Sample records for complexity policy design

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

    PubMed

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

    2013-11-08

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

  2. Systems science and obesity policy: a novel framework for analyzing and rethinking population-level planning.

    PubMed

    Johnston, Lee M; Matteson, Carrie L; Finegood, Diane T

    2014-07-01

    We demonstrate the use of a systems-based framework to assess solutions to complex health problems such as obesity. We coded 12 documents published between 2004 and 2013 aimed at influencing obesity planning for complex systems design (9 reports from US and Canadian governmental or health authorities, 1 Cochrane review, and 2 Institute of Medicine reports). We sorted data using the intervention-level framework (ILF), a novel solutions-oriented approach to complex problems. An in-depth comparison of 3 documents provides further insight into complexity and systems design in obesity policy. The majority of strategies focused mainly on changing the determinants of energy imbalance (food intake and physical activity). ILF analysis brings to the surface actions aimed at higher levels of system function and points to a need for more innovative policy design. Although many policymakers acknowledge obesity as a complex problem, many strategies stem from the paradigm of individual choice and are limited in scope. The ILF provides a template to encourage natural systems thinking and more strategic policy design grounded in complexity science.

  3. Designing Coherent Education Policy: Improving the System.

    ERIC Educational Resources Information Center

    Fuhrman, Susan H., Ed.

    This book examines issues in designing coherent education policy for public elementary and secondary schools. It seeks to expand the policy discussion by refining the definition of coherence and considering a number of complex questions raised by the notion of coherent policy. The book offers an in-depth look at systemic school reform and offers a…

  4. Informing Education Policy in Afghanistan: Using Design of Experiments and Data Envelopment Analysis to Provide Transparency in Complex Simulation

    ERIC Educational Resources Information Center

    Marlin, Benjamin

    2013-01-01

    Education planning provides the policy maker and the decision maker a logical framework in which to develop and implement education policy. At the international level, education planning is often confounded by both internal and external complexities, making the development of education policy difficult. This research presents a discrete event…

  5. A modelling tool for policy analysis to support the design of efficient and effective policy responses for complex public health problems.

    PubMed

    Atkinson, Jo-An; Page, Andrew; Wells, Robert; Milat, Andrew; Wilson, Andrew

    2015-03-03

    In the design of public health policy, a broader understanding of risk factors for disease across the life course, and an increasing awareness of the social determinants of health, has led to the development of more comprehensive, cross-sectoral strategies to tackle complex problems. However, comprehensive strategies may not represent the most efficient or effective approach to reducing disease burden at the population level. Rather, they may act to spread finite resources less intensively over a greater number of programs and initiatives, diluting the potential impact of the investment. While analytic tools are available that use research evidence to help identify and prioritise disease risk factors for public health action, they are inadequate to support more targeted and effective policy responses for complex public health problems. This paper discusses the limitations of analytic tools that are commonly used to support evidence-informed policy decisions for complex problems. It proposes an alternative policy analysis tool which can integrate diverse evidence sources and provide a platform for virtual testing of policy alternatives in order to design solutions that are efficient, effective, and equitable. The case of suicide prevention in Australia is presented to demonstrate the limitations of current tools to adequately inform prevention policy and discusses the utility of the new policy analysis tool. In contrast to popular belief, a systems approach takes a step beyond comprehensive thinking and seeks to identify where best to target public health action and resources for optimal impact. It is concerned primarily with what can be reasonably left out of strategies for prevention and can be used to explore where disinvestment may occur without adversely affecting population health (or equity). Simulation modelling used for policy analysis offers promise in being able to better operationalise research evidence to support decision making for complex problems, improve targeting of public health policy, and offers a foundation for strengthening relationships between policy makers, stakeholders, and researchers.

  6. Dynamic Systems Modeling in Educational System Design & Policy

    ERIC Educational Resources Information Center

    Groff, Jennifer Sterling

    2013-01-01

    Over the last several hundred years, local and national educational systems have evolved from relatively simple systems to incredibly complex, interdependent, policy-laden structures, to which many question their value, effectiveness, and direction they are headed. System Dynamics is a field of analysis used to guide policy and system design in…

  7. An operationalized post-normal science framework for assisting in the development of complex science policy solutions: the case of nanotechnology governance

    NASA Astrophysics Data System (ADS)

    Bernstein, Michael J.; Foley, Rider W.; Bennett, Ira

    2014-07-01

    Scientists, engineers, and policy analysts commonly suggest governance regimes for technology to maximize societal benefits and minimize negative societal and environmental impacts of innovation processes. Yet innovation is a complex socio-technical process that does not respond predictably to modification. Our human propensity to exclude complexity when attempting to manage systems often results in insufficient, one-dimensional solutions. The tendency to exclude complexity (1) reinforces itself by diminishing experience and capacity in the design of simple solutions to complex problems, and (2) leads to solutions that do not address the identified problem. To address the question of how to avoid a complexity- exclusion trap, this article operationalizes a post-normal science framework to assist in the enhancement or design of science policy proposals. A literature review of technological fixes, policy panaceas, and knowledge-to-action gaps is conducted to survey examples of post-normal science frameworks. Next, an operational framework is used to assess the case of a proposed international nanotechnology advisory board. The framework reveals that the board addresses a slice of the broader, more complex problem of nanotechnology governance. We argue that while the formation of an international advisory board is not problematic in-and-of-itself, it is symptomatic of and plays into a complexity- exclusion trap. We offer researchers, policy analysts, and decision-makers three recommendations that incorporate a more appropriate level of complexity into governance proposals.

  8. Contract Design, Supply Chain Complexity, and Accountability in Federal Contracts

    DTIC Science & Technology

    2016-04-30

    understanding how organizations, policy makers, and citizens use information to make decisions and influence public and organizational policy. He has...qÜáêíÉÉåíÜ=^ååì~ä= ^Åèìáëáíáçå=oÉëÉ~êÅÜ= póãéçëáìã= qÜìêëÇ~ó=pÉëëáçåë= sçäìãÉ=ff= = Contract Design, Supply Chain Complexity, and Accountability in Federal...Executive Officer, PEO IEW&S Contract Design, Supply Chain Complexity, and Accountability in Federal Contracts Adam Eckerd, Assistant Professor

  9. 'Complexity-compatible' policy for integrated care? Lessons from the implementation of Ontario's Health Links.

    PubMed

    Grudniewicz, Agnes; Tenbensel, Tim; Evans, Jenna M; Steele Gray, Carolyn; Baker, G Ross; Wodchis, Walter P

    2018-02-01

    Complex adaptive systems (CAS) theory views healthcare as numerous sub-systems characterized by diverse agents that interact, self-organize, and continuously adapt. We apply this complexity science perspective to examine the extent to which CAS theory is a useful lens for designing and implementing health policies. We present the case of Health Links, a "low rules" policy intervention in Ontario, Canada aimed at stimulating the development of voluntary networks of health and social organizations to improve care coordination for the most frequent users of the healthcare system. Our sample consisted of stakeholders from regional governance bodies and organizations partnering in Health Links. Qualitative interview data were coded using the key complexity concepts of sensemaking, self-organization, interconnections, coevolution, and emergence. We found that the complexity-compatible policy design successfully stimulated local dynamics of flexibility, experimentation, and learning and that important mediating factors include leadership, readiness, relationship-building, role clarity, communication, and resources. However, we saw tensions between preferences for flexibility and standardization. Desirable developments occurred only in some settings and failed to flow upward to higher levels, resulting in a piecemeal and patchy landscape. Attention needs to be paid not only to local dynamics and processes, but also to regional and provincial levels to ensure that learning flows to the top and informs decision-making. We conclude that implementation of complexity-compatible policies needs a balance between flexibility and consistency and the right leadership to coordinate the two. Complexity-compatible policy for integrated healthcare is more than simply 'letting a thousand flowers bloom'. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Assessing the Optimal Length of Parental Leave for Child and Parental Well-Being: How Can Research Inform Policy?

    ERIC Educational Resources Information Center

    Galtry, Judith; Callister, Paul

    2005-01-01

    Parental leave is a complex area of public policy. Concerns include health protection for working mothers, equal employment opportunities for women, access to adequate antenatal and birthing care, maternal recovery, optimal nutrition for infants, and gender equality within families. Given this complexity, the design of parental leave schemes,…

  11. Characterizing incentives: an investigation of wildfire response and environmental entry policy

    Treesearch

    Jude Bayham

    2013-01-01

    Policy makers face complex situations involving the analysis and weighting of multiple incentives that complicate the design of natural resource and environmental policy. The objective of this dissertation is to characterize policy makers’ incentives, and to investigate the consequences of those incentives on environmental and economic outcomes in the context of...

  12. Working with Policy and Regulatory Factors to Implement Universal Design in the Built Environment: The Australian Experience.

    PubMed

    Larkin, Helen; Hitch, Danielle; Watchorn, Valerie; Ang, Susan

    2015-07-15

    Built environments that are usable by all provide opportunities for engagement in meaningful occupations. However, enabling them in day to day design processes and practice is problematic for relevant professions. The purpose of this phenomenological study was to gain greater understanding of the policy and regulatory influences that promote or hinder the uptake of universal design in built environments, to inform better future design. Focus groups or telephone interviews were undertaken with 28 key building industry and disability stakeholders in Australia. Four themes were identified: the difficulties of definition; the push or pull of regulations and policy; the role of formal standards; and, shifting the focus of design thinking. The findings highlight the complexity of working within policy and regulatory contexts when implementing universal design. Occupational therapists working with colleagues from other professions must be aware of these influences, and develop the skills to work with them for successful practice.

  13. Using Vignettes to Tap Into Moral Reasoning in Public Health Policy: Practical Advice and Design Principles From a Study on Food Advertising to Children

    PubMed Central

    Taylor, Emily; Hoang, Sylvia; Cook, Brian

    2014-01-01

    In this article, we describe a process for designing and applying vignettes in public health policy research and practice. We developed this methodology for a study on moral reasoning underpinning policy debate on food advertising to children. Using vignettes prompted policy actors who were relatively entrenched in particular ways of speaking professionally about a controversial and ethically challenging issue to converse in a more authentic and reflective way. Vignettes hold benefits and complexities. They can focus attention on moral conflicts, draw out different types of evidence to support moral reasoning, and enable simultaneous consideration of real and ideal worlds. We suggest a process and recommendations on design features for crafting vignettes for public health policy. PMID:25121818

  14. Using vignettes to tap into moral reasoning in public health policy: practical advice and design principles from a study on food advertising to children.

    PubMed

    Mah, Catherine L; Taylor, Emily; Hoang, Sylvia; Cook, Brian

    2014-10-01

    In this article, we describe a process for designing and applying vignettes in public health policy research and practice. We developed this methodology for a study on moral reasoning underpinning policy debate on food advertising to children. Using vignettes prompted policy actors who were relatively entrenched in particular ways of speaking professionally about a controversial and ethically challenging issue to converse in a more authentic and reflective way. Vignettes hold benefits and complexities. They can focus attention on moral conflicts, draw out different types of evidence to support moral reasoning, and enable simultaneous consideration of real and ideal worlds. We suggest a process and recommendations on design features for crafting vignettes for public health policy.

  15. Optimal Navigation of Self-Propelled Colloids in Microstructured Mazes

    NASA Astrophysics Data System (ADS)

    Yang, Yuguang; Bevan, Michael

    Controlling navigation of self-propelled microscopic `robots' subject to random Brownian motion in complex microstructured environments (e.g., porous media, tumor vasculature) is important to many emerging applications (e.g., enhanced oil recovery, drug delivery). In this work, we design an optimal feedback policy to navigate an active self-propelled colloidal rod in complex mazes with various obstacle types. Actuation of the rods is modelled based on a light-controlled osmotic flow mechanism, which produces different propulsion velocities along the rod's long axis. Actuator-parameterized Langevin equations, with soft rod-obstacle repulsive interactions, are developed to describe the system dynamics. A Markov decision process (MDP) framework is used for optimal policy calculations with design goals of colloidal rods reaching target end points in minimum time. Simulations show that optimal MDP-based policies are able to control rod trajectories to reach target regions order-of-magnitudes faster than uncontrolled rods, which diverges as maze complexity increases. An efficient multi-graph based implementation for MDP is also presented, which scales linearly with the maze dimension.

  16. Informing education policy in Afghanistan: Using design of experiments and data envelopment analysis to provide transparency in complex simulation

    NASA Astrophysics Data System (ADS)

    Marlin, Benjamin

    Education planning provides the policy maker and the decision maker a logical framework in which to develop and implement education policy. At the international level, education planning is often confounded by both internal and external complexities, making the development of education policy difficult. This research presents a discrete event simulation in which individual students and teachers flow through the system across a variable time horizon. This simulation is then used with advancements in design of experiments, multivariate statistical analysis, and data envelopment analysis, to provide a methodology designed to assist the international education planning community. We propose that this methodology will provide the education planner with insights into the complexity of the education system, the effects of both endogenous and exogenous factors upon the system, and the implications of policies as they pertain to potential futures of the system. We do this recognizing that there are multiple actors and stochastic events in play, which although cannot be accurately forecasted, must be accounted for within the education model. To both test the implementation and usefulness of such a model and to prove its relevance, we chose the Afghan education system as the focal point of this research. The Afghan education system is a complex, real world system with competing actors, dynamic requirements, and ambiguous states. At the time of this writing, Afghanistan is at a pivotal point as a nation, and has been the recipient of a tremendous amount of international support and attention. Finally, Afghanistan is a fragile state, and the proliferation of the current disparity in education across gender, districts, and ethnicity could provide the catalyst to drive the country into hostility. In order to prevent the failure of the current government, it is essential that the education system is able to meet the demands of the Afghan people. This work provides insights into the Afghan education system, to include implications of security, the potential effects of societal issues, and prescriptive policy options. In using the proposed methodology, we provide justification for the future use of larger complex simulations in education planning |--- especially when said simulation is integrated with efficient design of experiments and data envelopment analysis.

  17. Teaching Statistics--Despite Its Applications

    ERIC Educational Resources Information Center

    Ridgway, Jim; Nicholson, James; McCusker, Sean

    2007-01-01

    Evidence-based policy requires sophisticated modelling and reasoning about complex social data. The current UK statistics curricula do not equip tomorrow's citizens to understand such reasoning. We advocate radical curriculum reform, designed to require students to reason from complex data.

  18. When 'solutions of yesterday become problems of today': crisis-ridden decision making in a complex adaptive system (CAS)--the Additional Duty Hours Allowance in Ghana.

    PubMed

    Agyepong, Irene Akua; Kodua, Augustina; Adjei, Sam; Adam, Taghreed

    2012-10-01

    Implementation of policies (decisions) in the health sector is sometimes defeated by the system's response to the policy itself. This can lead to counter-intuitive, unanticipated, or more modest effects than expected by those who designed the policy. The health sector fits the characteristics of complex adaptive systems (CAS) and complexity is at the heart of this phenomenon. Anticipating both positive and negative effects of policy decisions, understanding the interests, power and interaction between multiple actors; and planning for the delayed and distal impact of policy decisions are essential for effective decision making in CAS. Failure to appreciate these elements often leads to a series of reductionist approach interventions or 'fixes'. This in turn can initiate a series of negative feedback loops that further complicates the situation over time. In this paper we use a case study of the Additional Duty Hours Allowance (ADHA) policy in Ghana to illustrate these points. Using causal loop diagrams, we unpack the intended and unintended effects of the policy and how these effects evolved over time. The overall goal is to advance our understanding of decision making in complex adaptive systems; and through this process identify some essential elements in formulating, updating and implementing health policy that can help to improve attainment of desired outcomes and minimize negative unintended effects.

  19. Working with Policy and Regulatory Factors to Implement Universal Design in the Built Environment: The Australian Experience

    PubMed Central

    Larkin, Helen; Hitch, Danielle; Watchorn, Valerie; Ang, Susan

    2015-01-01

    Built environments that are usable by all provide opportunities for engagement in meaningful occupations. However, enabling them in day to day design processes and practice is problematic for relevant professions. The purpose of this phenomenological study was to gain greater understanding of the policy and regulatory influences that promote or hinder the uptake of universal design in built environments, to inform better future design. Focus groups or telephone interviews were undertaken with 28 key building industry and disability stakeholders in Australia. Four themes were identified: the difficulties of definition; the push or pull of regulations and policy; the role of formal standards; and, shifting the focus of design thinking. The findings highlight the complexity of working within policy and regulatory contexts when implementing universal design. Occupational therapists working with colleagues from other professions must be aware of these influences, and develop the skills to work with them for successful practice. PMID:26184278

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

    PubMed

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

    2014-09-27

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

  1. Optimal Policy of Cross-Layer Design for Channel Access and Transmission Rate Adaptation in Cognitive Radio Networks

    NASA Astrophysics Data System (ADS)

    He, Hao; Wang, Jun; Zhu, Jiang; Li, Shaoqian

    2010-12-01

    In this paper, we investigate the cross-layer design of joint channel access and transmission rate adaptation in CR networks with multiple channels for both centralized and decentralized cases. Our target is to maximize the throughput of CR network under transmission power constraint by taking spectrum sensing errors into account. In centralized case, this problem is formulated as a special constrained Markov decision process (CMDP), which can be solved by standard linear programming (LP) method. As the complexity of finding the optimal policy by LP increases exponentially with the size of action space and state space, we further apply action set reduction and state aggregation to reduce the complexity without loss of optimality. Meanwhile, for the convenience of implementation, we also consider the pure policy design and analyze the corresponding characteristics. In decentralized case, where only local information is available and there is no coordination among the CR users, we prove the existence of the constrained Nash equilibrium and obtain the optimal decentralized policy. Finally, in the case that the traffic load parameters of the licensed users are unknown for the CR users, we propose two methods to estimate the parameters for two different cases. Numerical results validate the theoretic analysis.

  2. Current Issues: Critical Issues Confronting the Nation and the World [and] Current Issues Teacher's Guide.

    ERIC Educational Resources Information Center

    Whittaker, Lynn Page

    1991-01-01

    This annual publication contains reading materials designed to help students understand the complexities of the domestic and foreign policy issues facing the United States. The first portion of the book features background reading on the structure of the Federal Government. Next, 10 domestic policy issues are covered: the economy, education, civil…

  3. Bridging the Policy-Implementation Gap in Federal Health Systems: Lessons from the Nigerian Experience

    PubMed Central

    Sokpo, Emmanuel

    2014-01-01

    The Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal, Newborn and Child Health initiative supports efforts by the government of Nigeria to bridge primary health care (PHC) policies and services at three levels of government: federal, state and local. The paper suggests that understandings informed by complexity theory and complex adaptive systems have been helpful in shaping policy and programme design across these levels. To illustrate this, three initiatives are explored: Bringing PHC under one roof, enhancing access to funding provided by the Global Alliance for Vaccines and Immunization, and strengthening the midwives service scheme. These initiatives have demonstrated how concepts and experience developed at subnational level can influence national policy and practice, and how work at subnational levels can add value to nationally conceived and nationally driven plans for PHC. PMID:28299131

  4. Science Under Attack! Public Policy, Science Education and the Emperor's New Clothes

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

    Krass, Lawrence

    2005-12-05

    The popular debate about the teaching of intelligent design in public schools is but one quandary for scientists and policy makers. Given recent developments which have worked to breed a general distrust of science, it is evident that researchers and politicians alike should be wary of using popular opinion as a guide for policy and pedagogy when it comes to science in public education. Dr. Krauss will qualify this complex issue and will address how educators, policy makers and scientists can work effectively to prevent public misconceptions of science.

  5. Science Under Attack! Public Policy, Science Education, and the Emperor's New Clothes

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

    Krauss, Lawrence

    2005-12-05

    The popular debate about the teaching of intelligent design in public schools is but one quandary for scientists and policy makers. Given recent developments which have worked to breed a general distrust of science, it is evident that researchers and politicians alike should be wary of using popular opinion as a guide for policy and pedagogy when it comes to science in public education. Dr. Krauss will qualify this complex issue and will address how educators, policy makers and scientists can work effectively to prevent public misconceptions of science.

  6. Toward the modelling of safety violations in healthcare systems.

    PubMed

    Catchpole, Ken

    2013-09-01

    When frontline staff do not adhere to policies, protocols, or checklists, managers often regard these violations as indicating poor practice or even negligence. More often than not, however, these policy and protocol violations reflect the efforts of well intentioned professionals to carry out their work efficiently in the face of systems poorly designed to meet the diverse demands of patient care. Thus, non-compliance with institutional policies and protocols often signals a systems problem, rather than a people problem, and can be influenced among other things by training, competing goals, context, process, location, case complexity, individual beliefs, the direct or indirect influence of others, job pressure, flexibility, rule definition, and clinician-centred design. Three candidates are considered for developing a model of safety behaviour and decision making. The dynamic safety model helps to understand the relationship between systems designs and human performance. The theory of planned behaviour suggests that intention is a function of attitudes, social norms and perceived behavioural control. The naturalistic decision making paradigm posits that decisions are based on a wider view of multiple patients, expertise, systems complexity, behavioural intention, individual beliefs and current understanding of the system. Understanding and predicting behavioural safety decisions could help us to encourage compliance to current processes and to design better interventions.

  7. Designing for Decision Making

    ERIC Educational Resources Information Center

    Jonassen, David H.

    2012-01-01

    Decision making is the most common kind of problem solving. It is also an important component skill in other more ill-structured and complex kinds of problem solving, including policy problems and design problems. There are different kinds of decisions, including choices, acceptances, evaluations, and constructions. After describing the centrality…

  8. 76 FR 20490 - Special Conditions: Eurocopter France Model AS350B Series, AS350D, and EC130 Helicopters...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... the system design integrity, system design environmental, and test and analysis requirements) of these... novel or unusual design features when modified by installing the Hoh Aeronautics, Inc. (Hoh) complex..., Regulations and Policy Group (ASW-111), 2601 Meacham Blvd., Fort Worth, Texas 76137; telephone (817) 222-5167...

  9. Police, Design, Plan and Manage: Developing a Framework for Integrating Staff Roles and Institutional Policies into a Plagiarism Prevention Strategy

    ERIC Educational Resources Information Center

    Walker, Christopher; White, Melanie

    2014-01-01

    When student plagiarism occurs, academic interest and institutional policy generally assume the fault rests with the student. This paper questions this assumption. We claim that plagiarism is a shared responsibility and a complex phenomenon that requires an ongoing calibration of the relative skills and experiences of students and staff in…

  10. A network control theory approach to modeling and optimal control of zoonoses: case study of brucellosis transmission in sub-Saharan Africa.

    PubMed

    Roy, Sandip; McElwain, Terry F; Wan, Yan

    2011-10-01

    Developing control policies for zoonotic diseases is challenging, both because of the complex spread dynamics exhibited by these diseases, and because of the need for implementing complex multi-species surveillance and control efforts using limited resources. Mathematical models, and in particular network models, of disease spread are promising as tools for control-policy design, because they can provide comprehensive quantitative representations of disease transmission. A layered dynamical network model for the transmission and control of zoonotic diseases is introduced as a tool for analyzing disease spread and designing cost-effective surveillance and control. The model development is achieved using brucellosis transmission among wildlife, cattle herds, and human sub-populations in an agricultural system as a case study. Precisely, a model that tracks infection counts in interacting animal herds of multiple species (e.g., cattle herds and groups of wildlife for brucellosis) and in human subpopulations is introduced. The model is then abstracted to a form that permits comprehensive targeted design of multiple control capabilities as well as model identification from data. Next, techniques are developed for such quantitative design of control policies (that are directed to both the animal and human populations), and for model identification from snapshot and time-course data, by drawing on recent results in the network control community. The modeling approach is shown to provide quantitative insight into comprehensive control policies for zoonotic diseases, and in turn to permit policy design for mitigation of these diseases. For the brucellosis-transmission example in particular, numerous insights are obtained regarding the optimal distribution of resources among available control capabilities (e.g., vaccination, surveillance and culling, pasteurization of milk) and points in the spread network (e.g., transhumance vs. sedentary herds). In addition, a preliminary identification of the network model for brucellosis is achieved using historical data, and the robustness of the obtained model is demonstrated. As a whole, our results indicate that network modeling can aid in designing control policies for zoonotic diseases.

  11. A Network Control Theory Approach to Modeling and Optimal Control of Zoonoses: Case Study of Brucellosis Transmission in Sub-Saharan Africa

    PubMed Central

    Roy, Sandip; McElwain, Terry F.; Wan, Yan

    2011-01-01

    Background Developing control policies for zoonotic diseases is challenging, both because of the complex spread dynamics exhibited by these diseases, and because of the need for implementing complex multi-species surveillance and control efforts using limited resources. Mathematical models, and in particular network models, of disease spread are promising as tools for control-policy design, because they can provide comprehensive quantitative representations of disease transmission. Methodology/Principal Findings A layered dynamical network model for the transmission and control of zoonotic diseases is introduced as a tool for analyzing disease spread and designing cost-effective surveillance and control. The model development is achieved using brucellosis transmission among wildlife, cattle herds, and human sub-populations in an agricultural system as a case study. Precisely, a model that tracks infection counts in interacting animal herds of multiple species (e.g., cattle herds and groups of wildlife for brucellosis) and in human subpopulations is introduced. The model is then abstracted to a form that permits comprehensive targeted design of multiple control capabilities as well as model identification from data. Next, techniques are developed for such quantitative design of control policies (that are directed to both the animal and human populations), and for model identification from snapshot and time-course data, by drawing on recent results in the network control community. Conclusions/Significance The modeling approach is shown to provide quantitative insight into comprehensive control policies for zoonotic diseases, and in turn to permit policy design for mitigation of these diseases. For the brucellosis-transmission example in particular, numerous insights are obtained regarding the optimal distribution of resources among available control capabilities (e.g., vaccination, surveillance and culling, pasteurization of milk) and points in the spread network (e.g., transhumance vs. sedentary herds). In addition, a preliminary identification of the network model for brucellosis is achieved using historical data, and the robustness of the obtained model is demonstrated. As a whole, our results indicate that network modeling can aid in designing control policies for zoonotic diseases. PMID:22022621

  12. USER MANUAL FOR THE EPA THIRD-GENERATION AIR QUALITY MODELING SYSTEM (MODELS-3 VERSION 3.0)

    EPA Science Inventory

    Models-3 is a flexible software system designed to simplify the development and use of environmental assessment and other decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of atmospheri...

  13. SYSTEM INSTALLATION AND OPERATION MANUAL FOR THE EPA THIRD-GENERATION AIR QUALITY MODELING SYSTEM (MODELS-3) VERSION 3.0

    EPA Science Inventory

    Models-3 is a flexible software system designed to simplify the development and use of environmental assessment and other decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of atmospheri...

  14. MODELS-3 INSTALLATION PROCEDURES FOR A PC WITH AN NT OPERATING SYSTEM (MODELS-3 VERSION 4.0)

    EPA Science Inventory

    Models-3 is a flexible software system designed to simplify the development and use of air quality models and other environmental decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of at...

  15. MODELS-3 INSTALLATION PROCEDURES FOR A PERSONAL COMPUTER WITH A NT OPERATING SYSTEM (MODELS-3 VERSION 4.1)

    EPA Science Inventory

    Models-3 is a flexible system designed to simplify the development and use of air quality models and other environmental decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of atmospheric...

  16. GMDPtoolbox: A Matlab library for designing spatial management policies. Application to the long-term collective management of an airborne disease

    PubMed Central

    Aubertot, Jean-Noël; Peyrard, Nathalie; Sabbadin, Régis

    2017-01-01

    Designing management policies in ecology and agroecology is complex. Several components must be managed together while they strongly interact spatially. Decision choices must be made under uncertainty on the results of the actions and on the system dynamics. Furthermore, the objectives pursued when managing ecological systems or agroecosystems are usually long term objectives, such as biodiversity conservation or sustainable crop production. The framework of Graph-Based Markov Decision Processes (GMDP) is well adapted to the qualitative modeling of such problems of sequential decision under uncertainty. Spatial interactions are easily modeled and integrated control policies (combining several action levers) can be designed through optimization. The provided policies are adaptive, meaning that management actions are decided at each time step (for instance yearly) and the chosen actions depend on the current system state. This framework has already been successfully applied to forest management and invasive species management. However, up to now, no “easy-to-use” implementation of this framework was available. We present GMDPtoolbox, a Matlab toolbox which can be used both for the design of new management policies and for comparing policies by simulation. We provide an illustration of the use of the toolbox on a realistic crop disease management problem: the design of long term management policy of blackleg of canola using an optimal combination of three possible cultural levers. This example shows how GMDPtoolbox can be used as a tool to support expert thinking. PMID:28982151

  17. GMDPtoolbox: A Matlab library for designing spatial management policies. Application to the long-term collective management of an airborne disease.

    PubMed

    Cros, Marie-Josée; Aubertot, Jean-Noël; Peyrard, Nathalie; Sabbadin, Régis

    2017-01-01

    Designing management policies in ecology and agroecology is complex. Several components must be managed together while they strongly interact spatially. Decision choices must be made under uncertainty on the results of the actions and on the system dynamics. Furthermore, the objectives pursued when managing ecological systems or agroecosystems are usually long term objectives, such as biodiversity conservation or sustainable crop production. The framework of Graph-Based Markov Decision Processes (GMDP) is well adapted to the qualitative modeling of such problems of sequential decision under uncertainty. Spatial interactions are easily modeled and integrated control policies (combining several action levers) can be designed through optimization. The provided policies are adaptive, meaning that management actions are decided at each time step (for instance yearly) and the chosen actions depend on the current system state. This framework has already been successfully applied to forest management and invasive species management. However, up to now, no "easy-to-use" implementation of this framework was available. We present GMDPtoolbox, a Matlab toolbox which can be used both for the design of new management policies and for comparing policies by simulation. We provide an illustration of the use of the toolbox on a realistic crop disease management problem: the design of long term management policy of blackleg of canola using an optimal combination of three possible cultural levers. This example shows how GMDPtoolbox can be used as a tool to support expert thinking.

  18. An Integrated Framework for Modeling Air Carrier Behavior, Policy, and Impacts in the U.S. Air Transportation System

    NASA Technical Reports Server (NTRS)

    Horio, Brant M.; Kumar, Vivek; DeCicco, Anthony H.; Hasan, Shahab; Stouffer, Virginia L.; Smith, Jeremy C.; Guerreiro, Nelson M.

    2015-01-01

    The implementation of the Next Generation Air Transportation System (NextGen) in the United States is an ongoing challenge for policymakers due to the complexity of the air transportation system (ATS) with its broad array of stakeholders and dynamic interdependencies between them. The successful implementation of NextGen has a hard dependency on the active participation of U.S. commercial airlines. To assist policymakers in identifying potential policy designs that facilitate the implementation of NextGen, the National Aeronautics and Space Administration (NASA) and LMI developed a research framework called the Air Transportation System Evolutionary Simulation (ATS-EVOS). This framework integrates large empirical data sets with multiple specialized models to simulate the evolution of the airline response to potential future policies and explore consequential impacts on ATS performance and market dynamics. In the ATS-EVOS configuration presented here, we leverage the Transportation Systems Analysis Model (TSAM), the Airline Evolutionary Simulation (AIRLINE-EVOS), the Airspace Concept Evaluation System (ACES), and the Aviation Environmental Design Tool (AEDT), all of which enable this research to comprehensively represent the complex facets of the ATS and its participants. We validated this baseline configuration of ATS-EVOS against Airline Origin and Destination Survey (DB1B) data and subject matter expert opinion, and we verified the ATS-EVOS framework and agent behavior logic through scenario-based experiments that explored potential implementations of a carbon tax, congestion pricing policy, and the dynamics for equipage of new technology by airlines. These experiments demonstrated ATS-EVOS's capabilities in responding to a wide range of potential NextGen-related policies and utility for decision makers to gain insights for effective policy design.

  19. Bridging Water Resources Policy and Environmental Engineering in the Classroom at Cornell University

    NASA Astrophysics Data System (ADS)

    Walter, M. T.; Shaw, S. B.; Seifert, S.; Schwarz, T.

    2006-12-01

    Current university undergraduate students in environmental sciences and engineering are the next generation of environmental protection practitioners. Recognizing this, Cornell's Biological and Environmental Engineering department has developed a popular class, Watershed Engineering (BEE 473), specifically designed to bridge the too-common gap between water resources policy and state-of-art science and technology. Weekly homework assignments are to design real-life solutions to actual water resources problems, often with the objective of applying storm water policies to local situations. Where appropriate, usually in conjunction with recent amendments to the Federal Clean Water Act, this course introduces water resource protection tools and concepts developed in the Cornell Soil and Water Lab. Here we present several examples of how we build bridges between university classrooms and the complex world of water resources policy.

  20. Critique and Complexity: Presenting a More Effective Way to Conceptualise the Knowledge Adoption Process

    ERIC Educational Resources Information Center

    Brown, Chris

    2013-01-01

    The process of "knowledge adoption" is defined as the means through which policy-makers digest, accept then "take on board" research findings. It is argued in Brown, however, that current models designed to explain knowledge adoption activity fail to fully account for the complexities that affect its operation. Within this…

  1. MODELS-3 INSTALLATION PROCEDURES FOR A SUN WORKSTATION WITH A UNIX-BASED OPERATING SYSTEM (MODELS-3 VERSION 4.1)

    EPA Science Inventory

    Models-3 is a flexible system designed to simplify the development and use of air quality models and other environmental decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of atmospheric...

  2. The challenges of climate for energy markets

    DOT National Transportation Integrated Search

    2009-09-01

    Among the many complex issues of technology, governance, and market design affecting the : electricity sector, climate policy has become dominant. From the perspective of a nonspecialist looking at this changing dominance, a quiz illuminates some of ...

  3. The effectiveness of competency-based education in equipping primary health care workers to manage chronic disease in Australian general practice settings.

    PubMed

    Glasgow, Nicholas J; Wells, Robert; Butler, James; Gear, Anna

    2008-04-21

    To review the literature on the effectiveness of competency-based education (CBE) as a means of equipping the Australian general practice workforce to deliver optimal chronic disease outcomes to articulate policy options for the Australian context. Systematic review of the literature (1991-2005) using a narrative approach followed by analysis of the findings using the actors/context/ processes/content framework of Buse et al. Few high-quality studies were identified. National policy options include incorporating clear statements about education and training, research and evaluation in any policy document targeting chronic disease; and provision of funding to enhance general practice teaching facilities and/or facilitate the development of supportive coordinating and administrative structures for training practices. Designers of CBE should consider five key questions: Are the educational objectives of the CBE clearly aligned with the chronic disease or workforce-related outcomes of interest? Is the design of the CBE sound? Have similar educational programs targeting the same outcomes been identified and every attempt made to maximise synergies between programs? Are the educational designers fully aware of and working within the existing complexity of the training environment? Are all involved in the program actively managing the process of change? Policy options range from those relatively simple and achievable to more complex and difficult. The full report is available at http://www.anu.edu.au/aphcri/Domain/Workforce/final_25_glasgow.pdf.

  4. Early Childhood Reform in Seven Communities: Front-Line Practice, Agency Management, and Public Policy. Volume III: Technical Appendix--Research Design and Methodology. Studies of Education Reform.

    ERIC Educational Resources Information Center

    Lopez, Elena

    The administration and funding of early childhood education programs has engendered recent federal policy debates. This volume is the third report in a series of three, which are derived from a study that examined how local organizations implement complex government programs for early childhood education. The study analyzed and documented…

  5. Barriers and Facilitators to Implementing Primary Stroke Center Policy in the United States: Results From 4 Case Study States

    PubMed Central

    Slade, Catherine P.; Brewer, Gene A.; Gase, Lauren N.

    2011-01-01

    Objectives. We identified barriers and facilitators to the state-level implementation of primary stroke center (PSC) policies, which encourage the certification or designation of specialized stroke treatment facilities and may address concerns such as transportation bypass, telemedicine, and treatment protocols. Methods. We studied the experiences of 4 states (Florida, Massachusetts, New Mexico, and New York) selected from the 18 states that had enacted PSC policies or were actively considering doing so. We conducted semistructured interviews during fieldwork in each case study state. Results. Our results showed that system fragmentation, gaps in human and financial resources, and complexity at the interorganizational and operational levels are common barriers and that policy champions, stakeholder support and communication, and operational adaptation are essential facilitators in the adoption and implementation of PSC policies. Conclusions. The identification of barriers and facilitators reveals the contextual elements that can help or hinder policy implementation and may be useful in informing policy formulation and implementation in other jurisdictions. Proactively identifying jurisdictional challenges and opportunities may help facilitate the policy process for PSC designation and allow jurisdictions to develop more effective stroke systems of care. PMID:21233430

  6. The evidence-policy divide: a 'critical computational linguistics' approach to the language of 18 health agency CEOs from 9 countries.

    PubMed

    Bell, Erica; Seidel, Bastian M

    2012-10-30

    There is an emerging body of literature suggesting that the evidence-practice divide in health policy is complex and multi-factorial but less is known about the processes by which health policy-makers use evidence and their views about the specific features of useful evidence. This study aimed to contribute to understandings of how the most influential health policy-makers view useful evidence, in ways that help explore and question how the evidence-policy divide is understood and what research might be supported to help overcome this divide. A purposeful sample of 18 national and state health agency CEOs from 9 countries was obtained. Participants were interviewed using open-ended questions that asked them to define specific features of useful evidence. The analysis involved two main approaches 1)quantitative mapping of interview transcripts using Bayesian-based computational linguistics software 2)qualitative critical discourse analysis to explore the nuances of language extracts so identified. The decision-making, conclusions-oriented world of policy-making is constructed separately, but not exclusively, by policy-makers from the world of research. Research is not so much devalued by them as described as too technical- yet at the same time not methodologically complex enough to engage with localised policy-making contexts. It is not that policy-makers are negative about academics or universities, it is that they struggle to find complexity-oriented methodologies for understanding their stakeholder communities and improving systems. They did not describe themselves as having a more positive role in solving this challenge than academics. These interviews do not support simplistic definitions of policy-makers and researchers as coming from two irreconcilable worlds. They suggest that qualitative and quantitative research is valued by policy-makers but that to be policy-relevant health research may need to focus on building complexity-oriented research methods for local community health and service development. Researchers may also need to better explain and develop the policy-relevance of large statistical generalisable research designs. Policy-makers and public health researchers wanting to serve local community needs may need to be more proactive about questioning whether the dominant definitions of research quality and the research funding levers that drive university research production are appropriately inclusive of excellence in such policy-relevant research.

  7. Addressing the determinants of child mental health: intersectionality as a guide to primary health care renewal.

    PubMed

    McPherson, Charmaine M; McGibbon, Elizabeth A

    2010-09-01

    Primary health care (PHC) renewal was designed explicitly to attend to the multidimensional factors impacting on health, including the social determinants of health. These determinants are central considerations in the development of integrated, cross-sectoral, and multi-jurisdictional policies such as those that inform models of shared mental health care for children. However, there are complex theoretical challenges in translating these multidimensional issues into policy. One of these is the rarely discussed interrelationships among the social determinants of health and identities such as race, gender, age, sexuality, and social class within the added confluence of geographic contexts. An intersectionality lens is used to examine the complex interrelationships among the factors affecting child mental health and the associated policy challenges surrounding PHC renewal. The authors argue that an understanding of the intersections of social determinants of health, identity, and geography is pivotal in guiding policy-makers as they address child mental health inequities using a PHC renewal agenda.

  8. Evaluation Report: Year 2 Implementation of the Small High Schools Initiative Manual Complex, Denver, Colorado

    ERIC Educational Resources Information Center

    Goldfeder, Elizabeth; Ross, Steven M.

    2003-01-01

    This report presents the findings of a study conducted by the Center for Research in Educational Policy (CREP) on the second year of implementation of the Small Schools Initiative at the Manual High School Complex. The major goal of this research was to evaluate perceived progress and outcomes at all three high schools. The design and methodology…

  9. Use of Participatory Systems Dynamics Modelling to Generate User-Friendly Decision Support Systems for the Design of Management Policies for Complex Human-Environmental Systems: A Case Study from the Varied Socio-environmental Landscape of Guatemala

    NASA Astrophysics Data System (ADS)

    Malard, J. J.; Baig, A. I.; Carrera, J.; Mellini, L.; Pineda, P.; Monterroso, O.; Melgar-Quiñonez, H.; Adamowski, J. F.; Halbe, J.; Monardes, H.; Gálvez, J.

    2014-12-01

    The design of effective management policies for socioenvironmental systems requires the development of comprehensive, yet sufficiently simple, decision support systems (DSS) for policy makers. Guatemala is a particularly complex case, combining an enormous diversity of climates, geographies, and agroecosystems within a very small geographical scale. Although food insecurity levels are very high, indicating a generally inadequate management of the varied agroecosystems of the country, different regions have shown vastly different trends in food insecurity over the past decade, including between regions with similar geophysical and climatic characteristics and/or governmental programmes (e.g., agricultural support). These observations suggest two important points: firstly, that not merely environmental conditions but rather socio-environmental interactions play a crucial role in the successful management of human-environmental systems, and, secondly, that differences in the geophysical and climatic environments between the diverse regions significantly impact the success or failure of policies. This research uses participatory systems dynamic modelling (SDM) to build a DSS that allows local decision-makers to (1) determine the impact of current and potential policies on agroecosystem management and food security, and (2) design sustainable and resilient policies for the future. The use of participatory SDM offers several benefits, including the active involvement of the end recipients in the development of the model, greatly increasing its acceptability; the integration of physical (e.g., precipitation, crop yield) and social components in one model; adequacy for modelling long-term trends in response to particular policy decisions; and the inclusion of local stakeholder knowledge on system structure and trends through the participatory process. Preliminary results suggest that there is a set of common variables explaining the generally high levels of food insecurity in Guatemala (e.g., agricultural productivity), while others (e.g., land dynamics and access to water resources) are restricted to certain regions and have a relatively important weight in determining the success or failure of policies in these regions.

  10. Contestations and complexities of nurses’ participation in policy-making in South Africa

    PubMed Central

    Ditlopo, Prudence; Blaauw, Duane; Penn-Kekana, Loveday; Rispel, Laetitia C.

    2014-01-01

    Background There has been increased emphasis globally on nurses’ involvement in health policy and systems development. However, there has been limited scholarly attention on nurses’ participation in policy-making in South Africa. Objective This paper analyses the dynamics, strengths, and weaknesses of nurses’ participation in four national health workforce policies: the 2008 Nursing Strategy, revision of the Scope of Practice for nurses, the new Framework for Nursing Qualifications, and the Occupation-Specific Dispensation (OSD) remuneration policy. Design Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 frontline nurses in four South African provinces. Thematic content analysis was done using the Atlas.ti software. Results The study found that nurses’ participation in policy-making is both contested and complex. The contestation relates to the extent and nature of nurses’ participation in nursing policies. There was a disjuncture between nursing leadership and frontline nurses in their levels of awareness of the four policies. The latter group was generally unaware of these policies with the exception of the OSD remuneration policy as it affected them directly. There was also limited consensus on which nursing group legitimately represented nursing issues in the policy arena. Shifting power relationships influenced who participated, how the participation happened, and the degree to which nurses’ views and inputs were considered and incorporated. Conclusions The South African health system presents major opportunities for nurses to influence and direct policies that affect them. This will require a combination of proactive leadership, health policy capacity and skills development among nurses, and strong support from the national nursing association. PMID:25537938

  11. Tackling 'wicked' health promotion problems: a New Zealand case study.

    PubMed

    Signal, Louise N; Walton, Mat D; Ni Mhurchu, Cliona; Maddison, Ralph; Bowers, Sharron G; Carter, Kristie N; Gorton, Delvina; Heta, Craig; Lanumata, Tolotea S; McKerchar, Christina W; O'Dea, Des; Pearce, Jamie

    2013-03-01

    This paper reports on a complex environmental approach to addressing 'wicked' health promotion problems devised to inform policy for enhancing food security and physical activity among Māori, Pacific and low-income people in New Zealand. This multi-phase research utilized literature reviews, focus groups, stakeholder workshops and key informant interviews. Participants included members of affected communities, policy-makers and academics. Results suggest that food security and physical activity 'emerge' from complex systems. Key areas for intervention include availability of money within households; the cost of food; improvements in urban design and culturally specific physical activity programmes. Seventeen prioritized intervention areas were explored in-depth and recommendations for action identified. These include healthy food subsidies, increasing the statutory minimum wage rate and enhancing open space and connectivity in communities. This approach has moved away from seeking individual solutions to complex social problems. In doing so, it has enabled the mapping of the relevant systems and the identification of a range of interventions while taking account of the views of affected communities and the concerns of policy-makers. The complex environmental approach used in this research provides a method to identify how to intervene in complex systems that may be relevant to other 'wicked' health promotion problems.

  12. An Analysis of Hospital Accreditation Policy in Iran

    PubMed Central

    YOUSEFINEZHADI, Taraneh; MOSADEGHRAD, Ali Mohammad; ARAB, Mohammad; RAMEZANI, Mozhdeh; SARI, Ali AKBARI

    2017-01-01

    Background: Public policymaking is complex and lacks research evidences, particularly in the Eastern Mediterranean Region (EMR). This policy analysis aims to generate insights about the process of hospital accreditation policy making in Iran, to identify factors influencing policymaking and to evaluate utilization of evidence in policy making process. Methods: The study examined the policymaking process using Walt and Gilson framework. A qualitative research design was employed. Thirty key informant interviews with policymakers and stakeholders were conducted. In addition hundred and five related documents were reviewed. Data was analyzed using framework analysis. Results: The accreditation program was a decision made at Ministry of Health and Medical Education in Iran. Many healthcare stakeholders were involved and evidence from leading countries was used to guide policy development. Poor hospital managers’ commitment, lack of physicians’ involvement and inadequate resources were the main barriers in policy implementation. Furthermore, there were too many accreditations standards and criteria, surveyors were not well-trained, had little motivation for their work and there was low consistency among them. Conclusion: This study highlighted the complex nature of policymaking cycle and highlighted various factors influencing policy development, implementation and evaluation. An effective accreditation program requires a robust well-governed accreditation body, various stakeholders’ involvement, sufficient resources and sustainable funds, enough human resources, hospital managers’ commitment, and technical assistance to hospitals. PMID:29308378

  13. Alternative Approaches to Evaluation in Empirical Microeconomics

    ERIC Educational Resources Information Center

    Blundell, Richard; Dias, Monica Costa

    2009-01-01

    This paper reviews some of the most popular policy evaluation methods in empirical microeconomics: social experiments, natural experiments, matching, instrumental variables, discontinuity design, and control functions. It discusses identification of traditionally used average parameters and more complex distributional parameters. The adequacy,…

  14. Observation-Driven Configuration of Complex Software Systems

    NASA Astrophysics Data System (ADS)

    Sage, Aled

    2010-06-01

    The ever-increasing complexity of software systems makes them hard to comprehend, predict and tune due to emergent properties and non-deterministic behaviour. Complexity arises from the size of software systems and the wide variety of possible operating environments: the increasing choice of platforms and communication policies leads to ever more complex performance characteristics. In addition, software systems exhibit different behaviour under different workloads. Many software systems are designed to be configurable so that policies can be chosen to meet the needs of various stakeholders. For complex software systems it can be difficult to accurately predict the effects of a change and to know which configuration is most appropriate. This thesis demonstrates that it is useful to run automated experiments that measure a selection of system configurations. Experiments can find configurations that meet the stakeholders' needs, find interesting behavioural characteristics, and help produce predictive models of the system's behaviour. The design and use of ACT (Automated Configuration Tool) for running such experiments is described, in combination a number of search strategies for deciding on the configurations to measure. Design Of Experiments (DOE) is discussed, with emphasis on Taguchi Methods. These statistical methods have been used extensively in manufacturing, but have not previously been used for configuring software systems. The novel contribution here is an industrial case study, applying the combination of ACT and Taguchi Methods to DC-Directory, a product from Data Connection Ltd (DCL). The case study investigated the applicability of Taguchi Methods for configuring complex software systems. Taguchi Methods were found to be useful for modelling and configuring DC- Directory, making them a valuable addition to the techniques available to system administrators and developers.

  15. Health Policy Roundtable—Policy by Numbers: The Role of Budget Estimates and Scoring in Health Care Reform

    PubMed Central

    Folz, Christina E

    2005-01-01

    The purpose of this roundtable is to explore the imperfect art of estimating the budget costs of health insurance proposals—called scoring when done by government agencies. The panel addresses the complexities involved in generating these estimates, which usually depend on many untested and untestable assumptions. For example, the Medicare prescription drug “donut hole” was invented so that policymakers could achieve budget targets. These budget scores play a critical role in the design of health policies, as well as in the reform proposals put forth by candidates in an election. The roundtable discusses how policymakers can and do use health policy estimates and budget scores. PMID:15762895

  16. Design an optimum safety policy for personnel safety management - A system dynamic approach

    NASA Astrophysics Data System (ADS)

    Balaji, P.

    2014-10-01

    Personnel safety management (PSM) ensures that employee's work conditions are healthy and safe by various proactive and reactive approaches. Nowadays it is a complex phenomenon because of increasing dynamic nature of organisations which results in an increase of accidents. An important part of accident prevention is to understand the existing system properly and make safety strategies for that system. System dynamics modelling appears to be an appropriate methodology to explore and make strategy for PSM. Many system dynamics models of industrial systems have been built entirely for specific host firms. This thesis illustrates an alternative approach. The generic system dynamics model of Personnel safety management was developed and tested in a host firm. The model was undergone various structural, behavioural and policy tests. The utility and effectiveness of model was further explored through modelling a safety scenario. In order to create effective safety policy under resource constraint, DOE (Design of experiment) was used. DOE uses classic designs, namely, fractional factorials and central composite designs. It used to make second order regression equation which serve as an objective function. That function was optimized under budget constraint and optimum value used for safety policy which shown greatest improvement in overall PSM. The outcome of this research indicates that personnel safety management model has the capability for acting as instruction tool to improve understanding of safety management and also as an aid to policy making.

  17. The Role of Social Science Research Institutes in the Formulation and Execution of Soviet Foreign Policy

    DTIC Science & Technology

    1976-03-01

    L FOREWORD In the long-term global competition between capitalism and socialism, the Soviet union designs and implements complex strategies which...successful communist resolution of the struggle by exploiting Soviet opportunities and Western vulnerabilities. Such complex strategies, involving as they...fact, a subject of controversy among Soviet theoreticians, the CPSU’s leading theoretical journal, Kommunist, has explained its appli - cation thus

  18. Integrating uncertainty into public energy research and development decisions

    NASA Astrophysics Data System (ADS)

    Anadón, Laura Díaz; Baker, Erin; Bosetti, Valentina

    2017-05-01

    Public energy research and development (R&D) is recognized as a key policy tool for transforming the world's energy system in a cost-effective way. However, managing the uncertainty surrounding technological change is a critical challenge for designing robust and cost-effective energy policies. The design of such policies is particularly important if countries are going to both meet the ambitious greenhouse-gas emissions reductions goals set by the Paris Agreement and achieve the required harmonization with the broader set of objectives dictated by the Sustainable Development Goals. The complexity of informing energy technology policy requires, and is producing, a growing collaboration between different academic disciplines and practitioners. Three analytical components have emerged to support the integration of technological uncertainty into energy policy: expert elicitations, integrated assessment models, and decision frameworks. Here we review efforts to incorporate all three approaches to facilitate public energy R&D decision-making under uncertainty. We highlight emerging insights that are robust across elicitations, models, and frameworks, relating to the allocation of public R&D investments, and identify gaps and challenges that remain.

  19. Simplified Interface to Complex Memory Hierarchies 1.x

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

    Lang, Michael; Ionkov, Latchesar; Williams, Sean

    2017-02-21

    Memory systems are expected to get evermore complicated in the coming years, and it isn't clear exactly what form that complexity will take. On the software side, a simple, flexible way of identifying and working with memory pools is needed. Additionally, most developers seek code portability and do not want to learn the intricacies of complex memory. Hence, we believe that a library for interacting with complex memory systems should expose two kinds of abstraction: First, a low-level, mechanism-based interface designed for the runtime or advanced user that wants complete control, with its focus on simplified representation but with allmore » decisions left to the caller. Second, a high-level, policy-based interface designed for ease of use for the application developer, in which we aim for best-practice decisions based on application intent. We have developed such a library, called SICM: Simplified Interface to Complex Memory.« less

  20. Information visualisation for science and policy: engaging users and avoiding bias.

    PubMed

    McInerny, Greg J; Chen, Min; Freeman, Robin; Gavaghan, David; Meyer, Miriah; Rowland, Francis; Spiegelhalter, David J; Stefaner, Moritz; Tessarolo, Geizi; Hortal, Joaquin

    2014-03-01

    Visualisations and graphics are fundamental to studying complex subject matter. However, beyond acknowledging this value, scientists and science-policy programmes rarely consider how visualisations can enable discovery, create engaging and robust reporting, or support online resources. Producing accessible and unbiased visualisations from complicated, uncertain data requires expertise and knowledge from science, policy, computing, and design. However, visualisation is rarely found in our scientific training, organisations, or collaborations. As new policy programmes develop [e.g., the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES)], we need information visualisation to permeate increasingly both the work of scientists and science policy. The alternative is increased potential for missed discoveries, miscommunications, and, at worst, creating a bias towards the research that is easiest to display. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Lost in the crowd? Using eye-tracking to investigate the effect of complexity on attribute non-attendance in discrete choice experiments.

    PubMed

    Spinks, Jean; Mortimer, Duncan

    2016-02-03

    The provision of additional information is often assumed to improve consumption decisions, allowing consumers to more accurately weigh the costs and benefits of alternatives. However, increasing the complexity of decision problems may prompt changes in information processing. This is particularly relevant for experimental methods such as discrete choice experiments (DCEs) where the researcher can manipulate the complexity of the decision problem. The primary aims of this study are (i) to test whether consumers actually process additional information in an already complex decision problem, and (ii) consider the implications of any such 'complexity-driven' changes in information processing for design and analysis of DCEs. A discrete choice experiment (DCE) is used to simulate a complex decision problem; here, the choice between complementary and conventional medicine for different health conditions. Eye-tracking technology is used to capture the number of times and the duration that a participant looks at any part of a computer screen during completion of DCE choice sets. From this we can analyse what has become known in the DCE literature as 'attribute non-attendance' (ANA). Using data from 32 participants, we model the likelihood of ANA as a function of choice set complexity and respondent characteristics using fixed and random effects models to account for repeated choice set completion. We also model whether participants are consistent with regard to which characteristics (attributes) they consider across choice sets. We find that complexity is the strongest predictor of ANA when other possible influences, such as time pressure, ordering effects, survey specific effects and socio-demographic variables (including proxies for prior experience with the decision problem) are considered. We also find that most participants do not apply a consistent information processing strategy across choice sets. Eye-tracking technology shows promise as a way of obtaining additional information from consumer research, improving DCE design, and informing the design of policy measures. With regards to DCE design, results from the present study suggest that eye-tracking data can identify the point at which adding complexity (and realism) to DCE choice scenarios becomes self-defeating due to unacceptable increases in ANA. Eye-tracking data therefore has clear application in the construction of guidelines for DCE design and during piloting of DCE choice scenarios. With regards to design of policy measures such as labelling requirements for CAM and conventional medicines, the provision of additional information has the potential to make difficult decisions even harder and may not have the desired effect on decision-making.

  2. mobilityRERC state of the science: How science influences public policy in seating and mobility.

    PubMed

    Hostak, Rita S; Edwards, Doran; Sprigle, Stephen

    2013-11-01

    In the United States (US), wheeled mobility and seating equipment is classified as Durable Medical Equipment (DME). DME includes a wide array of devices including canes, walkers, home oxygen equipment, hospital beds, and wheelchairs. Seating and mobility devices reflect a wide range of DME, from relatively simple standard manual wheelchairs and cushions to highly complex manual and power wheelchairs and custom seating systems. This wide range of complexity results in a wide range of policies that govern the provision of seating and mobility equipment. This article results from a presentation during the Wheeled Mobility Rehabilitation Engineering Research Center's (RERC's) State of the Science Conference in 2012. The presentation was designed to proffer key concepts related to coverage policies and policy decision-making. Topics covered include an introduction to key policy issues impacting seating and mobility equipment, a description of the barriers that prevent or hinder research being used to inform coverage policy decisions, discussion of the challenges surrounding evidence-based policy decisions regarding seating and mobility, and suggestions of strategies for including policy makers and other stakeholders in setting research priorities and in reporting research findings. In the United States, wheeled mobility and seating equipment are classified as Durable Medical Equipments which are governed by a wide range of policies. Researchers should be encouraged to supplement research articles with articles that explicitly address clinical and policy implications of the work. Policy-makers should be encouraged to engage researchers to insure the breadth of knowledge and evidence is represented and understood.

  3. National Ecosystem Services Classification System (NESCS): Framework Design and Policy Application

    EPA Science Inventory

    Understanding the ways in which ecosystems provide flows of “services” to humans is critical for decision making in many contexts; however, relationships between natural and human systems are complex. A well-defined framework for classifying ecosystem services is essential for sy...

  4. 33 CFR 273.13 - Program policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Program is designed to deal primarily with weed infestations of major economic significance including... should constitute investigation of a specific problem weed or weed complex, not generalized surveys of... Control Program, except as such areas may be used for experimental purposes in research performed for the...

  5. 33 CFR 273.13 - Program policy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Program is designed to deal primarily with weed infestations of major economic significance including... should constitute investigation of a specific problem weed or weed complex, not generalized surveys of... Control Program, except as such areas may be used for experimental purposes in research performed for the...

  6. 33 CFR 273.13 - Program policy.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Program is designed to deal primarily with weed infestations of major economic significance including... should constitute investigation of a specific problem weed or weed complex, not generalized surveys of... Control Program, except as such areas may be used for experimental purposes in research performed for the...

