"Harnessing genomics to improve health in Africa" - an executive course to support genomics policy.

PubMed

Smith, Alyna C; Mugabe, John; Singer, Peter A; Daar, Abdallah S

2005-01-24

BACKGROUND: Africa in the twenty-first century is faced with a heavy burden of disease, combined with ill-equipped medical systems and underdeveloped technological capacity. A major challenge for the international community is to bring scientific and technological advances like genomics to bear on the health priorities of poorer countries. The New Partnership for Africa's Development has identified science and technology as a key platform for Africa's renewal. Recognizing the timeliness of this issue, the African Centre for Technology Studies and the University of Toronto Joint Centre for Bioethics co-organized a course on Genomics and Public Health Policy in Nairobi, Kenya, the first of a series of similar courses to take place in the developing world. This article presents the findings and recommendations that emerged from this process, recommendations which suggest that a regional approach to developing sound science and technology policies is the key to harnessing genome-related biotechnology to improve health and contribute to human development in Africa. METHODS: The objectives of the course were to familiarize participants with the current status and implications of genomics for health in Africa; to provide frameworks for analyzing and debating the policy and ethical questions; and to begin developing a network across different sectors by sharing perspectives and building relationships. To achieve these goals the course brought together a diverse group of stakeholders from academic research centres, the media, non-governmental, voluntary and legal organizations to stimulate multi-sectoral debate around issues of policy. Topics included scientific advances in genomics innovation systems and business models, international regulatory frameworks, as well as ethical and legal issues. RESULTS: Seven main recommendations emerged: establish a network for sustained dialogue among participants; identify champions among politicians; use the New Plan for African Development (NEPAD) as entry point onto political agenda; commission an African capacity survey in genomics-related R&D to determine areas of strength; undertake a detailed study of R&D models with demonstrated success in the developing world, i.e. China, India, Cuba, Brazil; establish seven regional research centres of excellence; and, create sustainable financing mechanisms. A concrete outcome of this intensive five-day course was the establishment of the African Genome Policy Forum, a multi-stakeholder forum to foster further discussion on policy. CONCLUSION: With African leaders engaged in the New Partnership for Africa's Development, science and technology is well poised to play a valuable role in Africa's renewal, by contributing to economic development and to improved health. Africa's first course on Genomics and Public Health Policy aspired to contribute to the effort to bring this issue to the forefront of the policy debate, focusing on genomics through the lens of public health. The process that has led to this course has served as a model for three subsequent courses (in India, Venezuela and Oman), and the establishment of similar regional networks on genomics and policy, which could form the basis for inter-regional dialogue in the future.

Conversational Interaction and the Development of Conversational Competence in Additional Languages in Higher Education: Considerations for Students, Language Centres, and Language Policy Developers

ERIC Educational Resources Information Center

Meyer, Stephan; Blondel, Valérie; Mall-Grob, Beatrice

2017-01-01

This article addresses the questions: why is the development of conversational competence important within higher education? And how might this goal be pursued? We offer answers that may aid a broad range of stakeholders (language learners, course designers, lecturers, language development managers, and policy makers) in thinking through these…

Training early childcare providers in evidence-based nutrition strategies can help improve nutrition policies and practices of early childcare centres serving racially and ethnically diverse children from low-income families.

PubMed

Hollar, T Lucas; Cook, Nicole; Natale, Ruby; Quinn, David; Phillips, Teina; DeLucca, Michael

2018-05-01

We evaluated the extent to which providing training and technical assistance to early childcare centre (ECC) directors, faculty and staff in the implementation of evidence-based nutrition strategies improved the nutrition contexts, policies and practices of ECC serving racially and ethnically diverse, low-income children in Broward County, Florida, USA. The nutrition strategies targeted snack and beverage policies and practices, consistent with Caring for Our Children National Standards. We used the nutrition observation and document review portions of the Environment and Policy Assessment and Observation (EPAO) instrument to observe ECC as part of a one-group pre-test/post-test evaluation design. ECC located within areas of high rates of poverty, diabetes, minority representation and unhealthy food index in Broward County, Florida, USA. Eighteen ECC enrolled, mean 112·9 (sd 53·4) children aged 2-5 years; 12·3 (sd 7·2) staff members; and 10·2 (sd 4·6) children per staff member at each centre. We found significant improvements in centres' overall nutrition contexts, as measured by total EPAO nutrition scores (P=0·01). ECC made specific significant gains within written nutrition policies (P=0·03) and nutrition training and education (P=0·01). Our findings support training ECC directors, faculty and staff in evidence-based nutrition strategies to improve the nutrition policies and practices of ECC serving racially and ethnically diverse children from low-income families. The intervention resulted in improvements in some nutrition policies and practices, but not others. There remains a need to further develop the evaluation base involving the effectiveness of policy and practice interventions within ECC serving children in high-need areas.

One stop crisis centres: A policy analysis of the Malaysian response to intimate partner violence

PubMed Central

2011-01-01

Background This article aims to investigate the processes, actors and other influencing factors behind the development and the national scale-up of the One Stop Crisis Centre (OSCC) policy and the subsequent health model for violence-response. Methods Methods used included policy analysis of legal, policy and regulatory framework documents, and in-depth interviews with key informants from governmental and non-governmental organisations in two States of Malaysia. Results The findings show that women's NGOs and health professionals were instrumental in the formulation and scaling-up of the OSCC policy. However, the subsequent breakdown of the NGO-health coalition negatively impacted on the long-term implementation of the policy, which lacked financial resources and clear policy guidance from the Ministry of Health. Conclusion The findings confirm that a clearly-defined partnership between NGOs and health staff can be very powerful for influencing the legal and policy environment in which health care services for intimate partner violence are developed. It is critical to gain high level support from the Ministry of Health in order to institutionalise the violence-response across the entire health care system. Without clear operational details and resources policy implementation cannot be fully ensured and taken to scale. PMID:21693029

Risks for Children? Recent Developments in Early Childcare Policy in Germany

ERIC Educational Resources Information Center

Hubenthal, Maksim; Ifland, Anna Maria

2011-01-01

For some years now, a "child-centred social investment strategy" has been gaining influence in the German welfare state. In this context we are witnessing a social-investive turn within the policy for children and families and a significant increase in the importance of early childcare policy. Whereas the German federal government is…

Problems and Prospects of Education Resource Centres in Nigeria

ERIC Educational Resources Information Center

Ekanem, Johnson Efiong

2015-01-01

Nigeria has good policies on Education and one of such policies is the establishment of Education Resource Centres in every State of the Federation, including the Federal Capital Territory, Abuja. The need is clearly articulated in the National Policy on Education. Despite the lofty plan, most of the centres are not fulfilling the need for their…

Six essential roles of health promotion research centres: the Atlantic Canada experience

PubMed Central

Langille, Lynn L.; Crowell, Sandra J.; Lyons, Renée F.

2009-01-01

SUMMARY Over the past 20 years, the federal government and universities across Canada have directed resources towards the development of university-based health promotion research centres. Researchers at health promotion research centres in Canada have produced peer-reviewed papers and policy documents based on their work, but no publications have emerged that focus on the specific roles of the health promotion research centres themselves. The purpose of this paper is to propose a framework, based on an in-depth examination of one centre, to help identify the unique roles of health promotion research centres and to clarify the value they add to promoting health and advancing university goals. Considering the shifting federal discourse on health promotion over time and the vulnerability of social and health sciences to changes in research funding priorities, health promotion research centres in Canada and elsewhere may need to articulate their unique roles and contributions in order to maintain a critical focus on health promotion research. The authors briefly describe the Atlantic Health Promotion Research Centre (AHPRC), propose a framework that illustrates six essential roles of health promotion research centres and describe the policy contexts and challenges of health promotion research centres. The analysis of research and knowledge translation activities over 15 years at AHPRC sheds light on the roles that health promotion research centres play in applied research. The conclusion raises questions regarding the value of university-based research centres and challenges to their sustainability. PMID:19171668

Changing Social Institutions to Improve the Status of Women in Developing Countries. OECD Development Centre Policy Brief No. 27

ERIC Educational Resources Information Center

Jutting, Johannes: Morrisson, Christian

2005-01-01

One of the long-standing priorities of the international community is to reduce gender disparity in developing countries. Yet, the overall picture is still gloomy: women continue to be excluded from access to resources and employment and are denied basic human rights. This Policy Brief explains why progress has been so minimal and what should be…

"Harnessing genomics to improve health in Africa" – an executive course to support genomics policy

PubMed Central

Smith, Alyna C; Mugabe, John; Singer, Peter A; Daar, Abdallah S

2005-01-01

Background Africa in the twenty-first century is faced with a heavy burden of disease, combined with ill-equipped medical systems and underdeveloped technological capacity. A major challenge for the international community is to bring scientific and technological advances like genomics to bear on the health priorities of poorer countries. The New Partnership for Africa's Development has identified science and technology as a key platform for Africa's renewal. Recognizing the timeliness of this issue, the African Centre for Technology Studies and the University of Toronto Joint Centre for Bioethics co-organized a course on Genomics and Public Health Policy in Nairobi, Kenya, the first of a series of similar courses to take place in the developing world. This article presents the findings and recommendations that emerged from this process, recommendations which suggest that a regional approach to developing sound science and technology policies is the key to harnessing genome-related biotechnology to improve health and contribute to human development in Africa. Methods The objectives of the course were to familiarize participants with the current status and implications of genomics for health in Africa; to provide frameworks for analyzing and debating the policy and ethical questions; and to begin developing a network across different sectors by sharing perspectives and building relationships. To achieve these goals the course brought together a diverse group of stakeholders from academic research centres, the media, non-governmental, voluntary and legal organizations to stimulate multi-sectoral debate around issues of policy. Topics included scientific advances in genomics innovation systems and business models, international regulatory frameworks, as well as ethical and legal issues. Results Seven main recommendations emerged: establish a network for sustained dialogue among participants; identify champions among politicians; use the New Plan for African Development (NEPAD) as entry point onto political agenda; commission an African capacity survey in genomics-related R&D to determine areas of strength; undertake a detailed study of R&D models with demonstrated success in the developing world, i.e. China, India, Cuba, Brazil; establish seven regional research centres of excellence; and, create sustainable financing mechanisms. A concrete outcome of this intensive five-day course was the establishment of the African Genome Policy Forum, a multi-stakeholder forum to foster further discussion on policy. Conclusion With African leaders engaged in the New Partnership for Africa's Development, science and technology is well poised to play a valuable role in Africa's renewal, by contributing to economic development and to improved health. Africa's first course on Genomics and Public Health Policy aspired to contribute to the effort to bring this issue to the forefront of the policy debate, focusing on genomics through the lens of public health. The process that has led to this course has served as a model for three subsequent courses (in India, Venezuela and Oman), and the establishment of similar regional networks on genomics and policy, which could form the basis for inter-regional dialogue in the future. PMID:15667651

Regional Centre of Expertise as Transformational Platform for Sustainability: A Case Study of Universiti Sains Malaysia, Penang

ERIC Educational Resources Information Center

Sanusi, Zainal Abidin; Khelghat-Doost, Hamoon

2008-01-01

Purpose: The purpose of this paper is to share the experience of Universiti Sains Malaysia in promoting the sustainable development agenda through its leadership role in the Regional Centre of Expertise (RCE) Penang using an "inside-out approach". Design/methodology/approach: This paper describes the institutional structure, policies and…

Mind the Gap: Global Quality Norms, National Policy Interpretations and Local Praxis in Timor-Leste

ERIC Educational Resources Information Center

Shah, Ritesh; Quinn, Marie

2016-01-01

Increasingly, the imperative for improving educational quality in schooling systems throughout the developing world is harnessed to a particular set of teaching and learning practices, such as child-centred, child-friendly or learner-centred pedagogy (LCP). Such was the case in Timor-Leste where, after independence, LCP was heavily promoted as a…

Policy recommendations for rare disease centres of expertise.

PubMed

Syed, Ahmed M; Camp, Rob; Mischorr-Boch, Christina; Houÿez, Francois; Aro, Arja R

2015-10-01

Rare diseases are a serious public health concern and are a priority in the EU. This study aims to develop policy recommendations for rare disease centres of expertise (CoEs) in order to improve standards and quality of care. A modified 3-round Delphi technique was used. Participants included rare diseases patients, carers, patient representatives and healthcare professionals (HCPs) from CoEs in two countries-Denmark and the UK. The results suggest the need to make improvements within current CoE environments, access to CoEs and the need for coordination and cooperation of services within and outside CoEs. It is recommended that CoEs are not overly 'medicalised', while at the same time they should be established as research facilities. The importance of including patient representatives in CoE performance management was also highlighted. Raising awareness and provision of appropriate training amongst non-specialist HCPs is seen as a priority for early and correct diagnosis and ensuring high quality care. Similarly, provision of targeted information about patients' illness and care was considered essential along with access to social assistance within CoEs. Policy recommendations were developed in areas previously recognised as having gaps. Their implementation is expected to strengthen and improve current care provision for rare disease patients. In member states where national plans and strategies are being developed, it is recommended to replicate the methodological approach used in this study as it has proven to be a helpful tool in rare disease centres of expertise policy development. Copyright © 2015 Elsevier Ltd. All rights reserved.

Person-centred medicines optimisation policy in England: an agenda for research on polypharmacy.

PubMed

Heaton, Janet; Britten, Nicky; Krska, Janet; Reeve, Joanne

2017-01-01

Aim To examine how patient perspectives and person-centred care values have been represented in documents on medicines optimisation policy in England. There has been growing support in England for a policy of medicines optimisation as a response to the rise of problematic polypharmacy. Conceptually, medicines optimisation differs from the medicines management model of prescribing in being based around the patient rather than processes and systems. This critical examination of current official and independent policy documents questions how central the patient is in them and whether relevant evidence has been utilised in their development. A documentary analysis of reports on medicines optimisation published by the Royal Pharmaceutical Society (RPS), The King's Fund and National Institute for Health and Social Care Excellence since 2013. The analysis draws on a non-systematic review of research on patient experiences of using medicines. Findings The reports varied in their inclusion of patient perspectives and person-centred care values, and in the extent to which they drew on evidence from research on patients' experiences of polypharmacy and medicines use. In the RPS report, medicines optimisation is represented as being a 'step change' from medicines management, in contrast to the other documents which suggest that it is facilitated by the systems and processes that comprise the latter model. Only The King's Fund report considered evidence from qualitative studies of people's use of medicines. However, these studies are not without their limitations. We suggest five ways in which researchers could improve this evidence base and so inform the development of future policy: by facilitating reviews of existing research; conducting studies of patient experiences of polypharmacy and multimorbidity; evaluating medicines optimisation interventions; making better use of relevant theories, concepts and tools; and improving patient and public involvement in research and in guideline development.

It's more than money: policy options to secure medical specialist workforce for regional centres.

PubMed

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

Corrigendum to: It's more than money: policy options to secure medical specialist workforce for regional centres.

PubMed

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

The "German Children" of Mozambique: Long-Term Legacies of a Socialist Educational Experiment

ERIC Educational Resources Information Center

Muller, Tanja R.

2012-01-01

State-led education policies that centre on citizenship formation and are based on socialist-inspired values have been found in many newly independent post-colonial regimes. Such policies have led to a number of educational exchange programmes between developing countries and former "Eastern Bloc" countries. This paper looks at an…

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

ERIC Educational Resources Information Center

Riddell, Sheila; Weedon, Elisabet

2014-01-01

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

Social policy and drug dependence: an historical case study.

PubMed

Smart, C

1985-11-01

A detailed examination is presented of the background to the reports and policy developments concerning drug dependence which emerged in Britain during the 1960s. Analysis of documents and interviews with policy makers, officials and doctors involved in the events of the period, reveal that explanatory models in terms of 'moral panic' or 'power struggle' tend to oversimplify the complex processes involved. The role in policy formation of the media, government departments and groups within the medical profession is considered. The patterns of conflict and convergence are seen to overlap simple lines of 'interest'--we find conflict within the medical profession, convergence between the Home Office (legal) and elements of the medical professions (medical). The resulting legal and institutional framework involved only loose guidelines from the centre about treatment, and the shape of policy was determined by individual doctors in the new hospital treatment centres. The apparent re-run of the 1960s being staged in the 1980s will require detailed research in the future in order to avoid superficial comparisons.

Addiction research centres and the nurturing of creativity. The Centre for Alcohol and Drug Research: social science alcohol and drug research in Denmark.

PubMed

Pedersen, Mads U; Elmeland, Karen; Frank, Vibeke A

2011-12-01

The purpose of this paper is to introduce the social science alcohol and drug research undertaken by the Centre for Alcohol and Drug Research (CRF) and at the same time offer an insight into the development in Danish alcohol and drug research throughout the past 15-20 years. A review of articles, books and reports published by researcher from CRF from the mid-1990s until today and an analysis of the policy-making in the Danish substance use and misuse area. CRF is a result of the discussions surrounding social, health and allocation policy questions since the mid-1980s. Among other things, these discussions led to the formal establishment of the Centre in 1991 under the Aarhus University, the Faculty of Social Science. Since 2001 the Centre has received a permanent basic allocation, which has made it possible to appoint tenured senior researchers; to work under a more long-term research strategy; to function as a milieu for educating PhD students; and to diversify from commissioned research tasks to initiating projects involving more fundamental research. Research at the Centre is today pivoted around four core areas: consumption, policy, prevention and treatment. The emergence, continuation, financing and character of the research taking place at CRF can be linked closely to the specific Danish drug and alcohol discourse and to the division of the responsibility for alcohol and drug research into separate Ministries. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

The Australian Prevention Partnership Centre: systems thinking to prevent lifestyle-related chronic illness.

PubMed

Wilson, Andrew; Wutzke, Sonia; Overs, Marge

2014-11-28

Chronic diseases are the major cause of death in Australia and the biggest contributor to premature death and disability. Although prevention of chronic disease can be effective and cost-effective, it has proven difficult to systematically implement interventions that target important lifestyle-related risk factors for chronic disease such as poor nutrition, physical inactivity and harmful alcohol use. Prevention efforts targeting these lifestyle-related risk factors have had mixed success due to issues around designing and implementing effective interventions that address the complexity of risk factors, and incorporating evidence and implementing interventions at a scale, duration, intensity and quality required to achieve population effects. There is increasing recognition that multilevel, multisector approaches are required for the effective and sustained prevention of complex chronic disease. The Australian Prevention Partnership Centre, one of two National Health and Medical Research Council Partnership Centres established in 2013, is researching and developing systems perspectives to prevent lifestyle-related chronic disease in Australia. The Centre's collaborative approach is providing opportunities for researchers to work with policy makers and practitioners to develop research questions, conduct research, and analyse, interpret and disseminate the findings. As such, it is the model of interaction that is being tested as much as the specific projects. With its funding partners, the Centre has developed plans for more than 30 projects. It has also established four capacity units that will improve the gathering, sharing and use of evidence to build a prevention system in Australia. The Centre is exploring new ways to advance prevention by bringing together researchers, policy makers and practitioners to determine the information and actions needed for an effective prevention system for Australia.

Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples.

PubMed

Bailie, Ross; Si, Damin; Shannon, Cindy; Semmens, James; Rowley, Kevin; Scrimgeour, David J; Nagel, Tricia; Anderson, Ian; Connors, Christine; Weeramanthri, Tarun; Thompson, Sandra; McDermott, Robyn; Burke, Hugh; Moore, Elizabeth; Leon, Dallas; Weston, Richard; Grogan, Haylene; Stanley, Andrew; Gardner, Karen

2010-05-19

Strengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE) project has facilitated the implementation of modern Continuous Quality Improvement (CQI) approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1) explore the factors associated with variation in clinical performance; 2) examine specific strategies that have been effective in improving primary care clinical performance; and 3) work with health service staff, management and policy makers to enhance the effective implementation of successful strategies. The study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria) over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management. By linking researchers directly to users of research (service providers, managers and policy makers), the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary health care and fostering effective and efficient exchange and use of data and information among service providers and policy makers to achieve evidence-based resource allocation, service planning, system development, and improvements of service delivery and Indigenous health outcomes.

The challenges of leading change in health-care delivery from the front-line.

PubMed

Byers, Vivienne

2017-09-01

The public sector is facing turbulent times and this challenges nurses, who are expected to serve both patient interests and the efficiency drives of their organisations. In the context of implementing person-centred health policy, this paper explores the evolving role of front-line nurses as leaders and champions of change. Nurses can be seen to have some autonomy in health-care delivery. However, they are subject to systems of social control. In implementing person-centred policy, nurses can be seen to be doing the best they can within a constrained environment. A survey of nursing practice in person-centred health-policy implementation is presented. Despite much being written about managing health-professional resistance to policy implementation, there is a gap between what is being asked of nurses and the resources made available to them to deliver. In this milieu, nurses are utilising their discretion and leading from the front-line in championing change. Empowering nurses who seek to lead patient involvement could be the key to unlocking health-care improvement. Health services tend to be over-managed and under-led and there is a need to harness the potential of front-line nurses by facilitating leadership development through appropriate organisational support. © 2015 John Wiley & Sons Ltd.

Managing and Mobilising Talent in Malaysia: Issues, Challenges and Policy Implications for Malaysian Universities

ERIC Educational Resources Information Center

Azman, Norzaini; Sirat, Morshidi; Pang, Vincent

2016-01-01

The future of Malaysia as a high-income and competitive nation largely depends on its pool of highly skilled human capital. Hence, the issue of human capital development has taken centre stage in numerous reform agendas of Malaysia. This paper seeks to provide examples of policy initiatives aimed at facilitating the management of highly educated…

Doctorate Education in Canada: Findings from the Survey of Earned Doctorates, 2005/2006. Culture, Tourism and the Centre for Education Statistics. Research Paper. Catalogue no. 81-595-M No. 069

ERIC Educational Resources Information Center

King, Darren; Eisl-Culkin, Judy; Desjardins, Louise

2008-01-01

"Doctorate Education in Canada: Findings from the Survey of Earned Doctorates, 2005/2006" is the third paper in a series of reports written by the Learning Policy Directorate of Human Resources and Social Development Canada (HRSDC) and the Centre for Education Statistics of Statistics Canada. Each report presents an overview of doctoral…

Putting Children at the Centre: Making Policy as if Children Mattered

ERIC Educational Resources Information Center

St. John, Susan

2014-01-01

What do we mean when we say we want to put children at the centre of policy? What are the moral justifications for this approach? Has it become harder for us to understand this concept, when in practice paid work has been at the centre? In part confusion arises because the unpaid work of caring for children is invisible until it is marketized. In…

Development and implementation of a nurse-led walk-in centre: evidence lost in translation?

PubMed

Desborough, Jane; Parker, Rhian; Forrest, Laura

2013-07-01

The design of the first Australian public nurse-led primary care walk-in centre was modelled on those established in the English National Health Service (NHS). An independent evaluation of the first 12 months of operation of the Australian Capital Territory (ACT) Health walk-in centre, in 2011, analysed the translation of evidence from the national evaluation of the NHS walk-in centres to the policy development and implementation of the ACT walk-in centre. Whilst in a number of ways the evidence was used well, our interest for this paper was to examine three areas identified as problematic and to identify the points at which the evidence was lost or diluted. In addition to data obtained through nurse and key stakeholder interviews for the evaluation, an analysis was undertaken of documents on the planning and establishment of the ACT walk-in centre, either provided to the evaluation team or made publicly available. Three areas were identified as problematic in the way that evidence from the NHS evaluation was translated: the use of clinical decision support software (CDSS); the marketing of the walk-in centre; and its location. Our examination indicates that despite seeking evidence to inform the development of the ACT walk-in centre, the evidence was not fully used and some clear lessons ignored, resulting in much of the evidence being lost in translation.

Experiences and Lessons Learnt with Collaborative e-Research Infrastructure and the application of Identity Management and Access Control for the Centre for Environmental Data Analysis

NASA Astrophysics Data System (ADS)

Kershaw, P.

2016-12-01

CEDA, the Centre for Environmental Data Analysis, hosts a range of services on behalf of NERC (Natural Environment Research Council) for the UK environmental sciences community and its work with international partners. It is host to four data centres covering atmospheric science, earth observation, climate and space data domain areas. It holds this data on behalf of a number of different providers each with their own data policies which has thus required the development of a comprehensive system to manage access. With the advent of CMIP5, CEDA committed to be one of a number of centres to host the climate model outputs and make them available through the Earth System Grid Federation, a globally distributed software infrastructure developed for this purpose. From the outset, a means for restricting access to datasets was required, necessitating the development a federated system for authentication and authorisation so that access to data could be managed across multiple providers around the world. From 2012, CEDA has seen a further evolution with the development of JASMIN, a multi-petabyte data analysis facility. Hosted alongside the CEDA archive, it provides a range of services for users including a batch compute cluster, group workspaces and a community cloud. This has required significant changes and enhancements to the access control system. In common with many other examples in the research community, the experiences of the above underline the difficulties of developing collaborative e-Research infrastructures. Drawing from these there are some recurring themes: Clear requirements need to be established at the outset recognising that implementing strict access policies can incur additional development and administrative overhead. An appropriate balance is needed between ease of access desired by end users and metrics and monitoring required by resource providers. The major technical challenge is not with security technologies themselves but their effective integration with services and resources which they must protect. Effective policy and governance structures are needed for ongoing operations Federated identity infrastructures often exist only at the national level making it difficult for international research collaborations to exploit them.

Environmental Education in Costa Rica: Building a Framework for Sustainable Development?

ERIC Educational Resources Information Center

Blum, Nicole

2008-01-01

Environmental education is commonly claimed to be at the centre of efforts to achieve sustainable development. Since the 1980s, Costa Rica has been one of the acknowledged leaders in efforts to promote environmental learning, and national policy includes a three-fold national development strategy which simultaneously promotes education,…

Capacity building in anthelmintic drug discovery.

PubMed

Kron, Michael; Yousif, Fouad; Ramirez, Bernadette

2007-10-01

International collaboration in anthelmintic drug discovery holds special challenges compared with local or national discovery projects, and at the same time presents the opportunity to build capacity, forge long lasting inter-institutional relationships and strengthen infrastructure in multinational priority areas. This chapter discusses important issues that should be considered in the context of anthelmintic screening centre development and will give examples (Philippines and Egypt) of the productivity of developing country based screening centres. The positive outcomes of infrastructure building is realised in greater capacities for anthelmintic screening at institutions in the countries where the parasitic diseases are endemic and allows for optimum use of specialised resources for public health priority diseases that may be different from those in Western countries. Support for developing country based screening centres also can help countries optimise product development procedures and policies and can facilitate diffusion of desirable technology in corresponding global regions around the world.

Evaluating the Effects of Vocational Training in Africa (based on the "African Economic Outlook 2008"), OECD Development Centre Policy Insights, No. 61

ERIC Educational Resources Information Center

Kingombe, Christian

2008-01-01

The impact of vocational training on economic growth and poverty reduction in African countries is unknown. Without such knowledge, however, countries and donors cannot formulate appropriate policies. Even the 35 countries surveyed in the 2008 "African Economic Outlook" can only supply approximate data. More and better data are needed to…

Dispositional Development as a Form of Continuous Professional Development: Centre-Based Reflective Practices with Teachers of (Very) Young Children

ERIC Educational Resources Information Center

Swim, Terri Jo; Isik-Ercan, Zeynep

2013-01-01

The nature of professional development in early childhood education has recently been reconceptualised, with accompanying changes in policy and practice. This paper draws from teacher education literature to define the components of continuing professional development practices in the context of early childhood education practice. By relating…

Innovative Approaches to Funding the Millennium Development Goals. OECD Development Centre Policy Brief, No. 24

ERIC Educational Resources Information Center

Reisen, Helmut

2004-01-01

At the United Nations Millennium Summit in September 2000, world leaders adopted the Millennium Development Goals (MDGs), which set targets for reducing poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women by 20151. The need for additional development funding, if the MDGs are to be achieved by 2015, is…

Developing a Culture for Entrepreneurship in the East of England: The Value of Social and Human Capital

ERIC Educational Resources Information Center

Abubakar, Yazid; Mitra, Jay

2007-01-01

Most UK Regional Development Agencies (RDAs) have committed themselves to developing an Enterprise Strategy for their region. This commitment is mainly in response to the current Labour government's keenness to see enterprise and entrepreneurship at the centre of any economic development agenda. Pro-entrepreneurship policies have been embraced as…

A knowledge translation project on community-centred approaches in public health.

PubMed

Stansfield, J; South, J

2018-03-01

This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

Practising what we preach: A look at healthy active living policy and practice in Canadian paediatric hospitals

PubMed Central

Solh, Ziad; Adamo, Kristi B; Platt, Jennica L; Ambler, Kathryn; Boyd, Erin; Orrbine, Elaine; Cummings, Elizabeth; LeBlanc, Claire MA

2010-01-01

BACKGROUND: In the past 30 years, the rate of obesity has risen considerably among Canadian children. Paediatric hospitals are in a unique position to model healthy environments to Canadian children. OBJECTIVE: To obtain an overview of healthy active living (HAL) policy and practice in Canadian paediatric hospitals. METHODS: Working in partnership with the local Canadian Paediatric Society HAL champions and the Canadian Association of Paediatric Health Centres liaisons, a nationwide survey was conducted in 2006/2007 to identify healthy eating, physical activity and smoking cessation practices in all 16 Canadian paediatric academic hospitals. RESULTS: Policies addressing healthy eating and/or physical activity promotion were present in 50% of hospitals with a greater focus on nutrition. Wellness committees were created in 50% of the hospitals, most of which were recently established. Healthy food options were available in cafeterias, although they were often more expensive. Fast food outlets were present in 75% of hospitals. Although inpatient meals were designed by dietitians, 50% offered less nutritious replacement kids meals (ie, meal substitutions) on request. Options for play available to inpatients and outpatients were primarily sedentary, with screen-based activities and crafts predominating over active play. Physical activity promotion for staff focused on reduced membership fees to fitness centres and classes. CONCLUSION: Canadian paediatric hospitals do not adequately promote HAL for patients and staff. The present study findings suggest further effort is required to create necessary healthy lifestyle modifications in these institutions through Canadian Paediatric Society/Canadian Association of Paediatric Health Centres-led policy development and implementation initiatives. A national-level policy framework is required to regulate interhospital variability in policies and practices. PMID:22131867

A new model of collaborative research: experiences from one of Australia's NHMRC Partnership Centres for Better Health.

PubMed

Wutzke, Sonia; Redman, Sally; Bauman, Adrian; Hawe, Penelope; Shiell, Alan; Thackway, Sarah; Wilson, Andrew

2017-02-15

There is often a disconnection between the creation of evidence and its use in policy and practice. Cross-sectoral, multidisciplinary partnership research, founded on shared governance and coproduction, is considered to be one of the most effective means of overcoming this research-policy-practice disconnect. Similar to a number of funding bodies internationally, Australia's National Health and Medical Research Council has introduced Partnership Centres for Better Health: a scheme explicitly designed to encourage coproduced partnership research. In this paper, we describe our experiences of The Australian Prevention Partnership Centre, established in June 2013 to explore the systems, strategies and structures that inform decisions about how to prevent lifestyle-related chronic disease. We present our view on how the Partnership Centre model is working in practice. We comment on the unique features of the Partnership Centre funding model, how these features enable ways of working that are different from both investigator-initiated and commissioned research, and how these ways of working can result in unique outcomes that would otherwise not have been possible. Although not without challenges, the Partnership Centre approach addresses a major gap in the Australian research environment, whereby large-scale, research-policy-practice partnerships are established with sufficient time, resources and flexibility to deliver highly innovative, timely and accessible research that is of use to policy and practice.

Determining requirements for patient-centred care: a participatory concept mapping study.

PubMed

Ogden, Kathryn; Barr, Jennifer; Greenfield, David

2017-11-28

Recognition of a need for patient-centred care is not new, however making patient-centred care a reality remains a challenge to organisations. We need empirical studies to extend current understandings, create new representations of the complexity of patient-centred care, and guide collective action toward patient-centred health care. To achieve these ends, the research aim was to empirically determine what organisational actions are required for patient-centred care to be achieved. We used an established participatory concept mapping methodology. Cross-sector stakeholders contributed to the development of statements for patient-centred care requirements, sorting statements into groupings according to similarity, and rating each statement according to importance, feasibility, and achievement. The resultant data were analysed to produce a visual concept map representing participants' conceptualisation of patient-centred care requirements. Analysis included the development of a similarity matrix, multidimensional scaling, hierarchical cluster analysis, selection of the number of clusters and their labels, identifying overarching domains and quantitative representation of rating data. The outcome was the development of a conceptual map for the Requirements of Patient-Centred Care Systems (ROPCCS). ROPCCS incorporates 123 statements sorted into 13 clusters. Cluster labels were: shared responsibility for personalised health literacy; patient provider dynamic for care partnership; collaboration; shared power and responsibility; resources for coordination of care; recognition of humanity - skills and attributes; knowing and valuing the patient; relationship building; system review evaluation and new models; commitment to supportive structures and processes; elements to facilitate change; professional identity and capability development; and explicit education and learning. The clusters were grouped into three overarching domains, representing a cross-sectoral approach: humanity and partnership; career spanning education and training; and health systems, policy and management. Rating of statements allowed the generation of go-zone maps for further interrogation of the relative importance, feasibility, and achievement of each patient-centred care requirement and cluster. The study has empirically determined requirements for patient-centred care through the development of ROPCCS. The unique map emphasises collaborative responsibility of stakeholders to ensure that patient-centred care is comprehensively progressed. ROPCCS allows the complex requirements for patient-centred care to be understood, implemented, evaluated, measured, and shown to be occurring.

Scotland's Centre of Expertise for Waters - helping address Scotland's water policy challenges

NASA Astrophysics Data System (ADS)

MacDonald, Jannette; Morris, Sue; Hastings, Emily; Ferrier, Bob

2014-05-01

CREW connects water research and policy in Scotland. We deliver easily accessible research and expert opinion to support Scottish Government and its delivery partners in the development and implementation of water policy in Scotland. The main policy areas include the Water Framework Directive, Flooding Directive, and Scotland's Hydro Nation Strategy with links to cross cutting policies such as those relating to agriculture and climate change. CREW is unique in its demand-driven and free service for policy makers and practitioners, managing the engagement between scientists, policy makers and practitioners to work effectively across this interface. CREW aims are to; • deliver timely and accurate advice • coordinate and fund research, analysis and interpretation • stimulate innovative and proactive thinking • develop and implement a programme of knowledge exchange • develop the networks and skills of researchers, policy makers and practitioners to make best use of available science leading to improved environmental, social and economic outcomes for all CREW is a partnership between the James Hutton Institute and Scottish Universities, funded by the Scottish Government. http://www.crew.ac.uk/home

The international spread of Academic Health Science Centres: a scoping review and the case of policy transfer to England.

PubMed

French, Catherine E; Ferlie, Ewan; Fulop, Naomi J

2014-09-01

Academic Health Science Centres (AHSCs) have been a key feature of the North American healthcare landscape for many years, and the term is becoming more widely used internationally. The defining feature of these complex organisations is a tripartite mission of delivering high quality research, medical education and clinical care. The biomedical innovations developed in AHSCs are often well documented, but less is known about the policy and organisational processes which enable the translation of research into patient care. This paper has two linked purposes. Firstly, we present a scoping review of the literature which explores the managerial, political and cultural perspectives of AHSCs. The literature is largely normative with little social science theory underpinning commentary and descriptive case studies. Secondly, we contribute to addressing this gap by applying a policy transfer framework to the English case to examine how AHSC policy has spread internationally. We conclude by suggesting a research agenda on AHSCs using the relevant literatures of policy transfer, professional/managerial relations and boundary theory, and highlighting three key messages for policy makers: (1) competing policy incentives for AHSCs should be minimised; (2) no single AHSC model will fit all settings; (3) AHSC networks operate internationally and this should be encouraged. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Human Capital Formation and Foreign Direct Investment in Developing Countries. OECD Development Centre Working Paper No. 211 (Formerly Technical Paper No. 211)

ERIC Educational Resources Information Center

Miyamoto, Koji

2003-01-01

This paper synthesises the existing literature on human capital formation and foreign direct investment (FDI) in developing countries. The aim is to take a bird's eye view of the complex linkages between the activities of multinational enterprises (MNEs) and policies of host developing countries. In doing so, general trends, best practices and…

"Learner-Centred" Assessment Policies in Further Education: Putting Teachers' Time under Pressure

ERIC Educational Resources Information Center

Bailey, Gillian; Colley, Helen

2015-01-01

Since incorporation of further education (FE) in England in 1992, much research has critiqued the performative pressures on FE teachers created by a managerialist audit culture. These critiques have demonstrated the detrimental effects of the technicised delivery of learning outcomes on more learner-centred pedagogies. However, FE policies now…

The right to be informed and fear of disclosure: sustainability of a full error disclosure policy at an Italian cancer centre/clinic.

PubMed

D'Errico, Stefano; Pennelli, Sara; Colasurdo, Antonio Prospero; Frati, Paola; Sicuro, Lorella; Fineschi, Vittorio

2015-04-01

The aim of this study was to investigate the behaviour of physicians in cases of medical error as well as the nature of the information that should be given to the patient and to ascertain whether it is possible to institute a full error disclosure policy. Data was collected through the completion of anonymous questionnaires by medical directors of the IRCCS CROB (the Oncology Centre of Basilicata, Italy). An anonymous questionnaire consisting of 15 questions was prepared and administered to all the physicians working at the IRCCS CROB - the Oncology Centre of Basilicata. The main aim of the research was to evaluate the feasibility of adopting a full disclosure policy and the extent to which such a policy could help reduce administration and legal costs. The physicians interviewed unanimously recognize the importance of error disclosure, given that they themselves would want to be informed if they were the patients. However, 50% have never disclosed a medical error to their patients. Fear of losing the patient's trust (33%) and fear of lawsuits (31%) are the main obstacles to error disclosure. The authors found that physicians were in favour of a full policy disclosure at the IRCCS CROB - the Oncology Centre of Basilicata. Many more studies need to be carried out in order to comprehend the economic impact of a full error disclosure policy.

