrease for roughly two years and then stabilized. We also created maps of the fitted assaultive violence rates in New Orleans, as well as spatial residual maps which, together with Moran's I's, suggest that the spatial variation of the data is well accounted for by our model. We reach the conclusion that the implementation of the policy is associated with a significant decrease in the positive relationship between assaultive violence and the off-sale alcohol outlet density. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Sensitizing events as trigger for discursive renewal and institutional change in Flanders’ environmental health approach, 1970s-1990s

    PubMed Central

    2013-01-01

    Background Sensitizing events may trigger and stimulate discursive renewal. From a discursive institutional perspective, changing discourses are the driving force behind the institutional dynamics of policy domains. Theoretically informed by discursive institutionalism, this article assesses the impact of a series of four sensitizing events that triggered serious environmental health concerns in Flanders between the 1970s till the 1990s, and led onto the gradual institutionalization of a Flemish environmental health arrangement. Methods The Policy Arrangement Approach is used as the analytical framework to structure the empirical results of the historical analysis based on document analysis and in-depth interviews. Results Until the 1990s, environmental health was characterized as an ad hoc policy field in Flanders, where agenda setting was based on sensitizing events – also referred to as incident-driven. Each of these events contributed to a gradual rethinking of the epistemological discourses about environmental health risks and uncertainties. These new discourses were the driving forces behind institutional dynamics as they gradually resulted in an increased need for: 1) long-term, policy-oriented, interdisciplinary environmental health research; 2) policy coordination and integration between the environmental and public health policy fields; and 3) new forms of science-policy interactions based on mutual learning. These changes are desirable in order to detect environmental health problems as fast as possible, to react immediately and communicate appropriately. Conclusions The series of four events that triggered serious environmental health concerns in Flanders provided the opportunity to rethink and re-organize the current affairs concerning environmental health and gradually resulted into the institutionalization of a Flemish environmental health arrangement. PMID:23758822

  7. Policy Transfer Among Regional-Level Organizations: Insights from Source Water Protection in Ontario.

    PubMed

    de Loë, R C; Murray, D; Michaels, S; Plummer, R

    2016-07-01

    Organizations at the local and regional scales often face the challenge of developing policy mechanisms rapidly and concurrently, whether in response to expanding mandates, newly identified threats, or changes in the political environment. In the Canadian Province of Ontario, rapid, concurrent policy development was considered desirable by 19 regional organizations tasked with developing policies for protection of drinking water sources under very tight and highly prescribed mandates. An explicit policy transfer approach was used by these organizations. Policy transfer refers to using knowledge of policies, programs, and institutions in one context in the development of policies, programs, and institutions in another. This paper assesses three online mechanisms developed to facilitate policy transfer for source water protection in Ontario. Insights are based on a survey of policy planners from the 19 regional organizations who used the three policy transfer tools, supplemented by an analysis of three policies created and transferred among the 19 regional source water protection organizations. Policy planners in the study indicated they had used policy transfer to develop source protection policies for their regions-a finding confirmed by analysis of the text of policies. While the online policy transfer tools clearly facilitated systematic policy transfer, participants still preferred informal, direct exchanges with their peers in other regions over the use of the internet-based policy transfer mechanisms created on their behalf.

  8. A new decision sciences for complex systems.

    PubMed

    Lempert, Robert J

    2002-05-14

    Models of complex systems can capture much useful information but can be difficult to apply to real-world decision-making because the type of information they contain is often inconsistent with that required for traditional decision analysis. New approaches, which use inductive reasoning over large ensembles of computational experiments, now make possible systematic comparison of alternative policy options using models of complex systems. This article describes Computer-Assisted Reasoning, an approach to decision-making under conditions of deep uncertainty that is ideally suited to applying complex systems to policy analysis. The article demonstrates the approach on the policy problem of global climate change, with a particular focus on the role of technology policies in a robust, adaptive strategy for greenhouse gas abatement.

  9. The impact of food and agricultural policies on groundwater use in Syria

    NASA Astrophysics Data System (ADS)

    Aw-Hassan, Aden; Rida, Fadel; Telleria, Roberto; Bruggeman, Adriana

    2014-05-01

    During the last three decades, the expansion of irrigation using both surface water and groundwater resources has had an important positive impact on Syria’s agricultural production. It is an example of success in achieving food policy objectives, but it has also introduced the challenge of groundwater sustainability. This paper examines the trends in groundwater abstraction for irrigation and the effect of government policies, including input subsidies - such as the diesel fuel subsidy and the crop procurement price support. The fuel subsidy is an important driving force in groundwater depletion and over-abstraction. This analysis examines the interaction between policy signals and the use and allocation of water by farmers. The rapid decline in groundwater resources shows the limitations of this agricultural development strategy and questions its sustainability unless policies change and the rate of abstraction is changed so as not exceed the recharge rate.

  10. Welfare reform, family support, and child development: perspectives from policy analysis and developmental psychopathology.

    PubMed

    Knitzer, J; Yoshikawa, H; Cauthen, N K; Aber, J L

    2000-01-01

    This article explores the implications of recent welfare-related policy change for the well-being of children in low-income families, and for research investigating child development processes and outcomes. It provides an overview of current welfare-related policies and explores the implications for developmental researchers. The article also synthesizes early findings from research, highlighting both overall impacts and the more nuanced evidence that while families are transitioning off welfare, only a small number are transitioning out of poverty, and a subgroup of families at risk are not faring well. It then examines, from a theoretical and methodological framework, what developmental psychopathology might bring to the study of welfare-related impacts on children in the context of this complex and changing policy landscape, and what welfare researchers might bring to the field of developmental psychopathology. The article concludes with broad recommendations for both research and policy.

  11. “…still waiting for chloroquine”: the challenge of communicating changes in first-line treatment policy for uncomplicated malaria in a remote Kenyan district

    PubMed Central

    2014-01-01

    Background Widespread parasite resistance to first-line treatment for uncomplicated malaria leads to introduction of new drug interventions. Introducing such interventions is complex and sensitive because of stakeholder interests and public resistance. To enhance take up of such interventions, health policy communication strategies need to deliver accurate and accessible information to empower communities with necessary information and address problems of cultural acceptance of new interventions. Objectives To explore community understanding of policy changes in first-line treatment for uncomplicated malaria in Kenya; to evaluate the potential role of policy communication in influencing responses to changes in first-line treatment policy. Methods Data collection involved qualitative strategies in a remote district in the Kenyan Coast: in-depth interviews (n = 29), focus group discussions (n = 14), informal conversations (n = 11) and patient narratives (n = 8). Constant comparative method was used in the analysis. Being malaria-prone and remotely located, the district offered an ideal area to investigate whether or not and how policy communication about a matter as critical as change of treatment policy reaches vulnerable populations. Results Three years after initial implementation (2009), there was limited knowledge or understanding regarding change of first-line treatment from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL) for treatment of uncomplicated malaria in the study district. The print and electronic media used to create awareness about the drug change appeared to have had little impact. Although respondents were aware of the existence of AL, the drug was known neither by name nor as the official first-line treatment. Depending on individuals or groups, AL was largely viewed negatively. The weaknesses in communication strategy surrounding the change to AL included poor choice of communication tools, confusing advertisements of other drugs and conflicts between patients and providers. Conclusion Effective health policy communication is important for the uptake of new drug interventions and adherence to treatment regimens. Besides, prompt access to effective treatment may not be achieved if beneficiaries are not adequately informed about treatment policy changes. Future changes in treatment policy should ensure that the communication strategy is designed to pass sustained, accurate and effective messages that account for local contexts. PMID:25005337

  12. "…still waiting for chloroquine": the challenge of communicating changes in first-line treatment policy for uncomplicated malaria in a remote Kenyan district.

    PubMed

    Okungu, Vincent; Gilson, Lucy

    2014-07-08

    Widespread parasite resistance to first-line treatment for uncomplicated malaria leads to introduction of new drug interventions. Introducing such interventions is complex and sensitive because of stakeholder interests and public resistance. To enhance take up of such interventions, health policy communication strategies need to deliver accurate and accessible information to empower communities with necessary information and address problems of cultural acceptance of new interventions. To explore community understanding of policy changes in first-line treatment for uncomplicated malaria in Kenya; to evaluate the potential role of policy communication in influencing responses to changes in first-line treatment policy. Data collection involved qualitative strategies in a remote district in the Kenyan Coast: in-depth interviews (n = 29), focus group discussions (n = 14), informal conversations (n = 11) and patient narratives (n = 8). Constant comparative method was used in the analysis. Being malaria-prone and remotely located, the district offered an ideal area to investigate whether or not and how policy communication about a matter as critical as change of treatment policy reaches vulnerable populations. Three years after initial implementation (2009), there was limited knowledge or understanding regarding change of first-line treatment from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL) for treatment of uncomplicated malaria in the study district. The print and electronic media used to create awareness about the drug change appeared to have had little impact. Although respondents were aware of the existence of AL, the drug was known neither by name nor as the official first-line treatment. Depending on individuals or groups, AL was largely viewed negatively. The weaknesses in communication strategy surrounding the change to AL included poor choice of communication tools, confusing advertisements of other drugs and conflicts between patients and providers. Effective health policy communication is important for the uptake of new drug interventions and adherence to treatment regimens. Besides, prompt access to effective treatment may not be achieved if beneficiaries are not adequately informed about treatment policy changes. Future changes in treatment policy should ensure that the communication strategy is designed to pass sustained, accurate and effective messages that account for local contexts.

  13. Risks posed by climate change to the delivery of Water Framework Directive objectives in the UK.

    PubMed

    Wilby, R L; Orr, H G; Hedger, M; Forrow, D; Blackmore, M

    2006-12-01

    The EU Water Framework Directive (WFD) is novel because it integrates water quality, water resources, physical habitat and, to some extent, flooding for all surface and groundwaters and takes forward river basin management. However, the WFD does not explicitly mention risks posed by climate change to the achievement of its environmental objectives. This is despite the fact that the time scale for the implementation process and achieving particular objectives extends into the 2020s, when climate models project changes in average temperature and precipitation. This paper begins by reviewing the latest UK climate change scenarios and the wider policy and science context of the WFD. We then examine the potential risks of climate change to key phases of the River Basin Management Process that underpin the WFD (such as characterisation of river basins and their water bodies, risk assessments to identify pressures and impacts, programmes of measures (POMs) options appraisal, monitoring and modelling, policy and management activities). Despite these risks the WFD could link new policy and participative mechanisms (being established for the River Basin Management Plans) to the emerging framework of national and regional climate change adaptation policy. The risks are identified with a view to informing policy opportunities, objective setting, adaptation strategies and the research agenda. Key knowledge gaps have already been identified during the implementation of the WFD, such as the links between hydromorphology and ecosystem status, but the overarching importance of linking climate change to these considerations needs to be highlighted. The next generation of (probabilistic) climate change scenarios will present new opportunities and challenges for risk analysis and policy-making.

  14. Changes in Georgia restaurant and bar smoking policies from 2006 to 2012.

    PubMed

    Chandora, Rachna D; Whitney, Carrie F; Weaver, Scott R; Eriksen, Michael P

    2015-05-14

    The purpose of this study is to examine the change in smoking policy status among Georgia restaurants and bars from 2006 to 2012 and to identify restaurant and bar characteristics that are associated with allowing smoking. Data were obtained from similar cross-sectional indoor air surveys conducted in 2006 and 2012 in Georgia. Both surveys were designed to gather information about restaurant and bar smoking policies. Weighted χ(2) analyses were performed to identify changes in smoking policy status and other variables from 2006 to 2012. Weighted logistic regression analysis was used to test for significant associations between an establishment's smoking policy and other characteristics. The percentage of restaurants and bars in Georgia that allowed smoking nearly doubled, from 9.1% in 2006 to 17.6% in 2012. The analyses also showed a significant increase in the percentage of establishments that allow smoking when minors are present. Having a liquor license was a significant predictor of allowing smoking. The Smokefree Air Act was enacted in 2005 to protect the health and welfare of Georgia citizens, but study results suggest that policy makers should reevaluate the law and consider strengthening it to make restaurants and bars 100% smokefree without exemptions.

  15. Judges, Legislators, and Social Change

    ERIC Educational Resources Information Center

    Dienes, C. Thomas

    1970-01-01

    The interaction analysis scheme describes the adjustment of the legal system to change. It is a dynamic decision-making process interacting internally among the judicial and legislative subsystems, and, externally with the social environment in the policy-making process. (SE)

  16. Abortion in Latin America: changes in practice, growing conflict, and recent policy developments.

    PubMed

    Kulczycki, Andrzej

    2011-09-01

    Latin America is undergoing profound social, economic, political, demographic, and epidemiologic change. Reproductive health indicators have generally improved over the past two decades, but most pregnancies are still unintended and more than 4 million are terminated annually. Clandestine abortions necessitated by restrictive legal and social structures cause more than 1,000 deaths and 500,000 hospitalizations per year, primarily among poor and marginalized women. Abortions are becoming safer and less frequent, however, as a consequence of increased modern contraceptive use, misoprostol adoption, emergency contraception availability, and postabortion care provision, notwithstanding many impediments to these changes. Advocacy and conflict over abortion have grown. The contested policy shifts include Mexico City's 2007 legalization of first-trimester abortion. Drawing on numerous sources of evidence, this article provides a regional analysis of the rapidly changing practice and context of abortion in Latin America, and examines emerging issues, legal and policy developments, and contrasting country situations.

  17. Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study.

    PubMed

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

    2018-05-01

    There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced policy decisions through pathways involving policy issue networks, interest groups interaction and evidence-supported ideas and how they influenced the general climate for EIHSP.

  18. Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study

    PubMed Central

    Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2018-01-01

    Abstract There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced policy decisions through pathways involving policy issue networks, interest groups interaction and evidence-supported ideas and how they influenced the general climate for EIHSP. PMID:29506146

  19. Economic effect of restaurant smoking restrictions on restaurant business in Massachusetts, 1992 to 1998.

    PubMed

    Bartosch, William J; Pope, G C

    2002-06-01

    To determine if restaurant business declines or improves after the implementation of restrictive restaurant smoking policies. Analysis used a pre/post-quasi-experimental design that compared town meals tax receipts before and after the imposition of highly restrictive restaurant smoking policies in adopting versus non-adopting communities. The effect of restaurant smoking policies was estimated using a fixed effects regression model, entering a panel of 84 months of data for the 239 towns in the study. A separate model estimated the effect of restaurant smoking policies on establishments that served alcohol. Change in the trend in meals tax revenue (adjusted for population) following the implementation of highly restrictive restaurant smoking policies. The local adoption of restrictive restaurant smoking policies did not lead to a measurable deviation from the strong positive trend in revenue between 1992 and 1998 that restaurants in Massachusetts experienced. Controlling for other less restrictive restaurant smoking policies did not change this finding. Similar results were found for only those establishments that served alcoholic beverages. Highly restrictive restaurant smoking policies do not have a significant effect on a community's level of meal receipts, indicating that claims of community wide restaurant business decline under such policies are unwarranted.

  20. Ecosocial consequences and policy implications of disease management in East African agropastoral systems.

    PubMed

    Gutierrez, Andrew Paul; Gilioli, Gianni; Baumgärtner, Johann

    2009-08-04

    International research and development efforts in Africa have brought ecological and social change, but analyzing the consequences of this change and developing policy to manage it for sustainable development has been difficult. This has been largely due to a lack of conceptual and analytical models to access the interacting dynamics of the different components of ecosocial systems. Here, we examine the ecological and social changes resulting from an ongoing suppression of trypanosomiasis disease in cattle in an agropastoral community in southwest Ethiopia to illustrate how such problems may be addressed. The analysis combines physiologically based demographic models of pasture, cattle, and pastoralists and a bioeconomic model that includes the demographic models as dynamic constraints in the economic objective function that maximizes the utility of individual consumption under different level of disease risk in cattle. Field data and model analysis show that suppression of trypanosomiasis leads to increased cattle and human populations and to increased agricultural development. However, in the absence of sound management, these changes will lead to a decline in pasture quality and increase the risk from tick-borne diseases in cattle and malaria in humans that would threaten system sustainability and resilience. The analysis of these conflicting outcomes of trypanosomiasis suppression is used to illustrate the need for and utility of conceptual bioeconomic models to serve as a basis for developing policy for sustainable agropastoral resource management in sub-Saharan Africa.

  1. An Analysis of the President’s Budgetary Proposals for Fiscal Year 1993

    DTIC Science & Technology

    1992-03-01

    exchange value of determining the appropriate monetary policy . the dollar will provide a mild stimulus to net At the same time, the conduct of monetary...in function 3M0. and the proposed payout to Alaska of its share of receipts is shown in function 800. Proposed Changes Pay-As-You-Go Policy Changes The... firms through the over the next five years. Over the long term, formation of financial -services holding com- they should lead to a more diversified, more

  2. The Impacts of Changes to Nevada’s Net Metering Policy on the Financial Performance and Adoption of Distributed Photovoltaics

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gagnon, Pieter; Sigrin, Ben; Gleason, Mike

    Net energy metering (NEM) is a billing mechanism that has historically compensated owners of distributed generation systems at retail rates for any electricity that they export back to the grid rather than consume on-site. NEM can significantly enhance the financial performance of distributed generation systems from the owner’s perspective. The following analysis was designed to illustrate the potential impact of NEM policy and tariff changes implemented in early 2016 in Nevada.

  3. In Search of Leadership: What Happened to Management?

    ERIC Educational Resources Information Center

    Mertkan, Sefika

    2014-01-01

    Significant changes have taken place in the governance of education systems around the world. Shifts in education policy have led to a focus towards reform through leadership development and away from school management analysis. This shift in policy from management to leadership has fostered a large number of academic studies presenting a…

  4. Changing Legislation and Its Effects on Inclusive and Special Education: Scotland

    ERIC Educational Resources Information Center

    Riddell, Sheila; Weedon, Elisabet

    2014-01-01

    This article, by Sheila Riddell and Elisabet Weedon of the Centre for Research in Education Inclusion and Diversity, University of Edinburgh, analyses recent policy developments and outcomes in the field of additional support needs in Scotland in the context of devolution and austerity, drawing on a critical analysis of policy and administrative…

  5. Policy Choices in Vocational Education [and] Technical Appendix.

    ERIC Educational Resources Information Center

    Institute for the Future, Menlo Park, CA.

    This report examines the impact of changes in the vocational education environment that are likely to be important to policymakers over the next fifteen years. It contains forecasts of a number of trends that will be of significance to vocational educators, an analysis of the policy implications of those trends in the education environments, and…

  6. MOOCs, Institutional Policy and Change Dynamics in Higher Education

    ERIC Educational Resources Information Center

    O'Connor, Kate

    2014-01-01

    The last couple of years have witnessed a growing debate about online learning in higher education, notably in response to the global massive open online course (MOOC) phenomenon. This paper explores these developments from an institutional policy perspective, drawing on an analysis of the initial stages of different approaches to MOOCs and…

  7. Manpower Aspects of Recent Economic Developments in Europe.

    ERIC Educational Resources Information Center

    International Labour Office, Geneva (Switzerland).

    This book examined economic growth and manpower policy and developments in Europe. Chapter I presents statistical data on labor force growth, trends in unemployment, occupational structure, and technological change for 1950-65 and made projections for 1965-80. The second chapter is an analysis of the relationship of manpower policy to general…

  8. Japan's Higher Education Incorporation Policy: A Comparative Analysis of Three Stages of National University Governance

    ERIC Educational Resources Information Center

    Hanada, Shingo

    2013-01-01

    A number of countries with public higher education systems have implemented privatisation policies. In Japan, the national government introduced the National University Corporation Act (NUCA) in 2004 and changed the legal status of national universities from that of government-owned public institutions to independent administrative agencies. Its…

  9. Contemporary Public Policy Influencing Children and Families: "Compassionate" Social Provision or the Regulation of "Others"?

    ERIC Educational Resources Information Center

    Cannella, Gaile S.; Swadener, Beth Blue

    2006-01-01

    Critical analysis of change in public policy within and across nations recognizes that the education and welfare of children, families, and all citizens is intertwined with economics, politics, and cultural discourse(s). In the United States, increasingly narrow media, judiciary, and academic discourses have supported legislative actions that…

  10. Federal Support for Higher Education: A Position Perspective.

    ERIC Educational Resources Information Center

    Phillips, Roy G.

    An analysis is provided of the role of the federal government in higher education and the kinds and level of financial support the federal government should provide. Introductory material reviews recent changes to the prevailing federal policy over the past 25 years and discusses the policy issues raised by current efforts to reduce the federal…

  11. Higher Education Policy and Institutional Change: Intentions and Outcomes in Turbulent Environments.

    ERIC Educational Resources Information Center

    Trowler, Paul R., Ed.

    The chapters in this collection focus on three levels of analysis of higher education: national policymaking, institutional strategy, and the ground level of departments and individual academics. Examples from various countries are analyzed in light of recent theoretical understandings of the policy process. The chapters are: (1) Introduction:…

  12. Did state renewable portfolio standards induce technical change in methane mitigation in the U.S. landfill sector?

    NASA Astrophysics Data System (ADS)

    Delhotal, Katherine Casey

    Landfill gas (LFG) projects use the gas created from decomposing waste, which is approximately 49% methane, and substitute it for natural gas in engines, boilers, turbines, and other technologies to produce energy or heat. The projects are beneficial in terms of increased safety at the landfill, production of a cost-effective source of energy or heat, reduced odor, reduced air pollution emissions, and reduced greenhouse gas emissions. However, landfills sometimes face conflicting policy incentives. The theory of technical change shows that the diffusion of a technology or groups of technologies increases slowly in the beginning and then picks up speed as knowledge and better understanding of using the technology diffuses among potential users. Using duration analysis, data on energy prices, State and Federal policies related to landfill gas, renewable energy, and air pollution, as well as control data on landfill characteristics, I estimate the influence and direction of influence of renewable portfolio standards (RPS). The analysis found that RPS positively influences the diffusion of landfill gas technologies, encouraging landfills to consider electricity generation projects over direct sales of LFG to another facility. Energy price increases or increased revenues for a project are also critical. Barriers to diffusion include air emission permits in non-attainment areas and policies, such as net metering, which promote other renewables over LFG projects. Using the estimates from the diffusion equations, I analyze the potential influence of a Federal RPS as well as the potential interaction with a Federal, market based climate change policy, which will increase the revenue of a project through higher energy sale prices. My analysis shows that a market based climate change policy such as a cap-and-trade or carbon tax scheme would increase the number of landfill gas projects significantly more than a Federal RPS.

  13. The effects of country-level population policy for enhancing adaptation to climate change

    NASA Astrophysics Data System (ADS)

    Gunasekara, N. K.; Kazama, S.; Yamazaki, D.; Oki, T.

    2013-11-01

    The effectiveness of population policy in reducing the combined impacts of population change and climate change on water resources is explored. One no-policy scenario and two scenarios with population policy assumptions are employed in combination with water availability under the SRES scenarios A1b, B1 and A2 for the impact analysis. The population data used are from the World Bank. The river discharges per grid of horizontal resolution 0.5° are obtained from the Total Runoff Integrating Pathways (TRIP) of the University of Tokyo, Japan. Unlike the population scenarios utilized in the SRES emission scenarios and the newest representative concentration pathways, the scenarios employed in this research are based, even after 2050, on country-level rather than regional-level growth assumptions. Our analysis implies that the heterogeneous pattern of population changes across the world is the dominant driver of water stress, irrespective of future greenhouse gas emissions, with highest impacts occurring in the already water-stressed low latitudes. In 2100, Africa, Middle East and parts of Asia are under extreme water stress under all scenarios. The sensitivity analysis reveals that a small reduction in populations over the region could relieve a large number of people from high water stress, while a further increase in population from the assumed levels (SC1) might not increase the number of people under high water stress considerably. Most of the population increase towards 2100 occurs in the already water-stressed lower latitudes. Therefore, population reduction policies are recommended for this region as a method of adaptation to the future water stress conditions. Population reduction policies will facilitate more control over their future development pathways, even if these countries were not able to contribute significantly to greenhouse gas (GHG) emission cuts due to economic constraints. However, for the European region, the population living in water-stressed regions is almost 20 times lower than that in the lower latitudes. For countries with high population momentum, the population policy scenario with fertility-reduction assumptions gained a maximum of 6.1 times the water availability in Niger and 5.3 times that in Uganda compared with the no-policy scenario. Most of these countries are in sub-Saharan Africa. These countries represent 24.5% of the global population in the no-policy scenario, and the scenario with fertility-reduction assumptions reduces it to 8.7% by 2100. This scenario is also effective in reducing the area under extreme water stress in these countries. However, the policy scenario with assumptions of population stabilization at the replacement fertility rate increases the water stress in high-latitude countries. Nevertheless, the impact is low due to the high per capita water availability in the region. This research is expected to widen the understanding of the combined impacts of climate change in the future and of the strategies needed to enhance the space for adaptation.

  14. The Neo-Liberal Turn in Understanding Teachers' and School Leaders' Work Practices in Curriculum Innovation and Change: A Critical Discourse Analysis of a Newly Proposed Reform Policy in Lower Secondary Education in the Republic of Ireland

    ERIC Educational Resources Information Center

    Simmie, Geraldine Mooney

    2014-01-01

    The study in this article involved a critical discourse analysis of five policy documents in relation to a curriculum reform proposed for lower secondary education in the Republic of Ireland. It examined the (re)positioning of governance in relation to curriculum and teacher education. Findings indicate a predominant clinical discourse closely…

  15. Climate change studies and the human sciences

    NASA Astrophysics Data System (ADS)

    Holm, Poul; Winiwarter, Verena

    2017-09-01

    Policy makers have made repeated calls for integration of human and natural sciences in the field of climate change. Serious multidisciplinary attempts began already in the 1950s. Progress has certainly been made in understanding the role of humans in the planetary system. New perspectives have clarified policy advice, and three insights are singled out in the paper: the critique of historicism, the distinction between benign and wicked problems, and the cultural critique of the 'myths of nature'. Nevertheless, analysis of the IPCC Assessment Reports indicates that integration is skewed towards a particular dimension of human sciences (economics) and major insights from cultural theory and historical analysis have not made it into climate science. A number of relevant disciplines are almost absent in the composition of authorship. Nevertheless, selective assumptions and arguments are made about e.g. historical findings in key documents. In conclusion, we suggest to seek remedies for the lack of historical scholarship in the IPCC reports. More effort at science-policy exchange is needed, and an Integrated Platform to channel humanities and social science expertise for climate change research might be one promising way.

  16. Effective social justice advocacy: a theory-of-change framework for assessing progress.

    PubMed

    Klugman, Barbara

    2011-11-01

    This article offers a theory-of-change framework for social justice advocacy. It describes broad outcome categories against which activists, donors and evaluators can assess progress (or lack thereof) in an ongoing manner: changes in organisational capacity, base of support, alliances, data and analysis from a social justice perspective, problem definition and potential policy options, visibility, public norms, and population level impacts. Using these for evaluation enables activists and donors to learn from and rethink their strategies as the political context and/or actors change over time. The paper presents a case study comparing factors that facilitated reproductive rights policy wins during the transition from apartheid to democracy in South Africa and factors that undermined their implementation in the post-apartheid period. It argues that after legal and policy victories had been won, failure to maintain strong organizations and continually rethink strategies contributed to the loss of government focus on and resources for implementation of new policies. By implication, evaluating effectiveness only by an actual policy change does not allow for ongoing learning to ensure appropriate strategies. It also fails to recognise that a policy win can be overturned and needs vigilant monitoring and advocacy for implementation. This means that funding and organising advocacy should seldom be undertaken as a short-term proposition. It also suggests that the building and maintenance of organisational and leadership capacity is as important as any other of the outcome categories in enabling success. Copyright © 2011 Foundation Review. Published by Elsevier Ltd. All rights reserved.

  17. Production efficiencies of U.S. electric generation plants: Effects of data aggregation and greenhouse gas and renewable energy policy

    NASA Astrophysics Data System (ADS)

    Lynes, Melissa Kate

    Over the last few decades there has been a shift in electricity production in the U.S. Renewable energy sources are becoming more widely used. In addition, electric generation plants that use coal inputs are more heavily regulated than a couple decades ago. This shift in electricity production was brought on by changes in federal policy -- a desire for electricity produced in the U.S. which led to policies being adopted that encourage the use of renewable energy. The change in production practices due to policies may have led to changes in the productivity of electric generation plants. Multiple studies have examined the most efficient electric generation plants using the data envelopment analysis (DEA) approach. This study builds on past research to answer three questions: 1) Does the level of aggregation of fuel input variables affect the plant efficiency scores and how does the efficiency of renewable energy input compare to nonrenewable energy inputs; 2) Are policies geared toward directly or indirectly reducing greenhouse gas emissions affecting the production efficiencies of greenhouse gas emitting electric generation plants; and 3) Do renewable energy policies and the use of intermittent energy sources (i.e. wind and solar) affect the productivity growth of electric generation plants. All three analysis, presented in three essays, use U.S. plant level data obtained from the Energy Information Administration to answer these questions. The first two essays use DEA to determine the pure technical, overall technical, and scale efficiencies of electric generation plants. The third essay uses DEA within the Malmquist index to assess the change in productivity over time. Results indicate that the level of aggregation does matter particularly for scale efficiency. This implies that valuable information is likely lost when fuel inputs are aggregated together. Policies directly focused on reducing greenhouse gas emissions may improve the production efficiencies of greenhouse gas emitting electric generation plants. However, renewable energy policies do not have an effect on productivity growth. Renewable energy inputs are found to be as efficient if not more efficient than traditional energy sources.

  18. Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing.