  7. 33 CFR 273.13 - Program policy.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Program is designed to deal primarily with weed infestations of major economic significance including... should constitute investigation of a specific problem weed or weed complex, not generalized surveys of... Control Program, except as such areas may be used for experimental purposes in research performed for the...

  8. 33 CFR 273.13 - Program policy.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Program is designed to deal primarily with weed infestations of major economic significance including... should constitute investigation of a specific problem weed or weed complex, not generalized surveys of... Control Program, except as such areas may be used for experimental purposes in research performed for the...

  9. Assistive Technologies and Issues Relating to Privacy, Ethics and Security

    NASA Astrophysics Data System (ADS)

    Martin, Suzanne; Bengtsson, Johan E.; Dröes, Rose-Marie

    Emerging technologies provide the opportunity to develop innovative sustainable service models, capable of supporting adults with dementia at home. Devices range from simple stand-alone components that can generate a responsive alarm call to complex interoperable systems that even can be remotely controlled. From these complex systems the paradigm of the ubiquitous or ambient smart home has emerged, integrating technology, environmental design and traditional care provision. The service context is often complex, involving a variety of stakeholders and a range of interested agencies. Against this backdrop, as anecdotal evidence and government policies spawn further innovation it is critical that due consideration is given to the potential ethical ramifications at an individual, organisational and societal level. Well-grounded ethical thinking and proactive ethical responses to this innovation are required. Explicit policy and practice should therefore emerge which engenders confidence in existing supported living option schemes for adults with dementia and informs further innovation.

  10. The path to impact of operational research on tuberculosis control policies and practices in Indonesia

    PubMed Central

    Probandari, Ari; Widjanarko, Bagoes; Mahendradhata, Yodi; Sanjoto, Hary; Cerisha, Ancila; Nungky, Saverina; Riono, Pandu; Simon, Sumanto; Farid, Muhammad Noor; Giriputra, Sardikin; Putra, Artawan Eka; Burhan, Erlina; Wahyuni, Chatarina U.; Mustikawati, Dyah; Widianingrum, Christina; Tiemersma, Edine W.; Alisjahbana, Bachti

    2016-01-01

    Background Operational research is currently one of the pillars of the global strategy to control tuberculosis. Indonesia initiated capacity building for operational research on tuberculosis over the last decade. Although publication of the research in peer-reviewed journals is an important indicator for measuring the success of this endeavor, the influence of operational research on policy and practices is considered even more important. However, little is known about the process by which operational research influences tuberculosis control policy and practices. Objective We aimed to investigate the influence of operational research on tuberculosis control policy and practice in Indonesia between 2004 and 2014. Design Using a qualitative study design, we conducted in-depth interviews of 50 researchers and 30 policy makers/program managers and performed document reviews. Transcripts of these interviews were evaluated while applying content analysis. Results Operational research contributed to tuberculosis control policy and practice improvements, including development of new policies, introduction of new practices, and reinforcement of current program policies and practices. However, most of these developments had limited sustainability. The path from the dissemination of research results and recommendations to policy and practice changes was long and complex. The skills, interests, and political power of researchers and policy makers, as well as health system response, could influence the process. Conclusions Operational research contributed to improving tuberculosis control policy and practices. A systematic approach to improve the sustainability of the impact of operational research should be explored. PMID:26928217

  11. Integrating water and agricultural management: collaborative governance for a complex policy problem.

    PubMed

    Fish, Rob D; Ioris, Antonio A R; Watson, Nigel M

    2010-11-01

    This paper examines governance requirements for integrating water and agricultural management (IWAM). The institutional arrangements for the agriculture and water sectors are complex and multi-dimensional, and integration cannot therefore be achieved through a simplistic 'additive' policy process. Effective integration requires the development of a new collaborative approach to governance that is designed to cope with scale dependencies and interactions, uncertainty and contested knowledge, and interdependency among diverse and unequal interests. When combined with interdisciplinary research, collaborative governance provides a viable normative model because of its emphasis on reciprocity, relationships, learning and creativity. Ultimately, such an approach could lead to the sorts of system adaptations and transformations that are required for IWAM. Copyright © 2009 Elsevier B.V. All rights reserved.

  12. Information-theoretic approach to interactive learning

    NASA Astrophysics Data System (ADS)

    Still, S.

    2009-01-01

    The principles of statistical mechanics and information theory play an important role in learning and have inspired both theory and the design of numerous machine learning algorithms. The new aspect in this paper is a focus on integrating feedback from the learner. A quantitative approach to interactive learning and adaptive behavior is proposed, integrating model- and decision-making into one theoretical framework. This paper follows simple principles by requiring that the observer's world model and action policy should result in maximal predictive power at minimal complexity. Classes of optimal action policies and of optimal models are derived from an objective function that reflects this trade-off between prediction and complexity. The resulting optimal models then summarize, at different levels of abstraction, the process's causal organization in the presence of the learner's actions. A fundamental consequence of the proposed principle is that the learner's optimal action policies balance exploration and control as an emerging property. Interestingly, the explorative component is present in the absence of policy randomness, i.e. in the optimal deterministic behavior. This is a direct result of requiring maximal predictive power in the presence of feedback.

  13. Evaluation and mechanism for outcomes exploration of providing public health care in contract service in rural China: a multiple-case study with complex adaptive systems design.

    PubMed

    Zhou, Huixuan; Zhang, Shengfa; Zhang, Weijun; Wang, Fugang; Zhong, You; Gu, Linni; Qu, Zhiyong; Tian, Donghua

    2015-02-27

    The Chinese government has increased the funding for public health in 2009 and experimentally applied a contract service policy (could be seen as a counterpart to family medicine) in 15 counties to promote public health services in the rural areas in 2013. The contract service aimed to convert village doctors, who had privately practiced for decades, into general practitioners under the government management, and better control the rampant chronic diseases. This study made a rare attempt to assess the effectiveness of public health services delivered under the contract service policy, explore the influencing mechanism and draw the implications for the policy extension in the future. Three pilot counties and a non-pilot one with heterogeneity in economic and health development from east to west of China were selected by a purposive sampling method. The case study methods by document collection, non-participant observation and interviews (including key informant interview and focus group interview) with 84 health providers and 20 demanders in multiple level were applied in this study. A thematic approach was used to compare diverse outcomes and analyze mechanism in the complex adaptive systems framework. Without sufficient incentives, the public health services were not conducted effectively, regardless of the implementation of the contract policy. To appropriately increase the funding for public health by local finance and properly allocate subsidy to village doctors was one of the most effective approaches to stimulate health providers and demanders' positivity and promote the policy implementation. County health bureaus acted as the most crucial agents among the complex public health systems. Their mental models influenced by the compound and various environments around them led to the diverse outcomes. If they could provide extra incentives and make the contexts of the systems ripe enough for change, the health providers and demanders would be receptive to the transition of the policy. The innovative fund raising measures could be taken by relatively developed counties of China to conduct public health services. Policymakers could take systems thinking as a useful tool to design plans and predict the unintended outcomes during the process of public health reforms.

  14. The Reality of School Development

    ERIC Educational Resources Information Center

    Watson, Pauline

    2015-01-01

    Educational administration is a continuously evolving and complex methodology that is designed to assist schools to link bureaucratic policy making with theoretical management practices. Within this paper educational management theory and its practice within a local schooling context will be addressed. This will be achieved in two ways. Firstly,…

  15. Design an optimum safety policy for personnel safety management - A system dynamic approach

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

    Balaji, P.

    2014-10-06

    Personnel safety management (PSM) ensures that employee's work conditions are healthy and safe by various proactive and reactive approaches. Nowadays it is a complex phenomenon because of increasing dynamic nature of organisations which results in an increase of accidents. An important part of accident prevention is to understand the existing system properly and make safety strategies for that system. System dynamics modelling appears to be an appropriate methodology to explore and make strategy for PSM. Many system dynamics models of industrial systems have been built entirely for specific host firms. This thesis illustrates an alternative approach. The generic system dynamicsmore » model of Personnel safety management was developed and tested in a host firm. The model was undergone various structural, behavioural and policy tests. The utility and effectiveness of model was further explored through modelling a safety scenario. In order to create effective safety policy under resource constraint, DOE (Design of experiment) was used. DOE uses classic designs, namely, fractional factorials and central composite designs. It used to make second order regression equation which serve as an objective function. That function was optimized under budget constraint and optimum value used for safety policy which shown greatest improvement in overall PSM. The outcome of this research indicates that personnel safety management model has the capability for acting as instruction tool to improve understanding of safety management and also as an aid to policy making.« less

  16. Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction.

    PubMed

    Reyers, Belinda; Nel, Jeanne L; O'Farrell, Patrick J; Sitas, Nadia; Nel, Deon C

    2015-06-16

    Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social-ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making.

  17. Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction

    PubMed Central

    Reyers, Belinda; Nel, Jeanne L.; O’Farrell, Patrick J.; Sitas, Nadia; Nel, Deon C.

    2015-01-01

    Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social–ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making. PMID:26082541

  18. Climate Change Impacts and Vulnerability Assessment in Industrial Complexes

    NASA Astrophysics Data System (ADS)

    Lee, H. J.; Lee, D. K.

    2016-12-01

    Climate change has recently caused frequent natural disasters, such as floods, droughts, and heat waves. Such disasters have also increased industrial damages. We must establish climate change adaptation policies to reduce the industrial damages. It is important to make accurate vulnerability assessment to establish climate change adaptation policies. Thus, this study aims at establishing a new index to assess vulnerability level in industrial complexes. Most vulnerability indices have been developed with subjective approaches, such as the Delphi survey and the Analytic Hierarchy Process(AHP). The subjective approaches rely on the knowledge of a few experts, which provokes the lack of the reliability of the indices. To alleviate the problem, we have designed a vulnerability index incorporating objective approaches. We have investigated 42 industrial complex sites in Republic of Korea (ROK). To calculate weights of variables, we used entropy method as an objective method integrating the Delphi survey as a subjective method. Finally, we found our method integrating both subjective method and objective method could generate result. The integration of the entropy method enables us to assess the vulnerability objectively. Our method will be useful to establish climate change adaptation policies by reducing the uncertainties of the methods based on the subjective approaches.

  19. 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.

  20. The Affordable Care Act and health insurance exchanges: effects on the pediatric dental benefit.

    PubMed

    Orynich, C Ashley; Casamassimo, Paul S; Seale, N Sue; Reggiardo, Paul; Litch, C Scott

    2015-01-01

    To examine the relationship between state health insurance Exchange selection and pediatric dental benefit design, regulation and cost. Medical and dental plans were analyzed across three types of state health insurance Exchanges: State-based (SB), State-partnered (SP), and Federally-facilitated (FF). Cost-analysis was completed for 10,427 insurance plans, and health policy expert interviews were conducted. One-way ANOVA compared the cost-sharing structure of stand-alone dental plans (SADP). T-test statistics compared differences in average total monthly pediatric premium costs. No causal relationships were identified between Exchange selection and the pediatric dental benefit's design, regulation or cost. Pediatric medical and dental coverage offered through the embedded plan design exhibited comparable average total monthly premium costs to aggregate cost estimates for the separately purchased SADP and traditional medical plan (P=0.11). Plan designs and regulatory policies demonstrated greater correlation between the SP and FF Exchanges, as compared to the SB Exchange. Parameters defining the pediatric dental benefit are complex and vary across states. Each state Exchange was subject to barriers in improving the quality of the pediatric dental benefit due to a lack of defined, standardized policy parameters and further legislative maturation is required.

  1. 'Low-hanging fruit': counting and accounting for children in PEPFAR-funded HIV/AIDS programmes in South Africa.

    PubMed

    Reynolds, Lindsey J

    2014-01-01

    The article traces the social life of a policy that aimed to define and circumscribe the ambiguous and contested category of 'orphaned and vulnerable children' (or OVC) in South Africa at the height of the 'emergency response' to HIV/AIDS. Drawing on several months of institutional ethnographic research conducted over the course of five years with South African organisations receiving funding from the US President's Emergency Plan for AIDS Relief to provide services to 'OVC', the project interrogates the influence of governmental forms of counting and accounting on health policy and practice in South Africa. Focusing on the experiences of one organisation, the article describes a process of policy 'translation' typified by a series of disconnects between the intentions of a policy and the exigencies of implementation, structured by the ambiguous and flexible nature of the 'OVC' category. In this context, the article argues that the uncertainty produced by the implementation of the guidelines was not simply an artefact of a poorly designed policy, but rather signals an underlying epistemological tension in the practice of 'global health', in which quantitative metrics designed for monitoring and evaluation are often incapable of approximating the complexities of everyday life.

  2. Design of Adaptive Policy Pathways under Deep Uncertainties

    NASA Astrophysics Data System (ADS)

    Babovic, Vladan

    2013-04-01

    The design of large-scale engineering and infrastructural systems today is growing in complexity. Designers need to consider sociotechnical uncertainties, intricacies, and processes in the long- term strategic deployment and operations of these systems. In this context, water and spatial management is increasingly challenged not only by climate-associated changes such as sea level rise and increased spatio-temporal variability of precipitation, but also by pressures due to population growth and particularly accelerating rate of urbanisation. Furthermore, high investment costs and long term-nature of water-related infrastructure projects requires long-term planning perspective, sometimes extending over many decades. Adaptation to such changes is not only determined by what is known or anticipated at present, but also by what will be experienced and learned as the future unfolds, as well as by policy responses to social and water events. As a result, a pathway emerges. Instead of responding to 'surprises' and making decisions on ad hoc basis, exploring adaptation pathways into the future provide indispensable support in water management decision-making. In this contribution, a structured approach for designing a dynamic adaptive policy based on the concepts of adaptive policy making and adaptation pathways is introduced. Such an approach provides flexibility which allows change over time in response to how the future unfolds, what is learned about the system, and changes in societal preferences. The introduced flexibility provides means for dealing with complexities of adaptation under deep uncertainties. It enables engineering systems to change in the face of uncertainty to reduce impacts from downside scenarios while capitalizing on upside opportunities. This contribution presents comprehensive framework for development and deployment of adaptive policy pathway framework, and demonstrates its performance under deep uncertainties on a case study related to urban water catchment in Singapore. Ingredients of this approach are: (a) transient scenarios (time series of various uncertain developments such as climate change, economic developments, societal changes), (b) a methodology for exploring many options and sequences of these options across different futures, and (c) a stepwise policy analysis. The strategy is applied on case of flexible deployment of novel, so-called Next Generation Infrastructure, and assessed in context of the proposed. Results of the study show that flexible design alternatives deliver much enhanced performance compared to systems optimized under deterministic forecasts of the future. The work also demonstrates that explicit incorporation of uncertainty and flexibility into decision-making process reduces capital expenditures while allowing decision makers to learn about system evolution throughout the lifetime of the project.

  3. IMPACT: a generic tool for modelling and simulating public health policy.

    PubMed

    Ainsworth, J D; Carruthers, E; Couch, P; Green, N; O'Flaherty, M; Sperrin, M; Williams, R; Asghar, Z; Capewell, S; Buchan, I E

    2011-01-01

    Populations are under-served by local health policies and management of resources. This partly reflects a lack of realistically complex models to enable appraisal of a wide range of potential options. Rising computing power coupled with advances in machine learning and healthcare information now enables such models to be constructed and executed. However, such models are not generally accessible to public health practitioners who often lack the requisite technical knowledge or skills. To design and develop a system for creating, executing and analysing the results of simulated public health and healthcare policy interventions, in ways that are accessible and usable by modellers and policy-makers. The system requirements were captured and analysed in parallel with the statistical method development for the simulation engine. From the resulting software requirement specification the system architecture was designed, implemented and tested. A model for Coronary Heart Disease (CHD) was created and validated against empirical data. The system was successfully used to create and validate the CHD model. The initial validation results show concordance between the simulation results and the empirical data. We have demonstrated the ability to connect health policy-modellers and policy-makers in a unified system, thereby making population health models easier to share, maintain, reuse and deploy.

  4. A Model-Driven Architecture Approach for Modeling, Specifying and Deploying Policies in Autonomous and Autonomic Systems

    NASA Technical Reports Server (NTRS)

    Pena, Joaquin; Hinchey, Michael G.; Sterritt, Roy; Ruiz-Cortes, Antonio; Resinas, Manuel

    2006-01-01

    Autonomic Computing (AC), self-management based on high level guidance from humans, is increasingly gaining momentum as the way forward in designing reliable systems that hide complexity and conquer IT management costs. Effectively, AC may be viewed as Policy-Based Self-Management. The Model Driven Architecture (MDA) approach focuses on building models that can be transformed into code in an automatic manner. In this paper, we look at ways to implement Policy-Based Self-Management by means of models that can be converted to code using transformations that follow the MDA philosophy. We propose a set of UML-based models to specify autonomic and autonomous features along with the necessary procedures, based on modification and composition of models, to deploy a policy as an executing system.

  5. Simulation tools for developing policies for complex systems: modeling the health and safety of refugee communities.

    PubMed

    Anderson, James; Chaturvedi, Alok; Cibulskis, Mike

    2007-12-01

    The U.S. Committee for Refugees and Immigrants estimated that there were over 33 million refugees and internally displaced persons (IDPs) in the world at the beginning of 2005. IDP/Refugee communities behave in complex ways making it difficult to make policy decisions regarding the provision of humanitarian aid and health and safety. This paper reports the construction of an agent-based model that has been used to study humanitarian assistance policies executed by governments and NGOs that provide for the health and safety of refugee communities. Agent-based modeling (ABM) was chosen because the more widely used alternatives impose unrealistic restrictions and assumptions on the system being modeled and primarily apply to aggregate data. We created intelligent agents representing institutions, organizations, individuals, infrastructure, and governments and analyzed the resulting interactions and emergent behavior using a Central Composite Design of Experiments with five factors. The resulting model allows policy makers and analysts to create scenarios, to make rapid changes in parameters, and provides a test bed for concepts and strategies. Policies can be examined to see how refugee communities might respond to alternative courses of action and how these actions are likely to affect the health and well-being of the community.

  6. Quality of service policy control in virtual private networks

    NASA Astrophysics Data System (ADS)

    Yu, Yiqing; Wang, Hongbin; Zhou, Zhi; Zhou, Dongru

    2004-04-01

    This paper studies the QoS of VPN in an environment where the public network prices connection-oriented services based on source, destination and grade of service, and advertises these prices to its VPN customers (users). As different QoS technologies can produce different QoS, there are according different traffic classification rules and priority rules. The internet service provider (ISP) may need to build complex mechanisms separately for each node. In order to reduce the burden of network configuration, we need to design policy control technologies. We considers mainly directory server, policy server, policy manager and policy enforcers. Policy decision point (PDP) decide its control according to policy rules. In network, policy enforce point (PEP) decide its network controlled unit. For InterServ and DiffServ, we will adopt different policy control methods as following: (1) In InterServ, traffic uses resource reservation protocol (RSVP) to guarantee the network resource. (2) In DiffServ, policy server controls the DiffServ code points and per hop behavior (PHB), its PDP distributes information to each network node. Policy server will function as following: information searching; decision mechanism; decision delivering; auto-configuration. In order to prove the effectiveness of QoS policy control, we make the corrective simulation.

  7. Science Outside the Lab: Helping Graduate Students in Science and Engineering Understand the Complexities of Science Policy.

    PubMed

    Bernstein, Michael J; Reifschneider, Kiera; Bennett, Ira; Wetmore, Jameson M

    2017-06-01

    Helping scientists and engineers challenge received assumptions about how science, engineering, and society relate is a critical cornerstone for macroethics education. Scientific and engineering research are frequently framed as first steps of a value-free linear model that inexorably leads to societal benefit. Social studies of science and assessments of scientific and engineering research speak to the need for a more critical approach to the noble intentions underlying these assumptions. "Science Outside the Lab" is a program designed to help early-career scientists and engineers understand the complexities of science and engineering policy. Assessment of the program entailed a pre-, post-, and 1 year follow up survey to gauge student perspectives on relationships between science and society, as well as a pre-post concept map exercise to elicit student conceptualizations of science policy. Students leave Science Outside the Lab with greater humility about the role of scientific expertise in science and engineering policy; greater skepticism toward linear notions of scientific advances benefiting society; a deeper, more nuanced understanding of the actors involved in shaping science policy; and a continued appreciation of the contributions of science and engineering to society. The study presents an efficacious program that helps scientists and engineers make inroads into macroethical debates, reframe the ways in which they think about values of science and engineering in society, and more thoughtfully engage with critical mediators of science and society relationships: policy makers and policy processes.

  8. Technical basis, supporting information, and strategy for development and implementation of DOE policy for natural phenomena hazards

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

    Murray, R.C.

    1991-09-01

    Policy for addressing natural phenomenon comprises a hierarchy of interrelated documents. The top level of policy is contained in the code of Federal Regulations which establishes the framework and intent to ensure overall safety of DOE facilities when subjected to the effects of natural phenomena. The natural phenomena to be considered include earthquakes and tsunami, winds, hurricanes and tornadoes, floods, volcano effects and seiches. Natural phenomena criteria have been established for design of new facilities; evaluation of existing facilities; additions, modifications, and upgrades to existing facilities; and evaluation criteria for new or existing sites. Steps needed to implement these fourmore » general criteria are described. The intent of these criteria is to identify WHAT needs to be done to ensure adequate protection from natural phenomena. The commentary provides discussion of WHY this is needed for DOE facilities within the complex. Implementing procedures identifying HOW to carry out these criteria are next identified. Finally, short and long term tasks needed to identify the implementing procedure are tabulated. There is an overall need for consistency throughout the DOE complex related to natural phenomena including consistent terminology, policy, and implementation. 1 fig, 6 tabs.« less

  9. Using Formative Assessment to Support Complex Learning in Conditions of Social Adversity

    ERIC Educational Resources Information Center

    Crossouard, Barbara

    2011-01-01

    This article reports on research into formative assessment within a task design that produces multiple opportunities for teacher and pupil dialogue. It draws upon in-depth case studies conducted in schools in socially deprived areas of Scotland, using policy and documentary analysis, video-observation, and an iterative series of interviews with…

  10. Two-Year Impacts of Opportunity NYC by Families' Likelihood of Earning Rewards

    ERIC Educational Resources Information Center

    Berg, Juliette; Morris, Pamela; Aber, J. Lawrence

    2011-01-01

    Experimental approaches can help disentangle the impacts of policies from the effects of individual characteristics, but the heterogeneity of implementation inherent in studies with complex program designs may mask average treatment impacts (Morris & Hendra, 2009). In the case of the Opportunity NYC-Family Rewards (ONYC-Family Rewards),…

  11. Lysimetric evaluation of the APEX Model to simulate daily ET for irrigated crops in the Texas High Plains

    USDA-ARS?s Scientific Manuscript database

    The NTT (Nutrient Tracking Tool) was designed to provide an opportunity for all users, including producers, to simulate the complex models, such as APEX (Agricultural Policy Environmental eXtender) and associated required databases. The APEX model currently nested within NTT provides estimates of th...

  12. Systemic Change for RTI: Key Shifts for Practice

    ERIC Educational Resources Information Center

    Kozleski, Elizabeth B.; Huber, Jennifer J.

    2010-01-01

    RTI has the potential to meet the challenges of increasing diversity in student populations and the need for increasingly complex systems of instructional design. Three fundamental shifts in understanding systems and systems change must ground RTI policy and implementation work. First, RTI must be seen as an activity system nested within a larger…

  13. Social Security: A Pending Crisis a Leadership and Politics Debate

    ERIC Educational Resources Information Center

    Goertzen, Brent J.; Rackaway, Chapman

    2007-01-01

    Leadership is a social process that brings together the interests of multiple stakeholders for mutual benefit toward the common good (Burns, 1978; Rost, 1993). In an effort to engage individuals to understand the complexities of the leadership and public policy making processes the authors developed a simulation-debate exercise designed to target…

  14. Infographics And Public Policy: Using Data Visualization To Convey Complex Information.

    PubMed

    Otten, Jennifer J; Cheng, Karen; Drewnowski, Adam

    2015-11-01

    Data visualization combines principles from psychology, usability, graphic design, and statistics to highlight important data in accessible and appealing formats. Doing so helps bridge knowledge producers with knowledge users, who are often inundated with information and increasingly pressed for time. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Democracy and Education in a Multicultural Scandinavia: What Mandate Is Designated to Educators?

    ERIC Educational Resources Information Center

    Biseth, Heidi

    2009-01-01

    This paper investigates how education legislation in Denmark, Norway and Sweden define democracy, especially in relation to a complex society with diverse linguistic, religious and cultural practices. What tasks are assigned to educators through education policy documents pertaining to democratic values? The analysis points out that the designated…

  16. The Role of the New mTOR Complex, mTORC2, in Autism Spectrum Disorders

    DTIC Science & Technology

    2016-10-01

    memory in Pten fb-KO mice. a, Schematic of experimental design . b, For contextual fear conditioning, freezing times were recorded 24 hr after...official Department of the Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No...fb-DKO mice, the opposite is true , namely mTORC2 activity remains up-regulated by mTORC1 activity is normalized (Fig. 1). Hence, conditional

  17. Economic and Political Innovation for Nutritional Improvement.

    PubMed

    von Braun, Joachim

    2018-01-01

    Large shares of the world population are still affected by nutrition deficiencies and undernutrition. However, the current global agriculture and food system and its international governance shows signs of serious malfunctioning, and is not equipped to cope with the current and future challenges it is facing. In view of the complex and multi-dimensional nature of nutrition problems, a framework is put forward here to improve the understanding of underlying causalities, and to identify priorities for action. In doing so, this paper focuses on economic and policy innovation. Better nutrition policy requires systematic, multi-faceted policy innovations, that is, the re-design of the current global food and nutrition governance system, and the adoption of innovative economic and political approaches. To achieve efficient and effective nutrition policy, more attention, leadership, funds, and a global organizational home for better coordination are needed. A systematic science and policy interface in the form of an International Panel on Food, Nutrition and Agriculture is proposed to provide a strong evidence base for nutrition policies. © 2018 S. Karger AG, Basel.

  18. Developing a methodology to assess the impact of research grant funding: a mixed methods approach.

    PubMed

    Bloch, Carter; Sørensen, Mads P; Graversen, Ebbe K; Schneider, Jesper W; Schmidt, Evanthia Kalpazidou; Aagaard, Kaare; Mejlgaard, Niels

    2014-04-01

    This paper discusses the development of a mixed methods approach to analyse research funding. Research policy has taken on an increasingly prominent role in the broader political scene, where research is seen as a critical factor in maintaining and improving growth, welfare and international competitiveness. This has motivated growing emphasis on the impacts of science funding, and how funding can best be designed to promote socio-economic progress. Meeting these demands for impact assessment involves a number of complex issues that are difficult to fully address in a single study or in the design of a single methodology. However, they point to some general principles that can be explored in methodological design. We draw on a recent evaluation of the impacts of research grant funding, discussing both key issues in developing a methodology for the analysis and subsequent results. The case of research grant funding, involving a complex mix of direct and intermediate effects that contribute to the overall impact of funding on research performance, illustrates the value of a mixed methods approach to provide a more robust and complete analysis of policy impacts. Reflections on the strengths and weaknesses of the methodology are used to examine refinements for future work. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Disease registries on the nationwide health information network.

    PubMed

    Russler, Daniel

    2011-05-01

    Donation by individuals of their protected health information (PHI) for evidence-based research potentially benefits all individuals with disease through improved understandings of disease patterns. In the future, a better understanding of how disease features combine into unique patterns of disease will generate new disease classifications, supporting greater specificity in health management techniques. However, without large numbers of people who donate their PHI to disease registries designed for research, it is difficult for researchers to discover the existence of complex patterns or to create more specific evidence-based management techniques. In order to identify new opportunities in disease registry design, an analysis of the current stage of maturity of the newly created U.S. Nationwide Health Information Network (NwHIN) related to large-scale consumer donation of PHI is presented. Utilizing a use-case analysis methodology, the consumer-centric designs of the policies and technologies created for the NwHIN were examined for the potential to support consumer donations of PHI to research. The NwHIN design has placed the enforcement point for the policy-based release of PHI over the Internet into a specialized gateway accessible to consumer authorization. However, current NwHIN policies leave the final decision regarding release of PHI for research to the health care providers rather than to the consumers themselves. Should disease registries designed for research be established on the NwHIN, consumers might then directly authorize the donation of their PHI to these disease registries. However, under current NwHIN policies, consumer authorization does not guarantee release of PHI by health providers. © 2011 Diabetes Technology Society.

  20. Active Learning to Understand Infectious Disease Models and Improve Policy Making

    PubMed Central

    Vladislavleva, Ekaterina; Broeckhove, Jan; Beutels, Philippe; Hens, Niel

    2014-01-01

    Modeling plays a major role in policy making, especially for infectious disease interventions but such models can be complex and computationally intensive. A more systematic exploration is needed to gain a thorough systems understanding. We present an active learning approach based on machine learning techniques as iterative surrogate modeling and model-guided experimentation to systematically analyze both common and edge manifestations of complex model runs. Symbolic regression is used for nonlinear response surface modeling with automatic feature selection. First, we illustrate our approach using an individual-based model for influenza vaccination. After optimizing the parameter space, we observe an inverse relationship between vaccination coverage and cumulative attack rate reinforced by herd immunity. Second, we demonstrate the use of surrogate modeling techniques on input-response data from a deterministic dynamic model, which was designed to explore the cost-effectiveness of varicella-zoster virus vaccination. We use symbolic regression to handle high dimensionality and correlated inputs and to identify the most influential variables. Provided insight is used to focus research, reduce dimensionality and decrease decision uncertainty. We conclude that active learning is needed to fully understand complex systems behavior. Surrogate models can be readily explored at no computational expense, and can also be used as emulator to improve rapid policy making in various settings. PMID:24743387

  1. Active learning to understand infectious disease models and improve policy making.

    PubMed

    Willem, Lander; Stijven, Sean; Vladislavleva, Ekaterina; Broeckhove, Jan; Beutels, Philippe; Hens, Niel

    2014-04-01

    Modeling plays a major role in policy making, especially for infectious disease interventions but such models can be complex and computationally intensive. A more systematic exploration is needed to gain a thorough systems understanding. We present an active learning approach based on machine learning techniques as iterative surrogate modeling and model-guided experimentation to systematically analyze both common and edge manifestations of complex model runs. Symbolic regression is used for nonlinear response surface modeling with automatic feature selection. First, we illustrate our approach using an individual-based model for influenza vaccination. After optimizing the parameter space, we observe an inverse relationship between vaccination coverage and cumulative attack rate reinforced by herd immunity. Second, we demonstrate the use of surrogate modeling techniques on input-response data from a deterministic dynamic model, which was designed to explore the cost-effectiveness of varicella-zoster virus vaccination. We use symbolic regression to handle high dimensionality and correlated inputs and to identify the most influential variables. Provided insight is used to focus research, reduce dimensionality and decrease decision uncertainty. We conclude that active learning is needed to fully understand complex systems behavior. Surrogate models can be readily explored at no computational expense, and can also be used as emulator to improve rapid policy making in various settings.

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

    PubMed Central

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

    2013-01-01

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

  3. ‘Low-hanging fruit’: Counting and accounting for children in PEPFAR-funded HIV/AIDS programmes in South Africa

    PubMed Central

    Reynolds, Lindsey J.

    2014-01-01

    The article traces the social life of a policy that aimed to define and circumscribe the ambiguous and contested category of the ‘orphaned and vulnerable children’ (OVC) in South Africa at the height of the ‘emergency response’ to HIV/AIDS. Drawing on several months of institutional ethnographic research conducted over the course of five years with South African organisations receiving funding from the US President’s Emergency Plan for AIDS Relief to provide services to ‘OVC’, the project interrogates the influence of governmental forms of counting and accounting on health policy and practice in South Africa. Focusing on the experiences of one organisation, the article describes a process of policy ‘translation’ typified by a series of disconnects between the intentions of a policy and the exigencies of implementation, structured by the ambiguous and flexible nature of the category of the ‘orphaned and vulnerable child’. In this context, the article argues, the uncertainty produced by the implementation of the guidelines was not simply an artifact of a poorly designed policy, but rather signals an underlying epistemological tension in the practice of ‘global health’, in which quantitative metrics designed for monitoring and evaluation are often incapable of approximating the complexities of everyday life. PMID:24498970

  4. Historical account of the national health insurance formulation in Kenya: experiences from the past decade.

    PubMed

    Abuya, Timothy; Maina, Thomas; Chuma, Jane

    2015-02-12

    Many Low-and-Middle-Income countries are considering reviewing their health financing systems to meet the principles of Universal Health Coverage (UHC). One financing mechanism, which has dominated UHC reforms, is the development of health insurance schemes. We trace the historical development of the National Health Insurance (NHI) policy, illuminate stakeholders' perceptions on the design to inform future development of health financing policies in Kenya. We conducted a retrospective policy analysis of the development of a NHI policy in Kenya using data from document reviews and seven in depth interviews with key stakeholders involved in the NHI design. Analysis was conducted using a thematic framework. The design of a NHI scheme was marked by complex interaction of the actor's understanding of the design, proposed implementation strategies and the covert opposition of the reform due to several reasons. First, actor's perception of the cost of the NHI design and its implication to the economy generated opposition. This was due to inadequate communication strategies to articulate the policy, leading to a vacuum of factual information flow to various players. Secondly, perceived fear of implications of the changes among private sector players threatened support and success gained. Thirdly, underlying mistrust associated with perceived lack of government's commitment towards transparency and good governance affected active engagement of all key players dampening the spirit of collective bargain breeding opposition. Finally, some international actors perceived a clash of their role and that of international programs based on vertical approaches that were inherent in the health system. The thrust towards UHC using NHI schemes should not only focus on the design of a viable NHI package but should also involve stakeholder engagements, devise ways of improving the health care system, enhance transparency and develop adequate governance structures to institutions mandated to provide leadership in the reform process to overcome covert opposition.

  5. Equity for Students with High-Incidence Disabilities in Statewide Assessments: A Technology-Based Solution

    ERIC Educational Resources Information Center

    Meyen, Ed; Poggio, John; Seok, Soonhwa; Smith, Sean

    2006-01-01

    One of the most significant challenges facing policy makers in education today is to ensure that state assessments designed to measure student performance across specified grade-level curriculum content standards will allow all students to demonstrate what they have learned. This challenge is made complex by the varied attributes of students with…

  6. Visual Signaling in a High-Search Virtual World-Based Assessment: A SAVE Science Design Study

    ERIC Educational Resources Information Center

    Nelson, Brian C.; Kim, Younsu; Slack, Kent

    2016-01-01

    Education policy in the United States centers K-12 assessment efforts primarily on standardized tests. However, such tests may not provide an accurate and reliable representation of what students understand about the complexity of science. Research indicates that students tend to pass science tests, even if they do not understand the concepts…

  7. Citizens' Jury and Elder Care: Public Participation and Deliberation in Long-Term Care Policy in Thailand.

    PubMed

    Chuengsatiansup, Komatra; Tengrang, Kanisorn; Posayanonda, Tipicha; Sihapark, Siranee

    2018-02-16

    Health care policies for the elderly are complex, multidimensional, and contextually circumscribed. While engagement of health experts, economists, health care administrators, and political leaders is generally viewed as instrumental to the success and sustainability of eldercare programs, the elders themselves are often viewed as passive recipients of care and not included in the policy processes. Experiences and expectations from users' perspectives can be invaluable information for policy formulation and systems design. This paper examines a participatory policy process using a "citizens' jury" to promote public engagement in eldercare policy. The process was initiated by the National Health Commission Office in Thailand to explore how a citizens' jury as a model for civic deliberation can be utilized to provide sophisticated policy recommendations on long-term care policies for the elderly. The objectives of this paper are to (1) examine how public participation in health policy can be actualized through the citizens' jury as an operational model, (2) understand the strengths and weaknesses of the ways the idea was implemented, and (3) provide recommendations for further use of the model. Details of how a citizens' jury was deployed are discussed, with recommendations for further use provided at the end.

  8. Unravelling the concept of consumer preference: implications for health policy and optimal planning in primary care.

    PubMed

    Foster, Michele M; Earl, Peter E; Haines, Terry P; Mitchell, Geoffrey K

    2010-10-01

    Accounting for consumer preference in health policy and delivery system design makes good economic sense since this is linked to outcomes, quality of care and cost control. Probability trade-off methods are commonly used in policy evaluation, marketing and economics. Increasingly applied to health matters, the trade-off preference model has indicated that consumers of health care discriminate between different attributes of care. However, the complexities of the health decision-making environment raise questions about the inherent assumptions concerning choice and decision-making behavior which frame this view of consumer preference. In this article, we use the example of primary care in Australia as a vehicle to examine the concept of 'consumer preference' from different perspectives within economics and discuss the significance of how we model preferences for health policy makers. In doing so, we question whether mainstream thinking, namely that consumers are capable of deliberating between rival strategies and are willing to make trade-offs, is a reliable way of thinking about preferences given the complexities of the health decision-making environment. Alternative perspectives on preference can assist health policy makers and health providers by generating more precise information about the important attributes of care that are likely to enhance consumer engagement and optimise acceptability of health care. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Learning Relational Policies from Electronic Health Record Access Logs

    PubMed Central

    Malin, Bradley; Nyemba, Steve; Paulett, John

    2011-01-01

    Modern healthcare organizations (HCOs) are composed of complex dynamic teams to ensure clinical operations are executed in a quick and competent manner. At the same time, the fluid nature of such environments hinders administrators' efforts to define access control policies that appropriately balance patient privacy and healthcare functions. Manual efforts to define these policies are labor-intensive and error-prone, often resulting in systems that endow certain care providers with overly broad access to patients' medical records while restricting other providers from legitimate and timely use. In this work, we propose an alternative method to generate these policies by automatically mining usage patterns from electronic health record (EHR) systems. EHR systems are increasingly being integrated into clinical environments and our approach is designed to be generalizable across HCOs, thus assisting in the design and evaluation of local access control policies. Our technique, which is grounded in data mining and social network analysis theory, extracts a statistical model of the organization from the access logs of its EHRs. In doing so, our approach enables the review of predefined policies, as well as the discovery of unknown behaviors. We evaluate our approach with five months of access logs from the Vanderbilt University Medical Center and confirm the existence of stable social structures and intuitive business operations. Additionally, we demonstrate that there is significant turnover in the interactions between users in the HCO and that policies learned at the department level afford greater stability over time. PMID:21277996

  10. Low-Cost Approach to the Design and Fabrication of a LOX/RP-1 Injector

    NASA Technical Reports Server (NTRS)

    Shadoan, Michael D.; Sparks, Dave L.; Turner, James E. (Technical Monitor)

    2000-01-01

    NASA Marshall Space Flight Center (MSFC) has designed, built, and is currently testing Fastrac, a liquid oxygen (LOX)/RP-1 fueled 60K-lb thrust class rocket engine. One facet of Fastrac, which makes it unique is that it is the first large-scale engine designed and developed in accordance with the Agency's mandated "faster, better, cheaper" (FBC) program policy. The engine was developed under the auspices of MSFC's Low Cost Boost Technology office. Development work for the main injector actually began in 1993 in subscale form. In 1996, work began on the full-scale unit approximately 1 year prior to initiation of the engine development program. In order to achieve the value goals established by the FBC policy, a review of traditional design practices was necessary. This internal reevaluation would ultimately challenge more conventional methods of material selection. design process, and fabrication techniques. The effort was highly successful. This "new way" of thinking has resulted in an innovative injector design, one with reduced complexity and significantly lower cost. Application of lessons learned during this effort to new or existing designs can have a similar effect on costs and future program successes.

  11. Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.

    PubMed

    Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

    2014-01-01

    To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. Research methodology - Evaluation using theory-based realist methods for policy implementation. An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. © 2013 John Wiley & Sons Ltd.

  12. Program logic: a framework for health program design and evaluation - the Pap nurse in general practice program.

    PubMed

    Hallinan, Christine M

    2010-01-01

    In this paper, program logic will be used to 'map out' the planning, development and evaluation of the general practice Pap nurse program in the Australian general practice arena. The incorporation of program logic into the evaluative process supports a greater appreciation of the theoretical assumptions and external influences that underpin general practice Pap nurse activity. The creation of a program logic model is a conscious strategy that results an explicit understanding of the challenges ahead, the resources available and time frames for outcomes. Program logic also enables a recognition that all players in the general practice arena need to be acknowledged by policy makers, bureaucrats and program designers when addressing through policy, issues relating to equity and accessibility of health initiatives. Logic modelling allows decision makers to consider the complexities of causal associations when developing health care proposals and programs. It enables the Pap nurse in general practice program to be represented diagrammatically by linking outcomes (short, medium and long term) with both the program activities and program assumptions. The research methodology used in the evaluation of the Pap nurse in general practice program includes a descriptive study design and the incorporation of program logic, with a retrospective analysis of Australian data from 2001 to 2009. For the purposes of gaining both empirical and contextual data for this paper, a data set analysis and literature review was performed. The application of program logic as an evaluative tool for analysis of the Pap PN incentive program facilitates a greater understanding of complex general practice activity triggers, and also allows this greater understanding to be incorporated into policy to facilitate Pap PN activity, increase general practice cervical smear and ultimately decrease burden of disease.

  13. The Evolving Role of the Courts in Educational Policy: The Tension between Judicial, Scientific, and Democratic Decision Making in "Kitzmiller v. Dover"

    ERIC Educational Resources Information Center

    Superfine, Benjamin Michael

    2009-01-01

    In "Kitzmiller v. Dover" (2005), a court defined science to decide the legitimacy of teaching intelligent design to high school biology students. This study analyzes "Kitzmiller" in light of the complex and interrelated tensions between judicial, scientific, and democratic decision making that lie at the heart of modern…

  14. Designing Cyber Exercises

    DTIC Science & Technology

    2014-10-01

    maneuver • Traditional “ Brick and Mortar ” training models – Difficult to train regularly due to logistics/budget restrictions – Doesn’t scale...complexity, scenario, location , and resources available • Scalable 4-cell planning construct – Exercise Control (White Cell) – Threat Emulation (Red...business impact) • Collaborative effort  Trusted Agents ( SMEs ) – Threats – Cyber defense capabilities – Policies and procedures – Project and/or

  15. Capturing Complexity: Integrating Health and Education Research to Inform Health-Promoting Schools Policy and Practice

    ERIC Educational Resources Information Center

    Rowling, Louise; Jeffreys, Vicki

    2006-01-01

    Despite the intersectoral nature of health promotion practice many programs limit their evidence base to health sector research and do not draw on evidence from other sectors' research in program design. To help ensure programs are relevant and acceptable to intersectoral partners and intended outcomes are of value to all sectors involved,…

  16. The Role of Search in University Productivity: Inside, outside, and Interdisciplinary Dimensions. NEBR Working Paper No. 15489

    ERIC Educational Resources Information Center

    Adams, James D.; Clemmons, J. Roger

    2009-01-01

    Due to improving information technology, the growing complexity of research problems, and policies designed to foster interdisciplinary research, the practice of science in the United States has undergone significant structural change. Using a sample of 110 top U.S. universities observed during the late 20th century we find that knowledge flows,…

  17. Production of graphic symbol sentences by individuals with aphasia: efficacy of a computer-based augmentative and alternative communication intervention.

    PubMed

    Koul, Rajinder; Corwin, Melinda; Hayes, Summer

    2005-01-01

    The study employed a single-subject multiple baseline design to examine the ability of 9 individuals with severe Broca's aphasia or global aphasia to produce graphic symbol sentences of varying syntactical complexity using a software program that turns a computer into a speech output communication device. The sentences ranged in complexity from simple two-word phrases to those with morphological inflections, transformations, and relative clauses. Overall, results indicated that individuals with aphasia are able to access, manipulate, and combine graphic symbols to produce phrases and sentences of varying degrees of syntactical complexity. The findings are discussed in terms of the clinical and public policy implications.

  18. [Public policy, structures of the State and the advocacy of the right to health protection].

    PubMed

    Ruelas-Barajas, Enrique; Gay-Molina, Juan Gabriel

    2008-01-01

    Not always public policies for the advocacy of citizen rights meet their goal, among other things, because between their formulation and their implementation there is a lack of appropriate structures to generate, articulate and execute these policies. This has been the case of Mexico regarding the advocacy of the rights of non smokers. Very few has been achieved in this matter in the past. This article lists some of the potential causes of the lack of implementation of public policies. At the same time, explores the highly dynamic nature of the health care system at the present and towards the future. The magnitude of the challenges faced by the health care system requires concerted actions of many actors, not only from the very health care system but also from outside. Thus, public policies have to be considered not just at the governmental level but at the state level. Therefore, the main argument of this paper is that given the need to respond to complex challenges to protect the health of the population and their rights in a very complex context, there is a need to formulate and implement state policies that require the intervention of the appropriate state structures to make sure that the design and execution leads to the expected achievements. One such structure at the state level, among others, is the General Health Council, an organization established in 1841, that was incorporated within the Mexican Constitution in 1917, depending directly from the President of Mexico as Head of State. This Council has been reinforced to improve its assigned role to better participate, along other state structures, in the formulation and implementation of public policies such as those for the advocacy of citizen rights.

  19. Ancillary health effects of climate mitigation scenarios as drivers of policy uptake: a review of air quality, transportation and diet co-benefits modeling studies

    NASA Astrophysics Data System (ADS)

    Chang, Kelly M.; Hess, Jeremy J.; Balbus, John M.; Buonocore, Jonathan J.; Cleveland, David A.; Grabow, Maggie L.; Neff, Roni; Saari, Rebecca K.; Tessum, Christopher W.; Wilkinson, Paul; Woodward, Alistair; Ebi, Kristie L.

    2017-11-01

    Background: Significant mitigation efforts beyond the Nationally Determined Commitments (NDCs) coming out of the 2015 Paris Climate Agreement are required to avoid warming of 2 °C above pre-industrial temperatures. Health co-benefits represent selected near term, positive consequences of climate policies that can offset mitigation costs in the short term before the beneficial impacts of those policies on the magnitude of climate change are evident. The diversity of approaches to modeling mitigation options and their health effects inhibits meta-analyses and syntheses of results useful in policy-making. Methods/Design: We evaluated the range of methods and choices in modeling health co-benefits of climate mitigation to identify opportunities for increased consistency and collaboration that could better inform policy-making. We reviewed studies quantifying the health co-benefits of climate change mitigation related to air quality, transportation, and diet published since the 2009 Lancet Commission ‘Managing the health effects of climate change’ through January 2017. We documented approaches, methods, scenarios, health-related exposures, and health outcomes. Results/Synthesis: Forty-two studies met the inclusion criteria. Air quality, transportation, and diet scenarios ranged from specific policy proposals to hypothetical scenarios, and from global recommendations to stakeholder-informed local guidance. Geographic and temporal scope as well as validity of scenarios determined policy relevance. More recent studies tended to use more sophisticated methods to address complexity in the relevant policy system. Discussion: Most studies indicated significant, nearer term, local ancillary health benefits providing impetus for policy uptake and net cost savings. However, studies were more suited to describing the interaction of climate policy and health and the magnitude of potential outcomes than to providing specific accurate estimates of health co-benefits. Modeling the health co-benefits of climate policy provides policy-relevant information when the scenarios are reasonable, relevant, and thorough, and the model adequately addresses complexity. Greater consistency in selected modeling choices across the health co-benefits of climate mitigation research would facilitate evaluation of mitigation options particularly as they apply to the NDCs and promote policy uptake.

  20. Farmer Participation in U.S. Farm Bill Conservation Programs

    NASA Astrophysics Data System (ADS)

    Reimer, Adam P.; Prokopy, Linda S.

    2014-02-01

    Conservation policy in agricultural systems in the United States relies primarily on voluntary action by farmers. Federal conservation programs, including the Environmental Quality Incentives Program, offer incentives, both financial and technical, to farmers in exchange for adoption of conservation practices. Understanding motivations for (as well as barriers to) participation in voluntary programs is important for the design of future policy and effective outreach. While a significant literature has explored motivations and barriers to conservation practice adoption and participation in single programs, few studies in the U.S. context have explored general participation by farmers in one place and time. A mixed-methods research approach was utilized to explore farmer participation in all U.S. Farm Bill programs in Indiana. Current and past program engagement was high, with nearly half of survey respondents reporting participation in at least one program. Most participants had experience with the Conservation Reserve Program, with much lower participation rates in other programs. Most interview participants who had experience in programs were motivated by the environmental benefits of practices, with incentives primarily serving to reduce the financial and technical barriers to practice adoption. The current policy arrangement, which offers multiple policy approaches to conservation, offers farmers with different needs and motivations a menu of options. However, evidence suggests that the complexity of the system may be a barrier that prevents participation by farmers with scarce time or resources. Outreach efforts should focus on increasing awareness of program options, while future policy must balance flexibility of programs with complexity.

  1. Nukes in the Post-Cold War Era A View of the World from Inside the US Nuclear Weapons Program

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

    Wood, Blake Philip

    Why do we have nuclear weapons? What is in the US stockpile, how is it deployed and controlled, and how it has changed over the years? What is in the “nuclear weapons complex” and what does each lab and plant do? How do the DOE/NNSA Design Labs interact with the Intelligence Community? How does the US stockpile, NW complex, and NW policy compare with those of other countries? What is easy and hard about designing nuclear weapons?

  2. Changing the individual to promote health-enhancing physical activity: the difficulties of producing evidence and translating it into practice.

    PubMed

    Blamey, Avril; Mutrie, Nanette

    2004-08-01

    This paper presents conclusions from recent systematic reviews and highlights individually targeted interventions that are effective at increasing physical activity. It discusses the limitations of currently available evidence, considers what factors lead to these limitations and what barriers exist in terms of implementing the evidence as part of local and national policy and practice. Barriers present themselves in terms of getting evidence into practice and in terms of ensuring that practice informs the evidence base. These barriers include difficulties in conducting systematic reviews, disaggregating knowledge from complex interventions, making local adaptations to existing evidence, the lack of an evaluation culture, ethical and pragmatic difficulties in designing interventions, selecting appropriate outcome measures, poor designs and implementation of evidence and, finally, a recognition that policy making is not only based on the available evidence. New and more integrated approaches to evaluation and to practice are needed.

  3. Security Policy and Infrastructure in the Context of a Multi-Centeric Information System Dedicated to Autism Spectrum Disorder.

    PubMed

    Ben Said, Mohamed; Robel, Laurence; Golse, Bernard; Jais, Jean Philippe

    2017-01-01

    Autism spectrum disorders (ASD) are complex neuro-developmental disorders affecting children in their early age. The diagnosis of ASD relies on multidisciplinary investigations, in psychiatry, neurology, genetics, electrophysiology, neuro-imagery, audiology and ophthalmology. In order to support clinicians, researchers and public health decision makers, we designed an information system dedicated to ASD, called TEDIS. TEDIS was designed to manage systematic, exhaustive and continuous multi-centric patient data collection via secured Internet connections. In this paper, we present the security policy and security infrastructure we developed to protect ASD' patients' clinical data and patients' privacy. We tested our system on 359 ASD patient records in a local secured intranet environment and showed that the security system is functional, with a consistent, transparent and safe encrypting-decrypting behavior. It is ready for deployment in the nine ASD expert assessment centers in the Ile de France district.

  4. Tools and techniques for developing policies for complex and uncertain systems.

    PubMed

    Bankes, Steven C

    2002-05-14

    Agent-based models (ABM) are examples of complex adaptive systems, which can be characterized as those systems for which no model less complex than the system itself can accurately predict in detail how the system will behave at future times. Consequently, the standard tools of policy analysis, based as they are on devising policies that perform well on some best estimate model of the system, cannot be reliably used for ABM. This paper argues that policy analysis by using ABM requires an alternative approach to decision theory. The general characteristics of such an approach are described, and examples are provided of its application to policy analysis.

  5. Calorie postings in chain restaurants in a low-income urban neighborhood: measuring practical utility and policy compliance.

    PubMed

    Cohn, Elizabeth Gross; Larson, Elaine L; Araujo, Christina; Sawyer, Vanessa; Williams, Olajide

    2012-08-01

    Current strategies for combating obesity include recent federal legislation mandating calorie count postings in chain restaurants. This study describes the current practice of menu board calorie postings in a low-income urban neighborhood, identifies the extent to which current practice complies with existing policy, and evaluates the practical utility of menu boards to consumers. We conclude that although most postings were legally compliant, they did not demonstrate utility. Menu postings for individual servings are easily understood, but complex math skills are needed to interpret meals designed to serve more than one person. In some items, calories doubled depending on flavor and the calorie posting did not give enough information to make healthier selections. We identified specific strategies to improve practical utility and provide recommendations for policy implementation.

  6. Is Tolerance of Faiths Helpful in English School Policy? Reification, Complexity, and Values Education

    ERIC Educational Resources Information Center

    Bowie, Robert

    2017-01-01

    Government policies for teachers and schools in England promote values including tolerance of faiths and beliefs alongside law keeping, democracy, and respect. Tolerance of faiths has been highlighted as a key value but complexities around tolerance make interpretations and applications of the policy difficult. Policy documents in this area are…

  7. Large Spatial and Temporal Separations of Cause and Effect in Policy Making - Dealing with Non-linear Effects

    NASA Astrophysics Data System (ADS)

    McCaskill, John

    There can be large spatial and temporal separation of cause and effect in policy making. Determining the correct linkage between policy inputs and outcomes can be highly impractical in the complex environments faced by policy makers. In attempting to see and plan for the probable outcomes, standard linear models often overlook, ignore, or are unable to predict catastrophic events that only seem improbable due to the issue of multiple feedback loops. There are several issues with the makeup and behaviors of complex systems that explain the difficulty many mathematical models (factor analysis/structural equation modeling) have in dealing with non-linear effects in complex systems. This chapter highlights those problem issues and offers insights to the usefulness of ABM in dealing with non-linear effects in complex policy making environments.

  8. [Hospital self-management policy in Chile: perceptions of decision-makers].

    PubMed

    Méndez, Claudio A; Miranda, Christian; Torres, M Cristina; Márquez, Myriam

    2013-01-01

    To learn the perceptions of decision-makers concerning the imple-men-t-ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia and the Hospital San José de Osorno from August 2010 to December 2011. A convenience sample of 26 decision-makers was selected. The 26 interviews were recorded and transcribed verbatim. The information was analyzed using inductive content analysis. The interviewees consider the concept of self-management to be determined by autonomy in decision-making about resource allocation and the financing of health service delivery in the hospitals. They also stated that human resources and financing policies should be included to improve the implementation stage. They related weaknesses with the lack of organizational capabilities and managerial skills in the health teams implementing the changes. Conceptually, the hospital self-management policy is based on financial autonomy, and implementation is affected by persistent capacity gaps in policy design.

  9. Exploration of agent of change’s role in biodiesel energy transition process using agent-based model

    NASA Astrophysics Data System (ADS)

    Hidayatno, A.; Vicky, L. R.; Destyanto, A. R.

    2017-11-01

    As the world’s largest Crude Palm Oil (CPO) producer, Indonesia uses CPO as raw material for biodiesel. A number of policies have been designed by the Indonesian government to support adoption of biodiesel. However, the role of energy alternatives faced complex problems. Agent-based modeling can be applied to predict the impact of policies on the actors in the business process to acquire a rich discernment of the behavior and decision making by the biodiesel industries. This study evaluates government policy by attending at the adoption of the biodiesel industry in the tender run by a government with the intervention of two policy options biodiesel energy utilization by developing an agent-based model. The simulation result show that the policy of adding the biodiesel plant installed capacity has a good impact in increasing the production capacity and vendor adoption in the tender. Even so, the government should consider the cost to be incurred and the profits for vendors, so the biodiesel production targets can be successfully fulfilled.

  10. Categorizing the telehealth policy response of countries and their implications for complementarity of telehealth policy.

    PubMed

    Varghese, Sunil; Scott, Richard E

    2004-01-01

    Developing countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services. However, this process faces disparities, and no complementarity in telehealth policy development. Telehealth has the potential to transcend geopolitical boundaries, yet telehealth policy developed in one jurisdiction may hamper applications in another. Understanding such policy complexities is essential for telehealth to realize its full global potential. This study investigated 12 East Asian countries that may represent a microcosm of the world, to determine if the telehealth policy response of countries could be categorized, and whether any implications could be identified for the development of complementary telehealth policy. The countries were Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Three categories of country response were identified in regard to national policy support and development. The first category was "None" (Cambodia, Myanmar, and Vietnam) where international partners, driven by humanitarian concerns, lead telehealth activity. The second category was "Proactive" (China, Indonesia, Malaysia, Singapore, South Korea, Taiwan, and Thailand) where national policies were designed with the view that telehealth initiatives are a component of larger development objectives. The third was "Reactive" (Hong Kong and Japan), where policies were only proffered after telehealth activities were sustainable. It is concluded that although complementarity of telehealth policy development is not occurring, increased interjurisdictional telehealth activity, regional clusters, and concerted and coordinated effort amongst researchers, practitioners, and policy makers may alter this trend.

  11. "All who nurse for hire": nursing and the mixed legacy of legislative victories.

    PubMed

    Whelan, Jean C

    2013-01-01

    Sustained support of policy initiatives by nursing has resulted in significant legislative victories. One victory, the passage of the 1938 New York State Todd-Feld Act, which underwent legislative debate at a time when the nurse labor market was in disarray, during an economic depression, and before U.S. entry into World War II, reinforces our understanding that nursing must be a strong shepherd for policies beneficial for health care delivery. Designed to correct serious deficiencies in the nursing workforce, the act successfully required licensing for those working as registered and practical nurses. Yet, its provisions failed to stop all unlicensed nurse workers from practicing. Rapid changes occurring in the nurse labor market against the backdrop of growing hospital power over the employment of all nurse workers minimized the act's effectiveness. Policy implications include the need to focus on the complex nature of health care policy initiatives, flexibility in the face of changing circumstances, and acceptance of political realities. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. “All Who Nurse for Hire”: Nursing and the Mixed Legacy of Legislative Victories

    PubMed Central

    Whelan, Jean C.