An Evaluation of the Effectiveness of Policy Communication in the Professional Development Centre's Training Programs.

ERIC Educational Resources Information Center

Rudasill, Susann E.

In the face of rising juvenile violent crime rates and media talk of waste, abuse, fraud, and ineffectiveness within the Florida Department of Health and Rehabilitative Services (HRS), the state recommended the adoption of a family-focused approach in client intervention strategy. The Florida Atlantic University Professional Development Centre…

A Commentary on Education and Sustainable Development Goals

ERIC Educational Resources Information Center

Sterling, Stephen

2016-01-01

The Sustainable Development Goals (SDGs) are viewed in the context of Johan Rockström's work on planetary boundaries at the Stockholm Resilience Centre. This work sets a double challenge to educational policy and practice: to embrace and help achieve the Goals, but also to work towards a deeper change in consciousness which can reconcile people…

Successful Education Research: Guidelines for Getting Going, Getting Funded and Getting Published

ERIC Educational Resources Information Center

Deacon, Roger; Parker, Ben

2009-01-01

As part of the Teacher Education Research and Development Programme (TEP), a project focusing on "Stimulation of practice-based teacher education research", was undertaken by Dr. Roger Deacon and Dr. Ben Parker, in conjunction with the Centre for Education Policy Development (CEPD). As part of the project, a set of research guidelines…

Understanding health system reform - a complex adaptive systems perspective.

PubMed

Sturmberg, Joachim P; O'Halloran, Di M; Martin, Carmel M

2012-02-01

Everyone wants a sustainable well-functioning health system. However, this notion has different meaning to policy makers and funders compared to clinicians and patients. The former perceive public policy and economic constraints, the latter clinical or patient-centred strategies as the means to achieving a desired outcome. Theoretical development and critical analysis of a complex health system model. We introduce the concept of the health care vortex as a metaphor by which to understand the complex adaptive nature of health systems, and the degree to which their behaviour is predetermined by their 'shared values' or attractors. We contrast the likely functions and outcomes of a health system with a people-centred attractor and one with a financial attractor. This analysis suggests a shift in the system's attractor is fundamental to progress health reform thinking. © 2012 Blackwell Publishing Ltd.

The Impact of Social Institutions on the Economic Role of Women in Developing Countries. OECD Development Centre Working Paper No. 234

ERIC Educational Resources Information Center

Morrisson, Christian; Jutting, Johannes

2004-01-01

Donor agencies and policy makers tend to agree that increased access of women to education, health, credit, formal legal rights and employment opportunities, in conjunction with economic growth, will substantially improve the socio-economic role of women in developing countries. This paper challenges that view. It argues that these measures might…

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics

PubMed Central

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A.

2015-01-01

Background and Objectives: In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007–2012). Approach: Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. Results: The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. Conclusion: The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. PMID:26742118

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics.

PubMed

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A; Gill, Kathryn

2015-11-01

In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012). Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. Copyright © 2015 Longwoods Publishing.

Investigating patients' experiences: methodological usefulness of interpretive interactionism.

PubMed

Tower, Marion; Rowe, Jennifer; Wallis, Marianne

2012-01-01

To demonstrate the methodological usefulness of interpretive interactionism by applying it to the example of a study investigating healthcare experiences of women affected by domestic violence. Understanding patients' experiences of health, illness and health care is important to nurses. For many years, biomedical discourse has prevailed in healthcare language and research, and has influenced healthcare responses. Contemporary nursing scholarship can be developed by engaging with new ways of understanding therapeutic interactions with patients. Research that uses qualitative methods of inquiry is an important paradigm for nurses who seek to explain and understand or describe experiences rather than predict outcomes. Interpretive interactionism is an interpretive form of inquiry for conducting studies of social or personal problems that have healthcare policy implications. It puts the patient at the centre of the research process and makes visible the experiences of patients as they interact with the healthcare and social systems that surround them. Interpretive interactionism draws on concepts of symbolic interactionism, phenomenology and hermeneutics. Interpretive interactionism is a patient-centred methodology that provides an alternative way of understanding patients' experiences. It can contribute to policy and practice development by drawing on the perspectives and experiences of patients, who are central to the research process. It also allows research findings to be situated in and linked to healthcare policy, professional ethics and organisational approaches to care. Interpretive interactionism has methodological utility because it can contribute to policy and practice development by drawing on the perspectives and experiences of patients who are central to the research process. Interpretive interactionism allows research findings to be situated in and linked to health policy, professional ethics and organisational approaches to caring.

User and group storage management the CMS CERN T2 centre

NASA Astrophysics Data System (ADS)

Cerminara, G.; Franzoni, G.; Pfeiffer, A.

2015-12-01

A wide range of detector commissioning, calibration and data analysis tasks is carried out by CMS using dedicated storage resources available at the CMS CERN Tier-2 centre. Relying on the functionalities of the EOS disk-only storage technology, the optimal exploitation of the CMS user/group resources has required the introduction of policies for data access management, data protection, cleanup campaigns based on access pattern, and long term tape archival. The resource management has been organised around the definition of working groups and the delegation to an identified responsible of each group composition. In this paper we illustrate the user/group storage management, and the development and operational experience at the CMS CERN Tier-2 centre in the 2012-2015 period.

English in Education Policy Shift in Senegal: From Traditional Pedagogies to Communicative Language Teaching

ERIC Educational Resources Information Center

Diallo, Ibrahima

2014-01-01

Despite its allegiance to French, language-in-education planning in Senegal has given top priority to English in its education system. In the 1980s, policy-makers shifted English language teaching pedagogy from the Centre de Linguistique Appliquée de Dakar (CLAD) [Centre for Applied Linguistics of Dakar] teaching methods to Communicative Language…

Addiction research centres and the nurturing of creativity: National Drug Dependence Treatment Centre, India--a profile.

PubMed

Ray, Rajat; Dhawan, Anju; Chopra, Anita

2013-10-01

The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Teaching Excellence Initiatives: Modalities and Operational Factors

ERIC Educational Resources Information Center

Land, Ray; Gordon, George

2015-01-01

Teaching excellence is at the centre of national and international higher education policy. The Higher Education Academy (HEA) is a part of the debate to develop a shared understanding of what constitutes teaching excellence and has published research including "Considering Teaching Excellence in Higher Education: 2007-2013" by Dr Vicky…

Risk-Taking, Safety and Older People. Selected Bibliographies on Ageing 3.

ERIC Educational Resources Information Center

Jackson, Wendy, Comp.

This annotated bibliography, which was developed as part of a series of selected bibliographies on aging for Great Britain's Centre for Policy on Ageing, contains a total of 368 entries organized under the following subject headings: risk (identification, nature, responsibilities, risk taking, security); environmental safety (hazards, design,…

Approaches to Research Priorities for Policy: A Comparative Study. Occasional Paper

ERIC Educational Resources Information Center

Wilkinson, Diana

2010-01-01

Diana Wilkinson, Chief Social Researcher with the Scottish Government, assisted National Centre for Vocational Education Research (NCVER) to facilitate a forum to discuss the development of national research priorities for the vocational education and training sector. This paper summarises Diana Wilkinson's impression of the forum and uses two…

Politics, policy and payment--facilitators or barriers to person-centred rehabilitation?

PubMed

Turner-Stokes, Lynne

This paper explores the tensions between politics and payment in providing affordable services that satisfy the public demand for patient-centred care. The two main approaches taken by the UK Government to curtail the spiralling costs of healthcare have been to focus development in priority areas and to cap spending through the introduction of a fixed-tariff episode-based funding system. The National Service Framework for Long Term Neurological Conditions embraces many laudable principles of person-centred management, but the 'one-size-fits all' approach to reimbursement potentially cuts right across these. A series of tools have been developed to determine complexity of rehabilitation needs that will support the development of banded tariffs. A practical approach is also offered to demonstrate the cost-efficiency of rehabilitation services for people with complex needs, and help to ensure that they are not excluded from treatment because of their higher treatment costs. Whilst responding to public demand for person-centred care, we must recognize the current financial pressure on healthcare systems. Clinicians will have greater credibility if they routinely collect and share outcomes that demonstrate the economic benefits of intervention, as well the impact on health, function and quality of life.

Local sustainability and scaling up for user fee exemptions: medical NGOs vis-à-vis health systems

PubMed Central

2015-01-01

Free healthcare obviously works when a partner from abroad supplies a health centre or a health district with medicines and funding on a regular basis, provides medical, administrative and managerial training, and gives incentive bonuses and daily subsistence allowances to staff. The experiments by three international NGO in Burkina Faso, Mali and Niger have all been success stories. But withdrawing NGO support means that health centres that have enjoyed a time of plenty under NGO management will return to the fold of health centres run by the state in its present condition and the health system in its present condition, with the everyday consequences of late reimbursements and stock shortages. The local support given by international NGOs has more often than not an effect of triggering an addiction to aid instead of inducing local sustainability without infusion. In the same way, scaling up to the entire country a local pilot experiment conducted under an NGO involves its insertion into a national bureaucratic machine with its multiple levels, all of which are potential bottlenecks. Only experiments carried out under the "ordinary" management of the state are capable of laying bare the problems associated with this process. Without reformers 'on the inside' (within the health system itself and among health workers), no real reform of the health system induced by reformers 'from the outside' can succeed. The problems relating to the sustainability of public policies in Africa, especially when the policies benefit from development aid, in the area of health among others, are familiar to researchers and policy-makers. However, as far as user fee exemptions are concerned, debates about these problems have extended well beyond the narrow circle of experts and into the public domain in the countries concerned. Throughout our research, we have observed that the sustainability of free healthcare policies is a major concern of all the actors (health workers, users, managers and senior administrative staff), and an issue that has generated widespread scepticism, especially in Mali and Niger [1,2]. There is general unease about the state's ability to reimburse health centres and to provide essential inputs. The scepticism is fuelled by a two-fold negative experience: decades of incoherent public policies at national level, plagued by bad management and uncertain funding, on the one hand; and the endless U-turns by donors, the double binds of frequent contradictions in their funding policies and the short-term nature of the programmes they enact, on the other [3]. The first years of exemption policies, which were beset by late reimbursements and more or less chronic stock shortages, only added to the scepticism. The disquiet appears to be justified: despite their positive impact in terms of health centre attendance, without funding guaranteed over time, efficient management, secure supply channels and motivated staff, free healthcare policies fall foul of a host of adverse effects at every level of the health pyramid. PMID:26559444

An exploration of person-centred concepts in human services: A thematic analysis of the literature.

PubMed

Waters, Rebecca A; Buchanan, Angus

2017-10-01

Being 'person-centred' in the delivery of health and human services has become synonymous with quality care, and it is a core feature of policy reform in Australia and other Western countries. This research aimed to identify the uses, definitions and characteristics of the term 'person-centred' in the ageing, mental health and disability literature. A thematic analysis identified seven common core themes of person-centredness: honouring the person, being in relationship, facilitating participation and engagement, social inclusion/citizenship, experiencing compassionate love, being strengths/capacity focussed, and organisational characteristics. These suggest a set of higher-order experiences for people that are translated differently in different human services. There is no common definition of what it means to be person-centred, despite being a core feature of contemporary health and human service policy, and this suggests that its inclusion facilitates further misunderstanding and misinterpretation. A common understanding and policy conceptualisation of person-centredness is likely to support quality outcomes in service delivery especially where organisations work across human service groups. Further research into the application and service expressions of being 'person-centred' in context is necessary. Copyright © 2017 Elsevier B.V. All rights reserved.

Lifelong Learning and Adult Education: Russia Meets the West

NASA Astrophysics Data System (ADS)

Zajda, Joseph

2003-03-01

This article examines the impact of social change and economic transformation on adult education and lifelong learning in post-Soviet Russia. The article begins with a brief economic and historical background to lifelong learning and adult education in terms of its significance as a feature of the Russian cultural heritage. An analysis of Ministerial education policy and curriculum changes reveals that these policies reflect neo-liberal and neo-conservative paradigms in the post-Soviet economy and education. Current issues and trends in adult education are also discussed, with particular attention to the Adult Education Centres, which operate as a vast umbrella framework for a variety of adult education and lifelong learning initiatives. The Centres are designed to promote social justice by means of compensatory education and social rehabilitation for individuals dislocated by economic restructuring. The article comments on their role in helping to develop popular consciousness of democratic rights and active citizenship in a participatory and pluralistic democracy.

Pit and fissure sealants in dental public health – application criteria and general policy in Finland

PubMed Central

Kervanto-Seppälä, Sari; Pietilä, Ilpo; Meurman, Jukka H; Kerosuo, Eero

2009-01-01

Background Pit and fissure sealants (sealants) are widely used as a non-operative preventive method in public dental health in Finland. Most children under 19 years of age attend the community-organized dental health services free of charge. The aims of this study were to find out to what extent sealants were applied, what the attitudes of dental professionals towards sealant application were, and whether any existing sealant policies could be detected among the health centres or among the respondents in general. The study evaluated changes that had taken place in the policies used during a ten year period (1991–2001). Methods A questionnaire was mailed to each chief dental officer (CDO) of the 265 public dental health centres in Finland, and to a group of general dentists (GDP) applying sealants in these health centres, giving a total of 434 questionnaires with 22 questions. The response rate was 80% (N = 342). Results A majority of the respondents reported to application of sealants on a systematic basis for children with increased caries risk. The criteria for applying sealants and the actual strategies seemed to vary locally between the dentists within the health centres and between the health centres nationwide. The majority of respondents believed sealants had short- and long-term effects. The overall use of sealants decreased towards the end of the ten year period. The health centres (N = 28) choosing criteria to seal over detected or suspected enamel caries lesion had a DMFT value of 1.0 (SD ± 0.49) at age 12 (year 2000) compared to a value of 1.2 (SD ± 0.47) for those health centres (N = 177) applying sealants by alternative criteria (t-test, p < 0.05). Conclusion There seems to be a need for defined guidelines for sealant application criteria and policy both locally and nationwide. Occlusal caries management may be improved by shifting the sealant policy from the traditional approach of prevention to interception, i.e. applying the sealants over detected or suspected enamel caries lesions instead of sealing sound teeth. PMID:19193239

Shifting Directions in ECEC Policy in New Zealand: From a Child Rights to an Interventionist Approach

ERIC Educational Resources Information Center

Mitchell, Linda

2015-01-01

Early childhood education and care (ECEC) policy reflects ideas about childhood, labour force participation, education, the economy and the role of the state. This article spans a period of political change in New Zealand from a left of centre government during the first decade of the twenty-first century to a right of centre government from 2009.…

"Harnessing genomics to improve health in India" – an executive course to support genomics policy

PubMed Central

Acharya, Tara; Kumar, Nandini K; Muthuswamy, Vasantha; Daar, Abdallah S; Singer, Peter A

2004-01-01

Background The benefits of scientific medicine have eluded millions in developing countries and the genomics revolution threatens to increase health inequities between North and South. India, as a developing yet also industrialized country, is uniquely positioned to pioneer science policy innovations to narrow the genomics divide. Recognizing this, the Indian Council of Medical Research and the University of Toronto Joint Centre for Bioethics conducted a Genomics Policy Executive Course in January 2003 in Kerala, India. The course provided a forum for stakeholders to discuss the relevance of genomics for health in India. This article presents the course findings and recommendations formulated by the participants for genomics policy in India. Methods The course goals were to familiarize participants with the implications of genomics for health in India; analyze and debate policy and ethical issues; and develop a multi-sectoral opinion leaders' network to share perspectives. To achieve these goals, the course brought together representatives of academic research centres, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. Results Seven main recommendations emerged: increase funding for healthcare research with appropriate emphasis on genomics; leverage India's assets such as traditional knowledge and genomic diversity in consultation with knowledge-holders; prioritize strategic entry points for India; improve industry-academic interface with appropriate incentives to improve public health and the nation's wealth; develop independent, accountable, transparent regulatory systems to ensure that ethical, legal and social issues are addressed for a single entry, smart and effective system; engage the public and ensure broad-based input into policy setting; ensure equitable access of poor to genomics products and services; deliver knowledge, products and services for public health. A key outcome of the course was the internet-based opinion leaders' network – the Indian Genome Policy Forum – a multi-stakeholder forum to foster further discussion on policy. Conclusion We expect that the process that has led to this network will serve as a model to establish similar Science and Technology policy networks on regional levels and eventually on a global level. PMID:15151698

Transport policy and health inequalities: a health impact assessment of Edinburgh's transport policy.

PubMed

Gorman, D; Douglas, M J; Conway, L; Noble, P; Hanlon, P

2003-01-01

Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy.

Promoting equitable global health research: a policy analysis of the Canadian funding landscape.

PubMed

Plamondon, Katrina; Walters, Dylan; Campbell, Sandy; Hatfield, Jennifer

2017-08-29

Recognising radical shifts in the global health research (GHR) environment, participants in a 2013 deliberative dialogue called for careful consideration of equity-centred principles that should inform Canadian funding polices. This study examined the existing funding structures and policies of Canadian and international funders to inform the future design of a responsive GHR funding landscape. We used a three-pronged analytical framework to review the ideas, interests and institutions implicated in publically accessible documents relevant to GHR funding. These data included published literature and organisational documents (e.g. strategic plans, progress reports, granting policies) from Canadian and other comparator funders. We then used a deliberative approach to develop recommendations with the research team, advisors, industry informants and low- and middle-income country (LMIC) partners. In Canada, major GHR funders invest an estimated CA$90 M per annum; however, the post-2008 re-organization of funding structures and policies resulted in an uncoordinated and inefficient Canadian strategy. Australia, Denmark, the European Union, Norway, Sweden, the United Kingdom and the United States of America invest proportionately more in GHR than Canada. Each of these countries has a national strategic plan for global health, some of which have dedicated benchmarks for GHR funding and policy to allow funds to be held by partners outside of Canada. Key constraints to equitable GHR funding included (1) funding policies that restrict financial and cost burden aspects of partnering for GHR in LMICs; and (2) challenges associated with the development of effective governance mechanisms. There were, however, some Canadian innovations in funding research that demonstrated both unconventional and equitable approaches to supporting GHR in Canada and abroad. Among the most promising were found in the International Development Research Centre and the (no longer active) Global Health Research Initiative. Promoting equitable GHR funding policies and practices in Canada requires cooperation and actions by multiple stakeholders, including government, funding agencies, academic institutions and researchers. Greater cooperation and collaboration among these stakeholders in the context of recent political shifts present important opportunities for advancing funding policies that enable and encourage more equitable investments in GHR.

Post-Fukushima Energy and Nuclear Policy Evolution

NASA Astrophysics Data System (ADS)

Masuda, Tatsuo

2014-07-01

The Fukushima nuclear disaster should be marked as a point of departure towards energy policy evolution needed in the 21st century. Japan had cast off the skin after the oil shocks of the 1970s, where energy efficiency and saving played a critical role. Japan might have looked very different without these innovative policies. The post-Fukushima Japan faces multiple challenges, each of which constitutes a daunting task for policymakers such as surging LNG import costs and nuclear restarting. However, overcoming these problems one by one is not enough. Intensifying climate impact alerts us to the arrival of a historical inflection point requiring a radical shift in energy model worldwide, where Japan will be best suited to take the lead in view of its energy history and technology. The on-going effort after Fukushima to renew her energy and nuclear policy is suggestive of her potential to develop an innovative energy model by casting off the skin again. Asia will become the "problem centre" of the world if it may fail to address global environmental problems deriving from the heavy use of energy (about 46% of world's energy used by Asia alone in 2035). If successful, on the contrary, Asia will become the "solution centre" benefiting the global community. Asia is too big to fail as the whole world will be badly affected. The new energy model of Japan will serve as "public goods" for Asian countries in developing their new energy model towards sustainable future.

Infusing the New Technologies Debate with a Socio-Economic Agenda

ERIC Educational Resources Information Center

Wilson, Bruce

2014-01-01

Dramatic changes occurred in the international economy in the latter part of the twentieth century. CERI, the Centre for Education Research and Innovation at the OECD, was an important contributor to the understanding of the nature and implications of these developments, and in foreshadowing the central policy challenges which would arise. Jarl…

Educating Career Guidance Practitioners in the Twenty-First Century

ERIC Educational Resources Information Center

Gough, John

2017-01-01

Rapidly changing policy contexts in England have dramatically affected the provision of career guidance, and the training and development of its practitioners. This paper takes an autoethnographic and self-reflexive approach to exploring the experience of a Senior Lecturer in Career Guidance who manages a centre that offers the Qualification in…

Language Trends 2010 Secondary

ERIC Educational Resources Information Center

CILT, the National Centre for Languages, 2010

2010-01-01

The Language Trends survey is run jointly each year by CILT, the National Centre for Languages, the Association for Language Learning (ALL) and the Independent Schools Modern Languages Association (ISMLA). In this period of rapid change and policy development, it is vital to have an up to date picture of current issues for languages. Therefore,…

Growth Mindset and Motivation: A Study into Secondary School Science Learning

ERIC Educational Resources Information Center

Bedford, Susannah

2017-01-01

Motivation in science in school is a national issue but is often overlooked in educational reform (Usher, A., and N. Kober. 2012. "Student motivation -- An overlooked piece of school reform". Centre on Education Policy, Graduate School of Education and Human Development. The George Washington University). Despite new curriculum content…

Computer Education in the Vocational Teacher Training Centre at Eindhoven.

ERIC Educational Resources Information Center

Houben, J. W. M. A.; Verbunt, J. A.

1985-01-01

Teachers from The Netherland's 26 higher technical colleges in need of a teaching qualification (called an "informatica") were able to obtain it by in-service training, organized and offered by universities. Types of courses offered and policy describing information technology activities to be developed in the country by 1989 are…

Ethnography and Environmental Education: Understanding the Relationships between Schools and Communities in Costa Rica

ERIC Educational Resources Information Center

Blum, Nicole

2008-01-01

Environmental education has been at the centre of international and national policies of sustainable development for the last several decades, and has stimulated debate regarding both its inclusion in curricula and proposed methods for its implementation. Research has given critical attention to diverse theories and practices of environmental…

An Effective School Improvement Framework: Using the National School Improvement Tool

ERIC Educational Resources Information Center

Seifert, Deborah; Hartnell-Young, Elizabeth

2015-01-01

This occasional paper of the Centre for Education Policy and Practice outlines how the National School Improvement Tool, developed by the Australian Council for Educational Research (ACER) in collaboration with the Queensland Department of Education, Training and Employment is being used in Australian schools. The Tool is grounded in international…

The DIY Digital Medical Centre.

PubMed

Timmis, James Kenneth; Timmis, Kenneth

2017-09-01

Healthcare systems worldwide are confronted with major economic, organizational and logistical challenges. Historic evolution of health care has led to significant healthcare sector fragmentation, resulting in systemic inefficiencies and suboptimal resource exploitation. To attain a sustainable healthcare model, fundamental, system-wide improvements that effectively network, and ensure fulfilment of potential synergies between sectors, and include and facilitate coherent strategic planning and organisation of healthcare infrastructure are needed. Critically, they must be specifically designed to sustainably achieve peak performance within the current policy environment for cost-control, and efficiency and quality improvement for service delivery. We propose creation of a new healthcare cluster, to be embedded in existing healthcare systems. It consists of (i) local 24/7 walk-in virtually autonomous do-it-yourself Digital Medical Centres performing routine diagnosis, monitoring, prevention, treatment and standardized documentation and health outcome assessment/reporting, which are online interfaced with (ii) regional 24/7 eClinician Centres providing on-demand clinical supervision/assistance to Digital Medical Centre patients. Both of these are, in turn, online interfaced with (iii) the National Clinical Informatics Centre, which houses the national patient data centre (cloud) and data analysis units that conduct patient- and population-level, personalized and predictive(-medicine) intervention optimization analyses. The National Clinical Informatics Centre also interfaces with biomedical research and prioritizes and accelerates the translation of new discoveries into clinical practice. The associated Health Policy Innovation and Evaluation Centre rapidly integrates new findings with health policy/regulatory discussions. This new cluster would synergistically link all health system components in a circular format, enable not only access by all arms of the health service to latest patient data, but also automatic algorithm analysis and prediction of clinical development of individual patients, reduce bureaucratic burden on medical professionals by enabling a greater level of focus of their expertise on non-routine medical tasks, lead to automatic translation of aggregate patient data/new knowledge into medical practice, and orient future evolution of health systems towards greater cohesion/integration and hence efficiency. A central plank of the proposed concept is increased emphasis on reduction of disease incidence and severity, to diminish both patient suffering and treatment costs. This will be achieved at the individual and population levels, through (i) significantly improved access to medical services, (ii) stronger focus on primary and secondary prevention and early treatment measures, and disease susceptibility prediction via personalized medicine, involving inter alia genome analysis at birth and periodic analysis of microbiomes and biomarkers, and integration with other patient health and epidemiology parameters, (iii) improved surveillance and (iv) intervention outcome benchmarking. The dMCs will become drivers of innovation and integrative evolution in health systems, of disease reduction and efficiency gains, and thus major contributors to development of sustainability of health care. © 2017 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

What Gets in the Way of Person-Centred Care for People with Multimorbidity? Lessons from Ontario, Canada.

PubMed

Kuluski, Kerry; Peckham, Allie; Williams, A Paul; Upshur, Ross E G

2016-01-01

Person-centred care is becoming a key component of quality in health systems worldwide. Although the term can mean different things, it typically entails paying attention to the needs and background of health system users, involving them in decisions that affect their health, assessing their care goals and implementing a coordinated plan of care that aligns with their unique circumstances. The importance of practising a person-centred approach in care delivery dominates policy and research rhetoric worldwide, yet competing goals set by policy planners to save money, eliminate waste and sustain the healthcare system challenge the implementation of such an approach. In this commentary, we begin by exploring the concept of person-centred care and its importance among people who frequently use healthcare, such as those with multimorbidity. We then provide a brief overview of the evolution of Ontario's healthcare system and its emphasis on achieving cost savings. In doing so, we illustrate the implications for health system users, particularly people with multimorbidity, their carers and formal care providers. Finally, we reflect on examples of innovations that are striving to deliver person-centred care, despite a constrained healthcare environment. While a step in the right direction, we conclude that these "one-off" strategies are unsustainable in the absence of supporting policy levers.

Drivers of animal welfare policy in the Americas.

PubMed

Huertas, S M; Gallo, C; Galindo, F

2014-04-01

Owing to its large size and ethnic, social, cultural and economic diversity, the Americas' production volume is set to make the region one of the world's leading providers of animal foodstuffs. Animal husbandry, transport and slaughter conditions vary from country to country in response to their differing climatic and geographic characteristics. This article examines the main drivers of animal welfare in the Americas, including the standards of the World Organisation for Animal Health (OIE), legislation, codes of practice and advances in education, training, research and development. It recognises the important roles played by all the various stakeholders in changing perceptions of animal welfare by raising public awareness and promoting communication and cooperation as drivers of overall change in the Americas. Regional and international organisations, public and private-sector bodies, academia and non-governmental organisations have launched a number of initiatives with encouraging results. In 2009, the OIE established the Chile-Uruguay Collaborating Centre for Animal Welfare Research, which is now the OIE Collaborating Centre for Animal Welfare and Livestock Production Systems and has recently incorporated Mexico. The Collaborating Centre works closely with official OIE Delegates and the Focal Points for Animal Welfare of national Veterinary Services. The OIE Regional Animal Welfare Strategy for the Americas was adopted in 2012, under the coordination of the OIE Regional Representation for the Americas, as a guide for developing future policies based on a regional approach. The way to achieve cultural change for improving animal welfare, operator safety and the sector's profitability is through training and knowledge transfer. The results demonstrate that the joint efforts of all institutions and the active role of the Collaborating Centre have been most effective, as have the continuing education programmes implemented by universities.

Providing specialist clinical skills in soft tissue and intra-articular injection through a postgraduate masters module.

PubMed

Stevenson, Kay; Waterfield, Jackie

2005-01-01

Current philosophy and policy changes in the National Health Service are encouraging healthcare practitioners to extend their clinical skills to create a more patient-centred approach thus allowing patients to be seen in a timely and more appropriate manner. This often requires further development of the practitioners' skills and knowledge. One approach to achieve this is through collaboration between employers and educational providers to ensure that educational experience is not only evidence based but also responsive to the needs of the current and future workforce. A postgraduate module was developed to raise critical and evaluative skills, as well as the technical skills of practitioners using injections in the management of joint and soft tissue pathology, while developing a professional responsibility towards injection practice. The module emphasized learning though experience by contextualizing the theoretical aspects of the module and by its student centred assessments. Further strengths of this module are that it has utilized academic and clinical expertise and knowledge to enable clinicians to gain additional skills and the multidisciplinary approach engendered good working practice Overall the module was evaluated positively by both tutors and students and not only met its aims but also addressed the current professional and policy issues around continuing professional development. Copyright (c) 2005 John Wiley & Sons, Ltd.

Developing the security culture at the SEISMED Reference Centres.

PubMed

Fowler, J

1996-01-01

The paper gives a brief summary of the SEISMED project and the particular role played by the Reference Centres. Details are given of the hardware and application systems in use in the Royal Hospitals (NHS) Trust (RHT), one of the SEISMED Reference Centres. It proposes, without verification, a definition of a Security Culture based on three criteria. These are suggested to be the "Awareness" the "Acceptance" and the "Actions" of the management and staff to improve Information Systems Security throughout the RHT. The way that "Awareness" was increased is shown by the specific initiatives commenced as a result of a CRAMM Risk Analysis and the management and staff training programmes. The specific initiatives mentioned include, an Information Systems Security Policy, a contingency and disaster recovery plan, improvements in the physical protection of equipment and changes to the method of access control. The "Acceptance" by the staff of these measures is considered and the success or failure of "Developing A Security Culture" examined. The role of SEISMED in this process is assessed.

Implementation of information and communication technologies for health in Bangladesh

PubMed Central

Tabassum, Reshman

2015-01-01

Abstract Problem Bangladesh has yet to develop a fully integrated health information system infrastructure that is critical to guiding policy development and planning. Approach Initial pilot telemedicine and eHealth programmes were not coordinated at national level. However, in 2011, a national eHealth policy was implemented. Local setting Bangladesh has made substantial improvements to its health system. However, the country still faces public health challenges with limited and inequitable access to health services and lack of adequate resources to meet the demands of the population. Relevant changes In 2008, eHealth services were introduced, including computerization of health facilities at sub-district levels, internet connections, internet servers and an mHealth service for communicating with health-care providers. Health facilities at sub-district levels were provided with internet connections and servers. In 482 upazila health complexes and district hospitals, an mHealth service was set-up where an on-duty doctor is available for patients at all hours to provide consultations by mobile phone. A government operated telemedicine service was initiated and by 2014, 43 fully equipped centres were in service. These centres provide medical consultations by qualified physicians to patients visiting rural and remote community clinics and union health centres. Lessons learnt Despite early pilot interventions and successful implementation, progress in adopting eHealth strategies in Bangladesh has been slow. There is a lack of common standards on information technology for health, which causes difficulties in data management and sharing among different databases. Limited internet bandwidth and the high cost of infrastructure and software development are barriers to adoption of these technologies. PMID:26549909

Implementation of information and communication technologies for health in Bangladesh.

PubMed

Islam, Sheik Mohammed Shariful; Tabassum, Reshman

2015-11-01

Bangladesh has yet to develop a fully integrated health information system infrastructure that is critical to guiding policy development and planning. Initial pilot telemedicine and eHealth programmes were not coordinated at national level. However, in 2011, a national eHealth policy was implemented. Bangladesh has made substantial improvements to its health system. However, the country still faces public health challenges with limited and inequitable access to health services and lack of adequate resources to meet the demands of the population. In 2008, eHealth services were introduced, including computerization of health facilities at sub-district levels, internet connections, internet servers and an mHealth service for communicating with health-care providers. Health facilities at sub-district levels were provided with internet connections and servers. In 482 upazila health complexes and district hospitals, an mHealth service was set-up where an on-duty doctor is available for patients at all hours to provide consultations by mobile phone. A government operated telemedicine service was initiated and by 2014, 43 fully equipped centres were in service. These centres provide medical consultations by qualified physicians to patients visiting rural and remote community clinics and union health centres. Despite early pilot interventions and successful implementation, progress in adopting eHealth strategies in Bangladesh has been slow. There is a lack of common standards on information technology for health, which causes difficulties in data management and sharing among different databases. Limited internet bandwidth and the high cost of infrastructure and software development are barriers to adoption of these technologies.

Building research and evaluation capacity in population health: the NSW Health approach.

PubMed

Edwards, Barry; Stickney, Beth; Milat, Andrew; Campbell, Danielle; Thackway, Sarah

2016-02-01

Issue addressed An organisational culture that values and uses research and evaluation (R&E) evidence to inform policy and practice is fundamental to improving health outcomes. The 2016 NSW Government Program Evaluation Guidelines recommend investment in training and development to improve evaluation capacity. The purpose of this paper is to outline the approaches taken by the NSW Ministry of Health to develop R&E capacity and assess these against existing models of practice. Method The Ministry of Health's Centre for Epidemiology and Evidence (CEE) takes an evidence-based approach to building R&E capacity in population health. Strategies are informed by: the NSW Population Health Research Strategy, R&E communities of practice across the Ministry and health Pillar agencies and a review of the published evidence on evaluation capacity building (ECB). An internal survey is conducted biennially to monitor research activity within the Ministry's Population and Public Health Division. One representative from each of the six centres that make up the Division coordinates completion of the survey by relevant staff members for their centre. Results The review identified several ECB success factors including: implementing a tailored multifaceted approach; an organisational commitment to R&E; and offering experiential training and ongoing technical support to the workforce. The survey of research activity found that the Division funded a mix of research assets, research funding schemes, research centres and commissioned R&E projects. CEE provides technical advice and support services for staff involved in R&E and in 2015, 22 program evaluations were supported. R&E capacity building also includes a series of guides to assist policy makers, practitioners and researchers to commission, undertake and use policy-relevant R&E. Staff training includes workshops on critical appraisal, program logic and evaluation methods. From January 2013 to June 2014 divisional staff published 84 peer-reviewed papers and one book chapter. Conclusion A strategic approach to R&E capacity building compares favourably with organisational dimensions of ECB and has facilitated the generation of high quality population health R&E in NSW. So what? An evidence-based multistrategy approach to population health R&E can result in substantial contributions to the population-health evidence base.

A Road Travelled Too Far?: A Case Study of the Restructuring of University Adult and Continuing Education.

ERIC Educational Resources Information Center

Findsen, Brian

2001-01-01

Describes the restructuring of the Centre for Continuing Education and the University of Auckland within the context of political ideology, developments in New Zealand universities, and the historical role of adult and continuing education. Concludes that strategic neglect enabled external forces to drive policy and practice toward neoliberal…

Health, Education and Poverty Reduction. OECD Development Centre Policy Brief No. 19

ERIC Educational Resources Information Center

Morrisson, Christian

2002-01-01

It is generally agreed that spending on education and health is key to poverty reduction, but simply allocating more resources to these sectors does not ensure that poverty actually declines. On the basis of four in-depth case studies (on Indonesia, Madagascar, Peru and Tanzania) and three Technical Papers on malnutrition and primary education in…

Introducing Performance Measurements in the Evaluation of Assistance to Public Administration Reform in Central and Eastern Europe.

ERIC Educational Resources Information Center

Buxell, Ingrid T.; Ners, Krysztof J.

This paper focuses on the experience of the Policy Education Centre on Assistance to Transition in providing monitoring and evaluation services to "Support for Improvement in Governance and Management in Central and Eastern European Countries" (SIGMA), a joint project of the Organization for Economic Cooperation and Development and the…

The development of integrated service centre system for professional teachers empowerment in North Sumatera

NASA Astrophysics Data System (ADS)

Gultom, S.; Simanjorang, M. M.; Muchtar, Z.; Mansyur, A.

2018-03-01

Based on Act number 12 in year 2012 the function of higher education is related to individual, social community, knowledge and technology development. Hence, higher education providers need to think and develop policies in order to improve their service and fulfil the higher education function. As part of the effort to fulfil its function Universitas Negeri Medan (Unimed), which historically was a pre-service teacher training institute, should has a special interest on improving teachers’ professionalism. The Act number 14 in year 2005 described requirements for professional teacher, including academic qualification and set of competencies possessed by the teacher. The Act also guaranties teachers’ right to have opportunities for improving their competencies and academic qualification through training and other professionalism development programme. The question is how this guarantee can be implemented. In order to answer this question a developmental study has been done which aimed on developing an integrated service centre system for professional teachers empowerment. As the name implies, this integrated service centre system is expected to be a real manifestation of Unimed’s support towards the improvement of professional teachers quality, which in the end will boils down to the improvement of national education services quality. The result of this study is an integrated service centre system for professional teachers empowerment that fulfils the professionalism principles described in the Act number 14 in year 2005, which has been developed by considering problems faced by and also supports needed by teachers post certification programme.

Translating change: the development of a person-centred triage training programme for emergency nurses.