    PubMed

    Larkin, Ian; Ang, Desmond; Steinhart, Jonathan; Chao, Matthew; Patterson, Mark; Sah, Sunita; Wu, Tina; Schoenbaum, Michael; Hutchins, David; Brennan, Troyen; Loewenstein, George

    2017-05-02

    In an effort to regulate physician conflicts of interest, some US academic medical centers (AMCs) enacted policies restricting pharmaceutical representative sales visits to physicians (known as detailing) between 2006 and 2012. Little is known about the effect of these policies on physician prescribing. To analyze the association between detailing policies enacted at AMCs and physician prescribing of actively detailed and not detailed drugs. The study used a difference-in-differences multivariable regression analysis to compare changes in prescribing by physicians before and after implementation of detailing policies at AMCs in 5 states (California, Illinois, Massachusetts, Pennsylvania, and New York) that made up the intervention group with changes in prescribing by a matched control group of similar physicians not subject to a detailing policy. Academic medical center implementation of policies regulating pharmaceutical salesperson visits to attending physicians. The monthly within-drug class market share of prescriptions written by an individual physician for detailed and nondetailed drugs in 8 drug classes (lipid-lowering drugs, gastroesophageal reflux disease drugs, diabetes drugs, antihypertensive drugs, hypnotic drugs approved for the treatment of insomnia [sleep aids], attention-deficit/hyperactivity disorder drugs, antidepressant drugs, and antipsychotic drugs) comparing the 10- to 36-month period before implementation of the detailing policies with the 12- to 36-month period after implementation, depending on data availability. The analysis included 16 121 483 prescriptions written between January 2006 and June 2012 by 2126 attending physicians at the 19 intervention group AMCs and by 24 593 matched control group physicians. The sample mean market share at the physician-drug-month level for detailed and nondetailed drugs prior to enactment of policies was 19.3% and 14.2%, respectively. Exposure to an AMC detailing policy was associated with a decrease in the market share of detailed drugs of 1.67 percentage points (95% CI, -2.18 to -1.18 percentage points; P < .001) and an increase in the market share of nondetailed drugs of 0.84 percentage points (95% CI, 0.54 to 1.14 percentage points; P < .001). Associations were statistically significant for 6 of 8 study drug classes for detailed drugs (lipid-lowering drugs, gastroesophageal reflux disease drugs, antihypertensive drugs, sleep aids, attention-deficit/hyperactivity disorder drugs, and antidepressant drugs) and for 9 of the 19 AMCs that implemented policies. Eleven of the 19 AMCs regulated salesperson gifts to physicians, restricted salesperson access to facilities, and incorporated explicit enforcement mechanisms. For 8 of these 11 AMCs, there was a significant change in prescribing. In contrast, there was a significant change at only 1 of 8 AMCs that did not enact policies in all 3 areas. Implementation of policies at AMCs that restricted pharmaceutical detailing between 2006 and 2012 was associated with modest but significant reductions in prescribing of detailed drugs across 6 of 8 major drug classes; however, changes were not seen in all of the AMCs that enacted policies.

  19. Analysis of the policymaking process in Burkina Faso's health sector: case studies of the creation of two health system support units.

    PubMed

    Zida, Andre; Lavis, John N; Sewankambo, Nelson K; Kouyate, Bocar; Moat, Kaelan; Shearer, Jessica

    2017-02-13

    Burkina Faso has made a number of health system policy decisions to improve performance on health indicators and strengthen responsiveness to health-related challenges. These included the creation of a General Directorate of Health Information and Statistics (DGISS) and a technical unit to coordinate performance-based financing (CT-FBR). We analysed the policymaking processes associated with the establishment of these units, and documented the factors that influenced this process. We used a multiple-case study design based on Kingdon's agenda-setting model to investigate the DGISS and CT-FBR policymaking processes. Data were collected from interviews with key informants (n = 28), published literature, policy documents (including two strategic and 230 action plans), and 55 legal/regulatory texts. Interviews were analysed using thematic qualitative analysis. Data from the documentary analysis were triangulated with the qualitative interview data. Key factors influencing the policymaking processes associated with the two units involved the 'problem' (problem identification), 'policy' (formation of policy proposals), and 'politics' (political climate/change) streams, which came together in a way that resulted in proposals being placed on the decision agenda. A number of problems with Burkina Faso's health information and financing systems were identified. Policy proposals for the DGISS and CT-FBR units were developed in response to these problems, emerging from several sources including development partners. Changes in political and public service administrations (specifically the 2008 appointment of a new Minister of Health and the establishment of a new budget allocation system), with corresponding changes in the actors and interests involved, appeared key in elevating the proposals to the decision agenda. Efforts to improve performance on health indicators and strengthen responsiveness to health-related challenges need focus on the need for a compelling problem, a viable policy, and conducive politics in order to make it to the decision agenda.

  20. Public sector hospitals and organizational change: an agenda for policy analysis.

    PubMed

    Collins, C; Green, A

    1999-01-01

    An important feature of health care systems in recent years is the change in the organizational position and relations of public sector hospitals. Health sector reforms have led to increasing heterogeneity in the organizational location and status of public sector hospitals and new organizational forms of public-private relations are being developed by and for hospitals. These changes can have important implications for health and health care. They raise issues around equity, control, accountability and performance of health care. Yet the policy process in practice may be failing to develop and implement appropriate forms of policy formulation on health sector reform. This paper focuses on the organizational position and relations of hospitals within public sector health services. It firstly outlines key elements of health sector reform and relates these to two dimensions of organizational change for hospitals: increasing heterogeneity and forms of public-private relations. The paper provides a descriptive format for classifying forms of hospital organizational change and proposes a framework of six questions for analysing these organizational forms. This may be used to assess the appropriateness of specific policies to particular country situations and to develop more open debate around hospital organizational forms.

  1. A Methodology for Meta-Analysis of Local Climate Change Adaptation Policies

    EPA Science Inventory

    Local governments are beginning to take steps to address the consequences of climate change, such as sea level rise and heat events. However, we donot have a clear understanding of what local governments are doing -- the extent to which they expect climate change to affect their ...

  2. National malaria vector control policy: an analysis of the decision to scale-up larviciding in Nigeria.

    PubMed

    Tesfazghi, Kemi; Hill, Jenny; Jones, Caroline; Ranson, Hilary; Worrall, Eve

    2016-02-01

    New vector control tools are needed to combat insecticide resistance and reduce malaria transmission. The World Health Organization (WHO) endorses larviciding as a supplementary vector control intervention using larvicides recommended by the WHO Pesticides Evaluation Scheme (WHOPES). The decision to scale-up larviciding in Nigeria provided an opportunity to investigate the factors influencing policy adoption and assess the role that actors and evidence play in the policymaking process, in order to draw lessons that help accelerate the uptake of new methods for vector control. A retrospective policy analysis was carried out using in-depth interviews with national level policy stakeholders to establish normative national vector control policy or strategy decision-making processes and compare these with the process that led to the decision to scale-up larviciding. The interviews were transcribed, then coded and analyzed using NVivo10. Data were coded according to pre-defined themes from an analytical policy framework developed a priori. Stakeholders reported that the larviciding decision-making process deviated from the normative vector control decision-making process. National malaria policy is normally strongly influenced by WHO recommendations, but the potential of larviciding to contribute to national economic development objectives through larvicide production in Nigeria was cited as a key factor shaping the decision. The larviciding decision involved a restricted range of policy actors, and notably excluded actors that usually play advisory, consultative and evidence generation roles. Powerful actors limited the access of some actors to the policy processes and content. This may have limited the influence of scientific evidence in this policy decision. This study demonstrates that national vector control policy change can be facilitated by linking malaria control objectives to wider socioeconomic considerations and through engaging powerful policy champions to drive policy change and thereby accelerate access to new vector control tools. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  3. Economics of nuclear power and climate change mitigation policies.

    PubMed

    Bauer, Nico; Brecha, Robert J; Luderer, Gunnar

    2012-10-16

    The events of March 2011 at the nuclear power complex in Fukushima, Japan, raised questions about the safe operation of nuclear power plants, with early retirement of existing nuclear power plants being debated in the policy arena and considered by regulators. Also, the future of building new nuclear power plants is highly uncertain. Should nuclear power policies become more restrictive, one potential option for climate change mitigation will be less available. However, a systematic analysis of nuclear power policies, including early retirement, has been missing in the climate change mitigation literature. We apply an energy economy model framework to derive scenarios and analyze the interactions and tradeoffs between these two policy fields. Our results indicate that early retirement of nuclear power plants leads to discounted cumulative global GDP losses of 0.07% by 2020. If, in addition, new nuclear investments are excluded, total losses will double. The effect of climate policies imposed by an intertemporal carbon budget on incremental costs of policies restricting nuclear power use is small. However, climate policies have much larger impacts than policies restricting the use of nuclear power. The carbon budget leads to cumulative discounted near term reductions of global GDP of 0.64% until 2020. Intertemporal flexibility of the carbon budget approach enables higher near-term emissions as a result of increased power generation from natural gas to fill the emerging gap in electricity supply, while still remaining within the overall carbon budget. Demand reductions and efficiency improvements are the second major response strategy.

  4. Economics of nuclear power and climate change mitigation policies

    PubMed Central

    Bauer, Nico; Brecha, Robert J.; Luderer, Gunnar

    2012-01-01

    The events of March 2011 at the nuclear power complex in Fukushima, Japan, raised questions about the safe operation of nuclear power plants, with early retirement of existing nuclear power plants being debated in the policy arena and considered by regulators. Also, the future of building new nuclear power plants is highly uncertain. Should nuclear power policies become more restrictive, one potential option for climate change mitigation will be less available. However, a systematic analysis of nuclear power policies, including early retirement, has been missing in the climate change mitigation literature. We apply an energy economy model framework to derive scenarios and analyze the interactions and tradeoffs between these two policy fields. Our results indicate that early retirement of nuclear power plants leads to discounted cumulative global GDP losses of 0.07% by 2020. If, in addition, new nuclear investments are excluded, total losses will double. The effect of climate policies imposed by an intertemporal carbon budget on incremental costs of policies restricting nuclear power use is small. However, climate policies have much larger impacts than policies restricting the use of nuclear power. The carbon budget leads to cumulative discounted near term reductions of global GDP of 0.64% until 2020. Intertemporal flexibility of the carbon budget approach enables higher near-term emissions as a result of increased power generation from natural gas to fill the emerging gap in electricity supply, while still remaining within the overall carbon budget. Demand reductions and efficiency improvements are the second major response strategy. PMID:23027963

  5. The Distribution of Climate Change Public Opinion in Canada.

    PubMed

    Mildenberger, Matto; Howe, Peter; Lachapelle, Erick; Stokes, Leah; Marlon, Jennifer; Gravelle, Timothy

    2016-01-01

    While climate scientists have developed high resolution data sets on the distribution of climate risks, we still lack comparable data on the local distribution of public climate change opinions. This paper provides the first effort to estimate local climate and energy opinion variability outside the United States. Using a multi-level regression and post-stratification (MRP) approach, we estimate opinion in federal electoral districts and provinces. We demonstrate that a majority of the Canadian public consistently believes that climate change is happening. Belief in climate change's causes varies geographically, with more people attributing it to human activity in urban as opposed to rural areas. Most prominently, we find majority support for carbon cap and trade policy in every province and district. By contrast, support for carbon taxation is more heterogeneous. Compared to the distribution of US climate opinions, Canadians believe climate change is happening at higher levels. This new opinion data set will support climate policy analysis and climate policy decision making at national, provincial and local levels.

  6. Integrating ethics, health policy and health systems in low- and middle-income countries: case studies from Malaysia and Pakistan.

    PubMed

    Hyder, Adnan A; Merritt, Maria; Ali, Joseph; Tran, Nhan T; Subramaniam, Kulanthayan; Akhtar, Tasleem

    2008-08-01

    Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective.

  7. Advancing Strategies for Agenda Setting by Health Policy Coalitions: A Network Analysis of the Canadian Chronic Disease Prevention Survey.

    PubMed

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

    2018-06-11

    Health in all policies can address chronic disease morbidity and mortality by increasing population-level physical activity and healthy eating, and reducing tobacco and alcohol use. Both governmental and nongovernmental policy influencers are instrumental for health policy that modifies political, economic, and social environments. Policy influencers are informed and persuaded by coalitions that support or oppose changing the status quo. Empirical research examining policy influencers' contact with coalitions, as a social psychological exposure with health policy outcomes, can benefit from application of health communication theories. Accordingly, we analyzed responses to the 2014 Chronic Disease Prevention Survey for 184 Canadian policy influencers employed in provincial governments, municipalities, large workplaces, school boards, and the media. In addition to contact levels with coalitions, respondents' jurisdiction, organization, and ideology were analyzed as potential moderators. Calculating authority score centrality using network analysis, we determined health policy supporters to be more central in policy influencer networks, and theorized their potential to impact health policy public agenda setting via priming and framing processes. We discuss the implications of our results as presenting opportunities to more effectively promote health policy through priming and framing by coordinating coalitions across risk behaviors to advance a societal imperative for chronic disease prevention.

  8. Community intellectual disability nurses' public health roles in the United Kingdom: An exploratory documentary analysis.

    PubMed

    Mafuba, Kay; Gates, Bob; Cozens, Maria

    2018-03-01

    The aim of this study was to explore how public health policy in the United Kingdom was reflected in community intellectual disability nurses' (CIDNs)' job descriptions and person's specifications. The role of CIDNs has evolved due to policy changes. As these roles evolve, job descriptions and person specifications are important in highlighting employer's expectations staff, priorities, and professional values of their employees. This study involved an exploratory documentary analysis of n = 203 CIDNs' job descriptions and person specifications in the context of role theory. The CIDNs' public health roles identified in this study are health education, health protection, health prevention, health surveillance, and health promotion. Key policies themes were intellectual disability health access, public health strategies, policy evaluation/redesign, and public health policy. There is a lack of public health role clarity and inconsistency in role expectations across organizational boundaries in the United Kingdom.

  9. Adaptive salinity management in the Murray-Darling Basin: a transaction cost study

    NASA Astrophysics Data System (ADS)

    Loch, A. J.

    2017-12-01

    Transaction costs hinder or promote effective management of common good resource intertemporal externalities. Appropriate policy choices may reduce externalities and improve social welfare, and transaction cost analysis can help to evaluate policy choices. However, without measurement of relevant transaction costs such policy evaluation remains challenging. This article uses a time series dataset of salinity management program to test theory aimed at transaction cost-based policy evaluation and adaptive resource management over a period of 30 years worth of data. We identify peaks and troughs in transaction costs over time, lag-effects in program expenditure, and calculate the decay in transaction cost impacts. We conclude that Australian salinity management programs are achieving flexible institutional outcomes and effective policy arrangements with long-term benefits. Proposed changes to the program moving forward add weight to our assertions of adaptive strategies, and illustrate the value of the novel data-driven tracnsaction cost analysis approach for other jurisdictions.

  10. NASA's Agency-Wide Strategy for Environmental Regulatory Risk Analysis and Communication

    NASA Technical Reports Server (NTRS)

    Scroggins, Sharon; Duda, Kristen

    2008-01-01

    This viewgraph presentation gives an overview of NASA's risk analysis communication programs associated with changing environmental policies. The topics include: 1) NASA Program Transition; 2) Principal Center for Regulatory Risk Analysis and Communication (RRAC PC); and 3) Regulatory Tracking and Communication Process.

  11. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wallace Tyner

    The project had three main objectives: to build and incorporate an explicit biomass energy sector within the GTAP analytical framework and data base; to provide an analysis of the impact of renewable fuel standards and other policies in the U.S. and E.U, as well as alternative biofuel policies in other parts of the world, on changes in production, prices, consumption, trade and poverty; and to evaluate environmental impacts of alternative policies for bioenergy development. Progress and outputs related to each objective are reported.

  12. Transfers to the old, government debt and demographic change.

    PubMed

    Verbon, H A

    1990-01-01

    "In this paper we take the view that policy makers...take the relationship between (explicit) intergenerational transfer systems (including public pension schemes) and government deficits into account. It is assumed that policy makers are behaving altruistically towards past and future generations. Given the behavioral model, an analysis is made of the effects of demographic changes (such as the 'baby-boom' of the 1940s and 1950s and the decline of birth rates in the 1970s) on the decisions to be taken with respect to the tax rate of the public pension system and the size of government debt. From the analysis it appears that, with the assumption of altruistic decision-makers, periods of increasing or decreasing debt can occur alternately in periods of demographic change." The geographical focus is on developed countries. excerpt

  13. 76 FR 65769 - Airport Improvement Program: Modifications to Benefit Cost Analysis (BCA) Threshold

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ...This document announces the publication of the final policy changes to the Federal Aviation Administration's policy requiring a benefit cost analysis (BCA) for capacity projects funded by Airport Improvement Program (AIP) discretionary funds. On December 16, 2010, the FAA issued a Notice of Availability of Draft Guidance and Request for Comments with regard to the modification of its policy requiring benefit cost analyses (BCA) for capacity projects, which was published in the Federal Register. (78 FR 78798-02, December 16, 2010). The FAA now is (1) Issuing the final policy modifying the threshold at which BCAs are required from $5 million to $10 million in Airport Improvement Program (AIP) Discretionary funds, and (2) responding to comments requested in the Notice on December 16, 2010.

  14. Climate change mitigation policies and poverty in developing countries

    NASA Astrophysics Data System (ADS)

    Hussein, Zekarias; Hertel, Thomas; Golub, Alla

    2013-09-01

    Mitigation of the potential impacts of climate change is one of the leading policy concerns of the 21st century. However, there continues to be heated debate about the nature, the content and, most importantly, the impact of the policy actions needed to limit greenhouse gas emissions. One contributing factor is the lack of systematic evidence on the impact of mitigation policy on the welfare of the poor in developing countries. In this letter we consider two alternative policy scenarios, one in which only the Annex I countries take action, and the second in which the first policy is accompanied by a forest carbon sequestration policy in the non-Annex regions. Using an economic climate policy analysis framework, we assess the poverty impacts of the above policy scenarios on seven socio-economic groups in 14 developing countries. We find that the Annex-I-only policy is poverty friendly, since it enhances the competitiveness of non-Annex countries—particularly in agricultural production. However, once forest carbon sequestration incentives in the non-Annex regions are added to the policy package, the overall effect is to raise poverty in the majority of our sample countries. The reason for this outcome is that the dominant impacts of this policy are to raise returns to land, reduce agricultural output and raise food prices. Since poor households rely primarily on their own labor for income, and generally own little land, and since they also spend a large share of their income on food, they are generally hurt on both the earning and the spending fronts. This result is troubling, since forest carbon sequestration—particularly through avoided deforestation—is a promising, low cost option for climate change mitigation.

  15. Health manpower planning in Slovenia: a policy analysis of the changes in roles of stakeholders and methodologies.

    PubMed

    Albreht, Tit; Klazinga, Niek

    2002-12-01

    A heightened awareness about medical manpower issues can be observed in countries that are in a state of political, economic, and social transition. Slovenia entered the transition process in 1989 and became an independent country in 1991. Transition and independence influenced its health care in several ways. It changed the health care system and its financing (by introducing a Bismarckian style of social insurance). It then redistributed power from the Ministry of Health to several stakeholders. A major change occurred in the labor market in health care when the flow of health professionals from the newly independent countries greatly decreased. The decrease was partly due to the consequences of the war in the Balkans and partly due to independent labor legislation in Slovenia. Transitional changes brought new stakeholders to the scene, with a resulting redistribution of responsibilities for health manpower policies and the use of various methodologies. This policy analysis offers a detailed description of the contextual framework, quantitative data on medical manpower development, and, most important, interviews with representatives of the key stakeholders and study of relevant policy documents. We conclude that all stakeholders underpin the need for a structured approach toward health manpower planning in the form of a more coherent system of planning, decision making, and control. A compromise on mutual responsibilities between the less dominant Ministry of Health and the two new powerful stakeholders, the Health Insurance Institute of Slovenia and the Medical Chamber of Slovenia, seems necessary.

  16. Climate change policies and capital vintage effects: the cases of US pulp and paper, iron and steel, and ethylene.

    PubMed

    Ruth, Matthias; Davidsdottir, Brynhildur; Amato, Anthony

    2004-03-01

    Changes in material use, energy use and emissions profiles of industry are the result of complex interrelationships among a multitude of technological and economic drivers. To better understand and guide such changes requires that attention is paid to the time-varying consequences that technology and economic influences have on an industry's choice of inputs and its associated (desired and undesired) outputs. This paper lays out an approach to improving our understanding of the dynamics of large industrial systems. The approach combines engineering and econometric analysis with a detailed representation of an industry's capital stock structure. A transparent dynamic computer modeling approach is chosen to integrate information from these analyses in ways that foster participation of stakeholders from industry and government agencies in all stages of the modeling process-from problem definition and determination of system boundaries to generation of scenarios and interpretation of results. Three case studies of industrial energy use in the USA are presented-one each for the iron and steel, pulp and paper, and ethylene industry. Dynamic models of these industries are described and then used to investigate alternative carbon emissions and investment-led policies. A comparison of results clearly points towards two key issues: the need for industry specific policy approaches in order to effectively influence industrial energy use, fuel mix and carbon emissions, and the need for longer time horizons than have typically been chosen for the analysis of industrial responses to climate change policies.

  17. Effects of a Commercial Insurance Policy Restriction on Lumbar Fusion in North Carolina and the Implications for National Adoption

    PubMed Central

    Deyo, Richard A.; Lurie, Jon D.; Carey, Timothy S.; Tosteson, Anna N.A.; Mirza, Sohail K.

    2015-01-01

    Study design Analysis of the State Inpatient Database of North Carolina, 2005–2012, and the Nationwide Inpatient Sample, including all inpatient lumbar fusion admissions from non-federal hospitals. Objective To examine the influence of a major commercial policy change that restricted lumbar fusion for certain indications, and to forecast the potential impact if the policy were adopted nationally. Summary of Background Data Few studies have examined the effects of recent changes in commercial coverage policies that restrict the use of lumbar fusion. Methods We included adults undergoing elective lumbar fusion or re-fusion operations in North Carolina. We aggregated data into a monthly time series to report changes in the rates and volume of lumbar fusion operations for disc herniation or degeneration, spinal stenosis, spondylolisthesis, or revision fusions. Time series regression models were used to test for significant changes in the use of fusion operation following a major commercial coverage policy change initiated on January 1st, 2011. Results There was a substantial decline in the use of lumbar fusion for disc herniation or degeneration following the policy change on January 1st, 2011. Overall rates of elective lumbar fusion operations in North Carolina (per 100,000 residents) increased from 103.2 in 2005 to 120.4 in 2009, before declining to 101.9 by 2012. The population rate (per 100,000 residents) of fusion among those under age 65 increased from 89.5 in 2005 to 101.2 in 2009, followed by a sharp decline to 76.8 by 2012. There was no acceleration in the already increasing rate of fusion for spinal stenosis, spondylolisthesis or revision procedures, but there was a coincident increase in decompression without fusion. Conclusions This commercial insurance policy change had its intended effect of reducing fusion operations for indications with less evidence of effectiveness without changing rates for other indications or resulting in an overall reduction in spine surgery. Nevertheless, broader adoption of the policy could significantly reduce the national rates of fusion operations and associated costs. PMID:26679877

  18. Monitoring and Benchmarking eHealth in the Nordic Countries.

    PubMed

    Nøhr, Christian; Koch, Sabine; Vimarlund, Vivian; Gilstad, Heidi; Faxvaag, Arild; Hardardottir, Gudrun Audur; Andreassen, Hege K; Kangas, Maarit; Reponen, Jarmo; Bertelsen, Pernille; Villumsen, Sidsel; Hyppönen, Hannele

    2018-01-01

    The Nordic eHealth Research Network, a subgroup of the Nordic Council of Ministers eHealth group, is working on developing indicators to monitor progress in availability, use and outcome of eHealth applications in the Nordic countries. This paper reports on the consecutive analysis of National eHealth policies in the Nordic countries from 2012 to 2016. Furthermore, it discusses the consequences for the development of indicators that can measure changes in the eHealth environment arising from the policies. The main change in policies is reflected in a shift towards more stakeholder involvement and intensified focus on clinical infrastructure. This change suggests developing indicators that can monitor understandability and usability of eHealth systems, and the use and utility of shared information infrastructure from the perspective of the end-users - citizens/patients and clinicians in particular.

  19. Analysis of the Climate Change Technology Initiative

    EIA Publications

    1999-01-01

    Analysis of the impact of specific policies on the reduction of carbon emissions and their impact on U.S. energy use and prices in the 2008-2012 time frame. Also, analyzes the impact of the President's Climate Change Technology Initiative, as defined for the 2000 budget, on reducing carbon emissions from the levels forecast in the Annual Energy Outlook 1999 reference case.

  20. History and the future: Looking back to look forward?

    PubMed

    Berridge, Virginia

    2016-11-01

    History is often dismissed as of little utility in the analysis of policy. This paper provides a justification for its use as evidence. It surveys the rise of the use of history, including public history and history and policy. It looks at two issues which draw on the author's own work: the relationship between regulation and culture for smoking and alcohol; and the response to electronic cigarettes in the light of smoking and public health history. It analyses what history can contribute. Responses are time dependent and change is an essential parameter in understanding policy. Historical research can challenge stereotypes, for example that prohibition was abandoned because it 'failed'. It also forms the bedrock of historical interpretation, which is mutable and often misunderstood outside the profession. History provides policy analysis rather than policy prescription and is a challenging approach, not just a convenient support for established positions. The paper concludes that history is far from moribund as a policy science. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Constructing Advantage in the Knowledge Society: Roles of Universities Reconsidered--The Case of Japan

    ERIC Educational Resources Information Center

    Kitagawa, Fumi

    2005-01-01

    Based on an analysis of policy contexts in several OECD countries, this article examines the rapidly changing policy environment in Japan exemplified by the 2004 transformation of national universities into "incorporated" entities. The role of universities in the knowledge society is examined in light of the emergence of new research and…

  2. The Production of Bachelor's Degrees and Financial Aspects of State Higher Education Policy: A Dynamic Analysis

    ERIC Educational Resources Information Center

    Titus, Marvin A.

    2009-01-01

    Although several studies have examined the extent to which tuition influences college enrollment at the undergraduate level (e.g., Heller, 1999; Kane, 1995, 1999), there is no known research that examines how changes in financial aspects of state higher education policy affect the production of postsecondary degrees. Using state-level data…

  3. Institutional Diversity in Ontario's University Sector: A Policy Debate Analysis

    ERIC Educational Resources Information Center

    Piché, Pierre G.; Jones, Glen A.

    2016-01-01

    In order to meet the demands in a cost-effective manner of an emerging knowledge society that is global in scope, structural higher education policy changes have been introduced in many countries with a focus on systemic and programmatic diversity. There has been an ongoing debate about institutional diversity in Ontario higher education,…

  4. Two Fineless Years, A History, Analysis, and Evaluation.

    ERIC Educational Resources Information Center

    Meyer, Robert S.

    The purpose of this study is to summarize and evaluate the Alameda County, California library system's two years of operation under a no-fines policy and a centralized overdues facility, leading to recommendations for future action. The objectives of the study are to: (1) present an historical summary of the changes in the library policies and…

  5. Education Rights, Education Policies and Inequality in South Africa

    ERIC Educational Resources Information Center

    Spreen, Carol Anne; Vally, Salim

    2006-01-01

    In this article we explore education policy changes in South Africa through a rights-based framework. We situate our analysis in the context of deepening poverty and inequality arguing that progress (or the lack thereof) in schools cannot be divorced from poverty and its consequences. We show that education reform in South Africa has been situated…

  6. Curriculum Policy in Portugal (1995-2007): Global Agendas and Regional and National Reconfigurations

    ERIC Educational Resources Information Center

    Teodoro, Antonio; Estrela, Elsa

    2010-01-01

    This paper undertakes a critical analysis of recent education and curriculum policies in Portugal, focusing on the relationship between globalization, international agencies, and the curriculum. It aims to highlight not only changes in the organization of schools, but also the setting of a agenda structured at a global level for education in which…

  7. Career Education That Works: An Economic Analysis Using the British Cohort Study

    ERIC Educational Resources Information Center

    Kashefpakdel, Elnaz T.; Percy, Christian

    2017-01-01

    There is significant policy interest in the issue of young people's fractured transitions into the labour market. Many scholars and policy-makers believe that changes in the education system and labour market over recent decades have created a complex world for young people; and that this can partly be addressed by enhanced career education while…

  8. The (Bio)politics of Engagement: Shifts in Singapore's Policy and Public Discourse on Civics Education

    ERIC Educational Resources Information Center

    Weninger, Csilla; Kho, Ee Moi

    2014-01-01

    This article provides a historical overview of civic educational policy and political discourse in Singapore from 1959 to 2011, focusing on changes in the role attributed to students in the education process. A review of educational programmes and analysis of political speeches reveals that an earlier transmissionist approach that focused on value…

  9. The "Journal of Higher Education Policy and Management:" An Output Analysis

    ERIC Educational Resources Information Center

    Dobson, Ian R.

    2009-01-01

    This paper analyses the contents of the first thirty years of the "Journal of Higher Education Policy and Management" and its predecessor, the "Journal of Tertiary Education Administration." The paper examines the papers published between 1979 and 2008 according to their authorship, country of origin and broad content, noting changes over time. In…

  10. Behind the Curtain: Assessing the Case for National Curriculum Standards. Policy Analysis. No. 661

    ERIC Educational Resources Information Center

    McCluskey, Neal

    2010-01-01

    The argument for national curriculum standards sounds simple: set high standards, make all schools meet them, and watch American students achieve at high levels. It is straightforward and compelling, and it is driving a sea change in American education policy. Unfortunately, setting high standards and getting American students to hit them is…

  11. Conflict and Compromise in Public Health Policy: Analysis of Changes Made to Five Competitive Food Legislative Proposals Prior to Adoption

    ERIC Educational Resources Information Center

    Dinour, Lauren M.

    2015-01-01

    Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an…

  12. Government, politics and health policy: A quantitative analysis of 30 European countries.

    PubMed

    Mackenbach, Johan P; McKee, Martin

    2015-10-01

    Public health policies are often dependent on political decision-making, but little is known of the impact of different forms of government on countries' health policies. In this exploratory study we studied the association between a wide range of process and outcome indicators of health policy and four groups of political factors (levels of democracy, e.g. voice and accountability; political representation, e.g. voter turnout; distribution of power, e.g. constraints on the executive; and quality of government, e.g. absence of corruption) in contemporary Europe. Data on 15 aspects of government and 18 indicators of health policy as well as on potential confounders were extracted from harmonized international data sources, covering 30 European countries and the years 1990-2010. In a first step, multivariate regression analysis was used to relate cumulative measures of government to indicators of health policy, and in a second step panel regression with country fixed effects was used to relate changes in selected measures of government to changes in indicators of health policy. In multivariate regression analyses, measures of quality of democracy and quality of government had many positive associations with process and outcome indicators of health policy, while measures of distribution of power and political representation had few and inconsistent associations. Associations for quality of democracy were robust against more extensive control for confounding variables, including tests in panel regressions with country fixed effects, but associations for quality of government were not. In this period in Europe, the predominant political influence on health policy has been the rise of levels of democracy in countries in the Central & Eastern part of the region. In contrast to other areas of public policy, health policy does not appear to be strongly influenced by institutional features of democracy determining the distribution of power, nor by aspects of political representation. The effect of quality of government on health policy warrants more study. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Free formula milk in the prevention of mother-to-child transmission programme: voices of a peri-urban community in South Africa on policy change.