    2013-01-01

    Sustained support of policy initiatives by nursing have resulted in significant legislative victories. One victory, the passage of the 1938 New York State Todd-Fell Act which underwent legislative debate at a time when the nurse labor market was in disarray, during an economic depression, and prior to US entry into World War II, reinforces our understanding that nursing must be a strong shepherd for policies beneficial for health care delivery. Designed to correct serious deficiencies in the nursing workforce the Act successfully required licensing for those working as registered and practical nurses. Yet, its provisions failed to stop all unlicensed nurse workers from practicing. Rapid changes occurring in the nurse labor market against the backdrop of growing hospital power over the employment of all nurse workers minimized the Act’s effectiveness. Policy implications include the need to focus on the complex nature of health care policy initiatives, flexibility in the face of changing circumstances, and acceptance of political realities. PMID:24034469

  13. What Can Be Learned from Existing Investigations of Weight-Related Practices and Policies with the Potential to Impact Disparities in US Child-Care Settings? A Narrative Review and Call for Surveillance and Evaluation Efforts.

    PubMed

    Larson, Nicole; Ayers Looby, Anna; Frost, Natasha; Nanney, Marilyn S; Story, Mary

    2017-10-01

    Child-care settings and the combination of policies and regulations under which they operate may reduce or perpetuate disparities in weight-related health, depending on the environmental supports they provide for healthy eating and activity. The objectives of this review are to summarize research on state and local policies germane to weight-related health equity among young children in the United States and on how federal policies and regulations may provide supports for child-care providers serving families with the most limited resources. In addition, a third objective is to comprehensively review studies of whether there are differences in practices and policies within US child-care facilities according to the location or demographics of providers and children. The review found there is growing evidence addressing disparities in the social and physical child-care environments provided for young children, but scientific gaps are present in the current understanding of how resources should best be allocated and policies designed to promote health equity. Additional research is needed to address limitations of prior studies relating to the measurement of supports for weight-related health; complexities of categorizing socioeconomic position, ethnicity/race, and urban and rural areas; exclusion of legally nonlicensed care settings from most research; and the cross-sectional nature of most study designs. There is a particularly great need for the development of strong surveillance systems to allow for better monitoring and evaluation of state policies that may impact weight-related aspects of child-care environments, implementation at the program level, and needed implementation supports. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  14. NGOs and gender policy: some issues from the south Indian silk-reeling industry.

    PubMed

    Mayoux, L

    1993-10-01

    In India, silk reeling, the middle stage in silk production, is potentially very profitable, and the silk industry has been required to adopt gender-aware policies such as appointing female staff and introducing gender sensitization training. To date, policies designed to encourage women's entrepreneurship in the reeling industry have been unsuccessful. Men have appropriated credit issued in women's names, and no women's cooperatives are currently in operation. The policies designed to encourage female entrepreneurship in reeling woefully overlooked the complexity of this work which involves a substantial investment of capital and significant risk. Women and girls continue to work as unpaid family workers and wage laborers without the benefits of governmental policies to protect their interests. In fact, attempts to introduce labor legislation to protect women have been blocked on the national level by the powerful Reelers' Association. Policies which address gender issues in the family and in the wider context of the silk industry are also lacking, and there is a wide variation in how women are able or unable to manipulate their positions to their advantage. Women's inabilities are the root cause of their inability to become entrepreneurs and improve their labor status. Nongovernmental organizations can enhance entrepreneurship and cooperative development by improving training in all aspects of running a business and in group formation. Women laborers must organize to improve wages and working conditions, and women must be able to increase their control over income and resources and their access to the outside world even as they decrease the time spent on unpaid reproductive labor.

  15. Reluctant Colossus: America Enters the Age of Imperialism. Public Policy Debate in the Classroom. Choices for the 21st Century Education Project. Student and Teacher's Resource Book.

    ERIC Educational Resources Information Center

    Bakker, Don

    This packet contains student materials and a teacher's guide. The materials are designed to make complex international issues understandable and meaningful for students. The unit probes the political, moral, and racial issues raised by the Spanish-American War and the acquisition of an overseas empire. Students compare the values and concerns at…

  16. National nutrition planning in developing countries via gaming-simulation.

    PubMed

    Duke, R D; Cary, R

    1977-01-01

    A nutrition game designed for the Food Policy and Nutrition Division of the Food and Agriculture Organization of the United Nations to aid in planning national nutrition education programs in Third World countries is described. The Simulated Nutrition System Game allows high-level ministerial staff in developing countries to discuss, via a common language created by SNUS I, the issues, problems, and complexities of national nutrition programs.

  17. How Much Confidence Can We Have in EU-SILC? Complex Sample Designs and the Standard Error of the Europe 2020 Poverty Indicators

    ERIC Educational Resources Information Center

    Goedeme, Tim

    2013-01-01

    If estimates are based on samples, they should be accompanied by appropriate standard errors and confidence intervals. This is true for scientific research in general, and is even more important if estimates are used to inform and evaluate policy measures such as those aimed at attaining the Europe 2020 poverty reduction target. In this article I…

  18. Addressing refugee health through evidence-based policies: a case study

    PubMed Central

    de Bocanegra, Heike Thiel; Carter-Pokras, Olivia; Ingleby, J. David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I.; Smith-Gagen, Julie; Hidalgo, Bertha

    2017-01-01

    The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the US and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. PMID:28554498

  19. Changing choices in health care: implications for equity, efficiency and cost.

    PubMed

    Bevan, Gwyn; Helderman, Jan-Kees; Wilsford, David

    2010-07-01

    Although choice may be seen as an end in itself, the papers included in this special issue of Health Economics, Policy and Law, examine choice policies in European systems of health care, which aim to be effective instruments for ameliorating the systemic pressures from the iron triangle of equity, efficiency, and cost. Three papers consider the nature of differences between and within countries following the Beveridge and Bismarck models of financing and organising the delivery of care, and how choices are changing within different systems. Within countries following the Beveridge model, current policies in England, Denmark and Sweden emphasise increasing patient choice of provider. Within countries following the Bismarck model, current policies in France and Germany seek to restrict choice of specialists by introducing 'soft' gatekeeping; and in the Netherlands there is a system of managed competition with choice of insurer that, in principle, allows insurers to contract selectively with providers. A fourth paper considers how government policies that seek to restrict choice within systems of universal coverage have been subject to challenges in the courts. A commentary explores the implications of the fraught and complex nature of choices between insurers and providers of health care for designing effective choice policies.

  20. Group Policy Reference Systems and Network Attack Center (SNAC)

    DTIC Science & Technology

    2001-03-02

    Policy Snap-in for a given Active Directory container . It is hoped that this map will alleviate some of the complexity in managing and understanding...help the reader locate specific policies within the Group Policy Snap-in for a given Active Directory container . It is hoped that this map will alleviate...Policy Snap-in for a given Active Directory container . It is hoped that this map will alleviate some of the complexity in managing and

  1. Evaluating deceased organ donation: a programme theory approach.

    PubMed

    Manzano, Ana; Pawson, Ray

    2014-01-01

    Organ donation and transplantation services represent a microcosm of modern healthcare organisations. They are complex adaptive systems. They face perpetual problems of matching supply and demand. They operate under fierce time and resource constraints. And yet they have received relatively little attention from a systems perspective. The purpose of this paper is to consider some of the fundamental issues in evaluating, improving and policy reform in such complex systems. The paper advocates an approach based on programme theory evaluation. The paper explains how the death to donation to transplantation process depends on the accumulation of series of embedded, institutional sub-processes. Evaluators need to be concerned with this whole system rather than with its discrete parts or sectors. Policy makers may expect disappointment if they seek to improve donation rates by applying nudges or administrative reforms at a single point in the implementation chain. These services represent concentrated, perfect storms of complexity and the paper offers guidance to practitioners with bio-medical backgrounds on how such services might be evaluated and improved. For the methodological audience the paper caters for the burgeoning interest in programme theory evaluation while illustrating the design phase of this research strategy.

  2. The path to impact of operational research on tuberculosis control policies and practices in Indonesia.

    PubMed

    Probandari, Ari; Widjanarko, Bagoes; Mahendradhata, Yodi; Sanjoto, Hary; Cerisha, Ancila; Nungky, Saverina; Riono, Pandu; Simon, Sumanto; Farid, Muhammad Noor; Giriputra, Sardikin; Putra, Artawan Eka; Burhan, Erlina; Wahyuni, Chatarina U; Mustikawati, Dyah; Widianingrum, Christina; Tiemersma, Edine W; Alisjahbana, Bachti

    2016-01-01

    Operational research is currently one of the pillars of the global strategy to control tuberculosis. Indonesia initiated capacity building for operational research on tuberculosis over the last decade. Although publication of the research in peer-reviewed journals is an important indicator for measuring the success of this endeavor, the influence of operational research on policy and practices is considered even more important. However, little is known about the process by which operational research influences tuberculosis control policy and practices. We aimed to investigate the influence of operational research on tuberculosis control policy and practice in Indonesia between 2004 and 2014. Using a qualitative study design, we conducted in-depth interviews of 50 researchers and 30 policy makers/program managers and performed document reviews. Transcripts of these interviews were evaluated while applying content analysis. Operational research contributed to tuberculosis control policy and practice improvements, including development of new policies, introduction of new practices, and reinforcement of current program policies and practices. However, most of these developments had limited sustainability. The path from the dissemination of research results and recommendations to policy and practice changes was long and complex. The skills, interests, and political power of researchers and policy makers, as well as health system response, could influence the process. Operational research contributed to improving tuberculosis control policy and practices. A systematic approach to improve the sustainability of the impact of operational research should be explored.

  3. Applications of system dynamics modelling to support health policy.

    PubMed

    Atkinson, Jo-An M; Wells, Robert; Page, Andrew; Dominello, Amanda; Haines, Mary; Wilson, Andrew

    2015-07-09

    The value of systems science modelling methods in the health sector is increasingly being recognised. Of particular promise is the potential of these methods to improve operational aspects of healthcare capacity and delivery, analyse policy options for health system reform and guide investments to address complex public health problems. Because it lends itself to a participatory approach, system dynamics modelling has been a particularly appealing method that aims to align stakeholder understanding of the underlying causes of a problem and achieve consensus for action. The aim of this review is to determine the effectiveness of system dynamics modelling for health policy, and explore the range and nature of its application. A systematic search was conducted to identify articles published up to April 2015 from the PubMed, Web of Knowledge, Embase, ScienceDirect and Google Scholar databases. The grey literature was also searched. Papers eligible for inclusion were those that described applications of system dynamics modelling to support health policy at any level of government. Six papers were identified, comprising eight case studies of the application of system dynamics modelling to support health policy. No analytic studies were found that examined the effectiveness of this type of modelling. Only three examples engaged multidisciplinary stakeholders in collective model building. Stakeholder participation in model building reportedly facilitated development of a common 'mental map' of the health problem, resulting in consensus about optimal policy strategy and garnering support for collaborative action. The paucity of relevant papers indicates that, although the volume of descriptive literature advocating the value of system dynamics modelling is considerable, its practical application to inform health policy making is yet to be routinely applied and rigorously evaluated. Advances in software are allowing the participatory model building approach to be extended to more sophisticated multimethod modelling that provides policy makers with more powerful tools to support the design of targeted, effective and equitable policy responses for complex health problems. Building capacity and investing in communication to promote these modelling methods, as well as documenting and evaluating their applications, will be vital to supporting uptake by policy makers.

  4. 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.

  5. Disclosure of Research Results in Genetic Studies of Parkinson Disease Due to LRRK2 Mutations

    PubMed Central

    Bressman, Susan; Raymond, Deborah; Glickman, Amanda; Tolosa, Eduardo

    2015-01-01

    With the advent of large genetic studies examining both symptomatic and asymptomatic individuals, whether and how to disclose genetic research results have become pressing questions. The need is particularly acute in the case of LRRK2 research: Movement centers worldwide are recruiting cohorts of individuals with PD and their family members, including asymptomatic carriers, clinical features and treatment are complex and evolving, and disclosure policies vary at different sites and have been modified during the course of some studies. Herein, we present the major ethical principles of autonomy, beneficence, non-maleficence, and honesty that should guide disclosure policies in studies of families with LRRK2 mutations. We make recommendations regarding: genetic counseling, policies of either active or passive disclosure, responsibilities of funders to budget for genetic counseling, clinical genetic testing where locally required for disclosure, and aspects of study design to avoid mandatory disclosure whenever feasible. PMID:25952684

  6. The pit and the pendulum: the impact on teen smokers of including a designated smoking area in school tobacco control policy.

    PubMed

    Baillie, L E; Lovato, C Y; Taylor, E; Rutherford, M B; Smith, M

    2008-12-01

    Thirty per cent of school districts in British Columbia do not ban smoking outright on school grounds, and in several instances, smoking is permitted in smoking pits, regardless of school district policy. While there is evidence to suggest that enforcing a tobacco-free environment for students does reduce adolescent smoking rates, the concomitant safety and discipline problems it creates for school staff and administration are demanding and complex, and may override concerns regarding student smoking. This study uses a qualitative approach to explore the meanings that students place on tobacco control policy and the impact that these meanings have on their own smoking behaviours. We found that students were surprised and concerned that smoking was permitted on school property and that it negatively impacted their own tobacco prevention/control/cessation attempts.

  7. The management of conflict in nutrition policy formulation: choosing growth-monitoring indicators in the context of dual burden.

    PubMed

    Hoey, Lesli; Pelletier, David L

    2011-06-01

    We argue in this paper that a shared desire to find a solution to malnutrition and agreement at a broad level concerning priority, evidence-based interventions are important but not sufficient conditions for effective policy development. This paper illustrates this point, and draws out general implications, through a detailed analysis of a case in which conflict emerged when committed nutrition policy actors began discussing the details of program design and implementation. The case involves one country's effort to select "the best" anthropometric indicator for use in its national child growth-monitoring program. In this case the interested parties approached this deceptively simple decision for different reasons, using different sources and standards of evidence and focusing their attention on opposite, but equally critical, operational considerations, while being heavily influenced by global, national, and interorganizational events and relationships. We suggest that actors seeking to translate political commitment for nutrition into effective action should recognize the technical and sociopolitical complexity of seemingly simple decisions related to intervention design and employ more systematic, intentional, and inclusive decision-making procedures. Without attention to such practical matters, the current window of opportunity to reduce malnutrition on a global scale may quickly close.

  8. Policy experimentation and innovation as a response to complexity in China's management of health reforms.

    PubMed

    Husain, Lewis

    2017-08-03

    There are increasing criticisms of dominant models for scaling up health systems in developing countries and a recognition that approaches are needed that better take into account the complexity of health interventions. Since Reform and Opening in the late 1970s, Chinese government has managed complex, rapid and intersecting reforms across many policy areas. As with reforms in other policy areas, reform of the health system has been through a process of trial and error. There is increasing understanding of the importance of policy experimentation and innovation in many of China's reforms; this article argues that these processes have been important in rebuilding China's health system. While China's current system still has many problems, progress is being made in developing a functioning system able to ensure broad population access. The article analyses Chinese thinking on policy experimentation and innovation and their use in management of complex reforms. It argues that China's management of reform allows space for policy tailoring and innovation by sub-national governments under a broad agreement over the ends of reform, and that shared understandings of policy innovation, alongside informational infrastructures for the systemic propagation and codification of useful practices, provide a framework for managing change in complex environments and under conditions of uncertainty in which 'what works' is not knowable in advance. The article situates China's use of experimentation and innovation in management of health system reform in relation to recent literature which applies complex systems thinking to global health, and concludes that there are lessons to be learnt from China's approaches to managing complexity in development of health systems for the benefit of the poor.

  9. 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.

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

    PubMed

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

    2013-03-07

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

  11. FY 95 engineering work plan for the design reconstitution implementation action plan

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

    Bigbee, J.D.

    Design reconstitution work is to be performed as part of an overall effort to upgrade Configuration Management (CM) at TWRS. WHC policy is to implement a program that is compliant with DOE-STD-1073-93, Guide for Operational Configuration Management Program. DOE-STD-1073 requires an adjunct program for reconstituting design information. WHC-SD-WM-CM-009, Design Reconstitution Program Plan for Waste Tank Farms and 242-A Evaporator of Tank Waste Remediation System, is the TWRS plan for meeting DOE-STD-1073 design reconstitution requirements. The design reconstitution plan is complex requiring significant time and effort for implementation. In order to control costs, and integrate the work into other TWRS activities,more » a Design Reconstitution Implementation Action Plan (DR IAP) will be developed, and approved by those organizations having ownership or functional interest in this activity.« less

  12. Topological Properties of Some Integrated Circuits for Very Large Scale Integration Chip Designs

    NASA Astrophysics Data System (ADS)

    Swanson, S.; Lanzerotti, M.; Vernizzi, G.; Kujawski, J.; Weatherwax, A.

    2015-03-01

    This talk presents topological properties of integrated circuits for Very Large Scale Integration chip designs. These circuits can be implemented in very large scale integrated circuits, such as those in high performance microprocessors. Prior work considered basic combinational logic functions and produced a mathematical framework based on algebraic topology for integrated circuits composed of logic gates. Prior work also produced an historically-equivalent interpretation of Mr. E. F. Rent's work for today's complex circuitry in modern high performance microprocessors, where a heuristic linear relationship was observed between the number of connections and number of logic gates. This talk will examine topological properties and connectivity of more complex functionally-equivalent integrated circuits. The views expressed in this article are those of the author and do not reflect the official policy or position of the United States Air Force, Department of Defense or the U.S. Government.

  13. Tailoring Enterprise Systems Engineering Policy for Project Scale and Complexity

    NASA Technical Reports Server (NTRS)

    Cox, Renee I.; Thomas, L. Dale

    2014-01-01

    Space systems are characterized by varying degrees of scale and complexity. Accordingly, cost-effective implementation of systems engineering also varies depending on scale and complexity. Recognizing that systems engineering and integration happen everywhere and at all levels of a given system and that the life cycle is an integrated process necessary to mature a design, the National Aeronautic and Space Administration's (NASA's) Marshall Space Flight Center (MSFC) has developed a suite of customized implementation approaches based on project scale and complexity. While it may be argued that a top-level system engineering process is common to and indeed desirable across an enterprise for all space systems, implementation of that top-level process and the associated products developed as a result differ from system to system. The implementation approaches used for developing a scientific instrument necessarily differ from those used for a space station. .

  14. Complex governance structures and incoherent policies: Implementing the EU water framework directive in Sweden.

    PubMed

    Söderberg, Charlotta

    2016-12-01

    Contemporary processes of environmental policymaking in general span over several territorial tiers. This also holds for the EU Water Framework Directive system of environmental quality standards (EQS), which are part of a complex multi-level institutional landscape, embracing both EU, national and sub-national level. Recent evaluations show that many EU member states, including Sweden, have not reached the ecological goals for water in 2015. Departing from theories on policy coherence and multi-level governance, this paper therefore analyses Swedish water governance as a case to further our understanding of policy implementation in complex governance structures: how does policy coherence (or the lack thereof) affect policy implementation in complex governance structures? To answer this question, the paper maps out the formal structure of the water governance system, focusing on power directions within the system, analyses policy coherence in Swedish water governance through mapping out policy conflicts between the EQS for water and other goals/regulations and explore how they are handled by national and sub-national water bureaucrats. The study concludes that without clear central guidance, 'good ecological status' for Swedish water will be difficult to achieve since incoherent policies makes policy implementation inefficient due to constant power struggles between different authorities, and since environmental goals are often overridden by economic and other societal goals. Further research is needed in order to explore if similar policy conflicts between water quality and other objectives occur in other EU member states and how bureaucrats handle such conflicts in different institutional settings. This study of the Swedish case indicates that the role of the state as a navigator and rudder-holder is important in order to improve policy implementation in complex governance structures - otherwise; bureaucrats risk being lost in an incoherent archipelago of ecological, social and economic goals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Bilevel formulation of a policy design problem considering multiple objectives and incomplete preferences

    NASA Astrophysics Data System (ADS)

    Hawthorne, Bryant; Panchal, Jitesh H.

    2014-07-01

    A bilevel optimization formulation of policy design problems considering multiple objectives and incomplete preferences of the stakeholders is presented. The formulation is presented for Feed-in-Tariff (FIT) policy design for decentralized energy infrastructure. The upper-level problem is the policy designer's problem and the lower-level problem is a Nash equilibrium problem resulting from market interactions. The policy designer has two objectives: maximizing the quantity of energy generated and minimizing policy cost. The stakeholders decide on quantities while maximizing net present value and minimizing capital investment. The Nash equilibrium problem in the presence of incomplete preferences is formulated as a stochastic linear complementarity problem and solved using expected value formulation, expected residual minimization formulation, and the Monte Carlo technique. The primary contributions in this article are the mathematical formulation of the FIT policy, the extension of computational policy design problems to multiple objectives, and the consideration of incomplete preferences of stakeholders for policy design problems.

  16. Working at the nexus between public health policy, practice and research. Dynamics of knowledge sharing in the Netherlands

    PubMed Central

    2012-01-01

    Background Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions. This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing. Method An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories. Results Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives. Conclusion We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks. PMID:23075375

  17. Working at the nexus between public health policy, practice and research. Dynamics of knowledge sharing in The Netherlands.

    PubMed

    Jansen, Maria W; De Leeuw, Evelyne; Hoeijmakers, Marjan; De Vries, Nanne K

    2012-10-17

    Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. "Joining domains" implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions.This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing. An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories. Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives. We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers' involvement to establish mutually supportive networks.

  18. ICS-II USA research design and methodology.

    PubMed

    Rana, H; Andersen, R M; Nakazono, T T; Davidson, P L

    1997-05-01

    The purpose of the WHO-sponsored International Collaborative Study of Oral Health Outcomes (ICS-II) was to provide policy-markers and researchers with detailed, reliable, and valid data on the oral health situation in their countries or regions, together with comparative data from other dental care delivery systems. ICS-II used a cross-sectional design with no explicit control groups or experimental interventions. A standardized methodology was developed and tested for collecting and analyzing epidemiological, sociocultural, economic, and delivery system data. Respondent information was obtained by household interviews, and clinical examinations were conducted by calibrated oral epidemiologists. Discussed are the sampling design characteristics for the USA research locations, response rates, samples size for interview and oral examination data, weighting procedures, and statistical methods. SUDAAN was used to adjust variance calculations, since complex sampling designs were used.

  19. Modelling operations and security of cloud systems using Z-notation and Chinese Wall security policy

    NASA Astrophysics Data System (ADS)

    Basu, Srijita; Sengupta, Anirban; Mazumdar, Chandan

    2016-11-01

    Enterprises are increasingly using cloud computing for hosting their applications. Availability of fast Internet and cheap bandwidth are causing greater number of people to use cloud-based services. This has the advantage of lower cost and minimum maintenance. However, ensuring security of user data and proper management of cloud infrastructure remain major areas of concern. Existing techniques are either too complex, or fail to properly represent the actual cloud scenario. This article presents a formal cloud model using the constructs of Z-notation. Principles of the Chinese Wall security policy have been applied to design secure cloud-specific operations. The proposed methodology will enable users to safely host their services, as well as process sensitive data, on cloud.

  20. A dynamic modelling framework towards the solution of reduction in smoking prevalence

    NASA Astrophysics Data System (ADS)

    Halim, Tisya Farida Abdul; Sapiri, Hasimah; Abidin, Norhaslinda Zainal

    2016-10-01

    This paper presents a hypothetical framework towards the solution for reduction in smoking prevalence in Malaysia. The framework is design to assist in decision making process related to reduction in smoking prevalence using SD and OCT. In general, this framework is developed using SD approach where OCT is embedded in the policy evaluation process. Smoking prevalence is one of the determinant which plays an important role in measuring a successful implementation of anti-smoking strategies. Therefore, it is critical to determine the optimal value of smoking prevalence in order to trim down the hazardous effects of smoking to society. Conversely, smoking problem becomes increasingly complex since many issues that ranged from behavioral to economical need to be considered simultaneously. Thus, a hypothetical framework of the control model embedded in the SD methodology is expected to obtain the minimum value of smoking prevalence which the output in turn will provide a guideline for tobacco researchers as well as decision makers for policy design and evaluation.

  1. Abortion Providers' Experiences with Medicaid Abortion Coverage Policies: A Qualitative Multistate Study

    PubMed Central

    Dennis, Amanda; Blanchard, Kelly

    2013-01-01

    Objective To evaluate the implementation of state Medicaid abortion policies and the impact of these policies on abortion clients and abortion providers. Data Source From 2007 to 2010, in-depth interviews were conducted with representatives of 70 abortion-providing facilities in 15 states. Study Design In-depth interviews focused on abortion providers' perceptions regarding Medicaid and their experiences working with Medicaid and securing reimbursement in cases that should receive federal funding: rape, incest, and life endangerment. Data Extraction Data were transcribed verbatim before being coded. Principal Findings In two study states, abortion providers reported that 97 percent of submitted claims for qualifying cases were funded. Success receiving reimbursement was attributed to streamlined electronic billing procedures, timely claims processing, and responsive Medicaid staff. Abortion providers in the other 13 states reported reimbursement for 36 percent of qualifying cases. Providers reported difficulties obtaining reimbursement due to unclear rejections of qualifying claims, complex billing procedures, lack of knowledgeable Medicaid staff with whom billing problems could be discussed, and low and slow reimbursement rates. Conclusions Poor state-level implementation of Medicaid coverage of abortion policies creates barriers for women seeking abortion. Efforts to ensure policies are implemented appropriately would improve women's health. PMID:22742741

  2. Tobacco policies in Nazi Germany: not as simple as it seems

    PubMed Central

    Bachinger, Eleonore; McKee, Martin; Gilmore, Anna

    2008-01-01

    Summary Objective Reluctance to develop effective tobacco control measures in Germany has been attributed to the anti-smoking stance taken by the Nazis, which has encouraged pro-smoking groups to equate tobacco control advocacy with totalitarianism. This paper reassesses the scale and nature of tobacco control in Germany during the Third Reich. Design Analysis of documents and reports about the situation in Germany in the 1930s and 1940s supplemented by a review of Reich legal ordinances, party newspapers, health behaviour guidelines issued by Nazi party organizations, and interviews with expert informants. Results While there was considerable opposition to smoking in Nazi Germany, there was no consistent Nazi policy to combat smoking, and what did exist built on pre-existing policies. Although extreme measures were taken in isolated localities or by overzealous party members, there was a marked ambivalence to tobacco control at the highest levels. Many policies were contradictory; measures were often not enforced, and cigarettes were actively distributed to ‘deserving’ groups. Conclusion Policies on tobacco in Nazi Germany are much more complex than is often represented by those who invoke them to condemn those seeking to reduce the burden of disease caused by smoking. PMID:18222506

  3. Legislative and Policy Developments and Imperatives for Advancing the Primary Care Behavioral Health (PCBH) Model.

    PubMed

    Freeman, Dennis S; Hudgins, Cathy; Hornberger, Joel

    2018-06-01

    The Primary Care Behavioral Health (PCBH) practice model continues to gain converts among primary care and behavioral health professionals as the evidence supporting its effectiveness continues to accumulate. Despite a growing number of practices and organizations using the model effectively, widespread implementation has been hampered by outmoded policies and regulatory barriers. As policymakers and legislators begin to recognize the contributions that PCBH model services make to the care of complex patients and the expansion of access to those in need of behavioral health interventions, some encouraging policy initiatives are emerging and the policy environment is becoming more favorable to implementation of the PCBH model. This article outlines the necessity for policy change, exposing the policy issues and barriers that serve to limit the practice of the PCBH model; highlights innovative approaches some states are taking to foster integrated practice; and discusses the compatibility of the PCBH model with the nation's health care reform agenda. Psychologists have emerged as leaders in the design and implementation of PCBH model integration and are encouraged to continue to advance the model through the demonstration of efficient and effective clinical practice, participation in the expansion of an appropriately trained workforce, and advocacy for the inclusion of this practice model in emerging healthcare systems and value-based payment methodologies.

  4. Addressing refugee health through evidence-based policies: a case study.

    PubMed

    Thiel de Bocanegra, Heike; Carter-Pokras, Olivia; Ingleby, J David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I; Smith-Gagen, Julie; Hidalgo, Bertha

    2018-06-01

    The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the United States and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Early Childhood Practice and Refrains of Complexity

    ERIC Educational Resources Information Center

    Cumming, Tamara; Sumsion, Jennifer; Wong, Sandie

    2015-01-01

    Early childhood practice has often been described as complex in both policy documents and research literature; however, less attention has been given to exploring the nature and consequences of complexity in early childhood practice. At a time of intense policy attention in many national contexts, there is the potential for closing down, as well…

  6. "RePlay Health": An Experiential Role-Playing Sport for Modeling Healthcare Decisions, Policies, and Outcomes.

    PubMed

    Kaufman, Geoff; Flanagan, Mary; Seidman, Max; Wien, Simone

    2015-08-01

    This article presents the design and empirical investigation of the "RePlay Health" game ( www.replayhealth.com/ ), a novel "role-playing sport" derived from a complex, data-driven, computational simulation of healthcare dynamics. By immersing players in a fictional world in which they take on the role of characters facing specific behavioral and environmental risk factors, the "RePlay Health" game models the impact of health and healthcare policy on individual-level livelihood and community-level productivity. A randomized experiment tested the efficacy of the game for inspiring shifts in thinking about public health and healthcare policy. This study compared the impact of actively playing the game versus passively spectating: 31 young adults were assigned to one of these two roles. Participants completed pretest and posttest measures of their subjective ranking of healthcare policies and attributions for health outcomes. Active players (compared with spectators) reported significantly higher prioritizations (from pretest to posttest) in their subjective ranking of several health policies modeled by the game, such as "improving postdischarge care" and "increasing access to healthy foods." Furthermore, players, but not spectators, were significantly more likely following gameplay to identify environmental or systemic factors as potential causes of health problems. The fact that significant results emerged with a 1-week gap between gameplay and measurement demonstrates that the game could exert a lasting impact on attitudes and perceptions. More broadly, this work illustrates the value of incorporating experiential components, such as narrative, embodiment, and role-playing, in designing efficacious games for health.

  7. Complexity, Public Reporting, and Choice of Doctors: A Look Inside the Blackest Box of Consumer Behavior

    PubMed Central

    Schlesinger, Mark; Kanouse, David E.; Martino, Steven C.; Shaller, Dale; Rybowski, Lise

    2017-01-01

    Health care consumers often make choices that are imperfectly informed and inconsistent with their expressed preferences. Past research suggests that these shortcomings become more pronounced as choices become more complex, through either additional options or more performance metrics. But it is unclear why this is true: Consumer choice remains a “black box” that research has scarcely illuminated. In this article, we identify four pathways through which complexity may impair consumer choice. We examine these pathways using data from an experiment in which consumers (hypothetically) selected a primary care physician. Some of the loss of decision quality accompanying more complex choice sets can be explained by consumers’ skills and decision-making style, but even after accounting for these factors, complexity undermines the quality of decision making in ways that cannot be fully explained. We conclude by discussing implications for report designers, sponsors, and policy makers aspiring to promote consumer empowerment and health care quality. PMID:23999489

  8. Complexity, public reporting, and choice of doctors: a look inside the blackest box of consumer behavior.

    PubMed

    Schlesinger, Mark; Kanouse, David E; Martino, Steven C; Shaller, Dale; Rybowski, Lise

    2014-10-01

    Health care consumers often make choices that are imperfectly informed and inconsistent with their expressed preferences. Past research suggests that these shortcomings become more pronounced as choices become more complex, through either additional options or more performance metrics. But it is unclear why this is true: Consumer choice remains a "black box" that research has scarcely illuminated. In this article, we identify four pathways through which complexity may impair consumer choice. We examine these pathways using data from an experiment in which consumers (hypothetically) selected a primary care physician. Some of the loss of decision quality accompanying more complex choice sets can be explained by consumers' skills and decision-making style, but even after accounting for these factors, complexity undermines the quality of decision making in ways that cannot be fully explained. We conclude by discussing implications for report designers, sponsors, and policy makers aspiring to promote consumer empowerment and health care quality. © The Author(s) 2013.

  9. Creating a national citizen engagement process for energy policy

    PubMed Central

    Pidgeon, Nick; Demski, Christina; Butler, Catherine; Parkhill, Karen; Spence, Alexa

    2014-01-01

    This paper examines some of the science communication challenges involved when designing and conducting public deliberation processes on issues of national importance. We take as our illustrative case study a recent research project investigating public values and attitudes toward future energy system change for the United Kingdom. National-level issues such as this are often particularly difficult to engage the public with because of their inherent complexity, derived from multiple interconnected elements and policy frames, extended scales of analysis, and different manifestations of uncertainty. With reference to the energy system project, we discuss ways of meeting a series of science communication challenges arising when engaging the public with national topics, including the need to articulate systems thinking and problem scale, to provide balanced information and policy framings in ways that open up spaces for reflection and deliberation, and the need for varied methods of facilitation and data synthesis that permit access to participants’ broader values. Although resource intensive, national-level deliberation is possible and can produce useful insights both for participants and for science policy. PMID:25225393

  10. Creating a national citizen engagement process for energy policy.

    PubMed

    Pidgeon, Nick; Demski, Christina; Butler, Catherine; Parkhill, Karen; Spence, Alexa

    2014-09-16

    This paper examines some of the science communication challenges involved when designing and conducting public deliberation processes on issues of national importance. We take as our illustrative case study a recent research project investigating public values and attitudes toward future energy system change for the United Kingdom. National-level issues such as this are often particularly difficult to engage the public with because of their inherent complexity, derived from multiple interconnected elements and policy frames, extended scales of analysis, and different manifestations of uncertainty. With reference to the energy system project, we discuss ways of meeting a series of science communication challenges arising when engaging the public with national topics, including the need to articulate systems thinking and problem scale, to provide balanced information and policy framings in ways that open up spaces for reflection and deliberation, and the need for varied methods of facilitation and data synthesis that permit access to participants' broader values. Although resource intensive, national-level deliberation is possible and can produce useful insights both for participants and for science policy.

  11. Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities

    PubMed Central

    Carey, Gemma; Friel, Sharon

    2015-01-01

    Many of the societal level factors that affect health – the ‘social determinants of health (SDH)’ – exist outside the health sector, across diverse portfolios of government, and other major institutions including non-governmental organisations (NGOs) and the private sector. This has created growing interest in how to create and implement public policies which will drive better and fairer health outcomes. While designing policies that can improve the SDH is critical, so too is ensuring they are appropriately administered and implemented. In this paper, we draw attention to an important area for future public health consideration – how policies are managed and implemented through complex administrative layers of ‘the state.’ Implementation gaps have long been a concern of public administration scholarship. To precipitate further work in this area, in this paper, we provide an overview of the scholarly field of public administration and highlight its role in helping to understand better the challenges and opportunities for implementing policies and programs to improve health equity. PMID:26673462

  12. Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities.

    PubMed

    Carey, Gemma; Friel, Sharon

    2015-10-11

    Many of the societal level factors that affect health - the 'social determinants of health (SDH)' - exist outside the health sector, across diverse portfolios of government, and other major institutions including non-governmental organisations (NGOs) and the private sector. This has created growing interest in how to create and implement public policies which will drive better and fairer health outcomes. While designing policies that can improve the SDH is critical, so too is ensuring they are appropriately administered and implemented. In this paper, we draw attention to an important area for future public health consideration - how policies are managed and implemented through complex administrative layers of 'the state.' Implementation gaps have long been a concern of public administration scholarship. To precipitate further work in this area, in this paper, we provide an overview of the scholarly field of public administration and highlight its role in helping to understand better the challenges and opportunities for implementing policies and programs to improve health equity. © 2015 by Kerman University of Medical Sciences.

  13. JPRS Report, Science and Technology, USSR: Science and Technology Policy.

    DTIC Science & Technology

    1990-07-23

    complex jobs, which are now "nobody’s." For precisely these intermediate directions are the most promising with respect to future discoveries. At the...34Of course! I work as an aircraft designer, while the invention applies to medical equipment. The coopera- tive is prepared to pay all the necessary...the introduction and practical appli - cation of useful technical innovations. The main principle is "from the idea to the finished product." We

  14. Dynamic programming methods for concurrent design and dynamic allocation of vehicles embedded in a system-of-systems

    NASA Astrophysics Data System (ADS)

    Nusawardhana

    2007-12-01

    Recent developments indicate a changing perspective on how systems or vehicles should be designed. Such transition comes from the way decision makers in defense related agencies address complex problems. Complex problems are now often posed in terms of the capabilities desired, rather than in terms of requirements for a single systems. As a result, the way to provide a set of capabilities is through a collection of several individual, independent systems. This collection of individual independent systems is often referred to as a "System of Systems'' (SoS). Because of the independent nature of the constituent systems in an SoS, approaches to design an SoS, and more specifically, approaches to design a new system as a member of an SoS, will likely be different than the traditional design approaches for complex, monolithic (meaning the constituent parts have no ability for independent operation) systems. Because a system of system evolves over time, this simultaneous system design and resource allocation problem should be investigated in a dynamic context. Such dynamic optimization problems are similar to conventional control problems. However, this research considers problems which not only seek optimizing policies but also seek the proper system or vehicle to operate under these policies. This thesis presents a framework and a set of analytical tools to solve a class of SoS problems that involves the simultaneous design of a new system and allocation of the new system along with existing systems. Such a class of problems belongs to the problems of concurrent design and control of a new systems with solutions consisting of both optimal system design and optimal control strategy. Rigorous mathematical arguments show that the proposed framework solves the concurrent design and control problems. Many results exist for dynamic optimization problems of linear systems. In contrary, results on optimal nonlinear dynamic optimization problems are rare. The proposed framework is equipped with the set of analytical tools to solve several cases of nonlinear optimal control problems: continuous- and discrete-time nonlinear problems with applications on both optimal regulation and tracking. These tools are useful when mathematical descriptions of dynamic systems are available. In the absence of such a mathematical model, it is often necessary to derive a solution based on computer simulation. For this case, a set of parameterized decision may constitute a solution. This thesis presents a method to adjust these parameters based on the principle of stochastic approximation simultaneous perturbation using continuous measurements. The set of tools developed here mostly employs the methods of exact dynamic programming. However, due to the complexity of SoS problems, this research also develops suboptimal solution approaches, collectively recognized as approximate dynamic programming solutions, for large scale problems. The thesis presents, explores, and solves problems from an airline industry, in which a new aircraft is to be designed and allocated along with an existing fleet of aircraft. Because the life cycle of an aircraft is on the order of 10 to 20 years, this problem is to be addressed dynamically so that the new aircraft design is the best design for the fleet over a given time horizon.

  15. Achieving the Proper Balance Between Crew and Public Safety

    NASA Technical Reports Server (NTRS)

    Gowan, John; Silvestri, Ray; Stahl, Ben; Rosati, Paul; Wilde, Paul

    2011-01-01

    A paramount objective of all human-rated launch and reentry vehicle developers is to ensure that the risks to both the crew onboard and the public are minimized within reasonable cost, schedule, and technical constraints. Past experience has shown that proper attention to range safety requirements necessary to ensure public safety must be given early in the design phase to avoid additional operational complexities or threats to the safety of people onboard, and the design engineers must give these requirements the same consideration as crew safety requirements. For human spaceflight, the primary purpose and operational concept for any flight safety system is to protect the public while maximizing the likelihood of crew survival. This paper will outline the policy considerations, technical issues, and operational impacts regarding launch and reentry vehicle failure scenarios where crew and public safety are intertwined and thus addressed optimally in an integrated manner. An overview of existing range and crew safety policy requirements will be presented. Application of these requirements and lessons learned from both the Space Shuttle and Constellation Programs will also be discussed. Using these past programs as examples, the paper will detail operational, design, and analysis approaches to mitigate and balance the risks to people onboard and in the public. Manned vehicle perspectives from the Federal Aviation Administration (FAA) and Air Force organizations that oversee public safety will be summarized as well. Finally, the paper will emphasize the need to factor policy, operational, and analysis considerations into the early design trades of new vehicles to help ensure that both crew and public safety are maximized to the greatest extent possible.

  16. Achieving the Proper Balance between Crew & Public Safety

    NASA Astrophysics Data System (ADS)

    Wilde, P.; Gowan, J.; Silvestri, R.; Stahl, B.; Rosati, P.

    2012-01-01

    A paramount objective of all human-rated launch and reentry vehicle developers is to ensure that the risks to both the crew onboard and the public are minimized within reasonable cost, schedule, and technical constraints. Past experience has shown that proper attention to range safety requirements necessary to ensure public safety must be given early in the design phase to avoid additional operational complexities or threats to the safety of people onboard, and the design engineers must give these requirements the same consideration as crew safety requirements. For human spaceflight, the primary purpose and operational concept for any flight safety system is to protect the public while maximizing the likelihood of crew survival. This paper will outline the policy considerations, technical issues, and operational impacts regarding launch and reentry vehicle failure scenarios where crew and public safety are intertwined and thus addressed optimally in an integrated manner. An overview of existing range and crew safety policy requirements will be presented. Application of these requirements and lessons learned from both the Space Shuttle and Constellation Programs will also be discussed. Using these past programs as examples, the paper will detail operational, design, and analysis approaches to mitigate and balance the risks to people onboard and in the public. Crewed vehicle perspectives from the Federal Aviation Administration and Air Force organizations that oversee public safety will be summarized as well. Finally, the paper will emphasize the need to factor policy, operational, and analysis considerations into the early design trades of new vehicles to help ensure that both crew and public safety are maximized to the greatest extent possible.

  17. Very high speed integrated circuits - Into the second generation. V - The issues of standardization and technology insertion

    NASA Astrophysics Data System (ADS)

    Martin, J.

    1982-04-01

    It is shown that the fulfillment of very high speed integrated circuit (VHSIC) device development goals entails the restructuring of military electronics acquisition policy, standardization which produces the maximum number of systems and subsystems by means of the minimum number of flexible, broad-purpose, high-power semiconductors, and especially the standardization of bus structures incorporating a priorization system. It is expected that the Design Specification Handbook currently under preparation by the VHSIC program office of the DOD will make the design of such systems a task whose complexity is comparable to that of present integrated circuit electronics.

  18. God, the Devil, and Darwin - A Critique of Intelligent Design Theory

    NASA Astrophysics Data System (ADS)

    Shanks, Niall

    2007-03-01

    In the last fifteen years a controversial new theory of the origins of biological complexity and the nature of the universe has been fomenting bitter debates in education and science policy across North America, Europe, and Australia. Backed by intellectuals at respectable universities, Intelligent Design theory (ID) proposes an alternative to accepted accounts of evolutionary theory: that life is so complex, and that the universe is so fine-tuned for the appearance of life, that the only plausible explanation is the existence of an intelligent designer. For many ID theorists, the designer is taken to be the god of Christianity. Niall Shanks has written the first accessible introduction to, and critique of, this controversial new intellectual movement. Shanks locates the growth of ID in the last two decades of the twentieth century in the growing influence of the American religious right. But as he shows, its roots go back beyond Aquinas to Ancient Greece. After looking at the historical roots of ID, Shanks takes a hard look at its intellectual underpinnings, discussing modern understandings of thermodynamics, and how self-organizing processes lead to complex physical, chemical, and biological systems. He considers cosmological arguments for ID rooted in so-called "anthropic coincidences" and also tackles new biochemical arguments for ID based on "irreducible biological complexity." Throughout he shows how arguments for ID lack cohesion, rest on errors and unfounded suppositions, and generally are grossly inferior to evolutionary explanations. While ID has been proposed as a scientific alternative to evolutionary biology, Shanks argues that ID is in fact "old creationist wine in new designer label bottles" and moreover is a serious threat to the scientific and democratic values that are our cultural and intellectual inheritance from the Enlightenment.

  19. Methodological issues in oral health research: intervention studies.

    PubMed

    O'Mullane, Denis; James, Patrice; Whelton, Helen; Parnell, Carmel

    2012-02-01

    To provide a broad overview of methodological issues in the design and evaluation of intervention studies in dental public health, with particular emphasis on explanatory trials, pragmatic trials and complex interventions. We present a narrative summary of selected publications from the literature outlining both historical and recent challenges in the design and evaluation of intervention studies and describe some recent tools that may help researchers to address these challenges. It is now recognised that few intervention studies in dental public health are purely explanatory or pragmatic. We describe the PRECIS tool which can be used by trialists to assess and display the position of their trial on a continuum between the extremes of explanatory and pragmatic trials. The tool aims to help trialists make design decisions that are in line with their stated aims. The increasingly complex nature of dental public health interventions presents particular design and evaluation challenges. The revised Medical Research Council (MRC) guidance for the development and evaluation of complex interventions which emphasises the importance of planning and process evaluation is a welcome development. We briefly describe the MRC guidance and outline some examples of complex interventions in the field of oral health. The role of observational studies in monitoring public health interventions when the conduct of RCTs is not appropriate or feasible is acknowledged. We describe the STROBE statement and outline the implications of the STROBE guidelines for dental public health. The methodological challenges in the design, conduct and reporting of intervention studies in oral health are considerable. The need to provide reliable evidence to support innovative new strategies in oral health policy is a major impetus in these fields. No doubt the 'Methodological Issues in Oral Health Research' group will have further opportunities to highlight this work. © 2012 John Wiley & Sons A/S.

  20. Transnational Research Networks in Chinese Scientific Production. An Investigation on Health-Industry Related Sectors.

    PubMed

    Rubini, Lauretta; Pollio, Chiara; Di Tommaso, Marco R

    2017-08-29

    Transnational research networks (TRN) are becoming increasingly complex. Such complexity may have both positive and negative effects on the quality of research. Our work studies the evolution over time of Chinese TRN and the role of complexity on the quality of Chinese research, given the leading role this country has recently acquired in international science. We focus on the fields of geriatrics and gerontology. We build an original dataset of all scientific publications of China in these areas in 2009, 2012 and 2015, starting from the ISI Web of Knowledge (ISI WoK) database. Using Social Network Analysis (SNA), we analyze the change in scientific network structure across time. Second, we design indices to control for the different aspects of networks complexity (number of authors, country heterogeneity and institutional heterogeneity) and we perform negative binomial regressions to identify the main determinants of research quality. Our analysis shows that research networks in the field of geriatrics and gerontology have gradually become wider in terms of countries and have become more balanced. Furthermore, our results identify that different forms of complexity have different impacts on quality, including a reciprocal moderating effect. In particular, according to our analysis, research quality benefits from complex research networks both in terms of countries and of types of institutions involved, but that such networks should be "compact" in terms of number of authors. Eventually, we suggest that complexity should be carefully taken into account when designing policies aimed at enhancing the quality of research.

  1. Study protocol: developing a decision system for inclusive housing: applying a systematic, mixed-method quasi-experimental design.

    PubMed

    Zeeman, Heidi; Kendall, Elizabeth; Whitty, Jennifer A; Wright, Courtney J; Townsend, Clare; Smith, Dianne; Lakhani, Ali; Kennerley, Samantha

    2016-03-15

    Identifying the housing preferences of people with complex disabilities is a much needed, but under-developed area of practice and scholarship. Despite the recognition that housing is a social determinant of health and quality of life, there is an absence of empirical methodologies that can practically and systematically involve consumers in this complex service delivery and housing design market. A rigorous process for making effective and consistent development decisions is needed to ensure resources are used effectively and the needs of consumers with complex disability are properly met. This 3-year project aims to identify how the public and private housing market in Australia can better respond to the needs of people with complex disabilities whilst simultaneously achieving key corporate objectives. First, using the Customer Relationship Management framework, qualitative (Nominal Group Technique) and quantitative (Discrete Choice Experiment) methods will be used to quantify the housing preferences of consumers and their carers. A systematic mixed-method, quasi-experimental design will then be used to quantify the development priorities of other key stakeholders (e.g., architects, developers, Government housing services etc.) in relation to inclusive housing for people with complex disabilities. Stakeholders randomly assigned to Group 1 (experimental group) will participate in a series of focus groups employing Analytical Hierarchical Process (AHP) methodology. Stakeholders randomly assigned to Group 2 (control group) will participate in focus groups employing existing decision making processes to inclusive housing development (e.g., Risk, Opportunity, Cost, Benefit considerations). Using comparative stakeholder analysis, this research design will enable the AHP methodology (a proposed tool to guide inclusive housing development decisions) to be tested. It is anticipated that the findings of this study will enable stakeholders to incorporate consumer housing preferences into commercial decisions. Housing designers and developers will benefit from the creation of a parsimonious set of consumer-led housing preferences by which to make informed investments in future housing and contribute to future housing policy. The research design has not been applied in the Australian research context or elsewhere, and will provide a much needed blueprint for market investment to develop viable, consumer directed inclusive housing options for people with complex disability.

  2. Health policy evolution in Lao People’s Democratic Republic: context, processes and agency

    PubMed Central

    Jönsson, Kristina; Phoummalaysith, Bounfeng; Wahlström, Rolf; Tomson, Göran

    2015-01-01

    During the last 20 years Lao People’s Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. PMID:24740710

  3. Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches.

    PubMed

    Langlois, Etienne V; Becerril Montekio, Victor; Young, Taryn; Song, Kayla; Alcalde-Rabanal, Jacqueline; Tran, Nhan

    2016-03-17

    There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings. The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals' abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a 'buddying' process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design. In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge. The collaborative evidence-to-policy approaches underline the importance of iterations and continuity in the engagement of researchers and policymakers/programme managers, in order to account for swift evolutions in health policy planning and implementation. In developing and supporting evidence-to-policy interventions, due consideration should be given to fit-for-purpose approaches, as different needs in policymaking cycles require adapted processes and knowledge. Greater consideration should be provided to approaches embedding the use of research in real-world policymaking, better suited to the complex adaptive nature of health systems.

  4. Planning and Design of Water Resources Systems Under Climate Change and Variability

    NASA Astrophysics Data System (ADS)

    Strzepek, K. M.

    2014-12-01

    Regional and local water supplies and demands are impacted by global and national systems: climate, economics, population and energy as well as policies: development, energy, and environmental. These drivers can result in complex interactions that require deeper understanding in order to provide actionable information for water planners and stakeholders to develop strategic plans in the face of a changing and growing world. To add more complexity to this issue is the fact that all these drivers are uncertain and the type of uncertainty is not the same. This talk will address approaches to Water Resource Planning at sub-national water regions, national levels and trans-boundary river basins under a non-stationary hydro-climatic future. Additionally the talk will address the design of specific water resource projects such as reservoirs and hydroplants that are being designed now but will operate far in the future when the hydro-climatology will be very different. Examples will be drawn from recent work in Africa, Eastern Europe and Central Asia, and North America and some insights and outstanding questions will be presented.

  5. Achieving the Proper Balance Between Crew and Public Safety

    NASA Technical Reports Server (NTRS)

    Gowan, John; Rosati, Paul; Silvestri, Ray; Stahl, Ben; Wilde, Paul

    2011-01-01

    A paramount objective of all human-rated launch and reentry vehicle developers is to ensure that the risks to both the crew onboard and the public are minimized within reasonable cost, schedule, and technical constraints. Past experience has shown that proper attention to range safety requirements necessary to ensure public safety must be given early in the design phase to avoid additional operational complexities or threats to the safety of people onboard. This paper will outline the policy considerations, technical issues, and operational impacts regarding launch and reentry vehicle failure scenarios where crew and public safety are intertwined and thus addressed optimally in an integrated manner. Historical examples and lessons learned from both the Space Shuttle and Constellation Programs will be presented. Using these examples as context, the paper will discuss some operational, design, and analysis approaches to mitigate and balance the risks to people onboard and in the public. Manned vehicle perspectives from the FAA and Air Force organizations that oversee public safety will also be summarized. Finally, the paper will emphasize the need to factor policy, operational, and analysis considerations into the early design trades of new vehicles to help ensure that both crew and public safety are maximized to the greatest extent possible.

  6. A bottom-up approach to identifying the maximum operational adaptive capacity of water resource systems to a changing climate

    NASA Astrophysics Data System (ADS)

    Culley, S.; Noble, S.; Yates, A.; Timbs, M.; Westra, S.; Maier, H. R.; Giuliani, M.; Castelletti, A.

    2016-09-01

    Many water resource systems have been designed assuming that the statistical characteristics of future inflows are similar to those of the historical record. This assumption is no longer valid due to large-scale changes in the global climate, potentially causing declines in water resource system performance, or even complete system failure. Upgrading system infrastructure to cope with climate change can require substantial financial outlay, so it might be preferable to optimize existing system performance when possible. This paper builds on decision scaling theory by proposing a bottom-up approach to designing optimal feedback control policies for a water system exposed to a changing climate. This approach not only describes optimal operational policies for a range of potential climatic changes but also enables an assessment of a system's upper limit of its operational adaptive capacity, beyond which upgrades to infrastructure become unavoidable. The approach is illustrated using the Lake Como system in Northern Italy—a regulated system with a complex relationship between climate and system performance. By optimizing system operation under different hydrometeorological states, it is shown that the system can continue to meet its minimum performance requirements for more than three times as many states as it can under current operations. Importantly, a single management policy, no matter how robust, cannot fully utilize existing infrastructure as effectively as an ensemble of flexible management policies that are updated as the climate changes.

  7. Policy Actors: Doing Policy Work in Schools

    ERIC Educational Resources Information Center

    Ball, Stephen J.; Maguire, Meg; Braun, Annette; Hoskins, Kate

    2011-01-01

    This paper considers the "policy work" of teacher actors in schools. It focuses on the "problem of meaning" and offers a typology of roles and positions through which teachers engage with policy and with which policies get "enacted". It argues that "policy work" is made up of a set of complex and…

  8. Improved Intelligence Warning in an Age of Complexity

    DTIC Science & Technology

    2015-05-21

    at, and applying complexity science to this problem, which is represented by a multidiscipline study of large networks comprised of interdependent...For analysts and policy makers, complexity science offers methods to improve this understanding. As said by Ms. Irene Sanders, director of the... science to improve intelligence warning. The initial section describes how policy makers and national security leaders understand the current

  9. Genetics and educational attainment

    NASA Astrophysics Data System (ADS)

    Cesarini, David; Visscher, Peter M.

    2017-12-01

    We explore how advances in our understanding of the genetics of complex traits such as educational attainment could constructively be leveraged to advance research on education and learning. We discuss concepts and misconceptions about genetic findings with regard to causes, consequences, and policy. Our main thesis is that educational attainment as a measure that varies between individuals in a population can be subject to exactly the same experimental biological designs as other outcomes, for example, those studied in epidemiology and medical sciences, and the same caveats about interpretation and implication apply.

  10. Invited Commentary: Built Environment and Obesity Among Older Adults—Can Neighborhood-level Policy Interventions Make a Difference?

    PubMed Central

    Yen, Irene H.

    2009-01-01

    Obesity is more prevalent and its consequences severe among middle-aged and older adults. Efforts to understand and address neighborhood-level causes of obesity in this population offer the potential to enhance health and reduce the costs of obesity for everyone. The accompanying paper by Li et al. (Am J Epidemiol. 2009;169(4):401–408) presents new data on the apparently significant interaction between neighborhood and individual characteristics on 1-year change in body weight and waist circumference. Despite methodological limitations in measurement, this paper supports the importance of future research that considers the complex relation between people and where they live. Efforts to design neighborhood-level policy interventions to effectively address the problem of obesity will require greater interdisciplinary collaboration. PMID:19153213

  11. Unravelling gossamer with boxing gloves: problems in explaining the decline in smoking.

    PubMed Central

    Chapman, S

    1993-01-01

    For about three decades countries such as Australia, Great Britain, and the United States have been turning up the heat on tobacco advertising. Encouraging, sometimes dramatic falls in consumption have followed. On any given day in 1993 smokers in such countries are exposed to a welter of news, information, persuasion, and policies designed to turn them off smoking. For a long time explanations and evaluations of the effects of these policies and interventions have been tied to oversimplified causal models when the reality is rather more messy and complicated. Four factors largely explain the reluctance of researchers to move beyond these models: the reductionist tradition of science; the explanatory privileging of recent events and factors; pragmatic concern for policy "tractable" factors; and the relation of funding to the evaluative process. Broader research approaches to understanding changes in complex behaviours such as smoking are required--for example, qualitative methods. Images p431-a p432-a PMID:8374457

  12. Disclosure of research results in genetic studies of Parkinson's disease caused by LRRK2 mutations.

    PubMed

    Pont-Sunyer, Claustre; Bressman, Susan; Raymond, Deborah; Glickman, Amanda; Tolosa, Eduardo; Saunders-Pullman, Rachel

    2015-06-01

    With the advent of large genetic studies examining both symptomatic and asymptomatic individuals, whether and how to disclose genetic research results have become pressing questions. The need is particularly acute in the case of LRRK2 research: Movement centers worldwide are recruiting cohorts of individuals with Parkinson's disease (PD) and their family members, including asymptomatic carriers. Clinical features and treatment are complex and evolving, and disclosure policies vary at different sites and have been modified during the course of some studies. We present the major ethical principles of autonomy, beneficence, nonmaleficence, and honesty that should guide disclosure policies in studies of families with LRRK2 mutations. We make recommendations regarding genetic counseling, policies of either active or passive disclosure, responsibilities of funders to budget for genetic counseling, clinical genetic testing where locally required for disclosure, and aspects of study design to avoid mandatory disclosure whenever feasible. © 2015 International Parkinson and Movement Disorder Society. © 2015 International Parkinson and Movement Disorder Society.

  13. Mind the Gap: Integrating Science and Policy Cultures and Practices

    NASA Astrophysics Data System (ADS)

    Lev, S. M.; Simon, I.