PubMed

McBrien, Barry

2009-01-01

Within health care, there has been a change in practice from an illness-orientated service to one that is more health-focused and person-centred. The concept of person-centredness is frequently espoused by practitioners as being not only a desirable, but a necessary element of health care provision. Indeed, nationally and internationally, person-centred care has underpinned many healthcare documents and policies. Person-centred practice focuses on providing care, utilising a variety of processes that operationalise person-centred nursing and include working with patients' beliefs and values, engagement, presence, sharing decision-making and providing for physical needs. In the field of emergency nursing, the incorporation of person-centred care and its holistic foundation may require a significant shift in practice. There is evidence to suggest that emergency nurses view their role as one, which is predominantly concerned with providing urgent physical care, rather than one, which espouses the theories of holistic healthcare. To this extent, being person-centred in the context of emergency care, requires the nurse to move beyond the traditional notions of his/her role and to embrace the more holistic aspects of patient care. The aim of this article is to critically analyse how a change in nurse-led triage training in one Irish Emergency Department facilitated an improved person-centred approach in practice.

Learning from a Small State's Experience: Acknowledging the Importance of Context in Implementing Learner-Centred Pedagogy

ERIC Educational Resources Information Center

Di Biase, Rhonda

2015-01-01

The challenges of implementing learner-centred pedagogies have been well documented, noting that many reform efforts fail to consider important contextual factors. With attention to the disparity between policy and practice, this study investigated the conditions under which teachers can enact learner-centred pedagogy in the Maldives using…

Nurse educators' perceived challenges in mandatory continuing nursing education.

PubMed

Xiao, L D

2006-09-01

This paper reports a study that leads to understanding challenges facing nurse educators implementing mandatory continuing nursing education in The People's Republic of China. Mandatory continuing nursing education was instituted to maintain and develop registered nurses' competence in the context of healthcare reform in China in 1996. However, there is an increasing complaint of credit-focused and teacher-centred learning in Chinese literature. Despite an increasing appeal to improve the learning situation, little consensus has been reached. By examining nurse educators' perceived challenges and their coping strategies in implementing mandatory continuing nursing education, this study illuminates the possibilities for reform in mandatory continuing nursing education. Data were collected through in-depth interactive dialogues between the researcher and five nurse educators in five healthcare organizations in China, utilizing Gadamer's philosophical hermeneutics. Three themes were found in this study described as finding a way to support nurses' competence within a constrained situation, reconciling credit requirements and representing all stakeholders' interests. A tension between the mandatory continuing nursing education policy and the context of implementing the policy can contribute to credit-focused and teacher-centred learning. Regular policy review and educational support for nurse educators are crucial aspects to improve mandatory continuing nursing education.

Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

PubMed Central

Osei, Daniel; d'Almeida, Selassi; George, Melvill O; Kirigia, Joses M; Mensah, Ayayi Omar; Kainyu, Lenity H

2005-01-01

Background The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination) in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i) to estimate the relative technical efficiency (TE) and scale efficiency (SE) of a sample of public hospitals and health centres in Ghana; and (ii) to demonstrate policy implications for health sector policy-makers. Methods The Data Envelopment Analysis (DEA) approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. Results Eight (47%) hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD) of 12%. Ten (59%) hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%). Out of the 17 health centres, 3 (18%) were technically inefficient, with a mean TE score of 49% (STD = 27%). Eight health centres (47%) were scale inefficient, with an average SE score of 84% (STD = 16%). Conclusion This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres) in the course of the implementation of health sector reforms. PMID:16188021

Asians seek end to girls' trafficking.

PubMed

1997-01-01

Each year, approximately 1 million Asian children under 18 years old, many of them female, become prostitutes. With regard to this problem, the Summit Foundation, the United Nations Population Fund, UNICEF, and the Centre for Development and Population Activities are sponsoring a conference entitled "Girls' Rights, Society's Responsibility: Taking Action Against Child Sexual Exploitation," on December 8-10, 1997, at the Nehru Centre, Worli, Bombay. Policy makers from government, the legal and police professions, corporations, the tourism industry, and grassroots organizations will attend. Representatives from Bangladesh, Bhutan, China, India, Maldives, Myanmar, Nepal, Pakistan, the Philippines, Sri Lanka, and Thailand will develop coordinated strategies to end the abuse. The experiences of community-based nongovernmental organizations will be used to develop approaches to prevent exploitation, provide surveillance, and rehabilitate girls who have been exploited. The Nehru Centre, Jet Airways, and the President Hotel of Bombay will provide support. Participants are to include the Ford Foundation, the John D. and Catherine T. MacArthur Foundation, UNIFEM, the World Health Organization, the World Bank, the US Agency for International Development (USAID), Oxfam, CIDA, SIDA, NORAD, and many corporations (Bata, Apeejay, Pepsi, Tata, Godrej, Mahindra and Mahindra, and hotel and tourist businesses).

The impact of a local sugar sweetened beverage health promotion and price increase on sales in public leisure centre facilities.

PubMed

Breeze, Penny; Womack, Robert; Pryce, Robert; Brennan, Alan; Goyder, Elizabeth

2018-01-01

We aimed to evaluate the impact of a local sugar sweetened beverages (SSB) health promotion and 20p price increase in leisure centre venues and estimate the impact on consumption. Monthly cold drinks sales data and attendance at leisure centres across the city of Sheffield were analysed over the period January 2015-July 2017. Interrupted time-series methods were employed to estimate changes in consumption per attendance of SSB and non-SSB cold drinks following the introduction of the SSB policy from August 2016 adjusting for seasonal variation and autocorrelation. SSB price elasticities were estimated with fixed effects log-log models by SSB product type (soda can, soda bottle, soda post mix, energy drinks, juice from concentrate). We estimated a 31% (95% CI 4%, 59%) reduction in units of SSB sold per attendance in the year since the policy was introduced. We did not observe substitution effects to fruit juice or water but found sales of other artificially sweetened non-SSB products increased by 27% (95% CI 6%, 47%) after the introduction of the tax. Price elasticity analysis identified that a 1% increase in price alongside health promotion leads to a 3.8% (95% CI 3.1% 4.4%) decrease in demand for SSB's. Price elasticity of demand was highest for child friendly and high caffeine energy drinks. Demand for SSB drinks at leisure centre venues is highly responsive to the policy, particularly for child-friendly and high caffeine energy drinks, compared with other SSB tax policy evaluations. The policy also increased purchases of carbonated non-SSB.

Plumbing the brain drain.

PubMed

Saravia, Nancy Gore; Miranda, Juan Francisco

2004-08-01

Opportunity is the driving force of migration. Unsatisfied demands for higher education and skills, which have been created by the knowledge-based global economy, have generated unprecedented opportunities in knowledge-intensive service industries. These multi-trillion dollar industries include information, communication, finance, business, education and health. The leading industrialized nations are also the focal points of knowledge-intensive service industries and as such constitute centres of research and development activity that proactively draw in talented individuals worldwide through selective immigration policies, employment opportunities and targeted recruitment. Higher education is another major conduit of talent from less-developed countries to the centres of the knowledge-based global economy. Together career and educational opportunities drive "brain drain and recirculation". The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the asymmetric movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies to: provide world-class educational opportunities, construct knowledge-based research and development industries, and sustainably finance the required investment for these strategies. Brazil, China and India have moved in this direction, offering world-class education in areas crucial to national development, such as biotechnology and information technology, paralleled by investments in research and development. As a result, only a small proportion of the most highly educated individuals migrate from these countries, and research and development opportunities employ national talent and even attract immigrants.

Managing conflicts of interest in the UK National Institute for Health and Care Excellence (NICE) clinical guidelines programme: qualitative study.

PubMed

Graham, Tanya; Alderson, Phil; Stokes, Tim

2015-01-01

There is international concern that conflicts of interest (COI) may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs) are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence). Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE's guideline development centres and 6 chairs of guideline development groups (GDGs). We conducted a thematic analysis. Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take "on trust" the information they receive, certain types of COI (non-financial) are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills. We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice.

Addiction research centres and the nurturing of creativity. Monitoring the European drug situation: the ongoing challenge for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

PubMed

Griffiths, Paul; Mounteney, Jane; Lopez, Dominique; Zobel, Frank; Götz, Wolfgang

2012-02-01

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the designated hub for drug-related information in the European Union. The organization's role is to provide the European Union (EU) and its Member States with a factual overview of European drug problems and a common information framework to support the drugs debate. In order to achieve its mission, the EMCDDA coordinates and relies on a network of 30 national monitoring centres, the Reitox National Focal Points. The Centre publishes on a wide range of drug-related topics, across epidemiology, interventions, laws and policies. Every November, the EMCDDA publishes its Annual Report, providing a yearly update on the European drug situation, translated into 23 EU languages. In line with its founding regulation, the EMCDDA has a role acting as an interface between the worlds of science and policy. While not a research centre in the formal sense, the results the Centre generates serve as catalysts for new research questions and help to identify priorities. Current challenges facing the agency include continuing to increase scientific standards while maintaining a strong institutional role, as well as supporting European efforts to identify, share and codify best practice in the drugs field. © 2011 EMCDDA.

Impact of a population based intervention to increase the adoption of multiple physical activity practices in centre based childcare services: a quasi experimental, effectiveness study

PubMed Central

2012-01-01

Background There is considerable scope to improve the delivery of practices that increase the physical activity of children in centre based childcare services. Few studies have reported the effectiveness of interventions to address this, particularly at a population level. The primary aim of this study was to describe the impact of an intervention to increase the adoption of multiple policies and practices to promote physical activity in centre based childcare services. Methods A quasi experimental study was conducted in centre based childcare services (n =228) in New South Wales (NSW), Australia and involved a three month intervention to increase the adoption of eight practices within childcare services that have been suggested to promote child physical activity. Intervention strategies to support the adoption of practices included staff training, resources, incentives, follow-up support and performance monitoring and feedback. Randomly selected childcare services in the remainder of NSW acted as a comparison group (n = 164) and did not receive the intervention but may have been exposed to a concurrent NSW government healthy eating and physical activity initiative. Self reported information on physical activity policies, fundamental movement skills sessions, structured physical activity opportunities, staff involvement in active play and provision of verbal prompts to encourage physical activity, small screen recreation opportunities, sedentary time, and staff trained in physical activity were collected by telephone survey with childcare service managers at baseline and 18 months later. Results Compared with the comparison area, the study found significantly greater increases in the prevalence of intervention services with a written physical activity policy, with policy referring to placing limits on small screen recreation, and with staff trained in physical activity. In addition, non-significant trends towards a greater increase in the proportion of intervention services conducting daily fundamental movement skill sessions, and such services having a physical activity policy supporting physical activity training for staff were also evident. Conclusion The intervention was effective in improving a number of centre based childcare service policies and practices associated with promoting child physical activity. Adoption of a broader range of practices may require more intensive and prolonged intervention support. PMID:22929434

Sustainable diet policy development: implications of multi-criteria and other approaches, 2008-2017.

PubMed

Lang, Tim; Mason, Pamela

2017-12-04

The objective of the present paper is to draw lessons from policy development on sustainable diets. It considers the emergence of sustainable diets as a policy issue and reviews the environmental challenge to nutrition science as to what a 'good' diet is for contemporary policy. It explores the variations in how sustainable diets have been approached by policy-makers. The paper considers how international United Nations and European Union (EU) policy engagement now centres on the 2015 Sustainable Development Goals and Paris Climate Change Accord, which require changes across food systems. The paper outlines national sustainable diet policy in various countries: Australia, Brazil, France, the Netherlands, Qatar, Sweden, UK and USA. While no overarching common framework for sustainable diets has appeared, a policy typology of lessons for sustainable diets is proposed, differentiating (a) orientation and focus, (b) engagement styles and (c) modes of leadership. The paper considers the particularly tortuous rise and fall of UK governmental interest in sustainable diet advice. Initial engagement in the 2000s turned to disengagement in the 2010s, yet some advice has emerged. The 2016 referendum to leave the EU has created a new period of policy uncertainty for the UK food system. This might marginalise attempts to generate sustainable diet advice, but could also be an opportunity for sustainable diets to be a goal for a sustainable UK food system. The role of nutritionists and other food science professions will be significant in this period of policy flux.

Optimum random and age replacement policies for customer-demand multi-state system reliability under imperfect maintenance

NASA Astrophysics Data System (ADS)

Chen, Yen-Luan; Chang, Chin-Chih; Sheu, Dwan-Fang

2016-04-01

This paper proposes the generalised random and age replacement policies for a multi-state system composed of multi-state elements. The degradation of the multi-state element is assumed to follow the non-homogeneous continuous time Markov process which is a continuous time and discrete state process. A recursive approach is presented to efficiently compute the time-dependent state probability distribution of the multi-state element. The state and performance distribution of the entire multi-state system is evaluated via the combination of the stochastic process and the Lz-transform method. The concept of customer-centred reliability measure is developed based on the system performance and the customer demand. We develop the random and age replacement policies for an aging multi-state system subject to imperfect maintenance in a failure (or unacceptable) state. For each policy, the optimum replacement schedule which minimises the mean cost rate is derived analytically and discussed numerically.

Economic Growth and Poverty Reduction: Measurement and Policy Issues. OECD Development Centre Working Paper No. 246

ERIC Educational Resources Information Center

Klasen, Stephan

2005-01-01

The aim of this Working Paper is to broaden the debate on "pro-poor growth". An exclusive focus on the income dimension of poverty has neglected the non-income dimensions. After an examination of prominent views on the linkages between economic growth, inequality, and poverty reduction this paper discusses the proper definition and…

Evidence Synthesis for Knowledge Exchange: Balancing Responsiveness and Quality in Providing Evidence for Policy and Practice

ERIC Educational Resources Information Center

Morton, Sarah; Seditas, Karen

2018-01-01

Barriers to using research in practice are well documented. This paper describes an innovative process developed by the Centre for Research on Families and Relationships to address these barriers. We supported people to define what they needed to know; how existing evidence could help; and how to use evidence in practice. An action-focused…

Room for Improvement? The Impact of Compulsory Professional Development for Teachers in England's Further Education Sector

ERIC Educational Resources Information Center

Orr, Kevin

2008-01-01

After years of neglect, the New Labour government has identified the further education (FE) sector in England as being the crucial means to achieve two policies at the centre of their project: social justice through widening participation in education and enhancing the skills of the nation's workforce to compete in a globalised economy. This has…

"Clear Educational Routes": An Example of Conservative Modernization in Swedish Upper Secondary Schools

ERIC Educational Resources Information Center

Loeb, Ingrid Henning; Wass, Karin Lumsden

2015-01-01

This article concerns the development of education for young students in Sweden who do not attend regular pathways in upper secondary education, and analyses the changes of educational policy and the organizing of teaching for this group of students. The centre of interest is the upper secondary educational reform carried out in 2011. With this…

Research Strategy 2002-5. Influencing the Future: Informing Policy and Improving Practice through Research.

ERIC Educational Resources Information Center

Dewsbury, Angela, Ed.

England's Learning and Skills Research Centre (LSRC) is working to build a strong body of evidence from rigorous research that is focused on critical and innovative thinking and models and solutions for the long-term development of post-16 learning. In 2002-2005, the LSRC will focus on the following activities and goals: identify key priorities;…

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

PubMed

MacKenzie, Ross; Collin, Jeff

2017-04-01

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

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

PubMed

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

2012-03-01

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

The Presentation of Proper Indicators for Evaluation of WHO Collaboration Centres' Activities in Iran.

PubMed

Ardakani, S Motevallizadeh; Zakiani, Sh

2012-01-01

There are thirteen WHO collaborating centres in Iran which no mechanism or model has ever been foreseen for the evaluation of them. This original research is innovative in Iran, which has been offered by the researcher through a joint research project with WHO. The aforesaid model has been approved by the International Relation Department of Ministry of Health& education. This was done to develop model and indicators for evaluation of WHOCC's activities in Iran, which includes online survey, reports, literature reviews and website searches, published literature in another country, documents in Undersecretary for Research and Technology of Iranian Ministry of Health and Medical Education. We studied collaboration centres in other countries and then compared these indicators together and presented a proper indicators for evaluation of WHOCC' activities in Iran. Evaluation of WHOCC's activities could be used as a mean for implementing policies and promoting knowledge production. Evaluation of WHOCC' activities is country's requirements.

NATIONAL POLICIES TO MEET THE CHALLENGE OF SUBSTANCE ABUSE : PROGRAMMES AND IMPLEMENTATION

PubMed Central

Malhotra, Anil; Mohan, Ashwin

2000-01-01

Drug abuse has become a growing issue of concern to humanity. India has a large consumer base of drug and alcohol abusers. This has serious repercussions in terms of morbidity & mortality. Hence the need for a national policy. In India, the Narcotic Drugs and Psychotropic Substances Act. 1985 (NDPS) provides the framework for drug abuse control in the country. A large number of measures have been undertaken as part of demand reduction activities. These include framing policies and programmes, setting up of centres, developing pilot projects, etc. However, the implementation still needs a lot to be desired. The efforts have not yet been streamlined and no revision of policies has taken place based on experience. This paper critically reviews the initiatives taken thus far to control drug abuse in our country. PMID:21407973

The impact of a local sugar sweetened beverage health promotion and price increase on sales in public leisure centre facilities

PubMed Central

Womack, Robert; Pryce, Robert; Brennan, Alan; Goyder, Elizabeth

2018-01-01

Background We aimed to evaluate the impact of a local sugar sweetened beverages (SSB) health promotion and 20p price increase in leisure centre venues and estimate the impact on consumption. Method Monthly cold drinks sales data and attendance at leisure centres across the city of Sheffield were analysed over the period January 2015-July 2017. Interrupted time-series methods were employed to estimate changes in consumption per attendance of SSB and non-SSB cold drinks following the introduction of the SSB policy from August 2016 adjusting for seasonal variation and autocorrelation. SSB price elasticities were estimated with fixed effects log-log models by SSB product type (soda can, soda bottle, soda post mix, energy drinks, juice from concentrate). Findings We estimated a 31% (95% CI 4%, 59%) reduction in units of SSB sold per attendance in the year since the policy was introduced. We did not observe substitution effects to fruit juice or water but found sales of other artificially sweetened non-SSB products increased by 27% (95% CI 6%, 47%) after the introduction of the tax. Price elasticity analysis identified that a 1% increase in price alongside health promotion leads to a 3.8% (95% CI 3.1% 4.4%) decrease in demand for SSB’s. Price elasticity of demand was highest for child friendly and high caffeine energy drinks. Interpretation Demand for SSB drinks at leisure centre venues is highly responsive to the policy, particularly for child-friendly and high caffeine energy drinks, compared with other SSB tax policy evaluations. The policy also increased purchases of carbonated non-SSB. PMID:29847553

Think Tanks, "Policy Experts" and "Ideas for" Education Policy Making in Australia

ERIC Educational Resources Information Center

Lingard, Bob

2016-01-01

This paper provides a case study of the Centre for Independent Studies (CIS) in Australia with a focus on its education policy work, specifically the report, "School funding on a budget" (SFoB). CIS is a conservative right wing advocacy think tank, established in 1976 in the aftermath of the Whitlam government's policy activism, framed…

A review of the use of health examination data from the Health Survey for England in government policy development and implementation.

PubMed

Oyebode, Oyinlola; Mindell, Jennifer S

2014-01-01

Information is needed at all stages of the policy making process. The Health Survey for England (HSE) is an annual cross-sectional health examination survey of the non-institutionalised general population in England. It was originally set up to inform national policy making and monitoring by the Department of Health. This paper examines how the nurse collected physical and biological measurement data from the HSE have been essential or useful for identification of a health issue amenable to policy intervention; initiation, development or implementation of a strategy; choice and monitoring of targets; or assessment and evaluation of policies. Specific examples of use of HSE data were identified through interviews with senior members of staff at the Department of Health and the Health and Social Care Information Centre. Policy documents mentioned by interviewees were retrieved for review, and reference lists of associated policy documents checked. Systematic searches of Chief Medical Officer Reports, Government 'Command Papers', and clinical guidance documents were also undertaken. HSE examination data have been used at all stages of the policy making process. Data have been used to identify an issue amenable to policy-intervention (e.g. quantifying prevalence of undiagnosed chronic kidney disease), in strategy development (in models to inform chronic respiratory disease policy), for target setting and monitoring (the 1992 blood pressure target) and in evaluation of health policy (the effect of the smoking ban on second hand smoke exposure). A health examination survey is a useful part of a national health information system.

A review of the use of health examination data from the Health Survey for England in government policy development and implementation

PubMed Central

2014-01-01

Background Information is needed at all stages of the policy making process. The Health Survey for England (HSE) is an annual cross-sectional health examination survey of the non-institutionalised general population in England. It was originally set up to inform national policy making and monitoring by the Department of Health. This paper examines how the nurse collected physical and biological measurement data from the HSE have been essential or useful for identification of a health issue amenable to policy intervention; initiation, development or implementation of a strategy; choice and monitoring of targets; or assessment and evaluation of policies. Methods Specific examples of use of HSE data were identified through interviews with senior members of staff at the Department of Health and the Health and Social Care Information Centre. Policy documents mentioned by interviewees were retrieved for review, and reference lists of associated policy documents checked. Systematic searches of Chief Medical Officer Reports, Government ‘Command Papers’, and clinical guidance documents were also undertaken. Results HSE examination data have been used at all stages of the policy making process. Data have been used to identify an issue amenable to policy-intervention (e.g. quantifying prevalence of undiagnosed chronic kidney disease), in strategy development (in models to inform chronic respiratory disease policy), for target setting and monitoring (the 1992 blood pressure target) and in evaluation of health policy (the effect of the smoking ban on second hand smoke exposure). Conclusions A health examination survey is a useful part of a national health information system. PMID:25114791

Reframing family-centred obesity prevention using the Family Ecological Model.

PubMed

Davison, Kirsten K; Jurkowski, Janine M; Lawson, Hal A

2013-10-01

According to the Family Ecological Model (FEM), parenting behaviours are shaped by the contexts in which families are embedded. In the present study, we utilize the FEM to guide a mixed-methods community assessment and summarize the results. Additionally, we discuss the utility of the FEM and outline possible improvements. Using a cross-sectional design, qualitative and quantitative methods were used to examine the ecologies of parents’ cognitions and behaviours specific to children’s diet, physical activity and screen-based behaviours. Results were mapped onto constructs outlined in the FEM. The study took place in five Head Start centres in a small north-eastern city. The community assessment was part of a larger study to develop and evaluate a family-centred obesity prevention programme for low-income families. Participants included eighty-nine low-income parents/caregivers of children enrolled in Head Start. Parents reported a broad range of factors affecting their parenting cognitions and behaviours. Intrafamilial factors included educational and cultural backgrounds, family size and a lack of social support from partners. Organizational factors included staff stability at key organizations, a lack of service integration and differing school routines. Community factors included social connectedness to neighbours/friends, shared norms around parenting and the availability of safe public housing and play spaces. Policy- and media-related factors included requirements of public assistance programmes, back-to-work policies and children’s exposure to food advertisements. Based on these findings, the FEM was refined to create an evidence-based,temporally structured logic model to support and guide family-centred research in childhood obesity prevention.

Reframing family-centred obesity prevention using the Family Ecological Model

PubMed Central

Davison, Kirsten K; Jurkowski, Janine M; Lawson, Hal A

2017-01-01

Objective According to the Family Ecological Model (FEM), parenting behaviours are shaped by the contexts in which families are embedded. In the present study, we utilize the FEM to guide a mixed-methods community assessment and summarize the results. Additionally, we discuss the utility of the FEM and outline possible improvements. Design Using a cross-sectional design, qualitative and quantitative methods were used to examine the ecologies of parents’ cognitions and behaviours specific to children’s diet, physical activity and screen-based behaviours. Results were mapped onto constructs outlined in the FEM. Setting The study took place in five Head Start centres in a small north-eastern city. The community assessment was part of a larger study to develop and evaluate a family-centred obesity prevention programme for low-income families. Subjects Participants included eighty-nine low-income parents/caregivers of children enrolled in Head Start. Results Parents reported a broad range of factors affecting their parenting cognitions and behaviours. Intrafamilial factors included educational and cultural backgrounds, family size and a lack of social support from partners. Organizational factors included staff stability at key organizations, a lack of service integration and differing school routines. Community factors included social connectedness to neighbours/friends, shared norms around parenting and the availability of safe public housing and play spaces. Policy- and media-related factors included requirements of public assistance programmes, back-to-work policies and children’s exposure to food advertisements. Conclusions Based on these findings, the FEM was refined to create an evidence-based, temporally structured logic model to support and guide family-centred research in childhood obesity prevention. PMID:23089267

Implementation of evidence-based weekend service recommendations for allied health managers: a cluster randomised controlled trial protocol.

PubMed

Sarkies, Mitchell N; White, Jennifer; Morris, Meg E; Taylor, Nicholas F; Williams, Cylie; O'Brien, Lisa; Martin, Jenny; Bardoel, Anne; Holland, Anne E; Carey, Leeanne; Skinner, Elizabeth H; Bowles, Kelly-Ann; Grant, Kellie; Philip, Kathleen; Haines, Terry P

2018-04-24

It is widely acknowledged that health policy and practice do not always reflect current research evidence. Whether knowledge transfer from research to practice is more successful when specific implementation approaches are used remains unclear. A model to assist engagement of allied health managers and clinicians with research implementation could involve disseminating evidence-based policy recommendations, along with the use of knowledge brokers. We developed such a model to aid decision-making for the provision of weekend allied health services. This protocol outlines the design and methods for a multi-centre cluster randomised controlled trial to evaluate the success of research implementation strategies to promote evidence-informed weekend allied health resource allocation decisions, especially in hospital managers. This multi-centre study will be a three-group parallel cluster randomised controlled trial. Allied health managers from Australian and New Zealand hospitals will be randomised to receive either (1) an evidence-based policy recommendation document to guide weekend allied health resource allocation decisions, (2) the same policy recommendation document with support from a knowledge broker to help implement weekend allied health policy recommendations, or (3) a usual practice control group. The primary outcome will be alignment of weekend allied health service provision with policy recommendations. This will be measured by the number of allied health service events (occasions of service) occurring on weekends as a proportion of total allied health service events for the relevant hospital wards at baseline and 12-month follow-up. Evidence-based policy recommendation documents communicate key research findings in an accessible format. This comparatively low-cost research implementation strategy could be combined with using a knowledge broker to work collaboratively with decision-makers to promote knowledge transfer. The results will assist managers to make decisions on resource allocation, based on evidence. More generally, the findings will inform the development of an allied health model for translating research into practice. This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) ( ACTRN12618000029291 ). Universal Trial Number (UTN): U1111-1205-2621.

Interprofessional collaborative patient-centred care: a critical exploration of two related discourses.

PubMed

Fox, Ann; Reeves, Scott

2015-03-01

There has been sustained international interest from health care policy makers, practitioners, and researchers in developing interprofessional approaches to delivering patient-centred care. In this paper, we offer a critical exploration of a selection of professional discourses related to these practice paradigms, including interprofessional collaboration, patient-centred care, and the combination of the two. We argue that for some groups of patients, inequalities between different health and social care professions and between professionals and patients challenge the successful realization of the positive aims associated with these discourses. Specifically, we argue that interprofessional and professional-patient hierarchies raise a number of key questions about the nature of professions, their relationships with one another as well as their relationship with patients. We explore how the focus on interprofessional collaboration and patient-centred care have the potential to reinforce a patient compliance model by shifting responsibility to patients to do the "right thing" and by extending the reach of medical power across other groups of professionals. Our goal is to stimulate debate that leads to enhanced practice opportunities for health professionals and improved care for patients.

Recognition of Prior Learning at the Centre of a National Strategy: Tensions between Professional Gains and Personal Development

ERIC Educational Resources Information Center

Lima, Licínio C.; Guimarães, Paula

2016-01-01

This paper focuses on recognition of prior learning as part of a national policy based on European Union guidelines for lifelong learning, and it explains how recognition of prior learning has been perceived since it was implemented in Portugal in 2000. Data discussed are the result of a mixed method research project that surveyed adult learners,…

Multivariate Bioclimatic Ecosystem Change Approaches

DTIC Science & Technology

2015-02-06

course the sandy soils of the Sandhills will not migrate. This observation suggests that a new nomenclature for ecosystems must be developed if...Coast Sandhills. At that time period, not only will the climate be similar, but the soil character will also be similar. Therefore about the year 2115...Disaggregation of global circulation model outputs decision and policy analysis. Working Paper No. 2. Cali, Colombia : International Centre for Tropical

The impact of a bundled policy intervention on improving the performance of rural healthcare in China.

PubMed

Wu, Jian; Li, Xiaofang; Song, Yao; Shao, Hui; Shi, Qian; Qin, Doudou; Xie, Shuangbao; Shi, Lizheng

2016-03-10

The strategy of health policy has been changed for improving the performances to meeting the increasing healthcare demands. However, limited evidences were found to prove that the bundled payment was valid for service delivering in public sector. This study was designed to evaluate the effectiveness of a bundled policy on strengthening the county-village communication and improving the quality of chronic disease management. This is a retrospective cohort study using the data collected in 2011, 2012 and 2014 from the Rural Health Development Project in China. The policy intervention included performance-related contract with health facilities, developing technical guideline for doctors and nurses, routine monitoring of performance, and efforts to increase public awareness about the services. There were two intervention counties in Henan Province, China, while one county with similar characteristics in Henan was selected as control. Funding allocation, work load and salary for health care workers, volume of township-to-village technical assistance were reported before and after the policy was implemented. Our study also examined the policy impacts on improving treatment outcomes of diabetes and hypertension care. There were substantial increases in the provision of the basic package of services including 96.6 % of patients with hypertension, 91.2 % of patients with diabetes under the health management system. After the intervention, there were 34.3 % (hypertension) and 42.0 % (diabetes) increase in regular follow-up visit rates, 24.6 and 17.2 % increase in blood pressure and blood glucose control rates, respectively. The family health records system covered 96 % of the rural families. Technical assistance between township health centres and village clinics were enhanced. Compared with baseline, the monthly training meeting and field supervision & guidance between township health centres and village clinics increased 1.0 meeting, 1.5 field visits, respectively, while the increases in the control county were only 0.3 meeting and 0.3 field visits. At the end of this study, 93.8 % of health workers achieved their performance goals. More patients were referred to appropriate levels of care. This bundled policy intervention effectively improved rural health care delivery. The result of our study can be used for local governments to implement performance-based health system management in developing country.

Development of a framework to improve the utilisation of malaria research for policy development in Malawi.

PubMed

Mwendera, Chikondi; de Jager, Christiaan; Longwe, Herbert; Hongoro, Charles; Phiri, Kamija; Mutero, Clifford M

2017-11-21

The existing gap between research evidence and public health practice has attributed to the unmet Millennium Development Goals in Africa and consequently, has stimulated the development of frameworks to enhance knowledge translation. These efforts aim at maximising health research utilisation in policy and practice to address the world's disease burdens, including malaria. This study aimed at developing a contextual framework to improve the utilisation of malaria research for policy development in Malawi. The study used two approaches including: two case studies of policy analysis exploring the policy-making process in Malawi, utilisation of local malaria research, and the role of key stakeholders in policy formulation process; and the assessment of facilitating factors and barriers to malaria research utilisation for policy-making in Malawi. From the case studies' lessons and elements identified during the assessment of facilitating factors and barriers, a framework is developed to promote an integrated approach to knowledge translation. In this framework the Ministry of Health is considered as the main user of knowledge from research through the demand created by the research directorate and the National Malaria Control Programme. Key documents identified as being particularly relevant to the Ministry of Health for purposes of knowledge translation include the National Health Research Agenda, Guidelines for Policy Development and Analysis, and Guidelines for Evidence Use in Policy-making. Institutions conducting academic and policy-relevant malaria research in Malawi are identified and a consolidation of their linkages with the users of research is established through the Knowledge Translation Unit, the Evidence Informed decision-making Centre, and the African Institute for Development Policy. Equally, key players in this framework are the funding partners for both research and programmes that need to see accountability and impact of their support. Independent advisors, partners, and consultants also have their vital role in the process. The framework offers a practical basis for the factors identified and their linkages to promote a co-ordinated approach to malaria research utilisation in policy-making. Its applicability and success hinges on its wider dissemination and ownership by the government through the National Malaria Control Programme.

[Transparency in public health decision-making].

PubMed

García-Altés, Anna; Argimon, Josep M

2016-11-01

Improving the quality and transparency of governmental healthcare decision-making has an impact on the health of the population through policies, organisational management and clinical practice. Moreover, the comparison between healthcare centres and the transparent feedback of results to professionals and to the wider public contribute directly to improved results. The "Results Centre" of the Catalan healthcare system measures and disseminates the results achieved by the different healthcare centres in order to facilitate a shared decision-making process, thereby enhancing the quality of healthcare provided to the population of Catalonia (Spain). This is a pioneering initiative in Spain and is aligned with the most advanced countries in terms of policies of transparency and accountability. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

"If We Are Going to Include Them We Have to Do It before We Die": Norwegian Seniors' Views of Including Seniors with Intellectual Disability in Senior Centres

ERIC Educational Resources Information Center

Ingvaldsen, Anne Kristin; Balandin, Susan

2011-01-01

Background: Concepts of inclusion and participation are at the core of both international and Norwegian policy for people with intellectual disability. The aim of this study was to identify senior centre users' views of the barriers and solutions to the inclusion of seniors with intellectual disability in community senior centres. Method: Thirty…

The Documentation Centre for Education in Europe

ERIC Educational Resources Information Center

Educational Documentation and Information, 1971

1971-01-01

This account of the Centre, prepared by the Secretariat of the Council of Europe, is in three parts: the first, Background, explains its origins and policy framework; the sections headed Operations and Publications respectively describe its functions as a library" and as a publishing house." (Author)

Plumbing the brain drain.

PubMed Central

Saravia, Nancy Gore; Miranda, Juan Francisco

2004-01-01

Opportunity is the driving force of migration. Unsatisfied demands for higher education and skills, which have been created by the knowledge-based global economy, have generated unprecedented opportunities in knowledge-intensive service industries. These multi-trillion dollar industries include information, communication, finance, business, education and health. The leading industrialized nations are also the focal points of knowledge-intensive service industries and as such constitute centres of research and development activity that proactively draw in talented individuals worldwide through selective immigration policies, employment opportunities and targeted recruitment. Higher education is another major conduit of talent from less-developed countries to the centres of the knowledge-based global economy. Together career and educational opportunities drive "brain drain and recirculation". The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the asymmetric movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies to: provide world-class educational opportunities, construct knowledge-based research and development industries, and sustainably finance the required investment for these strategies. Brazil, China and India have moved in this direction, offering world-class education in areas crucial to national development, such as biotechnology and information technology, paralleled by investments in research and development. As a result, only a small proportion of the most highly educated individuals migrate from these countries, and research and development opportunities employ national talent and even attract immigrants. PMID:15375451

The Regulation of Multi-Age Groupings in Canadian Centre-based Child Care Settings: An Analysis of Provincial and Territorial Policies, Legislation and Regulations.

ERIC Educational Resources Information Center

Bernhard, Judith; Pollard, June; Chud, Gyda; Vukelich, Goranka; Pacini-Ketchabaw, Veronica

2000-01-01

Examined the ways Canadian provincial and territorial policies address the inclusion of infants in multi-age early childhood education settings and the ways practitioners and licensing personnel interpret these policies. Noted policy patterns that affect the inclusion of infants and older children. Derived recommendations for policymakers and…

Designing healthy communities: creating evidence on metrics for built environment features associated with walkable neighbourhood activity centres.

PubMed

Gunn, Lucy Dubrelle; Mavoa, Suzanne; Boulangé, Claire; Hooper, Paula; Kavanagh, Anne; Giles-Corti, Billie

2017-12-04

Evidence-based metrics are needed to inform urban policy to create healthy walkable communities. Most active living research has developed metrics of the environment around residential addresses, ignoring other important walking locations. Therefore, this study examined: metrics for built environment features surrounding local shopping centres, (known in Melbourne, Australia as neighbourhood activity centres (NACs) which are typically anchored by a supermarket); the association between NACs and transport walking; and, policy compliance for supermarket provision. In this observational study, cluster analysis was used to categorize 534 NACs in Melbourne, Australia by their built environment features. The NACS were linked to eligible Victorian Integrated Survey of Travel Activity 2009-2010 (VISTA) survey participants (n=19,984). Adjusted multilevel logistic regressions estimated associations between each cluster typology and two outcomes of daily walking: any transport walking; and, any 'neighbourhood' transport walking. Distance between residential dwellings and closest NAC was assessed to evaluate compliance with local planning policy on supermarket locations. Metrics for 19 built environment features were estimated and three NAC clusters associated with walkability were identified. NACs with significantly higher street connectivity (mean:161, SD:20), destination diversity (mean:16, SD:0.4); and net residential density (mean:77, SD:65) were interpreted as being 'highly walkable' when compared with 'low walkable' NACs, which had lower street connectivity (mean:57, SD:15); destination diversity (mean:11, SD:3); and net residential density (mean:10, SD:3). The odds of any daily transport walking was 5.85 times higher (95% CI: 4.22, 8.11), and for any 'neighborhood' transport walking 8.66 (95% CI: 5.89, 12.72) times higher, for residents whose closest NAC was highly walkable compared with those living near low walkable NACs. Only highly walkable NACs met the policy requirement that residents live within 1km of a local supermarket. Built environment features surrounding NACs must reach certain levels to encourage walking and deliver walkable communities. Research and metrics about the type and quantity of built environment features around both walking trip origins and destinations is needed to inform urban planning policies and urban design guidelines.

Public, patient and carers' views on palliative and end-of-life care in India.