    PubMed

    Ijumba, Petrida; Doherty, Tanya; Jackson, Debra; Tomlinson, Mark; Sanders, David; Persson, Lars-Åke

    2013-10-01

    In 2001, South Africa began implementing the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme. This programme included distribution of free formula milk for infants up to 6 months of age at all public health facilities. Effective from 1 January 2011, KwaZulu-Natal became the first province to phase out free formula milk from its PMTCT programme. On 23 August 2011, the South African National Department of Health adopted promotion of exclusive breastfeeding as the national infant feeding strategy and made a decision to withdraw free formula milk from the PMTCT programme. To explore the perceptions and understanding of households at community level on the policy decision to phase out free formula milk from the PMTCT programme in South Africa. An exploratory qualitative study was conducted amongst women enrolled in a community randomized trial known as Good Start III. Focus group discussions were held with grandmothers, fathers and teenage mothers; and in-depth interviews were performed with HIV-positive and HIV-negative mothers. Data were analysed using thematic analysis. Identified themes included: (1) variations in awareness and lack of understanding of the basis for the policy change, (2) abuse of and dysfunctional policy as perceived reasons for policy change and (3) proposed strategies for communicating the policy change. There is an urgent need to develop a multifaceted communication strategy clearly articulating the reasons for the infant feeding policy change and promoting the new breastfeeding strategy. The communication strategy should take into account inputs from the community. With a supportive environment and one national infant feeding strategy, South Africa has an opportunity to reverse years of poor infant feeding practices and to improve the health of all children in the country.

  14. The rise and fall of dental therapy in Canada: a policy analysis and assessment of equity of access to oral health care for Inuit and First Nations communities.

    PubMed

    Leck, Victoria; Randall, Glen E

    2017-07-20

    Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities. A policy analysis of the rise and fall of the dental therapy profession in Canada was conducted using historical and policy documents. The analysis is framed within Kingdon's agenda-setting framework and considers why dental therapy was originally pursued as an option to ensure equitable access to oral health care for Inuit and First Nations communities and why this policy has now been abandoned with the closure of Canada's last dental therapy training school. The closure of the last dental therapy program in Canada has the potential to further reduce access to dental care in some Inuit and First Nations communities. Overlaps between federal and provincial jurisdiction have contributed to the absence of a coordinated policy approach to address the equity gap in access to dental care which will exacerbate the inequalities in comparison to the general population. The analysis suggests that while a technically feasible policy solution is available there continues to be no politically acceptable solution and thus it remains unlikely that a window of opportunity for policy change will open any time soon. In the absence of federal government leadership, the most viable option forward may be incremental policy change. Provincial governments could expand the scope of practice for dental hygienists in the hope that it may support enhanced access, consumer choice, and efficiency in the delivery of oral health care to Inuit and First Nations communities in Canada.

  15. Theories of attitude change and the "beyond family planning" debate: the case for the persuasion approach in population policy.

    PubMed

    Crawford, T J

    1977-01-01

    The proposed abandonment of the persuasion approach in the area of population policy may be premature; the application of recent developments in attitude theory to family planning programs might refute the current pessimism concerning the power of persuasion in population policy. Persuasion and positive incentives are realistic and viable alternative in terms of Berelson's 6 criteria - scientific readiness, political viability, administrative feasibility, economic capability, ethical acceptability, and presumed effectiveness. Communication and persuasion programs that attempt to change behavior should direct their attention to changing intentions to engage in specific family planning behaviors within a given period of time rather than at changing global evaluations of "birth control" or "large families." There needs to be 1) an emphasis upon changing intentions to perform specific behaviors within a fixed time period, 2) a functional analysis of the relative importance of the 3 general needs served by attitudes as they influence behavioral intentions, 3) focus on what appear to be situationally engaged and behavior-relevant beliefs and attitudes, and 4) a change in both anticipated and actual situational determinants to behavior.

  16. Valuing Precaution in Climate Change Policy Analysis (Invited)

    NASA Astrophysics Data System (ADS)

    Howarth, R. B.

    2010-12-01

    The U.N. Framework Convention on Climate Change calls for stabilizing greenhouse gas concentrations to prevent “dangerous anthropogenic interference” (DAI) with the global environment. This treaty language emphasizes a precautionary approach to climate change policy in a setting characterized by substantial uncertainty regarding the timing, magnitude, and impacts of climate change. In the economics of climate change, however, analysts often work with deterministic models that assign best-guess values to parameters that are highly uncertain. Such models support a “policy ramp” approach in which only limited steps should be taken to reduce the future growth of greenhouse gas emissions. This presentation will explore how uncertainties related to (a) climate sensitivity and (b) climate-change damages can be satisfactorily addressed in a coupled model of climate-economy dynamics. In this model, capping greenhouse gas concentrations at ~450 ppm of carbon dioxide equivalent provides substantial net benefits by reducing the risk of low-probability, catastrophic impacts. This result formalizes the intuition embodied in the DAI criterion in a manner consistent with rational decision-making under uncertainty.

  17. Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis.

    PubMed

    Mc Hugh, Sheena M; Perry, Ivan J; Bradley, Colin; Brugha, Ruairí

    2014-09-18

    In 2006, the Health Service Executive (HSE) in Ireland established an Expert Advisory Group (EAG) for Diabetes, to act as its main source of operational policy and strategic advice for this chronic condition. The process was heralded as the starting point for the development of formal chronic disease management programmes. Although recommendations were published in 2008, implementation did not proceed as expected. Our aim was to examine the development of recommendations by the EAG as an instrumental case study of the policy formulation process, in the context of a health system undergoing organisational and financial upheaval. This study uses Kingdon's Multiple Streams Theory to examine the evolution of the EAG recommendations. Semi-structured interviews were conducted with a purposive sample of 15 stakeholders from the advisory group. Interview data were supplemented with documentary analysis of published and unpublished documents. Thematic analysis was guided by the propositions of the Kingdon model. In the problem stream, the prioritisation of diabetes within the policy arena was a gradual process resulting from an accumulation of evidence, international comparison, and experience. The policy stream was bolstered by group consensus rather than complete agreement on the best way to manage the condition. The EAG assumed the politics stream was also on course to converge with the other streams, as the group was established by the HSE, which had the remit for policy implementation. However, the politics stream did not converge due to waning support from health service management and changes to the organisational structure and financial capacity of the health system. These changes trumped the EAG process and the policy window remained closed, stalling implementation. Our results reflect the dynamic nature of the policy process and the importance of timing. The results highlight the limits of rational policy making in the face of organisational and fiscal upheaval. Diabetes care is coming on to the agenda again in Ireland under the National Clinical Care Programme. This may represent the opening of a new policy window for diabetes services, the challenge will be maintaining momentum and interest in the absence of dedicated resources.

  18. GPs' views of health policy changes: a qualitative 'netnography' study of UK general practice online magazine commentary.

    PubMed

    Elvey, Rebecca; Voorhees, Jennifer; Bailey, Simon; Burns, Taylor; Hodgson, Damian

    2018-06-01

    Shifts in health policy since 2010 have brought major structural changes to the English NHS, with government stating intentions to increase GPs' autonomy and improve access to care. Meanwhile, GPs' levels of job satisfaction are low, while stress levels are high. PulseToday is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice. To analyse readers' reactions to news stories about health policy changes published in an online general practice magazine. A qualitative 'netnography' was undertaken of readers' comments to PulseToday. METHOD: A sample of readers' comments on articles published in PulseToday was collated and subjected to thematic analysis. Around 300 comments on articles published between January 2012 and March 2016 were included in the analysis, using 'access to care' as a tracer theme. Concern about the demand and strain on general practice was perhaps to be expected. However, analysis revealed various dimensions to this concern: GPs' underlying feelings about their work and place in the NHS; constraints to GPs' control of their own working practices; a perceived loss of respect for the role of GP; and disappointment with representative bodies and GP leadership. This study shows a complex mix of resistance and resignation in general practice about the changing character of GPs' roles. This ambivalence deserves further attention because it could potentially shape responses to further change in primary care in ways that are as yet unknown. © British Journal of General Practice 2018.

  19. Evaluating the Potential Health and Revenue Outcomes of a 100% Healthy Vending Machine Nutrition Policy at a Large Agency in Los Angeles County, 2013-2015.

    PubMed

    Wickramasekaran, Ranjana N; Robles, Brenda; Dewey, George; Kuo, Tony

    Healthy vending machine policies are viewed as a promising strategy for combating the growing obesity epidemic in the United States. Few studies have evaluated the short- and intermediate-term outcomes of healthy vending policies, especially for interventions that require 100% healthy products to be stocked. To evaluate the potential impact of a 100% healthy vending machine nutrition policy. The vendor's quarterly revenue, product sales records, and nutritional information data from 359 unique vending machines were used to conduct a baseline and follow-up policy analysis. County of Los Angeles facilities, 2013-2015. Vending machines in facilities located across Los Angeles County. A healthy vending machine policy executed in 2013 that required 100% of all products sold in contracted machines meet specified nutrition standards. Policy adherence; average number of calories, sugar, and sodium in food products sold; revenue change. Policy adherence increased for snacks and beverages sold by the vending machines by 89% and 98%, respectively. Average snack and beverage revenues decreased by 37% and 34%, respectively, during the sampled period. Although a 100% healthy vending policy represents a promising strategy for encouraging purchases of healthier foods, steps should be taken to counteract potential revenue changes when planning its implementation.

  20. Analysis of misoprostol and chlorhexidine policy gains in Pakistan: the advocacy experience of Mercy Corps Pakistan.

    PubMed

    Sarwar, Zahida; Cutherell, Andrea; Noor, Arif; Naureen, Farah; Norman, Jennifer

    2015-11-25

    While Pakistan has made progress toward achieving Millennium Development Goal 5 for maternal health, it is unlikely to achieve the target; further, it is also not on track for Millennium Development Goal 4 regarding child health. Two low-cost, temperature stable and life-saving drugs, misoprostol and chlorhexidine, can respectively avert maternal and newborn deaths, and are particularly pertinent for poor and marginalized areas which bear the brunt of maternal and newborn deaths in Pakistan. In response, Mercy Corps led focused advocacy efforts to promote changes in policies, protocols, and regulatory environments for misoprostol (2012-2014) and for chlorhexidine (2014). These short-duration advocacy projects facilitated significant policy gains, such as inclusion of misoprostol and chlorhexidine into province-specific essential drug lists, development and endorsement of clinical protocols for the two drugs by provincial health departments, inclusion of misoprostol into pre-service training curriculum for several health cadres, and application for registration of chlorhexidine (at the concentration required for newborn care) by two pharmaceutical companies. These results were achieved by a consultative and evidence-based process which generated feedback from community members, program implementers, and policymakers, and ultimately put the government in the driver's seat to facilitate change. Community Action Dialogue forums were linked with provincial-level Technical Working Groups and Provincial Steering Committees, who passed on endorsed recommendations to the Health Secretary. The key factors which facilitated change were the identification of champions within the provincial health departments, prioritization of relationship building and follow-up, focus on concrete advocacy aims rather than broad objectives, and the use of multi-stakeholder forums to secure an enabling environment for the policy changes to take root. While these advocacy initiatives resulted in significant policy changes in Pakistan's devolved health system, to ensure these policy changes have an impact on health outcomes, Pakistan should focus on the scale-up of appropriate use of chlorhexidine and misoprostol. Further, future policy initiatives in Pakistan should make use of similar multi-stakeholder policy forums, while ensuring a third party to facilitate the process so that civil society and community voices are not lost in the policy development discussion.

  1. Lack of recognition of genetic biodiversity: International policy and its implementation in Baltic Sea marine protected areas.

    PubMed

    Laikre, Linda; Lundmark, Carina; Jansson, Eeva; Wennerström, Lovisa; Edman, Mari; Sandström, Annica

    2016-10-01

    Genetic diversity is needed for species' adaptation to changing selective pressures and is particularly important in regions with rapid environmental change such as the Baltic Sea. Conservation measures should consider maintaining large gene pools to maximize species' adaptive potential for long-term survival. In this study, we explored concerns regarding genetic variation in international and national policies that governs biodiversity and evaluated if and how such policy is put into practice in management plans governing Baltic Sea Marine Protected Areas (MPAs) in Sweden, Finland, Estonia, and Germany. We performed qualitative and quantitative textual analysis of 240 documents and found that agreed international and national policies on genetic biodiversity are not reflected in management plans for Baltic Sea MPAs. Management plans in all countries are largely void of goals and strategies for genetic biodiversity, which can partly be explained by a general lack of conservation genetics in policies directed toward aquatic environments.

  2. Analysis of pediatric lung donor allocation policy: a call for change?

    PubMed

    Gajarski, Robert; Bowman, Diana M

    2015-04-01

    In an unprecedented legal ruling in June 2013, a US federal district court judge decided that the existing policy for donor lung allocation be vacated to save the life of a ten-year-old girl dying from cystic fibrosis. This case has fueled much controversy in the United States among policy makers, ethicists, and physicians who treat other patients awaiting transplant. This article examines the creation of the current US lung allocation policy and its impact on outcomes and analyzes the multidimensionality of the ruling. After analyzing the current policy and investigating alternatives for donor pool expansion, the article concludes by articulating options that may mitigate the need for current policy revision. Copyright © 2015 by Duke University Press.

  3. [The climate change policy of the city of São Paulo, Brazil: reflexivity and permeability of the health sector].

    PubMed

    Landin, Rubens; Giatti, Leandro Luiz

    2014-10-01

    São Paulo is today an unsustainable city in which social and environmental vulnerabilities are obliged to tackle the uncertainties of climate change. To face up to this situation, in 2009 the city unveiled its Climate Change Policy. The scope of this paper is to analyze how the health sector is preparing to contribute to the implementation of this policy by 2012. Content analysis was the method adopted by examining official documents and conducting semi-structured interviews. In a context of social transformation affected by environmental degradation and socio-environmental consequences there is a need for the cessation of inertia and a demand for new knowledge systems. The outcomes of the study showed a positive intersectorial dialectic relationship, since the research hypothesis was that the health sector would be called upon to back actions on air quality monitoring. Its verification showed a broad scope introducing health promotion and preventive actions as the determinant focus, especially influencing other public policies. Thus, the process under scrutiny acquired reflexivity when evolving with interactive measures breaking with the traditional sectorial and reductionist policy model. It shows an intersectorial perspective based on the importance of issues related to local public health.

  4. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weldu, Yemane W., E-mail: ywweldem@ucalgary.ca; Assefa, Getachew; Athena Chair in Life Cycle Assessment in Design

    A roadmap for a more sustainable energy strategy is complex, as its development interacts critically with the economic, social, and environmental dimensions of sustainable development. This paper applied an impact matrix method to evaluate the environmental sustainability and to identify the desirable policy objectives of biomass-based energy strategy for the case of Alberta. A matrix with the sustainability domains on one axis and areas of environmental impact on the other was presented to evaluate the nexus effect of policy objectives and bioenergy production. As per to our analysis, economic diversification, technological innovation, and resource conservation came up as the desirablemore » policy objectives of sustainable development for Alberta because they demonstrated environmental benefits in all environmental impact categories, namely climate change, human health, and ecosystem. On the other hand, human health and ecosystem impacts were identified as trade-offs when the policy objectives for sustainability were energy security, job creation, and climate change. Thus, bioenergy can mitigate climate change but may impact human health and ecosystem which then in turn can become issues of concern. Energy strategies may result in shifting of risks from one environmental impact category to another, and from one sustainable domain to another if the technical and policy-related issues are not identified.« less

  5. Is There a Statistical Relationship between Economic Crises and Changes in Government Health Expenditure Growth? An Analysis of Twenty-Four European Countries

    PubMed Central

    Cylus, Jonathan; Mladovsky, Philipa; McKee, Martin

    2012-01-01

    Objective To identify whether, by what means, and the extent to which historically, government health care expenditure growth in Europe has changed following economic crises. Data Sources Organization for Economic Cooperation and Development Health Data 2011. Study Design Cross-country fixed effects multiple regression analysis is used to determine whether statutory health care expenditure growth in the year after economic crises differs from that which would otherwise be predicted by general economic trends. Better understanding of the mechanisms involved is achieved by distinguishing between policy responses which lead to cost-shifting and all others. Findings In the year after an economic downturn, public health care expenditure grows more slowly than would have been expected given the longer term economic climate. Cost-shifting and other policy responses are both associated with these slowdowns. However, while changes in tax-derived expenditure are associated with both cost-shifting and other policy responses following a crisis, changes in expenditure derived from social insurance have been associated only with changes in cost-shifting. Conclusions Disproportionate cuts to the health sector, as well as reliance on cost-shifting to slow growth in health care expenditure, serve as a warning in terms of potentially negative effects on equity, efficiency, and quality of health services and, potentially, health outcomes following economic crises. PMID:22670771

  6. Is there a statistical relationship between economic crises and changes in government health expenditure growth? an analysis of twenty-four European countries.

    PubMed

    Cylus, Jonathan; Mladovsky, Philipa; McKee, Martin

    2012-12-01

    To identify whether, by what means, and the extent to which historically, government health care expenditure growth in Europe has changed following economic crises. Organization for Economic Cooperation and Development Health Data 2011. Cross-country fixed effects multiple regression analysis is used to determine whether statutory health care expenditure growth in the year after economic crises differs from that which would otherwise be predicted by general economic trends. Better understanding of the mechanisms involved is achieved by distinguishing between policy responses which lead to cost-shifting and all others. In the year after an economic downturn, public health care expenditure grows more slowly than would have been expected given the longer term economic climate. Cost-shifting and other policy responses are both associated with these slowdowns. However, while changes in tax-derived expenditure are associated with both cost-shifting and other policy responses following a crisis, changes in expenditure derived from social insurance have been associated only with changes in cost-shifting. Disproportionate cuts to the health sector, as well as reliance on cost-shifting to slow growth in health care expenditure, serve as a warning in terms of potentially negative effects on equity, efficiency, and quality of health services and, potentially, health outcomes following economic crises. © Health Research and Educational Trust.

  7. Nexus Between Demographic Change and Elderly Care Need in the Gulf Cooperation Council (GCC) Countries: Some Policy Implications.

    PubMed

    Khan, Hafiz T A; Hussein, Shereen; Deane, John

    2017-01-01

    Population ageing is a phenomenon affecting the whole world. The countries that make up the Gulf Cooperation Council (GCC) are no exception but transitions in population ageing are still in the early stages of the process. With current demographic dividends experienced by the GCC and the rest of the Middle-East, the pace of population ageing will be faster than that experienced by many European countries. The purpose of this paper is to explore the population ageing experience of different GCC countries while situating this within a context of social policies that still at the very early stages of acknowledging such change. We utilise data from sources such as the United Nations and the World Bank, complemented by policy analysis of current age-related social security measures in the GCC. Given the importance of the family aged care system in the region, we consider the implications of changes in family structures, living conditions, and care needs for the elderly. The findings confirm the declining trend in fertility combined with increased life expectancy in all the six GCC countries. However, they highlight that social policy measures focused on the older generations and their care needs are still relatively at the early stages of each country's policy agenda. The implications of such changes are serious in term of both the demand for and supply of care. Policy-makers need to adapt cohesive social policy strategies that strengthen the complementing relationships between the state, family and wider community as stakeholders in the provision of aged care.

  8. Envisioning the Third Sector's Welfare Role: Critical Discourse Analysis of ‘Post-Devolution’ Public Policy in the UK 1998–2012

    PubMed Central

    Chaney, Paul; Wincott, Daniel

    2014-01-01

    Welfare state theory has struggled to come to terms with the role of the third sector. It has often categorized welfare states in terms of the pattern of interplay between state social policies and the structure of the labour market. Moreover, it has frequently offered an exclusive focus on state policy – thereby failing to substantially recognize the role of the formally organized third sector. This study offers a corrective view. Against the backdrop of the international shift to multi-level governance, it analyses the policy discourse of third sector involvement in welfare governance following devolution in the UK. It reveals the changing and contrasting ways in which post-devolution territorial politics envisions the sector's role as a welfare provider. The mixed methods analysis compares policy framing and the structural narratives associated with the development of the third sector across the four constituent polities of the UK since 1998. The findings reveal how devolution has introduced a new spatial policy dynamic. Whilst there are elements of continuity between polities – such as the increasing salience of the third sector in welfare provision – policy narratives also provide evidence of the territorialization of third sector policy. From a methodological standpoint, this underlines the distinctive and complementary role discourse-based analysis can play in understanding contemporary patterns and processes shaping welfare governance. PMID:25574063

  9. Envisioning the Third Sector's Welfare Role: Critical Discourse Analysis of 'Post-Devolution' Public Policy in the UK 1998-2012.

    PubMed

    Chaney, Paul; Wincott, Daniel

    2014-12-01

    Welfare state theory has struggled to come to terms with the role of the third sector. It has often categorized welfare states in terms of the pattern of interplay between state social policies and the structure of the labour market. Moreover, it has frequently offered an exclusive focus on state policy - thereby failing to substantially recognize the role of the formally organized third sector. This study offers a corrective view. Against the backdrop of the international shift to multi-level governance, it analyses the policy discourse of third sector involvement in welfare governance following devolution in the UK. It reveals the changing and contrasting ways in which post-devolution territorial politics envisions the sector's role as a welfare provider. The mixed methods analysis compares policy framing and the structural narratives associated with the development of the third sector across the four constituent polities of the UK since 1998. The findings reveal how devolution has introduced a new spatial policy dynamic. Whilst there are elements of continuity between polities - such as the increasing salience of the third sector in welfare provision - policy narratives also provide evidence of the territorialization of third sector policy. From a methodological standpoint, this underlines the distinctive and complementary role discourse-based analysis can play in understanding contemporary patterns and processes shaping welfare governance.

  10. From Forest Landscape to Agricultural Landscape in the Developing Tropical Country of Malaysia: Pattern, Process, and Their Significance on Policy

    NASA Astrophysics Data System (ADS)

    Abdullah, Saiful Arif; Hezri, Adnan A.

    2008-11-01

    Agricultural expansion and deforestation are spatial processes of land transformation that impact on landscape pattern. In peninsular Malaysia, the conversion of forested areas into two major cash crops—rubber and oil palm plantations—has been identified as driving significant environmental change. To date, there has been insufficient literature studying the link between changes in landscape patterns and land-related development policies. Therefore, this paper examines: (i) the links between development policies and changes in land use/land cover and landscape pattern and (ii) the significance and implications of these links for future development policies. The objective is to generate insights on the changing process of land use/land cover and landscape pattern as a functional response to development policies and their consequences for environmental conditions. Over the last century, the development of cash crops has changed the country from one dominated by natural landscapes to one dominated by agricultural landscapes. But the last decade of the century saw urbanization beginning to impact significantly. This process aligned with the establishment of various development policies, from land development for agriculture between the mid 1950s and the 1970s to an emphasis on manufacturing from the 1980s onward. Based on a case study in Selangor, peninsular Malaysia, a model of landscape pattern change is presented. It contains three stages according to the relative importance of rubber (first stage: 1900-1950s), oil palm (second stage: 1960s-1970s), and urban (third stage: 1980s-1990s) development that influenced landscape fragmentation and heterogeneity. The environmental consequences of this change have been depicted through loss of biodiversity, geohazard incidences, and the spread of vector-borne diseases. The spatial ecological information can be useful to development policy formulation, allowing diagnosis of the country’s “health” and sustainability. The final section outlines the usefulness of landscape analysis in the policy-making process to prevent further fragmentation of the landscape and forest loss in Malaysia in the face of rapid economic development.

  11. From forest landscape to agricultural landscape in the developing tropical country of Malaysia: pattern, process, and their significance on policy.

    PubMed

    Abdullah, Saiful Arif; Hezri, Adnan A

    2008-11-01

    Agricultural expansion and deforestation are spatial processes of land transformation that impact on landscape pattern. In peninsular Malaysia, the conversion of forested areas into two major cash crops--rubber and oil palm plantations--has been identified as driving significant environmental change. To date, there has been insufficient literature studying the link between changes in landscape patterns and land-related development policies. Therefore, this paper examines: (i) the links between development policies and changes in land use/land cover and landscape pattern and (ii) the significance and implications of these links for future development policies. The objective is to generate insights on the changing process of land use/land cover and landscape pattern as a functional response to development policies and their consequences for environmental conditions. Over the last century, the development of cash crops has changed the country from one dominated by natural landscapes to one dominated by agricultural landscapes. But the last decade of the century saw urbanization beginning to impact significantly. This process aligned with the establishment of various development policies, from land development for agriculture between the mid 1950s and the 1970s to an emphasis on manufacturing from the 1980s onward. Based on a case study in Selangor, peninsular Malaysia, a model of landscape pattern change is presented. It contains three stages according to the relative importance of rubber (first stage: 1900--1950s), oil palm (second stage: 1960s--1970s), and urban (third stage: 1980s--1990s) development that influenced landscape fragmentation and heterogeneity. The environmental consequences of this change have been depicted through loss of biodiversity, geohazard incidences, and the spread of vector-borne diseases. The spatial ecological information can be useful to development policy formulation, allowing diagnosis of the country's "health" and sustainability. The final section outlines the usefulness of landscape analysis in the policy-making process to prevent further fragmentation of the landscape and forest loss in Malaysia in the face of rapid economic development.

  12. Deregulation of sale of over-the-counter drugs outside of pharmacies in the Republic of Korea: interrupted-time-series analysis of outpatient visits before and after the policy.

    PubMed

    Chun, Sung-Youn; Park, Hye-Ki; Han, Kyu-Tae; Kim, Woorim; Lee, Hyo-Jung; Park, Eun-Cheol

    2017-07-12

    We evaluated the effectiveness of a policy allowing for the sale of over-the-counter drugs outside of pharmacies by examining its effect on number of monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. We used medical claims data extracted from the Korean National Health Insurance Cohort Database from 2009 to 2013. The Korean National Health Insurance Cohort Database comprises a nationally representative sample of claims - about 2% of the entire population - obtained from the medical record data held by the Korean National Health Insurance Corporation (which has data on the entire nation). The analysis included26,284,706 person-months of 1,042,728 individuals. An interrupted-time series analysis was performed. Outcome measures were monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. To investigate the effect of the policy, we compared the number of monthly visits before and after the policy's implementation in 2012. For acute upper respiratory infections, monthly outpatient visits showed a decreasing trend before the policy (ß = -0.0003);after it, a prompt change and increasing trend in monthly outpatient visits were observed, but these were non-significant. For dyspepsia, the trend was increasing before implementation (ß = -0.0101), but this reversed after implementation(ß = -0.007). For migraine, an increasing trend was observed before the policy (ß = 0.0057). After it, we observed a significant prompt change (ß = -0.0314) but no significant trend. Deregulation of selling over-the-counter medication outside of pharmacies reduced monthly outpatient visits for dyspepsia and migraine symptoms, but not acute upper respiratory infections.

  13. HIV/AIDS policy agenda setting in Iran

    PubMed Central

    Khodayari - Zarnaq, Rahim; Ravaghi, Hamid; Mohammad Mosaddeghrad, Ali; Sedaghat, Abbas; Mohraz, Minoo

    2016-01-01

    Background: HIV/AIDS control are one of the most important goals of the health systems. The aim of this study was to determine how HIV/AIDS control was initiated among policy makers’ agenda setting in Iran. Methods: A qualitative research (semi-structured interview) was conducted using Kingdon’s framework (problem, policy and politics streams, and policy windows and policy entrepreneurs) to analysis HIV/AIDS agenda setting in Iran. Thirty-two policy makers, managers, specialists, and researchers were interviewed. Also, 30 policy documents were analyzed. Framework analysis method was used for data analysis. Results: the increase of HIV among Injecting drug users (IDUs) and Female Sex Workers (FSWs), lack of control of their high-risk behaviors, and exceeding the HIV into concentrated phase were examples of problem stream. Policy stream was evidence-based solutions that highlighted the need for changing strategies for dealing with such a problem and finding technically feasible and acceptable solutions. Iran’s participation in United Nations General Assembly special sessions on HIV/AIDS (UNGASS), the establishment of National AIDS Committee; highlighting AIDS control in Iran’s five years development program and the support of the judiciary system of harm reduction policies were examples of politics stream. Policy entrepreneurs linking these streams put the HIV/AIDS on the national agenda (policy windows) and provide their solutions. Conclusion: There were mutual interactions among these three streams and sometimes, they weakened or reinforced each other. Future studies are recommended to understand the interactions between these streams’ parts and perhaps develop further Kingdon’s framework, especially in the health sector. PMID:27579283

  14. How robust is a robust policy? A comparative analysis of alternative robustness metrics for supporting robust decision analysis.

    NASA Astrophysics Data System (ADS)

    Kwakkel, Jan; Haasnoot, Marjolijn

    2015-04-01

    In response to climate and socio-economic change, in various policy domains there is increasingly a call for robust plans or policies. That is, plans or policies that performs well in a very large range of plausible futures. In the literature, a wide range of alternative robustness metrics can be found. The relative merit of these alternative conceptualizations of robustness has, however, received less attention. Evidently, different robustness metrics can result in different plans or policies being adopted. This paper investigates the consequences of several robustness metrics on decision making, illustrated here by the design of a flood risk management plan. A fictitious case, inspired by a river reach in the Netherlands is used. The performance of this system in terms of casualties, damages, and costs for flood and damage mitigation actions is explored using a time horizon of 100 years, and accounting for uncertainties pertaining to climate change and land use change. A set of candidate policy options is specified up front. This set of options includes dike raising, dike strengthening, creating more space for the river, and flood proof building and evacuation options. The overarching aim is to design an effective flood risk mitigation strategy that is designed from the outset to be adapted over time in response to how the future actually unfolds. To this end, the plan will be based on the dynamic adaptive policy pathway approach (Haasnoot, Kwakkel et al. 2013) being used in the Dutch Delta Program. The policy problem is formulated as a multi-objective robust optimization problem (Kwakkel, Haasnoot et al. 2014). We solve the multi-objective robust optimization problem using several alternative robustness metrics, including both satisficing robustness metrics and regret based robustness metrics. Satisficing robustness metrics focus on the performance of candidate plans across a large ensemble of plausible futures. Regret based robustness metrics compare the performance of a candidate plan with the performance of other candidate plans across a large ensemble of plausible futures. Initial results suggest that the simplest satisficing metric, inspired by the signal to noise ratio, results in very risk averse solutions. Other satisficing metrics, which handle the average performance and the dispersion around the average separately, provide substantial additional insights into the trade off between the average performance, and the dispersion around this average. In contrast, the regret-based metrics enhance insight into the relative merits of candidate plans, while being less clear on the average performance or the dispersion around this performance. These results suggest that it is beneficial to use multiple robustness metrics when doing a robust decision analysis study. Haasnoot, M., J. H. Kwakkel, W. E. Walker and J. Ter Maat (2013). "Dynamic Adaptive Policy Pathways: A New Method for Crafting Robust Decisions for a Deeply Uncertain World." Global Environmental Change 23(2): 485-498. Kwakkel, J. H., M. Haasnoot and W. E. Walker (2014). "Developing Dynamic Adaptive Policy Pathways: A computer-assisted approach for developing adaptive strategies for a deeply uncertain world." Climatic Change.

  15. Medical education, cost and policy: what are the drivers for change? Commentary.

    PubMed

    Walsh, Kieran

    2014-01-01

    Medical education is expensive. Its expense has led many stakeholders to speculate on how costs could be reduced. In an ideal world such decisions would be made on sound evidence; however this is impossible in the absence of evidence. Sometimes practice will be informed by policy, but policy will not always be evidence based. So how is policy in the field of cost and value in medical education actually developed? The foremost influence on policy in cost and value should be evidence-based knowledge. Unfortunately policy is sometimes influenced by what might at best be termed tradition and at worst inertia. Another influence on policy will be people--but some individuals may have more influence than others. A further influence on policy in this field is events, and mainly events that have gone wrong. One final influence on emerging policy in medical education cost analysis is that of the media.