    2015-12-01

    A 2014 survey conducted by the Pew Research Center asked members of the American Association for the Advancement of Science about their support for active engagement in public policy debates. The survey found that 87% of the respondents supported scientists taking an active role in public policy debates about science and technology (S&T), but most believed that regulations related to areas like land use and clean air and water are not guided by the best science. Despite the demand for actionable scientific information by policy makers, these survey results underscore the gap that exists between the scientific and the public policy communities. There are fundamental differences that exist between the perspectives of these two groups, even within Federal S&T agencies that are required to balance the perspectives of the science and policy communities in order to fulfill their agency mission. In support of an ongoing agency effort to strengthen communication and interaction among staff, we led a Federal S&T agency office through an examination and comparison of goals, processes, external drivers, decision making, and timelines within their organization. This workshop activity provided an opportunity to identify the interdependence of science and policy, as well as the challenges to developing effective science-based policy solutions. The workshop featured strategies for achieving balanced science policy outcomes using examples from a range of Federal S&T agencies. The examples presented during the workshop illustrated best practices for more effective communication and interaction to resolve complex science policy issues. The workshop culminated with a group activity designed to give participants the opportunity to identify the challenges and apply best practices to real world science policy problems. Workshop examples and outcomes will be presented along with lessons learned from this agency engagement activity.

  14. Primary and embedded steel imports to the U.S.: implications for the design of border tax adjustments.

    PubMed

    Izard, Catherine F; Weber, Christopher L; Matthews, H Scott

    2010-09-01

    Carbon Border Tax Adjustments (BTAs) are a politically popular strategy for avoiding competitive disadvantage problems when a country implements a unilateral climate change policy. A BTA taxes carbon embodied in imported goods in order to protect domestic industry and motivate other countries to implement climate change policy. To estimate the effectiveness of a BTA, is it is necessary to know which products are covered, where they were originally produced and ultimately exported from, and how the covered amount compares to total production in foreign countries. Using a scrap-adjusted, mixed-unit input-output model in conjunction with a multiregional input-output model, this analysis evaluates the effectiveness of BTAs for the case study of U.S. steel imports. Most imported steel by mass is embedded in finished products (60%), and 30% of that steel is produced in a different country than the one from which the final good is exported. Given the magnitudes involved and complexities of global supply chains, a BTA that protects domestic industry will be a challenge to implement. We propose a logistically feasible BTA structure that minimizes the information burden while still accounting for these complexities. However, the amount of steel imported to the U.S. is negligible (5%) compared to foreign production in BTA-eligible countries and is unlikely to motivate affected countries to impose an emissions reduction policy.

  15. Integrated agro-hydrological modelling and economic analysis of BMPs to support decision making and policy design

    NASA Astrophysics Data System (ADS)

    Maroy, E.; Rousseau, A. N.; Hallema, D. W.

    2012-12-01

    With recent efforts and increasing control over point source pollution of freshwater, agricultural non-point pollution sources have become responsible for most of sediment and nutrient loads in North American water systems. Environmental and agricultural agencies have recognised the need for reducing eutrophication and have developed various policies to compel or encourage producers to best management practices (BMPs). Addressing diffuse pollution is challenging considering the complex and cumulative nature of transport processes, high variability in space and time, and prohibitive costs of distributed water quality monitoring. Many policy options exist to push producers to adopt environmentally desirable behaviour while keeping their activity viable, and ensure equitable costs to consumers and tax payers. On the one hand, economic instruments (subsidies, taxes, water quality markets) are designed to maximize cost-effectiveness, so that farmers optimize their production for maximum profit while implementing BMPs. On the other hand, emission standards or regulation of inputs are often easier and less costly to implement. To study economic and environmental impacts of such policies, a distributed modelling approach is needed to deal with the complexity of the system and the large environmental and socio-economic data requirements. Our objective is to integrate agro-hydrological modelling and economic analysis to support decision and policy making processes of BMP implementation. The integrated modelling system GIBSI was developed in an earlier study within the Canadian WEBs project (Watershed Evaluation of BMPs) to evaluate the influence of BMPs on water quality. The case study involved 30 and 15 year records of discharge and water quality measurements respectively, in the Beaurivage River watershed (Quebec, Canada). GIBSI provided a risk-based overview of the impact of BMPs (including vegetated riparian buffer strips, precision slurry application, conversion to grassland and no-till) in terms of sediment, nutrient and pesticide yields and loads. Input data included characteristics of reservoirs, land cover, soil, agricultural management, livestock management and point sources of pollution. The present study continues from there by first assessing the cost-effectiveness of different sets of BMPs, based on farm budgets and environmental criteria selected by the user. We subsequently examine monetary trade-offs between on-farm costs and social value of water quality improvements using cost-benefit ratios. Because water quality is a non-excludable and non-rivalrous good, its benefits to society are evaluated with non-market evaluation techniques mostly based on quality-constrained recreational use of water. From a policy perspective, cost-effectiveness analysis is very helpful in assisting the decision maker in the highly complex process of defining priorities with respect to BMP strategies. With a user-friendly interface for economic analysis integrated into GIBSI, watershed organizations and stakeholders can use such a tool to promote sustainable agricultural practices and water use. This submission is part of Watershed Evaluation of BMPs project (WEBs) funded by Agriculture and Agri-Food Canada and Ducks Unlimited Canada

  16. Qualitative analysis of the dynamics of policy design and implementation in hospital funding reform.

    PubMed

    Palmer, Karen S; Brown, Adalsteinn D; Evans, Jenna M; Marani, Husayn; Russell, Kirstie K; Martin, Danielle; Ivers, Noah M

    2018-01-01

    As in many health care systems, some Canadian jurisdictions have begun shifting away from global hospital budgets. Payment for episodes of care has begun to be implemented. Starting in 2012, the Province of Ontario implemented hospital funding reforms comprising three elements: Global Budgets; Health Based Allocation Method (HBAM); and Quality-Based Procedures (QBP). This evaluation focuses on implementation of QBPs, a procedure/diagnosis-specific funding approach involving a pre-set price per episode of care coupled with best practice clinical pathways. We examined whether or not there was consensus in understanding of the program theory underpinning QBPs and how this may have influenced full and effective implementation of this innovative funding model. We undertook a formative evaluation of QBP implementation. We used an embedded case study method and in-depth, one-on-one, semi-structured, telephone interviews with key informants at three levels of the health care system: Designers (those who designed the QBP policy); Adoption Supporters (organizations and individuals supporting adoption of QBPs); and Hospital Implementers (those responsible for QBP implementation in hospitals). Thematic analysis involved an inductive approach, incorporating Framework analysis to generate descriptive and explanatory themes that emerged from the data. Five main findings emerged from our research: (1) Unbeknownst to most key informants, there was neither consistency nor clarity over time among QBP designers in their understanding of the original goal(s) for hospital funding reform; (2) Prior to implementation, the intended hospital funding mechanism transitioned from ABF to QBPs, but most key informants were either unaware of the transition or believe it was intentional; (3) Perception of the primary goal(s) of the policy reform continues to vary within and across all levels of key informants; (4) Four years into implementation, the QBP funding mechanism remains misunderstood; and (5) Ongoing differences in understanding of QBP goals and funding mechanism have created challenges with implementation and difficulties in measuring success. Policy drift and policy layering affected both the goal and the mechanism of action of hospital funding reform. Lack of early specification in both policy goals and hospital funding mechanism exposed the reform to reactive changes that did not reflect initial intentions. Several challenges further exacerbated implementation of complex hospital funding reforms, including a prolonged implementation schedule, turnover of key staff, and inconsistent messaging over time. These factors altered the trajectory of the hospital funding reforms and created confusion amongst those responsible for implementation. Enacting changes to hospital funding policy through a process that is transparent, collaborative, and intentional may increase the likelihood of achieving intended effects.

  17. Applying observations from technological transformations in complex adaptive systems to inform health policy on technology adoption.

    PubMed

    Phillips, Andrew B; Merrill, Jacqueline

    2012-01-01

    Many complex markets such as banking and manufacturing have benefited significantly from technology adoption. Each of these complex markets experienced increased efficiency, quality, security, and customer involvement as a result of technology transformation in their industry. Healthcare has not benefited to the same extent. We provide initial findings from a policy analysis of complex markets and the features of these transformations that can influence health technology adoption and acceptance.

  18. Cyberspace as a Complex Adaptive System and the Policy and Operational Implications for Cyber Warfare

    DTIC Science & Technology

    2014-05-22

    CYBERSPACE AS A COMPLEX ADAPTIVE SYSTEM AND THE POLICY AND OPERTIONAL IMPLICATIONS FOR CYBER WARFARE A Monograph by Major Albert O. Olagbemiro...serves the US, especially in regards to the protect ion o f the 1S. SUBJECT TERMS omplex Adaptive System, Cyberspace, lnfosphere, Cyber Warfare ber...System and the Policy and Operational Implications for Cyber Warfare Approved by: __________________________________, Monograph Director Jeffrey

  19. Health Policy and Management: in praise of political science. Comment on "On Health Policy and Management (HPAM): mind the theory-policy-practice gap".

    PubMed

    Hunter, David J

    2015-03-12

    Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems. © 2015 by Kerman University of Medical Sciences.

  20. The Energy-Water Nexus: Managing the Links between Energy and Water for a Sustainable Future

    NASA Astrophysics Data System (ADS)

    Hussey, Karen; Petit, Carine

    2010-05-01

    Water and energy are both indispensable inputs to modern economies but currently both resources are under threat owing to the impacts of an ever-increasing population and associated demand, unsustainable practices in agriculture and manufacturing, and the implications of a changing climate. However, it is where water and energy rely on each other that pose the most complex challenges for policy-makers. Water is needed for mining coal, drilling oil, refining gasoline, and generating and distributing electricity; and, conversely, vast amounts of energy are needed to pump, transport, treat and distribute water, particularly in the production of potable water through the use of desalination plants and waste water treatment plants. Despite the links, and the urgency in both sectors for security of supply, in existing policy frameworks energy and water policies are developed largely in isolation from one another. Worse still, some policies designed to encourage alternative energy supplies give little thought to the resultant consequences on water resources, and, similarly, policies designed to secure water supplies pay little attention to the resultant consequences on energy use. The development of new technologies presents both opportunities and challenges for managing the energy-water nexus but a better understanding of the links between energy and water is essential in any attempt to formulate policies for more resilient and adaptable societies. The energy-water nexus must be adequately integrated into policy and decision-making or governments run the risk of contradicting their efforts, and therefore failing in their objectives, in both sectors. A series of COST Exploratory Workshops, drawing on on-going research in the energy-water nexus from a number of international teams, identified the implications of the energy-water nexus on the development of (i) energy policies (ii) water resource management policies and (iii) climate adaptation and mitigation policies. A preliminary list of recommendations on how best to account for and integrate these impacts into policy and decision-making processes at various institutional levels was prepared and future research needs in the energy-water nexus were suggested as main outcomes. This presentation draws on the contributions to the COST water-energy-links exploratory workshops and the development of 12 case studies undertaken by researchers from Europe, the United States, Australia and China, which will be published in a Special Feature of Ecology and Society, mid-2010.

  1. Resource Management and Contingencies in Aerospace Concurrent Engineering

    NASA Technical Reports Server (NTRS)

    Karpati, Gabe; Hyde, Tupper; Peabody, Hume; Garrison, Matthew

    2012-01-01

    significant concern in designing complex systems implementing new technologies is that while knowledge about the system is acquired incrementally, substantial financial commitments, even make-or-break decisions, must be made upfront, essentially in the unknown. One practice that helps in dealing with this dichotomy is the smart embedding of contingencies and margins in the design to serve as buffers against surprises. This issue presents itself in full force in the aerospace industry, where unprecedented systems are formulated and committed to as a matter of routine. As more and more aerospace mission concepts are generated by concurrent design laboratories, it is imperative that such laboratories apply well thought-out contingency and margin structures to their designs. The first part of this publication provides an overview of resource management techniques and standards used in the aerospace industry. That is followed by a thought provoking treatise on margin policies. The expose presents the actual flight telemetry data recorded by the thermal discipline during several recent NASA Goddard Space Flight Center missions. The margins actually achieved in flight are compared against pre-flight predictions, and the appropriateness and the ramifications of having designed with rigid margins to bounding stacked worst case conditions are assessed. The second half of the paper examines the particular issues associated with the application of contingencies and margins in the concurrent engineering environment. In closure, a discipline-by-discipline disclosure of the contingency and margin policies in use at the Integrated Design Center at NASA s Goddard Space Flight Center is made.

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

    PubMed

    Brooks, Eleanor; Geyer, Robert

    2012-12-01

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

  3. The direct support workforce in community supports to individuals with developmental disabilities: issues, implications, and promising practices.

    PubMed

    Hewitt, Amy; Larson, Sheryl

    2007-01-01

    Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to the sustainability, growth, and quality of community services for people with developmental disabilities (ANCOR [2001] State of the states report. Alexandria, VA: ANCOR; Colorado Department of Human Services, [2000] Response to Footnote 106 of the FY 2001 appropriations long bill: Capacity of the community services systems for persons with developmental disabilities in Colorado; Hewitt [2000] Dynamics of the workforce crisis. Presentation at the NASDDDS Fall meeting. Alexandria, VA). While long in existence, these challenges are ones of growing concern because the number of people demanding community services is increasing and the population of people from which to recruit workers is declining (Office of the Assistant Secretary for Planning and Evaluation [2006] The supply of direct support professionals serving individuals with intellectual disabilities and other developmental disabilities: Report to Congress. Washington, DC: Office of Disability, Aging and Long-Term Care Policy, ASPE, U.S. Department of Health and Human Services). As the service system moves towards consumer direction, managed care, and more noncategorical service delivery systems, the difficulties of providing for an adequate and well-prepared workforce to support people with developmental disabilities becomes more complex and multifaceted. The solutions to those challenges are also more complex. This article reviews the literature regarding the complexity of the direct support workforce crisis, the effects of this crisis on various stakeholder groups, promising practices designed to address the challenges, and the related practice and policy implications. (c) 2007 Wiley-Liss, Inc.

  4. Feed-in Tariffs: Good Practices and Design Considerations

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

    Cox, Sadie; Esterly, Sean

    2016-01-02

    In recent years, feed-in tariff (FIT) activity has focused primarily on revisions to current policies, underscoring the need for stable and predictable, yet flexible, policy environments. This policy brief provides a primer on key FIT design elements, lessons from country experience, and support resources to enable more detailed and country-specific FIT policy design.

  5. Multimorbidity and unmet citizens’ needs and expectations urge for reforms in the health system of Cyprus: a questionnaire survey

    PubMed Central

    Theodosopoulou, Eleni; Papanastasiou, Elena

    2014-01-01

    Objective This study aims to investigate the prevalence of multimorbidity in Cyprus and the extent to which citizens are satisfied with the currently provided healthcare and to provide recommendations on the basis of findings. Design A nationally based survey conducted through personal interviews, using a structured questionnaire designed for this survey. Setting Cyprus rural and urban areas (excluding Turkish occupied areas). Participants Four hundred and sixty-five Cypriot adults, average age 53 years. Main outcome measures Lifetime prevalence of self-reported non-communicable diseases. Results This study demonstrated initial evidence for a high prevalence of non-age specific multimorbidity among Cypriots and dissatisfaction with their doctors, especially for the time allocated to discuss their general state of health. Recommendations focus on a new cost-effective, person-centred model of healthcare. The model prioritizes prevention rather than treatment, targeting the determinants of complexity before their influences create conditions that demand high-cost interventions, and it is based on three fundamental principles: (1) tackling health as a political issue, (2) empowering the patient and (3) introducing Applied Nutrition in the system. Conclusions This study threw light into the issue of patient complexity and revealed unmet people’s needs and expectations for a more person-centred care, providing a first challenge to the single disease-based system of healthcare in Cyprus. The findings of the study may have important implications for government policies and highlight the need for more research in this area to inform policy makers, particularly in view of the fact that a new Health System is currently being designed. PMID:25057367

  6. State insurance exchanges face challenges in offering standardized choices alongside innovative value-based insurance.

    PubMed

    Corlette, Sabrina; Downs, David; Monahan, Christine H; Yondorf, Barbara

    2013-02-01

    Value-based insurance is a relatively new approach to health insurance in which financial barriers, such as copayments, are lowered for clinical services that are considered high value, while consumer cost sharing may be increased for services considered to be of uncertain value. Such plans are complex and do not easily fit into the simplified, consumer-friendly comparison tools that many state health insurance exchanges are formulating for use in 2014. Nevertheless some states and plans are attempting to strike the right balance between a streamlined health exchange shopping experience and innovative, albeit complex, benefit design that promotes value. For example, agencies administering exchanges in Vermont and Oregon are contemplating offering value-based insurance plans as an option in addition to a set of standardized plans. In the postreform environment, policy makers must find ways to present complex value-based insurance plans in a way that consumers and employers can more readily understand.

  7. Impacts of Changing Marijuana Policies on Alcohol Use in the United States

    PubMed Central

    Guttmannova, Katarina; Lee, Christine M.; Kilmer, Jason R.; Fleming, Charles B.; Rhew, Isaac C.; Kosterman, Rick; Larimer, Mary E.

    2015-01-01

    Background Marijuana policies are rapidly evolving. In the United States, recreational use of marijuana is now legal in four states and medical marijuana is legal in 23 states. Research evaluating such policies has focused primarily on how policies affect issues of price, access to, use, and consequences of marijuana. Due to potential spillover effects, researchers also need to examine how marijuana policies may impact use and consequences of alcohol. Methods The current paper is a critical review of articles evaluating alcohol outcomes associated with marijuana decriminalization, medical marijuana legalization, and non-medical or recreational marijuana legalization. We identified articles and reports through (1) online searches of EBSCO host database including Academic search premier, Econlit, Legal collection, Medline, Psych articles, and PsycINFO, as well as PubMed and Google Scholar databases; (2) review of additional articles cited in papers identified through electronic searches; and (3) targeted searches of state and local government records regarding marijuana law implementation. We reviewed studies with respect to their data sources and sample characteristics, methodology, and the margin of alcohol and marijuana use, timing of policy change, and the aspects of laws examined. Results The extant literature provides some evidence for both substitution (i.e., more liberal marijuana policies related to less alcohol use as marijuana becomes a substitute) and complementary (i.e., more liberal marijuana policies related to increases in both marijuana and alcohol use) relationships in the context of liberalization of marijuana policies in the United States. Conclusions Impact of more liberal marijuana policies on alcohol use is complex, and likely depends on specific aspects of policy implementation, including how long the policy has been in place. Further, evaluation of marijuana policy effects on alcohol use may be sensitive to the age group studied and the margin of alcohol use examined. Design of policy evaluation research requires careful consideration of these issues. PMID:26727520

  8. Multiobjective optimization for Groundwater Nitrate Pollution Control. Application to El Salobral-Los Llanos aquifer (Spain).

    NASA Astrophysics Data System (ADS)

    Llopis-Albert, C.; Peña-Haro, S.; Pulido-Velazquez, M.; Molina, J.

    2012-04-01

    Water quality management is complex due to the inter-relations between socio-political, environmental and economic constraints and objectives. In order to choose an appropriate policy to reduce nitrate pollution in groundwater it is necessary to consider different objectives, often in conflict. In this paper, a hydro-economic modeling framework, based on a non-linear optimization(CONOPT) technique, which embeds simulation of groundwater mass transport through concentration response matrices, is used to study optimal policies for groundwater nitrate pollution control under different objectives and constraints. Three objectives were considered: recovery time (for meeting the environmental standards, as required by the EU Water Framework Directive and Groundwater Directive), maximum nitrate concentration in groundwater, and net benefits in agriculture. Another criterion was added: the reliability of meeting the nitrate concentration standards. The approach allows deriving the trade-offs between the reliability of meeting the standard, the net benefits from agricultural production and the recovery time. Two different policies were considered: spatially distributed fertilizer standards or quotas (obtained through multi-objective optimization) and fertilizer prices. The multi-objective analysis allows to compare the achievement of the different policies, Pareto fronts (or efficiency frontiers) and tradeoffs for the set of mutually conflicting objectives. The constraint method is applied to generate the set of non-dominated solutions. The multi-objective framework can be used to design groundwater management policies taking into consideration different stakeholders' interests (e.g., policy makers, agricultures or environmental groups). The methodology was applied to the El Salobral-Los Llanos aquifer in Spain. Over the past 30 years the area has undertaken a significant socioeconomic development, mainly due to the intensive groundwater use for irrigated crops, which has provoked a steady decline of groundwater levels as well as high nitrate concentrations at certain locations (above 50 mg/l.). The results showed the usefulness of this multi-objective hydro-economic approach for designing sustainable nitrate pollution control policies (as fertilizer quotas or efficient fertilizer pricing policies) with insight into the economic cost of satisfying the environmental constraints and the tradeoffs with different time horizons.

  9. EQUIP Healthcare: An overview of a multi-component intervention to enhance equity-oriented care in primary health care settings.

    PubMed

    Browne, Annette J; Varcoe, Colleen; Ford-Gilboe, Marilyn; Wathen, C Nadine

    2015-12-14

    The primary health care (PHC) sector is increasingly relevant as a site for population health interventions, particularly in relation to marginalized groups, where the greatest gains in health status can be achieved. The purpose of this paper is to provide an overview of an innovative multi-component, organizational-level intervention designed to enhance the capacity of PHC clinics to provide equity-oriented care, particularly for marginalized populations. The intervention, known as EQUIP, is being implemented in Canada in four diverse PHC clinics serving populations who are impacted by structural inequities. These PHC clinics serve as case studies for the implementation and evaluation of the EQUIP intervention. We discuss the evidence and theory that provide the basis for the intervention, describe the intervention components, and discuss the methods used to evaluate the implementation and impact of the intervention in diverse contexts. Research and theory related to equity-oriented care, and complexity theory, are central to the design of the EQUIP intervention. The intervention aims to enhance capacity for equity-oriented care at the staff level, and at the organizational level (i.e., policy and operations) and is novel in its dual focus on: (a) Staff education: using standardized educational models and integration strategies to enhance staff knowledge, attitudes and practices related to equity-oriented care in general, and cultural safety, and trauma- and violence-informed care in particular, and; (b) Organizational integration and tailoring: using a participatory approach, practice facilitation, and catalyst grants to foster shifts in organizational structures, practices and policies to enhance the capacity to deliver equity-oriented care, improve processes of care, and shift key client outcomes. Using a mixed methods, multiple case-study design, we are examining the impact of the intervention in enhancing staff knowledge, attitudes and practices; improving processes of care; shifting organizational policies and structures; and improving selected client outcomes. The multiple case study design provides an ideal opportunity to study the contextual factors shaping the implementation, uptake and impact of our tailored intervention within diverse PHC settings. The EQUIP intervention illustrates the complexities involved in enhancing the PHC sector's capacity to provide equity-oriented care in real world clinical contexts.

  10. Europeanisation and Policy Change in the Danish Vocational Education and Training System

    ERIC Educational Resources Information Center

    Cort, Pia

    2010-01-01

    This article aims to analyse the interrelationship between the Copenhagen Process, EU vocational education and training policy, and Danish initial vocational education and training policies in order to shed light on the role of EU policies in policy and institutional change. The article points to the complexity of policy-making and the…

  11. The European Arctic policy in progress

    NASA Astrophysics Data System (ADS)

    Conde Pérez, Elena; Yaneva, Zhaklin Valerieva

    2016-09-01

    The geostrategic, political, economic, and scientific relevance of the Arctic is constantly growing due to the complex process of climate change. Accordingly, the European Union-as a global political actor-, is already taking steps to ensure and strengthen its influence in the region while demonstrating readiness to face the many opportunities and challenges ahead in cooperation with the traditional stakeholders. Therefore, in order to reflect the renewed importance of the Arctic transformation, the Union has been designing its Arctic Policy focusing on climate change mitigation and multilateral cooperation as its main strengths. Unfortunately, despite the diligence and impetus that has been invested, this process has been delayed in several occasions as the Union had to deal with internal and external destabilizing factors, such as the later immigration crisis or the lack of uniformity among its member states' foreign policy interests. These factors will be analyzed along with the process of creation and development of the EU's Arctic policy. Despite some delays, on 27 April 2016, the long-awaited third communication was issued and progress has been made: even if, in general terms, the new document remains a political statement, there is also a clear commitment to action.

  12. The Politics of Universal Health Coverage in Low- and Middle-Income Countries: A Framework for Evaluation and Action.

    PubMed

    Fox, Ashley M; Reich, Michael R

    2015-10-01

    Universal health coverage has recently become a top item on the global health agenda pressed by multilateral and donor organizations, as disenchantment grows with vertical, disease-specific health programs. This increasing focus on universal health coverage has brought renewed attention to the role of domestic politics and the interaction between domestic and international relations in the health reform process. This article proposes a theory-based framework for analyzing the politics of health reform for universal health coverage, according to four stages in the policy cycle (agenda setting, design, adoption, and implementation) and four variables that affect reform (interests, institutions, ideas, and ideology). This framework can assist global health policy researchers, multilateral organization officials, and national policy makers in navigating the complex political waters of health reforms aimed at achieving universal health coverage. To derive the framework, we critically review the theoretical and applied literature on health policy reform in developing countries and illustrate the framework with examples of health reforms moving toward universal coverage in low- and middle-income countries. We offer a series of lessons stemming from these experiences to date. Copyright © 2015 by Duke University Press.

  13. Creating social policy to support women's agency in coercive settings: A case study from Uganda.

    PubMed

    Burgess, Rochelle; Campbell, Catherine

    2016-01-01

    Many emphasise the need for policies that support women's agency in highly coercive settings, and the importance of involving target women in public deliberation to inform policy design. The Ugandan Marriage and Divorce Bill seeks to strengthen women's agency in marriage, but has faced many obstacles, including objections from many women themselves in public consultations. We explore key stakeholders' accounts of the difficulties facing the Bill's progress to date, through focus groups with 24 rural and urban men and women, interviews with 14 gender champions in government, non-governmental organisations and legal sectors, and 25 relevant media and radio reports. Thematic analysis revealed an array of representations of the way the Bill's progress was shaped by the public consultation process, the nature of the Ugandan public sphere, the understanding and manipulation of concepts such as 'culture' and 'custom' in public discourse, the impact of economic inequalities on women's understandings of their gendered interests and low women's trust in the law and the political process. We discuss the complexities of involving highly marginalised women in public debates about gender issues and highlight possible implications for conceptualising agency, gender and social change as tools for gender policy and activism in extreme inequality.

  14. Sustainable urban systems: Co-design and framing for transformation.

    PubMed

    Webb, Robert; Bai, Xuemei; Smith, Mark Stafford; Costanza, Robert; Griggs, David; Moglia, Magnus; Neuman, Michael; Newman, Peter; Newton, Peter; Norman, Barbara; Ryan, Chris; Schandl, Heinz; Steffen, Will; Tapper, Nigel; Thomson, Giles

    2018-02-01

    Rapid urbanisation generates risks and opportunities for sustainable development. Urban policy and decision makers are challenged by the complexity of cities as social-ecological-technical systems. Consequently there is an increasing need for collaborative knowledge development that supports a whole-of-system view, and transformational change at multiple scales. Such holistic urban approaches are rare in practice. A co-design process involving researchers, practitioners and other stakeholders, has progressed such an approach in the Australian context, aiming to also contribute to international knowledge development and sharing. This process has generated three outputs: (1) a shared framework to support more systematic knowledge development and use, (2) identification of barriers that create a gap between stated urban goals and actual practice, and (3) identification of strategic focal areas to address this gap. Developing integrated strategies at broader urban scales is seen as the most pressing need. The knowledge framework adopts a systems perspective that incorporates the many urban trade-offs and synergies revealed by a systems view. Broader implications are drawn for policy and decision makers, for researchers and for a shared forward agenda.

  15. Knowledge exchange systems for youth health and chronic disease prevention: a tri-provincial case study.

    PubMed

    Murnaghan, D; Morrison, W; Griffith, E J; Bell, B L; Duffley, L A; McGarry, K; Manske, S

    2013-09-01

    The research teams undertook a case study design using a common analytical framework to investigate three provincial (Prince Edward Island, New Brunswick and Manitoba) knowledge exchange systems. These three knowledge exchange systems seek to generate and enhance the use of evidence in policy development, program planning and evaluation to improve youth health and chronic disease prevention. We applied a case study design to explore the lessons learned, that is, key conditions or processes contributing to the development of knowledge exchange capacity, using a multi-data collection method to gain an in-depth understanding. Data management, synthesis and analysis activities were concurrent, iterative and ongoing. The lessons learned were organized into seven "clusters." Key findings demonstrated that knowledge exchange is a complex process requiring champions, collaborative partnerships, regional readiness and the adaptation of knowledge exchange to diverse stakeholders. Overall, knowledge exchange systems can increase the capacity to exchange and use evidence by moving beyond collecting and reporting data. Areas of influence included development of new partnerships, expanded knowledge-sharing activities, and refinement of policy and practice approaches related to youth health and chronic disease prevention.

  16. Evaluating a complex, multi-site, community-based program to improve healthcare quality: the summative research design for the Aligning Forces for Quality initiative.

    PubMed

    Scanlon, Dennis P; Wolf, Laura J; Alexander, Jeffrey A; Christianson, Jon B; Greene, Jessica; Jean-Jacques, Muriel; McHugh, Megan; Shi, Yunfeng; Leitzell, Brigitt; Vanderbrink, Jocelyn M

    2016-08-01

    The Aligning Forces for Quality (AF4Q) initiative was the Robert Wood Johnson Foundation's (RWJF's) signature effort to increase the overall quality of healthcare in targeted communities throughout the country. In addition to sponsoring this 16-site complex program, RWJF funded an independent scientific evaluation to support objective research on the initiative's effectiveness and contributions to basic knowledge in 5 core programmatic areas. The research design, data, and challenges faced during the summative evaluation phase of this near decade-long program are discussed. A descriptive overview of the summative research design and its development for a multi-site, community-based, healthcare quality improvement initiative is provided. The summative research design employed by the evaluation team is discussed. The evaluation team's summative research design involved a data-driven assessment of the effectiveness of the AF4Q program at large, assessments of the impact of AF4Q in the specific programmatic areas, and an assessment of how the AF4Q alliances were positioned for the future at the end of the program. The AF4Q initiative was the largest privately funded community-based healthcare improvement initiative in the United States to date and was implemented at a time of rapid change in national healthcare policy. The implementation of large-scale, multi-site initiatives is becoming an increasingly common approach for addressing problems in healthcare. The summative evaluation research design for the AF4Q initiative, and the lessons learned from its approach, may be valuable to others tasked with evaluating similarly complex community-based initiatives.

  17. Analysis of agency relationships in the design and implementation process of the equity fund in Madagascar.

    PubMed

    Honda, Ayako

    2015-02-04

    There are large gaps in the literature relating to the implementation of user fee policy and fee exemption measures for the poor, particularly on how such schemes are implemented and why many have not produced expected outcomes. In October 2003, Madagascar instituted a user fee exemption policy which established "equity funds" at public health centres, and used medicine sales revenue to subsidise the cost of medicine for the poor. This study examines the policy design and implementation process of the equity fund in Madagascar in an attempt to explore factors influencing the poor equity outcomes of the scheme. This study applied an agency-incentive framework to investigate the equity fund policy design and implementation practices. It analysed agency relationships established during implementation; examined incentive structures given to the agency relationships in the policy design; and considered how incentive structures were shaped and how agents responded in practice. The study employed a case-study approach with in-depth analysis of three equity fund cases in Madagascar's Boeny region. Policy design problems, triggering implementation problems, caused poor equity performance. These problems were compounded by the re-direction of policy objectives by health administrators and strong involvement of the administrators in the implementation of policy. The source of the policy design and implementation failure was identified as a set of principal-agent problems concerning: monitoring mechanisms; facility-based fund management; and the nature and level of community participation. These factors all contributed to the financial performance of the fund receiving greater attention than its ability to financially protect the poor. The ability of exemption policies to protect the poor from user fees can be found in the details of the policy design and implementation; and implications of the policy design and implementation in a specific context determine whether a policy can realise its objectives. The equity fund experience in Madagascar, which illustrates the challenges of beneficiary identification, casts doubts on the application of the 'targeting' approach in health financing and raises issues to be considered in universal health policy formulation. The agency framework provides a useful lens through which to examine policy process issues.

  18. Alternative Policy Designs and the Socio-political Construction of Childcare

    ERIC Educational Resources Information Center

    Rigby, Elizabeth; Tarrant, Kate; Neuman, Michelle J.

    2007-01-01

    Policy makers and advocates have a variety of tools from which to choose when designing childcare policy. Policy design choices, such as whether to provide childcare assistance through a new government program or via a voucher for use in the private market, are in fact social, political, moral, and value-laden choices that shape the nature of…

  19. Slowing Entropy: Instructional Policy Design in New York City, 2011-12. Policy Brief #14-3

    ERIC Educational Resources Information Center

    Supovitz, Jonathan

    2014-01-01

    How do policymakers craft policies, particularly centered on the Common Core State Standards, to be more resilient and less likely to disintegrate during enactment? Researcher Jonathan Supovitz in "Slowing Entropy: Instructional Policy Design in New York City, 2011-12" examines the design of a New York City Department of Education policy…

  20. Patient Satisfaction by Design.

    PubMed

    Jacobs, Karen

    2016-11-01

    The concept of the patient experience as it relates to patient satisfaction is a complex dynamic. It is a dynamic that is becoming increasingly more important as patients are faced with multiple choices for their hearing and balance care. As reimbursement and performance policies have become more normative within health care, patient satisfaction has become a metric to measure quality. Patient satisfaction is no longer contained to just the interaction with the audiologist. It extends to the entire experience-the staff, the service, the product, and other factors. Many practices fail to capitalize on one of the primary components of the patient experience-office design. This article discusses the role of evidence-based design in facility planning as it relates to patient satisfaction. It will illustrate how design principles and ideal attributes may be used to send conscious and subconscious cues that will motivate staff, facilitate patient-centered care, and ultimately increase patient satisfaction.

  1. Patient Satisfaction by Design

    PubMed Central

    Jacobs, Karen

    2016-01-01

    The concept of the patient experience as it relates to patient satisfaction is a complex dynamic. It is a dynamic that is becoming increasingly more important as patients are faced with multiple choices for their hearing and balance care. As reimbursement and performance policies have become more normative within health care, patient satisfaction has become a metric to measure quality. Patient satisfaction is no longer contained to just the interaction with the audiologist. It extends to the entire experience—the staff, the service, the product, and other factors. Many practices fail to capitalize on one of the primary components of the patient experience—office design. This article discusses the role of evidence-based design in facility planning as it relates to patient satisfaction. It will illustrate how design principles and ideal attributes may be used to send conscious and subconscious cues that will motivate staff, facilitate patient-centered care, and ultimately increase patient satisfaction. PMID:28028324

  2. 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.

  3. 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

  4. Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease

    PubMed Central

    Barquera, Simon; Pedroza-Tobias, Andrea; Medina, Catalina

    2016-01-01

    Purpose of review There are today 11 mega-countries with more than 100 million inhabitants. Together these countries represent more than 60% of the world's population. All are facing noncommunicable chronic disease (NCD) epidemic where high cholesterol, obesity, diabetes, and cardiovascular diseases are becoming the main public health concerns. Most of these countries are facing the double burden of malnutrition where undernutrition and obesity coexist, increasing the complexity for policy design and implementation. The purpose of this study is to describe diverse sociodemographic characteristics of these countries and the challenges for prevention and control in the context of the nutrition transition. Recent findings Mega-countries are mostly low or middle-income and are facing important epidemiologic, nutrition, and physical activity transitions because of changes in food systems and unhealthy lifestyles. NCDs are responsible of two-thirds of the 57 million global deaths annually. Approximately, 80% of these are in low and middle-income countries. Only developed countries have been able to reduce mortality rates attributable to recognized risk factors for NCDs, in particular high cholesterol and blood pressure. Summary Mega-countries share common characteristics such as complex bureaucracies, internal ethnic, cultural and socioeconomic heterogeneity, and complexities to implement effective health promotion and education policies across population. Priorities for action must be identified and successful lessons and experiences should be carefully analyzed and replicated. PMID:27389629

  5. Municipal Officials' Participation in Built Environment Policy Development in the United States.

    PubMed

    Lemon, Stephenie C; Goins, Karin Valentine; Schneider, Kristin L; Brownson, Ross C; Valko, Cheryl A; Evenson, Kelly R; Eyler, Amy A; Heinrich, Katie M; Litt, Jill; Lyn, Rodney; Reed, Hannah L; Tompkins, Nancy O'Hara; Maddock, Jay

    2015-01-01

    This study examined municipal officials' participation in built environment policy initiatives focused on land use design, transportation, and parks and recreation. Web-based cross-sectional survey. Eighty-three municipalities with 50,000 or more residents in eight states. Four hundred fifty-three elected and appointed municipal officials. Outcomes included self-reported participation in land use design, transportation, and parks and recreation policy to increase physical activity. Independent variables included respondent position; perceptions of importance, barriers, and beliefs regarding physical activity and community design and layout; and physical activity partnership participation. Multivariable logistic regression models. Compared to other positions, public health officials had lower participation in land use design (78.3% vs. 29.0%), transportation (78.1% vs. 42.1%), and parks and recreation (67.1% vs. 26.3%) policy. Perceived limited staff was negatively associated with participation in each policy initiative. Perceptions of the extent to which physical activity was considered in community design and physical activity partnership participation were positively associated with participation in each. Perceived lack of collaboration was associated with less land use design and transportation policy participation, and awareness that community design affects physical activity was associated with more participation. Perceived lack of political will was associated with less parks and recreation policy participation. Public health officials are underrepresented in built environment policy initiatives. Improving collaborations may improve municipal officials' policy participation.

  6. Policy modeling for industrial energy use

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

    Worrell, Ernst; Park, Hi-Chun; Lee, Sang-Gon

    2003-03-01

    The international workshop on Policy Modeling for Industrial Energy Use was jointly organized by EETA (Professional Network for Engineering Economic Technology Analysis) and INEDIS (International Network for Energy Demand Analysis in the Industrial Sector). The workshop has helped to layout the needs and challenges to include policy more explicitly in energy-efficiency modeling. The current state-of-the-art models have a proven track record in forecasting future trends under conditions similar to those faced in the recent past. However, the future of energy policy in a climate-restrained world is likely to demand different and additional services to be provided by energy modelers. Inmore » this workshop some of the international models used to make energy consumption forecasts have been discussed as well as innovations to enable the modeling of policy scenarios. This was followed by the discussion of future challenges, new insights in the data needed to determine the inputs into energy model s, and methods to incorporate decision making and policy in the models. Based on the discussion the workshop participants came to the following conclusions and recommendations: Current energy models are already complex, and it is already difficult to collect the model inputs. Hence, new approaches should be transparent and not lead to extremely complex models that try to ''do everything''. The model structure will be determined by the questions that need to be answered. A good understanding of the decision making framework of policy makers and clear communication on the needs are essential to make any future energy modeling effort successful. There is a need to better understand the effects of policy on future energy use, emissions and the economy. To allow the inclusion of policy instruments in models, evaluation of programs and instruments is essential, and need to be included in the policy instrument design. Increased efforts are needed to better understand the effects of innovative (no n-monetary) policy instruments through evaluation and to develop approaches to model both conventional and innovative policies. The explicit modeling of barriers and decision making in the models seems a promising way to enable modeling of conventional and innovative policies. A modular modeling approach is essential to not only provide transparency, but also to use the available resources most effectively and efficiently. Many large models have been developed in the past, but have been abandoned after only brief periods of use. A development path based on modular building blocks needs the establishment of a flexible but uniform modeling framework. The leadership of international agencies and organizations is essential in the establishment of such a framework. A preference is given for ''softlinks'' between different modules and models, to increase transparency and reduce complexity. There is a strong need to improve the efficiency of data collection and interpretation efforts to produce reliable model inputs. The workshop participants support the need for the establishment of an (in-)formal exchanges of information, as well as modeling approaches. The development of an informal network of research institutes and universities to help build a common dataset and exchange ideas on specific areas is proposed. Starting with an exchange of students would be a relative low-cost way to start such collaboration. It would be essential to focus on specific topics. It is also essential to maintain means of regular exchange of ideas between researchers in the different focus points.« less

  7. A model infant feeding policy for Baby-Friendly designation in the USA.

    PubMed

    Feldman-Winter, Lori; Procaccini, Diane; Merewood, Anne

    2012-08-01

    In June 2010, the Communities Putting Prevention to Work program (Centers for Disease Control and Prevention) funded a New Jersey (NJ) Office on Nutrition and Fitness, Department of Health and Senior Services project to reduce obesity and increase exclusive breastfeeding by increased implementation of the Baby-Friendly Hospital Initiative in the state of NJ. At baseline, NJ had no Baby-Friendly hospitals and no hospital was using an infant feeding policy that conformed to standards required by Baby-Friendly USA for designation. To create a model infant feeding policy that would be adaptable for use at multiple NJ hospitals preparing for Baby-Friendly designation. Project consultants created a policy based on existent policies from the American Academy of Pediatrics, the Academy of Breastfeeding Medicine, certified Baby-Friendly hospitals, and guidance from Baby-Friendly USA. This policy was submitted to Baby-Friendly USA, the US body responsible for Baby-Friendly designation. Baby-Friendly USA requested changes; after adaptations, the policy was made available to targeted NJ hospitals via a statewide portal. The hospitals made relevant adaptations for their setting, and those that were ready submitted the policy during the Baby-Friendly designation process. The policy was acceptable to Baby-Friendly USA. A collaborative initiative can use a single breastfeeding policy template as an aid toward Baby-Friendly designation. Such work streamlines the process and saves time and resources.

  8. Performativity and Pedagogising Knowledge: Globalising Educational Policy Formation, Dissemination and Enactment

    ERIC Educational Resources Information Center

    Singh, Parlo

    2015-01-01

    Critical policy scholars have increasingly turned their attention to: (1) the work of policy actors engaged in globalised and globalising processes of policy formation, (2) the global flows or movements of education policies across multifaceted, hybrid networks of public-private agencies, and (3) the complex politics of global-national policy…

  9. Troubling the Boundaries: Overcoming Methodological Challenges in a Multi-Sectoral and Multi-Jurisdictional HIV/HCV Policy Scoping Review

    ERIC Educational Resources Information Center

    Hare, Kathleen A.; Dubé, Anik; Marshall, Zack; Gahagan, Jacqueline; Harris, Gregory E.; Tucker, Maryanne; Dykeman, Margaret; MacDonald, Jo-Ann

    2016-01-01

    Policy scoping reviews are an effective method for generating evidence-informed policies. However, when applying guiding methodological frameworks to complex policy evidence, numerous, unexpected challenges can emerge. This paper details five challenges experienced and addressed by a policy trainee-led, multi-disciplinary research team, while…

  10. Development of a Systems Science Curriculum to Engage Rural African American Teens in Understanding and Addressing Childhood Obesity Prevention.

    PubMed

    Frerichs, Leah; Hassmiller Lich, Kristen; Young, Tiffany L; Dave, Gaurav; Stith, Doris; Corbie-Smith, Giselle

    2018-06-01

    Engaging youth from racial and ethnic minority communities as leaders for change is a potential strategy to mobilize support for addressing childhood obesity, but there are limited curricula designed to help youth understand the complex influences on obesity. Our aim was to develop and pilot test a systems science curriculum to elicit rural African American youth perspectives on childhood obesity and enhance their understanding of and support for obesity prevention solutions. The curriculum was designed so it could be integrated with existing positive youth development curricula that help youth advocate for and implement identified solutions. We conducted four workshop sessions with youth that engaged them in systems learning activities such as guided systems diagramming activities. The participants ( n = 21) completed validated surveys presession and postsession that assessed their causal attributions of obesity and support for obesity prevention policies. The youths' perception that environmental factors cause obesity increased ( p < .05), and perceptions that individual behavior and biology cause obesity did not change. Their support for policies that addressed food access and food pricing significantly increased ( p < .05). The youths' system diagrams elucidated links between multilevel factors such as personal attitudes, social influence, and the built environment, which provides important information for designing synergistic solutions. The changes we observed in youths' perceptions of obesity and support for policy changes have important implications for youths' interest and willingness to advocate for social and environmental changes in their community. The strategies have a promising role in supporting community mobilization to address childhood obesity.

  11. Watermark: An Application and Methodology and Application for Interactive and intelligent Decision Support for Groundwater Systems

    NASA Astrophysics Data System (ADS)

    Pierce, S. A.; Wagner, K.; Schwartz, S.; Gentle, J. N., Jr.

    2016-12-01

    Critical water resources face the effects of historic drought, increased demand, and potential contamination, the need has never been greater to develop resources to effectively communicate conservation and protection across a broad audience and geographical area. The Watermark application and macro-analysis methodology merges topical analysis of context rich corpus from policy texts with multi-attributed solution sets from integrated models of water resource and other subsystems, such as mineral, food, energy, or environmental systems to construct a scalable, robust, and reproducible approach for identifying links between policy and science knowledge bases. The Watermark application is an open-source, interactive workspace to support science-based visualization and decision making. Designed with generalization in mind, Watermark is a flexible platform that allows for data analysis and inclusion of large datasets with an interactive front-end capable of connecting with other applications as well as advanced computing resources. In addition, the Watermark analysis methodology offers functionality that streamlines communication with non-technical users for policy, education, or engagement with groups around scientific topics of societal relevance. The technology stack for Watermark was selected with the goal of creating a robust and dynamic modular codebase that can be adjusted to fit many use cases and scale to support usage loads that range between simple data display to complex scientific simulation-based modelling and analytics. The methodology uses to topical analysis and simulation-optimization to systematically analyze the policy and management realities of resource systems and explicitly connect the social and problem contexts with science-based and engineering knowledge from models. A case example demonstrates use in a complex groundwater resources management study highlighting multi-criteria spatial decision making and uncertainty comparisons.

  12. HIV policy implementation in two health and demographic surveillance sites in Uganda: findings from a national policy review, health facility surveys and key informant interviews.

    PubMed

    McRobie, Ellen; Wringe, Alison; Nakiyingi-Miiro, Jessica; Kiweewa, Francis; Lutalo, Tom; Nakigozi, Gertrude; Todd, Jim; Eaton, Jeffrey William; Zaba, Basia; Church, Kathryn

    2017-04-05

    Successful HIV testing, care and treatment policy implementation is essential for realising the reductions in morbidity and mortality those policies are designed to target. While adoption of new HIV policies is rapid, less is known about the facility-level implementation of new policies and the factors influencing this. We assessed implementation of national policies about HIV testing, treatment and retention at health facilities serving two health and demographic surveillance sites (HDSS) (10 in Kyamulibwa, 14 in Rakai). Ugandan Ministry of Health HIV policy documents were reviewed in 2013, and pre-determined indicators were extracted relating to the content and nature of guidance on HIV service provision. Facility-level policy implementation was assessed via a structured questionnaire administered to in-charge staff from each health facility. Implementation of policies was classified as wide (≥75% facilities), partial (26-74% facilities) or minimal (≤25% facilities). Semi-structured interviews were conducted with key informants (policy-makers, implementers, researchers) to identify factors influencing implementation; data were analysed using the Framework Method of thematic analysis. Most policies were widely implemented in both HDSS (free testing, free antiretroviral treatment (ART), WHO first-line regimen as standard, Option B+). Both had notable implementation gaps for policies relating to retention on treatment (availability of nutritional supplements, support groups or isoniazid preventive therapy). Rakai implemented more policies relating to provision of antiretroviral treatment than Kyamulibwa and performed better on quality of care indicators, such as frequency of stock-outs. Factors facilitating implementation were donor investment and support, strong scientific evidence, low policy complexity, phased implementation and effective planning. Limited human resources, infrastructure and health management information systems were perceived as major barriers to effective implementation. Most HIV policies were widely implemented in the two settings; however, gaps in implementation coverage prevail and the value of ensuring complete coverage of existing policies should be considered against the adoption of new policies in regard to resource needs and health benefits.

  13. Medicaid's Complex Goals: Challenges for Managed Care and Behavioral Health

    PubMed Central

    Gold, Marsha; Mittler, Jessica

    2000-01-01

    The Medicaid program has become increasingly complex as policymakers use it to address various policy objectives, leading to structural tensions that surface with Medicaid managed care. In this article, we illustrate this complexity by focusing on the experience of three States with behavioral health carveouts—Maryland, Oregon, and Tennessee. Converting to Medicaid managed care forces policymakers to confront Medicaid's competing policy objectives, multiplicity of stakeholders, and diverse patients, many with complex needs. Emerging Medicaid managed care systems typically represent compromises in which existing inequities and fragmentation are reconfigured rather than eliminated. PMID:12500322

  14. Improvement attributes in healthcare: implications for integrated care.

    PubMed

    Harnett, Patrick John

    2018-04-16

    Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care. Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare. Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics. Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process. Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches.

  15. Youth and digital media: a policy research agenda.

    PubMed

    Montgomery, K

    2000-08-01

    At a time when researchers are still sorting out the complex relationship between adolescents and the mass media, the entire nature of the media system is undergoing dramatic change. The explosive growth of the Internet is ushering in a new digital media culture. Youth are embracing the new technologies much more rapidly than adults. In addition, because of their increased spending power, youth have become a valuable target market for advertisers. These trends have spurred the proliferation of Web sites and other forms of new-media content specifically designed for teens and children. The burgeoning digital marketplace has spawned a new generation of market research companies, and market research on children and youth is outpacing academic research on youth and the newer media. The emergence of this new media culture holds both promise and peril for youth. Whether the positive or negative vision of the digital future prevails will be determined, in large part, by decisions being made now and in the next few years in the halls of government and in corporate boardrooms. Research has contributed to the resolutions of several recent legislative and policy decisions in areas including television violence and the V-chip, children's educational television programming, and privacy and marketing to children on the Web. Future research needs to be designed with the public policy agenda in mind. The academic community has much to contribute to the debates over new developments in the digital age.

  16. Test-and-treat approach to HIV/AIDS: a primer for mathematical modeling.

    PubMed

    Nah, Kyeongah; Nishiura, Hiroshi; Tsuchiya, Naho; Sun, Xiaodan; Asai, Yusuke; Imamura, Akifumi

    2017-09-05

    The public benefit of test-and-treat has induced a need to justify goodness for the public, and mathematical modeling studies have played a key role in designing and evaluating the test-and-treat strategy for controlling HIV/AIDS. Here we briefly and comprehensively review the essence of contemporary understanding of the test-and-treat policy through mathematical modeling approaches and identify key pitfalls that have been identified to date. While the decrease in HIV incidence is achieved with certain coverages of diagnosis, care and continued treatment, HIV prevalence is not necessarily decreased and sometimes the test-and-treat is accompanied by increased long-term cost of antiretroviral therapy (ART). To confront with the complexity of assessment on this policy, the elimination threshold or the effective reproduction number has been proposed for its use in determining the overall success to anticipate the eventual elimination. Since the publication of original model in 2009, key issues of test-and-treat modeling studies have been identified, including theoretical problems surrounding the sexual partnership network, heterogeneities in the transmission dynamics, and realistic issues of achieving and maintaining high treatment coverage in the most hard-to-reach populations. To explicitly design country-specific control policy, quantitative modeling approaches to each single setting with differing epidemiological context would require multi-disciplinary collaborations among clinicians, public health practitioners, laboratory technologists, epidemiologists and mathematical modelers.

  17. Recommendations for sexual expression management in long-term care: a qualitative needs assessment

    PubMed Central

    Syme, Maggie L.; Lichtenberg, Peter; Moye, Jennifer

    2017-01-01

    Aims To conduct a qualitative needs assessment of Directors of Nursing regarding challenges and recommendations for addressing sexual expression and consent. Background Sexual expression management among long-term care residents is a complex issue for nursing home staff. Little guidance is available for those wanting to follow a person-centred approach. Policies and procedures are needed, and must be usable across long-term care settings. Design Qualitative design for in-depth exploration. Methods Semi-structured interviews were conducted with 20 Directors of Nursing in the spring and summer of 2013, representing a range of regions, facility sizes and resident populations. Interview questions prompted them to identify recommendations that address challenges to improving sexual expression management in long-term care settings. Results Comparative thematic analysis resulted in several codes, which were grouped into eight overall categories. Recommendation categories that addressed key challenges included: address the issue, make environmental changes, identify staff expertise, provide education and training, assess sexuality initially and recurrently, establish policies/procedures for sexual expression management, develop assessment tools for sexual expression and consent, and clarify legal issues. The recommendation to develop national guidelines was observed across categories. Discussion Directors of Nursing report several challenges to sexual expression management in their facilities, and perceive their current methods to be ad hoc. A proactive approach to policy and procedure development is needed. PMID:27188413

  18. Language Policy in Canada: Current Issues. A Selection of the Proceedings of the Papers Dealing with Language Policy Issues in Canada at the Conference "Language Policy and Social Problems" (Curacao, Venezuela, December, 1983). Publication B-150.

    ERIC Educational Resources Information Center

    Cobarrubias, Juan, Ed.

    The papers related to Canadian language policy at an international conference are presented: "Language Policy in Canada: Current Issues" (Juan Cobarrubias); "Multiculturalism and Language Policy in Canada" (Jim Cummins, Harold Troper); "Defining Language Policy in a Nationalistic Milieu and in a Complex Industrialized…

  19. A duality framework for stochastic optimal control of complex systems

    DOE PAGES

    Malikopoulos, Andreas A.

    2016-01-01

    In this study, we address the problem of minimizing the long-run expected average cost of a complex system consisting of interactive subsystems. We formulate a multiobjective optimization problem of the one-stage expected costs of the subsystems and provide a duality framework to prove that the control policy yielding the Pareto optimal solution minimizes the average cost criterion of the system. We provide the conditions of existence and a geometric interpretation of the solution. For practical situations having constraints consistent with those studied here, our results imply that the Pareto control policy may be of value when we seek to derivemore » online the optimal control policy in complex systems.« less

  20. Policy design and performance of emissions trading markets: an adaptive agent-based analysis.

    PubMed

    Bing, Zhang; Qinqin, Yu; Jun, Bi

    2010-08-01

    Emissions trading is considered to be a cost-effective environmental economic instrument for pollution control. However, the pilot emissions trading programs in China have failed to bring remarkable success in the campaign for pollution control. The policy design of an emissions trading program is found to have a decisive impact on its performance. In this study, an artificial market for sulfur dioxide (SO2) emissions trading applying the agent-based model was constructed. The performance of the Jiangsu SO2 emissions trading market under different policy design scenario was also examined. Results show that the market efficiency of emissions trading is significantly affected by policy design and existing policies. China's coal-electricity price system is the principal factor influencing the performance of the SO2 emissions trading market. Transaction costs would also reduce market efficiency. In addition, current-level emissions discharge fee/tax and banking mechanisms do not distinctly affect policy performance. Thus, applying emissions trading in emission control in China should consider policy design and interaction with other existing policies.

  1. Bias and the cannabis researcher.

    PubMed

    Ungerleider, J T; Andrysiak, T

    1981-01-01

    This report focuses on several aspects of the "drug" cannabis in our society: the historical notion of a chemical as a moral issue (i.e., good and evil) rather than a pharmacological one; the scientist as a human being as well as a witting or unwitting influencer of social policy; the statistical design and manipulation of research consciously or unconsciously for fame and fortune (grants); the research treatment "connection" as part of our drug abuse industrial complex, a billion dollar a year industry; and the covert governmental manipulation and distortion of cannabis (and other drug) data.

  2. Applying a Mixed-Methods Evaluation to Healthy Kids, Healthy Communities

    PubMed Central

    Brownson, Ross C.; Kemner, Allison L.; Brennan, Laura K.

    2016-01-01

    From 2008 to 2014, the Healthy Kids, Healthy Communities (HKHC) national program funded 49 communities across the United States and Puerto Rico to implement healthy eating and active living policy, system, and environmental changes to support healthier communities for children and families, with special emphasis on reaching children at highest risk for obesity on the basis of race, ethnicity, income, or geographic location. Evaluators designed a mixed-methods evaluation to capture the complexity of the HKHC projects, understand implementation, and document perceived and actual impacts of these efforts. PMID:25828217

  3. Performance analysis of complex repairable industrial systems using PSO and fuzzy confidence interval based methodology.

    PubMed

    Garg, Harish

    2013-03-01

    The main objective of the present paper is to propose a methodology for analyzing the behavior of the complex repairable industrial systems. In real-life situations, it is difficult to find the most optimal design policies for MTBF (mean time between failures), MTTR (mean time to repair) and related costs by utilizing available resources and uncertain data. For this, the availability-cost optimization model has been constructed for determining the optimal design parameters for improving the system design efficiency. The uncertainties in the data related to each component of the system are estimated with the help of fuzzy and statistical methodology in the form of the triangular fuzzy numbers. Using these data, the various reliability parameters, which affects the system performance, are obtained in the form of the fuzzy membership function by the proposed confidence interval based fuzzy Lambda-Tau (CIBFLT) methodology. The computed results by CIBFLT are compared with the existing fuzzy Lambda-Tau methodology. Sensitivity analysis on the system MTBF has also been addressed. The methodology has been illustrated through a case study of washing unit, the main part of the paper industry. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.