PubMed

Ramasamy Venkatasalu, M; Sirala Jagadeesh, N; Elavally, S; Pappas, Y; Mhlanga, F; Pallipalayam Varatharajan, R

2018-06-01

To systematically review the existing evidence on the Indian public, patient and carers' perspectives on palliative and end-of-life care. With a growing population of terminally ill people across the world, there is also an increasing awareness among international health policy makers of the need to improve the quality of life for terminally ill patients. Understanding service users' (patients, family and public) perspectives is crucial in developing and sustaining successful community-centred palliative nursing policies and service models especially in countries like India with diverse population. An integrative review was performed on five databases, using hand searches of key journals and reference citation tracking for empirical studies published in English from 1990 to 2015. A thematic analysis framework was used to analyse and identify key themes. Analysis of the six eligible studies revealed five themes. Themes describe how social, economic, cultural, religious, spiritual and traditional factors influenced the palliative and end-of-life care perspectives and experiences among Indians. They also illustrated preferences relating to place of care, as well as benefits and challenges of family caregiving during the last days of life. Although we found minimal evidence on user perspectives, nurses need to aware of those unique components of context-specific palliative and end-of-life care practices in India - socioeconomic, cultural and religious factors - on their nursing encounters. Nurses need to advocate same in policy development to enable accessibility and utility of palliative and end-of-life care services, which are scant in India. Nurses can be central in gathering the contextual evidence that advocate users' perspectives to inform further studies and national palliative care policies in India. Emerging policies in nursing education need to focus on integrating family-centred palliative and end-of-life care within curricula, whereas nursing practice may promote nurse-led community models to address the patchy palliative and end-of-life service provision in India. © 2017 International Council of Nurses.

Health research, development and innovation in England from 1988 to 2013: from research production to knowledge mobilization.

PubMed

Walshe, Kieran; Davies, Huw T O

2013-10-01

This paper presents a critical analysis of the development of government policy and practice on health research, development and innovation over the last 25 years - starting from the publication of a seminal report from the House of Lords Science and Technology Committee in 1988. We first set out to map and analyse the trends in ideas and thinking that have shaped research policy and practice over this period, and to put the development of health research, development and innovation in the wider context of health system reforms and changes. We argue that though this has been a transformative period for health research, rather less progress has been made in the domains of development and innovation, and we offer an analysis of why this might be the case. Drawing on advances in our understanding about how research informs practice, we then make the case for a more integrative model of research, development and innovation. This leads us to conclude that recent experiments with Collaborations for Leadership in Applied Health Research and Care and Academic Health Science Centres and Networks offer some important lessons for future policy directions.

Bridging the divide between families and health professionals’ perspectives on family‐centred care

PubMed Central

MacKean, Gail L.; Thurston, Wilfreda E.; Scott, Catherine M.

2005-01-01

Abstract Objectives  To describe and discuss key findings from a recent research project that challenge an increasingly prevalent theme, apparent in both family‐centred care research and practice, of conceptualizing family‐centred care as shifting care, care management, and advocacy responsibilities to families. The purpose of the research, from which these findings emerged, was to develop a conceptualization of family‐centred care grounded in the experiences of families and direct health‐care providers. Design  Qualitative research methods, following the grounded theory tradition, were used to develop a conceptual framework that described the dimensions of the concept of family‐centred care and their interrelationships, in the substantive area of children's developmental services. This article reports on and extends key findings from this grounded theory study, in light of current trends in the literature. Setting and participants  The substantive area that served as the setting for the research was developmental services at a children's hospital in Alberta, Canada. Data was collected through focus groups and individual interviews with 37 parents of children diagnosed with a developmental problem and 16 frontline health‐care providers. Findings  Key findings from this research project do not support the current emphasis in family‐centred care research and practice on conceptualizing family‐centred care as the shifting of care, care management, and advocacy responsibilities to families. Rather, what emerged was that parents want to work truly collaboratively with health‐care providers in making treatment decisions and on implementing a dynamic care plan that will work best for child and family. Discussion and conclusions  A definition of collaboration is provided, and the nature of collaborative relationships described. Contributing factors to the difficulty in establishing true collaborative relationships between families and health‐care professionals, where the respective roles to be played by health‐care professionals and families are jointly determined, are discussed. In light of these findings we strongly advocate for the re‐examination of current family‐centred care policy and practice. PMID:15713173

Women and tobacco: moving from policy to action.

PubMed Central

Ernster, V.; Kaufman, N.; Nichter, M.; Samet, J.; Yoon, S. Y.

2000-01-01

A gender perspective contributes to a better understanding of the epidemiological trends, social marketing strategies, economic policies, and international actions relating to women and the tobacco epidemic. Evidence is provided in this article for the negative impact of tobacco use by women and of passive smoking on the health of women and children. Use of tobacco by women is increasing and this is related to the tobacco industry's aggressive advertising, sponsorship and promotion strategies. Policy directions are proposed in this article. At all levels, a multi-pronged strategy--including changes in legislation and fiscal policies, improvements in gender-sensitive health services, and cessation programmes--should be considered. Much more gender-specific research on tobacco use is needed, particularly in developing countries. Women's empowerment and leadership should be at the centre of all tobacco control efforts and are essential for the success of national programmes and the recently introduced Framework Convention on Tobacco Control. PMID:10994262

Women and tobacco: moving from policy to action.

PubMed

Ernster, V; Kaufman, N; Nichter, M; Samet, J; Yoon, S Y

2000-01-01

A gender perspective contributes to a better understanding of the epidemiological trends, social marketing strategies, economic policies, and international actions relating to women and the tobacco epidemic. Evidence is provided in this article for the negative impact of tobacco use by women and of passive smoking on the health of women and children. Use of tobacco by women is increasing and this is related to the tobacco industry's aggressive advertising, sponsorship and promotion strategies. Policy directions are proposed in this article. At all levels, a multi-pronged strategy--including changes in legislation and fiscal policies, improvements in gender-sensitive health services, and cessation programmes--should be considered. Much more gender-specific research on tobacco use is needed, particularly in developing countries. Women's empowerment and leadership should be at the centre of all tobacco control efforts and are essential for the success of national programmes and the recently introduced Framework Convention on Tobacco Control.

Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

ERIC Educational Resources Information Center

Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William

2007-01-01

A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden.

PubMed

Fredriksson, Ingela; Geidne, Susanna; Eriksson, Charli

2018-02-01

The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden. In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis. As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

Leadership From the Centre: A New Foreign and Security Policy for Germany

DTIC Science & Technology

2016-03-01

this period, a new Germany confident enough to declare leadership from the centre assumed de facto leadership in the European Union. The dichotomy of...enough to declare leadership from the centre assumed de facto leadership in the European Union. The dichotomy of Germany’s past and ambitions in foreign...14 C. THE REALPOLITIK OF THE POST -WAR ORDER ........................ 17 III. REUNIFICATION AND THE RISE OF THE CIVILIAN POWER ............ 23 A

Barriers and facilitators to the implementation of person-centred care in different healthcare contexts.

PubMed

Moore, Lucy; Britten, Nicky; Lydahl, Doris; Naldemirci, Öncel; Elam, Mark; Wolf, Axel

2017-12-01

To empower patients and improve the quality of care, policy-makers increasingly adopt systems to enhance person-centred care. Although models of person-centredness and patient-centredness vary, respecting the needs and preferences of individuals receiving care is paramount. In Sweden, as in other countries, healthcare providers seek to improve person-centred principles and address gaps in practice. Consequently, researchers at the University of Gothenburg Centre for Person-Centred Care are currently delivering person-centred interventions employing a framework that incorporates three routines. These include eliciting the patient's narrative, agreeing a partnership with shared goals between patient and professional, and safeguarding this through documentation. To explore the barriers and facilitators to the delivery of person-centred care interventions, in different contexts. Qualitative interviews were conducted with a purposeful sample of 18 researchers from seven research studies across contrasting healthcare settings. Interviews were transcribed, translated and thematically analysed, adopting some basic features of grounded theory. The ethical code of conduct was followed and conformed to the ethical guidelines adopted by the Swedish Research Council. Barriers to the implementation of person-centred care covered three themes: traditional practices and structures; sceptical, stereotypical attitudes from professionals; and factors related to the development of person-centred interventions. Facilitators included organisational factors, leadership and training and an enabling attitude and approach by professionals. Trained project managers, patients taking an active role in research and adaptive strategies by researchers all helped person-centred care delivery. At the University of Gothenburg, a model of person-centred care is being initiated and integrated into practice through research. Knowledgeable, well-trained professionals facilitate the routines of narrative elicitation and partnership. Strong leadership and adaptive strategies are important for overcoming existing practices, routines and methods of documentation. This study provides guidance for practitioners when delivering and adapting person-centred care in different contexts. © 2016 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Centre for Applied Language Studies, University of Limerick, Ireland

ERIC Educational Resources Information Center

Chambers, Angela; Atkinson, David; Farr, Fiona

2015-01-01

The Centre for Applied Language Studies (CALS), founded in 1997, brings together researchers and postgraduate students from several disciplines in language studies, and is structured in three research clusters: New learning environments; Discourse, society and identity; and Plurilingualism and language policy. There is a certain amount of…

Detainees, staff, and health care services in immigration detention centres: a descriptive comparison of detention systems in Sweden and in the Benelux countries.

PubMed

Puthoopparambil, Soorej J; Bjerneld, Magdalena

2016-01-01

Immigration detention has been shown to negatively affect the health and well-being of detainees. The aim of the study was to describe and compare policies and practices that could affect the health and well-being of immigrant detainees in the Benelux countries (Belgium, the Netherlands, and Luxembourg) to those in Sweden. This was a case study. Data were collected in two phases using a questionnaire developed particularly for this study. In the first phase, authorities in the Benelux countries responded to the questionnaire via email. During the second phase, a research team visited detention centres in the Benelux countries to observe and further explore, strengthening findings through triangulation. Data on Swedish detention centres were collected in previous studies. Compared to the Benelux countries, Sweden has limited health care provision available in the detention centres. Swedish detention centres did not have mental health care professionals working at the centres and had fewer restrictions within the centres with regard to access to mobile phone, internet, and various recreational activities. Compared to Sweden, the detention centres in the Benelux countries have more staff categories providing services to the detainees that are provided with relevant and timely on-the-job training. All the countries, except Belgium, provide subsistence allowances to detainees. Despite the Common European Asylum System framework, differences exist among the four European Union member states in providing services to immigrant detainees. This study highlights these differences, thereby providing a window on how these diverse approaches may serve as a learning tool for improving services offered to immigrant detainees. In Sweden, the health care available to detainees and training and recruitment of staff should be improved, while the Benelux countries should strive to reduce restrictions within detention centres.

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

PubMed

Olinyk, Shannon; Gibbs, Andrew; Campbell, Catherine

2014-09-01

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

Drug policy and global regulatory capitalism: the case of new psychoactive substances (NPS).

PubMed

Seddon, Toby

2014-09-01

The recent emergence of vibrant markets in 'new psychoactive substances' or 'legal highs' has posed significant new challenges for drug policy. These partly concern what to do about them but the speed and complexity of change has also raised difficulties for how policy responses should be developed. Existing drug policy systems appear too slow and cumbersome to keep up with the pace of change, remaining locked in large part within 'old' ways of thinking that centre almost exclusively around the deployment (or not) of the criminal law and its related enforcement apparatus. In this paper, it is argued that we need to rethink the problem through the lens of regulation, in order to learn lessons from other sectors where more agile responses to changing markets and business innovation have often proved possible. By examining examples drawn from these other areas, an alternative policy-making framework can be developed, involving a more flexible mix of state regulation, civil society action and private law mechanisms. This new approach is founded on a recognition of the networked and polycentric character of effective market governance in an era of global regulatory capitalism. Copyright © 2014 Elsevier B.V. All rights reserved.

Faculty of Dentistry, Kuwait University, designated as a World Health Organization Collaborating Centre for Primary Oral Health Care.

PubMed

Behbehani, J M

2014-01-01

The Faculty of Dentistry, Kuwait University, was designated as a World Health Organization (WHO) Collaborating Centre for Primary Oral Health Care (POHC) in 2011. This article aimed to describe the following: (1) the background for this nomination, (2) the WHO Collaborating Centre for POHC, its terms of reference and 5 activities, (3) the primary health care concept as it was established in Alma-Ata, (4) the oral health situation in Kuwait and in the Middle-East region and, finally, (5) how POHC policy should be implemented in Kuwait and this region. It can be concluded that, because the caries experience is very high in Kuwait and in the other countries of the Eastern Mediterranean region, good POHC programmes should be designed and implemented in this region. The Faculty of Dentistry will strengthen its research tradition and as a WHO Collaborating Centre for POHC will try to collect information and experience from POHC in this region and exchange ideas between POHC experts in this region on how these programmes could be further developed. This will happen according to the terms of reference and activity plans of the WHO Collaborating Centre for POHC approved by the WHO Global Oral Health Programme. © 2014 S. Karger AG, Basel.

Faculty of Dentistry, Kuwait University, Designated as a World Health Organization Collaborating Centre for Primary Oral Health Care

PubMed Central

Behbehani, J.M.

2014-01-01

The Faculty of Dentistry, Kuwait University, was designated as a World Health Organization (WHO) Collaborating Centre for Primary Oral Health Care (POHC) in 2011. This article aimed to describe the following: (1) the background for this nomination, (2) the WHO Collaborating Centre for POHC, its terms of reference and 5 activities, (3) the primary health care concept as it was established in Alma-Ata, (4) the oral health situation in Kuwait and in the Middle-East region and, finally, (5) how POHC policy should be implemented in Kuwait and this region. It can be concluded that, because the caries experience is very high in Kuwait and in the other countries of the Eastern Mediterranean region, good POHC programmes should be designed and implemented in this region. The Faculty of Dentistry will strengthen its research tradition and as a WHO Collaborating Centre for POHC will try to collect information and experience from POHC in this region and exchange ideas between POHC experts in this region on how these programmes could be further developed. This will happen according to the terms of reference and activity plans of the WHO Collaborating Centre for POHC approved by the WHO Global Oral Health Programme. PMID:24504110

Risk communication and human biomonitoring: which practical lessons from the Belgian experience are of use for the EU perspective?

PubMed

Keune, Hans; Morrens, Bert; Loots, Ilse

2008-06-05

In order to investigate and monitor environmental health in Flanders (the Dutch speaking part of Belgium), the Flemish government funded the Centre of Expertise for Environment and Health, which started a human biomonitoring campaign in 2001. In addition to environmental health experts measuring environmental pollutants and health effects in human beings, social scientific experts at the Centre focus on risk communication associated with the human biomonitoring campaign. In the literature about risk communication an evolution can be traced from traditional, one-way communication, restricted to the dissemination of information from experts to the public, to more modern, two-way risk communication, with a focus on participation and cooperation between scientists, policy-makers and the public.Within the Centre of Expertise for Environment and Health this discourse was first translated into some general principles and guidelines for external communication, at a 'Ten Commandments level'. These principles needed to be incorporated in the day-to-day practice of human biomonitoring research. The social scientific experts at the Centre developed a combined risk communication strategy. On the one hand the strategy consists of traditional risk communication for external communication purposes, for example information meetings and digital newsletters. On the other hand it consists of a step by step approach of incorporating more modern risk communication, for example a risk perception questionnaire, dialogical experiments for involving local stakeholders, and an action-plan for interpreting results for policy making. With a parallel strategy of traditional and modern communication, of external and internal reflection, and through different social scientific projects, the Flemish Centre of Expertise of Environment and Health incorporates risk communication in the day-to-day practice of human biomonitoring research. A direct and continuous involvement of the social scientist, an openness between all colleagues involved, and the awareness of a fine balance between quality and practicability are important success factors. These lessons may be helpful and inspirational for a European human biomonitoring project.

Developing and implementing mental health policy in Zanzibar, a low income country off the coast of East Africa

PubMed Central

2011-01-01

Background The Zanzibar Ministry of Health and Social Welfare, concerned about mental health in the country, requested technical assistance from WHO in 1997. Aims This article describes the facilitation over many years by a WHO Collaborating Centre, of sustainable mental health developments in Zanzibar, one of the poorest countries in the world, using systematic approaches to policy design and implementation. Methods Based on intensive prior situation appraisal and consultation, a multi-faceted set of interventions combining situation appraisal to inform planning; sustained policy dialogue at Union and state levels; development of policy and legislation, development of strategic action plans, establishment of intersectoral national mental health implementation committee, establishment of national mental health coordination system, integration of mental health into primary care, strengthening of primary-secondary care liaison, rationalisation and strengthening of secondary care system, ensuring adequate supply of medicines, use of good practice guidelines and health information systems, development of services for people with intellectual disability, establishment of formal mechanism for close liaison between the mental health services and other governmental, non-governmental and traditional sectors, mental health promotion, suicide prevention, and research and development. Results The policy and legislation introduced in 1999 have resulted in enhanced mental health activities over the ensuing decade, within a setting of extreme low resource. However, advances ebb and flow and continued efforts are required to maintain progress and continue mental health developments. Lessons learnt have informed the development of mental health policies in neighbouring countries. Conclusions A multi-faceted and comprehensive programme can be effective in achieving considerable strengthening of mental health programmes and services even in extremely low resource settings, but requires sustained input and advocacy if gains are to be maintained and enhanced. PMID:21320308

Effect of patient choice and hospital competition on service configuration and technology adoption within cancer surgery: a national, population-based study.

PubMed

Aggarwal, Ajay; Lewis, Daniel; Mason, Malcolm; Purushotham, Arnie; Sullivan, Richard; van der Meulen, Jan

2017-11-01

There is a scarcity of evidence about the role of patient choice and hospital competition policies on surgical cancer services. Previous evidence has shown that patients are prepared to bypass their nearest cancer centre to receive surgery at more distant centres that better meet their needs. In this national, population-based study we investigated the effect of patient mobility and hospital competition on service configuration and technology adoption in the National Health Service (NHS) in England, using prostate cancer surgery as a model. We mapped all patients in England who underwent radical prostatectomy between Jan 1, 2010, and Dec 31, 2014, according to place of residence and treatment location. For each radical prostatectomy centre we analysed the effect of hospital competition (measured by use of a spatial competition index [SCI], with a score of 0 indicating weakest competition and 1 indicating strongest competition) and the effect of being an established robotic radical prostatectomy centre at the start of 2010 on net gains or losses of patients (difference between number of patients treated in a centre and number expected based on their residence), and the likelihood of closing their radical prostatectomy service. Between Jan 1, 2010, and Dec 31, 2014, 19 256 patients underwent radical prostatectomy at an NHS provider in England. Of the 65 radical prostatectomy centres open at the start of the study period, 23 (35%) had a statistically significant net gain of patients during 2010-14. Ten (40%) of these 23 were established robotic centres. 37 (57%) of the 65 centres had a significant net loss of patients, of which two (5%) were established robotic centres and ten (27%) closed their radical prostatectomy service during the study period. Radical prostatectomy centres that closed were more likely to be located in areas with stronger competition (highest SCI quartile [0·87-0·92]; p=0·0081) than in areas with weaker competition. No robotic surgery centre closed irrespective of the size of net losses of patients. The number of centres performing robotic surgery increased from 12 (18%) of the 65 centres at the beginning of 2010 to 39 (71%) of 55 centres open at the end of 2014. Competitive factors, in addition to policies advocating centralisation and the requirement to do minimum numbers of surgical procedures, have contributed to large-scale investment in equipment for robotic surgery without evidence of superior outcomes and contributed to the closure of cancer surgery units. If quality performance and outcome indicators are not available to guide patient choice, these policies could threaten health services' ability to deliver equitable and affordable cancer care. National Institute for Health Research. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Higher Education Policies in Mexico in the 1990s: A Critical Balance

ERIC Educational Resources Information Center

Rodriguez-Gomez, Roberto; Casanova-Cardiel, Hugo

2005-01-01

This article analyses recent policies in higher education in Mexico. The last two decades provide the starting point, and the interpretation centres around higher education policies drawn up by successive presidential administrations of Salinas de Gortari (1988-1994) and Zedillo Ponce de Leon (1994-2000). The second part sets out an initial…

Schooling Transnational Speakers of the Societal Language: Language Variation Policy-Making in Madrid and Toronto

ERIC Educational Resources Information Center

Schecter, Sandra R.; García Parejo, Isabel; Ambadiang, Théophile; James, Carl E.

2014-01-01

A cross-national comparative study in Toronto, Ontario, Canada and Madrid, Spain examines educational policies and practices that target immigrant students for whom the language variety normally spoken in the host country represents a second dialect. Policy contexts and schooling environments of the two urban centres were analyzed to gain deeper…

Politics of oil in Venezuela: A decision-making analysis of PDVSA's internationalisation policy

NASA Astrophysics Data System (ADS)

Baena, Cesar E.

The high degree of international vertical integration achieved by the Venezuelan state oil enterprise, Petroleos de Venezuela S.A. (PDVSA), has placed it among the most important oil multinationals (MNs). The policy of creating downstream outlets through the establishment of foreign direct investments (FDIs) in the form of refinery assets was given the term of 'internationalisation'. By analysing PDVSA's internationalisation policy, the thesis explores the difficulties encountered by a major state-owned enterprise (SOE) from a developing country in its efforts to grow beyond national borders. The study focuses on the impact of democratic bargaining on the process of oil policymaking in Venezuela, stressing the constraints posed by politics on PDVSA's efforts to expand its foreign operations. Specifically, the study examines the intricate policymaking process that shaped the origins and the development of PDVSA's internationalisation policy, underlying the events and factors that influenced each one of its three distinguishable phases: adoption, formulation, and implementation. The tensions between politics and corporate strategy are highlighted at the core of the policymaking process. The study also looks at the relationship between the oil industry and the other two key decision-making centres involved in the oil policymaking process: the executive and Congress. In exploring the ways in which each one of them sought to influence policy outcome, the study attempts to gain insight into the main factors that prompted the tensions among the policy actors involved. Three environments, or pressure-generating centres, constantly exert influence on the oil industry: the oil market, the political context and the government's financial situation. By seeking to determine the industry's response to their pervasive influence on policy formulation and implementation, this research ascertains the extent to which these variables influenced the decision-making process that characterised PDVSA's internationalisation policy. Being too powerful a company in a developing country context where the executive and the legislature find it increasingly difficult to exert their means of control over it had the effect of minimising some of PDVSA's characteristics as SOE: accountability to Congress and subordination to the executive. The thesis argues that as a result of its role as oil MN PDVSA has minimised some of its attributes as SOE. In turn, the more PDVSA has diminished its status as SOE, the more the government has increased its dependence over it. The successful accomplishment of PDVSA's internationalisation policy has stressed this equation, highlighting the contentious interaction between an excessively dependent govemment and a company struggling to reconcile its roles as both a SOE and a MN. By examining the policy process that brought about the international expansion of a large SOE from a developing country, the findings of the thesis contribute significantly to the political science and public administration literatures and suggests new paths for further research in the area of public policymaking processes. (Abstract shortened by UMI.).

Community and consumer participation in Australian health services--an overview of organisational commitment and participation processes.

PubMed

Johnson, A; Silburn, K

2000-01-01

This article briefly describes recent initiatives to improve consumer participation in health services that have led to the establishment of the National Resource Centre for Consumer Participation in Health. The results of a component of the needs assessment undertaken by the newly established Centre are presented. They provide a 'snapshot' of the types of feedback and participation processes mainly being utilised by Australian health services at the different levels of seeking information, information sharing and consultation, partnership, delegated power and consumer control. They also allow identification of the organisational commitment made by Australian health services to support a more coordinated approach to community and consumer feedback and participation at different levels of health services such as particular emphasis on determining the presence of community and consumer participation in key organisational statements, specific consumer policies and plans, identifiable leadership, inclusion into job descriptions, allocation of resources, and staff development and consumer training. Discussion centres around four key observations and some of the key perceived external barriers.

A Systems Approach to Identifying and Managing Opportunities and Constraints to Delivering Innovation Policy for Agriculture: An Analysis of the Australian Cooperative Research Centres (CRC) Program

ERIC Educational Resources Information Center

Sandall, Jean; Cooksey, Ray; Wright, Vic

2011-01-01

In this paper we outline an analytical approach to identifying points in the policy process where management intervention to adjust organizational design could enhance delivery of innovation policy over time. We illustrate this approach using an example from native vegetation policy in the state of Victoria, Australia. We then use this approach to…

Stakeholder perceptions of a nurse led walk-in centre.

PubMed

Parker, Rhian M; Desborough, Jane L; Forrest, Laura E

2012-11-05

As many countries face primary care medical workforce shortages and find it difficult to provide timely and affordable care they seek to find new ways of delivering first point of contact health care through developing new service models. In common with other areas of rural and regional Australia, the Australian Capital Territory (ACT) is currently experiencing a general practitioner (GP) workforce shortage which impacts significantly on the ability of patients to access GP led primary care services. The introduction of a nurse led primary care Walk-in Centre in the ACT aimed to fulfill an unmet health care need in the community and meet projected demand for health care services as well as relieve pressure on the hospital system. Stakeholders have the potential to influence health service planning and policy, to advise on the potential of services to meet population health needs and to assess how acceptable health service innovation is to key stakeholder groups. This study aimed to ascertain the views of key stakeholders about the Walk-in Centre. Stakeholders were purposively selected through the identification of individuals and organisations which had organisational or professional contact with the Walk-in Centre. Semi structured interviews around key themes were conducted with seventeen stakeholders. Stakeholders were generally supportive of the Walk-in Centre but identified key areas which they considered needed to be addressed. These included the service's systems, full utilisation of the nurse practitioner role and adequate education and training. It was also suggested that a doctor could be available to the Centre as a source of referral for patients who fall outside the nurses' scope of practice. The location of the Centre was seen to impact on patient flows to the Emergency Department. Nurse led Walk-in Centres are one response to addressing primary health care medical workforce shortages. Whilst some stakeholders have reservations about the model others are supportive and see the potential the model has to provide accessible primary health care. Any further developments of nurse-led Walk-in Centres need to take into account the views of key stakeholders so as to ensure that the model is acceptable and sustainable.

Flood Risk Management Policy in Scotland: Research Questions Past, Present and Future

NASA Astrophysics Data System (ADS)

Wilkinson, Mark; Hastings, Emily; MacDonald, Jannette

2016-04-01

Scotland's Centre of Expertise for Waters (CREW) delivers accessible research and expert opinion to support the Scottish Government and its delivery partners in the development and implementation of water policy. It was established in 2011 by the Scottish Government (Rural and Environmental Science and Analytical Services) in recognition of a gap in the provision of short term advice and research to policy (development and implementation). Key policy areas include the Water Framework Directive, Floods Directive, Drinking Water Directive, Habitats Directive and Scotland's Hydro Nation Strategy. CREW is unique in its demand-driven and free service for policy makers and practitioners, managing the engagement between scientists, policy makers and practitioners to work effectively across this interface. The users of CREW are the Scottish Government, Scottish Environment Protection Agency, Scottish Natural Heritage and Scottish Water. CREW has funded around 100 projects relating to water policy since its inception in 2011. Of these, a significant number relate to flood risk management policy. Based on a review of work to date, this poster will give an overview of these projects and a forward look at the challenges that remain. From learning from community led flood risk management to surface water flood forecasting for urban communities, links will be made between sustainable and traditional flood risk management while considering the perceptions of stakeholders to flood risk management. How can we deliver fully integrated flood risk management options? How policy makers, scientists and land managers can better work together will also be explored.

R&D Centres in Mexico in an Open Economy: Redefining Operating Practices

ERIC Educational Resources Information Center

de Gortari Rabiela, Rebeca; Corral, Maria Josefa Santos

2004-01-01

Structural changes in Mexico's economy and trade policies have influenced firms' efforts to achieve technological innovation and improve their learning processes. In this context, R&D centres face new challenges in responding to firms' technological needs. The authors analyse how this new environment is affecting the operating practices of R&D…

Managing the technological edge: the UNESCO International Computation Centre and the limits to the transfer of computer technology, 1946-61.

PubMed

Nofre, David

2014-07-01

The spread of the modern computer is assumed to have been a smooth process of technology transfer. This view relies on an assessment of the open circulation of knowledge ensured by the US and British governments in the early post-war years. This article presents new historical evidence that question this view. At the centre of the article lies the ill-fated establishment of the UNESCO International Computation Centre. The project was initially conceived in 1946 to provide advanced computation capabilities to scientists of all nations. It soon became a prize sought by Western European countries like The Netherlands and Italy seeking to speed up their own national research programs. Nonetheless, as the article explains, the US government's limitations on the research function of the future centre resulted in the withdrawal of European support for the project. These limitations illustrate the extent to which US foreign science policy could operate as (stealth) industrial policy to secure a competitive technological advantage and the prospects of US manufacturers in a future European market.

Patient-centred outcomes research: perspectives of patient stakeholders.

PubMed

Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Schwartz, J Sanford; Jayadevappa, Ravishankar

2017-11-01

To elicit patient stakeholders' experience and perspectives about patient-centred care. Qualitative. A large urban healthcare system. Four patient stakeholders who are prostate cancer survivors. Experience and perspectives of patient stakeholders regarding patient-centred care and treatment decisions. Our patient stakeholders represented a diverse socio-demographic group. The patient stakeholders identified engagement and dialogue with physicians as crucial elements of patient-centred care model. The degree of patient-centred care was observed to be dependent on the situations. High severity conditions warranted a higher level of patient involvement, compared to mild conditions. They agreed that patient-centred care should not mean that patients can demand inappropriate treatments. An important attribute of patient-centred outcomes research model is the involvement of stakeholders. However, we have limited knowledge about the experience of patient stakeholders in patient-centred outcomes research. Our study indicates that patient stakeholders offer a unique perspective as researchers and policy-makers aim to precisely define patient-centred research and care.

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial.

PubMed

Edvardsson, David; Sjögren, Karin; Lood, Qarin; Bergland, Ådel; Kirkevold, Marit; Sandman, Per-Olof

2017-01-17

The literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this. The study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents' thriving, relatives' satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives' experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention. The study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care. The trial was registered at ClinicalTrials.gov March 19, 2016, identifier NCT02714452 .

Sustainable urban development in Brisbane City--the Holy Grail?

PubMed

Rahman, K; Weber, T

2003-01-01

Impacts from urban stormwater runoff on receiving environments have been well documented, particularly through specific regional scientific studies. Using various local government planning and management elements, urban developments in Brisbane City are now able to address stormwater management in an increasingly holistic context. One key initiative includes facilitating Water Sensitive Urban Design (WSUD) components within an Integrated Water Management Strategy that looks at policy formation, planning strategies, design option, community marketing and acceptance, maintenance programs and finally evaluation of various WSUD approaches. These can include the use of Natural Channel Designs, grassed swales, bio-filtration systems, porous pavements and roofwater tanks in several economic combinations. By linking with the Cooperative Research Centre for Catchment Hydrology, Brisbane City Council has influenced the design of WSUD planning tools and benefited the city with academic inputs into extensive evaluation programs. As well, it has also contributed to the Cooperative Research Centre's research outcomes. These evaluation programs are increasingly providing better understanding of various stormwater quality best management practices throughout Australia. As part of the overall implementation process, active involvement by a range of stakeholders has been crucial. These stakeholders have included internal planning, development assessment and design staff, external consultants, developers, and other local and state government agencies. The latter two groups are assisting in the important task of "regionalisation" of Brisbane City Council's policies and guidelines. Implementation of WSUD initiatives and stormwater re-use strategies under Council's new "Integrated Water Management" agenda are showing some excellent results, suggesting that sustainable urban development is no longer like the search for the Holy Grail.

The adaptive approach for storage assignment by mining data of warehouse management system for distribution centres

NASA Astrophysics Data System (ADS)

Ming-Huang Chiang, David; Lin, Chia-Ping; Chen, Mu-Chen

2011-05-01

Among distribution centre operations, order picking has been reported to be the most labour-intensive activity. Sophisticated storage assignment policies adopted to reduce the travel distance of order picking have been explored in the literature. Unfortunately, previous research has been devoted to locating entire products from scratch. Instead, this study intends to propose an adaptive approach, a Data Mining-based Storage Assignment approach (DMSA), to find the optimal storage assignment for newly delivered products that need to be put away when there is vacant shelf space in a distribution centre. In the DMSA, a new association index (AIX) is developed to evaluate the fitness between the put away products and the unassigned storage locations by applying association rule mining. With AIX, the storage location assignment problem (SLAP) can be formulated and solved as a binary integer programming. To evaluate the performance of DMSA, a real-world order database of a distribution centre is obtained and used to compare the results from DMSA with a random assignment approach. It turns out that DMSA outperforms random assignment as the number of put away products and the proportion of put away products with high turnover rates increase.

Moving the mental health equity dialogue forward: the promise of a social entrepreneur framework.

PubMed

Kidd, Sean A; McKenzie, Kwame J

2013-03-01

In this commentary the authors highlight the difficulties developed countries have had in generating effective means of addressing inequities in mental health. Limitations in research, policy, and service responses are discussed and the social entrepreneurship framework is suggested as a means of better understanding how mental health disparities might be addressed. The example of the Canadian Centre for Victims of Torture is provided to illustrate the points made.

Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis

PubMed Central

Hui, Chi-Leung

2017-01-01

Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an (Q,r) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights. PMID:29527283

Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis.

PubMed

Pan, An; Hui, Chi-Leung

2017-01-01

Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an ( Q , r ) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.

National public health law: a role for WHO in capacity-building and promoting transparency.

PubMed

Marks-Sultan, Géraldine; Tsai, Feng-Jen; Anderson, Evan; Kastler, Florian; Sprumont, Dominique; Burris, Scott

2016-07-01

A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries' legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law - from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a public health law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in public health law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance.

National public health law: a role for WHO in capacity-building and promoting transparency

PubMed Central

Tsai, Feng-jen; Anderson, Evan; Kastler, Florian; Sprumont,, Dominique; Burris, Scott

2016-01-01

Abstract A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries’ legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law – from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a public health law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in public health law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance. PMID:27429492

Fostering Effective Early Learning (FEEL) through a professional development programme for early childhood educators to improve professional practice and child outcomes in the year before formal schooling: study protocol for a cluster randomised controlled trial.

PubMed

Melhuish, Edward; Howard, Steven J; Siraj, Iram; Neilsen-Hewett, Cathrine; Kingston, Denise; de Rosnay, Marc; Duursma, Elisabeth; Luu, Betty

2016-12-19

A substantial research base documents the benefits of attendance at high-quality early childhood education and care (ECEC) for positive behavioural and learning outcomes. Research has also found that the quality of many young children's experiences and opportunities in ECEC depends on the skills, dispositions and understandings of the early childhood adult educators. Increasingly, research has shown that the quality of children's interactions with educators and their peers, more than any other programme feature, influence what children learn and how they feel about learning. Hence, we sought to investigate the extent to which evidence-based professional development (PD) - focussed on promoting sustained shared thinking through quality interactions - could improve the quality of ECEC and, as a consequence, child outcomes. The Fostering Effective Early Learning (FEEL) study is a cluster randomised controlled trial for evaluating the benefits of a professional development (PD) programme for early childhood educators, compared with no extra PD. Ninety long-day care and preschool centres in New South Wales, Australia, will be selected to ensure representation across National Quality Standards (NQS) ratings, location, centre type and socioeconomic areas. Participating centres will be randomly allocated to one of two groups, stratified by centre type and NQS rating: (1) an intervention group (45 centres) receiving a PD intervention or (2) a control group (45 centres) that continues engaging in typical classroom practice. Randomisation to these groups will occur after the collection of baseline environmental quality ratings. Primary outcomes, at the child level, will be two measures of language development: verbal comprehension and expressive vocabulary. Secondary outcomes at the child level will be measures of early numeracy, social development and self-regulation. Secondary outcomes at the ECEC room level will be measures of environmental quality derived from full-day observations. In all cases, data collectors will be blinded to group allocation. This is the first randomised controlled trial of a new approach to PD, which is focussed on activities previously found to be influential in children's early language, numeracy, social and self-regulatory development. Results should inform practitioners, policy-makers and families of the value of specific professional development for early childhood educators. Australian New Zealand Clinical Trials Registry (ACTRN) identifier ACTRN12616000536460 . Registered on 27 April 2016. This trial was retrospectively registered, given the first participant (centre) had been enrolled at the time of registration.

Addiction research centres and the nurturing of creativity: The Centre for Addictions Research of British Columbia, Canada

PubMed Central

Stockwell, Tim; Reist, Dan; Macdonald, Scott; Benoit, Cecilia; Jansson, Mikael

2015-01-01

The Centre for Addictions Research of British Columbia (CARBC) was established as a multi-campus and multi-disciplinary research centre administered by the University of Victoria (UVic) in late 2003. Its core funding is provided from interest payments on an endowment of CAD$10.55 million. It is supported by a commitment to seven faculty appointments in various departments at UVic. The Centre has two offices, an administration and research office in Victoria and a knowledge exchange unit in Vancouver. The two offices are collaborating on the implementation of CARBC’s first 5-year plan which seeks to build capacity in British Columbia for integrated multi-disciplinary research and knowledge exchange in the areas substance use, addictions and harm reduction. Present challenges include losses to the endowment caused by the 2008/2009 economic crisis and difficulties negotiating faculty positions with the university administration. Despite these hurdles, to date each year has seen increased capacity for the Centre in terms of affiliated scientists, funding and staffing as well as output in terms of published reports, electronic resources and impacts on policy and practice. Areas of special research interest include: drug testing in the work-place, epidemiological monitoring, substance use and injury, pricing and taxation policies, privatization of liquor monopolies, poly-substance use, health determinants of indigenous peoples, street-involved youth and other vulnerable populations at risk of substance use problems. Further information about the Centre and its activities can be found on http://www.carbc.ca. PMID:20078479

Compelling Diversities, Educational Intersections: Policy, Practice, Parity

ERIC Educational Resources Information Center

Taylor, Yvette

2013-01-01

The ninth international Gender and Education Association Conference "Compelling Diversities, Educational Intersections" hosted by the Weeks Centre for Social and Policy Research, London South Bank University engages with key debates surrounding the interplay between dynamics of education, work, employment and society in the context of…

ESCAP/POPIN Expert Working Group on Development of Population Information Centres and Networks, 20-23 June 1984, Bangkok, Thailand.