  16. Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing

    PubMed Central

    Ang, Desmond; Steinhart, Jonathan; Chao, Matthew; Patterson, Mark; Sah, Sunita; Wu, Tina; Schoenbaum, Michael; Hutchins, David; Brennan, Troyen; Loewenstein, George

    2017-01-01

    Importance In an effort to regulate physician conflicts of interest, some US academic medical centers (AMCs) enacted policies restricting pharmaceutical representative sales visits to physicians (known as detailing) between 2006 and 2012. Little is known about the effect of these policies on physician prescribing. Objective To analyze the association between detailing policies enacted at AMCs and physician prescribing of actively detailed and not detailed drugs. Design, Setting, and Participants The study used a difference-in-differences multivariable regression analysis to compare changes in prescribing by physicians before and after implementation of detailing policies at AMCs in 5 states (California, Illinois, Massachusetts, Pennsylvania, and New York) that made up the intervention group with changes in prescribing by a matched control group of similar physicians not subject to a detailing policy. Exposures Academic medical center implementation of policies regulating pharmaceutical salesperson visits to attending physicians. Main Outcomes and Measures The monthly within-drug class market share of prescriptions written by an individual physician for detailed and nondetailed drugs in 8 drug classes (lipid-lowering drugs, gastroesophageal reflux disease drugs, diabetes drugs, antihypertensive drugs, hypnotic drugs approved for the treatment of insomnia [sleep aids], attention-deficit/hyperactivity disorder drugs, antidepressant drugs, and antipsychotic drugs) comparing the 10- to 36-month period before implementation of the detailing policies with the 12- to 36-month period after implementation, depending on data availability. Results The analysis included 16 121 483 prescriptions written between January 2006 and June 2012 by 2126 attending physicians at the 19 intervention group AMCs and by 24 593 matched control group physicians. The sample mean market share at the physician-drug-month level for detailed and nondetailed drugs prior to enactment of policies was 19.3% and 14.2%, respectively. Exposure to an AMC detailing policy was associated with a decrease in the market share of detailed drugs of 1.67 percentage points (95% CI, −2.18 to −1.18 percentage points; P < .001) and an increase in the market share of nondetailed drugs of 0.84 percentage points (95% CI, 0.54 to 1.14 percentage points; P < .001). Associations were statistically significant for 6 of 8 study drug classes for detailed drugs (lipid-lowering drugs, gastroesophageal reflux disease drugs, antihypertensive drugs, sleep aids, attention-deficit/hyperactivity disorder drugs, and antidepressant drugs) and for 9 of the 19 AMCs that implemented policies. Eleven of the 19 AMCs regulated salesperson gifts to physicians, restricted salesperson access to facilities, and incorporated explicit enforcement mechanisms. For 8 of these 11 AMCs, there was a significant change in prescribing. In contrast, there was a significant change at only 1 of 8 AMCs that did not enact policies in all 3 areas. Conclusions and Relevance Implementation of policies at AMCs that restricted pharmaceutical detailing between 2006 and 2012 was associated with modest but significant reductions in prescribing of detailed drugs across 6 of 8 major drug classes; however, changes were not seen in all of the AMCs that enacted policies. PMID:28464141

  17. Visual Analysis of Air Traffic Data

    NASA Technical Reports Server (NTRS)

    Albrecht, George Hans; Pang, Alex

    2012-01-01

    In this paper, we present visual analysis tools to help study the impact of policy changes on air traffic congestion. The tools support visualization of time-varying air traffic density over an area of interest using different time granularity. We use this visual analysis platform to investigate how changing the aircraft separation volume can reduce congestion while maintaining key safety requirements. The same platform can also be used as a decision aid for processing requests for unmanned aerial vehicle operations.

  18. Public Health Effects of Medical Marijuana Legalization in Colorado.

    PubMed

    Davis, Jonathan M; Mendelson, Bruce; Berkes, Jay J; Suleta, Katie; Corsi, Karen F; Booth, Robert E

    2016-03-01

    The public health consequences of the legalization of marijuana, whether for medical or recreational purposes, are little understood. Despite this, numerous states are considering medical or recreational legalization. In the context of abrupt changes in marijuana policy in 2009 in Colorado, the authors sought to investigate corresponding changes in marijuana-related public health indicators. This observational, ecologic study used an interrupted time-series analysis to identify changes in public health indicators potentially related to broad policy changes that occurred in 2009. This was records-based research from the state of Colorado and Denver metropolitan area. Data were collected to examine frequency and trends of marijuana-related outcomes in hospital discharges and poison center calls between time periods before and after 2009 and adjusted for population. Analyses were conducted in 2014. Hospital discharges coded as marijuana-dependent increased 1% per month (95% CI=0.8, 1.1, p<0.001) from 2007 to 2013. A change in trend was detected in poison center calls mentioning marijuana (p<0.01). After 2009, poison center calls increased 0.8% per month (95% CI=0.2, 1.4, p<0.01). Poison center calls also increased 56% (95% CI=49%, 63%, p<0.001) in the period following the policy change. Further, there was one hospital discharge coded as dependent for every 3,159 (95% CI=2465, 3853, p<0.001) medical marijuana registrant applications. The abrupt nature of these changes suggests public health effects related to broad policy changes associated with marijuana. This report may be used to assist in policy decisions regarding the short-term public health effects of marijuana legalization. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Development and application of earth system models.

    PubMed

    Prinn, Ronald G

    2013-02-26

    The global environment is a complex and dynamic system. Earth system modeling is needed to help understand changes in interacting subsystems, elucidate the influence of human activities, and explore possible future changes. Integrated assessment of environment and human development is arguably the most difficult and most important "systems" problem faced. To illustrate this approach, we present results from the integrated global system model (IGSM), which consists of coupled submodels addressing economic development, atmospheric chemistry, climate dynamics, and ecosystem processes. An uncertainty analysis implies that without mitigation policies, the global average surface temperature may rise between 3.5 °C and 7.4 °C from 1981-2000 to 2091-2100 (90% confidence limits). Polar temperatures, absent policy, are projected to rise from about 6.4 °C to 14 °C (90% confidence limits). Similar analysis of four increasingly stringent climate mitigation policy cases involving stabilization of greenhouse gases at various levels indicates that the greatest effect of these policies is to lower the probability of extreme changes. The IGSM is also used to elucidate potential unintended environmental consequences of renewable energy at large scales. There are significant reasons for attention to climate adaptation in addition to climate mitigation that earth system models can help inform. These models can also be applied to evaluate whether "climate engineering" is a viable option or a dangerous diversion. We must prepare young people to address this issue: The problem of preserving a habitable planet will engage present and future generations. Scientists must improve communication if research is to inform the public and policy makers better.

  20. Development and application of earth system models

    PubMed Central

    Prinn, Ronald G.

    2013-01-01

    The global environment is a complex and dynamic system. Earth system modeling is needed to help understand changes in interacting subsystems, elucidate the influence of human activities, and explore possible future changes. Integrated assessment of environment and human development is arguably the most difficult and most important “systems” problem faced. To illustrate this approach, we present results from the integrated global system model (IGSM), which consists of coupled submodels addressing economic development, atmospheric chemistry, climate dynamics, and ecosystem processes. An uncertainty analysis implies that without mitigation policies, the global average surface temperature may rise between 3.5 °C and 7.4 °C from 1981–2000 to 2091–2100 (90% confidence limits). Polar temperatures, absent policy, are projected to rise from about 6.4 °C to 14 °C (90% confidence limits). Similar analysis of four increasingly stringent climate mitigation policy cases involving stabilization of greenhouse gases at various levels indicates that the greatest effect of these policies is to lower the probability of extreme changes. The IGSM is also used to elucidate potential unintended environmental consequences of renewable energy at large scales. There are significant reasons for attention to climate adaptation in addition to climate mitigation that earth system models can help inform. These models can also be applied to evaluate whether “climate engineering” is a viable option or a dangerous diversion. We must prepare young people to address this issue: The problem of preserving a habitable planet will engage present and future generations. Scientists must improve communication if research is to inform the public and policy makers better. PMID:22706645

  1. Factors Affecting the Supply of Recent College Graduates in New England. Policy Brief 09-1

    ERIC Educational Resources Information Center

    Sasser, Alicia

    2009-01-01

    This policy brief investigates factors affecting New England's supply of recent college graduates and how those factors have changed over time, and suggests steps that states might take to expand this source of skilled labor. (Contains 3 figures.) [This brief summarizes analysis in NEPPC research report 08-1: "The Future of the Skilled Labor…

  2. Understanding Elementary Teachers' Different Responses to Reform: The Case of Implementation of an Assessment Reform in South Korea

    ERIC Educational Resources Information Center

    Choi, Jinyoung

    2017-01-01

    This study explores how teachers implemented an assessment reform in South Korea, with an analysis of different aspects of the reform. Using a mixed method design, this study reveals that the relation between policy and practice depends upon the nature of the changes that reform policies propose. Teachers' implementation varies in terms of…

  3. Suitable Penalty for Breach of Contract: AFROTC Cadets. A Research Report Submitted to the Faculty.

    ERIC Educational Resources Information Center

    Reese, Robert D.

    A legislative history of financial incentives in the Reserve Officer Training Corps gives perspective to an analysis of present law and policy concerning breach of contract for Air Force ROTC cadets. The changed environment, criticisms of the present law and policy, and the example of three other Western nations with all volunteer militaries are…

  4. Community Intellectual Disability Nurses' Public Health Roles in the United Kingdom: An Exploratory Documentary Analysis

    ERIC Educational Resources Information Center

    Mafuba, Kay; Gates, Bob; Cozens, Maria

    2018-01-01

    The aim of this study was to explore how public health policy in the United Kingdom was reflected in community intellectual disability nurses' (CIDNs)' job descriptions and person's specifications. The role of CIDNs has evolved due to policy changes. As these roles evolve, job descriptions and person specifications are important in highlighting…

  5. 12 for 2012: Issues to Move Education Forward in 2012

    ERIC Educational Resources Information Center

    Zinth, Jennifer Dounay, Ed.; Christie, Kathy, Ed.

    2012-01-01

    This publication is an ECS (Education Commission of the States) "read of the field," built on its scrutiny of new reports and research, and its analysis of emerging drivers of change. This publication is intended to stimulate thinking around how best to craft the "2.0" of powerful policy across the states. The 12 policy areas highlighted in this…

  6. A Policy Analysis of Child Care Subsidies: Increasing Quality, Access, and Affordability

    ERIC Educational Resources Information Center

    Moodie-Dyer, Amber

    2011-01-01

    Changing family dynamics over the past four decades, including rises in the numbers of working mothers and single-parent families, have created an increased need for affordable child care. Government response to this need has involved a number of stop-and-start policy approaches, which have led to a fractured child care system that makes it…

  7. Current systematic carbon-cycle observations and the need for implementing a policy-relevant carbon observing system

    Treesearch

    P. Ciais; A. J. Dolman; A. Bombelli; R. Duren; A. Peregon; P. J. Rayner; C. Miller; N. Gobron; G. Kinderman; G. Marland; N. Gruber; F. Chevallier; R. J. Andres; G. Balsamo; L. Bopp; F.-M. Bréon; G. Broquet; R. Dargaville; T. J. Battin; A. Borges; H. Bovensmann; M. Buchwitz; J. Butler; J. G. Canadell; R. B. Cook; R. DeFries; R. Engelen; K. R. Gurney; C. Heinze; M. Heimann; A. Held; M. Henry; B. Law; S. Luyssaert; J. Miller; T. Moriyama; C. Moulin; R. B. Myneni; C. Nussli; M. Obersteiner; D. Ojima; Y. Pan; J.-D. Paris; S. L. Piao; B. Poulter; S. Plummer; S. Quegan; P. Raymond; M. Reichstein; L. Rivier; C. Sabine; D. Schimel; O. Tarasova; R. Valentini; R. Wang; G. van der Werf; D. Wickland; M. Williams; C. Zehner

    2014-01-01

    A globally integrated carbon observation and analysis system is needed to improve the fundamental understanding of the global carbon cycle, to improve our ability to project future changes, and to verify the effectiveness of policies aiming to reduce greenhouse gas emissions and increase carbon sequestration. Building an integrated carbon observation system requires...

  8. Interpreting the Economic Growth and Development Policies of Post-Apartheid South Africa: Its Influence on Higher Education and Prospects for Women

    ERIC Educational Resources Information Center

    Eynon, Diane E.

    2010-01-01

    This dissertation is structured as a critical policy analysis employing historical methods. It examines how the post apartheid government's economic growth and development polices have informed the higher education system and how this has changed women's financial, occupational, political, social, and educational prospects in South Africa. Through…

  9. Efforts to Address the Aging Academic Workforce: Assessing Progress through a Three-Stage Model of Institutional Change

    ERIC Educational Resources Information Center

    Kaskie, Brian; Walker, Mark; Andersson, Matthew

    2017-01-01

    The aging of the academic workforce is becoming more relevant to policy discussions in higher education. Yet there has been no formal, large-scale analysis of institutional efforts to develop policies and programs for aging employees. We fielded a representative survey of human resource specialists at 187 colleges and universities across the…

  10. Privatisation Policies and Postprivatisation Control Devices in India's Higher Education: Evidence from a Regional Study and Implications for Developing Countries

    ERIC Educational Resources Information Center

    Narayana, M. R.

    2006-01-01

    This article focuses on economic analysis of privatisation policies and postprivatisation control devices in India's higher education. As a case study, the experiences of Karnataka State in collegiate education under general higher education are emphasised. A change in public financing, rather than a shift of public ownership and management to…

  11. Revised planetary protection policy for solar system exploration.

    PubMed

    DeVincenzi, D L; Stabekis, P D

    1984-01-01

    In order to control contamination of planets by terrestrial microorganisms and organic constituents, U.S. planetary missions have been governed by a planetary protection (or planetary quarantine) policy which has changed little since 1972. This policy has recently been reviewed in light of new information obtained from planetary exploration during the past decade and because of changes to, or uncertainties in, some parameters used in the existing quantitative approach. On the basis of this analysis, a revised planetary protection policy with the following key features is proposed: deemphasizing the use of mathematical models and quantitative analyses; establishing requirements for target planet/mission type (i.e., orbiter, lander, etc.) combinations; considering sample return missions a separate category; simplifying documentation; and imposing implementing procedures (i.e., trajectory biasing, cleanroom assembly, spacecraft sterilization, etc.) by exception, i.e., only if the planet/mission combination warrants such controls.

  12. Sustained Change: Institutionalizing Interdisciplinary Graduate Education

    ERIC Educational Resources Information Center

    Borrego, Maura; Boden, Daniel; Newswander, Lynita K.

    2014-01-01

    We employ Scott's three pillars of institutions (regulative, normative, and cultural-cognitive) to investigate how higher education organizations change to support interdisciplinary graduate education. Using document analysis and case study approaches, we illustrate how strategies which address both policies and cultural norms are most…

  13. Feminist Academics: Creative Agents for Change.

    ERIC Educational Resources Information Center

    Morley, Louise, Ed.; Walsh, Val, Ed.

    This collection of 13 essays and 1 poem demonstrates how feminist analysis of the micropolitics of British higher education in terms of power, policies, discourses, curriculum, pedagogy, and intra- and interpersonal relationships provides a framework for deprivatizing women's experiences and influencing change. It includes: (1) "Troubling…

  14. The Distribution of Climate Change Public Opinion in Canada

    PubMed Central

    Gravelle, Timothy

    2016-01-01

    While climate scientists have developed high resolution data sets on the distribution of climate risks, we still lack comparable data on the local distribution of public climate change opinions. This paper provides the first effort to estimate local climate and energy opinion variability outside the United States. Using a multi-level regression and post-stratification (MRP) approach, we estimate opinion in federal electoral districts and provinces. We demonstrate that a majority of the Canadian public consistently believes that climate change is happening. Belief in climate change’s causes varies geographically, with more people attributing it to human activity in urban as opposed to rural areas. Most prominently, we find majority support for carbon cap and trade policy in every province and district. By contrast, support for carbon taxation is more heterogeneous. Compared to the distribution of US climate opinions, Canadians believe climate change is happening at higher levels. This new opinion data set will support climate policy analysis and climate policy decision making at national, provincial and local levels. PMID:27486659

  15. State autonomy, policy paralysis: paradoxes of institutions and culture in the French health care system.

    PubMed

    Rochaix, Lise; Wilsford, David

    2005-01-01

    In this article, we assess the recent performance of the French state at containing costs in health care using political science concepts such as path dependency and incentives, which are central to an economic approach. The article focuses on institutional capacities and cultural immobilism and attempts to lay bare the tensions at play in seizing (or not) opportunities for structural change. In particular, we attempt to delineate what constitutes real change in this policy arena (big reforms versus the accumulation of many small policy movements) and to understand the variables at play in the coming together of conjunctures that provide for the big, as well as the underlying structures that allow the accumulation of the small. Except in cases of favorable conjuncture, the analysis bodes very ill for nonincremental reform and, indeed, for significant change over the long term.

  16. Assessing and forecasting population health: integrating knowledge and beliefs in a comprehensive framework.

    PubMed

    Van Meijgaard, Jeroen; Fielding, Jonathan E; Kominski, Gerald F

    2009-01-01

    A comprehensive population health-forecasting model has the potential to interject new and valuable information about the future health status of the population based on current conditions, socioeconomic and demographic trends, and potential changes in policies and programs. Our Health Forecasting Model uses a continuous-time microsimulation framework to simulate individuals' lifetime histories by using birth, risk exposures, disease incidence, and death rates to mark changes in the state of the individual. The model generates a reference forecast of future health in California, including details on physical activity, obesity, coronary heart disease, all-cause mortality, and medical expenditures. We use the model to answer specific research questions, inform debate on important policy issues in public health, support community advocacy, and provide analysis on the long-term impact of proposed changes in policies and programs, thus informing stakeholders at all levels and supporting decisions that can improve the health of populations.

  17. Explaining trends in alcohol-related harms in Scotland 1991-2011 (II): policy, social norms, the alcohol market, clinical changes and a synthesis.

    PubMed

    McCartney, G; Bouttell, J; Craig, N; Craig, P; Graham, L; Lakha, F; Lewsey, J; McAdams, R; MacPherson, M; Minton, J; Parkinson, J; Robinson, M; Shipton, D; Taulbut, M; Walsh, D; Beeston, C

    2016-03-01

    To provide a basis for evaluating post-2007 alcohol policy in Scotland, this paper tests the extent to which pre-2007 policy, the alcohol market, culture or clinical changes might explain differences in the magnitude and trends in alcohol-related mortality outcomes in Scotland compared to England & Wales (E&W). Rapid literature reviews, descriptive analysis of routine data and narrative synthesis. We assessed the impact of pre-2007 Scottish policy and policy in the comparison areas in relation to the literature on effective alcohol policy. Rapid literature reviews were conducted to assess cultural changes and the potential role of substitution effects between alcohol and illicit drugs. The availability of alcohol was assessed by examining the trends in the number of alcohol outlets over time. The impact of clinical changes was assessed in consultation with key informants. The impact of all the identified factors were then summarised and synthesised narratively. The companion paper showed that part of the rise and fall in alcohol-related mortality in Scotland, and part of the differing trend to E&W, were predicted by a model linking income trends and alcohol-related mortality. Lagged effects from historical deindustrialisation and socio-economic changes exposures also remain plausible from the available data. This paper shows that policy differences or changes prior to 2007 are unlikely to have been important in explaining the trends. There is some evidence that aspects of alcohol culture in Scotland may be different (more concentrated and home drinking) but it seems unlikely that this has been an important driver of the trends or the differences with E&W other than through interaction with changing incomes and lagged socio-economic effects. Substitution effects with illicit drugs and clinical changes are unlikely to have substantially changed alcohol-related harms: however, the increase in alcohol availability across the UK is likely to partly explain the rise in alcohol-related mortality during the 1990s. Future policy should ensure that alcohol affordability and availability, as well as socio-economic inequality, are reduced, in order to maintain downward trends in alcohol-related mortality in Scotland. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Integrating Climate Change Scenarios and Co-developed Policy Scenarios to Inform Coastal Adaptation: Results from a Tillamook County, Oregon Knowledge to Action Network

    NASA Astrophysics Data System (ADS)

    Lipiec, E.; Ruggiero, P.; Serafin, K.; Bolte, J.; Mills, A.; Corcoran, P.; Stevenson, J.; Lach, D.

    2014-12-01

    Local decision-makers often lack both the information and tools to reduce their community's overall vulnerability to current and future climate change impacts. Managers are restricted in their actions by the scale of the problem, inherent scientific uncertainty, limits of information exchange, and the global nature of available data, rendering place-based strategies difficult to generate. Several U.S. Pacific Northwest coastal communities are already experiencing chronic erosion and flooding, hazards only to be exacerbated by sea level rise and changing patterns of storminess associated with climate change. To address these issues, a knowledge to action network (KTAN) consisting of local Tillamook County stakeholders and Oregon State University researchers, was formed to project future flooding and erosion impacts and determine possible adaptation policies to reduce vulnerability. Via an iterative scenario planning process, the KTAN has developed four distinct adaptation policy scenarios, including 'Status Quo', 'Hold The Line', 'ReAlign', and 'Laissez-Faire'. These policy scenarios are being integrated with a range of climate change scenarios within the modeling framework Envision, a multi-agent GIS-based tool, which allows for the combination of physical processes data, probabilistic climate change information, coastal flood and erosion models, and stakeholder driven adaptation strategies into distinct plausible future scenarios. Because exact physical and social responses to climate change are impossible to ascertain, information about the differences between possible future scenarios can provide valuable information to decision-makers and the community at large. For example, the fewest projected coastal flood and erosion impacts to buildings occur under the 'ReAlign' policy scenario (i.e., adaptation strategies that move dwellings away from the coast) under both low and high climate change scenarios, especially in comparison to the 'Status Quo' or 'Hold The Line' scenarios. Statistical analysis of the scenario-based variations in impacts to private and public resources can help guide future adaptation policy implementation and support Oregon's coastal communities for years to come.

  19. Rural implications of Medicare's post-acute-care transfer payment policy.

    PubMed

    Schoenman, Julie A; Mueller, Curt D

    2005-01-01

    Under the Medicare post-acute-care (PAC) transfer policy, acute-care hospitals are reimbursed under a per-diem formula whenever beneficiaries are discharged from selected diagnosis-related groups (DRGs) to a skilled nursing facility, home health care, or a prospective payment system (PPS)-excluded facility. Total per-diem payments are below the full DRG payment only when the patient's length of stay (LOS) is short relative to the geometric mean LOS for the DRG; otherwise, the full DRG payment is received. This policy originally applied to 10 DRGs beginning in fiscal year 1999 and was expanded to additional DRGs in FY2004. The Secretary may include other DRGs and types of PAC settings in future expansions. This article examines how the initial policy change affected rural and urban hospitals and investigates the likely impact of the FY2004 expansion and other possible future expansions. The authors used 1998-2001 Medicare Provider Analysis and Review (MEDPAR) data to investigate changes in hospital discharge patterns after the original policy was implemented, compute the change in Medicare revenue resulting from the payment change, and simulate the expected revenue reductions under expansions to additional DRGs and swing-bed discharges. Neither rural nor urban hospitals appear to have made a sustained change in their discharge behavior so as to limit their exposure to the transfer policy. Financial impacts from the initial policy were similar in relative terms for both types of hospitals and would be expected to be fairly similar for an expansion to additional DRGs. On average, including swing-bed discharges in the transfer policy would have a very small financial impact on small rural hospitals; only hospitals that make extensive use of swing beds after a short inpatient stay might expect large declines in total Medicare revenue. Rural hospitals are not disproportionately harmed by the PAC transfer policy. An expanded policy may even benefit rural hospitals by recognizing their lower use of post-acute-care and readjusting DRG weights so that they are paid more appropriately when providing the full course of inpatient care.

  20. Chronic disease prevention policy in British Columbia and Ontario in light of public health renewal: a comparative policy analysis

    PubMed Central

    2013-01-01

    Background Public health strategies that focus on legislative and policy change involving chronic disease risk factors such as unhealthy diet and physical inactivity have the potential to prevent chronic diseases and improve quality of life as a whole. However, many public health policies introduced as part of public health reform have not yet been analyzed, such as in British Columbia and Ontario. The purpose of this paper is to present the results of a descriptive, comparative analysis of public health policies related to the Healthy Living Core Program in British Columbia and Chronic Disease Prevention Standard in Ontario that are intended to prevent a range of chronic diseases by promoting healthy eating and physical activity, among other things. Methods Policy documents were found through Internet search engines and Ministry websites, at the guidance of policy experts. These included government documents as well as documents from non-governmental organizations that were implementing policies and programs at a provincial level. Documents (n = 31) were then analysed using thematic content analysis to classify, describe and compare policies in a systematic fashion, using the software NVivo. Results Three main categories emerged from the analysis of documents: 1) goals for chronic disease prevention in British Columbia and Ontario, 2) components of chronic disease prevention policies, and 3) expected outputs of chronic disease prevention interventions. Although there were many similarities between the two provinces, they differed somewhat in terms of their approach to issues such as evidence, equity, and policy components. Some expected outputs were adoption of healthy behaviours, use of information, healthy environments and increased public awareness. Conclusions The two provincial policies present different approaches to support the implementation of related programs. Differences may be related to contextual factors such as program delivery structures and different philosophical approaches underlying the two frameworks. These differences and possible explanations for them are important to understand because they serve to contextualize the differences in health outcomes across the two provinces that might eventually be observed. This analysis informs future public health policy directions as the two provinces can learn from each other. PMID:24099140

  1. Chronic disease prevention policy in British Columbia and Ontario in light of public health renewal: a comparative policy analysis.

    PubMed

    Kothari, Anita; Gore, Dana; MacDonald, Marjorie; Bursey, Gayle; Allan, Diane; Scarr, Jennifer

    2013-10-08

    Public health strategies that focus on legislative and policy change involving chronic disease risk factors such as unhealthy diet and physical inactivity have the potential to prevent chronic diseases and improve quality of life as a whole. However, many public health policies introduced as part of public health reform have not yet been analyzed, such as in British Columbia and Ontario. The purpose of this paper is to present the results of a descriptive, comparative analysis of public health policies related to the Healthy Living Core Program in British Columbia and Chronic Disease Prevention Standard in Ontario that are intended to prevent a range of chronic diseases by promoting healthy eating and physical activity, among other things. Policy documents were found through Internet search engines and Ministry websites, at the guidance of policy experts. These included government documents as well as documents from non-governmental organizations that were implementing policies and programs at a provincial level. Documents (n = 31) were then analysed using thematic content analysis to classify, describe and compare policies in a systematic fashion, using the software NVivo. Three main categories emerged from the analysis of documents: 1) goals for chronic disease prevention in British Columbia and Ontario, 2) components of chronic disease prevention policies, and 3) expected outputs of chronic disease prevention interventions. Although there were many similarities between the two provinces, they differed somewhat in terms of their approach to issues such as evidence, equity, and policy components. Some expected outputs were adoption of healthy behaviours, use of information, healthy environments and increased public awareness. The two provincial policies present different approaches to support the implementation of related programs. Differences may be related to contextual factors such as program delivery structures and different philosophical approaches underlying the two frameworks. These differences and possible explanations for them are important to understand because they serve to contextualize the differences in health outcomes across the two provinces that might eventually be observed. This analysis informs future public health policy directions as the two provinces can learn from each other.

  2. Responses of Israeli HMOs to environmental change following the National Health Insurance Law: Opening the black box.

    PubMed

    Gross, Revital; Harrison, Michael I

    2006-04-01

    Managed competition was introduced into the Israeli health care system with the enactment of the National Health Insurance (NHI) Law of 1995, which radically transformed health management organizations' (HMO) regulatory and competitive environments. We conducted an in-depth, qualitative analysis of the strategies developed by two Israeli HMOs in response to this change, and developed the concept of a "strategic repertoire" to integrate diverse theories of organizational adaptation to environmental change. Although the responses of these organizations to managed competition were broadly comparable, they diverged from one another in important ways. Our analysis highlights how the interaction among organizational history, managerial choice, and environmental constraints creates divergence in organizational responses to national policy initiatives. Policy implications arising from the findings include ways of anticipating unintended consequences of policy initiatives, such as involving provider organizations in the structuring of reform, or simulating their response in advance, based on expert knowledge of their strategic repertoires; and the need to include mechanisms for obtaining feedback on organizational responses in the implementation of reform. This will facilitate the adjustment of program regulations and incentives in response to emerging practices.

  3. Health, climate change and energy vulnerability: a retrospective assessment of strategic health authority policy and practice in England.

    PubMed

    Richardson, J; Kagawa, F; Nichols, A

    2008-11-17

    A number of policy documents suggest that health services should be taking climate change and sustainability seriously and recommendations have been made to mitigate and adapt to the challenges health care providers will face. Actions include, for example, moving towards locally sourced food supplies, reducing waste, energy consumption and travel, and including sustainability in policies and strategies. A Strategic Health Authority (SHA) is part of the National Health Service (NHS) in England. They are responsible for developing strategies for the local health services and ensuring high-quality performance. They manage the NHS locally and are a key link between the U.K. Department of Health and the NHS. They also ensure that national priorities are integrated into local plans. Thus they are in a key position to influence policies and practices to mitigate and adapt to the impact of climate change and promote sustainability. The aim of this study was to review publicly available documents produced by Strategic Health Authorities (SHA) to assess the extent to which current activity and planning locally takes into consideration climate change and energy vulnerability. A retrospective thematic content analysis of publicly available materials was undertaken by two researchers over a six month period in 2008. These materials were obtained from the websites of the 10 SHAs in England. Materials included annual reports, plans, policies and strategy documents. Of the 10 SHAs searched, 4 were found to have an absence of content related to climate change and sustainability. Of the remaining 6 SHAs that did include content related to climate change and energy vulnerability on their websites consistent themes were seen to emerge. These included commitment to a regional sustainability framework in collaboration with other agencies in the pursuit and promotion of sustainable development. Results indicate that many SHAs in England have yet to embrace sustainability, or to integrate preparations for climate change and energy vulnerability within their organisational strategies. Evidence also suggests that SHAs that have recognised the importance of sustainability within their documentation and policies have yet to fully demonstrate this in practice through the implementation of these policies. Further research is required to investigate means by which SHAs (U.K.) and agencies responsible for health service policy in other countries may be enabled to include a greater consideration of sustainability and climate change within their policies, and to find effective ways of implementing these policies within daily working practice.