  4. SCALS: a fourth-generation study of assisted living technologies in their organisational, social, political and policy context

    PubMed Central

    Greenhalgh, Trisha; Shaw, Sara; Wherton, Joe; Hughes, Gemma; Lynch, Jenni; A'Court, Christine; Hinder, Sue; Fahy, Nick; Byrne, Emma; Finlayson, Alexander; Sorell, Tom; Procter, Rob; Stones, Rob

    2016-01-01

    Introduction Research to date into assisted living technologies broadly consists of 3 generations: technical design, experimental trials and qualitative studies of the patient experience. We describe a fourth-generation paradigm: studies of assisted living technologies in their organisational, social, political and policy context. Fourth-generation studies are necessarily organic and emergent; they view technology as part of a dynamic, networked and potentially unstable system. They use co-design methods to generate and stabilise local solutions, taking account of context. Methods and analysis SCALS (Studies in Co-creating Assisted Living Solutions) consists (currently) of 5 organisational case studies, each an English health or social care organisation striving to introduce technology-supported services to support independent living in people with health and/or social care needs. Treating these cases as complex systems, we seek to explore interdependencies, emergence and conflict. We employ a co-design approach informed by the principles of action research to help participating organisations establish, refine and evaluate their service. To that end, we are conducting in-depth ethnographic studies of people's experience of assisted living technologies (micro level), embedded in evolving organisational case studies that use interviews, ethnography and document analysis (meso level), and exploring the wider national and international context for assisted living technologies and policy (macro level). Data will be analysed using a sociotechnical framework developed from structuration theory. Ethics and dissemination Research ethics approval for the first 4 case studies has been granted. An important outcome will be lessons learned from individual co-design case studies. We will document the studies’ credibility and rigour, and assess the transferability of findings to other settings while also recognising unique aspects of the contexts in which they were generated. Academic outputs will include a cross-case analysis and progress in theory and method of fourth-generation assisted living technology research. We will produce practical guidance for organisations, policymakers, designers and service users. PMID:26880671

  5. Health policy evolution in Lao People's Democratic Republic: context, processes and agency.

    PubMed

    Jönsson, Kristina; Phoummalaysith, Bounfeng; Wahlström, Rolf; Tomson, Göran

    2015-05-01

    During the last 20 years Lao People's Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. © The Author 2014.

  6. 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.

  7. Integrating operation design into infrastructure planning to foster robustness of planned water systems

    NASA Astrophysics Data System (ADS)

    Bertoni, Federica; Giuliani, Matteo; Castelletti, Andrea

    2017-04-01

    Over the past years, many studies have looked at the planning and management of water infrastructure systems as two separate problems, where the dynamic component (i.e., operations) is considered only after the static problem (i.e., planning) has been resolved. Most recent works have started to investigate planning and management as two strictly interconnected faces of the same problem, where the former is solved jointly with the latter in an integrated framework. This brings advantages to multi-purpose water reservoir systems, where several optimal operating strategies exist and similar system designs might perform differently on the long term depending on the considered short-term operating tradeoff. An operationally robust design will be therefore one performing well across multiple feasible tradeoff operating policies. This work aims at studying the interaction between short-term operating strategies and their impacts on long-term structural decisions, when long-lived infrastructures with complex ecological impacts and multi-sectoral demands to satisfy (i.e., reservoirs) are considered. A parametric reinforcement learning approach is adopted for nesting optimization and control yielding to both optimal reservoir design and optimal operational policies for water reservoir systems. The method is demonstrated on a synthetic reservoir that must be designed and operated for ensuring reliable water supply to downstream users. At first, the optimal design capacity derived is compared with the 'no-fail storage' computed through Rippl, a capacity design function that returns the minimum storage needed to satisfy specified water demands without allowing supply shortfall. Then, the optimal reservoir volume is used to simulate the simplified case study under other operating objectives than water supply, in order to assess whether and how the system performance changes. The more robust the infrastructural design, the smaller the difference between the performances of different operating strategies.

  8. A European Perspective on Security Research

    NASA Astrophysics Data System (ADS)

    Liem, Khoen; Hiller, Daniel; Castex, Christoph

    Tackling the complexity and interdependence of today's security environment in the globalized world of the 21st century is an everlasting challenge. Whereas the end of the Cold War presented a caesura of global dimension for the political and economic architecture and a realignment of power distribution and international relations between former adversaries, September 11th of 2001 may be seen as another caesura. Since then, specifically among countries of the Western hemisphere, traditional security paradigms and theories have been critically questioned and the different security cultures and perceptions have resulted in diverse security and defence policies as well as in security research efforts of individual countries. Consensus, it seems, exists on the question of what the threats are that our modern interconnected societies are facing. Whether looking at international terrorism, organized crime, climate change, the illegal trafficking of goods and people or naturally caused catastrophes, these phenomena all have in common that they are in most cases of transnational nature. Formerly existing dividing lines between internal and external security continue to fade, presenting an enormous challenge for those in charge of designing security policy and even more so for the various institutions safeguarding European security. That is why dissent often revolves around the question on how to get hold of these complex problems. Geographic location, cultural background, ethical make-up of society as well as relations with neighbouring countries are all important aspects to be considered when assessing the security culture and policy of individual countries.

  9. Policy Enactment, Context and Performativity: Ontological Politics and Researching Australian National Partnership Policies

    ERIC Educational Resources Information Center

    Singh, Parlo; Heimans, Stephen; Glasswell, Kathryn

    2014-01-01

    Recently, critical policy scholars have used the concepts of enactment, context and performativity as an analytic toolkit to illuminate the complex processes of the policy cycle, in particular, the ways in which a multitude of official education reform policies are taken up, challenged and/or resisted by actors in local, situation-specific…

  10. Policy feedbacks and the impact of policy designs on public opinion.

    PubMed

    Campbell, Andrea Louise

    2011-12-01

    A recently developed analytic approach--policy feedback effects--provides health policy analysts with a crucial new tool for understanding the politics of health policy. Three cases--senior citizens' opposition to the Obama health care reform, tax breaks for employer-provided health insurance, and the Medicare Part D prescription drug program--demonstrate how policy designs affect subsequent policy outcomes. To differing degrees, the three cases show how public policies can create constituencies with particular understandings of their benefits who attempt to thwart reform; can highlight or reduce the visibility of the government role in health care, shaping attitudes about the worth of government action; and can provide half solutions that fail to maximize beneficiary welfare but that deflate momentum for policy improvements. The cases illustrate a general pattern revealed by wide-ranging research on policy feedback effects: the designs of public policies influence preferences and alter patterns of political mobilization, effects that feed back into the political system, shaping the political environment and the possibilities for future policy making.

  11. The Health and Sport Engagement (HASE) Intervention and Evaluation Project: protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity.

    PubMed

    Mansfield, Louise; Anokye, Nana; Fox-Rushby, Julia; Kay, Tess

    2015-10-26

    Sport is being promoted to raise population levels of physical activity for health. National sport participation policy focuses on complex community provision tailored to diverse local users. Few quality research studies exist that examine the role of community sport interventions in raising physical activity levels and no research to date has examined the costs and cost-effectiveness of such provision. This study is a protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity, the Health and Sport Engagement (HASE) project part of the national Get Healthy Get Active programme led by Sport England. The HASE study is a collaborative partnership between local community sport deliverers and sport and public health researchers. It involves designing, delivering and evaluating community sport interventions. The aim is to engage previously inactive people in sustained sporting activity for 1×30 min a week and to examine associated health and well-being outcomes. The study uses mixed methods. Outcomes (physical activity, health, well-being costs to individuals) will be measured by a series of self-report questionnaires and attendance data and evaluated using interrupted time series analysis controlling for a range of sociodemographic factors. Resource use will be identified and measured using diaries, interviews and records and presented alongside effectiveness data as incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. A longitudinal process evaluation (focus groups, structured observations, in-depth interview methods) will examine the efficacy of the project for achieving its aim using the principles of thematic analysis. The results of this study will be disseminated through peer-reviewed publications, academic conference presentations, Sport England and national public health organisation policy conferences, and practice-based case studies. Ethical approval was obtained through Brunel University London's research ethics committee (reference number RE33-12). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Evaluating Water Demand Using Agent-Based Modeling

    NASA Astrophysics Data System (ADS)

    Lowry, T. S.

    2004-12-01

    The supply and demand of water resources are functions of complex, inter-related systems including hydrology, climate, demographics, economics, and policy. To assess the safety and sustainability of water resources, planners often rely on complex numerical models that relate some or all of these systems using mathematical abstractions. The accuracy of these models relies on how well the abstractions capture the true nature of the systems interactions. Typically, these abstractions are based on analyses of observations and/or experiments that account only for the statistical mean behavior of each system. This limits the approach in two important ways: 1) It cannot capture cross-system disruptive events, such as major drought, significant policy change, or terrorist attack, and 2) it cannot resolve sub-system level responses. To overcome these limitations, we are developing an agent-based water resources model that includes the systems of hydrology, climate, demographics, economics, and policy, to examine water demand during normal and extraordinary conditions. Agent-based modeling (ABM) develops functional relationships between systems by modeling the interaction between individuals (agents), who behave according to a probabilistic set of rules. ABM is a "bottom-up" modeling approach in that it defines macro-system behavior by modeling the micro-behavior of individual agents. While each agent's behavior is often simple and predictable, the aggregate behavior of all agents in each system can be complex, unpredictable, and different than behaviors observed in mean-behavior models. Furthermore, the ABM approach creates a virtual laboratory where the effects of policy changes and/or extraordinary events can be simulated. Our model, which is based on the demographics and hydrology of the Middle Rio Grande Basin in the state of New Mexico, includes agent groups of residential, agricultural, and industrial users. Each agent within each group determines its water usage based on its own condition and the condition of the world around it. For example, residential agents can make decisions to convert to or from xeriscaping and/or low-flow appliances based on policy implementation, economic status, weather, and climatic conditions. Agricultural agents may vary their usage by making decisions on crop distribution and irrigation design. Preliminary results show that water usage can be highly irrational under certain conditions. Results also identify sub-sectors within each group that have the highest influence on ensemble group behavior, providing a means for policy makers to target their efforts. Finally, the model is able to predict the impact of low-probability, high-impact events such as catastrophic denial of service due to natural and/or man-made events.

  13. Qualitative analysis of the dynamics of policy design and implementation in hospital funding reform

    PubMed Central

    Brown, Adalsteinn D.; Evans, Jenna M.; Marani, Husayn; Russell, Kirstie K.; Martin, Danielle; Ivers, Noah M.

    2018-01-01

    Background As in many health care systems, some Canadian jurisdictions have begun shifting away from global hospital budgets. Payment for episodes of care has begun to be implemented. Starting in 2012, the Province of Ontario implemented hospital funding reforms comprising three elements: Global Budgets; Health Based Allocation Method (HBAM); and Quality-Based Procedures (QBP). This evaluation focuses on implementation of QBPs, a procedure/diagnosis-specific funding approach involving a pre-set price per episode of care coupled with best practice clinical pathways. We examined whether or not there was consensus in understanding of the program theory underpinning QBPs and how this may have influenced full and effective implementation of this innovative funding model. Methods We undertook a formative evaluation of QBP implementation. We used an embedded case study method and in-depth, one-on-one, semi-structured, telephone interviews with key informants at three levels of the health care system: Designers (those who designed the QBP policy); Adoption Supporters (organizations and individuals supporting adoption of QBPs); and Hospital Implementers (those responsible for QBP implementation in hospitals). Thematic analysis involved an inductive approach, incorporating Framework analysis to generate descriptive and explanatory themes that emerged from the data. Results Five main findings emerged from our research: (1) Unbeknownst to most key informants, there was neither consistency nor clarity over time among QBP designers in their understanding of the original goal(s) for hospital funding reform; (2) Prior to implementation, the intended hospital funding mechanism transitioned from ABF to QBPs, but most key informants were either unaware of the transition or believe it was intentional; (3) Perception of the primary goal(s) of the policy reform continues to vary within and across all levels of key informants; (4) Four years into implementation, the QBP funding mechanism remains misunderstood; and (5) Ongoing differences in understanding of QBP goals and funding mechanism have created challenges with implementation and difficulties in measuring success. Conclusions Policy drift and policy layering affected both the goal and the mechanism of action of hospital funding reform. Lack of early specification in both policy goals and hospital funding mechanism exposed the reform to reactive changes that did not reflect initial intentions. Several challenges further exacerbated implementation of complex hospital funding reforms, including a prolonged implementation schedule, turnover of key staff, and inconsistent messaging over time. These factors altered the trajectory of the hospital funding reforms and created confusion amongst those responsible for implementation. Enacting changes to hospital funding policy through a process that is transparent, collaborative, and intentional may increase the likelihood of achieving intended effects. PMID:29373587

  14. 24 CFR 570.205 - Eligible planning, urban environmental design and policy-planning-management-capacity building...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... environmental design and policy-planning-management-capacity building activities. 570.205 Section 570.205..., urban environmental design and policy-planning-management-capacity building activities. (a) Planning...; (iv) Open space and recreation; (v) Energy use and conservation; (vi) Floodplain and wetlands...

  15. 23 CFR 625.4 - Standards, policies, and standard specifications.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Pavement Design, refer to 23 CFR part 626. (b) Bridges and structures. (1) Standard Specifications for... TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.4 Standards, policies, and standard specifications.... (a) Roadway and appurtenances. (1) A Policy on Geometric Design of Highways and Streets, AASHTO 2001...

  16. 23 CFR 625.4 - Standards, policies, and standard specifications.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Pavement Design, refer to 23 CFR part 626. (b) Bridges and structures. (1) Standard Specifications for... TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.4 Standards, policies, and standard specifications.... (a) Roadway and appurtenances. (1) A Policy on Geometric Design of Highways and Streets, AASHTO 2001...

  17. 23 CFR 625.4 - Standards, policies, and standard specifications.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Pavement Design, refer to 23 CFR part 626. (b) Bridges and structures. (1) Standard Specifications for... TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.4 Standards, policies, and standard specifications.... (a) Roadway and appurtenances. (1) A Policy on Geometric Design of Highways and Streets, AASHTO 2001...

  18. 23 CFR 625.4 - Standards, policies, and standard specifications.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Pavement Design, refer to 23 CFR part 626. (b) Bridges and structures. (1) Standard Specifications for... TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.4 Standards, policies, and standard specifications.... (a) Roadway and appurtenances. (1) A Policy on Geometric Design of Highways and Streets, AASHTO 2001...

  19. 23 CFR 625.4 - Standards, policies, and standard specifications.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Pavement Design, refer to 23 CFR part 626. (b) Bridges and structures. (1) Standard Specifications for... TRAFFIC OPERATIONS DESIGN STANDARDS FOR HIGHWAYS § 625.4 Standards, policies, and standard specifications.... (a) Roadway and appurtenances. (1) A Policy on Geometric Design of Highways and Streets, AASHTO 2001...

  20. Electricity pricing policy: A neo-institutional, developmental and cross-national policy design map

    NASA Astrophysics Data System (ADS)

    Koundinya, Sridarshan Umesh

    This dissertation explores the role of ideas and ideology in the mental policy design maps of regulators in the US and in India. The research approach is to describe the regulatory design process in the history of the US electric industry from a neo-institutional and developmental perspective. And then to use the insights of such a study to suggest policy options to a sample of Indian experts. A regulatory process model explores the interactions among normative values, regulatory instruments and historical phases in policy design. A spectrum of seven regulatory instruments--subsidized rates, average cost pricing, marginal cost pricing, time-of-use pricing, ramsey pricing, incentive regulation and spot pricing is examined. A neo-institutional perspective characterizes the process of institutionalizing these regulatory instruments as a design process that infuses them with values beyond mere technical requirements. The process model includes normative values such as efficiency, fairness, free choice and political feasibility. These values arise from an analytical classification of various market metaphors debated in the history of economic thought. The theory of development and co-evolution applied to the history of electricity regulation yields a typology of evolutionary phases in the US. The typology describes hierarchically emergent relationships between supply and demand and among the normative values. The theory hypothesizes technologically contingent relationships between pricing policies and normative values in the historical phases of dependence (or rural), independence (or urban) and interdependence (or informational). The contents of this model are represented as related elements in a policy design map that simplifies the process of designing regulatory instruments in the US. This neo-institutional, developmental policy design map was used to design a survey instrument. The survey was conducted among electricity experts in India to test the hypothesized inter-relationships among various elements at different levels of the policy design map in a cross-national context. The study adds value with a comprehensive design map that helps to organize and give coherence to the policy prescriptions made by Indian experts as they converge on one institutional model. Thus the dissertation contributes to the transfer of knowledge about regulatory practice from the US to India.

  1. A Review of Patti Lather's "Engaging Science Policy from the Side of the Messy"

    ERIC Educational Resources Information Center

    Rosser, Sue V.

    2011-01-01

    In "Engaging Science Policy from the Side of the Messy," Patti Lather explores the relationship between science and policy. In this review Rosser explores how Lather argues for the use of all forms of research to make policy that is democratic, complex and messy.

  2. The MacGyver effect: alive and well in health services research?

    PubMed Central

    2011-01-01

    Background In a manner similar to the television action hero MacGyver, health services researchers need to respond to the pressure of unpredictable demands and constrained time frames. The results are often both innovative and functional, with the creation of outputs that could not have been anticipated in the initial planning and design of the research. Discussion In the conduct of health services research many challenges to robust research processes are generated as a result of the interface between academic research, health policy and implementation agendas. Within a complex and rapidly evolving environment the task of the health services researcher is, therefore, to juggle sometimes contradictory pressures to produce valid results. Summary This paper identifies the MacGyver-type dilemmas which arise in health services research, wherein innovation may be called for, to maintain the intended scientific method and rigour. These 'MacGyver drivers' are framed as opposing issues from the perspective of both academic and public policy communities. The ideas expressed in this paper are illustrated by four examples from research projects positioned at the interface between public policy strategy and academia. PMID:21929826

  3. How will greenhouse gas observations meet changing requirements, laws, and demands?

    NASA Astrophysics Data System (ADS)

    Butler, J. H.; Tans, P. P.; Sweeney, C.; Andrews, A. E.; Miller, J. B.; Montzka, S. A.

    2010-12-01

    Recent efforts to develop a global greenhouse gas information system (GHGIS) have been driven by an anticipated need to support future national emission reduction policies or international treaties with observations. Such an effort would be similar to that done in support of the Montreal Protocol on Substances that Deplete Ozone, but more complex. However, greenhouse gas emissions are much more difficult to manage and may not be controlled by international agreement. The Kyoto Protocol has been fraught with political and practical difficulties, not the least of which is the absence of an independent observation and analysis requirement. Nevertheless, no unifying agreement was reached at the much heralded 2009 Conference of Parties (COP-15) in Copenhagen. Thus, it is quite possible (likely?) that greenhouse gas emissions may be reduced owing to other, uncoordinated policies that have their own merits, e.g., energy efficiency, alternative energy development, air quality improvement, forest development, agricultural practices, etc. If this is the future, then what observations and observation system design are needed and to what end? This presentation will discuss those needs in light of critical observations, analytical approaches, and evolving, disparate policies.

  4. Improving the evidence base in palliative care to inform practice and policy: thinking outside the box.

    PubMed

    Aoun, Samar M; Nekolaichuk, Cheryl

    2014-12-01

    The adoption of evidence-based hierarchies and research methods from other disciplines may not completely translate to complex palliative care settings. The heterogeneity of the palliative care population, complexity of clinical presentations, and fluctuating health states present significant research challenges. The aim of this narrative review was to explore the debate about the use of current evidence-based approaches for conducting research, such as randomized controlled trials and other study designs, in palliative care, and more specifically to (1) describe key myths about palliative care research; (2) highlight substantive challenges of conducting palliative care research, using case illustrations; and (3) propose specific strategies to address some of these challenges. Myths about research in palliative care revolve around evidence hierarchies, sample heterogeneity, random assignment, participant burden, and measurement issues. Challenges arise because of the complex physical, psychological, existential, and spiritual problems faced by patients, families, and service providers. These challenges can be organized according to six general domains: patient, system/organization, context/setting, study design, research team, and ethics. A number of approaches for dealing with challenges in conducting research fall into five separate domains: study design, sampling, conceptual, statistical, and measures and outcomes. Although randomized controlled trials have their place whenever possible, alternative designs may offer more feasible research protocols that can be successfully implemented in palliative care. Therefore, this article highlights "outside the box" approaches that would benefit both clinicians and researchers in the palliative care field. Ultimately, the selection of research designs is dependent on a clearly articulated research question, which drives the research process. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. Collaborative-Large scale Engineering Assessment Networks for Environmental Research: The Overview

    NASA Astrophysics Data System (ADS)

    Moo-Young, H.

    2004-05-01

    A networked infrastructure for engineering solutions and policy alternatives is necessary to assess, manage, and protect complex, anthropogenic ally stressed environmental resources effectively. Reductionist and discrete disciplinary methodologies are no longer adequate to evaluate and model complex environmental systems and anthropogenic stresses. While the reductonist approach provides important information regarding individual mechanisms, it cannot provide complete information about how multiple processes are related. Therefore, it is not possible to make accurate predictions about system responses to engineering interventions and the effectiveness of policy options. For example, experts cannot agree on best management strategies for contaminated sediments in riverine and estuarine systems. This is due, in part to the fact that existing models do not accurately capture integrated system dynamics. In addition, infrastructure is not available for investigators to exchange and archive data, to collaborate on new investigative methods, and to synthesize these results to develop engineering solutions and policy alternatives. Our vision for the future is to create a network comprising field facilities and a collaboration of engineers, scientists, policy makers, and community groups. This will allow integration across disciplines, across different temporal and spatial scales, surface and subsurface geographies, and air sheds and watersheds. Benefits include fast response to changes in system health, real-time decision making, and continuous data collection that can be used to anticipate future problems, and to develop sound engineering solutions and management decisions. CLEANER encompasses four general aspects: 1) A Network of environmental field facilities instrumented for the acquisition and analysis of environmental data; 2) A Virtual Repository of Data and information technology for engineering modeling, analysis and visualization of data, i.e. an environmental cyber-infrastructure; 3) A Mechanism for multidisciplinary research and education activities designed to exploit the output of the instrumented sites and networked information technology, to formulate engineering and policy options directed toward the protection, remediation, and restoration of stressed environments and sustainability of environmental resources; and 4) A Collaboration among engineers, natural and social scientists, educators, policy makers, industry, non-governmental organizations, the public, and other stakeholders.

  6. Generalist solutions to complex problems: generating practice-based evidence - the example of managing multi-morbidity

    PubMed Central

    2013-01-01

    Background A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Discussion Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a ‘complex intervention’ (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Summary Answers to the complex problem of multi-morbidity won’t come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity. PMID:23919296

  7. Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.

    PubMed

    Reeve, Joanne; Blakeman, Tom; Freeman, George K; Green, Larry A; James, Paul A; Lucassen, Peter; Martin, Carmel M; Sturmberg, Joachim P; van Weel, Chris

    2013-08-07

    A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a 'complex intervention' (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Answers to the complex problem of multi-morbidity won't come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity.

  8. 24 CFR 1003.205 - Eligible planning, urban environmental design and policy-planning-management-capacity building...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Eligible planning, urban environmental design and policy-planning-management-capacity building activities. 1003.205 Section 1003.205... planning, urban environmental design and policy-planning-management-capacity building activities. (a...

  9. 24 CFR 1003.205 - Eligible planning, urban environmental design and policy-planning-management-capacity building...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Eligible planning, urban environmental design and policy-planning-management-capacity building activities. 1003.205 Section 1003.205... planning, urban environmental design and policy-planning-management-capacity building activities. (a...

  10. 76 FR 44613 - Designation of Eight Counties as High Intensity Drug Trafficking Areas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... OFFICE OF NATIONAL DRUG CONTROL POLICY Designation of Eight Counties as High Intensity Drug Trafficking Areas AGENCY: Office of National Drug Control Policy. ACTION: Notice. SUMMARY: The Director of the Office of National Drug Control Policy has designated eight additional counties as High Intensity Drug...

  11. Any qualified provider: a qualitative case study of one community NHS Trust's response

    PubMed Central

    Walumbe, Jackie; Swinglehurst, Deborah; Shaw, Sara

    2016-01-01

    Objective To examine how those managing and providing community-based musculoskeletal (MSK) services have experienced recent policy allowing patients to choose any provider that meets certain quality standards from the National Health Service (NHS), private or voluntary sector. Design Intrinsic case study combining qualitative analysis of interviews and field notes. Setting An NHS Community Trust (the main providers of community health services in the NHS) in England, 2013–2014. Participants NHS Community Trust employees involved in delivering MSK services, including clinical staff and managerial staff in senior and mid-range positions. Findings Managers (n=4) and clinicians (n=4) working within MSK services understood and experienced the Any Qualified Provider (AQP) policy as involving: (1) a perceived trade-off between quality and cost in its implementation; (2) deskilling of MSK clinicians and erosion of professional values; and (3) a shift away from interprofessional collaboration and dialogue. These ways of making sense of AQP policy were associated with dissatisfaction with market-based health reforms. Conclusions AQP policy is poorly understood. Clinicians and managers perceive AQP as synonymous with competition and privatisation. From the perspective of clinicians providing MSK services, AQP, and related health policy reforms, tend, paradoxically, to drive down quality standards, supporting reconfiguration of services in which the complex, holistic nature of specialised MSK care may become marginalised by policy concerns about efficiency and cost. Our analysis indicates that the potential of AQP policy to increase quality of care is, at best, equivocal, and that any consideration of how AQP impacts on practice can only be understood by reference to a wider range of health policy reforms. PMID:26908521

  12. Gender, sexuality and the participatory dimensions of a comparative life history policy study.

    PubMed

    Macdonnell, Judith A

    2011-12-01

    Gender, sexuality and the participatory dimensions of a comparative life history policy study In this paper, I explore how a critical feminist lens was a crucial element in creating a participatory policy study which used a qualitative design and comparative life history methodology. This study focused on Canadian nurses' political practice related to advocacy for lesbian health. Findings show that the combination of the gender lens and life history approach offers potential to create knowledge in ways aligned with health-promoting and emancipatory outcomes. However, the nature of participation and interaction by researcher and participants is contexualized and contested given complex dynamics of power that shape all aspects of this doctoral study process. The critical feminist lens with its focus on reflexivity informed the content and process of knowledge production in this study and shaped key turning points: the ways in which this policy study was conceptualized, the choice of comparative life history methodology, ethical considerations, data collection and analysis and representation of findings. Life history is unlikely to be the methodology that first comes to mind when undertaking a policy study. Its historical roots are associated with biographical, oral history and narrative approaches, which typically aim to elicit understanding of lived experience. Yet, it was this very aspect, this focus on lived experience, which rendered life history methodology fitting as I contemplated how to examine the relationship between nurses and policy. I was interested in understanding nurses' political practice, how policy influenced nurses' capacity to advocate in their everyday lives, as well as nurses' impacts on policy processes and their larger social worlds. © 2011 Blackwell Publishing Ltd.

  13. Government and Educational Reform: Policy Networks in Policy-Making in Zimbabwe, 1980-2008

    ERIC Educational Resources Information Center

    Moyo, Nathan; Modiba, Maropeng M.

    2013-01-01

    This paper reflects on the key actors in education policy making in Zimbabwe. It looks at the contextual complexities that characterized policy-making in this country to make sense of the contestations that the state had to confront and accommodate. The policy network approach is employed as an analytical framework to clarify how, in particular…

  14. When Neighbours Matter Most: Innovation, Diffusion and State Policy Adoption in Tertiary Education

    ERIC Educational Resources Information Center

    Cohen-Vogel, Lora; Ingle, William Kyle

    2007-01-01

    We now have ample evidence that public policies diffuse across the American states; that is, policy adoption is due at least in part to the emulation of policies enacted in nearby states. But, policy adoption is the result of a complex process, a process that often takes years and sometimes decades to complete. According to the "stage"…

  15. Music, Policy, and Place-Centered Education: Finding Space for Adaptability

    ERIC Educational Resources Information Center

    Schmidt, Patrick K.

    2012-01-01

    As a volatile educative space, musical education must be interwoven with other concerns and other more encompassing constructs if it is to build robust, meaningful, and complex learning outcomes. This paper attempts to do this by placing music education and a complex understanding of policy side by side, and outlining what people can learn from…

  16. Learning from Evidence in a Complex World

    PubMed Central

    Sterman, John D.

    2006-01-01

    Policies to promote public health and welfare often fail or worsen the problems they are intended to solve. Evidence-based learning should prevent such policy resistance, but learning in complex systems is often weak and slow. Complexity hinders our ability to discover the delayed and distal impacts of interventions, generating unintended “side effects.” Yet learning often fails even when strong evidence is available: common mental models lead to erroneous but self-confirming inferences, allowing harmful beliefs and behaviors to persist and undermining implementation of beneficial policies. Here I show how systems thinking and simulation modeling can help expand the boundaries of our mental models, enhance our ability to generate and learn from evidence, and catalyze effective change in public health and beyond. PMID:16449579

  17. Harm reduction as a complex adaptive system: A dynamic framework for analyzing Tanzanian policies concerning heroin use

    PubMed Central

    Ratliff, Eric A.; Kaduri, Pamela; Masao, Frank; Mbwambo, Jessie K.K.; McCurdy, Sheryl A.

    2016-01-01

    Contrary to popular belief, policies on drug use are not always based on scientific evidence or composed in a rational manner. Rather, decisions concerning drug policies reflect the negotiation of actors’ ambitions, values, and facts as they organize in different ways around the perceived problems associated with illicit drug use. Drug policy is thus best represented as a complex adaptive system (CAS) that is dynamic, self-organizing, and coevolving. In this analysis, we use a CAS framework to examine how harm reduction emerged around heroin trafficking and use in Tanzania over the past thirty years (1985-present). This account is an organizational ethnography based on of the observant participation of the authors as actors within this system. We review the dynamic history and self-organizing nature of harm reduction, noting how interactions among system actors and components have coevolved with patterns of heroin us, policing, and treatment activities over time. Using a CAS framework, we describe harm reduction as a complex process where ambitions, values, facts, and technologies interact in the Tanzanian socio-political environment. We review the dynamic history and self-organizing nature of heroin policies, noting how the interactions within and between competing prohibitionist and harm reduction policies have changed with patterns of heroin use, policing, and treatment activities over time. Actors learn from their experiences to organize with other actors, align their values and facts, and implement new policies. Using a CAS approach provides researchers and policy actors a better understanding of patterns and intricacies in drug policy. This knowledge of how the system works can help improve the policy process through adaptive action to introduce new actors, different ideas, and avenues for communication into the system. PMID:26790689

  18. Harm reduction as a complex adaptive system: A dynamic framework for analyzing Tanzanian policies concerning heroin use.

    PubMed

    Ratliff, Eric A; Kaduri, Pamela; Masao, Frank; Mbwambo, Jessie K K; McCurdy, Sheryl A

    2016-04-01

    Contrary to popular belief, policies on drug use are not always based on scientific evidence or composed in a rational manner. Rather, decisions concerning drug policies reflect the negotiation of actors' ambitions, values, and facts as they organize in different ways around the perceived problems associated with illicit drug use. Drug policy is thus best represented as a complex adaptive system (CAS) that is dynamic, self-organizing, and coevolving. In this analysis, we use a CAS framework to examine how harm reduction emerged around heroin trafficking and use in Tanzania over the past thirty years (1985-present). This account is an organizational ethnography based on of the observant participation of the authors as actors within this system. We review the dynamic history and self-organizing nature of harm reduction, noting how interactions among system actors and components have coevolved with patterns of heroin us, policing, and treatment activities over time. Using a CAS framework, we describe harm reduction as a complex process where ambitions, values, facts, and technologies interact in the Tanzanian sociopolitical environment. We review the dynamic history and self-organizing nature of heroin policies, noting how the interactions within and between competing prohibitionist and harm reduction policies have changed with patterns of heroin use, policing, and treatment activities over time. Actors learn from their experiences to organize with other actors, align their values and facts, and implement new policies. Using a CAS approach provides researchers and policy actors a better understanding of patterns and intricacies in drug policy. This knowledge of how the system works can help improve the policy process through adaptive action to introduce new actors, different ideas, and avenues for communication into the system. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. 78 FR 70542 - Reserve Forces Policy Board (RFPB); Notice of Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... Forces Policy Board will take place. The purpose of the meeting is to obtain, review and evaluate information related to strategies, policies, and practices designed to improve and enhance the capabilities... related to strategies, policies, and practices designed to improve and enhance the capabilities...

  20. Medical sociology as a vocation.

    PubMed

    Bosk, Charles L

    2014-12-01

    This article extends Weber's discussion of science as a vocation by applying it to medical sociology. Having used qualitative methods for nearly 40 years to interpret problems of meaning as they arise in the context of health care, I describe how ethnography, in particular, and qualitative inquiry, more generally, may be used as a tool for understanding fundamental questions close to the heart but far from the mind of medical sociology. Such questions overlap with major policy questions such as how do we achieve a higher standard for quality of care and assure the safety of patients. Using my own research, I show how this engagement takes the form of showing how simple narratives of policy change fail to address the complexities of the problems that they are designed to remedy. I also attempt to explain how I balance objectivity with a commitment to creating a more equitable framework for health care. © American Sociological Association 2014.

  1. School-site decision making in multicultural education: An Australian perspective

    NASA Astrophysics Data System (ADS)

    Kennedy, Kerry J.

    1985-12-01

    This paper examines a number of issues related to multicultural education and curriculum change. It focuses on school-level projects that were developed in Western Australian schools from 1979-1981. The results of the research raised the following points: teachers viewed multicultural education as a psycho-social rather than a socio-political phenomenon; the aims of multicultural education were seen to be best achieved by the collection of specific resource material; on-site implementation of the projects often led to changes being made to the original intentions of the project designers; qualitative research techniques proved more sensitive in portraying and consequently understanding the complexities associated with project implementation, and, finally, it seemed clear that more emphasis should be placed on understanding the role of the teacher as a policy mediator. It is at the school level that the final decisions are made about national policy intentions.

  2. Exporting doctoral education: experience of a state-supported university.

    PubMed

    Stoskopf, Carleen H; Xirasagar, Sudha; Han, Whiejong M; Snowdon, Sonja

    2007-01-01

    There is a demand for non-traditional doctoral education in healthcare management and policy among many countries in support of their health system reform efforts. Healthcare professionals need retooling to provide stewardship to complex new health financing systems. Most health service leaders are mid career professionals and cannot transplant themselves to study on American university campuses. They demand high quality programs, designed to enable most coursework to be completed overseas. Aided by recent distance education technology, the University of South Carolina's Department of Health Services Policy and Management developed and provides doctoral programs for working professionals in Taiwan and South Korea with a minimal and convenient campus attendance requirement. This paper presents the experience of setting up the programs, management, quality control, and benefits for both students overseas and for our Department's mission and on-campus programs. Our experience is that there are many challenges, but it is also rewarding from academic, scholarly, and financial perspectives.

  3. North Carolina's direct care workforce development journey: the case of the North Carolina New Organizational Vision Award Partner Team.

    PubMed

    Brannon, S Diane; Kemper, Peter; Barry, Theresa

    2009-01-01

    Better Jobs Better Care was a five-state direct care workforce demonstration designed to change policy and management practices that influence recruitment and retention of direct care workers, problems that continue to challenge providers. One of the projects, the North Carolina Partner Team, developed a unified approach in which skilled nursing, home care, and assisted living providers could be rewarded for meeting standards of workplace excellence. This case study documents the complex adaptive system agents and processes that coalesced to result in legislation recognizing the North Carolina New Organizational Vision Award. We used a holistic, single-case study design. Qualitative data from project work plans and progress reports as well as notes from interviews with key stakeholders and observation of meetings were coded into a simple rubric consisting of characteristics of complex adaptive systems. Key system agents in the state set the stage for the successful multistakeholder coalition. These included leadership by the North Carolina Department of Health and Human Services and a several year effort to develop a unifying vision for workforce development. Grant resources were used to facilitate both content and process work. Structure was allowed to emerge as needed. The coalition's own development is shown to have changed the context from which it was derived. An inclusive and iterative process produced detailed standards and measures for the voluntary recognition process. With effective facilitation, the interests of the multiple stakeholders coalesced into a policy response that encourages practice changes. Implications for managing change-oriented coalitions are discussed.

  4. Complexity Science: A Mechanism for Strategic Foresight and Resiliency in National Security Decision-Making.

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

    Ackermann, Mark R.; Hayden, Nancy Kay; Backus, George A.

    Most national policy decisions are complex with a variety of stakeholders, disparate interests and the potential for unintended consequences. While a number of analytical tools exist to help decision makers sort through the mountains of data and myriad of options, decision support teams are increasingly turning to complexity science for improved analysis and better insight into the potential impact of policy decisions. While complexity science has great potential, it has only proven useful in limited case s and when properly applied. In advance of more widespread use, a national - level effort to refine complexity science and more rigorously establishmore » its technical underpinnings is recommended.« less

  5. Silence and Policy Talk: Historical Puzzles about Gender and Education.

    ERIC Educational Resources Information Center

    Tyack, David; Hansot, Elisabeth

    1988-01-01

    The complexities of institutional change and stability in terms of gender policies are analyzed. The following three questions are central to the discussion: (1) why did some policy changes take place with only minor controversy? (2) why did vehement policy talk affect practice so little? and (3) how did gender reforms alter educational…

  6. Econometric Methods for Causal Evaluation of Education Policies and Practices: A Non-Technical Guide

    ERIC Educational Resources Information Center

    Schlotter, Martin; Schwerdt, Guido; Woessmann, Ludger

    2011-01-01

    Education policy-makers and practitioners want to know which policies and practices can best achieve their goals. But research that can inform evidence-based policy often requires complex methods to distinguish causation from accidental association. Avoiding econometric jargon and technical detail, this paper explains the main idea and intuition…

  7. Exploring the Complex Interplay of National Learning and Teaching Policy and Academic Development Practice

    ERIC Educational Resources Information Center

    Smith, Karen

    2016-01-01

    Academic developers are important interpreters of policy, yet little research has focussed on the interplay of policy and academic development practice. Using methods from critical discourse analysis, this article analyses a national learning and teaching policy, charts its development, and explores its interpretation by the academic development…

  8. Public Policy, Science, and Environmental Risk. Brookings Dialogues on Public Policy.

    ERIC Educational Resources Information Center

    Panem, Sandra, Ed.

    This workshop explored the complex issues involved in scientific measurement of environmental risk. Specific purposes were to articulate policy issues that concern the use of scientific data in environmental risk assessment and to contribute to the dialogue from which better policy might emerge. Viewpoints of workshop participants from the…

  9. Considering Materiality in Educational Policy: Messy Objects and Multiple Reals

    ERIC Educational Resources Information Center

    Fenwick, Tara; Edwards, Richard

    2011-01-01

    Educational analysts need new ways to engage with policy processes in a networked world of complex transnational connections. In this discussion, Tara Fenwick and Richard Edwards argue for a greater focus on materiality in educational policy as a way to trace the heterogeneous interactions and precarious linkages that enact policy as complex…

  10. Focusing the Sun: State Considerations for Designing Community Solar Policy

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

    Cook, Jeffrey J; Shah, Monisha R

    This report summarizes outcomes from the National Community Solar Partnership State Best Practices working group by identifying key differences in state policies that enable community solar and illustrating how various policy design approaches may impact the market. For the latter question, it is too early to quantify a relationship between policy design and market impacts, because most state programs have not been fully implemented. So, the authors conducted interviews with 19 subject matter experts, including project developers, regulators, and utilities to better understand how various policy design approaches may impact community solar markets. These perspectives, along with those gleaned frommore » the working group and relevant literature were synthesized to identify key considerations for policymakers designing community solar programs. Though state community solar policies vary in numerous ways, the report focuses on the following critical elements: program cap, project size cap, subscriber location requirements, subscriber eligibility requirements, low- and moderate-income stipulations, and subscriber compensation.« less

  11. 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.

  12. Autonomous Information Unit for Fine-Grain Data Access Control and Information Protection in a Net-Centric System

    NASA Technical Reports Server (NTRS)

    Chow, Edward T.; Woo, Simon S.; James, Mark; Paloulian, George K.

    2012-01-01

    As communication and networking technologies advance, networks will become highly complex and heterogeneous, interconnecting different network domains. There is a need to provide user authentication and data protection in order to further facilitate critical mission operations, especially in the tactical and mission-critical net-centric networking environment. The Autonomous Information Unit (AIU) technology was designed to provide the fine-grain data access and user control in a net-centric system-testing environment to meet these objectives. The AIU is a fundamental capability designed to enable fine-grain data access and user control in the cross-domain networking environments, where an AIU is composed of the mission data, metadata, and policy. An AIU provides a mechanism to establish trust among deployed AIUs based on recombining shared secrets, authentication and verify users with a username, X.509 certificate, enclave information, and classification level. AIU achieves data protection through (1) splitting data into multiple information pieces using the Shamir's secret sharing algorithm, (2) encrypting each individual information piece using military-grade AES-256 encryption, and (3) randomizing the position of the encrypted data based on the unbiased and memory efficient in-place Fisher-Yates shuffle method. Therefore, it becomes virtually impossible for attackers to compromise data since attackers need to obtain all distributed information as well as the encryption key and the random seeds to properly arrange the data. In addition, since policy can be associated with data in the AIU, different user access and data control strategies can be included. The AIU technology can greatly enhance information assurance and security management in the bandwidth-limited and ad hoc net-centric environments. In addition, AIU technology can be applicable to general complex network domains and applications where distributed user authentication and data protection are necessary. AIU achieves fine-grain data access and user control, reducing the security risk significantly, simplifying the complexity of various security operations, and providing the high information assurance across different network domains.

  13. Assisted-living spaces for end-users with complex needs: a proposed implementation and delivery model.

    PubMed

    Linskell, Jeremy; Bouamrane, Matt-Mouley

    2012-09-01

    An assisted living space (ALS) is a technology-enabled environment designed to allow people with complex health or social care needs to remain, and live independently, in their own home for longer. However, many challenges remain in order to deliver usable systems acceptable to a diverse range of stakeholders, including end-users, and their families and carers, as well as health and social care services. ALSs need to support activities of daily-living while allowing end-users to maintain important social connections. They must be dynamic, flexible and adaptable living environments. In this article, we provide an overview of the technological landscape of assisted-living technology (ALT) and recent policies to promote an increased adoption of ALT in Scotland. We discuss our experiences in implementing technology-supported ALSs and emphasise key lessons. Finally, we propose an iterative and pragmatic user-centred implementation model for delivering ALSs in complex-needs scenarios. This empirical model is derived from our past ALS implementations. The proposed model allows project stakeholders to identify requirements, allocate tasks and responsibilities, and identify appropriate technological solutions for the delivery of functional ALS systems. The model is generic and makes no assumptions on needs or technology solutions, nor on the technical knowledge, skills and experience of the stakeholders involved in the ALS design process.

  14. Factors Associated with the Income Distribution of Full-Time Physicians: A Quantile Regression Approach

    PubMed Central

    Shih, Ya-Chen Tina; Konrad, Thomas R

    2007-01-01

    Objective Physician income is generally high, but quite variable; hence, physicians have divergent perspectives regarding health policy initiatives and market reforms that could affect their incomes. We investigated factors underlying the distribution of income within the physician population. Data Sources Full-time physicians (N=10,777) from the restricted version of the 1996–1997 Community Tracking Study Physician Survey (CTS-PS), 1996 Area Resource File, and 1996 health maintenance organization penetration data. Study Design We conducted separate analyses for primary care physicians (PCPs) and specialists. We employed least square and quantile regression models to examine factors associated with physician incomes at the mean and at various points of the income distribution, respectively. We accounted for the complex survey design for the CTS-PS data using appropriate weighted procedures and explored endogeneity using an instrumental variables method. Principal Findings We detected widespread and subtle effects of many variables on physician incomes at different points (10th, 25th, 75th, and 90th percentiles) in the distribution that were undetected when employing regression estimations focusing on only the means or medians. Our findings show that the effects of managed care penetration are demonstrable at the mean of specialist incomes, but are more pronounced at higher levels. Conversely, a gender gap in earnings occurs at all levels of income of both PCPs and specialists, but is more pronounced at lower income levels. Conclusions The quantile regression technique offers an analytical tool to evaluate policy effects beyond the means. A longitudinal application of this approach may enable health policy makers to identify winners and losers among segments of the physician workforce and assess how market dynamics and health policy initiatives affect the overall physician income distribution over various time intervals. PMID:17850525

  15. The Challenge of Aviation Emergency and Abnormal Situations

    NASA Technical Reports Server (NTRS)

    Burian, Barbara K.; Barshi, Immanuel; Dismukes, Key

    2005-01-01

    Emergency and abnormal situations occur on flights everyday around the world. They range from minor situations readily managed to extremely serious and highly time-critical situations that deeply challenge the skills of even the most effective crews. How well crews respond to these situations is a function of several interacting sets of issues: (1) the design of non-normal procedures and checklists, (2) design of aircraft systems and automation, (3) specific aspects of the non-normal situation, such as time criticality and complexity of the situation, (4) human performance capabilities and cognitive limitations under high workload and stress, (5) design of training for non-normal situations, (6) philosophies, policies and practices within the industry, and (7) economic and regulatory constraints. Researchers and pilots working on NASA's Emergency and Abnormal Situations project are addressing these issues in a long-range study. In this paper we discuss these issues and illustrate them with examples from recent incidents and accidents.

  16. Energy Analysis Publications | Energy Analysis | NREL

    Science.gov Websites

    Systems Impact Analysis We perform impact analysis to evaluate and understand the impact of markets publications. Featured Publications Complex Systems Analysis Complex systems analysis integrates all aspects of , policies, and financing on technology uptake and the impact of new technologies on markets and policy

  17. Making sense of the global health crisis: policy narratives, conflict, and global health governance.

    PubMed

    Ney, Steven

    2012-04-01

    Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the "global health crisis." Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis.

  18. Characterization of NEOs from the Policy Perspective: Implications from Problem and Solution Definitions

    NASA Astrophysics Data System (ADS)

    Lindquist, E.

    2015-12-01

    The characterization of near-Earth-objects (NEOs) in regard to physical attributes and potential risk and impact factors presents a complex and complicates scientific and engineering challenge. The societal and policy risks and impacts are no less complex, yet are rarely considered in the same context as material properties or related factors. The objective of this contribution is to position the characterization of NEOs within the public policy process domain as a means to reflect on the science-policy nexus in regard to risks associated with NEOs. This will be accomplished through, first, a brief overview of the science-policy nexus, followed by a discussion of several policy process frameworks, such as agenda setting and the multiple streams model, focusing events, and punctuated equilibrium, and their application and appropriateness to the problem of NEOs. How, too, for example, does NEO hazard and risk compare with other low probability, high risk, hazards in regard to public policy? Finally, we will reflect on the implications of alternative NEO "solutions" and the characterization of the NEO "problem," and the political and public acceptance of policy alternatives as a way to link NEO science and policy in the context of the overall NH004 panel.

  19. Penetrated system' or normal' state An exploration of INF arms control policy, East-West economic relations, and inter-German policy in the Federal Republic of Germany, 1979-1987

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

    Fisher, C.S.

    1991-01-01

    The thesis explores policy-making processes in the Federal Republic from 1979-1987 in three areas: INF arms control policy, East-West economic relations, and inter-German policy. Each case study assesses the degree of complexity and domestic accountability in policy-making processes and evaluates the relative influence of domestic and external factors on policy choices. It argues that the trends in West German foreign policy toward greater assertiveness reflected the evolution of the FRG as a state, society, and polity. The maturation' of the Federal Republic has introduced greater complexity into foreign policy-making processes, and more frequent societal intervention into what heretofore were elitemore » deliberations. Domestic actors have begun to demand greater accountability, while West German leaders, in turn, have become more assertive and confident in defending German national interests. As the FRG has gained respect and self-respect, it has begun to assume the international role that might be expected of a state of its size, population, geo-political importance, and level of political and economic development. The FRG has become a normal' state.« less

  20. Design of Economic Evaluations of Mindfulness-Based Interventions: Ten Methodological Questions of Which to Be Mindful.

    PubMed

    Edwards, Rhiannon Tudor; Bryning, Lucy; Crane, Rebecca

    Mindfulness-based interventions (MBIs) are being increasingly applied in a variety of settings. A growing body of evidence to support the effectiveness of these interventions exists and there are a few published cost-effectiveness studies. With limited resources available within public sectors (health care, social care, and education), it is necessary to build in concurrent economic evaluations alongside trials in order to inform service commissioning and policy. If future research studies are well-designed, they have strong potential to investigate the economic impact of MBIs. The particular challenge to the health economist is how best to capture the ways that MBIs help people adjust to or build resilience to difficult life circumstances, and to disseminate effectively to enable policy makers to judge the value of the contribution that MBIs can make within the context of the limited resourcing of public services. In anticipation of more research worldwide evaluating MBIs in various settings, this article suggests ten health economics methodological design questions that researchers may want to consider prior to conducting MBI research. These questions draw on both published standards of good methodological practice in economic evaluation of medical interventions, and on the authors' knowledge and experience of mindfulness-based practice. We argue that it is helpful to view MBIs as both complex interventions and as public health prevention initiatives. Our suggestions for well-designed economic evaluations of MBIs in health and other settings, mirror current thinking on the challenges and opportunities of public health economics.

  1. Collective space of high-rise housing complex

    NASA Astrophysics Data System (ADS)

    Bakaeva, Tatyana

    2018-03-01

    The article considers the problems of support of citizens a comfortable living environment in the conditions of the limited territory of the megalopolis, the typological principles of formation of space-planning structure high-rise residence complexes with public space. The collective space for residents of high-rise housing estates on the example of international experience of design and construction is in detail considered. The collective space and the area of the standard apartment are analysed on comfort classes: a social - complex Pinnacle @ Duxton, a business - Monde Condos and an elite - Hamilton Scotts. Interdependence the area of the standard flat and the total area of housing collective space, in addiction on the comfort level, is revealed. In the conditions of high-density urban development, the collective space allows to form the comfortable environment for accommodation. The recommendations for achievement of integrity and improvement of quality of the city environment are made. The convenient collective space makes a contribution to civil policy, it creates the socializing sense of interaction of residents, coagulates social effect.

  2. Mapping healthcare systems: a policy relevant analytic tool

    PubMed Central

    Sekhri Feachem, Neelam; Afshar, Ariana; Pruett, Cristina; Avanceña, Anton L.V.

    2017-01-01

    Abstract Background In the past decade, an international consensus on the value of well-functioning systems has driven considerable health systems research. This research falls into two broad categories. The first provides conceptual frameworks that take complex healthcare systems and create simplified constructs of interactions and functions. The second focuses on granular inputs and outputs. This paper presents a novel translational mapping tool – the University of California, San Francisco mapping tool (the Tool) - which bridges the gap between these two areas of research, creating a platform for multi-country comparative analysis. Methods Using the Murray-Frenk framework, we create a macro-level representation of a country's structure, focusing on how it finances and delivers healthcare. The map visually depicts the fundamental policy questions in healthcare system design: funding sources and amount spent through each source, purchasers, populations covered, provider categories; and the relationship between these entities. Results We use the Tool to provide a macro-level comparative analysis of the structure of India's and Thailand's healthcare systems. Conclusions As part of the systems strengthening arsenal, the Tool can stimulate debate about the merits and consequences of different healthcare systems structural designs, using a common framework that fosters multi-country comparative analyses. PMID:28541518

  3. Preparing the Dutch delta for future droughts: model based support in the national Delta Programme

    NASA Astrophysics Data System (ADS)

    ter Maat, Judith; Haasnoot, Marjolijn; van der Vat, Marnix; Hunink, Joachim; Prinsen, Geert; Visser, Martijn

    2014-05-01

    Keywords: uncertainty, policymaking, adaptive policies, fresh water management, droughts, Netherlands, Dutch Deltaprogramme, physically-based complex model, theory-motivated meta-model To prepare the Dutch Delta for future droughts and water scarcity, a nation-wide 4-year project, called Delta Programme, is established to assess impacts of climate scenarios and socio-economic developments and to explore policy options. The results should contribute to a national adaptive plan that is able to adapt to future uncertain conditions, if necessary. For this purpose, we followed a model-based step-wise approach, wherein both physically-based complex models and theory-motivated meta-models were used. First step (2010-2011) was to make a quantitative problem description. This involved a sensitivity analysis of the water system for drought situations under current and future conditions. The comprehensive Dutch national hydrological instrument was used for this purpose and further developed. Secondly (2011-2012) our main focus was on making an inventory of potential actions together with stakeholders. We assessed efficacy, sell-by date of actions, and reassessed vulnerabilities and opportunities for the future water supply system if actions were (not) taken. A rapid assessment meta-model was made based on the complex model. The effects of all potential measures were included in the tool. Thirdly (2012-2013), with support of the rapid assessment model, we assessed the efficacy of policy actions over time for an ensemble of possible futures including sea level rise and climate and land use change. Last step (2013-2014) involves the selection of preferred actions from a set of promising actions that meet the defined objectives. These actions are all modeled and evaluated using the complex model. The outcome of the process will be an adaptive management plan. The adaptive plan describes a set of preferred policy pathways - sequences of policy actions - to achieve targets under changing conditions. The plan commits to short term actions, and identifies signpost indicators and trigger values to assess if next actions of the identified policy pathways need to be implemented or if reassessment of the plan is needed. For example, river discharges could be measured to monitor changes in low discharges as a result of climate change, and assess whether policy options such as diverting more water the main fresh water lake (IJsselmeer) need to be implemented sooner or later or not at all. The adaptive plan of the Delta Programme will be presented in 2014. First lessons of this part of the Delta Programme can already be drawn: Both the complex and meta-model had its own purpose in each phase. The meta-model was particularly useful for identifying promising policy options and for consultation of stakeholders due to the instant response. The complex model had much more opportunities to assess impacts of regional policy actions, and was supported by regional stakeholders that recognized their areas better in this model. Different sector impact assessment modules are also included in the workflow of the complex model. However, the complex model has a long runtime (i.e. three days for 1 year simulation or more than 100 days for 35 year time series simulation), which makes it less suitable to support the dynamic policy process on instant demand and interactively.

  4. Renewable Electricity Standards: Good Practices and Design Considerations

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

    Cox, Sadie; Esterly, Sean

    2016-01-02

    In widespread use globally, renewable electricity standards (RES) are one of the most widely adopted renewable energy policies and a critical regulatory vehicle to accelerate renewable energy deployment. This policy brief provides an introduction to key RES design elements, lessons from country experience, and support resources to enable more detailed and country-specific RES policy design.

  5. Transit Operator Guidelines for Transfer Policy Design

    DOT National Transportation Integrated Search

    1980-06-01

    This report provides guidelines to aid transit operators in the design of policies to accomodate bus and/or rail transfers policy may range from a complete set of operator actions involving vehicle routing and scheduling, transfer charges, passenger ...

  6. Design of Soil Salinity Policies with Tinamit, a Flexible and Rapid Tool to Couple Stakeholder-Built System Dynamics Models with Physically-Based Models

    NASA Astrophysics Data System (ADS)

    Malard, J. J.; Baig, A. I.; Hassanzadeh, E.; Adamowski, J. F.; Tuy, H.; Melgar-Quiñonez, H.

    2016-12-01

    Model coupling is a crucial step to constructing many environmental models, as it allows for the integration of independently-built models representing different system sub-components to simulate the entire system. Model coupling has been of particular interest in combining socioeconomic System Dynamics (SD) models, whose visual interface facilitates their direct use by stakeholders, with more complex physically-based models of the environmental system. However, model coupling processes are often cumbersome and inflexible and require extensive programming knowledge, limiting their potential for continued use by stakeholders in policy design and analysis after the end of the project. Here, we present Tinamit, a flexible Python-based model-coupling software tool whose easy-to-use API and graphical user interface make the coupling of stakeholder-built SD models with physically-based models rapid, flexible and simple for users with limited to no coding knowledge. The flexibility of the system allows end users to modify the SD model as well as the linking variables between the two models themselves with no need for recoding. We use Tinamit to couple a stakeholder-built socioeconomic model of soil salinization in Pakistan with the physically-based soil salinity model SAHYSMOD. As climate extremes increase in the region, policies to slow or reverse soil salinity buildup are increasing in urgency and must take both socioeconomic and biophysical spheres into account. We use the Tinamit-coupled model to test the impact of integrated policy options (economic and regulatory incentives to farmers) on soil salinity in the region in the face of future climate change scenarios. Use of the Tinamit model allowed for rapid and flexible coupling of the two models, allowing the end user to continue making model structure and policy changes. In addition, the clear interface (in contrast to most model coupling code) makes the final coupled model easily accessible to stakeholders with limited technical background.

  7. Climate policy: Uncovering ocean-related priorities

    NASA Astrophysics Data System (ADS)

    Barkemeyer, Ralf

    2017-11-01

    Given the complexity and multi-faceted nature of policy processes, national-level policy preferences are notoriously difficult to capture. Now, research applying an automated text mining approach helps to shed light on country-level differences and priorities in the context of marine climate issues.

  8. From Conception Through Delivery: Developing a Just and Equitable Faculty Maternity Leave Policy

    ERIC Educational Resources Information Center

    Untener, Joseph

    2008-01-01

    While much has been written on the need for faculty maternity leave policies in institutions of higher learning, the development of such policies is difficult given inherent administrative complexities and multiple approval processes. As a result, many institutions have either no policy or one that is inadequate or out of compliance with…

  9. The Role of School Context in Implementing a Statewide Anti-Bullying Policy and Protecting Students

    ERIC Educational Resources Information Center

    Hall, William J.; Chapman, Mimi V.

    2018-01-01

    Bullying is a significant problem in U.S. schools. Policies have been developed to reduce bullying, yet policy implementation by educators is an essential yet difficult and complex process. Few studies have investigated factors that act as barriers to or facilitators of bullying policy implementation and teacher protection of students. This study…

  10. Educational Change in Scotland: Policy, Context and Biography

    ERIC Educational Resources Information Center

    Priestley, M.; Miller, K.