PubMed

1984-07-01

An overview of current population information programs at the regional, national, and global level was presented at a meeting of the Expert Working Group on Development of Population Information Centres and Networks. On the global level, the decentralized Population Information Network (POPIN) was established, consisting of population libraries, clearinghouses, information systems, and documentation centers. The Economic and Social Commission for Asia and the Pacific (ESCAP) Regional Population Information Centre (PIC) has actively promoted the standardization of methodologies for the collection and processing of data, the use of compatible terminology, adoption of classification systems, computer-assisted data and information handling, and improved programs of publication and infomration dissemination, within and among national centers. Among the national PICs, 83% are attached to the primary national family planning/fertility control unit and 17% are attached to demographic data, research, and analysis units. Lack of access to specialized information handling equipment such as microcomputers, word processors, and computer terminals remains a problem for PICs. Recommendations were made by the Expert Working Group to improve the functions of PICs: 1) the mandate and resoponsibilities of the PIC should be explicilty stated; 2) PICs should collect, process, and disseminate population information in the most effective format to workers in the population feild; 3) PICs should be given flexibility in the performance of activitites by their governing bodies; 4) short-term training should be provided in computerization and dissemination of information; 5) research and evaluation mechanisms for PIC activities should be developed; 6) PIC staff should prepare policy briefs for decision makers; 7) access to parent organizations should be given to nongovernment PICs; 8) study tours to foreign PICs should be organized for PIC staff; and 9) on-the-job training in indexing and abstracting should be provided. Networking among PICs can be further facilitated by written acquisition policies, automation of bibliographic information, common classification systems, and exchange of ideas and experience between various systems.

"Putting Music On": Everyday Leisure Activities, Choice-Making and Person-Centred Planning in a Supported Living Scheme

ERIC Educational Resources Information Center

Hassan, Nedim

2017-01-01

Background: Person-centred planning, which commonly becomes formalised within services for people with learning disabilities through an Essential Lifestyle Plan (ELP), was intended to help place the choices of individuals at the forefront of service provision. However, beyond UK government policy rhetoric, scholars have raised issues regarding the…

People-centred science: strengthening the practice of health policy and systems research

PubMed Central

2014-01-01

Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research – recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change. PMID:24739525

People-centred science: strengthening the practice of health policy and systems research.

PubMed

Sheikh, Kabir; George, Asha; Gilson, Lucy

2014-04-17

Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research - recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change.

Integrated primary health care: Finnish solutions and experiences

PubMed Central

Kokko, Simo

2009-01-01

Background Finland has since 1972 had a primary health care system based on health centres run and funded by the local public authorities called ‘municipalities’. On the world map of primary health care systems, the Finnish solution claims to be the most health centre oriented and also the widest, both in terms of the numbers of staff and also of different professions employed. Offering integrated care through multi-professional health centres has been overshadowed by exceptional difficulties in guaranteeing a reasonable access to the population at times when they need primary medical or dental services. Solutions to the problems of access have been found, but they do not seem durable. Description of policy practice During the past 10 years, the health centres have become a ground of active development structural change, for which no end is in sight. Broader issues of municipal and public administration structures are being solved through rearranging primary health services. In these rearrangements, integration with specialist services and with social services together with mergers of health centres and municipalities are occurring at an accelerated pace. This leads into fundamental questions of the benefits of integration, especially if extensive integration leads into the threat of the loss of identity for primary health care. Discussion This article ends with some lessons to be learned from the situation in Finland for other countries. PMID:19590612

Integrated water cycle planning for towns in New South Wales, Australia.

PubMed

Schneider, P; Davison, A; Langdon, A; Freeman, G; Essery, C; Beatty, R; Toop, P

2003-01-01

Integration means different things to different people and as a consequence appears to only partially deliver on promised outcomes. For effective integrated water cycle management these outcomes should include improved water use efficiency, less waste, environmental sustainability, and provide secure and reliable supply to meet social and economic needs. The objective of integration is the management and combination of all these outcomes as part of a whole, so as to provide better outcomes than would be expected by managing the parts independently. Integration is also a consequence of the Water Reforms embarked on by the NSW State Government in 1995. The key goals of the reforms are clean and healthy rivers and groundwaters, and the establishment of more secure water entitlements for users. They are also essential for meeting the Council of Australian Government (COAG) water management strategies. The policies and guidelines that formed the NSW Water Reforms were the basis of the Water Management Act 2000 (NSW) (WMA) which is the legislative framework for water management in NSW. The NSW Department of Land and Water Conservation has developed an approach to integrated water cycle management for rural centres in NSW based on a catchment and policy context. This approach includes consideration of catchment wide needs and issues, environmental sustainability, government policy and community objectives in the development of an integrated water cycle plan. The approach provides for a transparent assessment of priorities and how to deal with them, and while specific to urban centres, could easily be expanded for use in the management of the whole of the catchment water cycle. Integration of the water cycle is expected to offer benefits to the local environment, community and economy. For instance, any unused proportion of an urban centre's water entitlement, or an offset against this entitlement created through returned flows (such as via good quality sewage effluent discharge to a river), can provide a surplus which is available to be traded on an annual basis. Further, improved demand management within an urban centre can be expected to result in a reduction in abstraction against the licence entitlement. This may result in the increased availability of in-stream water for environmental or other purposes and is expected to increase the economic value of returned water. Improved water use efficiencies are also expected to result in reduced capital works (and their associated costs) as the efficiency of service delivery and resource use improves. In this paper an example of the application of this process is provided and the outcomes discussed.

Addiction research centres and the nurturing of creativity. National institute on alcohol and drugs policies, Brazil.

PubMed

Laranjeira, Ronaldo; Mitsuhiro, Sandro Sendin

2012-04-01

The National Institute of Public Policy for Alcohol and Other Drugs (INPAD) is based at the Federal University of São Paulo, Brazil, and was created to collect scientific evidence regarding epidemiology, develop new therapeutic approaches, study health economics and provide education to subsidize the proper measures to change the Brazilian scenario of alcohol and drug consumption. Policies directed towards the control of alcohol and drugs in Brazil are fragmented, poorly enforced and therefore ineffective. The unregulated market of alcohol in Brazil has contributed to the worsening health of the Brazilian population. Since 1994, INPAD has participated actively in academic debates and discussions about alcohol and drug policies and their effects on the political welfare of the country. Many scientific papers and books have been published on this subject, and the internet and other media have provided excellent opportunities for the dissemination of specialized information to the general population. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Policy Towards Social Sciences in Asia and Oceania. Report on the Meeting of Experts. Manila, Philippines, 3-7 April 1978.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and Oceania.

The document reports on a meeting of Asian social science policy experts sponsored by UNESCO. The objectives of the meeting were to review the basic elements of the social science policies of countries in Asia and Oceania, to examine the feasibility of establishing a Regional Centre for Social Science Research, and to make recommendations for…

“A preferred consultant and partner to the Royal Government, NGOs, and the community”: British American Tobacco’s access to policymakers in Cambodia

PubMed Central

Collin, Jeff

2017-01-01

British American Tobacco Cambodia (BATC) has dominated the country’s tobacco market since its launch in 1996. Aggressive marketing in a weak regulatory environment and strategies to influence tobacco control policy have contributed to an emerging tobacco-related public health crisis. Analysis of internal tobacco industry documents, issues of BATC’s in-house newsletter, civil society reports and media demonstrate that BATC officials have successfully sought to align the company with Cambodia’s increasingly controversial political and business leadership that is centred around the Cambodian People’s Party with the aim of gaining access to policy makers and influencing the policy process. Connections to the political elite have resulted in official recognition of the company’s ostensible contribution to Cambodia’s economic and social development and, more significantly, provided BATC with opportunities to petition policy makers and to dilute tobacco control regulation. Corporate promotion of its contribution to Cambodia’s economic and social development is at odds with its determined efforts to thwart public health regulation and Cambodia’s compliance with the Framework Convention on Tobacco Control. PMID:27079136

Virtual care policy recommendations for patient-centred primary care: findings of a consensus policy dialogue using a nominal group technique.

PubMed

Shaw, James; Jamieson, Trevor; Agarwal, Payal; Griffin, Bailey; Wong, Ivy; Bhatia, R Sacha

2017-01-01

Background The development of new virtual care technologies (including telehealth and telemedicine) is growing rapidly, leading to a number of challenges related to health policy and planning for health systems around the world. Methods We brought together a diverse group of health system stakeholders, including patient representatives, to engage in policy dialogue to set health system priorities for the application of virtual care in the primary care sector in the Province of Ontario, Canada. We applied a nominal group technique (NGT) process to determine key priorities, and synthesized these priorities with group discussion to develop recommendations for virtual care policy. Methods included a structured priority ranking process, open-ended note-taking, and thematic analysis to identify priorities. Results Recommendations were summarized under the following themes: (a) identify clear health system leadership to embed virtual care strategies into all aspects of primary and community care; (b) make patients the focal point of health system decision-making; (c) leverage incentives to achieve meaningful health system improvements; and (d) building virtual care into streamlined workflows. Two key implications of our policy dialogue are especially relevant for an international audience. First, shifting the dialogue away from technology toward more meaningful patient engagement will enable policy planning for applications of technology that better meet patients' needs. Second, a strong conceptual framework on guiding the meaningful use of technology in health care settings is essential for intelligent planning of virtual care policy. Conclusions Policy planning for virtual care needs to shift toward a stronger focus on patient engagement to understand patients' needs.

Addiction research centres and the nurturing of creativity: The Alcohol & Drug Abuse Research Unit at the South African Medical Research Council - strengthening substance abuse research and policy in South Africa.

PubMed

Parry, Charles; Morojele, Neo; Myers, Bronwyn; Plüddemann, Andreas

2013-01-01

The Alcohol and Drug Abuse Research Unit (ADARU) was established at the South African Medical Research Council (MRC) at the beginning of 2001, although its origins lie in the activities of the Centre for Epidemiological Research in Southern Africa and other MRC entities. Initial challenges included attracting external funding, recruiting new staff, developing the skills of junior staff, publishing in international journals and building national and international collaborative networks. ADARU currently comprises a core staff of 33 members who work on 22 projects spanning substance use epidemiology and associated consequences, intervention studies with at-risk populations and services research. A large component of this portfolio focuses on the link between alcohol and other drug use and human immunodeficiency virus (HIV) risk behaviour, with funding from the US Centers for Disease Control and Prevention. Junior staff members are encouraged to develop independent research interests and pursue PhD studies. Research outputs, such as the 20 papers that were published in 2010 and the 35 conference presentations from that year, form an important part of the unit's research translation activities. We engage actively with policy processes at the local, provincial, national and international levels, and have given particular attention to alcohol policy in recent years. The paper includes an analysis of major challenges currently facing the unit and how we are attempting to address them. It ends with some thoughts on what the unit intends doing to enhance the quality of its research, the capacity of its staff and its international standing. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

CEDEFOP Annual Report 2013

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2014

2014-01-01

Accountability and dissemination of its work are important elements of Cedefop's policy to provide assurance to stakeholders for resources used and results achieved. For a centre of expertise and policy advice like Cedefop, the impact of which is hard to gauge for the common European citizen, legitimacy of public expenditure is important, and is…

Illusionary Inclusion--What Went Wrong with New Labour's Landmark Educational Policy?

ERIC Educational Resources Information Center

Hodkinson, Alan

2012-01-01

This article examines the emergence and evolution of New Labour's landmark educational policy; namely that of inclusion. The author, Alan Hodkinson, associate professor at the Centre for Cultural and Disability Studies at Liverpool Hope University, illuminates his conceptual difficulties in attempting to define what inclusion was and what…

From Sure Start to Children's Centres: Capturing the Erosion of Social Capital

ERIC Educational Resources Information Center

Bagley, Carl

2011-01-01

Discourses within the UK Labour government's welfare policy agenda have consistently featured a reformulation of programmatic governance away from both centralised hierarchies and neo-liberal markets to a social policy strategy that highlights a commitment to inclusive partnership working. Significantly, this process of meaningful social…

Passionate Attachments: Higher Education, Policy, Knowledge, Emotion and Social Justice

ERIC Educational Resources Information Center

Hey, Valerie; Leathwood, Carole

2009-01-01

We explore the significance of the "affective turn" in respect to higher education policy in the UK. This turn centres on creating new subjects of attention for the "employable" student and the "non-traditional" student, the latter defined as students from backgrounds with no earlier history of higher education…

Centring and Marginalizing: The "Soft Middle" and Japanese Minority Education

ERIC Educational Resources Information Center

Bondy, Christopher

2014-01-01

Examining the gap between national level minority education policies and local implementation in Japan, this paper considers this gap as a "soft middle" whereby local communities and schools have considerable leeway in how they implement policies. In particular, this paper focuses on Japan's largest minority group, the…

Multiliteracies and Family Language Policy in an Urban Inuit Community

ERIC Educational Resources Information Center

Patrick, Donna; Budach, Gabriele; Muckpaloo, Igah

2013-01-01

This study investigates the intersection of family language policy with Indigenous multiliteracies and urban Indigeneity. It documents a grassroots Inuit literacy initiative in Ottawa, Canada and considers literacy practices among Inuit at a local Inuit educational centre, where maintaining connections between urban Inuit and their homeland…

Bureaucracy, professionalization and school centred innovation strategies

NASA Astrophysics Data System (ADS)

Morris, Paul

1990-03-01

This paper examines an attempt to promote a school centred innovation strategy within a highly centralized educational system. The School Based Curriculum Project Scheme, which was introduced into Hong Kong in 1988, is analysed in terms of a professional-bureaucratic dichotomy. It is argued that the operational details of the scheme are designed to satisfy a range of bureaucratic concerns and these are not conducive to promoting the professional work ethic which is required for school centred innovation. Finally the paper identifies the implications which arise for policies designed to promote curriculum innovation.

Preparing and Training for the Full Spectrum of Military Challenges. Insights from the Experiences of China, France, the United Kingdom, India, and Israel

DTIC Science & Technology

2009-01-01

CPCO Centre de Planification et de Conduite des Opérations CPF Centre de Préparation des Forces CPX command post exercise CT collective training CTC...forces presides over the joint staff and commands French forces in the conduct of operations through the Centre de Planification et de Conduite des...i] t is difficult to identify a single concise statement of the government’s foreign policy.”17 The committee instead pointed to the mission state

Transforming Social and Educational Governance: Trade Training Centres and the Transition to Social Investment Politics in Australia

ERIC Educational Resources Information Center

Hay, Stephen

2009-01-01

Prior to its election to office in 2007, the Australian Labor Party announced a commitment to introduce Trade Training Centres (TTCs) into all Australian secondary schools as an initiative of its Education Revolution. TTCs were proposed as a key element of Federal Labor's education and training policy that aimed to manage future risks to…

Centre of IT Excellence for SMEs in the West Midlands, UK: A Suitable Project Methodology

ERIC Educational Resources Information Center

Thompson, Diana; Homer, Garry

2005-01-01

This paper presents an analysis of the IT Futures Centre, a European technology transfer project based at the University of Wolverhampton in the UK. After reviewing UK government policy in technology transfer, the authors highlight the project's two key elements--a new state-of-the-art building and an IT consultancy team--both of which are…

Grammar Correction in the Writing Centre: Expectations and Experiences of Monolingual and Multilingual Writers

ERIC Educational Resources Information Center

Eckstein, Grant

2016-01-01

Although most writing centres maintain policies against providing grammar correction during writing tutorials, it is undeniable that students expect some level of grammar intervention there. Just how much students expect and receive is a matter of speculation. This article examines the grammar-correction issue by reporting on a survey of L1, L2,…

NonTuberculous Mycobacteria infection and lung transplantation in cystic fibrosis: a worldwide survey of clinical practice.

PubMed

Tissot, Adrien; Thomas, Matthew F; Corris, Paul A; Brodlie, Malcolm

2018-05-22

In people with cystic fibrosis infection with NonTuberculous Mycobacteria is of increasing prevalence. Mycobacterium abscessus complex is of particular concern and has been associated with adverse clinical outcomes. Optimal treatment usually requires multiple antibiotics for over 12 months. When considering lung transplantation for patients with NonTuberculous Mycobacteria potential benefits must be balanced against the risks of uncontrolled infection post-transplant and significant side-effects associated with treatment. In this survey we assessed current international practice with regard to assessing and listing patients for lung transplantation. We designed a questionnaire enquiring about local practice regarding screening for NonTuberculous Mycobacteria infection, specific contra-indications to transplantation, management and segregation of patients pre- and post-transplant. The survey was sent via e-mail to 37 paediatric and adult lung transplant centres across Europe, North America and Australia. We gathered complete questionnaires from 21 centres (57% response rate). Few centres (29%) have a clear written policy regarding NonTuberculous Mycobacteria. Sixteen (76%) centres require molecular identification of NonTuberculous Mycobacteria species. Only four centres would consider infection with M. abscessus complex in itself a contra-indication for listing, however 76% regard it as a relative contra-indication. Eighty-six percent require treatment pre-transplantation. Finally, only 61% of centres had a clear policy regarding segration of patients pre-transplant and 48% post-transplant. The issue of NonTuberculous Mycobacteria infection in people with cystic fibrosis requiring lung transplantation is well-recognized however current international recommendations are not detailed and there is variation in practice between centres. There is an urgent requirement for high quality clinical data to inform decision-making.

Uncertainties in the governance of animal disease: an interdisciplinary framework for analysis

PubMed Central

Fish, Robert; Austin, Zoe; Christley, Robert; Haygarth, Philip M.; Heathwaite, Louise A.; Latham, Sophia; Medd, William; Mort, Maggie; Oliver, David M.; Pickup, Roger; Wastling, Jonathan M.; Wynne, Brian

2011-01-01

Uncertainty is an inherent feature of strategies to contain animal disease. In this paper, an interdisciplinary framework for representing strategies of containment, and analysing how uncertainties are embedded and propagated through them, is developed and illustrated. Analysis centres on persistent, periodic and emerging disease threats, with a particular focus on cryptosporidiosis, foot and mouth disease and avian influenza. Uncertainty is shown to be produced at strategic, tactical and operational levels of containment, and across the different arenas of disease prevention, anticipation and alleviation. The paper argues for more critically reflexive assessments of uncertainty in containment policy and practice. An interdisciplinary approach has an important contribution to make, but is absent from current real-world containment policy. PMID:21624922

Design and Formative Evaluation of the Policy Liaison Initiative: A Long-Term Knowledge Translation Strategy to Encourage and Support the Use of Cochrane Systematic Reviews for Informing

ERIC Educational Resources Information Center

Brennan, Sue E.; Cumpston, Miranda; Misso, Marie L.; McDonald, Steve; Murphy, Matthew J.; Green, Sally E.

2016-01-01

The Policy Liaison Initiative (PLI) is a long-term knowledge translation initiative designed to support the use of Cochrane systematic reviews in health policy. A joint initiative between the Australasian Cochrane Centre and Australian Government Department of Health and Ageing, the PLI includes: 1) a community of practice for evidence-informed…

Polish forensic medicine A.D. 2016 - report of the National Consultant.

PubMed

Teresiński, Grzegorz

2016-01-01

The aim of the study was to present the current state and basis of functioning of an academic model of forensic expert activities in Poland and perspectives of their further development. The study material included information obtained from a preliminary survey among regional consultants within the ongoing activities of the national consultant team. The recently completed period of research infrastructure support within the policy of coherence of the European Union contributed to significant advances in scientific-educational potential of the majority of university forensic medicine centres. However, the improved educational base and purchases of new diagnostic devices were not associated with a considerable increase in staff resources of individual units, which finally decides about the renown of the entire discipline. It is necessary to undertake initiatives to highlight the importance of forensic medicine as a separate medical field and to increase the number of physicians starting specialist trainings. A highly profiled nature of the speciality necessitates cooperation with other centres and receptiveness to clinical fields. The establishment of various forms of cooperation is a measure of optimal use of equipment and stimulation of multi-centre research.

Risk communication and human biomonitoring: which practical lessons from the Belgian experience are of use for the EU perspective?

PubMed Central

Keune, Hans; Morrens, Bert; Loots, Ilse

2008-01-01

Background In order to investigate and monitor environmental health in Flanders (the Dutch speaking part of Belgium), the Flemish government funded the Centre of Expertise for Environment and Health, which started a human biomonitoring campaign in 2001. In addition to environmental health experts measuring environmental pollutants and health effects in human beings, social scientific experts at the Centre focus on risk communication associated with the human biomonitoring campaign. Methods In the literature about risk communication an evolution can be traced from traditional, one-way communication, restricted to the dissemination of information from experts to the public, to more modern, two-way risk communication, with a focus on participation and cooperation between scientists, policy-makers and the public. Within the Centre of Expertise for Environment and Health this discourse was first translated into some general principles and guidelines for external communication, at a 'Ten Commandments level'. These principles needed to be incorporated in the day-to-day practice of human biomonitoring research. Results The social scientific experts at the Centre developed a combined risk communication strategy. On the one hand the strategy consists of traditional risk communication for external communication purposes, for example information meetings and digital newsletters. On the other hand it consists of a step by step approach of incorporating more modern risk communication, for example a risk perception questionnaire, dialogical experiments for involving local stakeholders, and an action-plan for interpreting results for policy making. Conclusion With a parallel strategy of traditional and modern communication, of external and internal reflection, and through different social scientific projects, the Flemish Centre of Expertise of Environment and Health incorporates risk communication in the day-to-day practice of human biomonitoring research. A direct and continuous involvement of the social scientist, an openness between all colleagues involved, and the awareness of a fine balance between quality and practicability are important success factors. These lessons may be helpful and inspirational for a European human biomonitoring project. PMID:18541065

Nasreya: a treatment and disposal facility for industrial hazardous waste in Alexandria, Egypt: phase I.

PubMed

Ramadan, Adham R; Kock, Per; Nadim, Amani

2005-04-01

A facility for the treatment and disposal of industrial hazardous waste has been established in Alexandria, Egypt. Phase I of the facility encompassing a secure landfill and solar evaporation ponds is ready to receive waste, and Phase II encompassing physico-chemical treatment, solidification, and interim storage is underway. The facility, the Nasreya Centre, is the first of its kind in Egypt, and represents the nucleus for the integration, improvement and further expansion of different hazardous waste management practices and services in Alexandria. It has been developed within the overall legal framework of the Egyptian Law for the Environment, and is expected to improve prospects for enforcement of the regulatory requirements specified in this law. It has been developed with the overall aim of promoting the establishment of an integrated industrial hazardous waste management system in Alexandria, serving as a demonstration to be replicated elsewhere in Egypt. For Phase I, the Centre only accepts inorganic industrial wastes. In this respect, a waste acceptance policy has been developed, which is expected to be reviewed during Phase II, with an expansion of the waste types accepted.

Integrating evidence into policy and sustainable disability services delivery in western New South Wales, Australia: the 'wobbly hub and double spokes' project.

PubMed

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

2012-03-21

Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remote communities is further complicated because relatively small numbers of clients are dispersed over large geographic areas. The aim of this five-year multi-stage project is to generate evidence to confirm and develop evidence-based policies and to evaluate their implementation in procedures that allow a regional allied health workforce to more expeditiously respond to disability service need in regional New South Wales, Australia. The project consists of four inter-related stages that together constitute a full policy cycle. It uses mixed quantitative and qualitative methods, guided by key policy concerns such as: access, complexity, cost, distribution of benefits, timeliness, effectiveness, equity, policy consistency, and community and political acceptability. Stage 1 adopts a policy analysis approach in which existing relevant policies and related documentation will be collected and reviewed. Policy-makers and senior managers within the region and in central offices will be interviewed about issues that influence policy development and implementation. Stage 2 uses a mixed methods approach to collecting information from allied health professionals, clients, and carers. Focus groups and interviews will explore issues related to providing and receiving allied health services. Discrete Choice Experiments will elicit staff and client/carer preferences. Stage 3 synthesises Stage 1 and 2 findings with reference to the key policy issues to develop and implement policies and procedures to establish several innovative regional workforce and service provision projects. Stage 4 uses mixed methods to monitor and evaluate the implementation and impact of new or adapted policies that arise from the preceding stages. The project will provide policy makers with research evidence to support consideration of the complex balance between: (i) the equitable allocation of scarce resources; (ii) the intent of current eligibility and prioritisation policies; (iii) workforce constraints (and strengths); and (iv) the most effective, evidence-based clinical practice.

Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation.

PubMed

Lafranca, Jeffrey A; Spoon, Emerentia Q W; van de Wetering, Jacqueline; IJzermans, Jan N M; Dor, Frank J M F

2017-01-01

The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide. 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based.

Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation

PubMed Central

Spoon, Emerentia Q. W.; van de Wetering, Jacqueline; IJzermans, Jan N. M.; Dor, Frank J. M. F.

2017-01-01

Background The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. Methods An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide. Results 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Conclusions Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based. PMID:28732093

Learning together: a Canada-Cuba research collaboration to improve the sustainable management of environmental health risks.

PubMed

Spiegel, Jerry; Garcia, Maricel; Bonet, Mariano; Yassi, Annalee

2006-01-01

To build a national Cuban capacity for training environmental health professionals directly linked to the needs of policy-makers and communities. The University of Manitoba and University of British Columbia collaborated with an established training centre in Cuba (the Instituto Nacional de Higiene y Epidemiologia--INHEM) and new centres in the Central (Santa Clara) and Eastern (Santiago) regions of the country. Cuba. In the mid-1990s, a comprehensive curriculum (masters and diploma programs) was collaboratively developed, applying interactive teaching methods, and was delivered through a series of workshops and other interactions in Cuba, and short-term visits to Canada by Cuban PhD students. The collaboration was successful in fulfilling capacity-building targets (over 50 Masters graduates, 467 Diploma graduates, over 30 trained core faculty in all regional centres as well as new curriculum and new accredited regional programs). Alongside this, a number of collaborative community-based research projects were undertaken in all three regions (drinking water in Santiago; housing and urban renewal, and dengue control in Havana; and tourism-related effects, and effective intersectoral management of population health determinants in Santa Clara). The collaboration led to adopting new strategies for challenges such as a dengue epidemic in 2002, and new research on the effectiveness of intersectoral management of risks of particular interest to both Cuban and Canadian policy-makers. It triggered an ambitious collaboration between the Canadian-Cuban team and colleagues in Ecuador in order to build a similar national network there, built on South-South and North-South links.

Pushing the Child Centred Approach in Myanmar: The Role of Cross National Policy Networks and the Effects in the Classroom

ERIC Educational Resources Information Center

Lall, Marie

2011-01-01

In Myanmar schools, rote learning is the norm. International aid and education organisations based in the country have been trying to promote the child centred approach (CCA) as a much more progressive form of teaching and learning. The CCA is being rolled out principally through monastic school networks aided by international and national…

Alternative systems in Malaysian drug rehabilitation: organization and control in comparative perspective.

PubMed

Lee, R L

1985-01-01

This paper examines four drug rehabilitation systems in Malaysia from an organizational perspective. It focuses on authority structures in rehabilitation centres and their impact on rehabilitees' identities. The findings show that there are important differences between government-run and private centres in terms of administration and approach to therapy. Some policy implications are derived from a comparison of these systems.

Getting the Price Right: Costing and Charging Commercial Provision in Centres of Vocational Excellence (CoVEs). Research Report

ERIC Educational Resources Information Center

Aitken, Liz; Chadwick, Arthur; Hughes, Maria

2006-01-01

Centres of Vocational Excellence (CoVEs) were established in 2001, intended to be a key driver in enhancing the contribution of the further education (FE) sector to meeting skills needs. Current government policy expects employers and individuals to pay a greater share of the costs of training, particularly at Level 3, which is the CoVE priority…

Revealing a Hidden Curriculum of Black Women's Erasure in Sexual Violence Prevention Policy

ERIC Educational Resources Information Center

Wooten, Sara Carrigan

2017-01-01

This article aims to challenge the framework by which rape and sexual assault prevention in higher education are being constituted by centring Black women's experiences of sexual violence within a prevention and response policy framework. Numerous research studies exist in the literature regarding the specific experience of sexual violence for…

Policy Reform: Testing Times for Teacher Education in Australia

ERIC Educational Resources Information Center

Fitzgerald, Tanya; Knipe, Sally

2016-01-01

In Australia as well as elsewhere, initial teacher education has become centre stage to a political agenda that calls for global competitiveness in the knowledge economy. The common problem cited has been declining educational standards linked with the quality of teaching and teacher education. The avalanche of review and policy reform has exposed…

Working Together. Policy and Practice in Scottish Early Childhood Centres

ERIC Educational Resources Information Center

Paton, Grace

2007-01-01

A key policy response to continuing concerns about levels of poverty and social exclusion in the United Kingdom has been the promotion of integrated children's services, involving professionals from education, social work, health and other fields working together on an inter-agency basis. This small-scale qualitative research project, using an…

Autonomy and Governance in Local Authority Provision for Children and Young People

ERIC Educational Resources Information Center

Boyask, Ruth; Donkin, Arnet; Waite, Sue; Lawson, Hazel

2013-01-01

The role of local government in addressing issues of social equity is undergoing significant reconstruction in current educational policy reforms in England. The current conceptualisation of social provision places individual rights at the centre of policy, and social responsibility is represented as the work of individuals. Drawing upon a…

A Question of Autonomy: Bourdieu's Field Approach and Higher Education Policy

ERIC Educational Resources Information Center

Maton, Karl

2005-01-01

The concept of field forms the centre of Pierre Bourdieu's relational sociology and the notion of "autonomy" is its keystone. This article explores the usefulness of these underexamined concepts for studying policy in higher education. It begins by showing how Bourdieu's "field" approach enables higher education to be examined…

Lesson Study for Learning Community (LSLC): Conceptualising Teachers' Practices within a Social Justice Perspective

ERIC Educational Resources Information Center

Saito, Eisuke; Atencio, Matthew

2015-01-01

Under neo-liberal policies in many countries, there has been an extensive trend of educational reform which intensifies competition. Such educational reform is underpinned by direct government control, seen in centre to periphery forms of policy administration and implementation with strong emphasis on managerialism and test-oriented…

Dockside Tarts and Modesty Boards: A Review of Recent Policy on Sexualisation

ERIC Educational Resources Information Center

Bragg, Sara

2012-01-01

In recent years, the "sexualisation of childhood" has moved into the centre ground of public policy and debate internationally, despite the conceptual confusions and inadequate evidence surrounding the processes denoted by the term. This paper focuses primarily on the most recent of several UK government-commissioned reviews and reports,…

Knowledge mobilisation for policy development: implementing systems approaches through participatory dynamic simulation modelling.

PubMed

Freebairn, Louise; Rychetnik, Lucie; Atkinson, Jo-An; Kelly, Paul; McDonnell, Geoff; Roberts, Nick; Whittall, Christine; Redman, Sally

2017-10-02

Evidence-based decision-making is an important foundation for health policy and service planning decisions, yet there remain challenges in ensuring that the many forms of available evidence are considered when decisions are being made. Mobilising knowledge for policy and practice is an emergent process, and one that is highly relational, often messy and profoundly context dependent. Systems approaches, such as dynamic simulation modelling can be used to examine both complex health issues and the context in which they are embedded, and to develop decision support tools. This paper reports on the novel use of participatory simulation modelling as a knowledge mobilisation tool in Australian real-world policy settings. We describe how this approach combined systems science methodology and some of the core elements of knowledge mobilisation best practice. We describe the strategies adopted in three case studies to address both technical and socio-political issues, and compile the experiential lessons derived. Finally, we consider the implications of these knowledge mobilisation case studies and provide evidence for the feasibility of this approach in policy development settings. Participatory dynamic simulation modelling builds on contemporary knowledge mobilisation approaches for health stakeholders to collaborate and explore policy and health service scenarios for priority public health topics. The participatory methods place the decision-maker at the centre of the process and embed deliberative methods and co-production of knowledge. The simulation models function as health policy and programme dynamic decision support tools that integrate diverse forms of evidence, including research evidence, expert knowledge and localised contextual information. Further research is underway to determine the impact of these methods on health service decision-making.

Development Policy in Thailand: From Top-down to Grass Roots.

PubMed

Kelly, Matthew; Yutthaphonphinit, Phattaraphon; Seubsman, Sam-Ang; Sleigh, Adrian

2012-11-01

Top-down industrial development strategies initially dominated the developing world after the second World War but were eventually found to produce inequitable economic growth. For a decade or more, governments and international development agencies have embraced the idea of participatory grass roots development as a potential solution. Here we review Thailand's experience with development strategies and we examine the current focus on participatory approaches. Thai government planning agencies have adopted "people centred development" and a "sufficiency economy", particularly emphasised since the disruptions caused by the 1997 Asian financial crisis. They aim to address the inequitable sharing of the benefits of decades of rapid growth that was particularly unfair for the rural poor. Thai policies aim to decentralise power to the local level, allowing civil society and Non-Governmental Organisations (NGOs) more of a voice in national decision making and promoting sustainable farming practices aimed at enriching rural communities. An example of this change in Thai government policy is the Community Worker Accreditation Scheme which is aiming to develop human resources at the local level by training community based leaders and supporting networks of community organisations. This enables autonomous local development projects led by trained and accredited individuals and groups. The political tensions notable in Thailand at present are part of this modern transition driven by conflicting models of top-down (industrial) development and the bottom-up (participatory) development ideals described above. Once resolved, Thailand will have few obstacles to moving to a new economic level.

Evolution of the concept of Capacity-building, results achieved during the past years and the future

NASA Astrophysics Data System (ADS)

Laffaiteur, M.; Camacho, S.

Capacity-building is one of the key elements for the implementation of space applications programmes, particularly in developing countries. As early as 1982, the work programme of the United Nations Programme on Space Applications was expanded in order to promote education and training by organizing seminars, training courses and workshops in various areas, such as astronomy, telecommunications and Earth observation. In the framework of this Programme, the Office for Outer Space Affairs undertook the initiative, at the beginning of the 1990's, aimed at establishing regional centres for space science and technology education, affiliated to the United Nations and located in developing countries. These centres have started their activities between 1995 and 2000 in Africa, Asia and the Pacific, and Latin America and the Caribbean. The centres are based on the concept that by pooling material and human resources, developing countries can have education and training centres, of an international-level quality. A considerable impetus has been given to capacity-building after the UNISPACE III Conference, in particular in the "Vienna Declaration on Space and Human Development". The necessity to enhance capacity-building through the development of human and budgetary resources, the training of teachers, the exchange of teaching methods, materials and experience and the development of infrastructure and policy regulatories. In the process of the implementation of the recommendations of UNISPACE III, Action Teams led by Governments were established. One of them was exclusively dealing with capacity-building. Its proposals have been reviewed last June by the Committee on the Peaceful Uses of Outer Space (COPUOS) and will be examined, among other reports of Action Teams, by the General Assembly in next October. A lot of work has been done during the past years and have produced very important results. But there is still an important gap in capacity-building between space-faring countries and developing countries. A strategy has been presented by the Action Team in order to implement a strategy aimed at increasing again the impact of the various initiatives already going on. The promotion of the sharing of educational materials and information could be facilitated by a network of bodies in UN Member States, dedicated organizations and UN regional centres. This presentation will aim to show the current status of this issue and to present results already achieved and the way forward.

Working in caseload midwifery care: the experience of midwives working in a birth centre in North Queensland.

PubMed

Edmondson, Marissa C; Walker, Sandra B

2014-03-01

Pregnancy, birth and child rearing are significant life events for women and their families. The demand for services that are family friendly, women focused, safe and accessible is increasing. These demands and rights of women have led to increased government and consumer interest in continuity of care and the establishment in Australia of birth centres, and the introduction of caseload midwifery models of care. The aim of this research project was to uncover how birth centre midwives working within a caseload model care constructed their midwifery role in order to maintain a positive work-life balance. A Grounded Theory study using semi-structured individual interviews was undertaken with seven midwives who work at a regional hospital birth centre to ascertain their views as to how they construct their midwifery role while working in a caseload model of care. The results showed that caseload midwifery care enabled the midwives to practice autonomously within hospital policies and guidelines for birth centre midwifery practice and that they did not feel too restricted in regards to the eligibility of women who could give birth at the centre. Work relationships were found to be a key component in being able to construct their birth centre midwifery role. The midwives valued the flexibility that came with working in supportive partnerships with many feeling this enabled them to achieve a good work-life balance. The research contributes to the current body of knowledge surrounding working in a caseload model of care as it shows how the birth centre midwives construct their midwifery role. It provides information for development and improvement of these models of care to ensure that sustainability and quality of care is provided to women and their families. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Creating and facilitating change for Person-Centred Coordinated Care (P3C): The development of the Organisational Change Tool (P3C-OCT).