  4. Photovoltaic technology for sustainability: An investigation of the distributed utility concept as a policy framework

    NASA Astrophysics Data System (ADS)

    Letendre, Steven Emery

    The U.S. electric utility sector in its current configuration is unsustainable. The majority of electricity in the United States is produced using finite fossil fuels. In addition, significant potential exists to improve the nation's efficient use of energy. A sustainable electric utility sector will be characterized by increased use of renewable energy sources and high levels of end-use efficiency. This dissertation analyzes two alternative policy approaches designed to move the U.S. electric utility sector toward sustainability. One approach is labeled incremental which involves maintaining the centralized structure of the electric utility sector but facilitating the introduction of renewable energy and efficiency into the electrical system through the pricing mechanism. A second policy approach was described in which structural changes are encouraged based on the emerging distributed utility (DU) concept. A structural policy orientation attempts to capture the unique localized benefits that distributed renewable resources and energy efficiency offer to electric utility companies and their customers. A market penetration analysis of PV in centralized energy supply and distributed peak-shaving applications is conducted for a case-study electric utility company. Sensitivity analysis was performed based on incremental and structural policy orientations. The analysis provides compelling evidence which suggests that policies designed to bring about structural change in the electric utility sector are needed to move the industry toward sustainability. Specifically, the analysis demonstrates that PV technology, a key renewable energy option likely to play an important role in a renewable energy future, will begin to penetrate the electrical system in distributed peak-shaving applications long before the technology is introduced as a centralized energy supply option. Most policies to date, which I term incremental, attempt to encourage energy efficiency and renewables through the pricing system. Based on past policy experience, it is unlikely that such an approach would allow PV to compete in Delaware as an energy supply option in the next ten to twenty years. Alternatively, a market-based, or green pricing, approach will not create significant market opportunities for PV as a centralized energy supply option. However, structural policies designed to encourage the explicit recognition of the localized benefits of distributed resources could result in PV being introduced into the electrical system early in the next century.

  5. Changes in the Medicare home health care market: the impact of reimbursement policy.

    PubMed

    Choi, Sunha; Davitt, Joan K

    2009-03-01

    The Balanced Budget Act of 1997 introduced 2 new reimbursement structures, the Interim Payment System (IPS, 1997-2000) and the Prospective Payment System (PPS, begun October 2000) for Medicare home health agencies (HHAs) under the fee-for-service program. This article describes and compares the impact of these changes on the Medicare home health market from a period before the BBA through the IPS and PPS in relation to agency characteristics. A secondary analysis of 1996, 1999, and 2002 Provider of Services data was conducted on all Medicare-certified HHAs. Frequencies and rates of change were calculated by agency characteristics to describe changes in the number of active agencies through those years. Logistic regression models were used to compare factors associated with market exits under different payment systems. The results indicate dramatic but disproportional changes in response to the IPS and the PPS among Medicare home health care agencies. Agency closures were greater and market entries fewer during the IPS, but more branch offices/subunits were closed during the PPS. Proprietary and freestanding agencies experienced greater volatility throughout, with the greatest number of closures seen in Region VI (Dallas). These results demonstrate the direct impact of policy changes on the home health care market and highlight the need to evaluate policy changes to understand both intended and unintended impacts on health markets. Future research should analyze the effect of these policy changes on other healthcare providers and systems and their impact on health outcomes for Medicare beneficiaries.

  6. Transportation impact analysis gets a failing grade when it comes to climate change and smart growth

    DOT National Transportation Integrated Search

    2008-12-01

    Transportation impact analysis performed to comply with environmental impact laws (i.e., the : California Environmental Quality Act or the National Environmental Policy Act) often focuses : on only one perspective about potential impacts. That perspe...

  7. A comparative policy analysis of seat belt laws : final report.

    DOT National Transportation Integrated Search

    2014-06-24

    This analysis examined data from a variety of sources to estimate the benefit of enhancing Iowas current law to require all : passengers to use seat belts. In addition to assessing Iowans opinions about changing the law, a literature review, a ...

  8. Analysis of a government policy to address nursing shortage and nursing education quality.

    PubMed

    Abhicharttibutra, K; Kunaviktikul, W; Turale, S; Wichaikhum, O-A; Srisuphan, W

    2017-03-01

    A well-educated, sufficient nursing workforce improves population health and standards of nursing care. Analysing workforce policies assists nurses to learn from the past and develop better future policies. Describe policy-making processes in the first Thai government plan to increase nursing capacity and improve nursing education quality. A qualitative study employing Longest's model to examine policy-making processes. Data were obtained from 28 in-depth interviews with key informants, who had been committee members and former deans of nursing involved with the policy processes in the 1990s. Both qualitative and quantitative data were extracted from relevant documents, and content analysis employed with all data. Three policy phases were identified. Policy formulation, where three streams of problems, politics and policy resulted in identification of nursing shortage, changes of government incumbents and needing to increase nurse production; Policy implementation included creating methods of implementation, appointing responsible people and committees, creating operational plans, producing more nurses and faculty development projects and Policy modification which incorporated implementing the first Thai international doctoral degree in English, a collaborative programme between universities. Not all key informants could be accessed due to the passage of time. Findings are unique to Thailand but inform internationally of nurses' abilities and need to be involved in policy. Nurses were involved in all policy phases. While the policy produced positive developments in growing nursing capacity and education in the past, nursing shortages remained and are now acute in Thailand. Lessons learned from this policy analysis help explain why the nursing education and nursing shortage policy was legislated through the government agenda, and the active involvement of Thai nurses in this process. Nurses globally need to be at the policy-making table to try to reduce nursing shortages, and enhance practice and education environments. © 2016 International Council of Nurses.

  9. An analysis of policy levers used to implement mental health reform in Australia 1992-2012.

    PubMed

    Grace, Francesca C; Meurk, Carla S; Head, Brian W; Hall, Wayne D; Carstensen, Georgia; Harris, Meredith G; Whiteford, Harvey A

    2015-10-24

    Over the past two decades, mental health reform in Australia has received unprecedented government attention. This study explored how five policy levers (organisation, regulation, community education, finance and payment) were used by the Australian Federal Government to implement mental health reforms. Australian Government publications, including the four mental health plans (published in 1992, 1998, 2003 and 2008) were analysed according to policy levers used to drive reform across five priority areas: [1] human rights and community attitudes; [2] responding to community need; [3] service structures; [4] service quality and effectiveness; and [5] resources and service access. Policy levers were applied in varying ways; with two or three levers often concurrently used to implement a single initiative or strategy. For example, changes to service structures were achieved using various combinations of all five levers. Attempts to improve service quality and effectiveness were instead made through a single lever-regulation. The use of some levers changed over time, including a move away from prescriptive, legislative use of regulation, towards a greater focus on monitoring service standards and consumer outcomes. Patterns in the application of policy levers across the National Mental Health Strategy, as identified in this analysis, represent a novel way of conceptualising the history of mental health reform in Australia. An improved understanding of the strategic targeting and appropriate utilisation of policy levers may assist in the delivery and evaluation of evidence-based mental health reform in the future.

  10. Medicare Long-Term CPAP Coverage Policy: A Cost-Utility Analysis

    PubMed Central

    Billings, Martha E.; Kapur, Vishesh K.

    2013-01-01

    Study Objectives: CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Design: Cost-utility and cost-effectiveness analysis. Setting: U.S. Medicare Population. Patients or Participants: N/A. Interventions: N/A. Measurements and Results: We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Conclusions: Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change. Citation: Billings ME; Kapur VK. Medicare long-term CPAP coverage policy: a cost-utility analysis. J Clin Sleep Med 2013;9(10):1023-1029. PMID:24127146

  11. From Protest to Challenge: Leadership and Higher Education Change in South Africa.

    ERIC Educational Resources Information Center

    Kulati, Tembile

    2003-01-01

    Explores the emerging approaches to leadership at South African higher education institutions within the context of the changes that followed the new higher education policy framework, as well as the challenges of globalization. The focus of the analysis is on the changing role of leadership in higher education, with a specific emphasis on the…

  12. Risk Analysis of Near-Coastal Species of the U.S. Pacific Coast: Case Study Comparing Risks Associated with Two Future Climate Scenarios

    EPA Science Inventory

    Fundamental questions for climate change policy and adaptation strategies are to what extent does ecological risk change under different climate scenarios and how do any changes in risk vary among taxa and geographically. To evaluate these questions, we developed a rule-based fra...

  13. Analysis of Urban-Rural Land-Use Change during 1995-2006 and Its Policy Dimensional Driving Forces in Chongqing, China

    PubMed Central

    Long, Hualou; Wu, Xiuqin; Wang, Wenjie; Dong, Guihua

    2008-01-01

    This paper analyzes the urban-rural land-use change of Chongqing and its policy dimensional driving forces from 1995 to 2006, using high-resolution Landsat TM (Thematic Mapper) data of 1995, 2000 and 2006, and socio-economic data from both research institutes and government departments. The outcomes indicated that urban-rural land-use change in Chongqing can be characterized by two major trends: First, the non-agricultural land increased substantially from 1995 to 2006, thus causing agricultural land especially farmland to decrease continuously. Second, the aggregation index of urban settlements and rural settlements shows that local urban-rural development experienced a process of changing from aggregation (1995-2000) to decentralization (2000-2006). Chongqing is a special area getting immersed in many important policies, which include the establishment of the municipality directly under the Central Government, the building of Three Gorges Dam Project, the Western China Development Program and the Grain-for-Green Programme, and bring about tremendous influences on its land-use change. By analyzing Chongqing's land-use change and its policy driving forces, some implications for its new policy of ‘Urban-rural Integrated Reform’ are obtained. That is more attentions need to be paid to curbing excessive and idle rural housing and consolidating rural construction land, and to laying out a scientific land-use plan for its rural areas taking such rural land-use issues as farmland occupation and rural housing land management into accounts, so as to coordinate and balance the urban-rural development. PMID:27879729

  14. The New Politics of US Health Care Prices: Institutional Reconfiguration and the Emergence of All-Payer Claims Databases.

    PubMed

    Rocco, Philip; Kelly, Andrew S; Béland, Daniel; Kinane, Michael

    2017-02-01

    Prices are a significant driver of health care cost in the United States. Existing research on the politics of health system reform has emphasized the limited nature of policy entrepreneurs' efforts at solving the problem of rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower consumers, purchasers, and states to make informed market and policy choices. Drawing on pragmatist institutional theory, this article shows how APCDs emerged as the dominant model for reforming health care prices. While APCD advocates faced significant institutional barriers to policy change, we show how they reconfigured existing ideas, tactical repertoires, and legal-technical infrastructures to develop a politically and technologically robust reform. Our analysis has important implications for theories of how change agents overcome structural barriers to health reform. Copyright © 2017 by Duke University Press.

  15. Beyond positivism: Understanding and addressing childhood obesity disparities through a Critical Theory perspective.

    PubMed

    Schroeder, Krista; Kulage, Kristine M; Lucero, Robert

    2015-10-01

    We apply Critical Theory to examine menu labeling with the aim of uncovering important implications for nursing practice, research, and policy. Our critical analysis uncovers barriers to menu labeling's effectiveness, particularly for vulnerable populations. Nurses must work to minimize the impact of these barriers and optimize the effectiveness of menu labeling, in order to strengthen the fight against obesity. We suggest changes, guided by this critical analysis, which can be implemented by nurses working in clinical practice, research, and policy. © 2015, Wiley Periodicals, Inc.

  16. Beyond Positivism: Understanding and addressing childhood obesity disparities through a Critical Theory perspective

    PubMed Central

    Schroeder, Krista; Kulage, Kristine M.; Lucero, Robert

    2016-01-01

    Purpose We apply Critical Theory to examine menu labeling with the aim of uncovering important implications for nursing practice, research, and policy. Conclusions Our critical analysis uncovers barriers to menu labeling's effectiveness, particularly for vulnerable populations. Nurses must work to minimize the impact of these barriers and optimize the effectiveness of menu labeling, in order to strengthen the fight against obesity. Practice implications We suggest changes, guided by this critical analysis,that can be implemented by nurses working in clinical practice, research, and policy. PMID:26112774

  17. Scenarios for coastal vulnerability assessment

    USGS Publications Warehouse

    Nicholls, Robert J.; Woodroffe, Colin D.; Burkett, Virginia; Hay, John; Wong, Poh Poh; Nurse, Leonard; Wolanski, Eric; McLusky, Donald S.

    2011-01-01

    Coastal vulnerability assessments tend to focus mainly on climate change and especially on sea-level rise. Assessment of the influence of nonclimatic environmental change or socioeconomic change is less well developed and these drivers are often completely ignored. Given that the most profound coastal changes of the twentieth century due to nonclimate drivers are likely to continue through the twenty-first century, this is a major omission. It may result in not only overstating the importance of climate change but also overlooking significant interactions of climate change and other drivers. To support the development of policies relating to climate change and coastal management, integrated assessments of climatic change in coastal areas are required, including the effects of all the relevant drivers. This chapter explores the development of scenarios (or "plausible futures") of relevant climate and nonclimate drivers that can be used for coastal analysis, with an emphasis on the nonclimate drivers. It shows the importance of analyzing the impacts of climate change and sea-level rise in a broader context of coastal change and all its drivers. This will improve the analysis of impacts, key vulnerabilities, and adaptation needs and, hence, inform climate and coastal policy. Stakeholder engagement is important in the development of scenarios, and the underlying assumptions need to be explicit, transparent, and open to scientific debate concerning their uncertainties/realism and likelihood.

  18. Alternative Energy Science and Policy: Biofuels as a Case Study

    NASA Astrophysics Data System (ADS)

    Ammous, Saifedean H.

    This dissertation studies the science and policy-making of alternative energy using biofuels as a case study, primarily examining the instruments that can be used to alleviate the impacts of climate change and their relative efficacy. Three case studies of policy-making on biofuels in the European Union, United States of America and Brazil are presented and discussed. It is found that these policies have had large unintended negative consequences and that they relied on Lifecycle Analysis studies that had concluded that increased biofuels production can help meet economic, energy and environmental goals. A close examination of these Lifecycle Analysis studies reveals that their results are not conclusive. Instead of continuing to attempt to find answers from Lifecycle Analyses, this study suggests an alternative approach: formulating policy based on recognition of the ignorance of real fuel costs and pollution. Policies to combat climate change are classified into two distinct approaches: policies that place controls on the fuels responsible for emissions and policies that target the pollutants themselves. A mathematical model is constructed to compare these two approaches and address the central question of this study: In light of an ignorance of the cost and pollution impacts of different fuels, are policies targeting the pollutants themselves preferable to policies targeting the fuels? It is concluded that in situations where the cost and pollution functions of a fuel are unknown, subsidies, mandates and caps on the fuel might result in increased or decreased greenhouse gas emissions; on the other hand, a tax or cap on carbon dioxide results in the largest decrease possible of greenhouse gas emissions. Further, controls on greenhouse gases are shown to provide incentives for the development and advancement of cleaner alternative energy options, whereas controls on the fuels are shown to provide equal incentives to the development of cleaner and dirtier alternative fuels. This asymmetry in outcomes---regardless of actual cost functions---is the reason why controls on greenhouse gases are deemed favorable to direct fuel subsidies and mandates.

  19. Human growth and body weight dynamics: an integrative systems model.

    PubMed

    Rahmandad, Hazhir

    2014-01-01

    Quantifying human weight and height dynamics due to growth, aging, and energy balance can inform clinical practice and policy analysis. This paper presents the first mechanism-based model spanning full individual life and capturing changes in body weight, composition and height. Integrating previous empirical and modeling findings and validated against several additional empirical studies, the model replicates key trends in human growth including A) Changes in energy requirements from birth to old ages. B) Short and long-term dynamics of body weight and composition. C) Stunted growth with chronic malnutrition and potential for catch up growth. From obesity policy analysis to treating malnutrition and tracking growth trajectories, the model can address diverse policy questions. For example I find that even without further rise in obesity, the gap between healthy and actual Body Mass Indexes (BMIs) has embedded, for different population groups, a surplus of 14%-24% in energy intake which will be a source of significant inertia in obesity trends. In another analysis, energy deficit percentage needed to reduce BMI by one unit is found to be relatively constant across ages. Accompanying documented and freely available simulation model facilitates diverse applications customized to different sub-populations.

  20. Human Growth and Body Weight Dynamics: An Integrative Systems Model

    PubMed Central

    Rahmandad, Hazhir

    2014-01-01

    Quantifying human weight and height dynamics due to growth, aging, and energy balance can inform clinical practice and policy analysis. This paper presents the first mechanism-based model spanning full individual life and capturing changes in body weight, composition and height. Integrating previous empirical and modeling findings and validated against several additional empirical studies, the model replicates key trends in human growth including A) Changes in energy requirements from birth to old ages. B) Short and long-term dynamics of body weight and composition. C) Stunted growth with chronic malnutrition and potential for catch up growth. From obesity policy analysis to treating malnutrition and tracking growth trajectories, the model can address diverse policy questions. For example I find that even without further rise in obesity, the gap between healthy and actual Body Mass Indexes (BMIs) has embedded, for different population groups, a surplus of 14%–24% in energy intake which will be a source of significant inertia in obesity trends. In another analysis, energy deficit percentage needed to reduce BMI by one unit is found to be relatively constant across ages. Accompanying documented and freely available simulation model facilitates diverse applications customized to different sub-populations. PMID:25479101

  1. An analysis of local government health policy against state priorities and a social determinants framework.

    PubMed

    Browne, Geoffrey R; Davern, Melanie T; Giles-Corti, Billie

    2016-04-01

    Victorian local governments are required to develop Municipal Public Health and Wellbeing Plans that incorporate state-level health planning priorities and address the social determinants of health. This paper describes a novel method for evaluating councils' performance against these requirements. Deductive content analysis was used to categorise all actions in 14 local government MPHWPs against Victorian state priorities as well as against social determinants of health policy areas. More than 1,000 actions were identified. However, fewer than half directly addressed a state priority, with many actions addressing policy areas known to be broader determinants of health. In particular, there was a marked focus on leisure and culture, and on building social cohesion through changes to living and working conditions. Councils are working beyond state priorities and there was a clear emphasis on addressing the diverse upstream 'causes of the causes' of health, rather than health promotion behaviour change programs. The approach for data analysis and presentation provides a useful method for rapid appraisal of health and wellbeing actions relative to councils', and the State's, responsibility and efficacy in public health. © 2015 Public Health Association of Australia.

  2. Resolving the psychiatric bed crisis: a critical analysis of policy.

    PubMed

    Loader, Katie

    The National Service Framework (NSF) for Mental Health in 1999 was central to the modernisation of mental health services under the New Labour government of 1997. It placed an emphasis on universal clinical standards and set out a vision for service developments over the next 10 years. One such proposal was the development of crisis resolution teams, aimed at reducing the psychiatric admissions rate by providing care at home. This article provides a critical analysis of policies relating to the provision of 24-hour access to mental health services, focusing on the specifications for creating crisis resolution teams, as laid out in the NSF for Mental Health and the NHS Plan. First, it looks at the historical context surrounding the policy, examining the content of the NSF and NHS plan and how policy was disseminated and implemented nationally and locally. Then it examines the effects and changes this policy brought about and, specifically, whether it has achieved its aims of reducing the nationwide acute psychiatric inpatient admission rate.

  3. Nursing education reform in South Africa – lessons from a policy analysis study

    PubMed Central

    Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C.

    2014-01-01

    Background Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. Objective We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. Design We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. Results The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. Conclusions The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which will need to be addressed if important nursing education reforms are to be realised. PMID:25537941

  4. Nursing education reform in South Africa--lessons from a policy analysis study.

    PubMed

    Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C

    2014-01-01

    Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which will need to be addressed if important nursing education reforms are to be realised.

  5. Regulatory responses to over-the-counter codeine analgesic misuse in Australia, New Zealand and the United Kingdom.

    PubMed

    Tobin, Claire L; Dobbin, Malcolm; McAvoy, Brian

    2013-10-01

    Analysis of the policy response by Australia's National Drugs and Poisons Schedule Committee (NDPSC) and comparison with recommendations by expert advisory committees in New Zealand and the United Kingdom. Analysis of public policy documents of relevant regulatory authorities was conducted. Data were extracted regarding changes to over-the-counter (OTC) codeine analgesic scheduling, indications, maximum unit dose, maximum daily dose, maximum pack size, warning labels, consumer medicine information and advertising. Where available, public submissions and other issues considered by the committees and rationale for their recommendations were recorded and thematically analysed. Expert advisory committees in Australia, NZ and the UK defined the policy problem of OTC codeine misuse and harm as small relative to total use and responded by restricting availability. Pharmacist supervision was required at the point-of-sale and pack sizes were reduced to short-term use. Comparison with recommendations by expert advisory committees in NZ and the UK suggests the NDPSC's actions in response to OTC codeine misuse were appropriate given the available evidence of misuse and harm, but highlights opportunities to utilise additional regulatory levers. Framing policy problems as matters of public health in the context of limited evidence may support decision makers to implement cautionary incremental policy change. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

  6. An Analysis of Alternatives to New York City's Current Marijuana Arrest and Detention Policy

    PubMed Central

    Johnson, Bruce D.; Golub, Andrew; Dunlap, Eloise; Sifaneck, Stephen J.

    2008-01-01

    During the 1990s, the New York Police Department (NYPD) instituted a policy of arresting and detaining people for minor offenses that occur in public as part of their quality-of-life (hereafter QOL) policing initiative. The number of NYPD arrests for smoking marijuana in public view (MPV) increased from 3,000 in 1994 to over 50,000 in 2000, and have been about 30,000 in the mid 2000s. Most of these arrestees (84%) have been minority; blacks have been 2.7 more likely and Hispanics 1.8 times more likely to be detained than whites for an MPV arrest. Minorities have been most likely to receive more severe dispositions, even controlling for demographics and prior arrest histories. This paper examines the pros and cons of the current policy; this is compared with possible alternatives including the following: arrest and issue a desk appearance ticket (DAT); issue a non-criminal citation (violation); street warnings; and tolerate public marijuana smoking. The authors recommend that the NYPD change to issuing DATs on a routine basis. Drug policy reformers might wish to further pursue changing statutes regarding smoking marijuana in public view into a violation (noncriminal) or encourage the wider use of street warnings. Any of these policy changes would help reduce the disproportionate burden on minorities associated with the current arrest and detention policy. These policies could help maintain civic norms against smoking marijuana in public. PMID:18726007

  7. The impact of climate change on the BRICS economies: The case of insurance demand.

    NASA Astrophysics Data System (ADS)

    Ranger, N.; Surminski, S.

    2012-04-01

    Session ERE5.1 Climate change impact on economical and industrial activities The impact of climate change on the BRICS economies: The case of insurance demand. Over the past decade, growth in the BRICS (Brazil, Russia, India, China and South Africa) economies has been a key driver of global economic growth. Current forecasts suggest that these markets will continue to be areas of significant growth for a large number of industries. We consider how climate change may influence these trends in the period to 2030, a time horizon that is long in terms of strategic planning in industry, but relatively short for climate change analysis, where the impacts are predicted to be most significant beyond around 2050. Based on current evidence, we expect climate change to affect the BRICS economies in four main ways: 1. The impact of physical climatic changes on the productivity of climate-sensitive economic activity, the local environment, human health and wellbeing, and damages from extreme weather. 2. Changing patterns of investment in climate risk management and adaptation 3. Changing patterns of investments in areas affected by greenhouse gas (GHG) mitigation policy, 4. The impacts of the above globally, including on international trade, growth, investment, policy, migration and commodity prices, and their impacts on the BRICS. We review the evidence on the impacts of climate change in the BRICS and then apply this to one particular industry sector: non-life insurance. We propose five potential pathways through which climate change could influence insurance demand: economic growth; willingness to pay for insurance; public policy and regulation; the insurability of natural catastrophe risks; and new opportunities associated with adaptation and greenhouse gas mitigation. We conclude that, with the exception of public policy and regulation, the influence of climate change on insurance demand to 2030 is likely to be small when compared with the expected growth due to rising incomes. The scale of the impacts and their direction depend to some extent on (re)insurer responses to the challenges of climate change. We outline five actions that could pave the way for future opportunities in the industry. Authors of the paper: Ranger, Nicola (Centre for Climate Change Economics and Policy/ Grantham Research Institute, London School of Economics, London, UK) and Surminski, Swenja (Centre for Climate Change Economics and Policy/ Grantham Research Institute, London School of Economics, London, UK)

  8. Implementing Health and Safety Policy Changes at the High School Level From a Leadership Perspective.

    PubMed

    Pagnotta, Kelly D; Mazerolle, Stephanie M; Pitney, William A; Burton, Laura J; Casa, Douglas J

    2016-04-01

    Although consensus statements and recommendations from professional organizations aim to reduce the incidence of injury or sudden death in sport, nothing is mandated at the high school level. This allows states the freedom to create and implement individual policies. An example of a recommended policy is heat acclimatization. Despite its efficacy in reducing sudden death related to heat stroke, very few states follow the recommended guidelines. To retroactively examine why and how 3 states were able to facilitate the successful creation and adoption of heat-acclimatization guidelines. Qualitative study. High school athletic associations in Arkansas, Georgia, and New Jersey. Eight men and 3 women (n = 11; 6 athletic trainers; 2 members of high school athletic associations; 2 parents; 1 physician) participated. Participant recruitment ceased when data saturation was reached. All phone interviews were digitally recorded and transcribed verbatim. A grounded-theory approach guided analysis and multiple analysts and peer review were used to establish credibility. Each state had a different catalyst to change (student-athlete death, empirical data, proactivity). Recommendations from national governing bodies guided the policy creation. Once the decision to implement change was made, the states displayed 2 similarities: shared leadership and open communication between medical professionals and members of the high school athletic association helped overcome barriers. The initiating factor that spurred the change varied, yet shared leadership and communication fundamentally allowed for successful adoption of the policy. Our participants were influenced by the recommendations from national governing bodies, which align with the institutional change theory. As more states begin to examine and improve their health and safety policies, this information could serve as a valuable resource for athletic trainers in other states and for future health and safety initiatives.

  9. Nepali Private Schools and Tolerated Illegality: A Foucauldian Analysis of Privatisation of Education in Nepal

    ERIC Educational Resources Information Center

    Sharma Poudyal, Chandra

    2017-01-01

    The Education Act 1971 is the main policy document under which schools in Nepal are operated. With the change in political regime, this policy has been amended as per the ideology of the incoming regime. Although private schools started to show their influence in Nepal in the late 1980s, excessive growth of private schools began with the…

  10. Effects of prescription adaptation by pharmacists

    PubMed Central

    2010-01-01

    Background Granting dispensing pharmacists the authority to prescribe has significant implications for pharmaceutical and health human resources policy, and quality of care. Despite the growing number of jurisdictions that have given pharmacists such privileges, there are few rigorous evaluations of these policy changes. This study will examine a January 2009 policy change in British Columbia (BC), Canada that allowed pharmacists to independently adapt and renew prescriptions. We hypothesize this policy increased drug utilization and drug costs, increased patient adherence to medication, and reduced total healthcare resource use. Methods/Design We will study a population-based cohort of approximately 4 million BC residents from 2004 through 2010. We will use data from BC PharmaNet on all of the prescriptions obtained by this cohort during the study period, and link it to administrative billings from physicians and hospital discharges. Using interrupted time series analysis, we will study longitudinal changes in drug utilization and costs, medication adherence, and short-term health care use. Further, using hierarchical modelling, we will examine the factors at the regional, pharmacy, patient, and prescription levels that are associated with prescription adaptations and renewals. Discussion In a recent survey of Canadian policymakers, many respondents ranked the issue of prescribing privileges as one of their most pressing policy questions. No matter the results of our study, they will be important for policymakers, as our data will make policy decisions surrounding pharmacist prescribing more evidence-based. PMID:21083922

  11. Conflict and compromise in public health policy: analysis of changes made to five competitive food legislative proposals prior to adoption.

    PubMed

    Dinour, Lauren M

    2015-04-01

    Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an important strategy for reducing childhood obesity. Yet little is known about the decision-making processes by which such legislation is formed and adopted. Using a comparative case study design, this study describes and analyzes the policy formation processes surrounding five state-level competitive food bills introduced in 2009-2010. Data for each case were drawn from multiple key informant interviews and document reviews. Case studies were conducted, analyzed, and written independently using a standard protocol and were subsequently compared for recurring and unique themes. Abbreviated case studies and summary tables are provided. Results indicate that bill cost is a major barrier to achieving strong, health-promoting policy change. Additionally, findings reveal that supporters of stronger competitive food policies often concede to changes that weaken a bill in order to neutralize opposition and achieve stakeholder buy-in. These challenges suggest that continued research on the development, implementation, and evaluation of public health policies can contribute to the advancement of new strategies for effective health promotion. © 2015 Society for Public Health Education.

  12. The "common sense" of the nonprofit hospital tax exemption: a policy analysis.

    PubMed

    Sanders, S M

    1995-01-01

    Although rarely discussed prior to the 1985 Utah Supreme Court ruling against Intermountain Health Care Inc., the question of whether to grant tax exemptions to nonprofit hospitals is currently being debated by federal, state, and local legislators, and by the courts. Changes to current policy seem likely. This policy analysis: (1) presents the historical and legal background; (2) examines the economic, political, and organizational implications of current tax-exemption policy; and (3) offers three alternatives to this current policy. The analysis indicates that the current policy provides little incentive for nonprofit hospitals to make contributions of charity care. Of the alternatives, eliminating the exemption is not politically feasible at this time; regulating hospital operations and outputs portends an implementation nightmare; and tying tax subsidy levels to output levels of charity care--perhaps the strongest and most efficient incentive--would require an unlikely political consensus on what constitute valid and reliable measures of charity care. If there is a movement toward subsidies, then linking subsidy amounts to levels of charity care will depend on whether policy analysts can design satisfactory empirical measures. With the advent of universal health coverage, the demand for charity care will decrease. The problem for tax-exempt hospitals will then become justifying the exemption by demonstrating the extent to which they generate community benefits at no or reduced cost to society.

  13. Does multi-functionality affect technical efficiency? A non-parametric analysis of the Scottish dairy industry.

    PubMed

    Barnes, A P

    2006-09-01

    Recent policy changes within the Common Agricultural Policy have led to a shift from a solely production-led agriculture towards the promotion of multi-functionality. Conversely, the removal of production-led supports would indicate that an increased concentration on production efficiencies would seem a critical strategy for a country's future competitiveness. This paper explores the relationship between the 'multi-functional' farming attitude desired by policy makers and its effect on technical efficiency within Scottish dairy farming. Technical efficiency scores are calculated by applying the non-parametric data envelopment analysis technique and then measured against causes of inefficiency. Amongst these explanatory factors is a constructed score of multi-functionality. This research finds that, amongst other factors, a multi-functional attitude has a significant positive effect on technical efficiency. Consequently, this seems to validate the promotion of a multi-functional approach to farming currently being championed by policy-makers.