    2012-01-01

    The poor success rate of policy for curriculum change has been widely noted in the educational change literature. Part of the problem lies in the complexity of schools, as policy-makers have proven unable to micro-manage the multifarious range of factors that impact upon the implementation of policy. This article draws upon empirical data from a…

  11. When Does Evidence-Based Policy Turn into Policy-Based Evidence? Configurations, Contexts and Mechanisms

    ERIC Educational Resources Information Center

    Strassheim, Holger; Kettunen, Pekka

    2014-01-01

    Many studies on evidence-based policy are still clinging to a linear model. Instead, we propose to understand expertise and evidence as "socially embedded" in authority relations and cultural contexts. Policy-relevant facts are the result of an intensive and complex struggle for political and epistemic authority. This is especially true…

  12. Safety and Stability for Foster Children: The Policy Context

    ERIC Educational Resources Information Center

    Allen, MaryLee; Bissell, Mary

    2004-01-01

    Even though federal laws have had a major influence on foster care and child welfare policy for more than 40 years, additional reforms are needed to ensure safe and stable families for children in care. This article describes the complex array of policies that shape federal foster care and observes: A number of federal policies addressing issues…

  13. Education Policy Implementation: A Literature Review and Proposed Framework. OECD Education Working Papers, No. 162

    ERIC Educational Resources Information Center

    Viennet, Romane; Pont, Beatriz

    2017-01-01

    This literature review focuses on education policy implementation, its definition, processes and determinants. It aims to clarify what implementing policies involve in complex education systems to support policy work, building on the literature and country examples. An introduction delves into the reasons behind the need to update the concept of…

  14. Pragmatics of policy: the compliance of dutch environmental policy instruments to European union standards.

    PubMed

    Kruitwagen, Sonja; Reudink, Melchert; Faber, Albert

    2009-04-01

    Despite a general decrease in Dutch environmental emission trends, it remains difficult to comply with European Union (EU) environmental policy targets. Furthermore, environmental issues have become increasingly complex and entangled with society. Therefore, Dutch environmental policy follows a pragmatic line by adopting a flexible approach for compliance, rather than aiming at further reduction at the source of emission. This may be politically useful in order to adequately reach EU targets, but restoration of environmental conditions may be delayed. However, due to the complexity of today's environmental issues, the restoration of environmental conditions might not be the only standard for a proper policy approach. Consequently this raises the question how the Dutch pragmatic approach to compliance qualifies in a broader policy assessment. In order to answer this question, we adapt a policy assessment framework, developed by Hemerijck and Hazeu (Bestuurskunde 13(2), 2004), based on the dimensions of legitimacy and policy logic. We apply this framework for three environmental policy assessments: flexible instruments in climate policy, fine-tuning of national and local measures to meet air quality standards, and derogation for the Nitrate Directive. We conclude with general assessment notes on the appliance of flexible instruments in environmental policy, showing that a broad and comprehensive perspective can help to understand the arguments to put such policy instruments into place and to identify trade-offs between assessment criteria.

  15. Individual decision making in the non-purchase of long-term care insurance.

    PubMed

    Curry, Leslie A; Robison, Julie; Shugrue, Noreen; Keenan, Patricia; Kapp, Marshall B

    2009-08-01

    Although prior research suggests that economic, behavioral, and psychosocial factors influence decisions not to purchase long-term care insurance, few studies have examined the interplay among these factors in depth and from the consumer's point of view. This study was intended to further illuminate these considerations, generate hypotheses about non-purchasing decisions, and inform the design of policies that are responsive to concerns and preferences of potential purchasers. Qualitative study using 32 in-depth interviews and 6 focus groups, following a grounded theory approach. Five themes characterize decisions not to purchase long-term care insurance: (a) the determination that a policy is "too costly" reflects highly individualized and complex trade-offs not solely economic in nature, (b) non-purchasers are skeptical about the viability and integrity of private insurance companies and seek an unbiased source of information, (c) family dynamics play an important role in insurance decisions, (d) contemplating personal risk for long-term care triggers psychological responses that have implications for decision making, and (e) non-purchasers feel inadequately informed and overwhelmed by the process of deciding whether to purchase long-term care insurance. States are seeking to offset escalating Medicaid long-term care expenditures through a variety of policy mechanisms, including stimulating individual purchase of long-term care insurance. Findings suggest that economic incentives such as lowering premiums will be necessary but not sufficient to attract appropriate candidates. Attention to behavioral and psychosocial factors is essential to designing incentives that are responsive to concerns and preferences of potential purchasers.

  16. Medicines counterfeiting is a complex problem: a review of key challenges across the supply chain.

    PubMed

    Tremblay, Michael

    2013-02-01

    The paper begins by asking why there is a market for counterfeit medicines, which in effect creates the problem of counterfeiting itself. Contributing factors include supply chain complexity and the lack of whole-systems thinking. These two underpin the author's view that counterfeiting is a complex (i.e. wicked) problem, and that corporate, public policy and regulatory actions need to be mindful of how their actions may be causal. The paper offers a problem-based review of key components of this complexity, viz., the knowledge end-users/consumers have of medicines; whether restrictive information policies may hamper information provision to patients; the internet's direct access to consumers; internet-enabled distribution of unsafe and counterfeit medicines; whether the internet is a parallel and competitive supply chain to legitimate routes; organised crime as an emerging medicines manufacturer and supplier and whether substandard medicines is really the bigger problem. Solutions respect the perceived complexity of the supply chain challenges. The paper identifies the need to avoid technologically-driven solutions, calling for 'technological agnosticism'. Both regulation and public policy need to reflect the dynamic nature of the problem and avoid creating perverse incentives; it may be, for instance, that medicines pricing and reimbursement policies, which affect consumer/patient access may act as market signals to counterfeiters, since this creates a cash market in cheaper drugs.

  17. Dynamic simulation modelling of policy responses to reduce alcohol-related harms: rationale and procedure for a participatory approach.

    PubMed

    Atkinson, Jo-An; O'Donnell, Eloise; Wiggers, John; McDonnell, Geoff; Mitchell, Jo; Freebairn, Louise; Indig, Devon; Rychetnik, Lucie

    2017-02-15

    Development of effective policy responses to address complex public health problems can be challenged by a lack of clarity about the interaction of risk factors driving the problem, differing views of stakeholders on the most appropriate and effective intervention approaches, a lack of evidence to support commonly implemented and acceptable intervention approaches, and a lack of acceptance of effective interventions. Consequently, political considerations, community advocacy and industry lobbying can contribute to a hotly contested debate about the most appropriate course of action; this can hinder consensus and give rise to policy resistance. The problem of alcohol misuse and its associated harms in New South Wales (NSW), Australia, provides a relevant example of such challenges. Dynamic simulation modelling is increasingly being valued by the health sector as a robust tool to support decision making to address complex problems. It allows policy makers to ask 'what-if' questions and test the potential impacts of different policy scenarios over time, before solutions are implemented in the real world. Participatory approaches to modelling enable researchers, policy makers, program planners, practitioners and consumer representatives to collaborate with expert modellers to ensure that models are transparent, incorporate diverse evidence and perspectives, are better aligned to the decision-support needs of policy makers, and can facilitate consensus building for action. This paper outlines a procedure for embedding stakeholder engagement and consensus building in the development of dynamic simulation models that can guide the development of effective, coordinated and acceptable policy responses to complex public health problems, such as alcohol-related harms in NSW.

  18. Design for sustainability of industrial symbiosis based on emergy and multi-objective particle swarm optimization.

    PubMed

    Ren, Jingzheng; Liang, Hanwei; Dong, Liang; Sun, Lu; Gao, Zhiqiu

    2016-08-15

    Industrial symbiosis provides novel and practical pathway to the design for the sustainability. Decision support tool for its verification is necessary for practitioners and policy makers, while to date, quantitative research is limited. The objective of this work is to present an innovative approach for supporting decision-making in the design for the sustainability with the implementation of industrial symbiosis in chemical complex. Through incorporating the emergy theory, the model is formulated as a multi-objective approach that can optimize both the economic benefit and sustainable performance of the integrated industrial system. A set of emergy based evaluation index are designed. Multi-objective Particle Swarm Algorithm is proposed to solve the model, and the decision-makers are allowed to choose the suitable solutions form the Pareto solutions. An illustrative case has been studied by the proposed method, a few of compromises between high profitability and high sustainability can be obtained for the decision-makers/stakeholders to make decision. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Policy Enacted--Teachers' Approaches to an Outcome-Based Framework for Course Design

    ERIC Educational Resources Information Center

    Barman, Linda; Bolander-Laksov, Klara; Silén, Charlotte

    2014-01-01

    In this paper, we report on how teachers in Higher Education enact policy. Outcome-based education (OBE) serves as an example of a governmental educational policy introduced with the European Bologna reform. With a hermeneutic approach, we have studied how 14 teachers interpreted this policy and re-designed their courses. The findings show…

  20. Governing Methods: Policy Innovation Labs, Design and Data Science in the Digital Governance of Education

    ERIC Educational Resources Information Center

    Williamson, Ben

    2015-01-01

    Policy innovation labs are emerging knowledge actors and technical experts in the governing of education. The article offers a historical and conceptual account of the organisational form of the policy innovation lab. Policy innovation labs are characterised by specific methods and techniques of design, data science, and digitisation in public…

  1. VSU Campus Alcohol and Drug Policies and Procedures. Revised 1990. Program Design and Questionnaire.

    ERIC Educational Resources Information Center

    Virginia State Univ., Petersburg.

    This document comprises the Virginia State University (VSU) Campus Alcohol and Drug Policies and Procedures booklet; a program design for a VSU drug education, treatment, and prevention program; and a drug and alcohol student survey. The booklet covering policies and procedures contains: a message from the president; a policy statement; a review…

  2. Evidence synthesis in international development: a critique of systematic reviews and a pragmatist alternative

    PubMed Central

    Cornish, Flora

    2015-01-01

    Systematic reviews are an instrument of Evidence-Based Policy designed to produce comprehensive, unbiased, transparent and clear assessments of interventions’ effectiveness. From their origins in medical fields, systematic reviews have recently been promoted as offering important advances in a range of applied social science fields, including international development. Drawing on a case study of a systematic review of the effectiveness of community mobilisation as an intervention to tackle HIV/AIDS, this article problematises the use of systematic reviews to summarise complex and context-specific bodies of evidence. Social development interventions, such as ‘community mobilisation’ often take different forms in different interventions; are made successful by their situation in particular contexts, rather than being successful or unsuccessful universally; and have a rhetorical value that leads to the over-application of positively valued terms (e.g. ‘community mobilisation’), invalidating the keyword search process of a systematic review. The article suggests that the policy interest in definitive summary statements of ‘the evidence’ is at odds with academic assessments that evidence takes multiple, contradictory and complex forms, and with practitioner experience of the variability of practice in context. A pragmatist philosophy of evidence is explored as an alternative. Taking this approach implies expanding the definition of forms of research considered to be ‘useful evidence’ for evidence-based policy-making; decentralising decisions about ‘what works’ to allow for the use of local practical wisdom; and prioritising the establishment of good processes for the critical use of evidence, rather than producing context-insensitive summaries of ‘the evidence’. PMID:26426502

  3. Evidence synthesis in international development: a critique of systematic reviews and a pragmatist alternative.

    PubMed

    Cornish, Flora

    2015-12-01

    Systematic reviews are an instrument of Evidence-Based Policy designed to produce comprehensive, unbiased, transparent and clear assessments of interventions' effectiveness. From their origins in medical fields, systematic reviews have recently been promoted as offering important advances in a range of applied social science fields, including international development. Drawing on a case study of a systematic review of the effectiveness of community mobilisation as an intervention to tackle HIV/AIDS, this article problematises the use of systematic reviews to summarise complex and context-specific bodies of evidence. Social development interventions, such as 'community mobilisation' often take different forms in different interventions; are made successful by their situation in particular contexts, rather than being successful or unsuccessful universally; and have a rhetorical value that leads to the over-application of positively valued terms (e.g. 'community mobilisation'), invalidating the keyword search process of a systematic review. The article suggests that the policy interest in definitive summary statements of 'the evidence' is at odds with academic assessments that evidence takes multiple, contradictory and complex forms, and with practitioner experience of the variability of practice in context. A pragmatist philosophy of evidence is explored as an alternative. Taking this approach implies expanding the definition of forms of research considered to be 'useful evidence' for evidence-based policy-making; decentralising decisions about 'what works' to allow for the use of local practical wisdom; and prioritising the establishment of good processes for the critical use of evidence, rather than producing context-insensitive summaries of 'the evidence'.

  4. Reproductive medicine: the ethical issues in the twenty-first century.

    PubMed

    Campbell, Alastair V

    2002-02-01

    Reproductive medicine has developed to such an extent that numerous moral questions arise about the boundaries of applications of new reproductive technology. It is possible to imagine a future in which 'designer babies' are created and in which cloning, sex selection and male pregnancy become the instruments of individual desire or social policy. In this article, the concept of 'natural' is explored but rejected as an insufficient moral criterion for deciding these complex questions. A case is made for the criterion of welfare of the child and for the concept of the child as gift rather than product.

  5. Evaluating Payments for Environmental Services: Methodological Challenges

    PubMed Central

    2016-01-01

    Over the last fifteen years, Payments for Environmental Services (PES) schemes have become very popular environmental policy instruments, but the academic literature has begun to question their additionality. The literature attempts to estimate the causal effect of these programs by applying impact evaluation (IE) techniques. However, PES programs are complex instruments and IE methods cannot be directly applied without adjustments. Based on a systematic review of the literature, this article proposes a framework for the methodological process of designing an IE for PES schemes. It revises and discusses the methodological choices at each step of the process and proposes guidelines for practitioners. PMID:26910850

  6. Exploring complex dynamics in multi agent-based intelligent systems: Theoretical and experimental approaches using the Multi Agent-based Behavioral Economic Landscape (MABEL) model

    NASA Astrophysics Data System (ADS)

    Alexandridis, Konstantinos T.

    This dissertation adopts a holistic and detailed approach to modeling spatially explicit agent-based artificial intelligent systems, using the Multi Agent-based Behavioral Economic Landscape (MABEL) model. The research questions that addresses stem from the need to understand and analyze the real-world patterns and dynamics of land use change from a coupled human-environmental systems perspective. Describes the systemic, mathematical, statistical, socio-economic and spatial dynamics of the MABEL modeling framework, and provides a wide array of cross-disciplinary modeling applications within the research, decision-making and policy domains. Establishes the symbolic properties of the MABEL model as a Markov decision process, analyzes the decision-theoretic utility and optimization attributes of agents towards comprising statistically and spatially optimal policies and actions, and explores the probabilogic character of the agents' decision-making and inference mechanisms via the use of Bayesian belief and decision networks. Develops and describes a Monte Carlo methodology for experimental replications of agent's decisions regarding complex spatial parcel acquisition and learning. Recognizes the gap on spatially-explicit accuracy assessment techniques for complex spatial models, and proposes an ensemble of statistical tools designed to address this problem. Advanced information assessment techniques such as the Receiver-Operator Characteristic curve, the impurity entropy and Gini functions, and the Bayesian classification functions are proposed. The theoretical foundation for modular Bayesian inference in spatially-explicit multi-agent artificial intelligent systems, and the ensembles of cognitive and scenario assessment modular tools build for the MABEL model are provided. Emphasizes the modularity and robustness as valuable qualitative modeling attributes, and examines the role of robust intelligent modeling as a tool for improving policy-decisions related to land use change. Finally, the major contributions to the science are presented along with valuable directions for future research.

  7. Urban adaptation to mega-drought: Anticipatory water modeling, policy, and planning in Phoenix

    NASA Astrophysics Data System (ADS)

    Gober, P.; Sampson, D. A.; Quay, R.; White, D. D.; Chow, W.

    2016-12-01

    There is increasing interest in using the results of water models for long-term planning and policy analysis. Achieving this goal requires more effective integration of human dimensions into water modeling and a paradigm shift in the way models are developed and used. A user-defined focus argues in favor of models that are designed to foster public debate and engagement about the difficult trade-offs that are inevitable in managing complex water systems. These models also emphasize decision making under uncertainty and anticipatory planning, and are developed through a collaborative and iterative process. This paper demonstrates the use of anticipatory modeling for long-term drought planning in Phoenix, one of the largest and fastest growing urban areas in the southwestern USA. WaterSim 5, an anticipatory water policy and planning model, was used to explore groundwater sustainability outcomes for mega-drought conditions across a range of policies, including population growth management, water conservation, water banking, direct reuse of RO reclaimed water, and water augmentation. Results revealed that business-as-usual population growth, per capita use trends, and management strategies may not be sustainable over the long term, even without mega-drought conditions as years of available groundwater supply decline over the simulation period from 2000 to 2060. Adding mega-drought increases the decline in aquifer levels and increases the variability in flows and uncertainty about future groundwater supplies. Simulations that combine drought management policies can return the region to sustainable. Results demonstrate the value of long-term planning and policy analysis for anticipating and adapting to environmental change.

  8. Stabilized Approach Criteria: Bridging the Gap Between Theory and Practice

    NASA Technical Reports Server (NTRS)

    Zaal, Petrus M.

    2018-01-01

    Approach and landing is the most common phase of flight for aviation accidents, accounting annually for approximately 65 percent of all accidents. A Flight Safety Foundation study of 16 years of runway excursions determined that 83 percent could have been avoided with a decision to go around. In other words, 54 percent of all accidents could potentially be prevented by going around. A critical industry policy designed to help prevent such accidents is the go-around policy. However, the collective industry performance of complying with go-around policies is extremely poor and only about three percent of unstable approaches result in a go-around. Improving the go-around compliance rate holds tremendous potential in reducing approach and landing accidents. There are many reasons for flight crews ignoring go-around policies related to pilot judgement and company policies. Examples are the collective industry norm to accept the noncompliance of go-around policies, management being disengaged from go-around noncompliance, and pilot fatigue and lack of situational awareness. One of the biggest factors is that pilots see current stabilized-approach criteria as too complex and restrictive for the operational environment. Following the American Airlines 1420 accident (Little Rock, 1999), where the aircraft overran the runway upon landing and crashed, the National Transportation Safety Board (NTSB) recommended that the Federal Aviation Administration (FAA) define detailed parameters for a stabilized approach, and develop detailed criteria indicating when a go-around should be performed. The experiment discussed in this presentation is the first step towards developing these go-around criteria for commercial transport aircraft.

  9. Research capacity for childhood obesity prevention in Latin America: an area for growth.

    PubMed

    Parra, Diana C; Vorkoper, Susan; Kohl, Harold W; Caballero, Benjamin; Batis, Carolina; Jauregui, Alejandra; Mason, Jessica; Pratt, Michael

    2017-07-01

    The rise of childhood obesity in Latin America calls for research capacity to understand, monitor and implement strategies, policies and programmes to address it. The objective of the study was to assess current research capacity in Latin America related to childhood obesity, nutrition and physical activity. We conducted a search of peer-reviewed articles on childhood obesity in Latin America with at least one Latin American author from 2010 to May 2015. We coded 484 published articles for author affiliation, study subjects' nationality, research topic and study design and extracted a series of networks per research topic, study design and collaborating country for each of the countries. Obesity is the most frequently explored topic. Nutrition and obesity are somewhat better developed compared with physical activity and sedentary behaviour. There are numerous observational and cross-sectional studies, indicating either a lack of capacity required for more complex research or the extent of the problem and associated factors is still unknown. The low number of intervention studies and the near absence of policy articles suggest a void in research capacity. For childhood obesity, there is a clear need to build research capacity that documents the current state of the problem and design evidence-based prevention and intervention efforts. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

  10. Good on paper: the gap between programme theory and real-world context in Pakistan's Community Midwife programme

    PubMed Central

    Mumtaz, Z; Levay, A; Bhatti, A; Salway, S

    2015-01-01

    Objective To understand why skilled birth attendance—an acknowledged strategy for reducing maternal deaths—has been effective in some settings but is failing in Pakistan and to demonstrate the value of a theory-driven approach to evaluating implementation of maternal healthcare interventions. Design Implementation research was conducted using an institutional ethnographic approach. Setting and population National programme and local community levels in Pakistan. Methods Observations, focus group discussions, and in-depth interviews were conducted with 38 Community Midwives (CMWs), 20 policymakers, 45 healthcare providers and 136 community members. A critical policy document review was conducted. National and local level data were brought together. Main outcomes Alignment of programme theory with real-world practice. Results Data revealed gaps between programme theory, assumptions and reality on the ground. The design of the programme failed to take into account: (1) the incongruity between the role of a midwife and dominant class and gendered norms that devalue such a role; (2) market and consumer behaviour that prevented CMWs from establishing private practices; (3) the complexity of public–private sector cooperation. Uniform deployment policies failed to consider existing provider density and geography. Conclusions Greater attention to programme theory and the ‘real-world’ setting during design of maternal health strategies is needed to achieve consistent results in different contexts. PMID:25315837

  11. Girls' Education: The Power of Policy Discourse

    ERIC Educational Resources Information Center

    Monkman, Karen; Hoffman, Lisa

    2013-01-01

    Girls' education has been a focus of international development policy for several decades. The discursive framing of international organizations' policy initiatives relating to girls' education, however, limits the potential for discussing complex gender issues that affect the possibilities for gender equity. Because discourse shapes our…

  12. 12 CFR Appendix A to Part 252 - Policy Statement on the Scenario Design Framework for Stress Testing

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Policy Statement on the Scenario Design... YY) Pt. 252, App. A Appendix A to Part 252—Policy Statement on the Scenario Design Framework for... (stress test rules) implementing section 165(i) of the Dodd-Frank Wall Street Reform and Consumer...

  13. 22 CFR 120.3 - Policy on designating or determining defense articles and services on the U.S. Munitions List.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Policy on designating or determining defense articles and services on the U.S. Munitions List. 120.3 Section 120.3 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS PURPOSE AND DEFINITIONS § 120.3 Policy on designating or determining...

  14. Research ethics consultation: ethical and professional practice challenges and recommendations.

    PubMed

    Sharp, Richard R; Taylor, Holly A; Brinich, Margaret A; Boyle, Mary M; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

    2015-05-01

    The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical and Translational Science Award Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: (1) managing multiple institutional roles and responsibilities, (2) managing sensitive information, and (3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services.

  15. Dissemination, Implementation, and Improvement Science Research in Population Health: Opportunities for Public Health and CTSAs.

    PubMed

    Kuo, Tony; Gase, Lauren N; Inkelas, Moira

    2015-12-01

    The complex, dynamic nature of health systems requires dissemination, implementation, and improvement (DII) sciences to effectively translate emerging knowledge into practice. Although they hold great promise for informing multisector policies and system-level changes, these methods are often not strategically used by public health. More than 120 stakeholders from Southern California, including the community, federal and local government, university, and health services were convened to identify key priorities and opportunities for public health departments and Clinical and Translational Science Awards programs (CTSAs) to advance DII sciences in population health. Participants identified challenges (mismatch of practice realities with narrowly focused research questions; lack of iterative learning) and solutions (using methods that fit the dynamic nature of the real world; aligning theories of change across sectors) for applying DII science research to public health problems. Pragmatic steps that public health and CTSAs can take to facilitate DII science research include: employing appropriate study designs; training scientists and practicing professionals in these methods; securing resources to advance this work; and supporting team science to solve complex-systems issues. Public health and CTSAs represent a unique model of practice for advancing DII research in population health. The partnership can inform policy and program development in local communities. © 2015 Wiley Periodicals, Inc.

  16. Research Ethics Consultation: Ethical and Professional Practice Challenges and Recommendations

    PubMed Central

    Sharp, Richard R.; Taylor, Holly A.; Brinich, Margaret A.; Boyle, Mary M.; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

    2015-01-01

    The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include: assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical Translational Science Award (CTSA) Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: 1) managing multiple institutional roles and responsibilities, 2) managing sensitive information, and 3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services. PMID:25607942

  17. Genomic Sequencing: Assessing The Health Care System, Policy, And Big-Data Implications

    PubMed Central

    Phillips, Kathryn A.; Trosman, Julia; Kelley, Robin K.; Pletcher, Mark J.; Douglas, Michael P.; Weldon, Christine B.

    2014-01-01

    New genomic sequencing technologies enable the high-speed analysis of multiple genes simultaneously, including all of those in a person's genome. Sequencing is a prominent example of a “big data” technology because of the massive amount of information it produces and its complexity, diversity, and timeliness. Our objective in this article is to provide a policy primer on sequencing and illustrate how it can affect health care system and policy issues. Toward this end, we developed an easily applied classification of sequencing based on inputs, methods, and outputs. We used it to examine the implications of sequencing for three health care system and policy issues: making care more patient-centered, developing coverage and reimbursement policies, and assessing economic value. We conclude that sequencing has great promise but that policy challenges include how to optimize patient engagement as well as privacy, develop coverage policies that distinguish research from clinical uses and account for bioinformatics costs, and determine the economic value of sequencing through complex economic models that take into account multiple findings and downstream costs. PMID:25006153

  18. Genomic sequencing: assessing the health care system, policy, and big-data implications.

    PubMed

    Phillips, Kathryn A; Trosman, Julia R; Kelley, Robin K; Pletcher, Mark J; Douglas, Michael P; Weldon, Christine B

    2014-07-01

    New genomic sequencing technologies enable the high-speed analysis of multiple genes simultaneously, including all of those in a person's genome. Sequencing is a prominent example of a "big data" technology because of the massive amount of information it produces and its complexity, diversity, and timeliness. Our objective in this article is to provide a policy primer on sequencing and illustrate how it can affect health care system and policy issues. Toward this end, we developed an easily applied classification of sequencing based on inputs, methods, and outputs. We used it to examine the implications of sequencing for three health care system and policy issues: making care more patient-centered, developing coverage and reimbursement policies, and assessing economic value. We conclude that sequencing has great promise but that policy challenges include how to optimize patient engagement as well as privacy, develop coverage policies that distinguish research from clinical uses and account for bioinformatics costs, and determine the economic value of sequencing through complex economic models that take into account multiple findings and downstream costs. Project HOPE—The People-to-People Health Foundation, Inc.

  19. 41 CFR 102-76.10 - What basic design and construction policy governs Federal agencies?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... basic design and construction policies: (a) Provide the highest quality services for designing and... requirements. (See 40 U.S.C. 3310 and 3312.) (d) Design Federal buildings to have a long life expectancy and...

  20. 41 CFR 102-76.10 - What basic design and construction policy governs Federal agencies?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... basic design and construction policies: (a) Provide the highest quality services for designing and... requirements. (See 40 U.S.C. 3310 and 3312.) (d) Design Federal buildings to have a long life expectancy and...

  1. Learning the wrong lessons? Science and fisheries management in the Chesapeake Bay blue crab fishery.

    PubMed

    Beem, Betsi

    2012-05-01

    This paper argues that information produced and then taken up for policy decision making is a function of a complex interplay within the scientific community and between scientists and the broader policy network who are all grappling with issues in a complex environment with a high degree of scientific uncertainty. The dynamics of forming and re-forming the scientific community are shaped by political processes, as are the directions and questions scientists attend to in their roles as policy advisors. Three factors: 1) social construction of scientific communities, 2) the indeterminacy of science, and 3) demands by policy makers to have concrete information for decision making; are intertwined in the production and dissemination of information that may serve as the basis for policy learning. Through this process, however, what gets learned may not be what is needed to mitigate the problem, be complete in terms of addressing multiple causations, or be correct.

  2. Cause for concern: the absence of consideration of public and ethical interest in British public policy

    PubMed Central

    Pattison, S; Evans, H M

    2006-01-01

    In the UK, many fundamentally important policy decisions that are likely to affect the relationship between citizens and care services are now made at the sublegislative level and without adequate ethical consideration and scrutiny. This is well exemplified in the proposed guidance on the disclosure of information on children. A recent consultation paper by the UK government on the subject proposes an approach that seeks a simple technical solution to a complex problem, emphasising control and surveillance. This reflects pressure to be seen to act. The document fails with regard to ethical reflection appropriate to the complexity of the issue, an appreciation of complex relationships of trust, and a proper sense of the richness and complexity of the public interest. Such policies would, if implemented, fundamentally change the relationships between citizens and their carers, and among carers and the law and the state. This and similar proposals require far more ethical scrutiny and consideration of the public interest in the widest sense. PMID:17145911

  3. Implementing the water framework directive: contract design and the cost of measures to reduce nitrogen pollution from agriculture.

    PubMed

    Bartolini, Fabio; Gallerani, Vittorio; Raggi, Meri; Viaggi, Davide

    2007-10-01

    The performance of different policy design strategies is a key issue in evaluating programmes for water quality improvement under the Water Framework Directive (60/2000). This issue is emphasised by information asymmetries between regulator and agents. Using an economic model under asymmetric information, the aim of this paper is to compare the cost-effectiveness of selected methods of designing payments to farmers in order to reduce nitrogen pollution in agriculture. A principal-agent model is used, based on profit functions generated through farm-level linear programming. This allows a comparison of flat rate payments and a menu of contracts developed through mechanism design. The model is tested in an area of Emilia Romagna (Italy) in two policy contexts: Agenda 2000 and the 2003 Common Agricultural Policy (CAP) reform. The results show that different policy design options lead to differences in policy costs as great as 200-400%, with clear advantages for the menu of contracts. However, different policy scenarios may strongly affect such differences. Hence, the paper calls for greater attention to the interplay between CAP scenarios and water quality measures.

  4. Implementing the Water Framework Directive: Contract Design and the Cost of Measures to Reduce Nitrogen Pollution from Agriculture

    NASA Astrophysics Data System (ADS)

    Bartolini, Fabio; Gallerani, Vittorio; Raggi, Meri; Viaggi, Davide

    2007-10-01

    The performance of different policy design strategies is a key issue in evaluating programmes for water quality improvement under the Water Framework Directive (60/2000). This issue is emphasised by information asymmetries between regulator and agents. Using an economic model under asymmetric information, the aim of this paper is to compare the cost-effectiveness of selected methods of designing payments to farmers in order to reduce nitrogen pollution in agriculture. A principal-agent model is used, based on profit functions generated through farm-level linear programming. This allows a comparison of flat rate payments and a menu of contracts developed through mechanism design. The model is tested in an area of Emilia Romagna (Italy) in two policy contexts: Agenda 2000 and the 2003 Common Agricultural Policy (CAP) reform. The results show that different policy design options lead to differences in policy costs as great as 200-400%, with clear advantages for the menu of contracts. However, different policy scenarios may strongly affect such differences. Hence, the paper calls for greater attention to the interplay between CAP scenarios and water quality measures.

  5. Control and design of multiple unmanned air vehicles for persistent surveillance

    NASA Astrophysics Data System (ADS)

    Nigam, Nikhil

    Control of multiple autonomous aircraft for search and exploration, is a topic of current research interest for applications such as weather monitoring, geographical surveys, search and rescue, tactical reconnaissance, and extra-terrestrial exploration, and the need to distribute sensing is driven by considerations of efficiency, reliability, cost and scalability. Hence, this problem has been extensively studied in the fields of controls and artificial intelligence. The task of persistent surveillance is different from a coverage/exploration problem, in that all areas need to be continuously searched, minimizing the time between visitations to each region in the target space. This distinction does not allow a straightforward application of most exploration techniques to the problem, although ideas from these methods can still be used. The use of aerial vehicles is motivated by their ability to cover larger spaces and their relative insensitivity to terrain. However, the dynamics of Unmanned Air Vehicles (UAVs) adds complexity to the control problem. Most of the work in the literature decouples the vehicle dynamics and control policies, but their interaction is particularly interesting for a surveillance mission. Stochastic environments and UAV failures further enrich the problem by requiring the control policies to be robust, and this aspect is particularly important for hardware implementations. For a persistent mission, it becomes imperative to consider the range/endurance constraints of the vehicles. The coupling of the control policy with the endurance constraints of the vehicles is an aspect that has not been sufficiently explored. Design of UAVs for desirable mission performance is also an issue of considerable significance. The use of a single monolithic optimization for such a problem has practical limitations, and decomposition-based design is a potential alternative. In this research high-level control policies are devised, that are scalable, reliable, efficient, and robust to changes in the environment. Most of the existing techniques that carry performance guarantees are not scalable or robust to changes. The scalable techniques are often heuristic in nature, resulting in lack of reliability and performance. Our policies are tested in a multi-UAV simulation environment developed for this problem, and shown to be near-optimal in spite of being completely reactive in nature. We explicitly account for the coupling between aircraft dynamics and control policies as well, and suggest modifications to improve performance under dynamic constraints. A smart refueling policy is also developed to account for limited endurance, and large performance benefits are observed. The method is based on the solution of a linear program that can be efficiently solved online in a distributed setting, unlike previous work. The Vehicle Swarm Technology Laboratory (VSTL), a hardware testbed developed at Boeing Research and Technology for evaluating swarm of UAVs, is described next and used to test the control strategy in a real-world scenario. The simplicity and robustness of the strategy allows easy implementation and near replication of the performance observed in simulation. Finally, an architecture for system-of-systems design based on Collaborative Optimization (CO) is presented. Earlier work coupling operations and design has used frameworks that make certain assumptions not valid for this problem. The efficacy of our approach is illustrated through preliminary design results, and extension to more realistic settings is also demonstrated.

  6. On the required complexity of vehicle dynamic models for use in simulation-based highway design.

    PubMed

    Brown, Alexander; Brennan, Sean

    2014-06-01

    This paper presents the results of a comprehensive project whose goal is to identify roadway design practices that maximize the margin of safety between the friction supply and friction demand. This study is motivated by the concern for increased accident rates on curves with steep downgrades, geometries that contain features that interact in all three dimensions - planar curves, grade, and superelevation. This complexity makes the prediction of vehicle skidding quite difficult, particularly for simple simulation models that have historically been used for road geometry design guidance. To obtain estimates of friction margin, this study considers a range of vehicle models, including: a point-mass model used by the American Association of State Highway Transportation Officials (AASHTO) design policy, a steady-state "bicycle model" formulation that considers only per-axle forces, a transient formulation of the bicycle model commonly used in vehicle stability control systems, and finally, a full multi-body simulation (CarSim and TruckSim) regularly used in the automotive industry for high-fidelity vehicle behavior prediction. The presence of skidding--the friction demand exceeding supply--was calculated for each model considering a wide range of vehicles and road situations. The results indicate that the most complicated vehicle models are generally unnecessary for predicting skidding events. However, there are specific maneuvers, namely braking events within lane changes and curves, which consistently predict the worst-case friction margins across all models. This suggests that any vehicle model used for roadway safety analysis should include the effects of combined cornering and braking. The point-mass model typically used by highway design professionals may not be appropriate to predict vehicle behavior on high-speed curves during braking in low-friction situations. However, engineers can use the results of this study to help select the appropriate vehicle dynamic model complexity to use in the highway design process. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Reproductive health policy affecting low-income women: historical precedents and current need for social work action.

    PubMed

    Averitt Taylor, Jessica

    2014-01-01

    This article provides an overview of the historical arguments surrounding reproductive health policy and current policy initiatives. Because reproductive policy itself is a vast subject matter with sometimes blurry boundaries, the struggle concerning the advent of birth control is used to illustrate the historic complexities of policy affecting such a wide array of individuals. The battle over introduction of the birth control pill is pertinent because the very same arguments are used today in debates over reproductive health policy.

  8. Navigating public health chemicals policy in Australia: a policy maker's and practitioner's guide.

    PubMed

    Capon, Adam; Smith, Wayne; Gillespie, James A

    2013-03-01

    Chemicals are ubiquitous in everyday life. Environmental health practitioners rely on a complex web of regulators and policy bodies to ensure the protection of public health, yet few understand the full extent of this web. A lack of understanding can hamper public health response and impede policy development. In this paper we map the public health chemicals policy landscape in Australia and conclude that an understanding of this system is essential for effective environmental health responses and policy development.

  9. Enacting Policy: The Capacity of School Leaders to Support Early Career Teachers through Policy Work

    ERIC Educational Resources Information Center

    Sullivan, Anna M.; Morrison, Chad

    2014-01-01

    Early career teachers often feel overwhelmed by the complex, intense and unpredictable nature of their work. Recently, policy initiatives have been introduced to provide new teachers with extra release-time from face-to-face classroom teaching duties to assist them in their transition to the workforce. This paper reports on a critical policy study…

  10. Towards a Policy Social Psychology: Teacher Engagement with Policy Enactment and the Core Concept of Affective Disruption

    ERIC Educational Resources Information Center

    Sheikh, Irfan; Bagley, Carl

    2018-01-01

    The article uncovers the complex process of educational policy enactment and the impact this process has on teachers as policy actors as they undertake the task of introducing a new mathematics curriculum in a Canadian secondary school. The three year study based on in-depth qualitative interviews adopts a classic grounded theory approach of…

  11. Policy as Practice: Local Appropriation of Language and Education Policies in Lesotho Primary Schools

    ERIC Educational Resources Information Center

    Backman, Stephen

    2009-01-01

    This dissertation study sets out to take a close look at the complex mix of factors on the ground, which influence the appropriation of language and education policies by local education stakeholders at Lesotho primary schools. I argue that much of the research in language policy and planning (LPP) has focused too largely on the macro-level…

  12. Understanding Public Policy Making through the Work of Committees: Utilizing a Student-Led Congressional Hearing Simulation

    ERIC Educational Resources Information Center

    Rinfret, Sara R.; Pautz, Michelle C.

    2015-01-01

    In an effort to help students better understand the complexity of making environmental policy and the role of policy actors in this process, we developed a mock congressional hearing simulation. In this congressional hearing, students in two environmental policy courses take on the roles of members of Congress and various interest groups to…

  13. Effects of behavioral response and vaccination policy on epidemic spreading--an approach based on evolutionary-game dynamics.

    PubMed

    Zhang, Hai-Feng; Wu, Zhi-Xi; Tang, Ming; Lai, Ying-Cheng

    2014-07-11

    How effective are governmental incentives to achieve widespread vaccination coverage so as to prevent epidemic outbreak? The answer largely depends on the complex interplay among the type of incentive, individual behavioral responses, and the intrinsic epidemic dynamics. By incorporating evolutionary games into epidemic dynamics, we investigate the effects of two types of incentives strategies: partial-subsidy policy in which certain fraction of the cost of vaccination is offset, and free-subsidy policy in which donees are randomly selected and vaccinated at no cost. Through mean-field analysis and computations, we find that, under the partial-subsidy policy, the vaccination coverage depends monotonically on the sensitivity of individuals to payoff difference, but the dependence is non-monotonous for the free-subsidy policy. Due to the role models of the donees for relatively irrational individuals and the unchanged strategies of the donees for rational individuals, the free-subsidy policy can in general lead to higher vaccination coverage. Our findings indicate that any disease-control policy should be exercised with extreme care: its success depends on the complex interplay among the intrinsic mathematical rules of epidemic spreading, governmental policies, and behavioral responses of individuals.

  14. An Education in Contrast: State-by-State Assessment of School Immunization Records Requirements

    PubMed Central

    Jessop, Amy B.; Field, Robert I.

    2014-01-01

    Objectives. We reviewed the complexities of school-related immunization policies, their relation to immunization information systems (IIS) and immunization registries, and the historical context to better understand this convoluted policy system. Methods. We used legal databases (Lexis-Nexis and Westlaw) to identify school immunization records policies for 50 states, 5 cities, and the District of Columbia (Centers for Disease Control and Prevention “grantees”). The original search took place from May to September 2010 (cross-referenced in July 2013 with the list on http://www.immunize.org/laws). We describe the requirements, agreement with IIS policies, and penalties for policy violations. Results. We found a complex web of public health, medical, and education-directed policies, which complicates immunization data sharing. Most (79%) require records of immunizations for children to attend school or for a child-care institution licensure, but only a few (11%) require coordination between IIS and schools or child-care facilities. Conclusions. To realize the full benefit of IIS investment, including improved immunization and school health program efficiencies, IIS and school immunization records policies must be better coordinated. States with well-integrated policies may serve as models for effective harmonization. PMID:25122033

  15. Effects of behavioral response and vaccination policy on epidemic spreading - an approach based on evolutionary-game dynamics

    NASA Astrophysics Data System (ADS)

    Zhang, Hai-Feng; Wu, Zhi-Xi; Tang, Ming; Lai, Ying-Cheng

    2014-07-01

    How effective are governmental incentives to achieve widespread vaccination coverage so as to prevent epidemic outbreak? The answer largely depends on the complex interplay among the type of incentive, individual behavioral responses, and the intrinsic epidemic dynamics. By incorporating evolutionary games into epidemic dynamics, we investigate the effects of two types of incentives strategies: partial-subsidy policy in which certain fraction of the cost of vaccination is offset, and free-subsidy policy in which donees are randomly selected and vaccinated at no cost. Through mean-field analysis and computations, we find that, under the partial-subsidy policy, the vaccination coverage depends monotonically on the sensitivity of individuals to payoff difference, but the dependence is non-monotonous for the free-subsidy policy. Due to the role models of the donees for relatively irrational individuals and the unchanged strategies of the donees for rational individuals, the free-subsidy policy can in general lead to higher vaccination coverage. Our findings indicate that any disease-control policy should be exercised with extreme care: its success depends on the complex interplay among the intrinsic mathematical rules of epidemic spreading, governmental policies, and behavioral responses of individuals.

  16. Factors influencing parents' decision-making when sending children with respiratory tract infections to nursery.

    PubMed

    Carroll, Fran E; Rooshenas, Leila; Owen-Smith, Amanda; Al-Janabi, Hareth; Hollinghurst, Sandra; Hay, Alastair D

    2016-06-01

    Many families rely on formal day care provision, which can be problematic when children are unwell. Attendance in these circumstances may impact on the transmission of infections in both day care and the wider community. Thirty-one semi-structured interviews were conducted to investigate how parents make decisions about nursery care when children are unwell. Topics for discussion included: illness attitudes, current practice during childhood illness and potential nursery policy changes that could affect decision-making. A combination of illness perceptions and external factors affected decision-making. Parents: (i) considered the severity of respiratory and non-respiratory symptoms differently, and stated that while most other contagious illnesses required nursery exclusion, coughs/colds did not; (ii) said decisions were not solely based on nursery policy, but on practical challenges such as work absences, financial penalties and alternative care availability; (iii) identified modifiable nursery policy factors that could potentially help parents keep unwell children at home, potentially reducing transmission of infectious illness. Decision-making is a complex interaction between the child's illness, personal circumstance and nursery policy. Improving our understanding of the modifiable aspects of nursery policies and the extent to which these factors affect decision-making could inform the design and implementation of interventions to reduce the transmission of infectious illness and the associated burden on NHS services. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. ARC-VM: An architecture real options complexity-based valuation methodology for military systems-of-systems acquisitions

    NASA Astrophysics Data System (ADS)

    Domercant, Jean Charles

    The combination of today's national security environment and mandated acquisition policies makes it necessary for military systems to interoperate with each other to greater degrees. This growing interdependency results in complex Systems-of-Systems (SoS) that only continue to grow in complexity to meet evolving capability needs. Thus, timely and affordable acquisition becomes more difficult, especially in the face of mounting budgetary pressures. To counter this, architecting principles must be applied to SoS design. The research objective is to develop an Architecture Real Options Complexity-Based Valuation Methodology (ARC-VM) suitable for acquisition-level decision making, where there is a stated desire for more informed tradeoffs between cost, schedule, and performance during the early phases of design. First, a framework is introduced to measure architecture complexity as it directly relates to military SoS. Development of the framework draws upon a diverse set of disciplines, including Complexity Science, software architecting, measurement theory, and utility theory. Next, a Real Options based valuation strategy is developed using techniques established for financial stock options that have recently been adapted for use in business and engineering decisions. The derived complexity measure provides architects with an objective measure of complexity that focuses on relevant complex system attributes. These attributes are related to the organization and distribution of SoS functionality and the sharing and processing of resources. The use of Real Options provides the necessary conceptual and visual framework to quantifiably and traceably combine measured architecture complexity, time-valued performance levels, as well as programmatic risks and uncertainties. An example suppression of enemy air defenses (SEAD) capability demonstrates the development and usefulness of the resulting architecture complexity & Real Options based valuation methodology. Different portfolios of candidate system types are used to generate an array of architecture alternatives that are then evaluated using an engagement model. This performance data is combined with both measured architecture complexity and programmatic data to assign an acquisition value to each alternative. This proves useful when selecting alternatives most likely to meet current and future capability needs.

  18. 3 CFR - Designation of Officers of the Office of Science and Technology Policy To Act as Director

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5, 2009 Designation of Officers of the Office of Science and Technology Policy To Act as Director Memorandum for the Director of the Office of Science and Technology Policy By the authority vested in me as... Science and Technology Policy (OSTP), in the order listed, shall act as and perform the functions and...

  19. Caltrans : highway design manual

    DOT National Transportation Integrated Search

    2008-07-01

    The Highway Design Manual establishes uniform policies and procedures to carry out the highway design functions of the California Department of Transportation (Caltrans). The policies established herein are for the information and guidance of the off...

  20. Energy: Production, Consumption, and Consequences.

    ERIC Educational Resources Information Center

    Helm, John L., Ed.

    Energy policy in the United States and much of the analysis behind those policies is largely incomplete according to many. Systems for energy production, distribution, and use have traditionally been analyzed by supply sector, yet such analyses cannot capture the complex interplay of technology, economics, public policy, and environmental concerns…

  1. Uneven Terrain: Educational Policy and Equity in Nepal

    ERIC Educational Resources Information Center

    Shields, Robin; Rappleye, Jeremy

    2008-01-01

    This paper investigates the relationship between educational policy, equity, and national development in Nepal. It argues that current inequities in educational opportunities and outcomes are largely attributable to persistent inequities and biases in the educational policy framework. We begin by surveying the complex, multifaceted reality of…

  2. Promoting good policy for leadership and governance of health related rehabilitation: a realist synthesis.

    PubMed

    McVeigh, Joanne; MacLachlan, Malcolm; Gilmore, Brynne; McClean, Chiedza; Eide, Arne H; Mannan, Hasheem; Geiser, Priscille; Duttine, Antony; Mji, Gubela; McAuliffe, Eilish; Sprunt, Beth; Amin, Mutamad; Normand, Charles

    2016-08-24

    Good governance may result in strengthened performance of a health system. Coherent policies are essential for good health system governance. The overall aim of this research is to provide the best available scientific evidence on principles of good policy related leadership and governance of health related rehabilitation services in less resourced settings. This research was also conducted to support development of the World Health Organization's (WHO) Guidelines on health related rehabilitation. An innovative study design was used, comprising two methods: a systematic search and realist synthesis of literature, and a Delphi survey of expert stakeholders to refine and triangulate findings from the realist synthesis. In accordance with Pawson and Tilley's approach to realist synthesis, we identified context mechanism outcome pattern configurations (CMOCs) from the literature. Subsequently, these CMOCs were developed into statements for the Delphi survey, whereby 18 expert stakeholders refined these statements to achieve consensus on recommendations for policy related governance of health related rehabilitation. Several broad principles emerged throughout formulation of recommendations: participation of persons with disabilities in policy processes to improve programme responsiveness, efficiency, effectiveness, and sustainability, and to strengthen service-user self-determination and satisfaction; collection of disaggregated disability statistics to support political momentum, decision-making of policymakers, evaluation, accountability, and equitable allocation of resources; explicit promotion in policies of access to services for all subgroups of persons with disabilities and service-users to support equitable and accessible services; robust inter-sectoral coordination to cultivate coherent mandates across governmental departments regarding service provision; and 'institutionalizing' programmes by aligning them with preexisting Ministerial models of healthcare to support programme sustainability. Alongside national policymakers, our policy recommendations are relevant for several stakeholders, including service providers and service-users. This research aims to provide broad policy recommendations, rather than a strict formula, in acknowledgement of contextual diversity and complexity. Accordingly, our study proposes general principles regarding optimal policy related governance of health related rehabilitation in less resourced settings, which may be valuable across diverse health systems and contexts.

  3. Designing effective incentives for energy conservation in the public sector

    NASA Astrophysics Data System (ADS)

    Drezner, Jeffrey Alan

    Understanding why government officials behave in certain ways under particular circumstances is an important theme in political science. This research explores the design of policies and incentives targeted at public sector officials, in particular the use of market based policy tools in a non-market environment, and the influence of that organizational environment on the effectiveness of the policy. The research examines the case of Department of Defense (DoD) facility energy management. DoD energy policy includes a provision for the retention of savings generated by conservation activities: two-thirds of the savings is retained at the installation generating the savings, half to used for further investment in energy conservation, and half to be used for general morale, welfare, and recreation activities. This policy creates a financial incentive for installation energy managers to establish higher quality and more active conservation programs. A formal written survey of installation energy managers within DoD was conducted, providing data to test hypotheses regarding policy effectiveness and factors affecting policy implementation. Additionally, two detailed implementation case studies were conducted in order to gain further insights. Results suggest that policy design needs to account for the environment within which the policy will be implemented, particularly organizational culture and standard operating procedures. The retention of savings policy failed to achieve its intended outcome---retention of savings for re-investment in energy conservation---because the role required of the financial management community was outside its normal mode of operation and interests and the budget process for allocating resources did not include a mechanism for retention of savings. The policy design did not adequately address these start-up barriers to implementation. This analysis has shown that in order for retention of savings, or similar policies based on market-type mechanisms, to be effective in the public sector context, the required cultural changes and appropriate implementing mechanisms must be provided for in the policy design.

  4. Design of price incentives for adjunct policy goals in formula funding for hospitals and health services

    PubMed Central

    Duckett, Stephen J

    2008-01-01

    Background Hospital policy involves multiple objectives: efficiency of service delivery, pursuit of high quality care, promoting access. Funding policy based on hospital casemix has traditionally been considered to be only about promoting efficiency. Discussion Formula-based funding policy can be (and has been) used to pursue a range of policy objectives, not only efficiency. These are termed 'adjunct' goals. Strategies to incorporate adjunct goals into funding design must, implicitly or explicitly, address key decision choices outlined in this paper. Summary Policy must be clear and explicit about the behaviour to be rewarded; incentives must be designed so that all facilities with an opportunity to improve have an opportunity to benefit; the reward structure is stable and meaningful; and the funder monitors performance and gaming. PMID:18384694

  5. Alternative Endpoints and Approaches Selected for the Remediation of Contaminated Groundwater at Complex Sites

    NASA Astrophysics Data System (ADS)

    Deeb, R. A.; Hawley, E.

    2011-12-01

    This presentation will focus on findings, statistics, and case studies from a recently-completed report for the Department of Defense's Environmental Security Technology Certification Program (ESTCP) (Project ER-0832) on alternative endpoints and alternative remedial strategies for groundwater remediation under a variety of Federal and state cleanup programs, including technical impracticability (TI) and other Applicable or Relevant and Appropriate Requirement (ARAR) waivers, state and local designations such as groundwater management zones, Alternate Concentration Limits (ACLs), use of monitored natural attenuation (MNA) over long timeframes, and more. The primary objective of the project was to provide environmental managers and regulators with tools, metrics, and information needed to evaluate alternative endpoints for groundwater remediation at complex sites. A statistical analysis of Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) sites receiving TI waivers will be presented as well as case studies of other types of alternative endpoints and alternative remedial strategies to illustrate the variety of approaches used at complex sites and the technical analyses used to predict and document cost, timeframe, and potential remedial effectiveness. Case studies provide examples of the flexible, site-specific, application of alternative endpoints and alternative remedial strategies that have been used in the past to manage and remediate groundwater contamination at complex sites. For example, at least 13 states consider some designation for groundwater containment in their corrective action policies, such as groundwater management zones, containment zones, and groundwater classification exemption areas. These designations typically indicate that groundwater contamination is present above permissible levels. Soil and groundwater within these zones are managed to protect human health and the environment. Lesson learned for the analyses conducted and the case studies evaluated allow for a more careful consideration of alternative, beneficial, and cost-effective cleanup objectives and metrics that can be achieved over the short-term (while eventually meeting long-term cleanup objectives or demonstrating the applicability of alternative endpoints), thus improving the site cleanup process at complex sites where appropriate.

  6. Conducting Nursing Research to Advance and Inform Health Policy.

    PubMed

    Ellenbecker, Carol Hall; Edward, Jean

    2016-11-01

    The primary roles of nurse scientists in conducting health policy research are to increase knowledge in the discipline and provide evidence for informing and advancing health policies with the goal of improving the health outcomes of society. Health policy research informs, characterizes, explains, or tests hypotheses by employing a variety of research designs. Health policy research focuses on improving the access to care, the quality and cost of care, and the efficiency with which care is delivered. In this article, we explain how nurses might envision their research in a policy process framework, describe research designs that nurse researchers might use to inform and advance health policies, and provide examples of research conducted by nurse researchers to explicate key concepts in the policy process framework. Health policies are well informed and advanced when nurse researchers have a good understanding of the political process. The policy process framework provides a context for improving the focus and design of research and better explicating the connection between research evidence and policy. Nurses should focus their research on addressing problems of importance that are on the healthcare agenda, work with interdisciplinary teams of researchers, synthesize, and widely disseminate results.

  7. 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.

  8. Teaching, Learning, and Leading: Preparing Teachers as Educational Policy Actors

    ERIC Educational Resources Information Center

    Heineke, Amy J.; Ryan, Ann Marie; Tocci, Charles

    2015-01-01

    Within the current federal, state, and local contexts of educational reform, teachers must be recognized as central actors in policy work, but rarely do we explicitly consider preparing teachers to become policy actors. Understanding these implications for teacher education, we investigate teacher candidates' learning of the complexity and…

  9. Youth Engaging Language Policy and Planning: Ideologies and Transformations from Within

    ERIC Educational Resources Information Center

    Phyak, Prem; Bui, Thuy Thi Ngoc

    2014-01-01

    This paper explores language policy and planning from the perspectives of global ideologies, national agendas, and local transformation in two Asian countries, Vietnam and Nepal. Through engaged ethnography, we not only unravel complex ideological contestations of neoliberal and nationalistic agendas, but also portray language policy resistance…

  10. Implementing Medical Teaching Policy in University Hospitals

    ERIC Educational Resources Information Center

    Engbers, Rik; Fluit, Cornelia Cornelia R. M. G.; Bolhuis, Sanneke; de Visser, Marieke; Laan, Roland F. J. M.

    2017-01-01

    Within the unique and complex settings of university hospitals, it is difficult to implement policy initiatives aimed at developing careers in and improving the quality of academic medical teaching because of the competing domains of medical research and patient care. Factors that influence faculty in making use of teaching policy incentives have…

  11. Understanding Policy Implementation: District-Level Leaders' Perceptions of Reading Policy Implementation Efforts

    ERIC Educational Resources Information Center

    Hall, Charles Dana

    2013-01-01

    Research investigating the complex, multi-directional relationships inherent to public education has become a focal point of reform research. This study investigated the perceptions held by district-level leaders regarding the Colorado Department of Education's efforts to facilitate the successful implementation of reading policy. In addition, it…

  12. Institutional Complexity and Policy Implementation: How Underlying Logics Drive Teacher Interpretations of Reform

    ERIC Educational Resources Information Center

    Bridwell-Mitchell, E. N.; Sherer, David G.

    2017-01-01

    One critical factor in policy implementation is how teachers interpret policy. Previous research largely overlooks how the broader culture shapes teachers' interpretations. In the current research, we explore how teachers' interpretations of instructional reforms are associated with the logics of broad societal institutions. Our longitudinal…

  13. Completion of Limitation of Medical Treatment forms by junior doctors for patients with dementia: clinical, medicolegal and education perspectives.

    PubMed

    Yoong, Jaclyn; MacPhail, Aleece; Trytel, Gael; Rajendram, Prashanti Yalini; Winbolt, Margaret; Ibrahim, Joseph E

    2017-10-01

    Objective Limitation of Medical Treatment (LMT) forms are an essential element of end-of-life care. Decision making around LMT is complex and often involves patients with dementia. Despite the complexity, junior doctors frequently play a central role in completing LMT forms. The present study sought perspectives from a range of stakeholders (hospital clinicians, medical education personnel, legal and advocacy staff) about junior doctors' roles in completing LMT forms in general and for patients with dementia. Methods Qualitative data were gathered in semi-structured interviews (SSI) and theoretical concepts were explored in roundtable discussion (RD). Participants were recruited through purposive and convenience sampling drawing on healthcare and legal personnel employed in the public hospital and aged care systems, selected from major metropolitan hospitals, healthcare and legal professional bodies and advocacy organisations in Victoria, Australia. The contents of the SSIs and RD were subject to thematic analysis using a framework approach. Data were indexed according to the topics established in the study aim; categories were systematically scrutinised, from which key themes were distilled. Results Stakeholders reported that completing LMT forms was difficult for junior doctors because of a lack of medical and legal knowledge, as well as clinical inexperience and inadequate training. Healthcare organisations (HCOs) either lacked policies about the role of junior doctors or had practices that were discordant with policy. In this process, there were substantial gaps pertaining to patients with dementia. Recommendations made by the study participants included the provision of supervised clinical exposure and additional training for junior doctors, strengthening HCO policies and explicit consideration of the needs of patients with dementia. Conclusions LMT forms should be designed for clarity and consistency across HCOs. Enhancing patient care requires appropriate and sensitive completion of LMT. Relevant HCO policy and clinical practice changes are discussed herein, and recommendations are made for junior doctors in this arena, specifically in the context of patients with dementia. What is known about the topic? Junior doctors continue to play a central role in LMT orders, a highly complex decision-making task that they are poorly prepared to complete. LMT decision making in Australia's aging population and for people with dementia is especially challenging. What does this paper add? A broad range of stakeholders, including hospital clinicians, medical education personnel and legal and advocacy staff, identified ongoing substantial gaps in education and training of junior doctors (despite what is already known in the literature). Furthermore, LMT decision making for patients with dementia is not explicitly considered in policy of practice. What are the implications for practitioners? Current policy and practice are not at the desired level to deliver appropriate end-of-life care with regard to LMT orders, especially for patients with dementia. Greater involvement of executives and senior clinicians is required to improve both practice at the bed side and the training and support of junior doctors, as well as creating more robust policy.