PubMed

Horrell, Jane; Lloyd, Helen; Sugavanam, Thavapriya; Close, James; Byng, Richard

2018-04-01

Person Centred Coordinated Care (P3C) is a UK priority for patients, carers, professionals, commissioners and policy makers. Services are developing a range of approaches to deliver this care with a lack of tools to guide implementation. A scoping review and critical examination of current policy, key literature and NHS guidelines, together with stakeholder involvement led to the identification of domains, subdomains and component activities (processes and behaviours) required to deliver P3C. These were validated through codesign with stakeholders via a series of workshops and cognitive interviews. Six core domains of P3C were identified as follows: (i) my goals, (ii) care planning, (iii) transitions, (iv) decision making (v), information and communication and (vi) organizational support activities. These were populated by 29 core subdomains (question items). A number of response codes (components) to each question provide examples of the processes and activities that can be actioned to achieve each core subdomain of P3C. The P3C-OCT provides a coherent approach to monitoring progress and supporting practice development towards P3C. It can be used to generate a shared understanding of the core domains of P3C at a service delivery level, and support reorganization of care for those with complex needs. The tool can reliably detect change over time, as demonstrated in a sample of 40 UK general practices. It is currently being used in four UK evaluations of new models of care and being further developed as a training tool for the delivery of P3C. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

PubMed

Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats

2017-01-06

Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises and newly created management structures. Developing comprehensive gender-sensitive health workforce monitoring systems and comparing progress across academic health centres in Europe could help to identify the gender leadership gap and utilise health human resources more effectively.

Technology, market and policy aspects of geothermal energy in Europe

NASA Astrophysics Data System (ADS)

Shortall, Ruth; Uihlein, Andreas

2017-04-01

The Strategic Energy Technology Plan (SET-Plan) is the technology pillar of the EU's energy and climate policy. The goal of the SET-Plan is to achieve EU worldwide leadership in the production of energy technological solutions capable of delivering EU 2020 and 2050 targets for a low carbon economy. The Joint Research Centre (JRC) runs and manages the SET-Plan Information System (SETIS) to support the SET-Plan. Under SETIS, the JRC publishes a number of regularly updated key references on the state of low carbon technology, research and innovation in Europe. Within the framework of the SET-Plan, the geothermal sector is placed into context with other power and heat generation technologies. The talk will give an introduction to some of JRC's geothermal research activities. Amongst others, the JRC Geothermal status report will be presented. This report aims to contribute to the general knowledge about the geothermal sector, its technology, economics and policies, with a focus on innovation, research, development and deployment activities as well as policy support schemes within the European Union. The speech will present the main findings of the report, providing an overview of the activities and progress made by the geothermal energy sector, the status of its sub-technologies and current developments. In addition, the speech will discuss the economic, market and policy aspects of geothermal energy for power production, direct use and ground source heat pumps in Europe and beyond.

Ethical dilemmas and human rights considerations arising from the evaluation of a smoking policy in a health promoting setting.

PubMed

Harvey, Harold D; Fleming, Paul; Patterson, Michael

2002-09-01

One of the key challenges in managing the Health Promoting Workplace is the development of an effective policy for the control of environmental tobacco smoke (ETS). This paper explores the ethical consequences raised when the implementation of such a policy was evaluated in a large multi-campus university. In a three-stage evaluation, the first stage involved a qualitative enquiry with the Health and Safety Committee to obtain the management perspective on the working of the policy. A survey of the perception of the ETS policy and smoking behaviours with a representative sample of staff and students constituted the second stage. In the final stage the Health and Safety Committee was engaged with the findings of stages 1 and 2 to develop a response to the evaluation. The ethical implications which arise from this evaluation centre, firstly, on the underlying reasons for undertaking an evaluation. Secondly, consideration is given to the consequences of applying utilitarian principles to smoking policy for the minority who smoke and thus find their work or study patterns affected by a smoking ban. Such a ban limits their autonomy and while it may be helpful (beneficent) in terms of their longer-term physical health, it may have harmful (maleficent) effects on their psychological wellbeing and the potential for negative consequences if they choose to contravene the ban on smoking. The implications of addressing this situation are explored.

Management of febrile children under five years in hospitals and health centres of rural Ghana.

PubMed

Webster, Jayne; Baiden, Frank; Bawah, Justina; Bruce, Jane; Tivura, Mathilda; Delmini, Rupert; Amenga-Etego, Seeba; Chandramohan, Daniel; Owusu-Agyei, Seth

2014-07-09

The case management of febrile children in hospitals' and health centres' pre-roll out of the new WHO policy on parasitological diagnosis was assessed. The delivery of artemisinin combination therapy (ACT) at these two levels of the health system was compared. Structured observations and exit interviews of 1,222 febrile children attending five hospitals and 861 attending ten health centres were conducted in six districts of the Brong Ahafo Region of Ghana. Effectiveness of delivery of case management of malaria was assessed. Proportions of children receiving ACT, anti-malarial monotherapy and antibiotics were described. Predictors of: a febrile child being given an ACT, a febrile child being given an antibiotic and of carers knowing how to correctly administer the ACT were assessed using logistic regression models stratified by hospitals and health centres. The system's effectiveness of delivering an ACT to febrile children diagnosed with malaria (parasitologically or clinically) was 31.4 and 42.4% in hospitals and health centres, respectively. The most ineffective process was that of ensuring that carers knew how to correctly administer the ACT. Overall 278 children who were not given an ACT were treated with anti-malarial monotherapy other than quinine. The majority of these children, 232/278 were given amodiaquine, 139 of these were children attending hospitals and 93 attending health centres. The cadre of health staff conducting consultation was a common predictor of the outcomes of interest. Presenting symptoms and examinations conducted were predictive of being given an ACT in hospitals and antibiotic in hospitals and health centres but not of being given an ACT in health centres. Treatment-seeking factors were predictive of being given an ACT if it was more than seven days since the fever began and an antibiotic in hospitals but not in health centres. Interventions to improve adherence to negative parasitological tests are needed, together with guidance on dispensing of antibiotics, but improving the education of carers on how to administer ACT will lead to the greatest immediate increase in the effectiveness of case management. Guidance is needed on implementation of the new test-based treatment for malaria policy in health facilities.

Telecommunications as a means to access health information: an exploratory study of migrants in australia.

PubMed

Greenstock, Louise; Woodward-Kron, Robyn; Fraser, Catriona; Bingham, Amie; Naccarella, Lucio; Elliott, Kristine; Morris, Michal

2012-12-28

Health policies increasingly promote e-health developments (e.g., consumers' access to online health information) to engage patients in their health care. In order to make these developments available for culturally and socially diverse communities, not only do Internet accessibility, literacy and e-health literacy need to be taken into account, but consumers' preferences and information seeking behaviours for accessing health information have also to be understood. These considerations are crucial when designing major new health policy directions, especially for migration destination countries with culturally diverse populations, such as Australia. The aim of this study was to examine how people from a culturally and linguistically diverse (CALD) community use telecommunications (phone, mobile, Internet) to access health information. A case study was conducted using a questionnaire exploring the use of telecommunications to access health information among CALD people. The study was carried out at a community health centre in a socially and economically disadvantaged area of Melbourne, a city of 4 million people with a large CALD and migrant population. Questionnaires were translated into three languages and interpreters were provided. Fifty-nine questionnaires were completed by users of the community health centre. Most of the CALD participants did not have access to the Internet at home and very few reported using telecommunications to access health information. The findings of the study suggest that telecommunications are not necessarily perceived to be an important channel for accessing health information by members of the CALD community.

Pedagogical Practices in Early Childhood Education and Care in Tanzania: Policy and Practices

ERIC Educational Resources Information Center

Mligo, Ignasia; Mitchell, Linda; Bell, Beverley

2016-01-01

The purpose of this study was to examine current pedagogical practices in early childhood education and care in Tanzania, a reflection from policy and practices to the implementation of Learner-Centred Pedagogy and to put forward possible improvements for the future. In 2005 a new pre-school education curriculum introduced a learner-centred…

The Ghosts of Higher Education Reform: On the Organisational Processes Surrounding Policy Borrowing

ERIC Educational Resources Information Center

Brøgger, Katja

2014-01-01

The Bologna Process is one of the most extensive examples of policy borrowing processes. Based on qualitative data, this article argues in favour of studying part of this process as "global smallness", centring on the organisational effects of the implementation of a globalised curriculum. Through Derrida's notion on hauntology,…

Reforms in the Policy of English Language Teaching in Malaysia

ERIC Educational Resources Information Center

Rashid, Radzuwan A. B.; Abdul Rahman, Shireena Basree; Yunus, Kamariah

2017-01-01

This paper reviews reforms related to English language teaching in the Malaysian education system. It begins by tracing the history of Malaysia as a former British colony which has had significant influences on the status of English in the country. Then, it reviews the key educational reforms which have mainly centred on language policy, thus…

Education Policy: Globalization, Citizenship and Democracy

ERIC Educational Resources Information Center

Olssen, Mark; Codd, John; O'Neill, Anne-Marie

2004-01-01

The thesis at the centre of this book is that education policy in the twenty-first century is the key to global security, sustainability and survival. The events of 11 September 2001 (9/11) have shown that the era of global interdependence and interconnectivity is also an era in which human survival is threatened not only by the actions of states…

Digital Technologies and English Instruction in China's Higher Education System

ERIC Educational Resources Information Center

Gao, Lianli

2012-01-01

The introduction of a new mandatory policy for the teaching of English at the higher education level in China, College English Curriculum Requirements (CECR, published in 2004), had the intention of modernising and improving the quality of English teaching at the tertiary level in China. The policy had a focus on student-centred approaches to…

To Know Ourselves? Research, Data and Policy-Making in the Scottish Education System

ERIC Educational Resources Information Center

Howieson, Cathy; Croxford, Linda

2017-01-01

This paper considers the role of independent research in helping an education and training system "know itself", illustrating this through the experience of the Centre for Educational Sociology (CES) of which David Raffe was a member and director. It highlights the tensions in the research-policy relationship arising from the different…

Rationality and Rationalisation in Teacher Education Policy Discourse in New Zealand

ERIC Educational Resources Information Center

O'Neill, John

2012-01-01

Background: A newly elected centre-right coalition government in New Zealand was forced to deal with the cumulative fiscal consequences of two unforeseen challenges: a global financial crisis in September 2008 and two major seismic events in the country's second largest city in 2009 and 2010. This paper examines the way in which policies for…

HPE in Aotearoa New Zealand: The Reconfiguration of Policy and Pedagogic Relations and Privatisation of Curriculum and Pedagogy

ERIC Educational Resources Information Center

Penney, Dawn; Petrie, Kirsten; Fellows, Sam

2015-01-01

This paper centres on research that investigated the contemporary policy, curriculum and pedagogical landscape of Health and Physical Education (HPE) in Aotearoa New Zealand, in the light of increasing impressions that provision was moving to an "open market" situation. Publicly available information sourced via the Internet was used to…

The Simple View of Education or Education Policy for Dummies

ERIC Educational Resources Information Center

Wadsworth, John

2010-01-01

In November 2009 the current Secretary of State for Education, Michael Gove, gave a speech at the Centre for Policy Studies in which he set out the Conservative Party's priorities for education. This article explores some of the proposals in his speech, with particular references to initial teacher education and his attraction to Nordic and US…

New hospital-based policy for children whose parents present at the ER due to domestic violence, substance abuse and/or a suicide attempt.

PubMed

Hoytema van Konijnenburg, Eva M M; Sieswerda-Hoogendoorn, Tessa; Brilleslijper-Kater, Sonja N; van der Lee, Johanna H; Teeuw, Arianne H

2013-02-01

Child maltreatment is a major social problem with many adverse consequences, and a substantial number of maltreated children are not identified by health care professionals. In 2010, in order to improve the identification of maltreated children in hospitals, a new hospital-based policy was developed in Amsterdam, The Netherlands. This policy was adapted from another policy that was developed in The Hague, the Netherlands, in 2007. In the new Amsterdam policy, all adults presenting at the emergency department due to domestic violence, substance abuse, and/or a suicide attempt are asked whether they have any children in their care. If this is the case, parents are urged to visit the outpatient pediatric department together with all of their children. During this visit, problems are evaluated and voluntary referrals can be arranged to different care organizations. If parents refuse to cooperate, their children are reported to the Dutch Child Abuse Counseling and Reporting Centre. The two aims of this study are to describe (1) characteristics of the identified families and (2) the referrals made to different voluntary and involuntary care organizations during the first 2 years after implementation of the policy. Data were collected from medical records. One hundred and six children from 60 households were included, of which 68 children because their mother was a victim of domestic violence. Referrals to care organizations were arranged for 99 children, of which 67 on a voluntary basis. The Amsterdam policy seems successful in arranging voluntary support for the majority of identified children.

WebGIS based community services architecture by griddization managements and crowdsourcing services

NASA Astrophysics Data System (ADS)

Wang, Haiyin; Wan, Jianhua; Zeng, Zhe; Zhou, Shengchuan

2016-11-01

Along with the fast economic development of cities, rapid urbanization, population surge, in China, the social community service mechanisms need to be rationalized and the policy standards need to be unified, which results in various types of conflicts and challenges for community services of government. Based on the WebGIS technology, the article provides a community service architecture by gridding management and crowdsourcing service. The WEBGIS service architecture includes two parts: the cloud part and the mobile part. The cloud part refers to community service centres, which can instantaneously response the emergency, visualize the scene of the emergency, and analyse the data from the emergency. The mobile part refers to the mobile terminal, which can call the centre, report the event, collect data and verify the feedback. This WebGIS based community service systems for Huangdao District of Qingdao, were awarded the “2015’ national innovation of social governance case of typical cases”.

Characteristics of Effective Interventions Promoting Healthy Eating for Pre-Schoolers in Childcare Settings: An Umbrella Review

PubMed Central

Coveney, John

2018-01-01

Early Childhood Education and Care (ECEC) settings have a pivotal role in shaping children’s dietary food habits by providing the contextual environment within which they develop these behaviours. This study examines systematic reviews for (1) the effectiveness of interventions to promote healthy eating in children aged 2–5 years attending centre-based childcare; (2) intervention characteristics which are associated with promoting healthy eating and; (3) recommendations for child-health policies and practices. An Umbrella review of systematic reviews was undertaken using a standardized search strategy in ten databases. Twelve systematic reviews were examined using validated critical appraisal and data extraction tools. Children’s dietary food intake and food choices were significantly influenced. Interventions to prevent obesity did not significantly change children’s anthropometric measures or had mixed results. Evidence was more convincing if interventions were multi-component, addressed physical activity and diet, targeted individual-level and environmental-level determinants and engaged parents. Positive outcomes were mostly facilitated by researchers/external experts and these results were not replicated when implemented in centres by ECEC providers without this support. The translation of expert-led interventions into practice warrants further exploration of implementation drivers and barriers. Based on the evidence reviewed, recommendations are made to inform child-health directed practices and policies. PMID:29494537

Sociology, environment and health: a materialist approach.

PubMed

Fox, N J; Alldred, P

2016-12-01

This paper reviews the sociology of environment and health and makes the case for a postanthropocentric approach based on new materialist theory. This perspective fully incorporates humans and their health into 'the environment', and in place of human-centred concerns considers the forces that constrain or enhance environmental capacities. This is not an empirical study. The paper uses a hypothetical vignette concerning child health and air pollution to explore the new materialist model advocated in the paper. This paper used sociological analysis. A new materialist and postanthropocentric sociology of environment and health are possible. This radically reconfigures both sociological theory and its application to research and associated policies on health and the environment. Theoretically, human health is rethought as one among a number of capacities emerging from humans interactions with the social and natural world. Practically, the focus of intervention and policy shifts towards fostering social and natural interactions that enhance environmental (and in the process, human) potentiality. This approach to research and policy development has relevance for public health practice and policy. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Attractiveness of people-centred and integrated Dutch Home Care: A nationwide survey among nurses.

PubMed

Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

2018-07-01

The World Health Organization is calling for a fundamental change in healthcare services delivery, towards people-centred and integrated health services. This includes providing integrated care around people's needs that is effectively co-ordinated across providers and co-produced by professionals, the patient, the family and the community. At the same time, healthcare policies aim to scale back hospital and residential care in favour of home care. This is one reason for the home-care nursing staff shortages in Europe. Therefore, this study aimed to examine whether people-centred, integrated home care appeals to nurses with different levels of education in home care and hospitals. A questionnaire survey was held among registered nurses in Dutch home-care organisations and hospitals in 2015. The questionnaire addressed the perceived attractiveness of different aspects of people-centred, integrated home care. In total 328 nurses filled in the questionnaire (54% response rate). The findings showed that most home-care nurses (70% to 97%) and 36% to 76% of the hospital nurses regard the different aspects of people-centred, integrated home care as attractive. Specific aspects that home-care nurses find attractive are promoting the patient's self-reliance and having a network in the community. Hospital nurses are mainly attracted to health-related prevention and taking control in complex situations. No clear differences between the educational levels were found. It is concluded that most home-care nurses and a minority of hospital nurses feel attracted to people-centred, integrated home care, irrespective of their educational level. The findings are relevant to policy makers and home-care organisations who aim to expand the home-care nursing workforce. © 2018 John Wiley & Sons Ltd.

Networking for rare diseases: a necessity for Europe.

PubMed

Aymé, S; Schmidtke, J

2007-12-01

Most rare diseases are life-threatening and chronically debilitating conditions, and the vast majority of them are genetically determined. Their individually low prevalence requires special combined efforts to address them so as to improve diagnosis, care and prevention. Though it is difficult to develop a public health policy specific to each rare disease, it is possible to have a global rather than a piecemeal approach in the areas of scientific and biomedical research, drug research and development, industry policy, information and training, social benefits, hospitalisation and outpatient care. In the recent past, several initiatives at EU and Member States levels have been taken and proved efficient in developing suitable solutions which are now having a positive impact on the quality of life of patients. These initiatives are presented here. They include the establishment of Orphanet, a database of rare diseases and orphan drugs providing an encyclopedia of rare diseases and a directory of associated expert services, the funding of research networks to boost the collaboration between research teams, as well as the funding of networks of clinical centres of reference to better serve the patients and contribute to developing clinical research.

Regulation of antibiotic sales in Mexico: an analysis of printed media coverage and stakeholder participation

PubMed Central

2012-01-01

Background Restricting antibiotics sales to those with medical prescriptions only is a central strategy for promoting appropriate use and containing antibiotic resistance; however, many low and middle income countries have not enforced policies that prevent widespread self-medication with antibiotics. In 2010, the Mexican government announced the enforcement of antibiotic sales regulations, a policy that gained media prominence. This study analyzes media coverage of issues, stakeholder representation, and positions taken during policy agenda setting, drafting, and implementation to shed light on policy making to promote appropriate antibiotic utilization. Methods We carried out a quantitative content analysis of 322 newspaper articles published between January 2009 and December 2010 in 18 national and regional newspapers. Additionally, we conducted a qualitative content analysis to understand the positions adopted and strategies developed by nine key stakeholders. Framing theory guided the analysis. Results The Ministry of Health dominated media coverage, justifying the enforcement policy by focusing on risks of self-medication, and to a lesser degree dangers of increasing antibiotic resistance. Pharmacy associations appeared to be the leading opponents, arguing that the policy created logistical difficulties and corruption, and had negative economic impact for pharmacies and their clients. The associations developed strategies against the regulation such as attempting to delay implementation and installing physicians’ consultation offices within pharmacies. While medical associations and academic institutions called for a comprehensive strategy to combat antibiotic resistance, improve prescription quality, and create public awareness, these issues had little impact on media coverage. Consumer groups and legislators received very little media coverage. Conclusions The narrowly-focused and polarized media coverage ─centred on problems of self- medication and economic impact ─ was a missed opportunity to publicly discuss and to develop a comprehensive national strategy on antibiotic use in Mexico. It highlights the need for discussing and developing interventions within the framework of a pharmaceutical policy. PMID:23217185

Regulation of antibiotic sales in Mexico: an analysis of printed media coverage and stakeholder participation.

PubMed

Dreser, Anahí; Vázquez-Vélez, Edna; Treviño, Sandra; Wirtz, Veronika J

2012-12-06

Restricting antibiotics sales to those with medical prescriptions only is a central strategy for promoting appropriate use and containing antibiotic resistance; however, many low and middle income countries have not enforced policies that prevent widespread self-medication with antibiotics. In 2010, the Mexican government announced the enforcement of antibiotic sales regulations, a policy that gained media prominence. This study analyzes media coverage of issues, stakeholder representation, and positions taken during policy agenda setting, drafting, and implementation to shed light on policy making to promote appropriate antibiotic utilization. We carried out a quantitative content analysis of 322 newspaper articles published between January 2009 and December 2010 in 18 national and regional newspapers. Additionally, we conducted a qualitative content analysis to understand the positions adopted and strategies developed by nine key stakeholders. Framing theory guided the analysis. The Ministry of Health dominated media coverage, justifying the enforcement policy by focusing on risks of self-medication, and to a lesser degree dangers of increasing antibiotic resistance. Pharmacy associations appeared to be the leading opponents, arguing that the policy created logistical difficulties and corruption, and had negative economic impact for pharmacies and their clients. The associations developed strategies against the regulation such as attempting to delay implementation and installing physicians' consultation offices within pharmacies. While medical associations and academic institutions called for a comprehensive strategy to combat antibiotic resistance, improve prescription quality, and create public awareness, these issues had little impact on media coverage. Consumer groups and legislators received very little media coverage. The narrowly-focused and polarized media coverage ─centred on problems of self- medication and economic impact ─ was a missed opportunity to publicly discuss and to develop a comprehensive national strategy on antibiotic use in Mexico. It highlights the need for discussing and developing interventions within the framework of a pharmaceutical policy.

No effect of user fee exemption on perceived quality of delivery care in Burkina Faso: a case-control study.

PubMed

Philibert, Aline; Ridde, Valéry; Bado, Aristide; Fournier, Pierre

2014-03-11

Although many developing countries have developed user fee exemption policies to move towards universal health coverage as a priority, very few studies have attempted to measure the quality of care. The present paper aims at assessing whether women's satisfaction with delivery care is maintained with a total fee exemption in Burkina Faso. A quasi-experimental design with both intervention and control groups was carried out. Six health centres were selected in rural health districts with limited resources. In the intervention group, delivery care is free of charge at health centres while in the control district women have to pay 900 West African CFA francs (U$2). A total of 870 women who delivered at the health centre were interviewed at home after their visit over a 60-day range. A series of principal component analyses (PCA) were carried out to identify the dimension of patients' satisfaction. Women's satisfaction loaded satisfactorily on a three-dimension principal component analysis (PCA): 1-provider-patient interaction; 2-nursing care services; 3-environment. Women in both the intervention and control groups were satisfied or very satisfied in 90% of cases (in 31 of 34 items). For each dimension, average satisfaction was similar between the two groups, even after controlling for socio-demographic factors (p = 0.436, p = 0.506, p = 0.310, respectively). The effects of total fee exemption on satisfaction were similar for any women without reinforcing inequalities between very poor and wealthy women (p ≥ 0.05). Although the wealthiest women were more dissatisfied with the delivery environment (p = 0.017), the poorest were more highly satisfied with nursing care services (p = 0.009). Contrary to our expectations, total fee exemption at the point of service did not seem to have a negative impact on quality of care, and women's perceptions remained very positive. This paper shows that the policy of completely abolishing user fees with organized implementation is certainly a way for developing countries to engage in universal coverage while maintaining the quality of care.

Integrated Approach as a Means of Leading the Degraded Post-Industrial Areas Out of Crisis - A Case Study of Lodz

NASA Astrophysics Data System (ADS)

Cysek-Pawlak, Monika; Krzysztofik, Sylwia

2017-10-01

The article analyses the issue of modern development strategies in post-industrial areas. The issue concerns many regions in Europe and is one of the fundamental challenges of urban policy. The aim of the study is to define the methods of achieving lasting changes in the quality of life in the degenerated areas of post-industrial cities. If projects in the spatial, cultural, economic and social sphere are carried out simultaneously, they produce long-term effects. Projects in the spatial, cultural, economic and social sphere carried out simultaneously produce long-term effects. In this context, projects improving the accessibility of the area, making use of its cultural heritage, which naturally includes architectural elements that create the identity of the city, as well as activities aimed at an economic recovery, are absolutely vital. Another key element is changing the city image, both in the eyes of the residents as well as outsiders. The study analyses approaches adopted by the urban policy of Lodz, a city which has received the largest EU funding for urban renewal in Poland. The article presents new legal mechanisms introduced by the Urban Renewal Act to the Polish legal system. The redevelopment of the city’s transport network, renovation of historic urban tissue, improving civil engineering infrastructure and quality of public spaces are all part of the projects implemented in Lodz. Moreover, a proposal to locate a cultural event of international importance in the heart of the city centre has been put forward. Lodz as the only European city applied to organize EXPO 2022. The exhibition area is located in the immediate vicinity of the newly built multimodal railway station, the biggest railway investment in the country in the recent years. These projects will improve city image, enhance economic recovery and raise the quality of life in the city centre. A consistent implementation of the development strategy, despite the centralization of projects in the city centre, will also have a positive impact on smaller urban settlements in the agglomeration, leading to sustainable development of the metropolis

Adoption of the B2SAFE EUDAT replication service by the EPOS community

NASA Astrophysics Data System (ADS)

Cacciari, Claudio; Fares, Massimo; Fiameni, Giuseppe; Michelini, Alberto; Danecek, Peter; Wittenburg, Peter

2014-05-01

B2SAFE is the EUDAT service for moving and replicating data between sites and storage systems for different purposes. The goal of B2SAFE is to keep the data from a repository safe by replicating it across different geographical and administrative zones according to a set of well-defined policies. It is also a way to store large volumes of data permanently at those sites which are providing powerful on-demand data analysis facilities. In particular, B2SAFE operates on the domain of registered data where data objects are referable via persistent identifiers (PIDs). B2SAFE is more than just copying data because the PIDs must be carefully managed when data objects are moved or replicated. The EUDAT B2SAFE Service offers functionality to replicate datasets across different data centres in a safe and efficient way while maintaining all information required to easily find and query information about the replica locations. The information about the replica locations and other important information is stored in PID records, each managed in separate administrative domains. The B2SAFE Service is implemented as an iRODS module providing a set of iRODS rules or policies to interface with the EPIC handle API and uses the iRODS middleware to replicate datasets from a source data (or community) centre to a destination data centre. The definition of the dataset(s) to replicate is flexible and up to the communities using the B2SAFE service. While the B2SAFE is internally using the EPIC handle API, communities have the choice to use any PID system they prefer to assign PIDs to their digital objects. A reference to one or more EUDAT B2SAFE PIDs is returned by the B2SAFE service when a dataset is replicated. The presentation will introduce the problem space of B2SAFE, presents the achievements that have been made during the last year for enabling communities to make use of the B2SAFE service, demonstrates a EPOS use cases, outlines the commonalities and differences between the policies for B2SAFE, presents new developments towards a common service layer interface and a data policy management framework.

'One health' and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia.

PubMed

Mwacalimba, Kennedy Kapala; Green, Judith

2015-03-01

'One World, One Health' has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of trade and development issues remain relatively unexamined, and few studies to date have explored the implications of global disease governance for resource-constrained countries outside the main centres of zoonotic outbreaks. This article draws on a policy study of national level avian and pandemic influenza preparedness between 2005 and 2009 across the sectors of trade, health and agriculture in Zambia. We highlight the challenges of integrating disease control interventions amidst trade and developmental realities in resource-poor environments. One Health prioritizes disease risk mitigation, sidelining those trade and development narratives which speak to broader public health concerns. We show how locally important trade and development imperatives were marginalized in Zambia, limiting the effectiveness of pandemic preparedness. Our findings are likely to be generalizable to other resource-constrained countries, and suggest that effective disease governance requires alignment with trade and development sectors, as well as integration of veterinary and public health sectors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

How to Improve Integrated Care for People with Chronic Conditions: Key Findings from EU FP-7 Project INTEGRATE and Beyond.

PubMed

Borgermans, Liesbeth; Marchal, Yannick; Busetto, Loraine; Kalseth, Jorid; Kasteng, Frida; Suija, Kadri; Oona, Marje; Tigova, Olena; Rösenmuller, Magda; Devroey, Dirk

2017-09-25

Political and public health leaders increasingly recognize the need to take urgent action to address the problem of chronic diseases and multi-morbidity. European countries are facing unprecedented demand to find new ways to deliver care to improve patient-centredness and personalization, and to avoid unnecessary time in hospitals. People-centred and integrated care has become a central part of policy initiatives to improve the access, quality, continuity, effectiveness and sustainability of healthcare systems and are thus preconditions for the economic sustainability of the EU health and social care systems. This study presents an overview of lessons learned and critical success factors to policy making on integrated care based on findings from the EU FP-7 Project Integrate, a literature review, other EU projects with relevance to this study, a number of best practices on integrated care and our own experiences with research and policy making in integrated care at the national and international level. Seven lessons learned and critical success factors to policy making on integrated care were identified. The lessons learned and critical success factors to policy making on integrated care show that a comprehensive systems perspective should guide the development of integrated care towards better health practices, education, research and policy.

How to Improve Integrated Care for People with Chronic Conditions: Key Findings from EU FP-7 Project INTEGRATE and Beyond

PubMed Central

Marchal, Yannick; Busetto, Loraine; Kalseth, Jorid; Kasteng, Frida; Suija, Kadri; Oona, Marje; Tigova, Olena; Rösenmuller, Magda; Devroey, Dirk

2017-01-01

Background: Political and public health leaders increasingly recognize the need to take urgent action to address the problem of chronic diseases and multi-morbidity. European countries are facing unprecedented demand to find new ways to deliver care to improve patient-centredness and personalization, and to avoid unnecessary time in hospitals. People-centred and integrated care has become a central part of policy initiatives to improve the access, quality, continuity, effectiveness and sustainability of healthcare systems and are thus preconditions for the economic sustainability of the EU health and social care systems. Purpose: This study presents an overview of lessons learned and critical success factors to policy making on integrated care based on findings from the EU FP-7 Project Integrate, a literature review, other EU projects with relevance to this study, a number of best practices on integrated care and our own experiences with research and policy making in integrated care at the national and international level. Results: Seven lessons learned and critical success factors to policy making on integrated care were identified. Conclusion: The lessons learned and critical success factors to policy making on integrated care show that a comprehensive systems perspective should guide the development of integrated care towards better health practices, education, research and policy. PMID:29588630

Evolution and diversification of National Cleaner Production Centres (NCPCs).

PubMed

Van Berkel, Rene

2010-07-01

Since 1994 UNIDO and UNEP cooperate in a Programme to establish National Cleaner Production Centres (NCPCs) as a mechanism for delivery of Cleaner Production (CP) services to businesses, governments and other organisations. In 2007, 38 NCPCs were operational in 37 developing and transition countries. While initially set up in near-identical ways in each country, over time NCPCs evolved in response to both programme-internal and country-level factors. The resulting diversity among NCPCs is described and analysed here. Differentiation and specialisation had occurred in service areas or topics both within and between NCPCs, however without a clear strategy for integration and synergy. NCPCs were becoming part of expanding networks of business services providers nationally forcing some to focus on audit and training services (tier 1), and others on specialist services in CP technology and/or policy (tier 2) and/or networking services (tier 3). All NCPCs were on a trajectory from a project management organisation to a nationally-owned entity. The different management requirements were not proactively managed and technical aspects of CP service delivery overshadowed institutional and governance aspects of establishing and operating the NCPC institution. Differences in service delivery methods between NCPCs are most evident in three service areas: CP assessments; policy advice; and transfer of Environmentally Sound Technologies. It is argued here that understanding root causes and benefits of this presently-observed differentiation, could lay the foundation for capturing and advancing best practice CP concepts, methods and policies. This in turn would enable strategic planning for customised interventions and support at the national level. Copyright 2010 Elsevier Ltd. All rights reserved.

1 to 3-Year-Old Children in Day Care Centres in Finland: An Overview of Eight Doctoral Dissertations

ERIC Educational Resources Information Center

Hannikainen, Maritta

2010-01-01

This article gives a general picture of the policy and main structural features of early childhood education services for the younger children in Finland. It also provides an overview of the research on 1 to 3-year-old children in day care centres carried out in Finland during the last 15 years, the focus being on a review of all the eight…

Making biomedicine in twentieth-century Italy: Domenico Marotta (1886-1974) and the Italian Higher Institute of Health.

PubMed

Cozzoli, Daniele; Capocci, Mauro

2011-12-01

This paper focuses on the role played by Domenico Marotta, director of the ISS (Higher Institute of Health) for over twenty-five years, in the development of twentieth-century Italian biomedicine. We will show that Marotta aimed to create an integrated centre for research and production able to interact with private industry. To accomplish this, Marotta shifted the original mission of the ISS, from public health to scientific research. Yet Mussolini's policy turned most of the ISS resources towards controls and military tasks, opposing Marotta's aspiration. By contrast, in the post-war years Marotta was able to turn the ISS into the most important Italian biomedical research institution, where research and production fruitfully cohabited. Nobel laureates, such as Ernst Chain, and future Nobel laureates, such as Daniel Bovet, were hired. The ISS built up an integrated research and production centre for penicillin and antibiotics. In the 1960s, Marotta's vision was in accord with the new centre-left government. However, he pursued his goals by ruling the ISS autocratically and beyond any legal control. This eventually led to his downfall and prosecution. This also marked the decline of the ISS, intertwined with the weakness of the centre-left government, who failed to achieve structural reforms and couple the modernization of the country with the democratization of its scientific institutions.

The new policy of the Food and Agriculture Organization of the United Nations and its Reference Centres for the Animal Production and Health Division.

PubMed

Lubroth, J

2007-01-01

The article explains the current procedures to be followed for institutes that are, were or would like to become Reference Centres for the Food and Agriculture Organization (FAO) of the United Nations. Within the realm of animal health many of the Reference Laboratories and Reference Centres of the World Organisation for Animal Health (OIE) are the same as those of the Animal and Health Division of FAO, particularly for diseases that are transboundary in nature, but they also address other aspects concerning health, production, standard setting, agriculture, conservation, water, and biotechnology.

Falls from heights: epidemiology and pattern of injury at the accident and emergency centre of the University of Benin Teaching Hospital.

PubMed

Osifo, Osarumwense David; Iribhogbe, Pius; Idiodi-Thomas, Hestia

2010-05-01

Knowledge of the epidemiology and the pattern of injury sustained following falls from heights may be crucial in formulating policy aimed at prevention and improved outcome of victims. This study aims to determine the epidemiology and the spectrum of injury sustained following falls from heights at a referral trauma centre in a developing country. This study is a retrospective analysis of cases of falls from heights between June 2007 and May 2008 at the Accident and Emergency Center of the University of Benin Teaching Hospital. Eighty-four patients aged between 1 and 60 years (median: 24 years) comprising 54 males and 30 females with a male/female ratio of 1.8:1 were managed. All the falls were accidental and occurred mainly among males aged between 18 and 30 years, with a peak incidence between March and May, which coincided with rainy and harvest seasons (P<0.0001). Consequently, falls from moving vehicles 13 (15.5%); off the top of buildings at construction sites, eight (9.5%), staircase, six (7.1%); and treetops, six (7.1%) were common. Children fell mainly indoors from relatively lower heights. Eighty (95.2%) patients sustained injury that ranged from minor abrasions (12; 14.3%) to severe life-threatening head injury (15; 17.9%), which resulted in one (1.2%) death. Sympathisers and passersby were rescuers who gave first aid and brought the patients to the centre using hazardous public transport with a mean time lag of 12h (range: 2-48 h) between the falls and presentation. Falls from heights were common in Benin. Health awareness programmes and a proper government policy will reduce incidences and improve outcome. (c) 2009 Elsevier Ltd. All rights reserved.

"It's Only Right that We Get Involved": Service-User Perspectives on Involvement in Learning Disability Services

ERIC Educational Resources Information Center

Hoole, Lucy; Morgan, Sally

2011-01-01

Promotion of service-user and carer involvement is part of the mainstream policy agenda in health and social care ["Crit Soc Policy 25" (2005) 164]. Much effort has been invested into involving people with learning disabilities in decisions regarding aspects of their lives through advocacy projects and the utilisation of person-centred planning…

Multiculturalism as State Policy. Conference Report. Second Canadian Conference on Multiculturalism, Government Conference Centre (Ottawa, Ontario, February 13-15, 1976).

ERIC Educational Resources Information Center

Canadian Consultative Council on Multiculturalism, Ottawa (Ontario).

The Second Canadian Conference on Multiculturalism was held to clarify some of the issues upon which multiculturalism as a concept and as a policy depend. Cultural pluralism was investigated within the social, political, and historical framework of Canadian society. The opening session, called "The Bear Pit," invited questions and…

Commentary: "'Mobilising for the Values of the Republic'--France's Education Policy Response to the 'Fragmented Society': A Commented Press Review"

ERIC Educational Resources Information Center

Proeschel, Claude

2017-01-01

The article by Matthias Busch and Nancy Morys "'Mobilising for the Values of the Republic'--France's Education Policy Response to the 'Fragmented Society': A Commented Press Review" is dedicated to the recent debates on moral education in France. The debates have centred on the proposed reforms, called "the great mobilisation of…

Being Socialised into Language Shift: The Impact of Extended Family Members on Family Language Policy

ERIC Educational Resources Information Center

Smith-Christmas, Cassie

2014-01-01

This paper examines a family language policy (FLP) in the context of an extended bilingual Gaelic-English family on the Isle of Skye, Scotland. It demonstrates how certain family members (namely, the children's mother and paternal grandmother) negotiate and reify a strongly Gaelic-centred FLP. It then discusses how other extended family members…

Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses.

PubMed

Feo, Rebecca; Conroy, Tiffany; Marshall, Rhianon J; Rasmussen, Philippa; Wiechula, Richard; Kitson, Alison L

2017-04-01

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. © 2016 John Wiley & Sons Ltd.

[Vocational rehabilitation in transition--challenges and perspectives].