  14. Potential External (non-DOE) Constraints on U.S. Fuel Cycle Options

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Steven J. Piet

    2012-07-01

    The DOE Fuel Cycle Technologies (FCT) Program will be conducting a screening of fuel cycle options in FY2013 to help focus fuel cycle R&D activities. As part of this screening, performance criteria and go/no-go criteria are being identified. To help ensure that these criteria are consistent with current policy, an effort was initiated to identify the status and basis of potentially relevant regulations, laws, and policies that have been established external to DOE. As such regulations, laws, and policies may be beyond DOE’s control to change, they may constrain the screening criteria and internally-developed policy. This report contains a historicalmore » survey and analysis of publically available domestic documents that could pertain to external constraints on advanced nuclear fuel cycles. “External” is defined as public documents outside DOE. This effort did not include survey and analysis of constraints established internal to DOE.« less

  15. Public Debates Shaping Forestry's Future: An Analysis.

    Treesearch

    David Fan; David Bengston

    1997-01-01

    The job of forest managers and policy makers is growing increasingly complex because of rapid change in the social, political, economic, and scientific environments in which forest management is carried out. Managing public lands in ways that are responsive to changing social conditions requires continuous monitoring and assessment. But traditional methods for...

  16. Changing Times in Adult Literacy Provision: Competition or Not?

    ERIC Educational Resources Information Center

    Bhela, Baljit

    2002-01-01

    Analysis of Australian national and state policies and reports on adult literacy identified themes and issues: (1) movement from volunteerism to marketization to globalization; (2) fluctuations and reductions in funding; (3) changes in the role of professional associations due to political and educational agendas; and (4) increased ties to…

  17. Second Thoughts on Work.

    ERIC Educational Resources Information Center

    Levitan, Sar A.; Johnson, Clifford M.

    This book examines the forces which are changing work in the 1980s and offers a concise analysis of the challenges for social policy which lie ahead. The first of nine chapters looks at changes affecting Americans' concept of work, including expectations, commitment to work, satisfaction, and work reform. Discussion in chapter 2 focuses on…

  18. Talking about the institutional complexity of the integrated rehabilitation system-the importance of coordination.

    PubMed

    Miettinen, Sari; Ashorn, Ulla; Lehto, Juhani

    2013-01-01

    Rehabilitation in Finland is a good example of functions divided among several welfare sectors, such as health services and social services. The rehabilitation system in Finland is a complex one and there have been many efforts to create a coordinated entity. The purpose of this study is to open up a complex welfare system at the upper policy level and to understand the meaning of coordination at the level of service delivery. We shed light in particular on the national rehabilitation policy in Finland and how the policy has tried to overcome the negative effects of institutional complexity. In this study we used qualitative content analysis and frame analysis. As a result we identified four different welfare state frames with distinct features of policy problems, policy alternatives and institutional failure. The rehabilitation policy in Finland seems to be divided into different components which may cause problems at the level of service delivery and thus in the integration of services. Bringing these components together could at policy level enable a shared view of the rights of different population groups, effective management of integration at the level of service delivery and also an opportunity for change throughout the rehabilitation system.

  19. Banning shisha smoking in public places in Iran: an advocacy coalition framework perspective on policy process and change.

    PubMed

    Khayatzadeh-Mahani, Akram; Breton, Eric; Ruckert, Arne; Labonté, Ronald

    2017-07-01

    Shisha smoking is a widespread custom in Iran with a rapidly growing prevalence especially among the youth. In this article, we analyze the policy process of enforcing a federal/state ban on shisha smoking in all public places in Kerman Province, Iran. Guided by the Advocacy Coalition Framework (ACF), we investigate how a shisha smoking ban reached the political agenda in 2011, how it was framed by different policy actors, and why no significant breakthrough took place despite its inclusion on the agenda. We conducted a qualitative study using a case study approach. Two main sources of data were employed: face-to-face in-depth interviews and document analysis of key policy texts. We interviewed 24 policy actors from diverse sectors. A qualitative thematic framework, incorporating both inductive and deductive analyses, was employed to analyze our data. We found that the health sector was the main actor pushing the issue of shisha smoking onto the political agenda by framing it as a public health risk. The health sector and its allies advocated enforcement of a federal law to ban shisha smoking in all public places including teahouses and traditional restaurants whereas another group of actors opposed the ban. The pro-ban group was unable to neutralize the strategies of the anti-ban group and to steer the debate towards the health harms of shisha smoking. Our analysis uncovers three main reasons behind the policy stasis: lack of policy learning due to lack of agreement over evidence and related analytical conflicts between the two groups linked to differences in core and policy beliefs; the inability of the pro-ban group to exploit opportunities in the external policy subsystem through generating stronger public support for enforcement of the shisha smoking ban; and the nature of the institutional setting, in particular the autocratic governance of CHFS which contributed to a lack of policy learning within the policy subsystem. Our research demonstrated the utility of ACF as a theoretical framework for analyzing the policy process and policy change to promote tobacco control. It shows the importance of accounting for policy actors' belief systems and issue-framing in understanding how some issues get more prominence in the policy-making process than others. Our findings further indicate a need for significant resources employed by the state through public awareness campaigns to change public perceptions of shisha smoking in Iran which is a deeply anchored cultural practice. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2017; all rights reserved.

  20. Nurses' policy influence: A concept analysis.

    PubMed

    Arabi, Akram; Rafii, Forough; Cheraghi, Mohammad Ali; Ghiyasvandian, Shahrzad

    2014-05-01

    Nurses' influence on health policy protects the quality of care by access to required recourses and opportunities. This is a new and important concept for nursing; however, research studies on policy influence of nurses in health care sector are lacking a basic conceptual understanding of what this concept represents. The aim of this paper is to clarify the concept of nurses' policy influence and to propose the definition of this concept, considering the context of Iran. The eight stages of Walker and Avant approach was used to guide this concept analysis. Various databases and internet engines were searched to find all related information about the concept. Textbooks were also searched manually. English language literature reports published between 1990 and 2012 were reviewed. Based on the analysis undertaken, nurses' policy influence is nurses' ability in influencing decisions and affairs related to health through political knowledge, effective communication, and collaboration with other members of the health team, which results in the improvement of nurses' job environment and increases patient outcomes. This is a dynamic process situated on a spectrum and is accompanied with nurses' knowledge, competency, power, and advocacy, and also their ability to change. Nurses have individual views on health care issues and influence health care policies in different ways. With a common understanding of nurses' policy influence as a concept, nurses will recognize the importance of policy making in the health sector and their influence on this process and also on patients' outcomes.

  1. Yinong Sun | NREL

    Science.gov Websites

    integration Impacts of climate change on energy system evolution Energy policy analysis Education M.E.M. in . Electric Sector Climate Impacts. International Energy Workshop, Maryland. View all NREL publications for

  2. Identifying Innovative Interventions to Promote Healthy Eating Using Consumption-Oriented Food Supply Chain Analysis.

    PubMed

    Hawkes, Corinna

    2009-07-01

    The mapping and analysis of supply chains is a technique increasingly used to address problems in the food system. Yet such supply chain management has not yet been applied as a means of encouraging healthier diets. Moreover, most policies recommended to promote healthy eating focus on the consumer end of the chain. This article proposes a consumption-oriented food supply chain analysis to identify the changes needed in the food supply chain to create a healthier food environment, measured in terms of food availability, prices, and marketing. Along with established forms of supply chain analysis, the method is informed by a historical overview of how food supply chains have changed over time. The method posits that the actors and actions in the chain are affected by organizational, financial, technological, and policy incentives and disincentives, which can in turn be levered for change. It presents a preliminary example of the supply of Coca-Cola beverages into school vending machines and identifies further potential applications. These include fruit and vegetable supply chains, local food chains, supply chains for health-promoting versions of food products, and identifying financial incentives in supply chains for healthier eating.

  3. Identifying Innovative Interventions to Promote Healthy Eating Using Consumption-Oriented Food Supply Chain Analysis

    PubMed Central

    Hawkes, Corinna

    2009-01-01

    The mapping and analysis of supply chains is a technique increasingly used to address problems in the food system. Yet such supply chain management has not yet been applied as a means of encouraging healthier diets. Moreover, most policies recommended to promote healthy eating focus on the consumer end of the chain. This article proposes a consumption-oriented food supply chain analysis to identify the changes needed in the food supply chain to create a healthier food environment, measured in terms of food availability, prices, and marketing. Along with established forms of supply chain analysis, the method is informed by a historical overview of how food supply chains have changed over time. The method posits that the actors and actions in the chain are affected by organizational, financial, technological, and policy incentives and disincentives, which can in turn be levered for change. It presents a preliminary example of the supply of Coca-Cola beverages into school vending machines and identifies further potential applications. These include fruit and vegetable supply chains, local food chains, supply chains for health-promoting versions of food products, and identifying financial incentives in supply chains for healthier eating. PMID:23144674

  4. Overview of the Special Issue: A Multi-Model Framework to Achieve Consistent Evaluation of Climate Change Impacts in the United States

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Waldhoff, Stephanie T.; Martinich, Jeremy; Sarofim, Marcus

    2015-07-01

    The Climate Change Impacts and Risk Analysis (CIRA) modeling exercise is a unique contribution to the scientific literature on climate change impacts, economic damages, and risk analysis that brings together multiple, national-scale models of impacts and damages in an integrated and consistent fashion to estimate climate change impacts, damages, and the benefits of greenhouse gas (GHG) mitigation actions in the United States. The CIRA project uses three consistent socioeconomic, emissions, and climate scenarios across all models to estimate the benefits of GHG mitigation policies: a Business As Usual (BAU) and two policy scenarios with radiative forcing (RF) stabilization targets ofmore » 4.5 W/m2 and 3.7 W/m2 in 2100. CIRA was also designed to specifically examine the sensitivity of results to uncertainties around climate sensitivity and differences in model structure. The goals of CIRA project are to 1) build a multi-model framework to produce estimates of multiple risks and impacts in the U.S., 2) determine to what degree risks and damages across sectors may be lowered from a BAU to policy scenarios, 3) evaluate key sources of uncertainty along the causal chain, and 4) provide information for multiple audiences and clearly communicate the risks and damages of climate change and the potential benefits of mitigation. This paper describes the motivations, goals, and design of the CIRA modeling exercise and introduces the subsequent papers in this special issue.« less

  5. Macroeconomics after Two Decades of Rational Expectations.

    ERIC Educational Resources Information Center

    McCallum, Bennett T.

    1994-01-01

    Discusses real business cycle analysis, growth theory, and other economic concepts in the context of the rational expectations revolution in macroeconomics. Focuses on post-1982 research. Concludes that the rejuvenation of growth analysis is an encouraging development because it could lead to changes in welfare policy. (CFR)

  6. On the Changing Relationships Between the Educational and Occupational Systems: Conceptions and Recent Trends.

    ERIC Educational Resources Information Center

    Teichler, Ulrich; And Others

    An explanation of the change that has taken place in the aims and purposes of educational policy of industralized societies as the relationship between the education and the occupation systems has changed over the course of the transformation of elite education into a mass phenomenon is the objective of this paper. Analysis and discussion is based…

  7. Towards a National Gang Strategy: A Meta-Policy Analysis of Leadership, Learning, and Organizational Change within the Law Enforcement Context

    ERIC Educational Resources Information Center

    Richards, Maurice V.

    2010-01-01

    This study examines the process of change within law enforcement, focusing on the leadership, learning, and organizational change required to reduce crime, violence, and social disruption caused by criminal street gangs. The study tests the viability, results, and implications of a new policing model, the trans-jurisdictional task force, through…

  8. Determinants of Urban Expansion and Agricultural Land Conversion in 25 EU Countries.

    PubMed

    Ustaoglu, Eda; Williams, Brendan

    2017-10-01

    Agricultural land conversion is resulting from ongoing complex interaction between the physical environment, policy settings and socio-economic factors. Case studies of the determinants of agricultural land conversion potentially contribute to the analysis of the main causes of land-use change. This can assist authorities and policy makers in understanding the relative importance of a wide range of factors on urban expansion and associated agricultural land-use change. This paper explores the determinants of agricultural land conversion to urban uses in the studied 25 European Union countries between 2000 and 2006. European-level as well as region-specific land-use changes are studied. The research is using the spatial data adapted from European Corine Land Cover maps of 2000 and 2006 and utilised other European sources regarding socio-economic, natural, geological, climate, and policy-related data. The differences in urbanisation processes observed in different regions in Europe emphasise the regional variations of urban conversion process of agricultural land use. This study identifies a combination of socio-economic drivers, policy-related factors, nature and location-based factors as key influences on agricultural land conversion processes in Europe. Specifically we found that the Common Agricultural Policy (CAP) subsidies were influential in curbing urbanisation and reducing agricultural land consumption.

  9. Determinants of Urban Expansion and Agricultural Land Conversion in 25 EU Countries

    NASA Astrophysics Data System (ADS)

    Ustaoglu, Eda; Williams, Brendan

    2017-10-01

    Agricultural land conversion is resulting from ongoing complex interaction between the physical environment, policy settings and socio-economic factors. Case studies of the determinants of agricultural land conversion potentially contribute to the analysis of the main causes of land-use change. This can assist authorities and policy makers in understanding the relative importance of a wide range of factors on urban expansion and associated agricultural land-use change. This paper explores the determinants of agricultural land conversion to urban uses in the studied 25 European Union countries between 2000 and 2006. European-level as well as region-specific land-use changes are studied. The research is using the spatial data adapted from European Corine Land Cover maps of 2000 and 2006 and utilised other European sources regarding socio-economic, natural, geological, climate, and policy-related data. The differences in urbanisation processes observed in different regions in Europe emphasise the regional variations of urban conversion process of agricultural land use. This study identifies a combination of socio-economic drivers, policy-related factors, nature and location-based factors as key influences on agricultural land conversion processes in Europe. Specifically we found that the Common Agricultural Policy (CAP) subsidies were influential in curbing urbanisation and reducing agricultural land consumption.

  10. Using a social justice and health framework to assess European climate change adaptation strategies.

    PubMed

    Boeckmann, Melanie; Zeeb, Hajo

    2014-11-28

    Climate change puts pressure on existing health vulnerabilities through higher frequency of extreme weather events, changes in disease vector distribution or exacerbated air pollution. Climate change adaptation policies may hold potential to reduce societal inequities. We assessed the role of public health and social justice in European climate change adaptation using a three-fold approach: a document analysis, a critical discourse analysis of a subgroup of strategies, and a ranking of strategies against our social justice framework. The ranking approach favored planning that includes various adaptation types, social issues and infrastructure changes. Themes on values identified in the five subgroup documents showed that risks are perceived as contradictory, technology is viewed as savior, responsibilities need to be negotiated, and social justice is advocated by only a few countries. Of 21 strategy documents assessed overall, those from Austria, England and Sweden received the highest scores in the ranking. Our qualitative assessment showed that in European adaptation planning, progress could still be made through community involvement into adaptation decisions, consistent consideration of social and demographic determinants, and a stronger link between infrastructural adaptation and the health sector. Overall, a social justice framework can serve as an evaluation guideline for adaptation policy documents.

  11. Which environmental problems get policy attention? Examining energy and agricultural sector policies in Sweden

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Engstroem, Rebecka; Nilsson, Mans; Finnveden, Goeran

    2008-05-15

    Not all environmental problems get the same level of policy attention. An interesting question is thus why certain aspects receive attention and others do not. This paper studies the level of policy attention given to different environmental aspects in agriculture and energy policy in Sweden and explores empirically some factors that can explain the level of attention. The first step was to explore the link between environmental issue characteristics and the level of policy attention. The level of policy attention was measured through a content analysis of Swedish government bills. The results from the content analysis are clear and stablemore » over the studied time period. In the agriculture sector biodiversity and toxicity are in focus whereas in the energy sector climate change and resources are given the attention. Besides these aspects, the attention is limited. These results were compared with the results from sector-wide environmental assessments of the same sectors. These assessments were based on hybrid input-output analysis and life cycle assessment methodologies. A main finding from the study is that issue importance is a necessary but not a sufficient condition for policy attention. Other explanations are needed to understand which environmental issues get attention in sectoral policy. Our assessment showed that while the level of knowledge does not provide an explanation, the presence of strong and well-organised stakeholders within the sector, with an interest in having a certain issue on the agenda, might be decisive for issue attention. Path dependency and limited attention capacity are other important factors.« less

  12. Impact of restricting diagnostic imaging reimbursement for uncomplicated low back pain in Ontario: a population-based interrupted time series analysis

    PubMed Central

    Fine, Benjamin; Schultz, Susan E.; White, Lawrence; Henry, David

    2017-01-01

    Background: In 2012, the Ontario government withdrew public insurance coverage of imaging tests for uncomplicated low back pain. We studied the impact of this restriction on test ordering by physicians. Methods: We compared the numbers of lumbar spine radiography, computed tomography (CT) and single-segment magnetic resonance imaging (MRI) studies ordered by physicians in the 3 years before and after the policy change. We linked claims data from the Ontario Health Insurance Program with physician details to calculate rates per test-ordering physician. We compared changes in rates of monthly test ordering by family physicians and specialists before and after the policy change using segmented regression analysis of interrupted time series data. Results: The number of lumbar spine radiography and spine CT studies ordered by family physicians decreased by 98 597 (28.7%) and 17 499 (28.7%), respectively, in the year after the policy change; there was little change in ordering by specialists. The number of lumbar spine radiography studies ordered per family physician by month decreased by 0.81 tests (p < 0.001) after the intervention, followed by a smaller rebound increase that remained below baseline. Monthly ordering of spine CT per family physician declined by 0.1 tests (p < 0.001), and that of limited spine MRI rose before the intervention, decreased by 0.18 tests (p < 0.001) after the intervention, then started to rise again. Monthly ordering of limited spine MRI by specialists, which had been stable before the policy change, decreased by 0.1 tests per specialist (p < 0.001) afterward, then rose to preintervention levels. Interpretation: The restriction in coverage of imaging tests caused a larger decrease in test ordering by family physicians than by specialists and a larger, more sustained reduction in the use of lumbar spine radiography and spine CT than of spine MRI. PMID:29042408

  13. Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care (CLAHRC) programme nationally and in North West London.

    PubMed

    Caldwell, Sarah E M; Mays, Nicholas

    2012-10-15

    The publication of Best research for best health in 2006 and the "ring-fencing" of health research funding in England marked the start of a period of change for health research governance and the structure of research funding in England. One response to bridging the 'second translational gap' between research knowledge and clinical practice was the establishment of nine Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The goal of this paper is to assess how national-level understanding of the aims and objectives of the CLAHRCs translated into local implementation and practice in North West London. This study uses a variation of Goffman's frame analysis to trace the development of the initial national CLAHRC policy to its implementation at three levels. Data collection and analysis were qualitative through interviews, document analysis and embedded research. Analysis at the macro (national policy), meso (national programme) and micro (North West London) levels shows a significant common understanding of the aims and objectives of the policy and programme. Local level implementation in North West London was also consistent with these. The macro-meso-micro frame analysis is a useful way of studying the transition of a policy from high-level idea to programme in action. It could be used to identify differences at a local (micro) level in the implementation of multi-site programmes that would help understand differences in programme effectiveness.

  14. Difference-in-Differences Analysis of the Association Between State Same-Sex Marriage Policies and Adolescent Suicide Attempts

    PubMed Central

    Raifman, Julia; Moscoe, Ellen; Austin, S. Bryn; McConnell, Margaret

    2018-01-01

    IMPORTANCE Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years. Adolescents who are sexual minorities experience elevated rates of suicide attempts. OBJECTIVE To evaluate the association between state same-sex marriage policies and adolescent suicide attempts. DESIGN, SETTING, AND PARTICIPANTS This study used state-level Youth Risk Behavior Surveillance System (YRBSS) data from January 1, 1999, to December 31, 2015, which are weighted to be representative of each state that has participation in the survey greater than 60%. A difference-in-differences analysis compared changes in suicide attempts among all public high school students before and after implementation of state policies in 32 states permitting same-sex marriage with year-to-year changes in suicide attempts among high school students in 15 states without policies permitting same-sex marriage. Linear regression was used to control for state, age, sex, race/ethnicity, and year, with Taylor series linearized standard errors clustered by state and classroom. In a secondary analysis among students who are sexual minorities, we included an interaction between sexual minority identity and living in a state that had implemented same-sex marriage policies. INTERVENTIONS Implementation of state policies permitting same-sex marriage during the full period of YRBSS data collection. MAIN OUTCOMES AND MEASURES Self-report of 1 or more suicide attempts within the past 12 months. RESULTS Among the 762 678 students (mean [SD] age, 16.0 [1.2] years; 366 063 males and 396 615 females) who participated in the YRBSS between 1999 and 2015, a weighted 8.6% of all high school students and 28.5% of students who identified as sexual minorities reported suicide attempts before implementation of same-sex marriage policies. Same-sex marriage policies were associated with a 0.6–percentage point (95% CI, −1.2 to −0.01 percentage points) reduction in suicide attempts, representing a 7% relative reduction in the proportion of high school students attempting suicide owing to same-sex marriage implementation. The association was concentrated among students who were sexual minorities. CONCLUSIONS AND RELEVANCE State same-sex marriage policies were associated with a reduction in the proportion of high school students reporting suicide attempts, providing empirical evidence for an association between same-sex marriage policies and mental health outcomes. PMID:28241285

  15. Difference-in-Differences Analysis of the Association Between State Same-Sex Marriage Policies and Adolescent Suicide Attempts.

    PubMed

    Raifman, Julia; Moscoe, Ellen; Austin, S Bryn; McConnell, Margaret

    2017-04-01

    Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years. Adolescents who are sexual minorities experience elevated rates of suicide attempts. To evaluate the association between state same-sex marriage policies and adolescent suicide attempts. This study used state-level Youth Risk Behavior Surveillance System (YRBSS) data from January 1, 1999, to December 31, 2015, which are weighted to be representative of each state that has participation in the survey greater than 60%. A difference-in-differences analysis compared changes in suicide attempts among all public high school students before and after implementation of state policies in 32 states permitting same-sex marriage with year-to-year changes in suicide attempts among high school students in 15 states without policies permitting same-sex marriage. Linear regression was used to control for state, age, sex, race/ethnicity, and year, with Taylor series linearized standard errors clustered by state and classroom. In a secondary analysis among students who are sexual minorities, we included an interaction between sexual minority identity and living in a state that had implemented same-sex marriage policies. Implementation of state policies permitting same-sex marriage during the full period of YRBSS data collection. Self-report of 1 or more suicide attempts within the past 12 months. Among the 762 678 students (mean [SD] age, 16.0 [1.2] years; 366 063 males and 396 615 females) who participated in the YRBSS between 1999 and 2015, a weighted 8.6% of all high school students and 28.5% of students who identified as sexual minorities reported suicide attempts before implementation of same-sex marriage policies. Same-sex marriage policies were associated with a 0.6-percentage point (95% CI, -1.2 to -0.01 percentage points) reduction in suicide attempts, representing a 7% relative reduction in the proportion of high school students attempting suicide owing to same-sex marriage implementation. The association was concentrated among students who were sexual minorities. State same-sex marriage policies were associated with a reduction in the proportion of high school students reporting suicide attempts, providing empirical evidence for an association between same-sex marriage policies and mental health outcomes.

  16. 2H and 18O Freshwater Isoscapes of Scotland

    NASA Astrophysics Data System (ADS)

    Meier-Augenstein, Wolfram; Hoogewerff, Jurian; Kemp, Helen; Frew, Danny

    2013-04-01

    Scotland's freshwater lochs and reservoirs provide a vital resource for sustaining biodiversity, agriculture, food production as well as for human consumption. Regular monitoring of freshwaters by the Scottish Environment Protection Agency (SEPA) fulfils legislative requirements with regards to water quality but new scientific methods involving stable isotope analysis present an opportunity combining these mandatory monitoring schemes with fundamental research to inform and deliver on current and nascent government policies [1] through gaining a greater understanding of Scottish waters and their importance in the context of climate change, environmental sustainability and food security. For example, 2H and 18O isoscapes of Scottish freshwater could be used to underpin research and its applications in: • Climate change - Using longitudinal changes in the characteristic isotope composition of freshwater lochs and reservoirs as proxy, isoscapes will provide a means to assess if and how changes in temperature and weather patterns might impact on precipitation patterns and amount. • Scottish branding - Location specific stable isotope signatures of Scottish freshwater have the potential to be used as a tool for provenancing and thus protecting premium Scottish produce such as Scottish beef, Scottish soft fruit and Scottish Whisky. During 2011 and 2012, with the support of SEPA more than 110 samples from freshwater lochs and reservoirs were collected from 127 different locations across Scotland including the Highlands and Islands. Here we present the results of this sampling and analysis exercise isotope analyses in form of 2H and 18O isoscapes with an unprecedented grid resolution of 26.5 × 26.5 km (or 16.4 × 16.4 miles). [1] Adaptation Framework - Adapting Our Ways: Managing Scotland's Climate Risk (2009): Scotland's Biodiversity: It's in Your Hands - A strategy for the conservation and enhancement of biodiversity in Scotland (2005); Recipe For Success - Scotland's National Food and Drink Policy (2009); Scottish Planning Policy Environmental Report (2009); Scottish Planning Policy (SPP) 15 Planning for Rural Development (2005); National Planning Policy Guideline (NPPG) 14: Natural Heritage (1999).

  17. Commentary: the emergence and application of active aging in Europe.

    PubMed

    Walker, Alan

    2009-01-01

    Active aging is established as the leading global policy strategy in response to population aging. In practice, however, the term active aging serves as a convenient shelter for a wide range of policy discourses and initiatives concerning demographic change. The twin purposes of this article are, first, to examine its European origins and how it has been applied in the world's oldest region. This policy analysis illustrates the contrast between the primarily European discourse on active aging, which emphasizes health, participation, and well-being, and the U.S. discourse that prioritizes productivity. The application of active aging in Europe has, nonetheless, been predominantly in the productivist mold. The examination of the emergence of this key policy concept in Europe is contextualized by an outline of the changing politics of aging in this region. The second purpose of the article is to set out a new, comprehensive strategy on active aging that is intended to realize the full potential of the concept. Understanding of the need for this broad vision of active aging is facilitated by the historical policy review.

  18. Factors shaping political priorities for violence against women-mitigation policies in Sri Lanka.

    PubMed

    Colombini, Manuela; Mayhew, Susannah H; Lund, Ragnhild; Singh, Navpreet; Swahnberg, Katarina; Infanti, Jennifer; Schei, Berit; Wijewardene, Kumudu

    2018-05-25

    Although violence against women (VAW) is a global public health issue, its importance as a health issue is often unrecognized in legal and health policy documents. This paper uses Sri Lanka as a case study to explore the factors influencing the national policy response to VAW, particularly by the health sector. A document based health policy analysis was conducted to examine current policy responses to VAW in Sri Lanka using the Shiffman and Smith (2007) policy analysis framework. The findings suggest that the networks and influences of various actors in Sri Lanka, and their ideas used to frame the issue of VAW, have been particularly important in shaping the nature of the policy response to date. The Ministry of Women and Child Affairs led the national response on VAW, but suffered from limited financial and political support. Results also suggest that there was low engagement by the health sector in the initial policy response to VAW in Sri Lanka, which focused primarily on criminal legislation, following global influences. Furthermore, a lack of empirical data on VAW has impeded its promotion as a health policy issue, despite financial support from international organisations enabling an initial health systems response by the Ministry of Health. Until a legal framework was established (2005), the political context provided limited opportunities for VAW to also be construed as a health issue. It was only then that the Ministry of Health got legitimacy to institutionalise VAW services. Nearly a decade later, a change in government has led to a new national plan on VAW, giving a clear role to the health sector in the fight against VAW. High-level political will, criminalisation of violence, coalesced women's groups advocating for legislative change, prevalence data, and financial support from influential institutions are all critical elements helping frame violence as a national public health issue.

  19. Pedestrian paths: why path-dependence theory leaves health policy analysis lost in space.

    PubMed

    Brown, Lawrence D

    2010-08-01

    Path dependence, a model first advanced to explain puzzles in the diffusion of technology, has lately won allegiance among analysts of the politics of public policy, including health care policy. Though the central premise of the model--that past events and decisions shape options for innovation in the present and future--is indisputable (indeed path dependence is, so to speak, too shallow to be false), the approach, at least as applied to health policy, suffers from ambiguities that undercut its claims to illuminate policy projects such as managed care, on which this article focuses. Because path dependence adds little more than marginal value to familiar images of the politics of policy--incrementalism, for one--analysts might do well to put it on the back burner and pursue instead "thick descriptions" that help them to distinguish different degrees of openness to exogenous change among diverse policy arenas.

  20. Analysis of the spatio-temporal and semantic aspects of land-cover/use change dynamics 1991-2001 in Albania at national and district levels.

    PubMed

    Jansen, Louisa J M; Carrai, Giancarlo; Morandini, Luca; Cerutti, Paolo O; Spisni, Andrea

    2006-08-01

    In the turmoil of a rapidly changing economy the Albanian government needs accurate and timely information for management of their natural resources and formulation of land-use policies. The transformation of the forestry sector has required major changes in the legal, regulatory and management framework. The World Bank financed Albanian National Forest Inventory project provides an analysis of spatially explicit land-cover/use change dynamics in the period 1991-2001 using the FAO/UNEP Land Cover Classification System for codification of classes, satellite remote sensing and field survey for data collection and elements of the object-oriented geo-database approach to handle changes as an evolution of land-cover/use objects, i.e. polygons, over time to facilitate change dynamics analysis. Analysis results at national level show the trend of natural resources depletion in the form of modifications and conversions that lead to a gradual shift from land-cover/use types with a tree cover to less dense tree covers or even a complete removal of trees. Policy failure (e.g., corruption, lack of law enforcement) is seen as the underlying cause. Another major trend is urbanisation of areas near large urban centres that change urban-rural linkages. Furthermore, after privatisation agricultural areas increased in the hills where environmental effects may be detrimental, while prime agricultural land in the plains is lost to urbanisation. At district level, the local variability of spatially explicit land-cover/use changes shows different types of natural resources depletion. The distribution of changes indicates a regional prevalence, thus a decentralised approach to the natural resources management could be advocated.

  1. The Effect of Share 35 on Biliary Complications: an Interrupted Time Series Analysis.

    PubMed

    Fleming, J N; Taber, D J; Axelrod, D; Chavin, K D

    2018-05-16

    The purpose of the Share 35 allocation policy was to improve liver transplant waitlist mortality, targeting high MELD waitlisted patients. However, policy changes may also have unintended consequences that must be balanced with the primary desired outcome. We performed an interrupted time series assessing the impact of Share 35 on biliary complications in a select national liver transplant population using the Vizient CDB/RM ™ database. Liver transplants that occurred between October 2012 and September 2015 were included. There was a significant change in the incident-rate of biliary complications between Pre-Share 35 (n=3,018) and Post-Share 35 (n=9,984) cohorts over time (p=0.023, r2=0.44). As a control, a subanalysis was performed throughout the same time period in Region 9 transplant centers, where a broad sharing agreement had previously been implemented. In the subanalysis, there was no change in the incident-rate of biliary complications between the two time periods. Length of stay and mean direct cost demonstrated a change after implementation of Share 35, although they did not meet statistical difference. While the target of improved waitlist mortality is of utmost importance for the equitable allocation of organs, unintended consequences of policy changes should be studied for a full assessment of a policy's impact. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Move it or lose it? The ecological ethics of relocating species under climate change.