  14. Contestations and complexities of nurses' participation in policy-making in South Africa.

    PubMed

    Ditlopo, Prudence; Blaauw, Duane; Penn-Kekana, Loveday; Rispel, Laetitia C

    2014-01-01

    There has been increased emphasis globally on nurses' involvement in health policy and systems development. However, there has been limited scholarly attention on nurses' participation in policy-making in South Africa. This paper analyses the dynamics, strengths, and weaknesses of nurses' participation in four national health workforce policies: the 2008 Nursing Strategy, revision of the Scope of Practice for nurses, the new Framework for Nursing Qualifications, and the Occupation-Specific Dispensation (OSD) remuneration policy. Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 frontline nurses in four South African provinces. Thematic content analysis was done using the Atlas.ti software. The study found that nurses' participation in policy-making is both contested and complex. The contestation relates to the extent and nature of nurses' participation in nursing policies. There was a disjuncture between nursing leadership and frontline nurses in their levels of awareness of the four policies. The latter group was generally unaware of these policies with the exception of the OSD remuneration policy as it affected them directly. There was also limited consensus on which nursing group legitimately represented nursing issues in the policy arena. Shifting power relationships influenced who participated, how the participation happened, and the degree to which nurses' views and inputs were considered and incorporated. The South African health system presents major opportunities for nurses to influence and direct policies that affect them. This will require a combination of proactive leadership, health policy capacity and skills development among nurses, and strong support from the national nursing association.

  15. What should health insurance cover? A comparison of Israeli and US approaches to benefit design under national health reform.

    PubMed

    Nissanholtz Gannot, Rachel; Chinitz, David P; Rosenbaum, Sara

    2018-04-01

    What health insurance should cover and pay for represents one of the most complex questions in national health policy. Israel shares with the US reliance on a regulated insurance market and we compare the approaches of the two countries regarding determining health benefits. Based on review and analysis of literature, laws and policy in the United States and Israel. The Israeli experience consists of selection of a starting point for defining coverage; calculating the expected cost of covered benefits; and creating a mechanism for updating covered benefits within a defined budget. In implementing the Affordable Care Act, the US rejected a comprehensive and detailed approach to essential health benefits. Instead, federal regulators established broadly worded minimum standards that can be supplemented through more stringent state laws and insurer discretion. Notwithstanding differences between the two systems, the elements of the Israeli approach to coverage, which has stood the test of time, may provide a basis for the United States as it renews its health reform debate and considers delegating decisions about coverage to the states. Israel can learn to emulate the more forceful regulation of supplemental and private insurance that characterizes health policy in the United States.

  16. A novel framework for analyzing conservation impacts: evaluation, theory, and marine protected areas.

    PubMed

    Mascia, Michael B; Fox, Helen E; Glew, Louise; Ahmadia, Gabby N; Agrawal, Arun; Barnes, Megan; Basurto, Xavier; Craigie, Ian; Darling, Emily; Geldmann, Jonas; Gill, David; Holst Rice, Susie; Jensen, Olaf P; Lester, Sarah E; McConney, Patrick; Mumby, Peter J; Nenadovic, Mateja; Parks, John E; Pomeroy, Robert S; White, Alan T

    2017-07-01

    Environmental conservation initiatives, including marine protected areas (MPAs), have proliferated in recent decades. Designed to conserve marine biodiversity, many MPAs also seek to foster sustainable development. As is the case for many other environmental policies and programs, the impacts of MPAs are poorly understood. Social-ecological systems, impact evaluation, and common-pool resource governance are three complementary scientific frameworks for documenting and explaining the ecological and social impacts of conservation interventions. We review key components of these three frameworks and their implications for the study of conservation policy, program, and project outcomes. Using MPAs as an illustrative example, we then draw upon these three frameworks to describe an integrated approach for rigorous empirical documentation and causal explanation of conservation impacts. This integrated three-framework approach for impact evaluation of governance in social-ecological systems (3FIGS) accounts for alternative explanations, builds upon and advances social theory, and provides novel policy insights in ways that no single approach affords. Despite the inherent complexity of social-ecological systems and the difficulty of causal inference, the 3FIGS approach can dramatically advance our understanding of, and the evidentiary basis for, effective MPAs and other conservation initiatives. © 2017 New York Academy of Sciences.

  17. Understanding Policy Diffusion in the U.S.: An Information-Theoretical Approach to Unveil Connectivity Structures in Slowly Evolving Complex Systems.

    PubMed

    Anderson, Ross P; Jimenez, Geronimo; Bae, Jin Yung; Silver, Diana; Macinko, James; Porfiri, Maurizio

    2016-01-01

    Detecting and explaining the relationships among interacting components has long been a focal point of dynamical systems research. In this paper, we extend these types of data-driven analyses to the realm of public policy, whereby individual legislative entities interact to produce changes in their legal and political environments. We focus on the U.S. public health policy landscape, whose complexity determines our capacity as a society to effectively tackle pressing health issues. It has long been thought that some U.S. states innovate and enact new policies, while others mimic successful or competing states. However, the extent to which states learn from others, and the state characteristics that lead two states to influence one another, are not fully understood. Here, we propose a model-free, information-theoretical method to measure the existence and direction of influence of one state's policy or legal activity on others. Specifically, we tailor a popular notion of causality to handle the slow time-scale of policy adoption dynamics and unravel relationships among states from their recent law enactment histories. The method is validated using surrogate data generated from a new stochastic model of policy activity. Through the analysis of real data in alcohol, driving safety, and impaired driving policy, we provide evidence for the role of geography, political ideology, risk factors, and demographic and economic indicators on a state's tendency to learn from others when shaping its approach to public health regulation. Our method offers a new model-free approach to uncover interactions and establish cause-and-effect in slowly-evolving complex dynamical systems.

  18. Understanding Policy Diffusion in the U.S.: An Information-Theoretical Approach to Unveil Connectivity Structures in Slowly Evolving Complex Systems

    PubMed Central

    Anderson, Ross P.; Jimenez, Geronimo; Bae, Jin Yung; Silver, Diana; Macinko, James; Porfiri, Maurizio

    2017-01-01

    Detecting and explaining the relationships among interacting components has long been a focal point of dynamical systems research. In this paper, we extend these types of data-driven analyses to the realm of public policy, whereby individual legislative entities interact to produce changes in their legal and political environments. We focus on the U.S. public health policy landscape, whose complexity determines our capacity as a society to effectively tackle pressing health issues. It has long been thought that some U.S. states innovate and enact new policies, while others mimic successful or competing states. However, the extent to which states learn from others, and the state characteristics that lead two states to influence one another, are not fully understood. Here, we propose a model-free, information-theoretical method to measure the existence and direction of influence of one state’s policy or legal activity on others. Specifically, we tailor a popular notion of causality to handle the slow time-scale of policy adoption dynamics and unravel relationships among states from their recent law enactment histories. The method is validated using surrogate data generated from a new stochastic model of policy activity. Through the analysis of real data in alcohol, driving safety, and impaired driving policy, we provide evidence for the role of geography, political ideology, risk factors, and demographic and economic indicators on a state’s tendency to learn from others when shaping its approach to public health regulation. Our method offers a new model-free approach to uncover interactions and establish cause-and-effect in slowly-evolving complex dynamical systems. PMID:29075163

  19. Reflexivity, Position, and the Ambivalent Public Space: The Politics of Educational Policy in Taiwan's Local Governments

    ERIC Educational Resources Information Center

    Huang, Teng; Ou, Yung-Sheng

    2017-01-01

    The rise of reflexivity and neoliberalism has led to a change in the nature of the public sphere and policy management. Thus, focusing only on analyses of state-initiated policy and the actions of central government is not conducive to understanding the complex process of policy implementation today. Hence, this study aims to analyse the politics…

  20. Practices Influenced by Policy? An Exploration of Newly Hired Science Teachers at Sites in South Africa and the United States

    ERIC Educational Resources Information Center

    Navy, S. L.; Luft, J. A.; Toerien, R.; Hewson, P. W.

    2018-01-01

    In many parts of the world, newly hired science teachers' practices are developing in a complex policy environment. However, little is known about how newly hired science teachers' practices are enacted throughout a cycle of instruction and how these practices can be influenced by macro-, meso-, and micro-policies. Knowing how policies impact…

  1. Policy and Research in a Post-Conflict Context: Issues and Challenges in the Implementation of the Rwandan Teacher Development and Management Policy

    ERIC Educational Resources Information Center

    Rutaisire, John; Gahima, Charles

    2009-01-01

    Purpose: The purpose of this paper is to assess the relationship between policy development and research evidence with specific reference to the Rwandan Teacher Development and Management Policy introduced in 2005. It aims to highlight the complexity of implementing large-scale system wide change in the specific context of a small African nation…

  2. The project organization as a policy tool in implementing welfare reforms in the public sector.

    PubMed

    Jensen, Christian; Johansson, Staffan; Löfström, Mikael

    2013-01-01

    Organizational design is considered in policy literature as a forceful policy tool to put policy to action. However, previous research has not analyzed the project organization as a specific form of organizational design and, hence, has not given much attention to such organizations as a strategic choice when selecting policy tools. The purpose of the article is to investigate the project as a policy tool; how do such temporary organizations function as a specific form of organization when public policy is implemented? The article is based on a framework of policy implementation and is illustrated with two welfare reforms in the Swedish public sector, which were organized and implemented as project organizations. The case studies and the analysis show that it is crucial that a project organization fits into the overall governance structure when used as a policy tool. If not, the project will remain encapsulated and will not have sufficient impact on the permanent organizational structure. The concept of encapsulation indicates a need to protect the project from a potential hostile environment. The implication of this is that organizational design as a policy tool is a matter that deserves more attention in the strategic discussion on implementing public policies and on the suitability of using certain policy tools. Copyright © 2012 John Wiley & Sons, Ltd.

  3. SCALS: a fourth-generation study of assisted living technologies in their organisational, social, political and policy context.

    PubMed

    Greenhalgh, Trisha; Shaw, Sara; Wherton, Joe; Hughes, Gemma; Lynch, Jenni; A'Court, Christine; Hinder, Sue; Fahy, Nick; Byrne, Emma; Finlayson, Alexander; Sorell, Tom; Procter, Rob; Stones, Rob

    2016-02-15

    Research to date into assisted living technologies broadly consists of 3 generations: technical design, experimental trials and qualitative studies of the patient experience. We describe a fourth-generation paradigm: studies of assisted living technologies in their organisational, social, political and policy context. Fourth-generation studies are necessarily organic and emergent; they view technology as part of a dynamic, networked and potentially unstable system. They use co-design methods to generate and stabilise local solutions, taking account of context. SCALS (Studies in Co-creating Assisted Living Solutions) consists (currently) of 5 organisational case studies, each an English health or social care organisation striving to introduce technology-supported services to support independent living in people with health and/or social care needs. Treating these cases as complex systems, we seek to explore interdependencies, emergence and conflict. We employ a co-design approach informed by the principles of action research to help participating organisations establish, refine and evaluate their service. To that end, we are conducting in-depth ethnographic studies of people's experience of assisted living technologies (micro level), embedded in evolving organisational case studies that use interviews, ethnography and document analysis (meso level), and exploring the wider national and international context for assisted living technologies and policy (macro level). Data will be analysed using a sociotechnical framework developed from structuration theory. Research ethics approval for the first 4 case studies has been granted. An important outcome will be lessons learned from individual co-design case studies. We will document the studies' credibility and rigour, and assess the transferability of findings to other settings while also recognising unique aspects of the contexts in which they were generated. Academic outputs will include a cross-case analysis and progress in theory and method of fourth-generation assisted living technology research. We will produce practical guidance for organisations, policymakers, designers and service users. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. The fit between health impact assessment and public policy: practice meets theory.

    PubMed

    Harris, Patrick; Sainsbury, Peter; Kemp, Lynn

    2014-05-01

    The last decade has seen increased use of health impact assessment (HIA) to influence public policies developed outside the Health sector. HIA has developed as a structured, linear and technical process to incorporate health, broadly defined, into policy. This is potentially incongruent with complex, non-linear and tactical policy making which does not necessarily consider health. HIA research has however not incorporated existing public policy theory to explain practitioners' experiences with HIA and policy. This research, therefore, used public policy theory to explain HIA practitioners' experiences and investigate 'What is the fit between HIA and public policy?' Empirical findings from nine in-depth interviews with international HIA practitioners were re-analysed against public policy theory. We reviewed the HIA literature for inclusion of public policy theories then compared these for compatibility with our critical realist methodology and the empirical data. The theory 'Policy Cycles and Subsystems' (Howlett et al., 2009) was used to re-analyse the empirical data. HIAs for policy are necessarily both tactical and technical. Within policy subsystems using HIA to influence public policy requires tactically positioning health as a relevant public policy issue and, to facilitate this, institutional support for collaboration between Public Health and other sectors. HIA fits best within the often non-linear public policy cycle as a policy formulation instrument. HIA provides, tactically and technically, a space for practical reasoning to navigate facts, values and processes underlying the substantive and procedural dimensions of policy. Re-analysing empirical experiential data using existing public policy theory provided valuable explanations for future research, policy and practice concerning why and how HIA fits tactically and technically with the world of public policy development. The use of theory and empiricism opens up important possibilities for future research in the search for better explanations of complex practical problems. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Openness in participation, assessment, and policy making upon issues of environment and environmental health: a review of literature and recent project results.

    PubMed

    Pohjola, Mikko V; Tuomisto, Jouni T

    2011-06-16

    Issues of environment and environmental health involve multiple interests regarding e.g. political, societal, economical, and public concerns represented by different kinds of organizations and individuals. Not surprisingly, stakeholder and public participation has become a major issue in environmental and environmental health policy and assessment. The need for participation has been discussed and reasoned by many, including environmental legislators around the world. In principle, participation is generally considered as desirable and the focus of most scholars and practitioners is on carrying out participation, and making participation more effective. In practice also doubts regarding the effectiveness and importance of participation exist among policy makers, assessors, and public, leading even to undermining participatory practices in policy making and assessment.There are many possible purposes for participation, and different possible models of interaction between assessment and policy. A solid conceptual understanding of the interrelations between participation, assessment, and policy making is necessary in order to design and implement effective participatory practices. In this paper we ask, do current common conceptions of assessment, policy making and participation provide a sufficient framework for achieving effective participation? This question is addresses by reviewing the range of approaches to participation in assessment and policy making upon issues of environment and environmental health and some related insights from recent research projects, INTARESE and BENERIS.Openness, considered e.g. in terms of a) scope of participation, b) access to information, c) scope of contribution, d) timing of openness, and e) impact of contribution, provides a new perspective to the relationships between participation, assessment and policy making. Participation, assessment, and policy making form an inherently intertwined complex with interrelated objectives and outcomes. Based on experiences from implementing openness, we suggest complete openness as the new default, deviation from which should be explicitly argued, in assessment and policy making upon issues of environment and environmental health. Openness does not undermine the existing participatory models and techniques, but provides conceptual means for their more effective application, and opens up avenues for developing new kinds of effective participatory practices that aim for societal development through collaborative creation of knowledge.

  6. Openness in participation, assessment, and policy making upon issues of environment and environmental health: a review of literature and recent project results

    PubMed Central

    2011-01-01

    Issues of environment and environmental health involve multiple interests regarding e.g. political, societal, economical, and public concerns represented by different kinds of organizations and individuals. Not surprisingly, stakeholder and public participation has become a major issue in environmental and environmental health policy and assessment. The need for participation has been discussed and reasoned by many, including environmental legislators around the world. In principle, participation is generally considered as desirable and the focus of most scholars and practitioners is on carrying out participation, and making participation more effective. In practice also doubts regarding the effectiveness and importance of participation exist among policy makers, assessors, and public, leading even to undermining participatory practices in policy making and assessment. There are many possible purposes for participation, and different possible models of interaction between assessment and policy. A solid conceptual understanding of the interrelations between participation, assessment, and policy making is necessary in order to design and implement effective participatory practices. In this paper we ask, do current common conceptions of assessment, policy making and participation provide a sufficient framework for achieving effective participation? This question is addresses by reviewing the range of approaches to participation in assessment and policy making upon issues of environment and environmental health and some related insights from recent research projects, INTARESE and BENERIS. Openness, considered e.g. in terms of a) scope of participation, b) access to information, c) scope of contribution, d) timing of openness, and e) impact of contribution, provides a new perspective to the relationships between participation, assessment and policy making. Participation, assessment, and policy making form an inherently intertwined complex with interrelated objectives and outcomes. Based on experiences from implementing openness, we suggest complete openness as the new default, deviation from which should be explicitly argued, in assessment and policy making upon issues of environment and environmental health. Openness does not undermine the existing participatory models and techniques, but provides conceptual means for their more effective application, and opens up avenues for developing new kinds of effective participatory practices that aim for societal development through collaborative creation of knowledge. PMID:21679456

  7. A comparison of campfire impacts and policies in seven protected areas

    USGS Publications Warehouse

    Reid, S.E.; Marion, J.L.

    2005-01-01

    Using resource-monitoring data from seven protected areas, the effectiveness of three campfire policies-campfire ban, designated campfires, and unregulated campfires-were assessed based on the number of fire sites and the amount of tree damage. Results indicate that unregulated campfire policies permitted substantial numbers of fire sites and tree damage in campsites, although fire bans did not eliminate or even substantially decrease these problems. A designated campfire policy was effective in decreasing number of fire sites, but little difference was found among policies regarding tree damage. Given the importance of campfires to visitor experiences, campfire prohibitions could be viewed as unnecessarily restrictive based on their limited success in preventing resource damage. Conclusions encourage protected-area managers to consider designated campfire policies and prohibitions on axes, hatchets, and saws to better meet resource protection and visitor experience mandates.

  8. Persistent misunderstandings about evidence-based (sorry: informed!) policy-making.

    PubMed

    Bédard, Pierre-Olivier; Ouimet, Mathieu

    2016-01-01

    The field of research on knowledge mobilization and evidence-informed policy-making has seen enduring debates related to various fundamental assumptions such as the definition of 'evidence', the relative validity of various research methods, the actual role of evidence to inform policy-making, etc. In many cases, these discussions serve a useful purpose, but they also stem from serious disagreement on methodological and epistemological issues. This essay reviews the rationale for evidence-informed policy-making by examining some of the common claims made about the aims and practices of this perspective on public policy. Supplementing the existing justifications for evidence-based policy making, we argue in favor of a greater inclusion of research evidence in the policy process but in a structured fashion, based on methodological considerations. In this respect, we present an overview of the intricate relation between policy questions and appropriate research designs. By closely examining the relation between research questions and research designs, we claim that the usual points of disagreement are mitigated. For instance, when focusing on the variety of research designs that can answer a range of policy questions, the common critical claim about 'RCT-based policy-making' seems to lose some, if not all of its grip.

  9. Improving Direct-Care Compensation in Nursing Homes: Medicaid Wage Pass-through Adoption, 1999 – 2004

    PubMed Central

    Miller, Edward Alan; Wang, Lili; Feng, Zhanlian; Mor, Vincent

    2013-01-01

    Because states play such a prominent role in the U.S. health care system, they have long grappled with how to best control health care costs while maintaining high quality of care. There are many policy tools available to address efficiency and quality concerns — from pure state regulation to market-oriented competition designs. Given public discourse and official party platforms, one would assume that states controlled by Democrats would be more likely to adopt regulatory reforms. This study examines whether party control, as well as other economic and political factors, is associated with adopting wage pass-through (WPT) policies, which direct a portion of Medicaid reimbursement or its increase toward nursing home staff in an effort to reduce staff turnover, thereby increasing efficiency and the quality of care provided. Contrary to expectations, results indicate that states with Republican governors were against WPT adoption only when for-profit industry pressure increased; otherwise, they were more likely to favor adoption than their Democratic counterparts. This suggests a more complex relationship between partisanship and state-level policy adoption than is typically assumed. Results also indicate that state officials reacted predictably to prevailing political and economic conditions affecting state fiscal-year decisions but required sufficient governing capacity to successfully integrate WPTs into existing reimbursement system arrangements. This suggests that WPTs represent a hybrid between comprehensive and incremental policy change. PMID:22323236

  10. Occupational health and safety management practices and musculoskeletal disorders in aged care.

    PubMed

    Oakman, Jodi; Bartram, Timothy

    2017-05-15

    Purpose The purpose of this paper is to examine whether occupational health and safety (OHS) management used to manage musculoskeletal disorders (MSDs) in the aged care sector reflects contemporary research evidence of best practice to reduce the incidence of these disorders. Design/methodology/approach In total, 58 interviews were conducted with managers and supervisors in the aged care sector across four organisations in Australia. Policies and procedures relating to MSDs were reviewed for each organisation. Findings Policies and procedures for managing MSDs do not reflect contemporary evidence, which supports a complex aetiology, related to a range of physical and psychosocial workplace factors. Despite strong evidence that psychosocial factors contribute to MSD development, these were not included in the policies and procedures reviewed. Findings from the interviews management practices including leadership and various components of HRM were functioning well but fragmentation was evident due to the challenging nature of the aged care sector. Practical implications To address the significant burden of MSDs in the aged care sector, policies and procedures need to include coverage of psychosocial and physical workplace factors. The development of systematic and integrated OHS management at the workplace level may play an important role in the effective management of MSDs. Originality/value This study offers insights into the previously unexplored area of MSD risk management and the role of management practices such as HRM in the aged care sector.

  11. 17 CFR 23.605 - Conflicts of interest policies and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... subject to this rule must adopt and implement written policies and procedures reasonably designed to... information in the research report, to provide for non-substantive editing, to format the layout or style of... swap participant must establish written policies and procedures reasonably designed to ensure the...

  12. A Policy Reader in Universal Design for Learning

    ERIC Educational Resources Information Center

    Gordon, David T., Ed.; Gravel, Jenna W., Ed.; Schifter, Laura A., Ed.

    2009-01-01

    Universal Design for Learning (UDL) stands at the forefront of contemporary efforts to create access to education curricula for all students, including those with disabilities. This policy reader comprises a notably wide range of articles that address the challenges and opportunities facing policy makers as they consider UDL's implications for…

  13. Analysing policy delivery in the United Kingdom: the case of street crime and anti-social behaviour.

    PubMed

    Smith, Martin; Richards, David; Geddes, Andrew; Mathers, Helen

    2011-01-01

    For all governments, the principle of how and whether policies are implemented as intended is fundamental. The aim of this paper is to examine the difficulties for governments in delivering policy goals when they do not directly control the processes of implementation. This paper examines two case studies – anti-social behaviour and street crime – and demonstrates the difficulties faced by policy-makers in translating policy into practice when the policy problems are complex and implementation involves many actors.

  14. Systems Science Methods in Public Health

    PubMed Central

    Luke, Douglas A.; Stamatakis, Katherine A.

    2012-01-01

    Complex systems abound in public health. Complex systems are made up of heterogeneous elements that interact with one another, have emergent properties that are not explained by understanding the individual elements of the system, persist over time and adapt to changing circumstances. Public health is starting to use results from systems science studies to shape practice and policy, for example in preparing for global pandemics. However, systems science study designs and analytic methods remain underutilized and are not widely featured in public health curricula or training. In this review we present an argument for the utility of systems science methods in public health, introduce three important systems science methods (system dynamics, network analysis, and agent-based modeling), and provide three case studies where these methods have been used to answer important public health science questions in the areas of infectious disease, tobacco control, and obesity. PMID:22224885

  15. Dismantling institutional racism: theory and action.

    PubMed

    Griffith, Derek M; Mason, Mondi; Yonas, Michael; Eng, Eugenia; Jeffries, Vanessa; Plihcik, Suzanne; Parks, Barton

    2007-06-01

    Despite a strong commitment to promoting social change and liberation, there are few community psychology models for creating systems change to address oppression. Given how embedded racism is in institutions such as healthcare, a significant shift in the system's policies, practices, and procedures is required to address institutional racism and create organizational and institutional change. This paper describes a systemic intervention to address racial inequities in healthcare quality called dismantling racism. The dismantling racism approach assumes healthcare disparities are the result of the intersection of a complex system (healthcare) and a complex problem (racism). Thus, dismantling racism is a systemic and systematic intervention designed to illuminate where and how to intervene in a given healthcare system to address proximal and distal factors associated with healthcare disparities. This paper describes the theory behind dismantling racism, the elements of the intervention strategy, and the strengths and limitations of this systems change approach.

  16. Water resources planning based on complex system dynamics: A case study of Tianjin city

    NASA Astrophysics Data System (ADS)

    Zhang, X. H.; Zhang, H. W.; Chen, B.; Chen, G. Q.; Zhao, X. H.

    2008-12-01

    A complex system dynamic (SD) model focusing on water resources, termed as TianjinSD, is developed for the integrated and scientific management of the water resources of Tianjin, which contains information feedback that governs interactions in the system and is capable of synthesizing component-level knowledge into system behavior simulation at an integrated level, thus presenting reasonable predictive results for policy-making on water resources allocation and management. As for the Tianjin city, interactions among 96 components for 12 years are explored and four planning alternatives are chosen, one of which is based on the conventional mode assuming that the existing pattern of human activities will be prevailed, while the others are alternative planning designs based on the interaction of local authorities and planning researchers. Optimal mode is therefore obtained according to different scenarios when compared the simulation results for evaluation of different decisions and dynamic consequences.

  17. Health by Design: Interweaving Health Promotion into Environments and Settings

    PubMed Central

    Springer, Andrew E.; Evans, Alexandra E.; Ortuño, Jaquelin; Salvo, Deborah; Varela Arévalo, Maria Teresa

    2017-01-01

    The important influence of the environmental context on health and health behavior—which includes place, settings, and the multiple environments within place and settings—has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population’s health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context, defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments (the policy environment, the information environment, the social/cultural/organizational environment, and the physical environment), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet one which merits further intentionality as a specific health promotion planning design approach. PMID:29043248

  18. Cognitive laboratory approach to designing questionnaires for surveys of the elderly.

    PubMed Central

    Jobe, J B; Mingay, D J

    1990-01-01

    Data from surveys of the elderly are used by policy analysts to design health services programs. Consequently, the quality of survey data on elderly respondents has important implications for this growing segment of society: improving the quality of data should result in more cost effective programs for the elderly. However, studies suggest that the quality of responses from the elderly may be less than that for other respondents. Moreover, the increasing needs of policy analysts and health researchers for data have resulted in more complex survey questions that place a high cognitive burden on respondents. New methods for improving the design of these questionnaires are needed. This project investigated whether new techniques of questionnaire design, adapted from the theories and methods of cognitive psychology, could be effectively used in interviewing older respondents. The techniques used in this study, concurrent think-aloud interviews with followup probe questions, have been shown recently to be effective with younger respondents. Problems that elderly respondents have in comprehending survey questions, retrieving relevant information from memory, and using decision processes to estimate and provide answers were investigated. Questions on functional ability and social support were taken from the 1984 Supplement on Aging to the National Health Interview Survey. Analysis of respondents' think-aloud protocols and responses to probes suggest that the cognitive interview procedures were effective in identifying problems with the survey questions that would result in data of poorer quality and in suggesting the wording of questions that would be likely to result in answers of greater validity and reliability. Implications of these results for survey design and validation studies are discussed. PMID:2120731

  19. Health by Design: Interweaving Health Promotion into Environments and Settings.

    PubMed

    Springer, Andrew E; Evans, Alexandra E; Ortuño, Jaquelin; Salvo, Deborah; Varela Arévalo, Maria Teresa

    2017-01-01

    The important influence of the environmental context on health and health behavior-which includes place, settings, and the multiple environments within place and settings-has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population's health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context , defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments ( the policy environment, the information environment, the social/cultural/organizational environment , and the physical environment ), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet one which merits further intentionality as a specific health promotion planning design approach.

  20. Evidence on public policy: methodological issues, political issues and examples.

    PubMed

    Attanasio, Orazio P

    2014-03-01

    In this paper I discuss how evidence on public policy is generated and in particular the issue of evaluation of public policies. In economics, the issue of attribution and the identification of causal links has recently received considerable attention. Important methodological issues have been tackled and new techniques have been proposed and used. Randomized Control Trials have become some sort of gold standard. However, they are not exempt from problems and have important limitations: in some case they cannot be constructed and, more generally, problems of external validity and transferability of results can be important. The paper then moves on to discuss the political economy of policy evaluations for policy evaluations to have an impact for the conduct of actual policy, it is important that the demand for evaluation comes directly from the policy making process and is generated endogenously within it. In this sense it is important that the institutional design of policy making is such that policy making institutions are incentivized to use rigorous evaluation in the process of designing policies and allocating resources to alternative options. Economists are currently involved in the design and evaluation of many policies, including policies about health, nutrition and education. The role they can play in these fields is not completely obvious. The paper argues that their main contribution is in the modelling of how individual reacts to incentives (including those provided by public policies).

  1. Elective ventilation for organ donation: law, policy and public ethics.

    PubMed

    Coggon, John

    2013-03-01

    This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: 'basic elective ventilation'; 'epistemically complex elective ventilation'; 'practically complex elective ventilation'; and 'epistemically and practically complex elective ventilation'. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

  2. Integrated and Sustainable Water Management of Red-Thai Binh Rivers System Under Change

    NASA Astrophysics Data System (ADS)

    Giuliani, M.; Anghileri, D.; Castelletti, A.; Mason, E.; Micotti, M.; Soncini-Sessa, R.; Weber, E.

    2014-12-01

    Vietnam is currently undergoing a rapid economic and demographic development, characterized by internal migrations from the rural areas to the main cities with increasing water demands to guarantee adequate energy and food productions. Hydropower is the primary renewable energy resource in the country, accounting for 33% of the total electric power production, while agriculture contributes for 18% of the national GDP and employs 70% of the population. To cope with this heterogeneous and fast-evolving context, water resources development and management have to be reconsidered by enlarging their scope across sectors and by adopting effective tools to analyze the potential of current and projected infrastructure along with their operating strategies. This work contributes a novel decision-analytic framework based on Multi-Objective Evolutionary Direct Policy Search (MOE-DPS) to support the design of integrated and sustainable water resources management strategies in the Red-Thai Binh River system. The Red River Basin is the second largest basin of Vietnam, with a total area of about 169,000 km2, and comprises three main tributaries and several reservoirs, namely SonLa and HoaBinh on the Da River, ThacBa and TuyenQuang on the Lo River. These reservoirs are regulated for maximizing hydropower production, mitigating flood primarily in Hanoi, and guaranteeing irrigation water supply to the agricultural districts in the delta. The dimensionality of the system and the number of objectives involved increase the complexity of the problem. We address these challenges by combining the MOE-DPS framework with Gaussian radial basis functions policy approximation and the Borg MOEA, which have been demonstrated to guarantee good solutions quality in such many objective policy design problems. Results show that the proposed framework successfully identified alternative management strategies for the system, which explore different tradeoffs among the multi-sector services involved. These solutions are then evaluated under various scenarios of climate change and projected socio-economic conditions to identify their vulnerabilities and, possibly, to design improved operating policies, which are more robust to the future uncertainties.

  3. Sustainable management of non-timber forest resources

    Treesearch

    Secretariat of the Convention on Biological Diversity

    2001-01-01

    If policy on sustainable management of non-timber forest resources (NTFR) is to be implemented successfully, then recognition that there is no "one size fits all" policy is essential. Policies and their implementation practice have to be tailored to local ecological, economic, cultural and political circumstances. This complexity and the diversity of species...

  4. Social Policy as Social Process. Final Report.

    ERIC Educational Resources Information Center

    Newitt, Jane

    A decade's explosive growth in the scope, funding and complexity of national social policy has created serious problems in the United States. This first overview report notes that the Office of Economic Opportunity (now known as the Community Services Administration) has ceased to provide a focal point for national social policy. It was this state…

  5. Critical Perspectives on the National Policy on Education 2016

    ERIC Educational Resources Information Center

    Bhattacharya, Somdatta; Deb, Swarupa; Nair, Hari; Shukla, Tanu; Yadav, Anupam

    2017-01-01

    This article brings together critical perspectives on a broad range of issues that emerge from a reading of the National Policy on Education 2016. The issues vary from accountability to transdisciplinarity and from the marginalization of transgender people to value education. Such a complex task of critiquing this policy document cannot be…

  6. The Affordances and Constraints of Special Education Initial Teacher Licensure Policy for Teacher Preparation

    ERIC Educational Resources Information Center

    Blanton, Linda P.; Boveda, Mildred; Munoz, Lorena R.; Pugach, Marleen C.

    2017-01-01

    Initial licensure polices in special education were examined to determine how these policies support or hinder reform efforts to develop teacher education programs that prepare graduates for the increasingly complex needs of diverse students. Initial special education licensure policies are described with an emphasis on the differences across…

  7. National Language Policy Theory: Exploring Spolsky's Model in the Case of Iceland

    ERIC Educational Resources Information Center

    Albury, Nathan John

    2016-01-01

    Language policies are born amidst the complex interplay of social, cultural, religious and political forces. With this in mind, Bernard Spolsky theorises that the language policy of any independent nation is driven, at its core, by four co-occurring conditions--national ideology, English in the globalisation process, a nation's attendant…

  8. Student Participation and Disadvantage: Limitations in Policy and Practice

    ERIC Educational Resources Information Center

    Black, Rosalyn

    2011-01-01

    The public policy of numerous nations, including Australia, articulates a clear expectation that schools will develop young people's capacities to participate in civic society and its democratic structures and processes. A romantic policy rhetoric hides a reality that is both more complex and less well understood than is typically acknowledged.…

  9. A Practical Method of Policy Analysis by Estimating Effect Size

    ERIC Educational Resources Information Center

    Phelps, James L.

    2011-01-01

    The previous articles on class size and other productivity research paint a complex and confusing picture of the relationship between policy variables and student achievement. Missing is a conceptual scheme capable of combining the seemingly unrelated research and dissimilar estimates of effect size into a unified structure for policy analysis and…

  10. Navigating Local Smoke-Free Multi-Unit Housing Policy Adoption

    ERIC Educational Resources Information Center

    Satterlund, Travis D.; Treiber, Jeanette; Cassady, Diana

    2013-01-01

    California state-funded local tobacco control projects have instituted smoke-free multi-unit housing (MUH) policy adoption campaigns in order to secure voluntary policy throughout the state. While landlords can legally prohibit smoking at MUH complexes in California, they often oppose such measures. The objective of this study was to analyze…

  11. Better Skills, Better Jobs, Better Lives: A Strategic Approach to Skills Policies

    ERIC Educational Resources Information Center

    OECD Publishing (NJ3), 2012

    2012-01-01

    Recognising both the complexity of skills policies and the potential for peer learning, the OECD has developed a global Skills Strategy that helps countries to identify the strengths and weaknesses of their national skills systems, benchmark them internationally, and develop policies that can transform better skills into better jobs, economic…

  12. Traveling Policies: Mobility, Transformation and Continuities in Higher Education Public Policy

    ERIC Educational Resources Information Center

    Britez, Rodrigo G.

    2012-01-01

    This article presents an assessment of the impact and implications of the international mobilities operating in the national public policy environment. In fact, patterns of transformations that take place in national higher education systems are generating diverse and complex outcomes in different countries, in ways that may preclude a simple…

  13. Student Voice: An Emerging Discourse in Irish Education Policy

    ERIC Educational Resources Information Center

    Fleming, Domnall

    2015-01-01

    In positioning student voice within the Irish education policy discourse it is imperative that this emergent and complex concept is explored and theorized in the context of its definition and motivation. Student voice can then be positioned and critiqued as it emerged within Irish education policy primarily following Ireland's ratification of the…

  14. Factors affecting evidence-use in food policy-making processes in health and agriculture in Fiji.

    PubMed

    Waqa, Gade; Bell, Colin; Snowdon, Wendy; Moodie, Marj

    2017-01-09

    There is limited research on the use of evidence to inform policy-making in the Pacific. This study aims to identify and describe factors that facilitate or limit the use of evidence in food-related policy-making in the Health and Agriculture Ministries in Fiji. Semi-structured face-to-face interviews were conducted with selected policy-makers in two government ministries that were instrumental in the development of food-related policies in Fiji designed to prevent Non-Communicable Diseases (NCDs). Snowball sampling was used to recruit, as key informants, senior policy-makers in management positions such as national advisors and directors who were based at either the national headquarters or equivalent. Interviewees were asked about their experiences in developing food-related or other policies, barriers or facilitators encountered in the policy development and implementation process and the use of evidence. Each interview lasted approximately 45-60 minutes, and was conducted in English. Audio-recorded interviews were transcribed, thematically coded and analyzed using N-Vivo 8.0 software. Thirty-one policy-makers from the Ministry of Health and Medical Services (MoHMS n = 18) and the Ministry of Agriculture (MoA n = 13) in Fiji participated in the study. Whilst evidence is sometimes used in food-related policy-making in both the Health and Agriculture Ministries (including formal evidence such as published research and informal evidence such as personal experiences and opinions), it is not yet embedded as an essential part of the process. Participants indicated that a lack of resources, poor technical support in terms of training, the absence of clear strategies for improving competent use of evidence, procedures regarding engagement with other stakeholders across sectors, varying support from senior managers and limited consultation across sectors were barriers to evidence use. The willingness of organizations to create a culture of using evidence was reported as a facilitator. The use of evidence in policy-making will only become a reality in Fiji if it is a formalized part of the government's policy-making systems. A systems approach to food-related policy-making and implementation may achieve this by helping Ministries manage the complex and dynamic nature of food-related policy-making in Fiji.

  15. Integrated Data Modeling and Simulation on the Joint Polar Satellite System Program

    NASA Technical Reports Server (NTRS)

    Roberts, Christopher J.; Boyce, Leslye; Smith, Gary; Li, Angela; Barrett, Larry

    2012-01-01

    The Joint Polar Satellite System is a modern, large-scale, complex, multi-mission aerospace program, and presents a variety of design, testing and operational challenges due to: (1) System Scope: multi-mission coordination, role, responsibility and accountability challenges stemming from porous/ill-defined system and organizational boundaries (including foreign policy interactions) (2) Degree of Concurrency: design, implementation, integration, verification and operation occurring simultaneously, at multiple scales in the system hierarchy (3) Multi-Decadal Lifecycle: technical obsolesce, reliability and sustainment concerns, including those related to organizational and industrial base. Additionally, these systems tend to become embedded in the broader societal infrastructure, resulting in new system stakeholders with perhaps different preferences (4) Barriers to Effective Communications: process and cultural issues that emerge due to geographic dispersion and as one spans boundaries including gov./contractor, NASA/Other USG, and international relationships.

  16. More Effective VET and Lifelong Learning Policies: Awareness Raising, Analysis and Advice--Cedefop's Achievements in 2012 and Plans for 2013. Briefing Note

    ERIC Educational Resources Information Center

    Cedefop - European Centre for the Development of Vocational Training, 2013

    2013-01-01

    Reform of vocational education and training (VET) in Europe is complex, especially at a time of economic crisis. Cedefop raises awareness and provides analysis and advice to policy-makers at European level and in Member States to help them decide on policies and actions. Cedefop's work supports the European policy agenda for VET and lifelong…

  17. Impact of school peanut-free policies on epinephrine administration.

    PubMed

    Bartnikas, Lisa M; Huffaker, Michelle F; Sheehan, William J; Kanchongkittiphon, Watcharoot; Petty, Carter R; Leibowitz, Robert; Hauptman, Marissa; Young, Michael C; Phipatanakul, Wanda

    2017-08-01

    Children with food allergies spend a large proportion of time in school but characteristics of allergic reactions in schools are not well studied. Some schools self-designate as peanut-free or have peanut-free areas, but the impact of policies on clinical outcomes has not been evaluated. We sought to determine the effect of peanut-free policies on rates of epinephrine administration for allergic reactions in Massachusetts public schools. In this retrospective study, we analyzed (1) rates of epinephrine administration in all Massachusetts public schools and (2) Massachusetts public school nurse survey reports of school peanut-free policies from 2006 to 2011 and whether schools self-designated as "peanut-free" based on policies. Rates of epinephrine administration were compared for schools with or without peanut-restrictive policies. The percentage of schools with peanut-restrictive policies did not change significantly in the study time frame. There was variability in policies used by schools self-designated as peanut-free. No policy was associated with complete absence of allergic reactions. Both self-designated peanut-free schools and schools banning peanuts from being served in school or brought from home reported allergic reactions to nuts. Policies restricting peanuts from home, served in schools, or having peanut-free classrooms did not affect epinephrine administration rates. Schools with peanut-free tables, compared to without, had lower rates of epinephrine administration (incidence rate per 10,000 students 0.2 and 0.6, respectively, P = .009). These data provide a basis for evidence-based school policies for children with food allergies. Further studies are required before decisions can be made regarding peanut-free policies in schools. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Challenge clusters facing LCA in environmental decision-making-what we can learn from biofuels.

    PubMed

    McManus, Marcelle C; Taylor, Caroline M; Mohr, Alison; Whittaker, Carly; Scown, Corinne D; Borrion, Aiduan Li; Glithero, Neryssa J; Yin, Yao

    Bioenergy is increasingly used to help meet greenhouse gas (GHG) and renewable energy targets. However, bioenergy's sustainability has been questioned, resulting in increasing use of life cycle assessment (LCA). Bioenergy systems are global and complex, and market forces can result in significant changes, relevant to LCA and policy. The goal of this paper is to illustrate the complexities associated with LCA, with particular focus on bioenergy and associated policy development, so that its use can more effectively inform policymakers. The review is based on the results from a series of workshops focused on bioenergy life cycle assessment. Expert submissions were compiled and categorized within the first two workshops. Over 100 issues emerged. Accounting for redundancies and close similarities in the list, this reduced to around 60 challenges, many of which are deeply interrelated. Some of these issues were then explored further at a policy-facing workshop in London, UK. The authors applied a rigorous approach to categorize the challenges identified to be at the intersection of biofuels/bioenergy LCA and policy. The credibility of LCA is core to its use in policy. Even LCAs that comply with ISO standards and policy and regulatory instruments leave a great deal of scope for interpretation and flexibility. Within the bioenergy sector, this has led to frustration and at times a lack of obvious direction. This paper identifies the main challenge clusters: overarching issues, application and practice and value and ethical judgments. Many of these are reflective of the transition from application of LCA to assess individual products or systems to the wider approach that is becoming more common. Uncertainty in impact assessment strongly influences planning and compliance due to challenges in assigning accountability, and communicating the inherent complexity and uncertainty within bioenergy is becoming of greater importance. The emergence of LCA in bioenergy governance is particularly significant because other sectors are likely to transition to similar governance models. LCA is being stretched to accommodate complex and broad policy-relevant questions, seeking to incorporate externalities that have major implications for long-term sustainability. As policy increasingly relies on LCA, the strains placed on the methodology are becoming both clearer and impedimentary. The implications for energy policy, and in particular bioenergy, are large.

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

    McManus, Marcelle C.; Taylor, Caroline M.; Mohr, Alison

    Purpose: Bioenergy is increasingly used to help meet greenhouse gas (GHG) and renewable energy targets. However, bioenergy’s sustainability has been questioned, resulting in increasing use of life cycle assessment (LCA). Bioenergy systems are global and complex, and market forces can result in significant changes, relevant to LCA and policy. The goal of this paper is to illustrate the complexities associated with LCA, with particular focus on bioenergy and associated policy development, so that its use can more effectively inform policymakers. Methods: The review is based on the results from a series of workshops focused on bioenergy life cycle assessment. Expertmore » submissions were compiled and categorized within the first two workshops. Over 100 issues emerged. Accounting for redundancies and close similarities in the list, this reduced to around 60 challenges, many of which are deeply interrelated. Some of these issues were then explored further at a policy-facing workshop in London, UK. The authors applied a rigorous approach to categorize the challenges identified to be at the intersection of biofuels/bioenergy LCA and policy. Results and discussion: The credibility of LCA is core to its use in policy. Even LCAs that comply with ISO standards and policy and regulatory instruments leave a great deal of scope for interpretation and flexibility. Within the bioenergy sector, this has led to frustration and at times a lack of obvious direction. This paper identifies the main challenge clusters: overarching issues, application and practice and value and ethical judgments. Many of these are reflective of the transition from application of LCA to assess individual products or systems to the wider approach that is becoming more common. Uncertainty in impact assessment strongly influences planning and compliance due to challenges in assigning accountability, and communicating the inherent complexity and uncertainty within bioenergy is becoming of greater importance. Conclusions: The emergence of LCA in bioenergy governance is particularly significant because other sectors are likely to transition to similar governance models. LCA is being stretched to accommodate complex and broad policy-relevant questions, seeking to incorporate externalities that have major implications for long-term sustainability. As policy increasingly relies on LCA, the strains placed on the methodology are becoming both clearer and impedimentary. The implications for energy policy, and in particular bioenergy, are large.« less

  20. Challenge clusters facing LCA in environmental decision-making—what we can learn from biofuels

    DOE PAGES

    McManus, Marcelle C.; Taylor, Caroline M.; Mohr, Alison; ...

    2015-08-07

    Purpose: Bioenergy is increasingly used to help meet greenhouse gas (GHG) and renewable energy targets. However, bioenergy’s sustainability has been questioned, resulting in increasing use of life cycle assessment (LCA). Bioenergy systems are global and complex, and market forces can result in significant changes, relevant to LCA and policy. The goal of this paper is to illustrate the complexities associated with LCA, with particular focus on bioenergy and associated policy development, so that its use can more effectively inform policymakers. Methods: The review is based on the results from a series of workshops focused on bioenergy life cycle assessment. Expertmore » submissions were compiled and categorized within the first two workshops. Over 100 issues emerged. Accounting for redundancies and close similarities in the list, this reduced to around 60 challenges, many of which are deeply interrelated. Some of these issues were then explored further at a policy-facing workshop in London, UK. The authors applied a rigorous approach to categorize the challenges identified to be at the intersection of biofuels/bioenergy LCA and policy. Results and discussion: The credibility of LCA is core to its use in policy. Even LCAs that comply with ISO standards and policy and regulatory instruments leave a great deal of scope for interpretation and flexibility. Within the bioenergy sector, this has led to frustration and at times a lack of obvious direction. This paper identifies the main challenge clusters: overarching issues, application and practice and value and ethical judgments. Many of these are reflective of the transition from application of LCA to assess individual products or systems to the wider approach that is becoming more common. Uncertainty in impact assessment strongly influences planning and compliance due to challenges in assigning accountability, and communicating the inherent complexity and uncertainty within bioenergy is becoming of greater importance. Conclusions: The emergence of LCA in bioenergy governance is particularly significant because other sectors are likely to transition to similar governance models. LCA is being stretched to accommodate complex and broad policy-relevant questions, seeking to incorporate externalities that have major implications for long-term sustainability. As policy increasingly relies on LCA, the strains placed on the methodology are becoming both clearer and impedimentary. The implications for energy policy, and in particular bioenergy, are large.« less

  1. Species, habitats, society: an evaluation of research supporting EU's Natura 2000 network.

    PubMed

    Popescu, Viorel D; Rozylowicz, Laurentiu; Niculae, Iulian M; Cucu, Adina L; Hartel, Tibor

    2014-01-01

    The Natura 2000 network is regarded as one of the conservation success stories in the global effort to protect biodiversity. However, significant challenges remain in Natura 2000 implementation, owing to its rapid expansion, and lack of a coherent vision for its future. Scientific research is critical for identifying conservation priorities, setting management goals, and reconciling biodiversity protection and society in the complex political European landscape. Thus, there is an urgent need for a comprehensive evaluation of published Natura 2000 research to highlight prevalent research themes, disciplinary approaches, and spatial entities. We conducted a systematic review of 572 scientific articles and conference proceedings focused on Natura 2000 research, published between 1996 and 2014. We grouped these articles into 'ecological' and 'social and policy' categories. Using a novel application of network analysis of article keywords, we found that Natura 2000 research forms a cohesive small-world network, owing to the emphasis on ecological research (79% of studies, with a strong focus on spatial conservation planning), and the underrepresentation of studies addressing 'social and policy' issues (typically focused on environmental impact assessment, multi-level governance, agri-environment policy, and ecosystem services valuation). 'Ecological' and 'social and policy' research shared only general concepts (e.g., Natura 2000, Habitats Directive) suggesting a disconnection between these disciplines. The UK and the Mediterranean basin countries dominated Natura 2000 research, and there was a weak correlation between number of studies and proportion of national territory protected. Approximately 40% of 'social and policy' research and 26% of 'ecological' studies highlighted negative implications of Natura 2000, while 21% of studies found positive social and biodiversity effects. We emphasize the need for designing inter- and transdisciplinary research in order to promote a social-ecological understanding of Natura 2000, and advance EU conservation policies.

  2. Setting the Context for Using Complexity Theory in Evaluation: Boundaries, Governance and Utilisation

    ERIC Educational Resources Information Center

    Walton, Mat

    2016-01-01

    Recent literature has usefully explored the application of complexity theory to evaluation. However, there is little discussion of the contextual conditions in applying complexity theory. Drawing upon a single complexity-consistent public health programme evaluation and subsequent policy decisions, this paper considers how programme framing and…

  3. Air-quality implications of widespread adoption of cool roofs on ozone and particulate matter in southern California

    NASA Astrophysics Data System (ADS)

    Ban-Weiss, G. A.; Lee, S. M.; Katzenstein, A. S.; Carreras-Sospedra, M.; Zhang, X.; Farina, S.; Vahmani, P.; Fine, P.; Epstein, S. A.

    2017-12-01

    The installation of roofing materials with increased solar reflectance (i.e., "cool roofs") can mitigate the urban heat island effect and reduce energy use. In addition, meteorological changes, along with the possibility of enhanced UV reflection from these surfaces, can have complex impacts on ozone and PM2.5 concentrations. We aim to evaluate the air-quality impacts of widespread cool-roof installations prescribed by building energy efficiency standards within the heavily populated and polluted South Coast Air Basin (SoCAB) in Southern California. Development of a comprehensive rooftop area database and evaluation of spectral reflectance measurements of roofing materials allows us to predict potential future changes in solar and UV reflectance for simulations using the Weather Research Forecast and Community Multiscale Air Quality (CMAQ) models. Meteorological simulations indicate a decrease in daily maximum temperatures, daily maximum boundary layer heights, and ventilation coefficients throughout the SoCAB upon widespread installation of cool roofs. CMAQ simulations show significant increases in PM2.5 concentrations and policy-relevant design values. Changes in 8-h ozone concentrations depend on the potential change in UV reflectance, ranging from a decrease in population-weighted concentrations when UV reflectance remains unchanged to an increase when changes in UV reflectance are at an upper bound. However, 8-h policy-relevant ozone design values increase in all cases. Although the other benefits of cool roofs could outweigh small air-quality penalties, UV reflectance standards for cool roofing materials could mitigate these negative consequences. Results of this study motivate the careful consideration of future rooftop and pavement solar reflectance modification policies.

  4. A qualitative study of nulliparous women's decision making on mode of delivery under China's two-child policy.

    PubMed

    Gu, Chunyi; Zhu, Xinli; Ding, Yan; Setterberg Simone; Wang, Xiaojiao; Tao, Hua; Zhang, Yu

    2018-07-01

    To explore nulliparous women's perceptions of decision making regarding mode of delivery under China's two-child policy. Qualitative descriptive design with in-depth semi-structured interviews. Postnatal wards at a tertiary specialized women's hospital in Shanghai, China. 21 nulliparous women 2-3 days postpartum were purposively sampled until data saturation. In-depth semi-structured interviews were conducted between October 8th, 2015 and January 31st, 2016. Two overarching descriptive categories were identified: (1) women's decision-making process: stability versus variability, and (2) factors affecting decision making: variety versus interactivity. Four key themes emerged from each category: (1) initial decision making with certainty: anticipated trial of labour, failed trial of labour, 'shy away' and compromise, anticipated caesarean delivery; (2) initial decision making with uncertainty: anticipated trial of labour, failed trial of labour, 'shy away' and compromise; (3) internal factors affecting decision making: knowledge and attitude, and childbirth self-efficacy; and (4) external factors affecting decision making: social support, and the situational environment. At the initial period of China's two-child policy, nulliparous women have perceived their decision-making process regarding mode of delivery as one with complexity and uncertainty, influenced by both internal and external factors. This may have implications for the obstetric setting to develop a well-designed decision support system for pregnant women during the entire pregnancy periods. And it is recommended that care providers should assess women's preferences for mode of delivery from early pregnancy and provide adequate perinatal support and continuity of care for them. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. 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.

  6. A goal programming approach for a joint design of macroeconomic and environmental policies: a methodological proposal and an application to the Spanish economy.

    PubMed

    André, Francisco J; Cardenete, M Alejandro; Romero, Carlos

    2009-05-01

    The economic policy needs to pay increasingly more attention to the environmental issues, which requires the development of methodologies able to incorporate environmental, as well as macroeconomic, goals in the design of public policies. Starting from this observation, this article proposes a methodology based upon a Simonian satisficing logic made operational with the help of goal programming (GP) models, to address the joint design of macroeconomic and environmental policies. The methodology is applied to the Spanish economy, where a joint policy is elicited, taking into consideration macroeconomic goals (economic growth, inflation, unemployment, public deficit) and environmental goals (CO(2), NO( x ) and SO( x ) emissions) within the context of a computable general equilibrium model. The results show how the government can "fine-tune" its policy according to different criteria using GP models. The resulting policies aggregate the environmental and the economic goals in different ways: maximum aggregate performance, maximum balance and a lexicographic hierarchy of the goals.

  7. Linking biomedical engineering ethics case study approach and policy.

    PubMed

    Dibrell, William; Dobie, Elizabeth Ann

    2007-01-01

    In this paper we link bioengineering case study methods to the development of policy. The case study approach to ethics is an excellent way to show the complex nature of practical/moral reasoning. This approach can, however, lead to a kind of overwhelming complexity. The individual nature of each case makes it difficult to identify the most important information and difficult to see what moral considerations are most relevant. In order to make the overwhelming complexity less debilitating, we present a framework for moral decision making derived from suggestions made by W.D. Ross and Virginia Held. Ross articulates the multiple sources of morality and Held deepens the discussion by reminding us of the foundational importance of care and sympathy to our moral natures. We show how to use the notion of prima facie duty and discuss moral conflict. In doing this, we show how the framework, applied to cases, can be of assistance in helping us develop policies and codes of ethics with sufficient plasticity to be useful in the complex world of the bioengineer.

  8. Use of Comparative Case Study Methodology for US Public Health Policy Analysis: A Review.

    PubMed

    Dinour, Lauren M; Kwan, Amy; Freudenberg, Nicholas

    There is growing recognition that policies influence population health, highlighting the need for evidence to inform future policy development and reform. This review describes how comparative case study methodology has been applied to public health policy research and discusses the methodology's potential to contribute to this evidence. English-language, peer-reviewed articles published between 1995 and 2012 were sought from 4 databases. Articles were included if they described comparative case studies addressing US public health policy. Two researchers independently assessed the 20 articles meeting review criteria. Case-related characteristics and research design tactics utilized to minimize threats to reliability and validity, such as the use of multiple sources of evidence and a case study protocol, were extracted from each article. Although comparative case study methodology has been used to analyze a range of public health policies at all stages and levels, articles reported an average use of only 3.65 (out of 10) research design tactics. By expanding the use of accepted research design tactics, public health policy researchers can contribute to expanding the evidence needed to advance health-promoting policies.

  9. Near Earth Objects and Cascading Effects from the Policy Perspective: Implications from Problem and Solution Definition

    NASA Astrophysics Data System (ADS)

    Lindquist, Eric

    2016-04-01

    The characterization of near-Earth-objects (NEOs) in regard to physical attributes and potential risk and impact factors presents a complex and complicates scientific and engineering challenge. The societal and policy risks and impacts are no less complex, yet are rarely considered in the same context as material properties or related factors. Further, NEO impacts are typically considered as discrete events, not as initial events in a dynamic cascading system. The objective of this contribution is to position the characterization of NEOs within the public policy process domain as a means to reflect on the science-policy nexus in regard to risks and multi-hazard impacts associated with these hazards. This will be accomplished through, first, a brief overview of the science-policy nexus, followed by a discussion of policy process frameworks, such as agenda setting and the multiple streams model, focusing events, and punctuated equilibrium, and their application and appropriateness to the problem of NEOs. How, too, for example, does NEO hazard and risk compare with other low probability, high risk, hazards in regard to public policy? Finally, we will reflect on the implications of alternative NEO "solutions" and the characterization of the NEO "problem," and the political and public acceptance of policy alternatives as a way to link NEO science and policy in the context of the overall NH9.12 panel.

  10. Treatment for ADHD: Is More Complex Treatment Cost-Effective for More Complex Cases?

    PubMed Central

    Foster, E Michael; Jensen, Peter S; Schlander, Michael; Pelham, William E; Hechtman, Lily; Arnold, L Eugene; Swanson, James M; Wigal, Timothy

    2007-01-01

    Objective To determine the cost-effectiveness of three alternative high-quality treatments for attention deficit hyperactivity disorder (ADHD) relative to community care (CC) and to determine whether cost-effectiveness varies with the presence of comorbid disorders. Data Sources/Collection The study included 579 children ages 7–9.9 with diagnosed ADHD at six sites. Data for the study were distilled from administrative data and from interviews with parents, including estimates of the child's functional impairment. These analyses focus on changes in functional impairment over 14 months. Study Design The study involved a large clinical trial that randomized participants to one of four arms: routine CC, intensive medication management (MedMgt), multicomponent behavioral treatment, and a combination of behavioral treatment and medication. Principal Findings We assessed the cost-effectiveness of the alternatives using costs measured from a payer perspective. The preferred cost-effective treatment varies as a function of the child's comorbidity and of the policy maker's willingness to pay. For pure (no comorbidity) ADHD, high-quality MedMgt appears likely to be cost-effective at all levels of willingness to pay. In contrast, for some comorbid conditions, willingness to pay is critical: the policy maker with low willingness to pay likely will judge MedMgt most cost-effective. On the other hand, a policy maker willing to pay more now in expectation of future costs savings (involving, for example, juvenile justice), will recognize that the most cost-effective choice for comorbid conditions likely involves behavior therapy, with or without medication. Conclusions Analyses of costs and effectiveness of treatment for ADHD must consider the role of comorbidities. PMID:17355587

  11. Personality traits and environmental choices: On the search for understanding.

    PubMed

    Farizo, Begoña A; Oglethorpe, David; Soliño, Mario

    2016-10-01

    In this paper we hypothesize that individuals will choose among alternative courses of action for power generation from wind farms according to their personality profiles. Through a factor analysis we found that certain characteristics of personality do indeed have an effect on environmental choice. The study involves an extensive survey based on the Big Five Traits model to find a pattern of choice that will help to better understand environmental decisions and be useful for policy makers to identify target groups and preview reactions to different courses of action. The research is potentially useful for the better preparation and design of publicity material, awareness raising campaigns and information provision for complex or unpopular policies affecting the environment or in environmental education in general. This research is especially interested in shedding some light on how personality is involved in the processes of environmental decision making, despite the limitations of the present study. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Insider Threat and Information Security Management

    NASA Astrophysics Data System (ADS)

    Coles-Kemp, Lizzie; Theoharidou, Marianthi

    The notion of insider has multiple facets. An organization needs to identify which ones to respond to. The selection, implementetion and maintenance of information security countermeasures requires a complex combination of organisational policies, functions and processes, which form Information Security Management. This chapter examines the role of current information security management practices in addressing the insider threat. Most approaches focus on frameworks for regulating insider behaviour and do not allow for the various cultural responses to the regulatory and compliance framework. Such responses are not only determined by enforcement of policies and awareness programs, but also by various psychological and organisational factors at an individual or group level. Crime theories offer techniques that focus on such cultural responses and can be used to enhance the information security management design. The chapter examines the applicability of several crime theories and concludes that they can contribute in providing additional controls and redesign of information security management processes better suited to responding to the insider threat.