PubMed

Schmidt, C; Froböse, I; Schian, H-M

2006-08-01

The present article outlines the challenges in occupational rehabilitation arising from the successive erosion of the financial foundations of the welfare system, from changes in industry as well as in health, education and labour-market policy. Five perspectives are discussed to design and develop strategies in occupational rehabilitation. Among these are: (1) Rehabilitation in companies is mostly based on miscarried efforts to prevent separation. The discontinuance and the re-integration in a position or in a company have therefore to be regarded as an interlocking process between vocational training centre, social insurance agencies and employers; (2) Regional vocational rehabilitation centres with the objective to promote participation in work life may advance to institutionalized junctions to connect the rehabilitation landscape and would represent the logistic context; (3) The development of participation benefits should mainly be directed towards individualized allocation of resources as well as the possibility of direct transfer to work in close cooperation with employers; (4) Structural solutions and process-innovation could be supported by application-orientated research; (5) A new consensus to assign future tasks and objectives should be defined among the responsible bodies and service organisations involved in occupational rehabilitation.

Patient safety culture and leadership within Canada's Academic Health Science Centres: towards the development of a collaborative position paper.

PubMed

Nicklin, Wendy; Mass, Heather; Affonso, Dyanne D; O'Connor, Patricia; Ferguson-Paré, Mary; Jeffs, Lianne; Tregunno, Deborah; White, Peggy

2004-03-01

Currently, the Academy of Canadian Executive Nurses (ACEN) is working with the Association of Canadian Academic Healthcare Organizations (ACAHO) to develop a joint position paper on patient safety cultures and leadership within Academic Health Science Centres (AHSCs). Pressures to improve patient safety within our healthcare system are gaining momentum daily. Because AHSCs in Canada are the key organizations that are positioned regionally and nationally, where service delivery is the platform for the education of future healthcare providers, and where the development of new knowledge and innovation through research occurs, leadership for patient safety logically must emanate from them. As a primer, ACEN provides an overview of current patient safety initiatives in AHSCs to date. In addition, the following six key areas for action are identified to ensure that AHSCs continue to be leaders in delivering quality, safe healthcare in Canada. These include: (1) strategic orientation to safety culture and quality improvement, (2) open and transparent disclosure policies, (3) health human resources integral to ensuring patient safety practices, (4) effective linkages between AHSCs and academic institutions, (5) national patient safety accountability initiatives and (6) collaborative team practice.

A global map of travel time to cities to assess inequalities in accessibility in 2015

NASA Astrophysics Data System (ADS)

Weiss, D. J.; Nelson, A.; Gibson, H. S.; Temperley, W.; Peedell, S.; Lieber, A.; Hancher, M.; Poyart, E.; Belchior, S.; Fullman, N.; Mappin, B.; Dalrymple, U.; Rozier, J.; Lucas, T. C. D.; Howes, R. E.; Tusting, L. S.; Kang, S. Y.; Cameron, E.; Bisanzio, D.; Battle, K. E.; Bhatt, S.; Gething, P. W.

2018-01-01

The economic and man-made resources that sustain human wellbeing are not distributed evenly across the world, but are instead heavily concentrated in cities. Poor access to opportunities and services offered by urban centres (a function of distance, transport infrastructure, and the spatial distribution of cities) is a major barrier to improved livelihoods and overall development. Advancing accessibility worldwide underpins the equity agenda of ‘leaving no one behind’ established by the Sustainable Development Goals of the United Nations. This has renewed international efforts to accurately measure accessibility and generate a metric that can inform the design and implementation of development policies. The only previous attempt to reliably map accessibility worldwide, which was published nearly a decade ago, predated the baseline for the Sustainable Development Goals and excluded the recent expansion in infrastructure networks, particularly in lower-resource settings. In parallel, new data sources provided by Open Street Map and Google now capture transportation networks with unprecedented detail and precision. Here we develop and validate a map that quantifies travel time to cities for 2015 at a spatial resolution of approximately one by one kilometre by integrating ten global-scale surfaces that characterize factors affecting human movement rates and 13,840 high-density urban centres within an established geospatial-modelling framework. Our results highlight disparities in accessibility relative to wealth as 50.9% of individuals living in low-income settings (concentrated in sub-Saharan Africa) reside within an hour of a city compared to 90.7% of individuals in high-income settings. By further triangulating this map against socioeconomic datasets, we demonstrate how access to urban centres stratifies the economic, educational, and health status of humanity.

A global map of travel time to cities to assess inequalities in accessibility in 2015.

PubMed

Weiss, D J; Nelson, A; Gibson, H S; Temperley, W; Peedell, S; Lieber, A; Hancher, M; Poyart, E; Belchior, S; Fullman, N; Mappin, B; Dalrymple, U; Rozier, J; Lucas, T C D; Howes, R E; Tusting, L S; Kang, S Y; Cameron, E; Bisanzio, D; Battle, K E; Bhatt, S; Gething, P W

2018-01-18

The economic and man-made resources that sustain human wellbeing are not distributed evenly across the world, but are instead heavily concentrated in cities. Poor access to opportunities and services offered by urban centres (a function of distance, transport infrastructure, and the spatial distribution of cities) is a major barrier to improved livelihoods and overall development. Advancing accessibility worldwide underpins the equity agenda of 'leaving no one behind' established by the Sustainable Development Goals of the United Nations. This has renewed international efforts to accurately measure accessibility and generate a metric that can inform the design and implementation of development policies. The only previous attempt to reliably map accessibility worldwide, which was published nearly a decade ago, predated the baseline for the Sustainable Development Goals and excluded the recent expansion in infrastructure networks, particularly in lower-resource settings. In parallel, new data sources provided by Open Street Map and Google now capture transportation networks with unprecedented detail and precision. Here we develop and validate a map that quantifies travel time to cities for 2015 at a spatial resolution of approximately one by one kilometre by integrating ten global-scale surfaces that characterize factors affecting human movement rates and 13,840 high-density urban centres within an established geospatial-modelling framework. Our results highlight disparities in accessibility relative to wealth as 50.9% of individuals living in low-income settings (concentrated in sub-Saharan Africa) reside within an hour of a city compared to 90.7% of individuals in high-income settings. By further triangulating this map against socioeconomic datasets, we demonstrate how access to urban centres stratifies the economic, educational, and health status of humanity.

Hydrocortisone use in ventilated extremely preterm infants decreased bronchopulmonary dysplasia with no effects on neurodevelopment after two years.

PubMed

Renault, Anaïs; Patkaï, Juliana; Dassieu, Gilles; El Ayoubi, Mayass; Canouï-Poitrine, Florence; Durrmeyer, Xavier

2016-09-01

We assessed the outcomes of ventilated extremely premature infants treated with late postnatal corticosteroids from 2005-2008, according to permissive or restrictive policies in two centres. This retrospective study included inborn infants below 27 weeks of gestational age who were ventilator dependent after 14 days. Centre P permitted postnatal corticosteroids but centre R restricted their use. The effects on infants were assessed in hospital and after two years using multivariable analysis. We compared 62 infants from centre P, including 92% who received hydrocortisone, and 48 infants from centre R, including 13% who received betamethasone. Infants from both centres had comparable baseline characteristics and perinatal management, but bronchopulmonary dysplasia (BPD) rates were significantly lower in centre P (30% versus 71%, p < 0.001) and this centre was significantly associated with a younger post-conceptional age at oxygen weaning, with an adjusted hazard ratio (aHR) of 0.45 and an aHR of 0.51at discharge. At two years of corrected age, 18% of centre P infants and 30% of centre R infants showed poor neurodevelopmental outcome (p = 0.18). Using hydrocortisone after 14 days on ventilated extremely preterm infants was associated with decreased BPD, with no apparent effects on neurodevelopment at two years of corrected age. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Cost of maternal health services in selected primary care centres in Ghana: a step down allocation approach

PubMed Central

2013-01-01

Background There is a paucity of knowledge on the cost of health care services in Ghana. This poses a challenge in the economic evaluation of programmes and inhibits policy makers in making decisions about allocation of resources to improve health care. This study analysed the overall cost of providing health services in selected primary health centres and how much of the cost is attributed to the provision of antenatal and delivery services. Methods The study has a cross-sectional design and quantitative data was collected between July and December 2010. Twelve government run primary health centres in the Kassena-Nankana and Builsa districts of Ghana were randomly selected for the study. All health-care related costs for the year 2010 were collected from a public service provider’s perspective. The step-down allocation approach recommended by World Health Organization was used for the analysis. Results The average annual cost of operating a health centre was $136,014 US. The mean costs attributable to ANC and delivery services were $23,063 US and $11,543 US respectively. Personnel accounted for the largest proportion of cost (45%). Overall, ANC (17%) and delivery (8%) were responsible for less than a quarter of the total cost of operating the health centres. By disaggregating the costs, the average recurrent cost was estimated at $127,475 US, representing 93.7% of the total cost. Even though maternal health services are free, utilization of these services at the health centres were low, particularly for delivery (49%), leading to high unit costs. The mean unit costs were $18 US for an ANC visit and $63 US for spontaneous delivery. Conclusion The high unit costs reflect underutilization of the existing capacities of health centres and indicate the need to encourage patients to use health centres .The study provides useful information that could be used for cost effectiveness analyses of maternal and neonatal care interventions, as well as for policy makers to make appropriate decisions regarding the allocation and sustainability of health care resources. PMID:23890185

Challenges of user-centred assistive technology provision in Australia: shopping without a prescription.

PubMed

Steel, Emily J; Layton, Natasha Ann; Foster, Michele M; Bennett, Sally

2016-01-01

People with disability have a right to assistive technology devices and services, to support their inclusion and participation in society. User-centred approaches aim to address consumer dissatisfaction and sub-optimal outcomes from assistive technology (AT) provision, but make assumptions of consumer literacy and empowerment. Policy discourses about consumer choice prompt careful reflection, and this paper aims to provide a critical perspective on user involvement in assistive technology provision. User-centred approaches are considered, using literature to critically reflect on what user involvement means in AT provision. Challenges at the level of interactions between practitioners and consumers, and also the level of markets and policies are discussed, using examples from Australia. There is no unanimous conceptual framework for user-centred practice. Power imbalances and differing perspectives between practitioners and consumers make it difficult for consumers to feel empowered. Online access to information and international suppliers has not surmounted information asymmetries for consumers or lifted the regulation of publicly funded AT devices. Ensuring access and equity in the public provision of AT is challenging in an expanding market with diverse stakeholders. Consumers require personalised information and support to facilitate their involvement and choice in AT provision. Implications for Rehabilitation Variations in approaches informing AT provision practices have a profound impact on equity of access and outcomes for consumers. An internationalised and online market for AT devices is increasing the need for effective information provision strategies and services. Power imbalances between practitioners and consumers present barriers to the realisation of user-centred practice.

Perspectives for integration into the local health system of community-based management of acute malnutrition in children under 5 years: a qualitative study in Bangladesh.

PubMed

Kouam, Camille Eric; Delisle, Hélène; Ebbing, Hans J; Israël, Anne Dominique; Salpéteur, Cécile; Aïssa, Myriam Aït; Ridde, Valery

2014-03-20

Acute malnutrition is a major cause of death among under-five children in low- and middle-income countries. United Nations agencies recommend the integration of community-based management of acute malnutrition (CMAM) into the local health systems for sustainability. The objective of the study was to assess the preparedness of the health system to implement CMAM targeting children under-five years in two sub-districts of Bangladesh. The assessment was performed through direct observation of 44 health centres, individual interviews of seven policy makers, three donors, four health and nutrition implementing partners, 29 health workers, and review of secondary data. Assessment themes, derived from the WHO six Building Blocks, were nutrition governance, nutrition financing, health service delivery, human resources, equipment and supply, referral, monitoring and supervision mechanism. They were subdivided into 16 criteria. Findings were compared with CMAM operational recommendations according to WHO, Valid International and Food and Nutrition Technical Assistance guidelines. The government of Bangladesh has developed inpatient and outpatient CMAM guidelines, and a policy offering free-of-charge health care for under-five children. Nutrition coordination was not under full government leadership. Most of funds (74%) dedicated to CMAM were provided by donors, for short-term interventions. Of the total 44 health centres assessed, 39 (88.6%) were active, among which 4 (10.2%) delivered inpatient services, 35 (89.8%) outpatient services, and 24 (61.5%) outreach services. These were regarded as opportunities to include CMAM activities. There were 48.9% vacant positions and the health workers were not trained for management of acute malnutrition. Equipment and supplies did not meet the operational recommendations for management of acute malnutrition. Implementing CMAM through the health centres of both sub-districts would warrant progressive strengthening of the overall health system in the light of identified barriers. A short term strategy would consist of strengthening government coordination of nutrition interventions, exploring additional funding sources, equipping and supplying functional health centres, training health workers and actively involving community health workers to cope with health facility staff shortage. A mid-term strategy would consist of securing permanent funding for CMAM, rehabilitating non-functional health centres, attracting and retaining health workers in rural areas.

Perspectives for integration into the local health system of community-based management of acute malnutrition in children under 5 years: a qualitative study in Bangladesh

PubMed Central

2014-01-01

Background Acute malnutrition is a major cause of death among under-five children in low- and middle-income countries. United Nations agencies recommend the integration of community-based management of acute malnutrition (CMAM) into the local health systems for sustainability. The objective of the study was to assess the preparedness of the health system to implement CMAM targeting children under-five years in two sub-districts of Bangladesh. Methods The assessment was performed through direct observation of 44 health centres, individual interviews of seven policy makers, three donors, four health and nutrition implementing partners, 29 health workers, and review of secondary data. Assessment themes, derived from the WHO six Building Blocks, were nutrition governance, nutrition financing, health service delivery, human resources, equipment and supply, referral, monitoring and supervision mechanism. They were subdivided into 16 criteria. Findings were compared with CMAM operational recommendations according to WHO, Valid International and Food and Nutrition Technical Assistance guidelines. Results The government of Bangladesh has developed inpatient and outpatient CMAM guidelines, and a policy offering free-of-charge health care for under-five children. Nutrition coordination was not under full government leadership. Most of funds (74%) dedicated to CMAM were provided by donors, for short-term interventions. Of the total 44 health centres assessed, 39 (88.6%) were active, among which 4 (10.2%) delivered inpatient services, 35 (89.8%) outpatient services, and 24 (61.5%) outreach services. These were regarded as opportunities to include CMAM activities. There were 48.9% vacant positions and the health workers were not trained for management of acute malnutrition. Equipment and supplies did not meet the operational recommendations for management of acute malnutrition. Conclusion Implementing CMAM through the health centres of both sub-districts would warrant progressive strengthening of the overall health system in the light of identified barriers. A short term strategy would consist of strengthening government coordination of nutrition interventions, exploring additional funding sources, equipping and supplying functional health centres, training health workers and actively involving community health workers to cope with health facility staff shortage. A mid-term strategy would consist of securing permanent funding for CMAM, rehabilitating non-functional health centres, attracting and retaining health workers in rural areas. PMID:24649941

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

PubMed

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

2018-04-16

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

Professional groups driving change toward patient-centred care: interprofessional working in stroke rehabilitation in Denmark.

PubMed

Burau, Viola; Carstensen, Kathrine; Lou, Stina; Kuhlmann, Ellen

2017-09-16

Patient-centred care based on needs has been gaining momentum in health policy and the workforce. This creates new demand for interprofessional teams and redefining roles and tasks of professionals, yet little is known on how to implement new health policies more effectively. Our aim was to analyse the role and capacity of health professions in driving organisational change in interprofessional working and patient-centred care. A case study of the introduction of interprofessional, early discharge teams in stroke rehabilitation in Denmark was conducted with focus on day-to-day coordination of care tasks and the professional groups' interests and strategies. The study included 5 stroke teams and 17 interviews with different health professionals conducted in 2015. Professional groups expressed highly positive professional interest in reorganised stroke rehabilitation concerning patients, professional practice and intersectoral relations; individual professional and collective interprofessional interests strongly coincided. The corresponding strategies were driven by a shared goal of providing needs-based care for patients. Individual professionals worked independently and on behalf of the team. There was also a degree of skills transfer as individual team members screened patients on behalf of other professional groups. The study identified supportive factors and contexts of patient-centred care. This highlights capacity to improve health workforce governance through professional participation, which should be explored more systematically in a wider range of healthcare services.

History of health technology assessment in Belgium.

PubMed

Cleemput, Irina; Van Wilder, Philippe

2009-07-01

This paper gives an overview of health technology assessment (HTA) in Belgium. The information included in the overview is based on legal documents and publicly available year reports of the Belgian Health Care Knowledge Centre (KCE). Belgium has a relatively young history in HTA. The principle of evidence-based medicine (EBM) was introduced in the drug reimbursement procedure in 2001, with the establishment of the Drug Reimbursement Committee (DRC). The DRC assesses the efficacy, safety, convenience, applicability, and effectiveness of a drug relative to existing treatment alternatives. For some drugs, relative cost-effectiveness is also evaluated. The activities of the DRC can, therefore, be considered to be the first official HTA activities in Belgium. Later, in 2003, KCE was established. Its mission was to perform policy preparing research in the healthcare and health insurance sector and to give advice to policy makers about how they can obtain an efficient allocation of limited healthcare resources that optimizes the quality and accessibility of health care. This broad mission has been operationalized by activities in three domains of research: HTA, health services research, and good clinical practice. KCE is independent from the policy maker. Its HTAs contain policy recommendations that may inform policy decisions but are not binding. Although the Belgian history of HTA is relatively short, its foundations are strong and the impact of HTA increasing. Nevertheless KCE has many challenges for the future, including continued quality assurance, further development of international collaboration, and further development of methodological guidance for HTA.

Divergent modes of integration: the Canadian way.

PubMed

Jiwani, Izzat; Fleury, Marie-Josée

2011-01-01

The paper highlights key trajectories and outcomes of the recent policy developments toward integrated health care delivery systems in Quebec and Ontario in the primary care sector and in the development of regional networks of health and social services. It particularly explores how policy legacies, interests and cultures may be mitigated to develop and sustain different models of integrated health care that are pertinent to the local contexts. In Quebec, three decades of iterative developments in health and social services evolved in 2005 into integrated centres for health and social services at the local levels (CSSSs). Four integrated university-based health care networks provide ultra-specialised services. Family Medicine Groups and network clinics are designed to enhance access and continuity of care. Ontario's Family Health Teams (2004) constitute an innovative public funding for private delivery model that is set up to enhance the capacity of primary care and to facilitate patient-based care. Ontario's Local Health Integration Networks (LHINs) with autonomous boards of provider organisations are intended to coordinate and integrate care. Integration strategies in Quebec and Ontario yield clinical autonomy and power to physicians while simultaneously making them key partners in change. Contextual factors combined with increased and varied forms of physician remunerations and incentives mitigated some of the challenges from policy legacies, interests and cultures. Virtual partnerships and accountability agreements between providers promise positive but gradual movement toward integrated health service systems.

Online stochastic optimization of radiotherapy patient scheduling.

PubMed

Legrain, Antoine; Fortin, Marie-Andrée; Lahrichi, Nadia; Rousseau, Louis-Martin

2015-06-01

The effective management of a cancer treatment facility for radiation therapy depends mainly on optimizing the use of the linear accelerators. In this project, we schedule patients on these machines taking into account their priority for treatment, the maximum waiting time before the first treatment, and the treatment duration. We collaborate with the Centre Intégré de Cancérologie de Laval to determine the best scheduling policy. Furthermore, we integrate the uncertainty related to the arrival of patients at the center. We develop a hybrid method combining stochastic optimization and online optimization to better meet the needs of central planning. We use information on the future arrivals of patients to provide an accurate picture of the expected utilization of resources. Results based on real data show that our method outperforms the policies typically used in treatment centers.

The role of the concentration camps in the Nazi repression of prostitutes, 1933-9.

PubMed

Harris, Victoria

2010-01-01

This article uses prostitutes as a case study in order to investigate the role of the early concentration camps as centres of detention for social deviants. In contrasting the intensification of repressive policies towards prostitutes against narratives which demonstrate the unexpectedly lax treatment of these women, it explores what the reasons behind these contradictions might have been, and what this demonstrates about the development of these institutions. It asks the following questions. How and why were prostitutes interned? Which bureaucrats were responsible for incarcerating these women and what did they view the role of the camp to be? Were such policies centrally directed or the product of local decision-making? Through asking these questions, the article explores to what extent these camps were unique as mechanisms for the repression and marginalization of prostitutes.

The Evolution of School Leadership Policy and Practice in Singapore: Responses to Changing Socio-Economic and Political Contexts ("Insurgents," "Implementers," "Innovators")

ERIC Educational Resources Information Center

Gopinathan, S.; Wong, Benjamin; Tang, Nicholas

2008-01-01

The nature, quality and preparation of school leaders are once more at the centre of policy and practice decisions about education. But it is important to understand that school leadership, as both a historical and cultural construction, is intimately related to changing socio-political realities. In the case of Singapore, the historical evolution…

Naive Change Agent or Canny Political Collaborator? The Change in Leadership Role from Nursery School to Children's Centre

ERIC Educational Resources Information Center

Curtis, Lesley; Burton, Diana

2009-01-01

This article presents initial findings from a consideration of early years Labour government policy from 1997 to date and from a case study of an early years leadership journey. The article explores the social policies underlying early years initiatives that have impacted upon early years leadership journeys and roles. The challenge of the role is…

[Building bridges between research and policy to extend social protection in health in Latin America and the Caribbean: a strategy for cooperation].

PubMed

Bazzani, Roberto; Levcovitz, Eduardo; Urrutia, Soledad; Zarowsky, Christina

2006-01-01

The Pan American Health Organization (PAHO) and International Development Research Centre (IDRC) have promoted a joint initiative to design, implement, and evaluate innovative strategies for the Extension of Social Protection in Health (SPH) in Latin America and the Caribbean (LAC), involving active partnership between researchers and research users. This initiative was based on a previous review of research on health sector reforms and the recommendations of the workshop on "Health Sector Reforms in the Americas: Strengthening the Links between Research and Policy" (Montreal, Canada, 2001). In its first phase, the initiative supported the development of proposals aiming to extend SPH, elaborated jointly by researchers and decision-makers. In the second phase, the implementation of five of these proposals was supported in order to promote the development of new SPH strategies and new stakeholder interaction models. In this edition of the journal, the process of linking researchers and decision-makers will be analyzed in the context of the five projects supported by this initiative.

Using drawings to understand the child's experience of child-centred care on admission to a paediatric high dependency unit.

PubMed

Foster, Mandie; Whitehead, Lisa

2018-01-01

Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.

The Centre for International Mental Health Approach to Mental Health System Development

PubMed Central

Minas, Harry

2012-01-01

Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to developmental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka. (harv rev psychiatry 2012;20:37–46.) PMID:22335181

Telecommunications as a Means to Access Health Information: An Exploratory Study of Migrants in Australia

PubMed Central

Greenstock, Louise; Woodward-Kron, Robyn; Fraser, Catriona; Bingham, Amie; Naccarella, Lucio; Elliott, Kristine; Morris, Michal

2012-01-01

Background Health policies increasingly promote e-health developments (e.g., consumers’ access to online health information) to engage patients in their health care. In order to make these developments available for culturally and socially diverse communities, not only do Internet accessibility, literacy and e-health literacy need to be taken into account, but consumers’ preferences and information seeking behaviours for accessing health information have also to be understood. These considerations are crucial when designing major new health policy directions, especially for migration destination countries with culturally diverse populations, such as Australia. The aim of this study was to examine how people from a culturally and linguistically diverse (CALD) community use telecommunications (phone, mobile, Internet) to access health information. Design and Methods A case study was conducted using a questionnaire exploring the use of telecommunications to access health information among CALD people. The study was carried out at a community health centre in a socially and economically disadvantaged area of Melbourne, a city of 4 million people with a large CALD and migrant population. Questionnaires were translated into three languages and interpreters were provided. Fifty-nine questionnaires were completed by users of the community health centre. Results Most of the CALD participants did not have access to the Internet at home and very few reported using telecommunications to access health information. Conclusions The findings of the study suggest that telecommunications are not necessarily perceived to be an important channel for accessing health information by members of the CALD community. PMID:25170467

Paediatric nurses' perceptions and practices of family-centred care in Saudi hospitals: A mixed methods study.

PubMed

Alabdulaziz, Hawa; Moss, Cheryle; Copnell, Beverley

2017-04-01

Family-centred care is widely accepted as the underlying philosophy of paediatric nursing. Studies of family-centred care have mainly been conducted in western countries and little is known of its practice in other contexts. No studies have been undertaken in the Middle East. To explore family-centred care in the Saudi context from the perspectives of paediatric nurses. A mixed methodology was utilised with an explanatory sequential design. In the quantitative phase a convenience sample of 234 nurses from six hospitals in Jeddah, Saudi Arabia completed the Family Centred Care Questionnaire. The qualitative phase took place in one hospital and involved 140h of non-participant observation of paediatric nurses' practice. A convenience sample of 14 nurses was involved. Additionally, 10 face-to-face semi-structured interviews were conducted with key staff members. A purposeful sample of 10 nurses was involved. The findings from both phases were integrated in the final analysis. The survey results indicated that participants identified most elements of family-centred care as necessary for its practice. They were less likely to incorporate them into their practice (p<0.001, paired t-tests, all subscales). These findings were supported by the observation data, which revealed that, while several elements of family-centred care were frequently practised, others were implemented either inconsistently or not at all. Findings from the interview data indicated that participants had limited and superficial understanding of what family-centred care means as a model of care; rather, they worked with the elements as a set of core tasks. In the current study, there were similarities between what has been found in the Saudi context and findings from other studies using the same tool in western contexts. There is general agreement regarding the differences between theory and practice. Nurses do believe and acknowledge the importance of family-centred care; however, they struggle with practising this model in their everyday work. In the current study, many factors contributed to this issue, including language barriers, communication issues, cultural issues and hospital policies. Western concepts of family-centred care appear to be accepted by paediatric nurses in Saudi Arabia. However, full adoption of family-centred care in keeping with western values is likely not to be appropriate or successful in the Saudi context where both nurses and families have a non-western culture. The western model of family-centred care requires cultural modification and further development to fit Saudi and Middle Eastern cultures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Do regions of ALICE matter? Social relationships and data exchanges in the Grid

NASA Astrophysics Data System (ADS)

Widmer, E. D.; Carminati, F.; Grigoras, C.; Viry, G.; Galli Carminati, G.

2012-06-01

Following a previous publication [1], this study aims at investigating the impact of regional affiliations of centres on the organisation of collaboration within the Distributed Computing ALICE infrastructure, based on social networks methods. A self-administered questionnaire was sent to all centre managers about support, email interactions and wished collaborations in the infrastructure. Several additional measures, stemming from technical observations were produced, such as bandwidth, data transfers and Internet Round Trip Time (RTT) were also included. Information for 50 centres were considered (60% response rate). Empirical analysis shows that despite the centralisation on CERN, the network is highly organised by regions. The results are discussed in the light of policy and efficiency issues.

Do regions matter in ALICE?. Social relationships and data exchanges in the Grid

NASA Astrophysics Data System (ADS)

Widmer, E. D.; Viry, G.; Carminati, F.; Galli-Carminati, G.

2012-02-01

This study aims at investigating the impact of regional affiliations of centres on the organisation of collaborations within the Distributed Computing ALICE infrastructure, based on social networks methods. A self-administered questionnaire was sent to all centre managers about support, email interactions and wished collaborations in the infrastructure. Several additional measures, stemming from technical observations were collected, such as bandwidth, data transfers and Internet Round Trip Time (RTT) were also included. Information for 50 centres were considered (about 70% response rate). Empirical analysis shows that despite the centralisation on CERN, the network is highly organised by regions. The results are discussed in the light of policy and efficiency issues.

Policy versus practice: a community-based qualitative study of the realities of pharmacy services in Nunavut, Canada.

PubMed

Romain, Sandra J; Kohler, Jillian C; Young, Kue

2015-01-01

Nunavut is an Arctic territory in Canada subject to many social, economic and health disparities in comparison to the rest of the nation. The territory is affected by health care provision challenges caused by small, geographically isolated communities where staffing shortages and weather related access barriers are common concerns. In addition to national universal healthcare, the majority of the inhabitants of Nunavut (~85 %) are Inuit beneficiaries of no-charge pharmaceuticals provided through federal and/or territorial budgetary allocations. This research examines how existing pharmaceutical administration and distribution policies and practices in Nunavut impact patient care. This grounded theory research includes document analysis and semi-structured interviews conducted in 2013/14 with patients, health care providers, administrators and policy makers in several communities in Nunavut. Thirty five informants in total participated in the study. Interviews were audiotaped, transcribed and analyzed with qualitative data analysis software for internal consistency and emerging themes. Four distinct themes emerge from the research that have the potential to impact patient care and which may provide direction for future policy development: 1) tensions between national versus territorial financial responsibilities influence health provider decisions that may affect patient care, 2) significant human resources are utilized in Community Health Centres to perform distribution duties associated with retail pharmacy medications, 3) large quantities of unclaimed prescription medications are suggestive of significant financial losses, suboptimal patient care and low adherence rates, and 4) the absence of a clear policy and oversight for some controlled substances, such as narcotics, leaves communities at risk for potential illegal procurement or abuse. Addressing these issues in future policy development may result in system-wide economic benefits, improved patient care and adherence, and reduced risk to communities. The interview informants who participated in this research are best positioned to identify issues in need of attention and will benefit the most from policy development to address their concerns.

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

PubMed

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

2015-11-01

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

Interactions with the pharmaceutical industry: a survey of family medicine residents in Ontario.

PubMed Central

Sergeant, M D; Hodgetts, P G; Godwin, M; Walker, D M; McHenry, P

1996-01-01

OBJECTIVE: To determine the attitudes, knowledge and practices of family medicine residents relating to the pharmaceutical industry and to assess the effectiveness of existing guidelines on appropriate interactions with the pharmaceutical industry. DESIGN: Survey by mailed questionnaire. SETTING: Ontario. PARTICIPANTS: All 262 second-year family medicine residents in Ontario (seven centres); 226 (86.3%) responded. RESULTS: Fifty-two (23.0%) of the residents who responded stated that they had read the CMA policy statement on appropriate interactions between physicians and the pharmaceutical industry. A total of 124 (54.9%) stated that they would attend a private dinner paid for by a pharmaceutical representative; the proportion was not significantly reduced among those who had read the CMA guidelines, which prohibit the acceptance of personal gifts. In all, 186 (82.3%) reported that they would like the opportunity to interact with pharmaceutical representatives in an educational setting, even though several programs now discourage these interactions. Approximately three quarters (172/226 [76.1%]) of the residents indicated that they plan to see pharmaceutical representatives in their future practice. Residents at Centre 2 were significantly more critical of the pharmaceutical industry than those from the other centres. Overall, being aware of, and familiar with, departmental policy or CMA policy on interactions with the pharmaceutical industry did not affect the residents' attitudes or intended future practices. CONCLUSION: The presence of guidelines concerning physicians' interactions with the pharmaceutical industry does not appear to have a significant impact on family medicine residents in Ontario. PMID:8911290

Civil Society Organizations and medicines policy change: a case study of registration, procurement, distribution and use of misoprostol in Uganda.

PubMed

Atukunda, Esther Cathyln; Brhlikova, Petra; Agaba, Amon Ganafa; Pollock, Allyson M

2015-04-01

Misoprostol use for postpartum haemorrhage (PPH) has been promoted by Civil Society Organizations (CSOs) since the early 2000s. Yet, CSOs' role in improving access to misoprostol and shaping health policy at global and national levels is not well understood. We document the introduction of misoprostol in Uganda in 2008 from its registration, addition to treatment guidelines and national Essential Medicines List (EML), to its distribution and use. We then analyse the contribution of CSOs to this health policy change and service provision. Policy documents, procurement data and 82 key informant interviews with government officials, healthcare providers, and CSOs in four Ugandan districts of Kampala, Mbarara, Apac, Bundibugyo were collected between 2010 and 2013. Five key CSOs promoted and accelerated the rollout of misoprostol in Uganda. They supported the registration of misoprostol with the National Drug Authority, the development of clinical guidelines, and the piloting and training of health care providers. CSOs and National Medical Stores were procuring and distributing misoprostol country-wide to health centres two years before it was added to the clinical guidelines and EML of Uganda and in the absence of good evidence. The evidence suggests an increasing trend of misoprostol procurement and availability over the medicine of choice, oxytocin. This shift in national priorities has serious ramifications for maternal health care that need urgent evaluation. The absence of clinical guidelines in health centres and the lack of training preclude rational use of misoprostol. CSOs shifted their focus from the public to the private sector, where some of them continue to promote its use for off-label indications including induction of labour and abortion. There is an urgent need to build capacity to improve the robustness of the national and local institutions in assessing the safety and effectiveness of all medicines and their indications in Uganda. Copyright © 2015 Elsevier Ltd. All rights reserved.

Supporting youth wellbeing with a focus on eating well and being active: views from an Aboriginal community deliberative forum.

PubMed

Street, Jackie; Cox, Heather; Lopes, Edilene; Motlik, Jessie; Hanson, Lisa

2018-04-01

Including and prioritising community voice in policy development means policy is more likely to reflect community values and priorities. This project trialled and evaluated a storyboard approach in a deliberative community forum to engage Australian Aboriginal people in health policy priority setting. The forum was co-constructed with two Aboriginal community-controlled organisations. A circle storyboard was used to centre Aboriginal community knowledge and values and encourage the group to engage with broader perspectives and evidence. The forum asked a diverse (descriptively representative) group of Aboriginal people in a rural town what governments should do to support the wellbeing of children and youth, particularly to encourage them to eat well and be active. The storyboard provided a tactile device to allow shared stories and identification of community issues. The group identified policies they believed governments should prioritise, including strategies to combat racism and provide local supports and outlets for young people. An informed deliberative storyboard approach offers a novel way of engaging with Aboriginal communities in a culturally appropriate and inclusive manner. Implications for public health: The identification of racism as a major issue of concern in preventing children from living healthy lifestyles highlights the need for policy responses in this area. © 2018 The Authors.

Perceptions of nursery staff and parent views of healthy eating promotion in preschool settings: an exploratory qualitative study.

PubMed

McSweeney, Lorraine A; Rapley, Tim; Summerbell, Carolyn D; Haighton, Catherine A; Adamson, Ashley J

2016-08-19

In the UK just over a fifth of all children start school overweight or obese and overweight 2-5 year olds are at least 4 times more likely to become overweight adults. This can lead to serious future health problems. The WHO have recently highlighted the preschool years as a critical time for obesity prevention, and have recommended preschools as an ideal setting for intervention. However, existing evidence suggests that the preschool environment, including the knowledge, beliefs and practices of preschool staff and parents of young children attending nurseries can be a barrier to the successful implementation of healthy eating interventions in this setting. This study examined the perceptions of preschool centre staff and parents' of preschool children of healthy eating promotion within preschool settings. The participants were preschool staff working in private and local authority preschool centres in the North East of England, and parents of preschool children aged 3-4 years. Preschool staff participated in semi-structured interviews (n = 16 female, 1 male). Parents completed a mapping activity interview (n = 14 mothers, 1 father). Thematic analysis was applied to interpret the findings. Complex communication issues surrounding preschool centre dietary 'rules' were apparent. The staff were keen to promote healthy eating to families and felt that parents needed 'education' and 'help'. The staff emphasised that school policies prohibited providing children with sugary or fatty snacks such as crisps, cakes, sweets and 'fizzy' drinks, however, some preschool centres appeared to have difficulty enforcing such guidelines. Parents were open to the idea of healthy eating promotion in preschool settings but were wary of being 'told what to do' and being thought of as 'bad parents'. There is a need to further explore nursery staff members' personal perceptions of health and how food policies which promote healthier food in preschool settings can be embedded and implemented. Family friendly healthy eating strategies and activities which utilise nudge theory should be developed and delivered in a manner that is sensitive to parents' concerns. Preschool settings may offer an opportunity for delivery of such activities.

The politics of patient-centred care.

PubMed

Kreindler, Sara A

2015-10-01

Despite widespread belief in the importance of patient-centred care, it remains difficult to create a system in which all groups work together for the good of the patient. Part of the problem may be that the issue of patient-centred care itself can be used to prosecute intergroup conflict. This qualitative study of texts examined the presence and nature of intergroup language within the discourse on patient-centred care. A systematic SCOPUS and Google search identified 85 peer-reviewed and grey literature reports that engaged with the concept of patient-centred care. Discourse analysis, informed by the social identity approach, examined how writers defined and portrayed various groups. Managers, physicians and nurses all used the discourse of patient-centred care to imply that their own group was patient centred while other group(s) were not. Patient organizations tended to downplay or even deny the role of managers and providers in promoting patient centredness, and some used the concept to advocate for controversial health policies. Intergroup themes were even more obvious in the rhetoric of political groups across the ideological spectrum. In contrast to accounts that juxtaposed in-groups and out-groups, those from reportedly patient-centred organizations defined a 'mosaic' in-group that encompassed managers, providers and patients. The seemingly benign concept of patient-centred care can easily become a weapon on an intergroup battlefield. Understanding this dimension may help organizations resolve the intergroup tensions that prevent collective achievement of a patient-centred system. © 2013 John Wiley & Sons Ltd.

Research, empiricism and clinical practice in low-income countries.