    PubMed

    Minteer, Ben A; Collins, James P

    2010-10-01

    Managed relocation (also known as assisted colonization, assisted migration) is one of the more controversial proposals to emerge in the ecological community in recent years. A conservation strategy involving the translocation of species to novel ecosystems in anticipation of range shifts forced by climate change, managed relocation (MR) has divided many ecologists and conservationists, mostly because of concerns about the potential invasion risk of the relocated species in their new environments. While this is indeed an important consideration in any evaluation of MR, moving species across the landscape in response to predicted climate shifts also raises a number of larger and important ethical and policy challenges that need to be addressed. These include evaluating the implications of a more aggressive approach to species conservation, assessing MR as a broader ecological policy and philosophy that departs from longstanding scientific and management goals focused on preserving ecological integrity, and considering MR within a more comprehensive ethical and policy response to climate change. Given the complexity and novelty of many of the issues at stake in the MR debate, a more dynamic and pragmatic approach to ethical analysis and debate is needed to help ecologists, conservationists, and environmental decision makers come to grips with MR and the emerging ethical challenges of ecological policy and management under global environmental change.

  3. Changing Policy Framing as a Deliberate Strategy for Public Health Advocacy: A Qualitative Policy Case Study of Minimum Unit Pricing of Alcohol

    PubMed Central

    Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona

    2014-01-01

    Context Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. Methods We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Findings Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Conclusions Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in other public health areas. PMID:24890247

  4. Changing policy framing as a deliberate strategy for public health advocacy: a qualitative policy case study of minimum unit pricing of alcohol.

    PubMed

    Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona

    2014-06-01

    Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in other public health areas. © 2014 Milbank Memorial Fund.

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

    PubMed

    McNamara, Courtney

    2015-10-12

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

  6. Evidence, Power, and Policy Change in Community-Based Participatory Research

    PubMed Central

    Tsui, Emma

    2014-01-01

    Meaningful improvements in health require modifying the social determinants of health. As policies are often underlying causes of the living conditions that shape health, policy change becomes a health goal. This focus on policy has led to increasing interest in expanding the focus of community-based participatory research (CBPR) to change not only communities but also policies. To best realize this potential, the relationship between evidence and power in policy change must be more fully explored. Effective action to promote policies that improve population health requires a deeper understanding of the roles of scientific evidence and political power in bringing about policy change; the appropriate scales for policy change, from community to global; and the participatory processes that best acknowledge the interplay between power and evidence. PMID:24228677

  7. Barriers to Career Flexibility in Academic Medicine: A Qualitative Analysis of Reasons for the Underutilization of Family-Friendly Policies, and Implications for Institutional Change and Department Chair Leadership.

    PubMed

    Shauman, Kimberlee; Howell, Lydia P; Paterniti, Debora A; Beckett, Laurel A; Villablanca, Amparo C

    2018-02-01

    Academic medical and biomedical professionals need workplace flexibility to manage the demands of work and family roles and meet their commitments to both, but often fail to use the very programs and benefits that provide flexibility. This study investigated the reasons for faculty underutilization of work-life programs. As part of a National Institutes of Health-funded study, in 2010 the authors investigated attitudes of clinical and/or research biomedical faculty at the University of California, Davis, toward work-life policies, and the rationale behind their individual decisions regarding use of flexibility policies. The analysis used verbatim responses from 213 of 472 faculty (448 unstructured comments) to a series of open-ended survey questions. Questions elicited faculty members' self-reports of policy use, attitudes, and evaluations of the policies, and their perceptions of barriers that limited full benefit utilization. Data were coded and analyzed using a grounded theory approach. Faculty described how their utilization of workplace flexibility benefits was inhibited by organizational influences: the absence of reliable information about program eligibility and benefits, workplace norms and cultures that stigmatized program participation, influence of uninformed/unsupportive department heads, and concerns about how participation might burden coworkers, damage collegial relationships, or adversely affect workflow and grant funding. Understanding underuse of work-life programs is essential to maximize employee productivity and satisfaction, minimize turnover, and provide equal opportunities for career advancement to all faculty. The findings are discussed in relation to specific policy recommendations, implications for institutional change, and department chair leadership.

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

    PubMed Central

    Houngbo, P. Th.; Zweekhorst, M.; De Cock Buning, Tj.; Medenou, D.; Bunders, J. F. G.

    2017-01-01

    Good governance (GG) is an important concept that has evolved as a set of normative principles for low- and middle-income countries (LMICs) to strengthen the functional capacity of their public bodies, and as a conditional prerequisite to receive donor funding. Although much is written on good governance, very little is known on how to implement it. This paper documents the process of developing a strategy to implement a GG model for Health Technology Management (HTM) in the public health sector, based on lessons learned from twenty years of experience in policy development and implementation in Benin. The model comprises six phases: (i) preparatory analysis, assessing the effects of previous policies and characterizing the HTM system; (ii) stakeholder identification and problem analysis, making explicit the perceptions of problems by a diverse range of actors, and assessing their ability to solve these problems; (iii) shared analysis and visioning, delineating the root causes of problems and hypothesizing solutions; (iv) development of policy instruments for pilot testing, based on quick-win solutions to understand the system’s responses to change; (v) policy development and validation, translating the consensus solutions identified by stakeholders into a policy; and (vi) policy implementation and evaluation, implementing the policy through a cycle of planning, action, observation and reflection. The policy development process can be characterized as bottom-up, with a central focus on the participation of diverse stakeholders groups. Interactive and analytical tools of action research were used to integrate knowledge amongst actor groups, identify consensus solutions and develop the policy in a way that satisfies criteria of GG. This model could be useful for other LMICs where resources are constrained and the majority of healthcare technologies are imported. PMID:28056098

  9. Gender, intoxication and the developing brain: Problematisations of drinking among young adults in Australian alcohol policy.

    PubMed

    Manton, Elizabeth; Moore, David

    2016-05-01

    In this article, we draw on recent scholarly work in the poststructuralist analysis of policy to consider how policy itself functions as a key site in the constitution of alcohol 'problems', and the political implications of these problematisations. We do this by examining Australian alcohol policy as it relates to young adults (18-24 years old). Our critical analysis focuses on three national alcohol policies (1990, 2001 and 2006) and two Victorian state alcohol policies (2008 and 2013), which together span a 25-year period. We argue that Australian alcohol policies have conspicuously ignored young adult men, despite their ongoing over-representation in the statistical 'evidence base' on alcohol-related harm, while increasingly problematising alcohol consumption amongst other population subgroups. We also identify the development of a new problem representation in Australian alcohol policy, that of 'intoxication' as the leading cause of alcohol-related harm and rising hospital admissions, and argue that changes in the classification and diagnosis of intoxication may have contributed to its prioritisation and problematisation in alcohol policy at the expense of other forms of harm. Finally, we draw attention to how preliminary and inconclusive research on the purported association between binge drinking and brain development in those under 25 years old has been mobilised prematurely to support calls to increase the legal purchasing age from 18 to 21 years. Our critical analysis of the treatment of these three issues - gender, intoxication, and brain development - is intended to highlight the ways in which policy functions as a key site in the constitution of alcohol 'problems'. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. The Politics of Leadership: Superintendents and School Boards in Changing Times. Educational Policy in the 21st Century: Opportunities, Challenges and Solutions

    ERIC Educational Resources Information Center

    Petersen, George J., Ed.; Fusarelli, Lance, Ed.

    2006-01-01

    The primary contribution of this book, is not its advocacy of a specific position but rather, its objective analysis of cogent topics. The content prompts individuals to consider governance in relation to quality education and to ponder alternative policy strategies that have yet to be fully evaluated. As a young doctoral student more than a few…

  11. The Origins of Race-Conscious Affirmative Action in Undergraduate Admissions: A Comparative Analysis of Institutional Change in Higher Education

    ERIC Educational Resources Information Center

    Stulberg, Lisa M.; Chen, Anthony S.

    2014-01-01

    What explains the rise of race-conscious affirmative action policies in undergraduate admissions? The dominant theory posits that adoption of such policies was precipitated by urban and campus unrest in the North during the late 1960s. Based on primary research in a sample of 17 selective schools, we find limited support for the dominant theory.…

  12. Culture Matters in Educational Policy Transfer: The Case of Curricular Reforms in the Two Koreas during the Soviet and US Military Occupation

    ERIC Educational Resources Information Center

    Kim, Sun

    2017-01-01

    This paper investigates the influence of cultural and historical factors on educational policy transfer, drawing on an analysis of the curricular reforms made during the Soviet and US military occupation of the two Koreas. In South Korea, curricular changes were made, such as the introduction of the subject of social studies, in order to teach…

  13. Re-Conceptualizing Teachers' Continuous Professional Development within a New Paradigm of Change in the Indian Context: An Analysis of Literature and Policy Documents

    ERIC Educational Resources Information Center

    Subitha, G. V.

    2018-01-01

    Located within the context of Indian education reforms, this study is a critique of the current model of continuous professional development of teachers. The study, by reviewing national policy documents and research literature, argues that there is a need to re-conceptualize and re-define the current model of professional development of teachers.…

  14. Adjusting Hours to Increase Jobs: An Analysis of the Options. A Special Report of the National Commission for Manpower Policy. Special Report No. 15.

    ERIC Educational Resources Information Center

    Clark, Robert

    This fifteenth special report of the National Commission for Manpower Policy examines the interplay between the forces determining work schedules and the incidence and prevalence of unemployment. In the first chapter the author sets forth the major trends in hours of work and in the changing structure of the labor force that has led increasingly…

  15. The impacts of final demand changes on total output of Indonesian ICT sectors: An analysis using input-output approach

    NASA Astrophysics Data System (ADS)

    Zuhdi, Ubaidillah

    2014-06-01

    The purpose of this study is to analyze the impacts of final demand changes on total output of Indonesian Information and Communication Technology (ICT) sectors. This study employs Input-Output (IO) analysis as a tool of analysis. More specifically, demand-pull IO quantity model is applied in order to achieve the objective. "Whole sector change" and "pure change" conditions are considered in this study. The results of calculation show that, in both conditions, the biggest positive impact to the total output of the sectors is given by the change of households consumption while the change of import has a negative impact. One of the recommendations suggested from this study is to construct import restriction policy for ICT products.

  16. Public health human resources: a comparative analysis of policy documents in two Canadian provinces

    PubMed Central

    2014-01-01

    Background Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. Methods A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Results Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. Conclusion This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing evidence of beginning policy development and implementation. While many similarities exist between the provinces, the context distinctive to each province has influenced and shaped how they have focused their public health human resources policies. PMID:24564931

  17. Public health human resources: a comparative analysis of policy documents in two Canadian provinces.

    PubMed

    Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy

    2014-02-24

    Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing evidence of beginning policy development and implementation. While many similarities exist between the provinces, the context distinctive to each province has influenced and shaped how they have focused their public health human resources policies.

  18. Making Connections: After the Factories Revisited.

    ERIC Educational Resources Information Center

    Rosenfeld, Stuart A.; Bergman, Edward M.

    This analysis of employment patterns in the American South extends a 1985 report, "After the Factories: Changing Employment Patterns in the Rural South," which was based on the years between 1977-1982. The 1985 report included Texas, but this analysis includes only the 12 Southern Growth Policies Board (SGPB) member states. This new…

  19. 76 FR 17160 - Notice of Finding of No Significant Antitrust Changes and Time for Filing Requests for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-28

    ... Time for Filing Requests for Reevaluation. FOR FURTHER INFORMATION CONTACT: Aaron Szabo, Financial Analyst, Financial Analysis and International Projects Branch, Division of Policy and Rulemaking, Office... Analysis and Recommendation In reaching this conclusion, the NRC staff considered the structure of the...

  20. Health Effects of Environmental Exposures, Occupational Hazards and Climate Change in Ethiopia: Synthesis of Situational Analysis, Needs Assessment and the Way Forward.

    PubMed

    Berhane, Kiros; Kumie, Abera; Samet, Jonathan

    2016-01-01

    The burden of diseases caused by environmental and occupational health hazards and the effects of global climate change are of growing concerns in Ethiopia. However, no adequate information seems to be available on the current situation. This means there is a critical gap in research, policy framework and implementation in the country. The purpose of this paper was to synthesize evidence from a systematic situational analysis and needs assessment to help establish a hub for research and training on three major themes and their related policy frameworks: air pollution and health, occupational health and safety and climate change and health. The methods used in this work include a systematic review of secondary data from peer-reviewed literature, thesis reports from academia, government and national statistical reports. Limited primary data based on key informant interviews held with major stakeholders were also used as sources of data. Exposures to high levels of indoor and outdoor air pollutants were found to be major sources of public health challenges. Lack of occupational safety and health due to agricultural activities and exposure to industries was found to be substantial. Worse is the growing fear that climate change will pose increasingly significant multidimensional challenges to the environment and public health. Across all three areas of focus, there was a paucity of information on local scientific evidence. There is also very limited trained skilled manpower and physical infrastructure to monitor the environment and enforce regulatory guidelines. Research, policy frameworks and regulatory mechanisms were among the cross-cutting issues that needed urgent attention. Critical gaps were observed in research and training across the three themes. Also, there is a limitation in implementing the link between policy and related regulations in the environment and health.

  1. Medicare long-term CPAP coverage policy: a cost-utility analysis.

    PubMed

    Billings, Martha E; Kapur, Vishesh K

    2013-10-15

    CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Cost-utility and cost-effectiveness analysis. U.S. Medicare Population. N/A. N/A. We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change.

  2. Value for money of changing healthcare services? Economic evaluation of quality improvement

    PubMed Central

    Severens, J

    2003-01-01

    

 There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369

  3. Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective.

    PubMed

    Nigenda, Gustavo; González-Robledo, Luz María; Juárez-Ramírez, Clara; Adam, Taghreed

    2016-05-13

    In 2003, Mexico's Seguro Popular de Salud (SPS), was launched as an innovative financial mechanism implemented to channel new funds to provide health insurance to 50 million Mexicans and to reduce systemic financial inequities. The objective of this article is to understand the complexity and dynamics that contributed to the adaptation of the policy in the implementation stage, how these changes occurred, and why, from a complex and adaptive systems perspective. A complex adaptive systems (CAS) framework was used to carry out a secondary analysis of data obtained from four SPS's implementation evaluations. We first identified key actors, their roles, incentives and power, and their responses to the policy and guidelines. We then developed a causal loop diagram to disentangle the feedback dynamics associated with the modifications of the policy implementation which we then analyzed using a CAS perspective. Implementation variations were identified in seven core design features during the first 10 years of implementation period, and in each case, the SPS's central coordination introduced modifications in response to the reactions of the different actors. We identified several CAS phenomena associated with these changes including phase transitions, network emergence, resistance to change, history dependence, and feedback loops. Our findings generate valuable lessons to policy implementation processes, especially those involving a monetary component, where the emergence of coping mechanisms and other CAS phenomena inevitably lead to modifications of policies and their interpretation by those who implement them. These include the difficulty of implementing strategies that aim to pool funds through solidarity among beneficiaries where the rich support the poor when there are no incentives for the rich to do so. Also, how resistance to change and history dependence can pose significant challenges to implementing changes, where the local actors use their significant power to oppose or modify these changes.

  4. Engaging with Comparative Risk Appraisals: Public Views on Policy Priorities for Environmental Risk Governance.

    PubMed

    Rocks, Sophie A; Schubert, Iljana; Soane, Emma; Black, Edgar; Muckle, Rachel; Petts, Judith; Prpich, George; Pollard, Simon J

    2017-09-01

    Communicating the rationale for allocating resources to manage policy priorities and their risks is challenging. Here, we demonstrate that environmental risks have diverse attributes and locales in their effects that may drive disproportionate responses among citizens. When 2,065 survey participants deployed summary information and their own understanding to assess 12 policy-level environmental risks singularly, their assessment differed from a prior expert assessment. However, participants provided rankings similar to those of experts when these same 12 risks were considered as a group, allowing comparison between the different risks. Following this, when individuals were shown the prior expert assessment of this portfolio, they expressed a moderate level of confidence with the combined expert analysis. These are important findings for the comprehension of policy risks that may be subject to augmentation by climate change, their representation alongside other threats within national risk assessments, and interpretations of agency for public risk management by citizens and others. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  5. Examination of the relationship between theory-driven policies and allowed lost-time back claims in workers' compensation: a system dynamics model.

    PubMed

    Wong, Jessica J; McGregor, Marion; Mior, Silvano A; Loisel, Patrick

    2014-01-01

    The purpose of this study was to develop a model that evaluates the impact of policy changes on the number of workers' compensation lost-time back claims in Ontario, Canada, over a 30-year timeframe. The model was used to test the hypothesis that a theory- and policy-driven model would be sufficient in reproducing historical claims data in a robust manner and that policy changes would have a major impact on modeled data. The model was developed using system dynamics methods in the Vensim simulation program. The theoretical effects of policies for compensation benefit levels and experience rating fees were modeled. The model was built and validated using historical claims data from 1980 to 2009. Sensitivity analysis was used to evaluate the modeled data at extreme end points of variable input and timeframes. The degree of predictive value of the modeled data was measured by the coefficient of determination, root mean square error, and Theil's inequality coefficients. Correlation between modeled data and actual data was found to be meaningful (R(2) = 0.934), and the modeled data were stable at extreme end points. Among the effects explored, policy changes were found to be relatively minor drivers of back claims data, accounting for a 13% improvement in error. Simulation results suggested that unemployment, number of no-lost-time claims, number of injuries per worker, and recovery rate from back injuries outside of claims management to be sensitive drivers of back claims data. A robust systems-based model was developed and tested for use in future policy research in Ontario's workers' compensation. The study findings suggest that certain areas within and outside the workers' compensation system need to be considered when evaluating and changing policies around back claims. © 2014. Published by National University of Health Sciences All rights reserved.

  6. Financial incentives and use of Cesarean delivery: Taiwan birth data 2003 to 2007.

    PubMed

    Hong, Yi-Chen; Linn, George Chinhung

    2012-01-01

    The Cesarean section (CS) rate in Taiwan has exceeded 30% since 2000. To lower the CS rate, the Bureau of National Health Insurance in Taiwan raised the payment for vaginal delivery (VD) in May 2005, and also increased the insured's copayment for elective CS in May 2006. This study clarifies the influences of these financial incentives, and explores whether the 2 policies lowered the CS rate. The materials used are birth cases obtained from a systematic sampling of the original inpatient claim data in the National Health Insurance research database between 2003 and 2007. The empirical analysis of this study groups the birth data into 4 types: VD, unplanned CS, planned CS, and elective CS. The 4 delivery types represent the dependent variable. A multinomial logistic regression model was adopted as the empirical method. The policy changes, hospital attributes, and insured status were considered independent variables. Results indicate that the supply-side policy change in May 2005 reduced the number of CS cases. However, the policy effect was not very significant, and the CS rate decreased mainly because of planned CS cases. The demand-side policy change in May 2006 did not lower the rate of elective CS. The results imply that the financial incentives were not the main consideration for both the demand and supply sides. To encourage more VDs and lower the CS rate, the authorities could consider mechanisms other than adjusting the payment or changing the copayment.

  7. Unconventional politics of unconventional gas: Environmental reframing and policy change

    NASA Astrophysics Data System (ADS)

    Kear, Andrew Robert

    The present Rocky Mountain West natural gas boom, enabled by historic pro-resource-development political, institutional, economic, and cultural structures, is a politically contested battle over values. Volatile political action, unconventional coalitions, and unconventional politics engulf this unconventional gas boom -- especially at the state level. In this comparative case study of natural gas policy in Wyoming, Colorado, and New Mexico, I measure and compare these values, expressed as frames, through textual analysis of interest group public documents and state legislative bills and statutes from 1999-2008. By developing a new measure of state legislative framing, I test the relationship between interest group and institutional framing and also provide a viable measure of policy change useful to Narrative Policy Analysis theory. Results show that competing interest group and state legislative framing efforts are dynamic, measurably different, and periodically correlative. Competing interest groups rarely engage each other, except as the conflict matures when status-quo-supporters break their silence and engage the challengers' frames that have gained legislative traction. Environmental and land-use counter-framing ensues, but status-quo-supporters remain vigilant in their economic framing. Economic frames retain their institutional privilege within Wyoming and New Mexico, but natural gas policy undergoes a complete environmental reframe in the Colorado state legislature. Although the historically dominant economy frame based on "Old West" values remains largely intact, the respective state legislatures partially reframe policy (within 4 years) using environment, alternative land-uses, and democracy frames based on "New West" and long-extant but previously marginalized status-quo-challenger definitions. This reframing is not a strictly partisan issue, but rather it is influenced by political context, policy diffusion, and long-term interest group advocacy and framing efforts. A policy punctuation is observed in state legislative reframing and by the passage of three status-quo-challenging statutes in Wyoming (2005), four in Colorado (2007), and one in New Mexico (2007). Policy reframing, although rare in most policy areas, is common during this natural gas policy punctuation. The politics of successful reframing is the politics of punctuation.

  8. Higher Education Research, Policy, and the Challenges of Reform

    ERIC Educational Resources Information Center

    Tierney, William G.

    2014-01-01

    Postsecondary institutions always have been in a state of change. The author discusses four key areas of higher education--systems of tertiary education, privatization, academic work, and technology--that demand careful analysis that have always been of concern but now are entering a new phase of change. The author offers an interpretation of the…

  9. Globalization and Higher Education Organizational Change: A Framework for Analysis

    ERIC Educational Resources Information Center

    Vaira, Massimiliano

    2004-01-01

    The aim of this article is to outline a theoretical framework to address Higher Education organizational change in a globalized and globalizing age. The paper will start with a brief description of trends characterizing the global landscape and their relationships with Higher Education policies and institutions. Although these trends are well…

  10. Policy Analysis and Suggested Changes in Vocational Education.

    ERIC Educational Resources Information Center

    Pucinski, Roman

    Studies mandated to the National Institute of Education (NIE) by the Vocational Education Amendments of 1976 can provide an on-going assessment of vocational education's success in meeting changing needs of the states and nation. They can provide new concepts to help meet vocational education's goals in eight ways. These are (1) clarifying who has…

  11. Urban inequities; urban rights: a conceptual analysis and review of impacts on children, and policies to address them.

    PubMed

    Stephens, Carolyn

    2012-06-01

    This paper explores current conceptual understanding of urban social, environmental, and health inequality and inequity, and looks at the impact of these processes on urban children and young people in the 21st century. This conceptual analysis was commissioned for a discussion paper for UNICEF's flagship publication: State of the World's Children 2012: Children in an Urban World. The aim of the paper is to examine evidence on the meaning of urban inequality and inequity for urban children and young people. It further looks at the controversial policies of targeting "vulnerable" young people, and policies to achieve the urban MDGs. Finally, the paper looks briefly at the potential of concepts such as environment justice and rights to change our understanding of urban inequality and inequity.

  12. Water-Energy Nexus Challenges & Opportunities in the Arabian Peninsula under Climate Change

    NASA Astrophysics Data System (ADS)

    Flores-Lopez, F.; Yates, D. N.; Galaitsi, S.; Binnington, T.; Dougherty, W.; Vinnaccia, M.; Glavan, J. C.

    2016-12-01

    Demand for water in the GCC countries relies mainly on fossil groundwater resources and desalination. Satisfying water demand requires a great deal of energy as it treats and moves water along the supply chain from sources, through treatment processes, and ultimately to the consumer. Hence, there is an inherent connection between water and energy and with climate change, the links between water and energy are expected to become even stronger. As part of AGEDI's Local, National, and Regional Climate Change Programme, a study of the water-energy nexus of the countries in the Arabian Peninsula was implemented. For water, WEAP models both water demand - and its main drivers - and water supply, simulating policies, priorities and preferences. For energy, LEAP models both energy supply and demand, and is able to capture the impacts of low carbon development strategies. A coupled WEAP-LEAP model was then used to evaluate the future performance of the energy-water system under climate change and policy scenarios. The coupled models required detailed data, which were obtained through literature reviews and consultations with key stakeholders in the region. As part of this process, the outputs of both models were validated for historic periods using existing data The models examined 5 policy scenarios of different futures of resource management to the year 2060. A future under current management practices with current climate and a climate projection based on the RCP8.5; a High Efficiency scenario where each country gradually implements policies to reduce the consumption of water and electricity; a Natural Resource Protection scenario with resource efficiency and phasing out of groundwater extraction and drastic reduction of fossil fuel usage in favor of solar; and an Integrated Policy scenario that integrates the prior two policy scenarios Water demands can mostly be met in any scenario through supply combinations of groundwater, desalination and wastewater reuse, with some regional fossil groundwater basins draw to extinction by 2060. While the analysis includes both demand and supply oriented scenarios, the results of the analysis strongly suggest that the region will need to simultaneously purse demand and supply side policies to achieve more sustainable uses of water and energy into the second half of the 21st century.

  13. Aircraft modifications: Assessing the current state of Air Force aircraft modifications and the implications for future military capability

    NASA Astrophysics Data System (ADS)

    Hill, Owen Jacob

    How prepared is the U.S. Air Force to modify its aircraft fleet in upcoming years? Aircraft modernization is a complex interaction of new and legacy aircraft, organizational structure, and planning policy. This research will take one component of modernization: aircraft modification, and apply a new method of analysis in order to help formulate policy to promote modernization. Departing from previous small-sample studies dependent upon weight as a chief explanatory variable, this dissertation incorporates a comprehensive dataset that was constructed for this research of all aircraft modifications from 1996 through 2005. With over 700 modification programs, this dataset is used to examine changes to the current modification policy using policy-response regression models. These changes include separating a codependent procurement and installation schedule, reducing the documentation requirements for safety modifications, and budgeting for aging aircraft modifications. The research then concludes with predictive models for the F-15 and F-16 along with their replacements: the F-22 and F-35 Joint Strike Fighter.

  14. Evaluation of Energy Policy Instruments for the Adoption of Renewable Energy: Case of Wind Energy in the Pacific Northwest U.S

    NASA Astrophysics Data System (ADS)

    Abotah, Remal

    The wide use of renewable energy technologies for generating electricity can be seen as one way of meeting environmental and climate change challenges along with a progression to a low-carbon economy. A large number of policy instruments have been formed and employed to support the adoption of renewable energy technologies in the power generation sector. However, the success of these policies in achieving their goals relies on how effective they are in satisfying their targets and thus increasing renewable energy adoption. One measurement for effectiveness of policy instruments can be their contribution to the input of the process of renewable energy adoption and their effect on satisfying regional goal. The objective of this research is evaluate the effectiveness of energy policy instruments on increasing the adoption of renewable energy by developing a comprehensive evaluation model. Criteria used in this assessment depend on five perspectives that are perceived by decision makers as important for adoption process. The decision model linked the perspectives to policy targets and various energy policy instruments. These perspectives are: economic, social, political, environmental and technical. The research implemented the hierarchical decision model (HDM) to construct a generalized policy assessment framework. Data for wind energy adoption in the Pacific Northwest region were collected as a case study and application for the model. Experts' qualitative judgments were collected and quantified using the pair-wise comparison method and the final rankings and effectiveness of policy alternatives with respect to the mission were identified. Results of this research identified economic feasibility improvement of renewable energy projects as the most influential perspective and that renewable portfolio standards and tax credits are the two most effective criteria to accomplish that. The research also applied sensitivity analysis and scenario analysis to identify the effect of regional perspectives future priority changes on determining the most effective policy for this perspective. Results showed that renewable portfolio standards and tax credits were found to be the two most effective policies among the alternatives assessed. The research model and outcome can serve as policy check tool in policy making for renewable energy development in any region. Based on the overall research findings, policymakers can apply specific policy instruments to support adoption efforts for any given scenario and regional emphasis.

  15. Higher Education Policy Change in the European Higher Education Area: Divergence of Quality Assurance Systems in England and the Netherlands

    ERIC Educational Resources Information Center

    Hsieh, Chuo-Chun; Huisman, Jeroen

    2017-01-01

    In the context of globalising higher education (HE) policies, there is an increasing interest among scholars in detecting patterns of policy change, including the rate and magnitude of policy change and the direction of change (convergence or divergence) This paper adds to that literature by comparing the pattern of policy change and by providing…

  16. Whose policy is it anyway? International and national influences on health policy development in Uganda.

    PubMed

    Okuonzi, S A; Macrae, J

    1995-06-01

    As national resources for health decline, so dependence on international resources to finance the capital and recurrent costs is increasing. This dependence, combined with an increasing emphasis on policy-based, as opposed to project-based, lending and grant-making has been accompanied by greater involvement of international actors in the formation of national health policy. This paper explores the process of health policy development in Uganda and examines how major donors are influencing and conflicting with national policy-making bodies. Focusing on two examples of user fees and drugs policies, it argues that while the content of international prescriptions to strengthen the health system may not be bad in itself, the process by which they are applied potentially threatens national sovereignty and weakens mechanisms for ensuring accountability. It concludes by proposing that in order to increase the sustainability of policy reforms, much greater emphasis should be placed on strengthening national capacity for policy analysis and research, building up policy networks and enhancing the quality of information available to the public concerning key policy changes.

  17. Retail pharmacy policy to end the sale of tobacco products: what is the impact on disparity in neighborhood density of tobacco outlets?

    PubMed Central

    Tucker-Seeley, Reginald D.; Bezold, Carla P.; James, Peter; Miller, Melecia; Wallington, Sherrie F.

    2016-01-01

    Background Population-level research on the implications of retail pharmacy policies to end the sale of tobacco products is scant, and the impact of such policies on racial/ethnic and socioeconomic disparities across neighborhoods in access to tobacco products remains unexplored. Methods We investigated the association between neighborhood sociodemographic characteristics and tobacco retail density in Rhode Island (RI) (N=240 census tracts). We also investigated whether the CVS Health (N=60) policy to end the sale of tobacco products reduces the disparity in the density of tobacco retail across neighborhoods, and we conducted a prospective policy analysis to determine if a similar policy change in all pharmacies in RI (N=135) would reduce the disparity in tobacco retail density. Results The results revealed statistically significant associations between neighborhood sociodemographic characteristics and tobacco retail outlet density across RI neighborhoods. The results when excluding the CVS Health locations, as well as all pharmacies as tobacco retailers, revealed no change in the pattern for this association. Conclusions The results of this study suggest that while a commendable tobacco control policy, the CVS Health policy appears to have no impact on the neighborhood racial/ethnic and socioeconomic disparities in the density of tobacco retailers in RI. Prospective policy analyses showed no impact on this disparity even if all other pharmacies in the state adopted a similar policy Impact Policy efforts aimed at reducing the disparity in access to tobacco products should focus on reducing the density of tobacco outlets in poor and racial/ethnic neighborhoods. PMID:27302724

  18. A policy-driven large scale ecological restoration: quantifying ecosystem services changes in the Loess Plateau of China.