  13. Commentary on two classroom observation systems: moving toward a shared understanding of effective teaching.

    PubMed

    Connor, Carol McDonald

    2013-12-01

    In this commentary, I make five points: that designing observation systems that actually predict students' outcomes is challenging; second that systems that capture the complex and dynamic nature of the classroom learning environment are more likely to be able to meet this challenge; three, that observation tools are most useful when developed to serve a particular purpose and are put to that purpose; four that technology can help; and five, there are policy implications for valid and reliable classroom observation tools. The two observation systems presented in this special issue represent an important step forward and a move toward policy that promises to make a true difference in what is defined as high quality and effective teaching, what it looks like in the classroom, and how these practices can be more widely disseminated so that all children, including those attending under-resourced schools, can experience effective instruction, academic success and the lifelong accomplishment that follows. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  14. Strengthening Data Confidentiality and Integrity Protection in the Context of a Multi-Centric Information System Dedicated to Autism Spectrum Disorder.

    PubMed

    Ben Said, Mohamed; Robel, Laurence; Golse, Bernard; Jais, Jean Philippe

    2017-01-01

    Autism spectrum disorders (ASD) are complex neuro-developmental disorders affecting children in early age. Diagnosis relies on multidisciplinary investigations, in psychiatry, neurology, genetics, electrophysiology, neuro-imagery, audiology, and ophthalmology. To support clinicians, researchers, and public health decision makers, we developed an information system dedicated to ASD, called TEDIS. It was designed to manage systematic, exhaustive and continuous multi-centric patient data collection via secured internet connections. TEDIS will be deployed in nine ASD expert assessment centers in Ile-DeFrance district. We present security policy and infrastructure developed in context of TEDIS to protect patient privacy and clinical information. TEDIS security policy was organized around governance, ethical and organisational chart-agreement, patients consents, controlled user access, patients' privacy protection, constrained patients' data access. Security infrastructure was enriched by further technical solutions to reinforce ASD patients' privacy protection. Solutions were tested on local secured intranet environment and showed fluid functionality with consistent, transparent and safe encrypting-decrypting results.

  15. Commentary on Two Classroom Observation Systems: Moving Toward a Shared Understanding of Effective Teaching

    PubMed Central

    Connor, Carol McDonald

    2016-01-01

    In this commentary, I make five points: that designing observation systems that actually predict students’ outcomes is challenging; second that systems that capture the complex and dynamic nature of the classroom learning environment are more likely to be able to meet this challenge; three, that observation tools are most useful when developed to serve a particular purpose and are put to that purpose; four that technology can help; and five, there are policy implications for valid and reliable classroom observation tools. The two observation systems presented in this special issue represent an important step forward and a move toward policy that promises to make a true difference in what is defined as high quality and effective teaching, what it looks like in the classroom, and how these practices can be more widely disseminated so that all children, including those attending under-resourced schools, can experience effective instruction, academic success and the lifelong accomplishment that follows. PMID:24341927

  16. 78 FR 71435 - Policy Statement on the Scenario Design Framework for Stress Testing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... Statement III. Summary of Comments A. Design of Stress Test Scenarios B. Additional Variables C. Severely... policy statement and its overall organization. A. Design of Stress Test Scenarios Commenters suggested a variety of ways for the Board to alter or improve the design of stress test scenarios, including by making...

  17. 78 FR 9633 - Policy Statement on the Scenario Design Framework for Stress Testing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-11

    ... Statement on the Scenario Design Framework for Stress Testing AGENCY: Board of Governors of the Federal... design for stress testing that would be used in connection with the supervisory and company-run stress...) requesting public comment on a policy statement on the approach to scenario design for stress testing that...

  18. A Protocol for Evaluating Contextual Design Principles

    PubMed Central

    Stamps, Arthur

    2014-01-01

    This paper explains how scientific data can be incorporated into urban design decisions, such as evaluating contextual design principles. The recommended protocols are based on the Cochrane Reviews that have been widely used in medical research. The major concepts of a Cochrane Review are explained, as well as the underlying mathematics. The underlying math is meta-analysis. Data are reported for three applications and seven contextual design policies. It is suggested that use of the Cochrane protocols will be of great assistance to planners by providing scientific data that can be used to evaluate the efficacies of contextual design policies prior to implementing those policies. PMID:25431448

  19. Privacy as an enabler, not an impediment: building trust into health information exchange.

    PubMed

    McGraw, Deven; Dempsey, James X; Harris, Leslie; Goldman, Janlori

    2009-01-01

    Building privacy and security protections into health information technology systems will bolster trust in such systems and promote their adoption. The privacy issue, too long seen as a barrier to electronic health information exchange, can be resolved through a comprehensive framework that implements core privacy principles, adopts trusted network design characteristics, and establishes oversight and accountability mechanisms. The public policy challenges of implementing this framework in a complex and evolving environment will require improvements to existing law, new rules for entities outside the traditional health care sector, a more nuanced approach to the role of consent, and stronger enforcement mechanisms.

  20. Connecting mathematics learning through spatial reasoning

    NASA Astrophysics Data System (ADS)

    Mulligan, Joanne; Woolcott, Geoffrey; Mitchelmore, Michael; Davis, Brent

    2018-03-01

    Spatial reasoning, an emerging transdisciplinary area of interest to mathematics education research, is proving integral to all human learning. It is particularly critical to science, technology, engineering and mathematics (STEM) fields. This project will create an innovative knowledge framework based on spatial reasoning that identifies new pathways for mathematics learning, pedagogy and curriculum. Novel analytical tools will map the unknown complex systems linking spatial and mathematical concepts. It will involve the design, implementation and evaluation of a Spatial Reasoning Mathematics Program (SRMP) in Grades 3 to 5. Benefits will be seen through development of critical spatial skills for students, increased teacher capability and informed policy and curriculum across STEM education.

  1. Economic networks: the new challenges.

    PubMed

    Schweitzer, Frank; Fagiolo, Giorgio; Sornette, Didier; Vega-Redondo, Fernando; Vespignani, Alessandro; White, Douglas R

    2009-07-24

    The current economic crisis illustrates a critical need for new and fundamental understanding of the structure and dynamics of economic networks. Economic systems are increasingly built on interdependencies, implemented through trans-national credit and investment networks, trade relations, or supply chains that have proven difficult to predict and control. We need, therefore, an approach that stresses the systemic complexity of economic networks and that can be used to revise and extend established paradigms in economic theory. This will facilitate the design of policies that reduce conflicts between individual interests and global efficiency, as well as reduce the risk of global failure by making economic networks more robust.

  2. Advance Care Planning: is quality end of life care really that simple?

    PubMed

    Johnson, Stephanie; Kerridge, Ian; Butow, Phyllis N; Tattersall, Martin H N

    2017-04-01

    The routine implementation of Advance Care Planning (ACP) is now a prominent feature of policy directed at improving end of life care in Australia. However, while complex ACP interventions may modestly reduce medical care at the end of life and enable more people to die at home or outside of acute hospital settings, existing legal, organisational, cultural and conceptual barriers limit the implementation and utility of ACP. We suggest that meaningful improvements in end of life care will not result from the institutionalisation of ACP but from more significant changes to the design and delivery of care. © 2017 Royal Australasian College of Physicians.

  3. Mapping healthcare systems: a policy relevant analytic tool.

    PubMed

    Sekhri Feachem, Neelam; Afshar, Ariana; Pruett, Cristina; Avanceña, Anton L V

    2017-07-01

    In the past decade, an international consensus on the value of well-functioning systems has driven considerable health systems research. This research falls into two broad categories. The first provides conceptual frameworks that take complex healthcare systems and create simplified constructs of interactions and functions. The second focuses on granular inputs and outputs. This paper presents a novel translational mapping tool - the University of California, San Francisco mapping tool (the Tool) - which bridges the gap between these two areas of research, creating a platform for multi-country comparative analysis. Using the Murray-Frenk framework, we create a macro-level representation of a country's structure, focusing on how it finances and delivers healthcare. The map visually depicts the fundamental policy questions in healthcare system design: funding sources and amount spent through each source, purchasers, populations covered, provider categories; and the relationship between these entities. We use the Tool to provide a macro-level comparative analysis of the structure of India's and Thailand's healthcare systems. As part of the systems strengthening arsenal, the Tool can stimulate debate about the merits and consequences of different healthcare systems structural designs, using a common framework that fosters multi-country comparative analyses. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  4. Component-Based Modelling for Scalable Smart City Systems Interoperability: A Case Study on Integrating Energy Demand Response Systems.

    PubMed

    Palomar, Esther; Chen, Xiaohong; Liu, Zhiming; Maharjan, Sabita; Bowen, Jonathan

    2016-10-28

    Smart city systems embrace major challenges associated with climate change, energy efficiency, mobility and future services by embedding the virtual space into a complex cyber-physical system. Those systems are constantly evolving and scaling up, involving a wide range of integration among users, devices, utilities, public services and also policies. Modelling such complex dynamic systems' architectures has always been essential for the development and application of techniques/tools to support design and deployment of integration of new components, as well as for the analysis, verification, simulation and testing to ensure trustworthiness. This article reports on the definition and implementation of a scalable component-based architecture that supports a cooperative energy demand response (DR) system coordinating energy usage between neighbouring households. The proposed architecture, called refinement of Cyber-Physical Component Systems (rCPCS), which extends the refinement calculus for component and object system (rCOS) modelling method, is implemented using Eclipse Extensible Coordination Tools (ECT), i.e., Reo coordination language. With rCPCS implementation in Reo, we specify the communication, synchronisation and co-operation amongst the heterogeneous components of the system assuring, by design scalability and the interoperability, correctness of component cooperation.

  5. On the design of flight-deck procedures

    NASA Technical Reports Server (NTRS)

    Degani, Asaf; Wiener, Earl L.

    1994-01-01

    In complex human-machine systems, operations, training, and standardization depend on a elaborate set of procedures which are specified and mandated by the operational management of the organization. The intent is to provide guidance to the pilots, to ensure a logical, efficient, safe, and predictable means of carrying out the mission objectives. In this report the authors examine the issue of procedure use and design from a broad viewpoint. The authors recommend a process which we call 'The Four P's:' philosophy, policies, procedures, and practices. We believe that if an organization commits to this process, it can create a set of procedures that are more internally consistent, less confusing, better respected by the flight crews, and that will lead to greater conformity. The 'Four-P' model, and the guidelines for procedural development in appendix 1, resulted from cockpit observations, extensive interviews with airline management and pilots, interviews and discussion at one major airframe manufacturer, and an examination of accident and incident reports. Although this report is based on airline operations, we believe that the principles may be applicable to other complex, high-risk systems, such as nuclear power production, manufacturing process control, space flight, and military operations.

  6. Component-Based Modelling for Scalable Smart City Systems Interoperability: A Case Study on Integrating Energy Demand Response Systems

    PubMed Central

    Palomar, Esther; Chen, Xiaohong; Liu, Zhiming; Maharjan, Sabita; Bowen, Jonathan

    2016-01-01

    Smart city systems embrace major challenges associated with climate change, energy efficiency, mobility and future services by embedding the virtual space into a complex cyber-physical system. Those systems are constantly evolving and scaling up, involving a wide range of integration among users, devices, utilities, public services and also policies. Modelling such complex dynamic systems’ architectures has always been essential for the development and application of techniques/tools to support design and deployment of integration of new components, as well as for the analysis, verification, simulation and testing to ensure trustworthiness. This article reports on the definition and implementation of a scalable component-based architecture that supports a cooperative energy demand response (DR) system coordinating energy usage between neighbouring households. The proposed architecture, called refinement of Cyber-Physical Component Systems (rCPCS), which extends the refinement calculus for component and object system (rCOS) modelling method, is implemented using Eclipse Extensible Coordination Tools (ECT), i.e., Reo coordination language. With rCPCS implementation in Reo, we specify the communication, synchronisation and co-operation amongst the heterogeneous components of the system assuring, by design scalability and the interoperability, correctness of component cooperation. PMID:27801829

  7. The complex remuneration of human resources for health in low-income settings: policy implications and a research agenda for designing effective financial incentives.

    PubMed

    Bertone, Maria Paola; Witter, Sophie

    2015-07-28

    Human resources for health represent an essential component of health systems and play a key role to accelerate progress towards universal health coverage. Many countries in sub-Saharan Africa face challenges regarding the availability, distribution and performance of health workers, which could be in part addressed by providing effective financial incentives. Based on an overview of the existing literature, the paper highlights the gaps in the existing research in low-income countries exploring the different components of health workers' incomes. It then proposes a novel approach to the analysis of financial incentives and delineates a research agenda, which could contribute to shed light on this topic. The article finds that, while there is ample research that investigates separately each of the incomes health workers may earn (for example, salary, fee-for-service payments, informal incomes, "top-ups" and per diems, dual practice and non-health activities), there is a dearth of studies which look at the health workers' "complex remuneration", that is, the whole of the financial incentives available. Little research exists which analyses simultaneously all revenues of health workers, quantifies the overall remuneration and explores its complexity, its multiple components and their features, as well as the possible interaction between income components. However, such a comprehensive approach is essential to fully comprehend health workers' incentives, by investigating the causes (at individual and system level) of the fragmentation in the income structure and the variability in income levels, as well as the consequences of the "complex remuneration" on motivation and performance. This proposition has important policy implications in terms of devising effective incentive packages as it calls for an active consideration of the role that "complex remuneration" plays in determining recruitment, retention and motivation patterns, as well as, more broadly, the performance of health systems. This paper argues that research focusing on the health workers' "complex remuneration" is critical to address some of the most challenging issues affecting human resources for health. An empirical research agenda is proposed to fill the gap in our understanding.

  8. Policy.

    ERIC Educational Resources Information Center

    Evans, Judith L.; And Others

    1995-01-01

    This theme issue is devoted to discussions of early childhood policy issues. "Creating a Shared Vision: How Policy Affects Early Childhood Care and Development" (Judith L. Evans) defines policy, discusses the motivation for changing or creating national policy and the process for changing such policies, and provides a sample design for…

  9. The politics of toxic waste

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

    Rahm, D.

    1998-12-31

    Toxic waste, and the public policy that deals with it, is a complex issue. Much of the complexity stems from the science and technology embedded in the topic, but a great deal also results from the intricate interactions between the social organizations and institutions involved. The politics of toxic waste plays out within three key aspects of this complexity. The first of these is the nature of the intergovernmental relations involved. For toxic waste issues, these intergovernmental relations can be between sovereign states or between a nation and an international governing organization, or they may be restricted to a domesticmore » context. If the later is the case, the relationship can be between federal, state, and local governments or between different bureaus, departments, or agencies within the same level of government. A second feature of this complexity can be seen in the consequences of divergent organizational or institutional interests. When conflicting organizational or institutional perspectives, positions, or concerns arise, public policy outcomes are affected.The tug and pull of competing actors move policy in the direction favored by the winner. This may or may not be the most rational alternative. A third aspect of this interorganizational puzzle involves the question of where the locus of authority for decisionmaking resides and to what extent stakeholders, who do not possess direct authority, can influence policy outcomes.« less

  10. Sustainable development goals for global health: facilitating good governance in a complex environment.

    PubMed

    Haffeld, Just

    2013-11-01

    Increasing complexity is following in the wake of rampant globalization. Thus, the discussion about Sustainable Development Goals (SDGs) requires new thinking that departs from a critique of current policy tools in exploration of a complexity-friendly approach. This article argues that potential SDGs should: treat stakeholders, like states, business and civil society actors, as agents on different aggregate levels of networks; incorporate good governance processes that facilitate early involvement of relevant resources, as well as equitable participation, consultative processes, and regular policy and programme implementation reviews; anchor adoption and enforcement of such rules to democratic processes in accountable organizations; and include comprehensive systems evaluations, including procedural indicators. A global framework convention for health could be a suitable instrument for handling some of the challenges related to the governance of a complex environment. It could structure and legitimize government involvement, engage stakeholders, arrange deliberation and decision-making processes with due participation and regular policy review, and define minimum standards for health services. A monitoring scheme could ensure that agents in networks comply according to whole-systems targets, locally defined outcome indicators, and process indicators, thus resolving the paradox of government control vs. local policy space. A convention could thus exploit the energy created in the encounter between civil society, international organizations and national authorities. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  11. Virtual Control Policy for Binary Ordered Resources Petri Net Class.

    PubMed

    Rovetto, Carlos A; Concepción, Tomás J; Cano, Elia Esther

    2016-08-18

    Prevention and avoidance of deadlocks in sensor networks that use the wormhole routing algorithm is an active research domain. There are diverse control policies that will address this problem being our approach a new method. In this paper we present a virtual control policy for the new specialized Petri net subclass called Binary Ordered Resources Petri Net (BORPN). Essentially, it is an ordinary class constructed from various state machines that share unitary resources in a complex form, which allows branching and joining of processes. The reduced structure of this new class gives advantages that allow analysis of the entire system's behavior, which is a prohibitive task for large systems because of the complexity and routing algorithms.

  12. Using Systems Thinking to train future leaders in global health.

    PubMed

    Paxton, Anne; Frost, Laura J

    2017-07-09

    Systems Thinking provides a useful set of concepts and tools that can be used to train students to be effective and innovative global health leaders in an ever-changing and often chaotic world. This paper describes an experiential, multi-disciplinary curriculum that uses Systems Thinking to frame and analyse global health policies and practices. The curriculum uses case studies and hands-on activities to deepen students' understanding of the following concepts: complex adaptive systems, dynamic complexity, inter-relationships, feedback loops, policy resistance, mental models, boundary critique, leverage points, and multi-disciplinary, multi-sectoral, and multi-stakeholder thinking and action. A sample of Systems Thinking tools for analysing global health policies and practices are also introduced.

  13. A New Socio-technical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems

    PubMed Central

    Sittig, Dean F.; Singh, Hardeep

    2011-01-01

    Conceptual models have been developed to address challenges inherent in studying health information technology (HIT). This manuscript introduces an 8-dimensional model specifically designed to address the socio-technical challenges involved in design, development, implementation, use, and evaluation of HIT within complex adaptive healthcare systems. The 8 dimensions are not independent, sequential, or hierarchical, but rather are interdependent and interrelated concepts similar to compositions of other complex adaptive systems. Hardware and software computing infrastructure refers to equipment and software used to power, support, and operate clinical applications and devices. Clinical content refers to textual or numeric data and images that constitute the “language” of clinical applications. The human computer interface includes all aspects of the computer that users can see, touch, or hear as they interact with it. People refers to everyone who interacts in some way with the system, from developer to end-user, including potential patient-users. Workflow and communication are the processes or steps involved in assuring that patient care tasks are carried out effectively. Two additional dimensions of the model are internal organizational features (e.g., policies, procedures, and culture) and external rules and regulations, both of which may facilitate or constrain many aspects of the preceding dimensions. The final dimension is measurement and monitoring, which refers to the process of measuring and evaluating both intended and unintended consequences of HIT implementation and use. We illustrate how our model has been successfully applied in real-world complex adaptive settings to understand and improve HIT applications at various stages of development and implementation. PMID:20959322

  14. A new sociotechnical model for studying health information technology in complex adaptive healthcare systems.

    PubMed

    Sittig, Dean F; Singh, Hardeep

    2010-10-01

    Conceptual models have been developed to address challenges inherent in studying health information technology (HIT). This manuscript introduces an eight-dimensional model specifically designed to address the sociotechnical challenges involved in design, development, implementation, use and evaluation of HIT within complex adaptive healthcare systems. The eight dimensions are not independent, sequential or hierarchical, but rather are interdependent and inter-related concepts similar to compositions of other complex adaptive systems. Hardware and software computing infrastructure refers to equipment and software used to power, support and operate clinical applications and devices. Clinical content refers to textual or numeric data and images that constitute the 'language' of clinical applications. The human--computer interface includes all aspects of the computer that users can see, touch or hear as they interact with it. People refers to everyone who interacts in some way with the system, from developer to end user, including potential patient-users. Workflow and communication are the processes or steps involved in ensuring that patient care tasks are carried out effectively. Two additional dimensions of the model are internal organisational features (eg, policies, procedures and culture) and external rules and regulations, both of which may facilitate or constrain many aspects of the preceding dimensions. The final dimension is measurement and monitoring, which refers to the process of measuring and evaluating both intended and unintended consequences of HIT implementation and use. We illustrate how our model has been successfully applied in real-world complex adaptive settings to understand and improve HIT applications at various stages of development and implementation.

  15. A review of materials for spectral design coatings in signature management applications

    NASA Astrophysics Data System (ADS)

    Andersson, Kent E.; Škerlind, Christina

    2014-10-01

    The current focus in Swedish policy towards national security and high-end technical systems, together with a rapid development in multispectral sensor technology, adds to the utility of developing advanced materials for spectral design in signature management applications. A literature study was performed probing research databases for advancements. Qualitative text analysis was performed using a six-indicator instrument: spectrally selective reflectance; low gloss; low degree of polarization; low infrared emissivity; non-destructive properties in radar and in general controllability of optical properties. Trends are identified and the most interesting materials and coating designs are presented with relevant performance metrics. They are sorted into categories in the order of increasing complexity: pigments and paints, one-dimensional structures, multidimensional structures (including photonic crystals), and lastly biomimic and metamaterials. The military utility of the coatings is assessed qualitatively. The need for developing a framework for assessing the military utility of incrementally increasing the performance of spectrally selective coatings is identified.

  16. Knowing and Doing Vocational Education and Training Reform: Evidence, Learning and the Policy Process

    ERIC Educational Resources Information Center

    McGrath, Simon; Lugg, Rosemary

    2012-01-01

    Much of VET policy internationally draws on a toolkit that has been seriously questioned for its logic, international relevance and effectiveness by considerable amounts of academic research. Reflecting primarily on our experiences of leading a complex, multi-country policy study, we develop an account that seeks to explore ways in which the…

  17. Use of the Trusted Computer System Evaluation Criteria (TCSEC) for Complex, Evolving, Multipolicy Systems.

    DTIC Science & Technology

    1994-07-01

    incorporate the Bell-La Padula rules for implementing the DoD security policy. The policy from which we begin here is the organization’s operational...security policy, which assumes the Bell-La Padula model and assigns the required security variables to elements of the system. A way to ensure a

  18. Using Contribution Analysis to Evaluate the Impacts of Research on Policy: Getting to "Good Enough"

    ERIC Educational Resources Information Center

    Riley, Barbara L.; Kernoghan, Alison; Stockton, Lisa; Montague, Steve; Yessis, Jennifer; Willis, Cameron D.

    2018-01-01

    Assessing societal impacts of research is more difficult than assessing advances in knowledge. Methods to evaluate research impact on policy processes and outcomes are especially underdeveloped, and are needed to optimize the influence of research on policy for addressing complex issues such as chronic diseases. Contribution analysis (CA), a…

  19. Evidence-Based Programming in the Context of Practice and Policy. Social Policy Report. Volume XXIII, Number III

    ERIC Educational Resources Information Center

    McCall, Robert B.

    2009-01-01

    Scholars, practice professionals, and policymakers should welcome the new era of evidence-based programming and policies, but these constituencies need to be realistic about the complexities, uncertainties, and limitations that lie beneath what could easily become a simplistic process. This paper discusses some of the requirements for the…

  20. Increasingly Segregated and Unequal Schools as Courts Reverse Policy

    ERIC Educational Resources Information Center

    Orfield, Gary; Frankenberg, Erica

    2014-01-01

    Purpose: School administrators and policy makers live in a complex, changing policy universe in which there are many competing demands and political pressures. Rarely is there much time to think about sensitive issues of long duration that are not part of the immediate demands they face. This article is about such an issue, a question that will…

  1. Integrating science and policy in natural resource management: lessons and opportunities from North America.

    Treesearch

    Roger N. Clark; Errol E. Meidinger

    1998-01-01

    Relations between science and policy concerning many issues (e.g., health, energy, natural resources) have been changing worldwide. Public pressure to resolve such complex and often controversial issues has resulted in policymakers and policy implementers seeking better knowledge on which to base their decisions. As a result, scientists have become more actively...

  2. Convergent Evolution in the Interest of Integrative Problem Solving: Connecting the Policy Sciences and Interdisciplinary Studies

    ERIC Educational Resources Information Center

    Wallace, Richard L.; Clark, Susan G.

    2014-01-01

    The contemporary fields of interdisciplinary studies and the policy sciences have evolved over similar intellectual paths and timelines, beginning in the early 20th century. Both have their roots in professional efforts--within and outside the academy--to address numerous, growing, and complex problems that face humanity. The policy sciences'…

  3. Intercultural Education "in situ": Examining Intercultural Policy in Cyprus in the Context of European Integration

    ERIC Educational Resources Information Center

    Hadjisoteriou, Christina; Angelides, Panayiotis

    2016-01-01

    Purpose: The overarching purpose of this paper is to explore the transformation of intercultural education in Cyprus in the context of European integration. More specifically, it indicates the ways in which intercultural policy has been formed by complex and often counteractive influences. The analysis draws upon policy documents collected from…

  4. Science and Policy: Connecting What We Know to What We Do

    ERIC Educational Resources Information Center

    Zigler, Edward F.; Gilliam, Walter S.

    2009-01-01

    American families are affected by a complex array of community, financial, health, and educational stressors. Unfortunately, social policies in the United States have not kept pace with societal demands. The nation is, as a result, in a state of disequilibrium wherein social policies are not in synchrony with the realities of contemporary family…

  5. The Lego Story: Remolding Education Policy and Practice

    ERIC Educational Resources Information Center

    Pirrie, Anne

    2017-01-01

    The aim of this article is to develop a more nuanced understanding of the complex nature of learning as it relates to both the educational and social aims of education as manifested in contemporary European education policy. The article explores tensions in education policy and practice by exploring the evolution of the global brand Lego. The…

  6. 42 CFR 121.8 - Allocation of organs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... allocation. All such experimental policies shall be accompanied by a research design and include data... into a transplant candidate; (5) Shall be designed to avoid wasting organs, to avoid futile transplants... performance goals. Allocation policies shall be designed to achieve equitable allocation of organs among...

  7. 42 CFR 121.8 - Allocation of organs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... allocation. All such experimental policies shall be accompanied by a research design and include data... into a transplant candidate; (5) Shall be designed to avoid wasting organs, to avoid futile transplants... performance goals. Allocation policies shall be designed to achieve equitable allocation of organs among...

  8. 42 CFR 121.8 - Allocation of organs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... allocation. All such experimental policies shall be accompanied by a research design and include data... into a transplant candidate; (5) Shall be designed to avoid wasting organs, to avoid futile transplants... performance goals. Allocation policies shall be designed to achieve equitable allocation of organs among...

  9. 42 CFR 121.8 - Allocation of organs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... allocation. All such experimental policies shall be accompanied by a research design and include data... into a transplant candidate; (5) Shall be designed to avoid wasting organs, to avoid futile transplants... performance goals. Allocation policies shall be designed to achieve equitable allocation of organs among...

  10. 42 CFR 121.8 - Allocation of organs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... allocation. All such experimental policies shall be accompanied by a research design and include data... into a transplant candidate; (5) Shall be designed to avoid wasting organs, to avoid futile transplants... performance goals. Allocation policies shall be designed to achieve equitable allocation of organs among...

  11. Continuity of care in mental health: understanding and measuring a complex phenomenon.

    PubMed

    Burns, T; Catty, J; White, S; Clement, S; Ellis, G; Jones, I R; Lissouba, P; McLaren, S; Rose, D; Wykes, T

    2009-02-01

    Continuity of care is considered by patients and clinicians an essential feature of good quality care in long-term disorders, yet there is general agreement that it is a complex concept. Most policies emphasize it and encourage systems to promote it. Despite this, there is no accepted definition or measure against which to test policies or interventions designed to improve continuity. We aimed to operationalize a multi-axial model of continuity of care and to use factor analysis to determine its validity for severe mental illness. A multi-axial model of continuity of care comprising eight facets was operationalized for quantitative data collection from mental health service users using 32 variables. Of these variables, 22 were subsequently entered into a factor analysis as independent components, using data from a clinical population considered to require long-term consistent care. Factor analysis produced seven independent continuity factors accounting for 62.5% of the total variance. These factors, Experience and Relationship, Regularity, Meeting Needs, Consolidation, Managed Transitions, Care Coordination and Supported Living, were close but not identical to the original theoretical model. We confirmed that continuity of care is multi-factorial. Our seven factors are intuitively meaningful and appear to work in mental health. These factors should be used as a starting-point in research into the determinants and outcomes of continuity of care in long-term disorders.

  12. 10 CFR Appendix A to Subpart B of... - Policy Statement for Electric Motors Covered Under the Energy Policy and Conservation Act

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... with NEMA Design A or B characteristics, or equivalent designs such as IEC Design N (IEC); and (8... design for use at variable speeds. However, NEMA Design A or B motors that are single speed, meet all... single-speed induction motor, built in a two-digit frame number series in accordance with NEMA Standards...

  13. 10 CFR Appendix A to Subpart B of... - Policy Statement for Electric Motors Covered Under the Energy Policy and Conservation Act

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... with NEMA Design A or B characteristics, or equivalent designs such as IEC Design N (IEC); and (8... design for use at variable speeds. However, NEMA Design A or B motors that are single speed, meet all... single-speed induction motor, built in a two-digit frame number series in accordance with NEMA Standards...

  14. Analyzing public health policy: three approaches.

    PubMed

    Coveney, John

    2010-07-01

    Policy is an important feature of public and private organizations. Within the field of health as a policy arena, public health has emerged in which policy is vital to decision making and the deployment of resources. Public health practitioners and students need to be able to analyze public health policy, yet many feel daunted by the subject's complexity. This article discusses three approaches that simplify policy analysis: Bacchi's "What's the problem?" approach examines the way that policy represents problems. Colebatch's governmentality approach provides a way of analyzing the implementation of policy. Bridgman and Davis's policy cycle allows for an appraisal of public policy development. Each approach provides an analytical framework from which to rigorously study policy. Practitioners and students of public health gain much in engaging with the politicized nature of policy, and a simple approach to policy analysis can greatly assist one's understanding and involvement in policy work.

  15. Policy Implications Analysis: A Methodological Advancement for Policy Research and Evaluation.

    ERIC Educational Resources Information Center

    Madey, Doren L.; Stenner, A. Jackson

    Policy Implications Analysis (PIA) is a tool designed to maximize the likelihood that an evaluation report will have an impact on decision-making. PIA was designed to help people planning and conducting evaluations tailor their information so that it has optimal potential for being used and acted upon. This paper describes the development and…

  16. Learning Support Policy for Mathematics in Irish Primary Schools: Equal Access but Unequal Needs

    ERIC Educational Resources Information Center

    Travers, Joseph

    2010-01-01

    This paper critiques learning-support policy for mathematics in Irish primary schools. The key policy question addressed is how equitable the development of the learning-support service has been in addressing low achievement in mathematics in designated schools compared to non-designated schools. The core argument developed is that there is a link…

  17. On the Impact of Government Policy on Programme Design in New Zealand Post-Compulsory Education

    ERIC Educational Resources Information Center

    Govers, Elly

    2010-01-01

    The impact of national education policies on programme design practice in post-compulsory education tends to be marginalised in scholarly literature. This paper reviews and analyses the literature to explore how neo-liberalist discourses introduced in tertiary education and qualifications policies in New Zealand since 1989 continue to influence…

  18. Twelve Principles for Green Energy Storage in Grid Applications.

    PubMed

    Arbabzadeh, Maryam; Johnson, Jeremiah X; Keoleian, Gregory A; Rasmussen, Paul G; Thompson, Levi T

    2016-01-19

    The introduction of energy storage technologies to the grid could enable greater integration of renewables, improve system resilience and reliability, and offer cost effective alternatives to transmission and distribution upgrades. The integration of energy storage systems into the electrical grid can lead to different environmental outcomes based on the grid application, the existing generation mix, and the demand. Given this complexity, a framework is needed to systematically inform design and technology selection about the environmental impacts that emerge when considering energy storage options to improve sustainability performance of the grid. To achieve this, 12 fundamental principles specific to the design and grid application of energy storage systems are developed to inform policy makers, designers, and operators. The principles are grouped into three categories: (1) system integration for grid applications, (2) the maintenance and operation of energy storage, and (3) the design of energy storage systems. We illustrate the application of each principle through examples published in the academic literature, illustrative calculations, and a case study with an off-grid application of vanadium redox flow batteries (VRFBs). In addition, trade-offs that can emerge between principles are highlighted.

  19. Photovoltaic performance models - A report card

    NASA Technical Reports Server (NTRS)

    Smith, J. H.; Reiter, L. R.

    1985-01-01

    Models for the analysis of photovoltaic (PV) systems' designs, implementation policies, and economic performance, have proliferated while keeping pace with rapid changes in basic PV technology and extensive empirical data compiled for such systems' performance. Attention is presently given to the results of a comparative assessment of ten well documented and widely used models, which range in complexity from first-order approximations of PV system performance to in-depth, circuit-level characterizations. The comparisons were made on the basis of the performance of their subsystem, as well as system, elements. The models fall into three categories in light of their degree of aggregation into subsystems: (1) simplified models for first-order calculation of system performance, with easily met input requirements but limited capability to address more than a small variety of design considerations; (2) models simulating PV systems in greater detail, encompassing types primarily intended for either concentrator-incorporating or flat plate collector PV systems; and (3) models not specifically designed for PV system performance modeling, but applicable to aspects of electrical system design. Models ignoring subsystem failure or degradation are noted to exclude operating and maintenance characteristics as well.

  20. Procedures in complex systems: the airline cockpit.

    PubMed

    Degani, A; Wiener, E L

    1997-05-01

    In complex human-machine systems, successful operations depend on an elaborate set of procedures which are specified by the operational management of the organization. These procedures indicate to the human operator (in this case the pilot) the manner in which operational management intends to have various tasks done. The intent is to provide guidance to the pilots and to ensure a safe, logical, efficient, and predictable (standardized) means of carrying out the objectives of the job. However, procedures can become a hodge-podge. Inconsistent or illogical procedures may lead to noncompliance by operators. Based on a field study with three major airlines, the authors propose a model for procedure development called the "Four P's": philosophy, policies, procedures, and practices. Using this model as a framework, the authors discuss the intricate issue of designing flight-deck procedures, and propose a conceptual approach for designing any set of procedures. The various factors, both external and internal to the cockpit, that must be considered for procedure design are presented. In particular, the paper addresses the development of procedures for automated cockpits--a decade-long, and highly controversial issue in commercial aviation. Although this paper is based on airline operations, we assume that the principles discussed here are also applicable to other high-risk supervisory control systems, such as space flight, manufacturing process control, nuclear power production, and military operations.

  1. An illustration of whole systems thinking.

    PubMed

    Kalim, Kanwal; Carson, Ewart; Cramp, Derek

    2006-08-01

    The complexity of policy-making in the NHS is such that systemic, holistic thinking is needed if the current government's plans are to be realized. This paper describes systems thinking and illustrates its value in understanding the complexity of the diabetes National Service Framework (NSF); its role in identifying problems and barriers previously not predicted; and in reaching conclusions as to how it should be implemented. The approach adopted makes use of soft systems methodology (SSM) devised by Peter Checkland. This analysis reveals issues relating to human communication, information provision and resource allocation needing to be addressed. From this, desirable and feasible changes are explored as means of achieving a more effective NSF, examining possible changes from technical, organizational, economic and cultural perspectives. As well as testing current health policies and plans, SSM can be used to test the feasibility of new health policies. This is achieved by providing a greater understanding and appreciation of what is happening in the real world and how people work. Soft systems thinking is the best approach, given the complexity of health care. It is a flexible, cost-effective solution, which should be a prerequisite before any new health policy is launched.

  2. Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process.

    PubMed

    Etiaba, Enyi; Uguru, Nkoli; Ebenso, Bassey; Russo, Giuliano; Ezumah, Nkoli; Uzochukwu, Benjamin; Onwujekwe, Obinna

    2015-05-06

    In Nigeria, there is a high burden of oral health diseases, poor coordination of health services and human resources for delivery of oral health services. Previous attempts to develop an Oral Health Policy (OHP) to decrease the oral disease burden failed. However, a policy was eventually developed in November 2012. This paper explores the role of contextual factors, actors and the policy process in the development of the OHP and possible reasons why the current approved OHP succeeded. The study was undertaken across Nigeria; information gathered through document reviews and in-depth interviews with five groups of purposively selected respondents. Analysis of the policy development process was guided by the policy triangle framework, examining context, policy process and actors involved in the policy development. The foremost enabling factor was the yearning among policy actors for a policy, having had four failed attempts. Other factors were the presence of a democratically elected government, a framework for health sector reform instituted by the Federal Ministry of Health (FMOH). The approved OHP went through all stages required for policy development unlike the previous attempts. Three groups of actors played crucial roles in the process, namely academics/researchers, development partners and policy makers. They either had decision making powers or influenced policy through funding or technical ability to generate credible research evidence, all sharing a common interest in developing the OHP. Although evidence was used to inform the development of the policy, the complex interactions between the context and actors facilitated its approval. The OHP development succeeded through a complex inter-relationship of context, process and actors, clearly illustrating that none of these factors could have, in isolation, catalyzed the policy development. Availability of evidence is necessary but not sufficient for developing policies in this area. Wider socio-political contexts in which actors develop policy can facilitate and/or constrain actors' roles and interests as well as policy process. These must be taken into consideration at stages of policy development in order to produce policies that will strengthen the health system, especially in low and middle-income countries, where policy processes and influences can be often less than transparent.

  3. Adoption and Design of Emerging Dietary Policies to Improve Cardiometabolic Health in the US.

    PubMed

    Huang, Yue; Pomeranz, Jennifer; Wilde, Parke; Capewell, Simon; Gaziano, Tom; O'Flaherty, Martin; Kersh, Rogan; Whitsel, Laurie; Mozaffarian, Dariush; Micha, Renata

    2018-04-14

    Suboptimal diet is a leading cause of cardiometabolic disease and economic burdens. Evidence-based dietary policies within 5 domains-food prices, reformulation, marketing, labeling, and government food assistance programs-appear promising at improving cardiometabolic health. Yet, the extent of new dietary policy adoption in the US and key elements crucial to define in designing such policies are not well established. We created an inventory of recent US dietary policy cases aiming to improve cardiometabolic health and assessed the extent of their proposal and adoption at federal, state, local, and tribal levels; and categorized and characterized the key elements in their policy design. Recent federal dietary policies adopted to improve cardiometabolic health include reformulation (trans-fat elimination), marketing (mass-media campaigns to increase fruits and vegetables), labeling (Nutrition Facts Panel updates, menu calorie labeling), and food assistance programs (financial incentives for fruits and vegetables in the Supplemental Nutrition Assistance Program (SNAP) and Women, Infant and Children (WIC) program). Federal voluntary guidelines have been proposed for sodium reformulation and food marketing to children. Recent state proposals included sugar-sweetened beverage (SSB) taxes, marketing restrictions, and SNAP restrictions, but few were enacted. Local efforts varied significantly, with certain localities consistently leading in the proposal or adoption of relevant policies. Across all jurisdictions, most commonly selected dietary targets included fruits and vegetables, SSBs, trans-fat, added sugar, sodium, and calories; other healthy (e.g., nuts) or unhealthy (e.g., processed meats) factors were largely not addressed. Key policy elements to define in designing these policies included those common across domains (e.g., level of government, target population, dietary target, dietary definition, implementation mechanism), and domain-specific (e.g., media channels for food marketing domain) or policy-specific (e.g., earmarking for taxes) elements. Characteristics of certain elements were similarly defined (e.g., fruit and vegetable definition, warning language used in SSB warning labels), while others varied across cases within a policy (e.g., tax base for SSB taxes). Several key elements were not always sufficiently characterized in government documents, and dietary target selections and definitions did not consistently align with the evidence-base. These findings highlight recent action on dietary policies to improve cardiometabolic health in the US; and key elements necessary to design such policies.

  4. Two logics of policy intervention in immigrant integration: an institutionalist framework based on capabilities and aspirations.

    PubMed

    Lutz, Philipp

    2017-01-01

    The effectiveness of immigrant integration policies has gained considerable attention across Western democracies dealing with ethnically and culturally diverse societies. However, the findings on what type of policy produces more favourable integration outcomes remain inconclusive. The conflation of normative and analytical assumptions on integration is a major challenge for causal analysis of integration policies. This article applies actor-centered institutionalism as a new framework for the analysis of immigrant integration outcomes in order to separate two different mechanisms of policy intervention. Conceptualising integration outcomes as a function of capabilities and aspirations allows separating assumptions on the policy intervention in assimilation and multiculturalism as the two main types of policy approaches. The article illustrates that assimilation is an incentive-based policy and primarily designed to increase immigrants' aspirations, whereas multiculturalism is an opportunity-based policy and primarily designed to increase immigrants' capabilities. Conceptualising causal mechanisms of policy intervention clarifies the link between normative concepts of immigrant integration and analytical concepts of policy effectiveness.

  5. Complexity of Work-Life Identities and Policy Development: Implications for Work-Life in Higher Education

    ERIC Educational Resources Information Center

    Lester, Jaime

    2016-01-01

    This chapter describes the themes that emerged in this volume with attention to important policy implications on the federal, state, and institutional levels. Recommendations for future research are provided.

  6. Trade policy and public health.

    PubMed

    Friel, Sharon; Hattersley, Libby; Townsend, Ruth

    2015-03-18

    Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health.

  7. False Dichotomies and Health Policy Research Designs: Randomized Trials Are Not Always the Answer.

    PubMed

    Soumerai, Stephen B; Ceccarelli, Rachel; Koppel, Ross

    2017-02-01

    Some medical scientists argue that only data from randomized controlled trials (RCTs) are trustworthy. They claim data from natural experiments and administrative data sets are always spurious and cannot be used to evaluate health policies and other population-wide phenomena in the real world. While many acknowledge biases caused by poor study designs, in this article we argue that several valid designs using administrative data can produce strong findings, particularly the interrupted time series (ITS) design. Many policy studies neither permit nor require an RCT for cause-and-effect inference. Framing our arguments using Campbell and Stanley's classic research design monograph, we show that several "quasi-experimental" designs, especially interrupted time series (ITS), can estimate valid effects (or non-effects) of health interventions and policies as diverse as public insurance coverage, speed limits, hospital safety programs, drug abuse regulation and withdrawal of drugs from the market. We further note the recent rapid uptake of ITS and argue for expanded training in quasi-experimental designs in medical and graduate schools and in post-doctoral curricula.

  8. Why performance-based contracting failed in Uganda--an "open-box" evaluation of a complex health system intervention.

    PubMed

    Ssengooba, Freddie; McPake, Barbara; Palmer, Natasha

    2012-07-01

    Performance-based contracting (PBC) is a tool that links rewards to attainment of measurable performance targets. Significant problems remain in the methods used to evaluate this tool. The primary focus of evaluations on the effects of PBC (black-box) and less attention to how these effects arise (open-box) generates suboptimal policy learning. A black-box impact evaluation of PBC pilot by the Development Research Group of the World Bank (DRG) and the Ministry of Health (MOH) concluded that PBC was ineffective. This paper reports a theory-based case study intended to clarify how and why PBC failed to achieve its objectives. To explain the observed PBC implementation and responses of participants, this case study employed two related theories i.e. complex adaptive system and expectancy theory respectively. A prospective study trailed the implementation of PBC (2003-2006) while collecting experiences of participants at district and hospital levels. Significant problems were encountered in the implementation of PBC that reflected its inadequate design. As problems were encountered, hasty adaptations resulted in a de facto intervention distinct from the one implied at the design stage. For example, inadequate time was allowed for the selection of service targets by the health centres yet they got 'locked-in' to these poor choices. The learning curve and workload among performance auditors weakened the validity of audit results. Above all, financial shortfalls led to delays, short-cuts and uncertainty about the size and payment of bonuses. The lesson for those intending to implement similar interventions is that PBC should not be attempted 'on the cheap'. It requires a plan to boost local institutional and technical capacities of implementers. It also requires careful consideration of the responses of multiple actors - both insiders and outsiders to the intended change process. Given the costs and complexity of PBC implementation, strengthening conventional approaches that are better attuned to low income contexts (financing resource inputs and systems management) remains a viable policy option towards improving health service delivery. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Impact of emergency medical services stroke routing protocols on Primary Stroke Center certification in California.

    PubMed

    Schuberg, Sam; Song, Sarah; Saver, Jeffrey L; Mack, William J; Cen, Steven Y; Sanossian, Nerses

    2013-12-01

    Organized stroke systems of care include Primary Stroke Center (PSC) certification and preferential emergency medical services (EMS) routing of suspected patients with stroke to designated PSCs. Stroke EMS routing is not nationally governed; in California, routing is determined by county. EMS routing policies might provide an incentive for PSC accreditation. We evaluated the relationship between independent adoption of EMS routing protocols and PSC designation acquisition in California. Dates of PSC certification were obtained through The Joint Commissions Website and confirmatory calls to stroke coordinators. Starting date of county EMS PSC routing policies was obtained from county EMS agencies. We provide descriptive analysis of number of hospitals achieving PSC designation relative to implementation of EMS routing policies for all counties with PSCs. By June 2012, there were 131 California PSCs in 27 counties, and 22 of 58 counties had implemented EMS routing policies. The greatest number of PSCs was in Los Angeles (30) followed by San Diego (11), Orange (9), and Santa Clara (9) counties. Achievement of PSC designation occurred more frequently immediately before and after EMS routing: 51 PSCs (39%) within 1 year; 85 PSCs (65%) within 2 years. The yearly rate of eligible hospital conversion to PSC designation accelerated concurrent with EMS diversion policy adoption from 3.8% before to 16.2% during and decelerated afterward to 7.6%. Implementation of EMS routing policies may be an important factor driving PSC certification. National adoption of stroke routing policies may lead to more PSCs, positively impacting patient care.

  10. Economic Growth, Climate Change, and Obesity.

    PubMed

    Minos, Dimitrios; Butzlaff, Iris; Demmler, Kathrin Maria; Rischke, Ramona

    2016-12-01

    Human and planetary health as well as economic growth are firmly interlinked and subject to complex interaction effects. In this paper, we provide an overview of interlinkages between economic growth, climate change, and obesity focusing on recent advances in the literature. In addition to empirical findings, we discuss different theoretical frameworks used to conceptualize these complex links and highlight policy options and challenges. We conclude that policies addressing both climate change and obesity simultaneously are particularly promising and often suitable for ensuring sustainable development.

  11. Holistic flood risk assessment using agent-based modelling: the case of Sint Maarten Island

    NASA Astrophysics Data System (ADS)

    Abayneh Abebe, Yared; Vojinovic, Zoran; Nikolic, Igor; Hammond, Michael; Sanchez, Arlex; Pelling, Mark

    2015-04-01

    Floods in coastal regions are regarded as one of the most dangerous and harmful disasters. Though commonly referred to as natural disasters, coastal floods are also attributable to various social, economic, historical and political issues. Rapid urbanisation in coastal areas combined with climate change and poor governance can lead to a significant increase in the risk of pluvial flooding coinciding with fluvial and coastal flooding posing a greater risk of devastation in coastal communities. Disasters that can be triggered by hydro-meteorological events are interconnected and interrelated with both human activities and natural processes. They, therefore, require holistic approaches to help understand their complexity in order to design and develop adaptive risk management approaches that minimise social and economic losses and environmental impacts, and increase resilience to such events. Being located in the North Atlantic Ocean, Sint Maarten is frequently subjected to hurricanes. In addition, the stormwater catchments and streams on Sint Maarten have several unique characteristics that contribute to the severity of flood-related impacts. Urban environments are usually situated in low-lying areas, with little consideration for stormwater drainage, and as such are subject to flash flooding. Hence, Sint Maarten authorities drafted policies to minimise the risk of flood-related disasters on the island. In this study, an agent-based model is designed and applied to understand the implications of introduced policies and regulations, and to understand how different actors' behaviours influence the formation, propagation and accumulation of flood risk. The agent-based model built for this study is based on the MAIA meta-model, which helps to decompose, structure and conceptualize socio-technical systems with an agent-oriented perspective, and is developed using the NetLogo simulation environment. The agents described in this model are households and businesses, and policies on spatial planning rules are implemented. Preliminary results demonstrate the evolving nature of flood risks and describe the effectiveness of different planning policies to reduce risk and increase resilience.

  12. Ecological public health and climate change policy.

    PubMed

    Morris, George P

    2010-01-01

    The fact that health and disease are products of a complex interaction of factors has long been recognized in public health circles. More recently, the term 'ecological public health' has been used to characterize an era underpinned by the paradigm that, when it comes to health and well-being, 'everything matters'. The challenge for policy makers is one of navigating this complexity to deliver better health and greater equality in health. Recent work in Scotland has been concerned to develop a strategic approach to environment and health. This seeks to embrace complexity within that agenda and recognize a more subtle relationship between health and place but remain practical and relevant to a more traditional hazard-focused environmental health approach. The Good Places, Better Health initiative is underpinned by a new problem-framing approach using a conceptual model developed for that purpose. This requires consideration of a wider social, behavioural etc, context. The approach is also used to configure the core systems of the strategy which gather relevant intelligence, subject it to a process of evaluation and direct its outputs to a broad policy constituency extending beyond health and environment. This paper highlights that an approach, conceived and developed to deliver better health and greater equality in health through action on physical environment, also speaks to a wider public health agenda. Specifically it offers a way to help bridge a gap between paradigm and policy in public health. The author considers that with development, a systems-based approach with close attention to problem-framing/situational modelling may prove useful in orchestrating what is a necessarily complex policy response to mitigate and adapt to climate change.

  13. How is unemployment among people with mental illness conceptualized within social policy? A case study of the Ontario Disability Support Program.

    PubMed

    Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

    2015-01-01

    Government policy shapes and is shaped by society's views of important social issues such as employment among people with disabilities. This article explores how unemployment among people with mental illness has been understood and characterized within social policy. Drawing on a qualitative case study that explored the construction and implementation of policy reform within the employment support branch of the Ontario Disability Support Program, this paper examines assumptions about unemployment among people with mental illness that underlie social policy and their impact on employment services and supports. The most prominent messages that emerged from the data focused on unemployment among people with mental illness as a function of personal responsibility, limitations and a lack of motivation. Although there was awareness of the role of social and systemic factors, these issues were given less weight, especially when describing employment support practices. There is a lack of sufficient attention to complex and deeply-rooted social and systemic inequalities within social policy and employment services. There is a need to expand conceptualizations of unemployment among people with mental illness within social policy, and develop interventions that address complex social factors and systemic constraints that can limit employment opportunities.

  14. Technology policy and sustainability: An empirical study of renewable energy development in India

    NASA Astrophysics Data System (ADS)

    Iyer, Maithili

    In the debate over sustainability and development paradigms, energy assumes a unique position by virtue of its direct link with environmental sustainability and its role as an essential vehicle for development. Agenda 21 recognizes that coupling end-use energy efficiency with renewable sources of energy will help meet a large share of the world's energy needs while reducing the environmental impacts of energy use. Nevertheless, the extent and scope of diffusion of new and renewable energy technologies is contingent upon the capabilities of the countries concerned to realize firstly, a need, and subsequently, the resources for utilizing the technologies. India has one of the largest renewable energy programs (REPs) in the world, however, renewables continue to remain a marginal contributor to the total energy supply. The need to fundamentally change the program design of REPs has been suggested by many critics and experts in view of the implementation problems. However, mainstream thinking maintains that Poor financial conditions in the energy sector, not program design flaws, are at the heart of poor implementation results, leading to the premise that infusion of capital and efforts at market transformation through the involvement of the private sector could solve the problem. This dissertation uses case studies on solar photovoltaics, wind energy, and biogas in India to analyze the implementation of renewable energy technologies. Based on stakeholder interviews, documents, and site visits, this dissertation argues that the problems currently recognized are in reality symptomatic of a combination of three underlying problems: (1) An inadequate understanding of the needs of energy users and the complex interplay of existing policies and technological choices with user needs and behavior; (2) An institutional network, both at the local and the national level, that lacks the capacity to facilitate information exchange within and between institutions, thereby losing the opportunity to transfer valuable knowledge gained from implementing REPs; and (3) A program design that does not include adequate planning for infrastructure and policy support, which undermines the effectiveness of the programs.

  15. Determinants analysis of outpatient service utilisation in Georgia: can the approach help inform benefit package design?

    PubMed

    Gotsadze, George; Tang, Wenze; Shengelia, Natia; Zoidze, Akaki

    2017-05-02

    The healthcare financing reforms initiated by the Government of Georgia in 2007 have positively affected inpatient service utilisation and enhanced financial protection, especially for the poor, but they have failed to facilitate outpatient service use among chronic patients. Non-communicable diseases significantly affect Georgia's ageing population. Consequently, in this paper, we look at the evidence emerging from determinants analysis of outpatient service utilisation and if the finding can help identify possible policy choices in Georgia, especially regarding benefit package design for individuals with chronic conditions. We used Andersen's behavioural model of health service utilisation to identify the critical determinants that affect outpatient service use. A multinomial logistic regression was carried out with complex survey design using the data from two nationally representative cross-sectional population-based health utilisation and expenditure surveys conducted in Georgia in 2007 and 2010, which allowed us to assess the relationship between the determinants and outpatient service use. The study revealed the determinants that significantly impede outpatient service use. Low income, 45- to 64-year-old Georgian males with low educational attainment and suffering from a chronic health problem have the lowest odds for service use compared to the rest of the population. Using Andersen's behavioural model and assessing the determinants of outpatient service use has the potential to inform possible policy responses, especially those driving services use among chronic patients. The possible policy responses include reducing financial access barriers with the help of public subsidies for sub-groups of the population with the lowest access to care; focusing/expanding state-funded benefits for the most prevalent chronic conditions, which are responsible for the greatest disease burden; or supporting chronic disease management programs for the most prevalent chronic diseases and for special age groups aimed at the timely detection, education and management of chronic patients.

  16. 75 FR 52780 - Designation of Nine Counties as High Intensity Drug Trafficking Areas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... EXECUTIVE OFFICE OF THE PRESIDENT Office of National Drug Control Policy Designation of Nine Counties as High Intensity Drug Trafficking Areas ACTION: Notice. SUMMARY: The Director of the Office of National Drug Control Policy designated nine additional counties as High Drug Trafficking Areas pursuant to...

  17. 75 FR 21368 - Designation of Five Counties as High Intensity Drug Trafficking Areas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... EXECUTIVE OFFICE OF THE PRESIDENT Office of National Drug Control Policy Designation of Five Counties as High Intensity Drug Trafficking Areas ACTION: Notice. SUMMARY: The Director of the Office of National Drug Control Policy designated five additional counties as High Drug Trafficking Areas pursuant to...

  18. A NEW FRAMEWORK FOR URBAN SUSTAINABILITY ASSESSMENTS: LINKING COMPLEXITY, INFORMATION AND POLICY

    EPA Science Inventory

    Urban systems emerge as distinct entities from the complex interactions among social, economic and cultural attributes, and information, energy and material stocks and flows that operate on different temporal and spatial scales. Such complexity poses a challenge to identify the...

  19. NEW FRAMEWORKS FOR URBAN SUSTAINABILITY ASSESSMENTS: LINKING COMPLEXITY, INFORMATION AND POLICY

    EPA Science Inventory

    Urban systems emerge as distinct entities from the complex interactions among social, economic and cultural attributes, and information, energy and material stocks and flows that operate on different temporal and spatial scales. Such complexity poses a challenge to identify the c...

  20. Healthy by Design: Using a Gender Focus to Influence Complete Streets Policy.

    PubMed

    Keippel, April Ennis; Henderson, Melissa A; Golbeck, Amanda L; Gallup, TommiLee; Duin, Diane K; Hayes, Stephen; Alexander, Stephanie; Ciemins, Elizabeth L

    2017-10-17

    Public health leaders in Yellowstone County, Montana, formed an alliance to address community-wide issues. One such issue is Complete Streets, with its vision of safe streets for all. This case study focuses on development and adoption of a Complete Streets policy. It examines how a community coalition, Healthy By Design, infused a gender focus into the policymaking process. An incremental and nonlinear policymaking process was aided by a focus on gender and health equity. The focus on a large constituency helped to frame advocacy in terms of a broad population's needs, not just special interests. The city council unanimously adopted a Complete Streets resolution, informed by a gender lens. Healthy By Design further used gender information to successfully mobilize the community in response to threats of repeal of the policy, and then influenced the adoption of a revised policy. Policies developed with a focus on equity, including gender equity, may have broader impact on the community. Such policies may pave the way for future policies that seek to transform gender norms toward building a healthier community for all residents. Published by Elsevier Inc.

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