    PubMed

    Lü, Yihe; Fu, Bojie; Feng, Xiaoming; Zeng, Yuan; Liu, Yu; Chang, Ruiying; Sun, Ge; Wu, Bingfang

    2012-01-01

    As one of the key tools for regulating human-ecosystem relations, environmental conservation policies can promote ecological rehabilitation across a variety of spatiotemporal scales. However, quantifying the ecological effects of such policies at the regional level is difficult. A case study was conducted at the regional level in the ecologically vulnerable region of the Loess Plateau, China, through the use of several methods including the Universal Soil Loss Equation (USLE), hydrological modeling and multivariate analysis. An assessment of the changes over the period of 2000-2008 in four key ecosystem services was undertaken to determine the effects of the Chinese government's ecological rehabilitation initiatives implemented in 1999. These ecosystem services included water regulation, soil conservation, carbon sequestration and grain production. Significant conversions of farmland to woodland and grassland were found to have resulted in enhanced soil conservation and carbon sequestration, but decreased regional water yield under a warming and drying climate trend. The total grain production increased in spite of a significant decline in farmland acreage. These trends have been attributed to the strong socioeconomic incentives embedded in the ecological rehabilitation policy. Although some positive policy results have been achieved over the last decade, large uncertainty remains regarding long-term policy effects on the sustainability of ecological rehabilitation performance and ecosystem service enhancement. To reduce such uncertainty, this study calls for an adaptive management approach to regional ecological rehabilitation policy to be adopted, with a focus on the dynamic interactions between people and their environments in a changing world.

  19. A Policy-Driven Large Scale Ecological Restoration: Quantifying Ecosystem Services Changes in the Loess Plateau of China

    PubMed Central

    Lü, Yihe; Fu, Bojie; Feng, Xiaoming; Zeng, Yuan; Liu, Yu; Chang, Ruiying; Sun, Ge; Wu, Bingfang

    2012-01-01

    As one of the key tools for regulating human-ecosystem relations, environmental conservation policies can promote ecological rehabilitation across a variety of spatiotemporal scales. However, quantifying the ecological effects of such policies at the regional level is difficult. A case study was conducted at the regional level in the ecologically vulnerable region of the Loess Plateau, China, through the use of several methods including the Universal Soil Loss Equation (USLE), hydrological modeling and multivariate analysis. An assessment of the changes over the period of 2000–2008 in four key ecosystem services was undertaken to determine the effects of the Chinese government's ecological rehabilitation initiatives implemented in 1999. These ecosystem services included water regulation, soil conservation, carbon sequestration and grain production. Significant conversions of farmland to woodland and grassland were found to have resulted in enhanced soil conservation and carbon sequestration, but decreased regional water yield under a warming and drying climate trend. The total grain production increased in spite of a significant decline in farmland acreage. These trends have been attributed to the strong socioeconomic incentives embedded in the ecological rehabilitation policy. Although some positive policy results have been achieved over the last decade, large uncertainty remains regarding long-term policy effects on the sustainability of ecological rehabilitation performance and ecosystem service enhancement. To reduce such uncertainty, this study calls for an adaptive management approach to regional ecological rehabilitation policy to be adopted, with a focus on the dynamic interactions between people and their environments in a changing world. PMID:22359628

  20. Downsizing of a provincial department of health--causes and implications for fiscal policy.

    PubMed

    Blecher, Mark

    2002-06-01

    To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Western Cape (WC) Department of Health (DOH). Downsizing involving 9,282 health workers (27.9%) and closure of 3,601 hospital beds (24.4%) over 5 years. Total aggregate provincial transfers (all provinces) remained fairly constant in real terms. The WC's share decreased from 11.8% in 1996/97 to 9.8% in 2002/03. This was offset by the DOH's share of the WC budget increasing from 25.6% to 29.6%, mainly because of an increase in national health conditional grants. The net effect of financing changes was that the DOH's allocation in real terms was similar in 2002/03 and 1995/96, which suggests that financing changes are not the major cause of downsizing. Expenditure analysis revealed a 39.7% real rise in the average cost of health personnel. Substantial interprovincial inequities remain. The major cause of downsizing was wage growth, particularly following the 1996 wage agreement. Disjointed fiscal and wage policy has affected health services. Simultaneous application of policies of fiscal constraint, redistribution and substantial real wage growth has resulted in substantial downsizing with limited inroads into inequities. Inequities will continue to call for further redistribution, reduction in conditional grants and downsizing, much of which could have been avoided if fiscal and wage policy choices had been optimal.

  1. LGBT in the Military: Policy Development in Sweden 1944-2014.

    PubMed

    Sundevall, Fia; Persson, Alma

    This article contributes to the growing field of research on military LGBT policy development by exploring the case of Sweden, a non-NATO-member nation regarded as one of the most progressive in terms of the inclusion of LGBT personnel. Drawing on extensive archival work, the article shows that the story of LGBT policy development in the Swedish Armed Forces from 1944 to 2014 is one of long periods of status quo and relative silence, interrupted by leaps of rapid change, occasionally followed by the re-appearance of discriminatory policy. The analysis brings out two periods of significant change, 1971-1979 and 2000-2009, here described as turns in LGBT policy. During the first turn, the military medical regulation protocol's recommendation to exempt gay men from military service was the key issue. During these years, homosexuality was classified as mental illness, but in the military context it was largely framed in terms of security threats, both on a national level (due to the risk of blackmail) and for the individual homosexual (due to the homophobic military environment). In the second turn, the focus was increasingly shifted from the LGBT individual to the structures, targeting the military organization itself. Furthermore, the analysis shows that there was no ban against LGBT people serving in the Swedish Armed Forces, but that ways of understanding and regulating sexual orientation and gender identity have nonetheless shaped the military organization in fundamental ways, and continue to do so.

  2. A rapid assessment and response approach for socially marketed nutrition commodities in Viet Nam.

    PubMed

    Turk, Tahir; Quang, Nguyen Dinh; Nga, Tran Thuy; Phuong, Huynh; Tung, Le Van Anh; Trang, Vu Hoang

    2017-01-01

    The leading cause of death in children in developing countries is protein-energy malnutrition. In Viet Nam, 25.9% of children under 5 experience stunted growth and 6.6% are moderately wasted. Iron deficiency anaemia and vitamin A deficiency contribute to these and other malnutrition conditions. Given these factors, more evidence based approaches are required to improve understanding of current attitudes, opinions and behaviours of mothers with young children, in order to operationalise social marketing of nutrition commodities in Viet Nam. A literature review supported a rapid assessment and response method involving semi-structured interviews with 77 stakeholders and focus group discussions with 80 program beneficiaries from four geographic locations in the north and south of Viet Nam. Discussion agendas were developed to address key program issues with grounded theory utilized for data analysis. Data analysis highlighted challenges and opportunities within the six Ps of social marketing: Supply and demand side issues included: cost and the quality of products, the limited scale of interventions and promotional activities. Policy issues identified related to current policies that inhibited the broader promotion and distribution of micronutrient products, and opportunities for improved dialogue with policy partners. Partnerships further emphasized the need for public private partnerships to support the social change process. Implications for theory, policy, and practice indicates that rapid assessment and response is a cost-effective, pragmatic method of public health research, in resource constrained settings, to explore policies and behaviours amenable to change and build stakeholder engagement in the program.

  3. Newborn survival in Uganda: a decade of change and future implications.

    PubMed

    Mbonye, Anthony K; Sentongo, Miriam; Mukasa, Gelasius K; Byaruhanga, Romano; Sentumbwe-Mugisa, Olive; Waiswa, Peter; Naamala Sengendo, Hanifah; Aliganyira, Patrick; Nakakeeto, Margaret; Lawn, Joy E; Kerber, Kate

    2012-07-01

    Each year in Uganda 141 000 children die before reaching their fifth birthday; 26% of these children die in their first month of life. In a setting of persistently high fertility rates, a crisis in human resources for health and a recent history of civil unrest, Uganda has prioritized Millennium Development Goals 4 and 5 for child and maternal survival. As part of a multi-country analysis we examined change for newborn survival over the past decade through mortality and health system coverage indicators as well as national and donor funding for health, and policy and programme change. Between 2000 and 2010 Uganda's neonatal mortality rate reduced by 2.2% per year, which is greater than the regional average rate of decline but slower than national reductions in maternal mortality and under-five mortality after the neonatal period. While existing population-based data are insufficient to measure national changes in coverage and quality of services, national attention for maternal and child health has been clear and authorized from the highest levels. Attention and policy change for newborn health is comparatively recent. This recognized gap has led to a specific focus on newborn health through a national Newborn Steering Committee, which has been given a mandate from the Ministry of Health to advise on newborn survival issues since 2006. This multi-disciplinary and inter-agency network of stakeholders has been able to preside over a number of important policy changes at the level of facility care, education and training, community-based service delivery through Village Health Teams and changes to essential drugs and commodities. The committee's comprehensive reach has enabled rapid policy change and increased attention to newborn survival in a relatively short space of time. Translating this favourable policy environment into district-level implementation and high quality services is now the priority.

  4. Unintended impacts of regulatory changes to British Columbia Methadone Maintenance Program on addiction and HIV-related outcomes: an interrupted time series analysis

    PubMed Central

    Socías, M. Eugenia; Wood, Evan; McNeil, Ryan; Kerr, Thomas; Dong, Huiru; Shoveller, Jean; Montaner, Julio; Milloy, M-J

    2018-01-01

    Background In February 2014, several regulatory reforms were introduced to the methadone maintenance treatment (MMT) program in British Columbia, Canada, including a switch to a ten-times more concentrated methadone formulation and restrictions in pharmacy delivery services. We evaluated possible unintended effects of these changes on illicit drug use patterns and HIV treatment outcomes among HIV-positive opioid users. Methods Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive people who use illicit drugs in Vancouver, Canada. Interrupted time series analyses were used to evaluate impacts of the policy change on monthly rates of MMT enrollment, illicit heroin injection, antiretroviral therapy (ART) adherence, and HIV viral suppression among HIV-positive opioid users between November 2012 and May 2015. Results A total of 331 HIV-positive opioid users were included. The MMT policy change led to a significant immediate 11.5% increase in heroin injection, and 15.9% drop in optimal ART adherence. A gradual increase in the prevalence of MMT enrolment after the policy change was also documented (0.9% per month). No changes in viral suppression rates were observed. Conclusions We observed immediate increases in illicit heroin injection and decreases in ART adherence in the wake of regulatory changes to the local MMT program. These findings underscore the need to consider potential unintended effects of altering health programmes for vulnerable populations, the need to develop appropriate mitigation strategies, as well as to involve all relevant stakeholders in the planning and implementations of new policies. PMID:28454044

  5. Unintended impacts of regulatory changes to British Columbia Methadone Maintenance Program on addiction and HIV-related outcomes: An interrupted time series analysis.

    PubMed

    Socías, M Eugenia; Wood, Evan; McNeil, Ryan; Kerr, Thomas; Dong, Huiru; Shoveller, Jean; Montaner, Julio; Milloy, M-J

    2017-07-01

    In February 2014, several regulatory reforms were introduced to the methadone maintenance treatment (MMT) program in British Columbia, Canada, including a switch to a ten-times more concentrated methadone formulation and restrictions in pharmacy delivery services. We evaluated possible unintended effects of these changes on illicit drug use patterns and HIV treatment outcomes among HIV-positive opioid users. Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive people who use illicit drugs in Vancouver, Canada. Interrupted Time Series Analyses were used to evaluate impacts of the policy change on monthly rates of MMT enrolment, illicit heroin injection, antiretroviral therapy (ART) adherence, and HIV viral suppression among HIV-positive opioid users between November 2012 and May 2015. A total of 331 HIV-positive opioid users were included. The MMT policy change led to a significant immediate 11.5% increase in heroin injection, and 15.9% drop in optimal ART adherence. A gradual increase in the prevalence of MMT enrolment after the policy change was also documented (0.9% per month). No changes in viral suppression rates were observed. We observed immediate increases in illicit heroin injection and decreases in ART adherence in the wake of regulatory changes to the local MMT program. These findings underscore the need to consider potential unintended effects of altering health programmes for vulnerable populations, the need to develop appropriate mitigation strategies, as well as to involve all relevant stakeholders in the planning and implementations of new policies. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Psychology and the politics of same-sex desire in the United States: an analysis of three cases.

    PubMed

    Hammack, Phillip L; Windell, Eric P

    2011-08-01

    Psychological science has assumed an increasingly explicit role in public policies related to same-sex desire in the United States. In this article, we present a historical analysis of the relationship between policy discourse and scientific discourse on homosexuality produced within U.S. psychology over the 20th and early 21st centuries through the lens of three cases: Bowers v. Hardwick (1986), Lawrence v. Texas (2003), and Perry v. Schwarzenegger (2010). Our analysis suggests that, for the majority of its disciplinary history, psychology produced knowledge that supported a status quo of legal and cultural subordination for same-sex-attracted individuals. The discipline's shift in understanding of homosexuality, reflected in a 1975 policy statement of the American Psychological Association, reversed this relationship and opened up space for advocacy for social and political change regarding homosexuality. Our analysis of policy decisions rendered by the courts reveals the increasingly important role psychological science has assumed in challenging the legal subordination of same-sex-attracted individuals, though the basis upon which psychological science has sought to inform policy remains limited. We conclude with a critical discussion of the type of knowledge claims psychologists have traditionally used to advocate for gay and lesbian rights, suggesting the vitality of a narrative approach which can reveal the meaning individuals make of legal subordination and political exclusion.

  7. How funding structures for HIV/AIDS research shape outputs and utilization: a Swiss case study

    PubMed Central

    2011-01-01

    Background Research policy in the field of HIV has changed substantially in recent decades in Switzerland. Until 2004, social science research on HIV/AIDS was funded by specialized funding agencies. After 2004, funding of such research was “normalized” and integrated into the Swiss National Science Foundation as the main funding agency for scientific research in Switzerland. This paper offers a longitudinal analysis of the relationship between the changing nature of funding structures on the one hand and the production and communication of policy-relevant scientific knowledge in the field of HIV on the other hand. Methods The analysis relies on an inventory of all social sciences research projects on HIV in Switzerland that were funded between 1987 and 2010, including topics covered and disciplines involved, as well as financial data. In addition, in-depth interviews were conducted with 18 stakeholders. Results The analysis highlights that the pre-2004 funding policy ensured good coverage of important social science research themes. Specific incentives and explicit promotion of social science research related to HIV gave rise to a multidisciplinary, integrative and health-oriented approach. The abolition of a specific funding policy in 2004 was paralleled by a drastic reduction in the number of social science research projects submitted for funding, and a decline of public money dedicated to such research. Although the public administration in charge of HIV policy still acknowledges the relevance of findings from social sciences for the development of prevention, treatment and care, HIV-related social science research does not flourish under current funding conditions. Conclusions The Swiss experience sheds light on the difficulties of sustaining social science research and multidisciplinary approaches related to HIV without specialized funding agencies. Future funding policy might not necessarily require specialized agencies, but should better take into account research dynamics and motivations in the field of social sciences. PMID:21968292

  8. How funding structures for HIV/AIDS research shape outputs and utilization: a Swiss case study.

    PubMed

    Frey, Kathrin; Kübler, Daniel

    2011-09-27

    Research policy in the field of HIV has changed substantially in recent decades in Switzerland. Until 2004, social science research on HIV/AIDS was funded by specialized funding agencies. After 2004, funding of such research was "normalized" and integrated into the Swiss National Science Foundation as the main funding agency for scientific research in Switzerland. This paper offers a longitudinal analysis of the relationship between the changing nature of funding structures on the one hand and the production and communication of policy-relevant scientific knowledge in the field of HIV on the other hand. The analysis relies on an inventory of all social sciences research projects on HIV in Switzerland that were funded between 1987 and 2010, including topics covered and disciplines involved, as well as financial data. In addition, in-depth interviews were conducted with 18 stakeholders. The analysis highlights that the pre-2004 funding policy ensured good coverage of important social science research themes. Specific incentives and explicit promotion of social science research related to HIV gave rise to a multidisciplinary, integrative and health-oriented approach. The abolition of a specific funding policy in 2004 was paralleled by a drastic reduction in the number of social science research projects submitted for funding, and a decline of public money dedicated to such research. Although the public administration in charge of HIV policy still acknowledges the relevance of findings from social sciences for the development of prevention, treatment and care, HIV-related social science research does not flourish under current funding conditions. The Swiss experience sheds light on the difficulties of sustaining social science research and multidisciplinary approaches related to HIV without specialized funding agencies. Future funding policy might not necessarily require specialized agencies, but should better take into account research dynamics and motivations in the field of social sciences.

  9. History Matters: The Critical Contribution of Historical Analysis to Contemporary Health Policy and Health Care.

    PubMed

    Sheard, Sally

    2018-06-01

    History is popular with health policymakers, if the regularity with which they invoke historical anecdotes to support policy change is used as an indicator. Yet the ways in which they 'use' history vary enormously, as does its impact. This paper explores, from the perspective of a UK academic historian, the development of 'applied' history in health policy. It draws on personal experience of different types and levels of engagement with policymakers, and highlights mechanisms through which this dialogue and partnership can be made more efficient, effective, and intellectually rewarding for all involved.

  10. Evaluating efficacy of an environmental policy to prevent biological invasions.

    PubMed

    Bailey, Sarah A; Deneau, Matthew G; Jean, Laurent; Wiley, Chris J; Leung, Brian; MacIsaac, Hugh J

    2011-04-01

    Enactment of any environmental policy should be followed by an evaluation of its efficacy to ensure optimal utilization of limited resources, yet measuring the success of these policies can be a challenging task owing to a dearth of data and confounding factors. We examine the efficacy of ballast water policies enacted to prevent biological invasions in the Laurentian Great Lakes. We utilize four criteria to assess the efficacy of this environmental regulation: (1) Is the prescribed management action demonstrably effective? (2) Is the management action effective under operational conditions? (3) Can compliance be achieved on a broad scale? (4) Are desired changes observed in the environment? The four lines of evidence resulting from this analysis indicate that the Great Lakes ballast water management program provides robust, but not complete, protection against ship-mediated biological invasions. Our analysis also indicates that corresponding inspection and enforcement efforts should be undertaken to ensure that environmental policies translate into increased environmental protection. Similar programs could be implemented immediately around the world to protect the biodiversity of the many freshwater ecosystems which receive ballast water discharges by international vessels. This general framework can be extended to evaluate efficacy of other environmental policies.

  11. Understanding public elderly care policy in Norway: A narrative analysis of governmental White papers.

    PubMed

    Jacobsen, Frode F

    2015-08-01

    How the general public in Norway conceives being an older adult and the meaning of chronological age has changed over the last few decades. As narratives of aging may be identified in the Norwegian mass media and in the population at large, dominant narratives may also be identified in policy documents, such as government health policy papers. This article explores a narrative analytical framework based on stories, subtexts, and counterstories; it argues that such narratives are characterized as much by what is unsaid as by what is said, and as much by choice of words and word combinations as by explicit messages. Culture strongly influences the conception of a likely future (what will be) and an envisioned future (what ought to be) regarding aging and geriatric care in Norway, as expressed in the public policy papers. The public policy story is discussed as both a story continuously developing, where later health policy papers relate to and comment on earlier documents, and as a story characterized by a measure of cultural incoherence. Some recent government documents dealing with professional geriatric care will serve as material for a narrative analysis. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. The role of a food policy coalition in influencing a local food environment: an Australian case study.

    PubMed

    McCartan, Julia; Palermo, Claire

    2017-04-01

    To explore how an Australian rural food policy coalition acts to influence a local food environment, focusing specifically on its composition, functions and processes as well as its food-related strategies and policy outputs. A qualitative case study approach was undertaken. Three sources were used to triangulate data: eleven semi-structured in-depth interviews with coalition members, analysis of thirty-seven documents relating to the coalition and observation at one coalition meeting. Data were analysed using a thematic and constant comparison approach. Community Coalition Action Theory provided a theoretical framework from which to interpret findings. Two rural local government areas on the south-eastern coast of Victoria, Australia. Eleven members of the food policy coalition. Five themes emerged from the data analysis. The themes described the coalition's leadership processes, membership structure, function to pool resources for food system advocacy, focus on collaborative cross-jurisdictional strategies and ability to influence policy change. This Australian case study demonstrates that with strong leadership, a small-sized core membership and focus on collaborative strategies, food policy coalitions may be a mechanism to positively influence local food environments.

  13. Analysis of Carbon Policies for Electricity Networks with High Penetration of Green Generation

    NASA Astrophysics Data System (ADS)

    Feijoo, Felipe A.

    In recent decades, climate change has become one of the most crucial challenges for humanity. Climate change has a direct correlation with global warming, caused mainly by the green house gas emissions (GHG). The Environmental Protection Agency in the U.S. (EPA) attributes carbon dioxide to account for approximately 82% of the GHG emissions. Unfortunately, the energy sector is the main producer of carbon dioxide, with China and the U.S. as the highest emitters. Therefore, there is a strong (positive) correlation between energy production, global warming, and climate change. Stringent carbon emissions reduction targets have been established in order to reduce the impacts of GHG. Achieving these emissions reduction goals will require implementation of policies like as cap-and-trade and carbon taxes, together with transformation of the electricity grid into a smarter system with high green energy penetration. However, the consideration of policies solely in view of carbon emissions reduction may adversely impact other market outcomes such as electricity prices and consumption. In this dissertation, a two-layer mathematical-statistical framework is presented, that serves to develop carbon policies to reduce emissions level while minimizing the negative impacts on other market outcomes. The bottom layer of the two layer model comprises a bi-level optimization problem. The top layer comprises a statistical model and a Pareto analysis. Two related but different problems are studied under this methodology. The first problem looks into the design of cap-and-trade policies for deregulated electricity markets that satisfy the interest of different market constituents. Via the second problem, it is demonstrated how the framework can be used to obtain levels of carbon emissions reduction while minimizing the negative impact on electricity demand and maximizing green penetration from microgrids. In the aforementioned studies, forecasts for electricity prices and production cost are considered. This, this dissertation also presents anew forecast model that can be easily integrated in the two-layer framework. It is demonstrated in this dissertation that the proposed framework can be utilized by policy-makers, power companies, consumers, and market regulators in developing emissions policy decisions, bidding strategies, market regulations, and electricity dispatch strategies.

  14. Health Policy Responsiveness: Lessons Learned from Maryland and Prince George's County.

    PubMed

    Sogie-Thomas, Byron; Sankofa, John; Reed, Crystal; Mfume, Kweisi; Doamekpor, Lauren Abla

    2018-04-01

    Effective, timely, and intentional policy efforts can significantly impact and improve the public's health and reduce racial and ethnic health disparities across the nation. Creating and implementing responsive policies at the state and county level is essential to supporting community efforts to improve health behaviors and health outcomes, particularly for communities of color who bear the brunt of disease risk and negative health outcomes. Using policy examples from the State of Maryland and Prince George's County, the largest and wealthiest predominately African-American county in the USA, this case study highlights the importance of state and county policy action when presented with opportunities to affect long-lasting, positive change. We examine each jurisdiction's policy response through the lens of timeliness, intentionality, and effectiveness. At first glance, it would appear that Maryland responded effectively to the rise in tobacco use. Similarly, at face value, it appears that Prince George's County's unchecked rise in obesity rates among African-Americans is an example of nonresponsiveness among local policymakers in the face of an obesity epidemic. However-guided by a more nuanced understanding of "policy responsiveness"-this analysis uncovers a more revealing picture, with important strengths and limitations seen in both policy situations. This analysis raises critical questions about the determinants of jurisdictions' health policy capacity and how policymakers might best be supported in their efforts to build an arsenal of health policies that are timely, effective, and intentional in meeting the needs of vulnerable communities.

  15. A retrospective health policy analysis of the development and implementation of the voluntary health insurance system in Lebanon: learning from failure.

    PubMed

    El-Jardali, Fadi; Bou-Karroum, Lama; Ataya, Nour; El-Ghali, Hana Addam; Hammoud, Rawan

    2014-12-01

    Public policymaking is complex and suffers from limited uptake of research evidence, particularly in the Eastern Mediterranean Region (EMR). In-depth case studies examining health policymaking in the EMR are lacking. This retrospective policy analysis aims at generating insights about how policies are being made, identifying factors influencing policymaking and assessing to what extent evidence is used in this process by using the Lebanese Voluntary Health Insurance policy as a case study. The study examined the policymaking process through a policy tracing technique that covered a period of 12 years. The study employed a qualitative research design using a case study approach and was conducted in two phases over the course of two years. Data was collected using multiple sources including: 1) a comprehensive and chronological media review; 2) twenty-two key informant interviews with policymakers, stakeholders, and journalists; and 3) a document review of legislations, minutes of meetings, actuarial studies, and official documents. Data was analyzed and validated using thematic analysis. Findings showed that the voluntary health insurance policy was a political decision taken by the government to tackle an urgent political problem. Evidence was not used to guide policy development and implementation and policy implementers and other stakeholders were not involved in policy development. Factors influencing policymaking were political interests, sectarianism, urgency, and values of policymakers. Barriers to the use of evidence were lack of policy-relevant research evidence, political context, personal interests, and resource constraints. Findings suggest that policymakers should be made more aware of the important role of evidence in informing public policymaking and the need for building capacity to develop, implement and evaluate policies. Study findings are likely to matter in light of the changes that are unfolding in some Arab countries and the looming opportunities for policy reforms. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. The Causes and Consequences of Child Poverty in the United States. Innocenti Occasional Papers, Number 10. Special Subseries: Child Poverty in Industrialized Countries.

    ERIC Educational Resources Information Center

    Danziger, Sheldon; Stern, Jonathan

    This report addresses the sources and remedies for child poverty in the United States through a review of the effects of trends, policies, and changes in social relationships; and an analysis of data concerning poverty and children. An introduction sketches the present condition of children in poverty and the policies and attitudes of the past 30…

  17. The effect of Medicaid nursing home reimbursement policy on Medicare hospice use in nursing homes.

    PubMed

    Miller, Susan C; Gozalo, Pedro; Lima, Julie C; Mor, Vincent

    2011-09-01

    To understand how changes in Medicaid nursing home (NH) reimbursement policy and rates affect a NH's approach to end-of-life care (ie, its use of hospice). This longitudinal study merged US NH decedents' (1999 to 2004) resident assessment data (MDS) with Part A claims data to determine the proportion of a NH's decedents using hospice. Freestanding NHs across the 48 contiguous US states were included. A NH-level analytic file was merged with NH survey (ie, OSCAR) and area resource file data, and with annual data on state Medicaid NH rates, case-mix reimbursement policies, and hospice certificate of need (CON). NH fixed-effect (within) regression analysis examined the effect of changing state policies, controlling for differing time trends in CON and case-mix states and for facility-level and county-level attributes. Models were stratified by urban/rural status. A $10 increase in the Medicaid rate resulted in a 0.41% [95% confidence interval (CI): 0.275, 0.553] increase in hospice use in urban NHs and a 0.37% decrease (95% CI: -0.676, -0.063) in rural NHs not adjacent to urban areas. There was a nonstatistically significant increase in rural NHs adjacent to urban areas. Introduction of case-mix reimbursement resulted in a 2.14% (95% CI: 1.388, 2.896) increase in hospice use in urban NHs, with comparable increases in rural NHs. This study supports and extends previous research by showing changes in Medicaid NH reimbursement policies affect a NH's approach to end-of-life care. It also shows how policy changes can have differing effects depending on a NH's urban/rural status.

  18. Producing alcohol and other drugs as a policy 'problem': A critical analysis of South Africa's 'National Drug Master Plan' (2013-2017).

    PubMed

    Pienaar, Kiran; Savic, Michael

    2016-04-01

    The strong symbolic value of illicit drug use makes it a contested issue, which attracts mixed public opinion, intense media attention and close political scrutiny. This means that the formulation of plausible, authoritative policies governing illicit drugs must navigate fraught political terrain. In a country like South Africa with its long unique history of institutionalised oppression of the black majority, the issues confronting drug policy are particularly complex and the need for carefully formulated policy responses especially urgent. Yet despite this, the area of drug policy development in South Africa has received little scholarly attention to date. This paper explores the complexities of policymaking in the South African context by drawing on feminist scholar Carol Bacchi's poststructuralist approach to policy analysis, which focuses on how policy helps to produce the problems it purports to solve. Taking as its empirical focus, South Africa's current drug policy, the third National Drug Master Plan (NDMP), 2013-2017, the paper analyses how the policy constitutes the 'problem of alcohol and other drugs' (AODs). We identify three central policy proposals through which specific problematisations emerge: (1) the proposal that drug use is a global issue requiring a coordinated policy response, (2) appeals to evidence-based policy proposals and (3) the proposal that AOD 'use' and 'abuse' be treated interchangeably. We suggest that these proposals reveal a tendency towards inflating the 'problem of AODs' and thus work to justify punitive policy measures. In an effort to explore the implications of particular problematisations for effecting social change, we clarify the ways in which the policy may work to undermine the interests of those it seeks to aid by reinforcing stigma and marginalisation. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. A case study of polypharmacy management in nine European countries: Implications for change management and implementation.

    PubMed

    McIntosh, Jennifer; Alonso, Albert; MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

    2018-01-01

    Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives.

  20. The more it changes; the more it remains the same: a Foucauldian analysis of Canadian policy documents relevant to student selection for medical school.

    PubMed

    Razack, Saleem; Lessard, David; Hodges, Brian D; Maguire, Mary H; Steinert, Yvonne

    2014-05-01

    Calls to increase the demographic representativeness of medical classes to better reflect the diversity of society are part of a growing international trend. Despite this, entry into medical school remains highly competitive and exclusive of marginalized groups. To address these questions, we conducted a Foucauldian discourse analysis of 15 publically available policy documents from the websites of Canadian medical education regulatory bodies, using the concepts of "excellence" (institutional or in an applicant), "diversity," and "equity" to frame the analysis. In most documents, there were appeals to broaden definitions of institutional excellence to include concerns for greater social accountability. Equity concerns tended to be represented as needing to be dealt with by people in positions of authority in order to counter a "hidden curriculum." Diversity was represented as an object of value, situated within a discontinuous history. As a rhetorical strategy, documents invoked complex societal shifts to promote change toward a more humanistic medical education system and profession. "Social accountability" was reified as an all-encompassing solution to most issues of representation. Although the policy documents proclaimed rootedness in an ethos of improving the societal responsiveness of the medical profession, our analysis takes a more critical stance towards the discourses identified. On the basis of our research findings, we question whether these calls may contribute to the maintenance of the specific power relations they seek to address. These conclusions lead us to consider the possibility that the discourses represented in the documents might be reframed to take into account issues of power distribution and its productive and reproductive features. A reframing of discourses could potentially generate greater inclusiveness in policy development processes, and afford disadvantaged and marginalized groups more participatory roles in the discussion.

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