PubMed

Isaac, Mohan; Chand, Prabhat; Murthy, Pratima

2007-10-01

Mental health problems are relevant for every country. They are particularly important for low-income countries which face a high burden of illness due to infectious disease, greater socio-economic disparities, and have limited resources for mental health care. There is a great mismatch in the areas of mental health research, practice, policy and services in comparison to developed countries. There have been a few studies that have investigated major mental health problems prevailing in these countries but missed out significant health problems. Studies have tended to be more donor driven and conducted in tertiary centres. The low priority accorded to mental health by the policy makers, scarcity of human resources, lack of culture-specific study instruments, lack of support from scientific journals have been some of the impediments to mental health research in these countries. In addition, lack of community participation and absence of sound mental health policies have deprived the vast majority of the benefit of modern psychiatric treatments. Recently, with increase in collaboration in research, availability of treatment including low-priced psychotropics, and a growing emphasis on the need for mental health policy in some low-income countries, the bleak scenario is expected to change.

The Impact of the Free Swimming Programme in a Local Community in the South East of England: Giving with One Hand, Taking Away with the Other

PubMed Central

Kokolakakis, Themis; Pappous, Athanasios Sakis; Meadows, Steve

2015-01-01

The purpose of this study is to examine the impact of the introduction of the Free Swimming Programme (FSP) in a local community (not identified to preserve anonymity) in the South East of England. The question has been approached in a variety of ways: by using primary quantitative data from leisure centres and logistic regressions based on the Active People Survey (APS). Problems are identified related to the introduction of the FSP in this community and suggestions are made for future policy. A brief examination of swimming participation in England enables researchers to place this community into a national context. The problems and policies of sport organisation developed in this community are not dissimilar to a more general application reflecting the English experience; in this sense it is anticipated that the findings will enable managers of sport organisations, along with public health policy makers, to focus more effectively on raising sport participation. The unique selling points of this article are the examination of FSP for adult participants, the local analysis of junior and senior participation, and the overall assessment of the policy based on APS. PMID:25913188

Reforms: a quest for efficiency or an opportunity for vested interests'? A case study of pharmaceutical policy reforms in Tanzania.

PubMed

Mori, Amani Thomas; Kaale, Eliangiringa Amos; Risha, Peter

2013-07-13

Regulation of the pharmaceutical sector is a challenging task for most governments in the developing countries. In Tanzania, this task falls under the Food and Drugs Authority and the Pharmacy Council. In 2010, the Pharmacy Council spearheaded policy reforms in the pharmaceutical sector aimed at taking over the control of the regulation of the business of pharmacy from the Tanzania Food and Drugs Authority. This study provides a critical analysis of these reforms. The study employed a qualitative case-study design. Data was collected through in-depth interviews, focus group discussions and document reviews. Data was analyzed thematically using a policy triangle framework. The analysis was done manually. The reforms adopted an incremental model of public policy-making and the process was characterized by lobbying for political support, negotiations and bargaining between the interest groups. These negotiations were largely centred on vested interests and not on the impact of the reforms on the efficiency of pharmaceutical regulations in the country. Stakeholders from the micro and meso levels were minimally involved in the policy reforms. Recent pharmaceutical regulation reforms in Tanzania were overshadowed by vested interests, displacing a critical analysis of optimal policy options that have the potential to increase efficiency in the regulation of the business of pharmacy. Politics influenced decision-making at different levels of the reform process.

On Adaptive Extended Compatibility Changing Type of Product Design Strategy

NASA Astrophysics Data System (ADS)

Wenwen, Jiang; Zhibin, Xie

The article uses research ways of Enterprise localization and enterprise's development course to research strategy of company's product design and development. It announces at different stages for development, different kinds of enterprises will adopt product design and development policies of different modes. It also announces close causality between development course of company and central technology and product. The result indicated enterprises in leading position in market, technology and brand adopt pioneer strategy type of product research and development. These enterprise relying on the large-scale leading enterprise offering a complete set service adopts the passively duplicating type tactic of product research and development. Some enterprise in part of advantage in technology, market, management or brand adopt following up strategy of product research and development. The enterprises with relative advantage position adopt the strategy of technology applied taking optimizing services as centre in product research and development in fields of brand culture and market service.

The war on obesity: a social determinant of health.

PubMed

O'Hara, Lily; Gregg, Jane

2006-12-01

The weight-centred health paradigm is an important contributor to the broader cultural paradigm in which corpulence is eschewed in favour of leanness. The desirability to reduce body fat or weight or to prevent gaining 'excess' fat is driven by both aesthetic and health ideals. The 'war on obesity' is a broad health-based set of policies and programs designed to problematise 'excess' body fat and create solutions to the 'problem'. There is a substantial body of literature that claims to demonstrate the harmful effects of 'excess' body fat. Recent critiques of 'obesity prevention' programs have highlighted the importance of focusing on environmental changes rather than individuals due in part to the risk of harmful consequences associated with individualistic, victim-blaming approaches. Beyond this, there are suggestions that framing body weight as the source of health problems - known as the weight-centred health paradigm - is in itself a harmful approach. The range of harms includes body dissatisfaction, dieting, disordered eating, discrimination and death. Health promotion policies and programs that operate within the weight-centred paradigm have the potential to have a negative impact on the health and well-being of individuals and communities.

How unique is continuity of care? A review of continuity and related concepts.

PubMed

Uijen, Annemarie A; Schers, Henk J; Schellevis, François G; van den Bosch, Wil J H M

2012-06-01

The concept of 'continuity of care' has changed over time and seems to be entangled with other care concepts, for example coordination and integration of care. These concepts may overlap, and differences between them often remain unclear. In order to clarify the confusion of tongues and to identify core values of these patient-centred concepts, we provide a historical overview of continuity of care and four related concepts: coordination of care, integration of care, patient-centred care and case management. We identified and reviewed articles including a definition of one of these concepts by performing an extensive literature search in PubMed. In addition, we checked the definition of these concepts in the Oxford English Dictionary. Definitions of continuity, coordination, integration, patient-centred care and case management vary over time. These concepts show both great entanglement and also demonstrate differences. Three major common themes could be identified within these concepts: personal relationship between patient and care provider, communication between providers and cooperation between providers. Most definitions of the concepts are formulated from the patient's perspective. The identified themes appear to be core elements of care to patients. Thus, it may be valuable to develop an instrument to measure these three common themes universally. In the patient-centred medical home, such an instrument might turn out to be an important quality measure, which will enable researchers and policy makers to compare care settings and practices and to evaluate new care interventions from the patient perspective.

Mazingira Centre: A state-of-the-art environmental research infrastructure in Eastern Africa

NASA Astrophysics Data System (ADS)

Merbold, Lutz; Butterbach-Bahl, Klaus; Goopy, John; Mutuo, Paul; Korir, Daniel; Pelster, David; Wanyama, George

2017-04-01

Measurements of greenhouse gases (GHGs), performed in various terrestrial and marine ecosystems have led to a fundamental understanding of the Earth System during the last century. While there are numerous extant long-term measurements of GHGs across the globe, these are mainly located in developed countries of the northern hemisphere, leaving large regions such as Sub-Saharan Africa (SSA) without a consolidated observational network. Moreover, in SSA also infrastructures capable of measuring GHGs following best scientific practice are lacking. The Mazingira Centre - a state-of-the-art environmental laboratory - hosted by the International Livestock Research Institute in Kenya has been established in 2013. The laboratory is equipped with state-of-the-art GHG measurement technology (gas chromatographs, animal respiration chambers, laser absorption spectrometers) and aims at providing fundamental environmental data (e.g. GHGs and auxiliary information) from the most common land-cover types in Eastern Africa and beyond. Thereby a special focus is given to mixed crop-livestock systems managed by smallholders. The first results from the activities of the Mazingira Centre show much lower GHG emissions from manure management and arable systems as commonly assumed using emission factor approaches (EFs). This highlights the need of direct, in-situ measurements from all land-cover types and agricultural systems in Eastern Africa. The Mazingira Centre is furthermore a core training facility for undergraduate and graduate students, technicians as well policy makers that report GHG emissions to the UNFCCC with reliable and accurate emissions factors.

The Globalisation Challenge for European Higher Education: Convergence and Diversity, Centres and Peripheries. Higher Education Research and Policy. Volume 4

ERIC Educational Resources Information Center

Zgaga, Pavel, Ed.; Teichler, Ulrich, Ed.; Brennan, John, Ed.

2013-01-01

The last decade has marked the European higher education with a particular dynamics. Today, after a decade of a «concerted» policy, national systems look much more convergent but new questions and dilemmas are emerging: about its nature and quality, about real impact of recent reforms in different countries as well as about its future. The book…

Negotiating and Appropriating the "One Person, One Language" Policy within the Complex Reality of a Multilingual Crèche in Strasbourg

ERIC Educational Resources Information Center

Caporal-Ebersold, Eloise; Young, Andrea

2016-01-01

The aim of this article is to analyse the early childhood education and care (ECEC) language policy in the city of Strasbourg, focusing on an ethnographic case study of a newly established bilingual English-French crèche in the city. In France, establishing an early childhood education structure--more specifically, a day care centre catering to…

Developing child mental health services in resource-poor countries.

PubMed

Omigbodun, Olayinka

2008-06-01

Despite significant gains in tackling the major causes of child mortality and evidence of an urgent need for child mental health services, resource-poor countries continue to lag behind in child and adolescent mental health service development. This paper analyses possible barriers to the development of child mental health services in resource-poor countries and attempts to proffer solutions. Obstacles identified are the magnitude of child mental health problems that remain invisible to policy makers, an absence of child mental policies to guide the process of service development, and overburdened child mental health professionals. The belief systems about mental illness also prompt help seeking in alternative health systems, thereby reducing the evidence for the burden associated with health seeking. Solutions that may support child mental health service development are the provision of adequate advocacy tools to reveal the burden, poverty alleviation, health awareness programmes, enforcing legislation, training centred within the region, and partnerships with professionals in developed countries. These solutions require simultaneous approaches to encourage service development and utilization. Reductions in child mortality in resource-poor countries will be even more dramatic in the years to come and preparations need to be made to take care of the mental health needs of the children who will survive.

Implantation of subcutaneous implantable cardioverter defibrillators in Europe: results of the European Heart Rhythm Association survey.

PubMed

Boveda, Serge; Lenarczyk, Radoslaw; Haugaa, Kristina; Fumagalli, Stefano; Madrid, Antonio Hernandez; Defaye, Pascal; Broadhurst, Paul; Dagres, Nikolaos

2016-09-01

The purpose of this European Heart Rhythm Association (EHRA) survey is to provide an overview of the current use of subcutaneous cardioverter defibrillators (S-ICDs) across a broad range of European centres. A questionnaire was sent via the internet to centres participating in the EHRA electrophysiology research network. Questions included standards of care and policies used for patient management, indications, and techniques of implantation of the S-ICDs. In total, 52 centres replied to the questionnaire. More than one-fourth of the responding centres does not implant the S-ICD (n = 14, 27%). The majority reported to have implanted <10 (50%) or 10-29 (23%) S-ICDs during the last 12 months. Lack of reimbursement (25%), non-availability (19%), and cost of the device (25%) seem to limit the use of the S-ICD. The most commonly reported indications for S-ICD implantation are a difficult vascular access (82%), a history of previous complicated transvenous ICD (8O%), young age (69%), or an anticipated higher risk of infection (63%). Inappropriate therapies were the most frequently reported major problems (38%), but the majority of respondents (51%) never encountered any issue after an S-ICD implantation. Most of the respondents (83%) anticipate significant increase of S-ICD use within the next 2 years. This survey provides a contemporary insight into S-ICD implantation and management in the European electrophysiology centres, showing different approaches, depending on local policies. Cost issues or lack of reimbursement strongly influence the dissemination of the device. However, most respondents retain that S-ICD use will significantly increase in a very short time. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Economic Analysis of Delivering Primary Health Care Services through Community Health Workers in 3 North Indian States

PubMed Central

Prinja, Shankar; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2014-01-01

Background We assessed overall annual and unit cost of delivering package of services and specific services at sub-centre level by CHWs and cost effectiveness of Government of India’s policy of introducing a second auxiliary nurse midwife (ANM) at the sub-centre compared to scenario of single ANM sub-centre. Methods We undertook an economic costing of health services delivered by CHWs, from a health system perspective. Bottom-up costing method was used to collect data on resources spent in 50 randomly selected sub-centres selected from 4 districts. Mean unit cost along with its 95% confidence intervals were estimated using bootstrap method. Multiple linear regression model was used to standardize cost and assess its determinants. Results Annually it costs INR 1.03 million (USD 19,381), or INR 187 (USD 3.5) per capita per year, to provide a package of preventive, curative and promotive services through community health workers. Unit costs for antenatal care, postnatal care, DOTS treatment and immunization were INR 525 (USD 10) per full ANC care, INR 767 (USD 14) per PNC case registered, INR 974 (USD 18) per DOTS treatment completed and INR 97 (USD 1.8) per child immunized in routine immunization respectively. A 10% increase in human resource costs results in 6% rise in per capita cost. Similarly, 10% increment in the ANC case registered per provider through-put results in a decline in unit cost ranging from 2% in the event of current capacity utilization to 3% reduction in case of full capacity utilization. Incremental cost of introducing 2nd ANM at sub-centre level per unit percent increase ANC coverage was INR 23,058 (USD 432). Conclusion Our estimates would be useful in undertaking full economic evaluations or equity analysis of CHW programs. Government of India’s policy of hiring 2nd ANM at sub-centre level is very cost effective from Indian health system perspective. PMID:24626285

Reference centres for adults with rare and complex cancers - Policy recommendations to improve the organisation of care in Belgium.

PubMed

Stordeur, S; Vrijens, F; Leroy, R

2016-02-01

Rare and/or complex cancers call for a very specific expertise and adequate infrastructure. In Belgium, every hospital with a programme in oncology can deliver care for adults with rare and/or complex cancer types, without having demonstrated a specific know-how to adequately manage these patients. Therefore, the Minister of Health ordered a scenario for the organisation of care for adults with rare and/or complex cancers, taking into account the current Belgian situation and relevant foreign experience. Combined methods were used in this study: a literature review, the consultation of stakeholders, in depth discussions in 14 multidisciplinary groups leading to concrete proposals for several rare/complex cancers and the consultation of a panel of expert pathologists. The core recommendation is the set-up of shared care networks around reference centres, with multidisciplinary teams of recognised expertise in specific rare/complex cancers. The definition of minimum caseloads for hospitals and medical specialists, the evaluation of the quality of care, a model of diagnostic confirmation and the set-up of a national portal website which provides information on rare and/or complex cancers and reference centres are highly recommended. It is no longer practicable, efficient or ethical that every hospital or every practitioner continues to offer care for every rare/complex cancer. Improving the quality of rare/complex cancer care requires to concentrate expertise and sophisticated infrastructure in reference centres. Furthermore, the formation of networks between reference centres and peripheral centres will allow a delivery of care combining expertise and proximity. The next step is the translation of the recommendations into policy decisions. It is very well realised that this will take some courage and that a certain degree of resistance will have to be surmounted, but eventually, the best interest of the patient should prevail. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China.

PubMed

Li, Man; Zhong, Renyao; Zhu, Shanwen; Ramsay, Lauren C; Li, Fen; Coyte, Peter C

2018-06-06

Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1) explore regional differences in community living infrastructure; and (2) to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015)”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

Survey of prenatal counselling practices regarding aneuploidy risk modification, invasive diagnostic procedure risks, and procedure eligibility criteria in Canadian centres.

PubMed

Hull, Danna; Davies, Gregory; Armour, Christine M

2012-07-01

To explore prenatal practices related to aneuploidy screening, risk modification, and invasive diagnostic procedures across Canadian centres. We conducted a survey of members of the Canadian Association of Genetic Counsellors, the Canadian College of Medical Genetics, and the Canadian Society of Maternal Fetal Medicine, who provide direct counselling or management of prenatal patients in Canada. Eighty-two of 157 respondents indicated that their centre's definition of advanced maternal age was ≥ 35 years, with 33/157 respondents reporting an advanced maternal age definition of ≥ 40 years. The majority of respondents reported that prenatal serum screening for aneuploidy is provincially funded in their province or territory (121/147). The majority of respondents who reported that prenatal screening is not provincially funded (17/147) were from Quebec (14/17). Thirty-nine of 123 respondents reported that their centre defines increased nuchal translucency as ≥ 3.0 mm, whereas 49/123 reported a definition of ≥ 3.5 mm. Sixty-four of 150 respondents reported that the aneuploidy risk provided by serum screening is modified by a soft marker likelihood ratio, whereas 46/150 respondents reported that both age-related and serum screening risks are modified. Fifty-nine of 124 respondents reported that their centre will modify aneuploidy risk after a normal ultrasound; the most commonly cited negative likelihood ratio was 0.5. The most commonly reported procedure-related risk for chorionic villus sampling was 1/100 (123/147) and for amniocentesis was 1/200 (73/142). This study demonstrates inconsistencies in prenatal practices and access to screening programs across Canada. The information gained from this study will inform policy advisors developing prenatal practice guidelines at both the provincial and national levels.

Much ado about flu: A mixed methods study of parental perceptions, trust and information seeking in a pandemic.

PubMed

King, Catherine L; Chow, Maria Y K; Wiley, Kerrie E; Leask, Julie

2018-07-01

Effective public health messaging is essential in both the planning phase and duration of a pandemic. This study aimed to gain an understanding of parental information seeking, trusted sources and needs in relation to pandemic influenza A 2009 (pH1N1) to inform future policy planning and resource development. We conducted a mixed methods study; parents from 16 childcare centres in Sydney, Australia, were surveyed between 16 November and 9 December 2009, and interviews were conducted with participants from six childcare centres between June 2009 and May 2011. From 972 surveys distributed, 431 were completed; a response rate of 44%. Most parents (90%) reported that doctors were "trusted a lot" as a source of influenza information, followed by nurses (59%), government (56%) and childcare centres (52%). Less trusted sources included media (7% selected "trusted a lot"), antivaccination groups (6%) and celebrities (1%). Parents identified a range of key search terms for influenza infection and vaccine. From 42 in-depth interviews, key themes were as follows: "Action trigger," "In an emergency, think Emergency," "Fright to hype" and "Dr Google and beyond." Parents relied heavily on media messages, but cynicism emerged when the pandemic was milder than expected. Parents viewed a range of information sources as trustworthy, including doctors, authoritative hospital or government websites, and childcare centres and schools. A user-centred orientation is vital for pandemic communications including tailored information provision, via trusted sources based on what parents want to know and how they can find it. © 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Towards a shared service centre for telemedicine: Telemedicine in Denmark, and a possible way forward.

PubMed

Larsen, Simon Bo; Sørensen, Nanna Skovgaard; Petersen, Matilde Grøndahl; Kjeldsen, Gitte Friis

2016-12-01

Although evidence of the effectiveness of telemedicine is accumulating, knowledge of how to make best use of telemedicine is limited. This article presents results from a multi-stakeholder project that developed a new concept, a 'shared service centre' for telemedicine that is envisioned as working across different telemedical initiatives to support the implementation and wider adoption of telemedicine. One year of participatory design and analysis of the shared service centre concept involved stakeholders, such as clinicians, patients, technicians, policy makers, lawyers, economists and information technology architects. More than 100 people contributed to the findings. Most of the ideas generated for potential centre support for telemedicine could be categorised under four service categories. The need for such support services was verified in the cases investigated, and by agreement among stakeholders from regional health authorities, municipalities, and general practice. Therefore, it is probable that a shared service centre could help enable the wider deployment of telemedicine. In this article, we use 'telemedicine' as an umbrella term for all the 'tele-' labels that are sometimes used rather indiscriminately to denote the use of information and technology to support healthcare services, including 'telehealth', 'telemonitoring', 'telehomecare', 'e-health', and so on. As per our definition, telemedicine may be synchronous and/or asynchronous, and may apply to any information and technology-based means of connecting healthcare actors and the patient, such as video communication, e-mail, electronic monitoring equipment, and Internet portals. Furthermore, the term 'telemedical initiative' covers projects in which telemedicine is conducted by a temporary project organisation, as well as self-contained telemedicine services used in daily, clinical practice in existing organisations. © The Author(s) 2015.

Hearing voices: re/presenting the findings of narrative research into patient experience as poems.

PubMed

Stenhouse, R

2014-06-01

The study aimed to understand the experience of being a patient on an acute psychiatric inpatient ward. A further aim was to open up spaces for the voices of participants to be heard. Contemporary government policy places patient experience at the centre of healthcare policy and service development. Despite this, those who occupy marginalized discourses struggle to be heard within the dominant discourse of health care. A qualitative approach was used, and narrative was conceptualized as representing experience. Sociolinguistic theories informed the development of the analytic framework treating meaning as contextual and arising from both content and structure of narratives. Concepts of representation, voice and authorship were problematized. Thirteen people who had been inpatients on an acute psychiatric inpatient ward participated. Narrative data were gathered using unstructured interviews. The data were analysed holistically using a method that attended to both the structure and content of the narrative. The product of these holistic narratives was the development of a poem representing each participant's experience. This paper focuses on the development of these poems as a method of decentring the authorial voice and opening up spaces for the voices of the participants to be heard. © 2013 John Wiley & Sons Ltd.

ATLAS computing on CSCS HPC

NASA Astrophysics Data System (ADS)

Filipcic, A.; Haug, S.; Hostettler, M.; Walker, R.; Weber, M.

2015-12-01

The Piz Daint Cray XC30 HPC system at CSCS, the Swiss National Supercomputing centre, was the highest ranked European system on TOP500 in 2014, also featuring GPU accelerators. Event generation and detector simulation for the ATLAS experiment have been enabled for this machine. We report on the technical solutions, performance, HPC policy challenges and possible future opportunities for HEP on extreme HPC systems. In particular a custom made integration to the ATLAS job submission system has been developed via the Advanced Resource Connector (ARC) middleware. Furthermore, a partial GPU acceleration of the Geant4 detector simulations has been implemented.

Parents' experiences of healthcare provider actions when their child dies: an integrative review of the literature.

PubMed

Butler, Ashleigh; Hall, Helen; Willetts, Georgina; Copnell, Beverley

2015-01-01

To review, critique and synthesise current research studies that examine parental perceptions of healthcare provider actions during and after the death of a child. Five main themes were synthesised from the literature: staff attitudes and affect; follow-up care and ongoing contact; communication; attending to the parents; and continuity of care. This review helps to identify important aspects of paediatric end-of-life care as recognised by parents, with the intention of placing the family at the centre of any future end-of-life care education or policy/protocol development. © 2014, Wiley Periodicals, Inc.

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

PubMed

Belaid, Loubna; Ridde, Valéry

2012-12-08

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

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

PubMed Central

2012-01-01

Background To bring down its high maternal mortality ratio, Burkina Faso adopted a national health policy in 2007 that designed to boost the assisted delivery rate and improving quality of emergency obstetrical and neonatal care. The cost of transportation from health centres to district hospitals is paid by the policy. The worst-off are exempted from all fees. Methods The objectives of this paper are to analyze perceptions of this policy by health workers, assess how this health policy was implemented at the district level, identify difficulties faced during implementation, and highlight interactional factors that have an influence on the implementation process. A multiple site case study was conducted at 6 health centres in the district of Djibo in Burkina Faso. The following sources of data were used: 1) district documents (n = 23); 2) key interviews with district health managers (n = 10), health workers (n = 16), traditional birth attendants (n = 7), and community management committees (n = 11); 3) non-participant observations in health centres; 4) focus groups in communities (n = 62); 5) a feedback session on the findings with 20 health staff members. Results All the activities were implemented as planned except for completely subsidizing the worst-off, and some activities such as surveys for patients and the quality assurance service team aiming to improve quality of care. District health managers and health workers perceived difficulties in implementing this policy because of the lack of clarity on some topics in the guidelines. Entering the data into an electronic database and the long delay in reimbursing transportation costs were the principal challenges perceived by implementers. Interactional factors such as relations between providers and patients and between health workers and communities were raised. These factors have an influence on the implementation process. Strained relations between the groups involved may reduce the effectiveness of the policy. Conclusions Implementation analysis in the context of improving financial access to health care in African countries is still scarce, especially at the micro level. The strained relations of the providers with patients and the communities may have an influence on the implementation process and on the effects of this health policy. Therefore, power relations between actors of the health system and the community should be taken into consideration. More studies are needed to better understand the influence of power relations on the implementation process in low-income countries. PMID:23216874

The Dutch Birth Centre Study: study design of a programmatic evaluation of the effect of birth centre care in the Netherlands.

PubMed

Hermus, Marieke A A; Wiegers, Therese A; Hitzert, Marit F; Boesveld, Inge C; van den Akker-van Marle, M Elske; Akkermans, Henk A; Bruijnzeels, Marc A; Franx, Arie; de Graaf, Johanna P; Rijnders, Marlies E B; Steegers, Eric A P; van der Pal-de Bruin, Karin M

2015-07-16

Birth centres are regarded as settings where women with uncomplicated pregnancies can give birth, assisted by a midwife and a maternity care assistant. In case of (threatening) complications referral to a maternity unit of a hospital is necessary. In the last decade up to 20 different birth centres have been instituted in the Netherlands. This increase in birth centres is attributed to various reasons such as a safe and easy accessible place of birth, organizational efficiency in integration of care and direct access to obstetric hospital care if needed, and better use of maternity care assistance. Birth centres are assumed to offer increased integration and quality of care and thus to contribute to better perinatal and maternal outcomes. So far there is no evidence for this assumption as no previous studies of birth centres have been carried out in the Netherlands. The aims are 1) Identification of birth centres and measuring integration of organization and care 2) Measuring the quality of birth centre care 3) Effects of introducing a birth centre on regional quality and provision of care 4) Cost-effectiveness analysis 5) In depth longitudinal analysis of the organization and processes in birth centres. Different qualitative and quantitative methods will be used in the different sub studies. The design is a multi-centre, multi-method study, including surveys, interviews, observations, and analysis of registration data and documents. The results of this study will enable users of maternity care, professionals, policy makers and health care financers to make an informed choice about the kind of birth location that is appropriate for their needs and wishes.

Impact of a nutrition award scheme on the food and nutrient intakes of 2- to 4-year-olds attending long day care.

PubMed

Bell, Lucinda K; Hendrie, Gilly A; Hartley, Jo; Golley, Rebecca K

2015-10-01

Early childhood settings are promising avenues to intervene to improve children's nutrition. Previous research has shown that a nutrition award scheme, Start Right - Eat Right (SRER), improves long day care centre policies, menus and eating environments. Whether this translates into improvements in children's dietary intake is unknown. The present study aimed to determine whether SRER improves children's food and nutrient intakes. Pre-post cohort study. Twenty long day care centres in metropolitan Adelaide, South Australia, Australia. Children aged 2-4 years (n 236 at baseline, n 232 at follow-up). Dietary intake (morning tea, lunch, afternoon tea) was assessed pre- and post-SRER implementation using the plate wastage method. Centre nutrition policies, menus and environments were evaluated as measures of intervention fidelity. Comparisons between baseline and follow-up were made using t tests. At follow-up, 80 % of centres were fully compliant with the SRER award criteria, indicating high scheme implementation and adoption. Intake increased for all core food groups (range: 0·2-0·4 servings/d, P<0·001) except for vegetable intake. Energy intake increased and improvements in intakes of eleven out of the nineteen nutrients evaluated were observed. SRER is effective in improving children's food and nutrient intakes at a critical time point when dietary habits and preferences are established and can inform future public health nutrition interventions in this setting.

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

Integrating Public Health Policy, Practice, Evaluation, Surveillance, and Research: The School Health Action Planning and Evaluation System

PubMed Central

Cameron, Roy; Manske, Stephen; Brown, K. Stephen; Jolin, Mari Alice; Murnaghan, Donna; Lovato, Chris

2007-01-01

The Canadian Cancer Society and the National Cancer Institute of Canada have charged their Centre for Behavioral Research and Program Evaluation with contributing to the development of the country’s systemic capacity to link research, policy, and practice related to population-level interventions. Local data collection and feedback systems are integral to this capacity. Canada’s School Health Action Planning and Evaluation System (SHAPES) allows data to be collected from all of a school’s students, and these data are used to produce computer-generated school “health profiles.” SHAPES is being used for intervention planning, evaluation, surveillance, and research across Canada. Strong demand and multipartner investment suggest that SHAPES is adding value in all of these domains. Such systems can contribute substantially to evidence-informed public health practice, public engagement, participatory action research, and relevant, timely population intervention research. PMID:17329662

A journey towards inclusive education; a case study from a 'township' in South Africa.

PubMed

Luger, Rosemary; Prudhomme, Debbie; Bullen, Ann; Pitt, Catherine; Geiger, Martha

2012-01-01

The purpose of this case study was to relate part of the journey to appropriate education for two young children with physical disabilities in a low socio-economic peri-urban informal settlement - or 'township' - in South Africa. The part of the on-going journey described here spanned four-and-a-half years and included the two children, their families, their teachers, their community and a small team of rehabilitation professionals working for a non-profit organisation in the area. The rehabilitation professionals' goals were to provide support for the children, their families, their current special care centre and the school(s) they would attend in the future. The steps from the special care centre, to a mainstream early childhood development (ECD) centre for both of them, and then on to (a) a school for learners with special educational needs (LSEN) for one child and (b) a mainstream primary school for the other, are described. Challenges encountered on the way included parental fears, community attitudes and physical accessibility. Practical outcomes included different placements for the two children with implications and recommendations for prioritised parent involvement, individual approaches, interdisciplinary and community-based collaborations. Recommendations are given for clinical contexts, curricula and policy matters; for research and for scaling up such a programme through community workers.

Educating for action: Aligning skills with policies for sustainable development in the Danube river basin.

PubMed

Irvine, Kenneth; Weigelhofer, Gabriele; Popescu, Ioana; Pfeiffer, Ellen; Păun, Andrei; Drobot, Radu; Gettel, Gretchen; Staska, Bernadette; Stanica, Adrian; Hein, Thomas; Habersack, Helmut

2016-02-01

Sustainable river basin management depends on knowledge, skills and education. The DANCERS project set out to identify feasible options for achieving education for sustainable water management across the Danube river basin, and its integration with broader education and economic development. The study traced the historic, regulatory and educational landscape of water management in the basin, contrasting it with the complex political decision-making, data-heavy decision support, learning-centred collaboration, and information-based participation that are all inherent components of Integrated Water Resource Management (IWRM). While there is a wide range of educational opportunities and mobility schemes available to individuals, there is no coherent network related to training in water management and sustainable development in the study region. Progress in addressing the multi-layered environmental challenges within the basin requires further aligning of economic, environmental and educational policies, advancing the EU Bologna Process across the region, and the development of dedicated training programmes that combine technical and relational skills. The DANCERS project identified key short and medium term needs for education and research to support progressive adoption of sustainable development, and the necessary dialogue across the public and private sectors to align policies. These include the development of new education networks for masters and PhD programmes, including joint programmes; improved access to technical training and life-long learning programmes for skills development; developing formalized and certified competency structures and associated accreditation of institutions where such skilled individuals work; and developing a co-ordinated research infrastructure and pan-basin programme for research for water management and sustainable development. Copyright © 2015 Elsevier B.V. All rights reserved.

Assessing value-based health care delivery for haemodialysis.

PubMed

Parra, Eduardo; Arenas, María Dolores; Alonso, Manuel; Martínez, María Fernanda; Gamen, Ángel; Aguarón, Juan; Escobar, María Teresa; Moreno-Jiménez, José María; Alvarez-Ude, Fernando

2017-06-01

Disparities in haemodialysis outcomes among centres have been well-documented. Besides, attempts to assess haemodialysis results have been based on non-comprehensive methodologies. This study aimed to develop a comprehensive methodology for assessing haemodialysis centres, based on the value of health care. The value of health care is defined as the patient benefit from a specific medical intervention per monetary unit invested (Value = Patient Benefit/Cost). This study assessed the value of health care and ranked different haemodialysis centres. A nephrology quality management group identified the criteria for the assessment. An expert group composed of stakeholders (patients, clinicians and managers) agreed on the weighting of each variable, considering values and preferences. Multi-criteria methodology was used to analyse the data. Four criteria and their weights were identified: evidence-based clinical performance measures = 43 points; yearly mortality = 27 points; patient satisfaction = 13 points; and health-related quality of life = 17 points (100-point scale). Evidence-based clinical performance measures included five sub-criteria, with respective weights, including: dialysis adequacy; haemoglobin concentration; mineral and bone disorders; type of vascular access; and hospitalization rate. The patient benefit was determined from co-morbidity-adjusted results and corresponding weights. The cost of each centre was calculated as the average amount expended per patient per year. The study was conducted in five centres (1-5). After adjusting for co-morbidity, value of health care was calculated, and the centres were ranked. A multi-way sensitivity analysis that considered different weights (10-60% changes) and costs (changes of 10% in direct and 30% in allocated costs) showed that the methodology was robust. The rankings: 4-5-3-2-1 and 4-3-5-2-1 were observed in 62.21% and 21.55%, respectively, of simulations, when weights were varied by 60%. Value assessments may integrate divergent stakeholder perceptions, create a context for improvement and aid in policy-making decisions. © 2015 John Wiley & Sons, Ltd.

One psychiatrist's experience of visiting offshore processing centres for people seeking asylum in Australia.

PubMed

Adler, Robert

2016-02-01

To describe the author's experience of visiting Christmas Island and Nauru offshore detention centres as a visiting child and adolescent psychiatrist in the context of his own experience as a refugee from Europe after WWII. Following a visit to Nauru the author wrote to the Prime Minister and leader of the Opposition expressing his objections to the policies of recent Coalition and Labor Governments. His actions have led to the author not being invited to return to these centres as a visiting psychiatrist. The author acknowledges the importance of stopping the boats and proposes that a more humane approach is needed for asylum seekers who arrive by boat. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Development of the roadmap for reducing cardiovascular morbidity and mortality through the detection, treatment and control of hypertension in Africa: report of a working group of the PASCAR Hypertension Task Force.

PubMed

Dzudie, Anastase; Kane, Abdoul; Kramoh, Euloge; Anzouan-Kacou, Jean-Baptiste; Damourou, Jean Marie; Allawaye, Lucien; Nzisabira, Jolis; Mousse, Latif; Balde, Dadier; Nouhom, Ouane; Nkoa, Jean Louis; Kaki, Kimbally; Djomou, Armel; Menanga, Alain; Nganou, Christ Nadege; Mipinda, Jean Bruno; Nebie, Lucie; Kuate, Liliane Mfeukeu; Kingue, Samuel; Ba, Serigne Abdou

The fourth Pan-African Society of Cardiology (PASCAR) hypertension taskforce meeting was held at the Yaoundé Hilton Hotel on 16 March 2016. Its main goals were to update and facilitate understanding of the PASCAR roadmap for the control of hypertension on the continent, to refine the PASCAR hypertension algorithm, and to discuss the next steps of the PASCAR hypertension policy, including how the PASCAR initiative can be customised at country level. The formation of the PASCAR coalition against hypertension, the writing group and the current status of the PASCAR hypertension policy document as well as the algorithm were presented to delegates representing 12 French-speaking countries. The urgency to finalise the continental policy was recognised and consensus was achieved by discussion on the main points and strategy. Relevant scientific issues were discussed and comments were received on all points, including how the algorithm could be simplified and made more accessible for implementation at primary healthcare centres.

Wheelchair interventions, services and provision for disabled children: a mixed-method systematic review and conceptual framework

PubMed Central

2014-01-01

Background Wheelchairs for disabled children (≤18 years) can provide health, developmental and social benefits. World Health Organisation and United Kingdom Government reports demonstrate the need for improved access to wheelchairs both locally and internationally. The use of health economics within this field is lacking. Provision of wheelchairs based on cost-effectiveness evidence is not currently possible. We conducted the first systematic review in this field to incorporate evidence of effectiveness, service user perspectives, policy intentions and cost-effectiveness in order to develop a conceptual framework to inform future research and service development. Methods We used an adapted EPPI-Centre mixed-method systematic review design with narrative summary, thematic and narrative synthesis. 11 databases were searched. Studies were appraised for quality using one of seven appropriate tools. A conceptual framework was developed from synthesised evidence. Results 22 studies and 14 policies/guidelines were included. Powered wheelchairs appear to offer benefits in reduced need for caregiver assistance; improved communicative, personal-social and cognitive development; and improved mobility function and independent movement. From 14 months of age children can learn some degree of powered wheelchair driving competence. However, effectiveness evidence was limited and low quality. Children and parents placed emphasis on improving social skill and independence. Participation in wider society and development of meaningful relationships were key desired outcomes. Policy intentions and aspirations are in line with the perspectives of children and parents, although translation of policy recommendations into practice is lacking. Conclusions There is a distinct lack of high quality effectiveness and economic evidence in this field. Social and health needs should be seen as equally important when assessing the mobility needs of disabled children. Disabled children and parents placed highest priority on independence and psychosocial outcomes of wheelchair interventions. Translation of policy and guidelines into practice is lacking and more effective implementation strategies are required to improve services and outcomes. Future research should focus on outcome measure development, developing economic evaluation tools and incorporating these into high quality studies to address known research gaps. The novel conceptual framework maps current gaps in evidence and outlines areas for development. PMID:25034517

The adverse outcome pathway for skin sensitisation: Moving closer to replacing animal testing.

PubMed

Schultz, Terry W; Dimitrova, Gergana; Dimitrov, Sabcho; Mekenyan, Ovanes G

2016-10-01

This article outlines the work of the Organisation for Economic Co-operation and Development (OECD) that led to being jointly awarded the 2015 Lush Black Box Prize. The award-winning work centred on the development of 'The Adverse Outcome Pathway for Skin Sensitisation Initiated by Covalent Binding to Proteins'. This Adverse Outcome Pathway (AOP) has provided the mechanistic basis for the integration of skin sensitisation-related information. Recent developments in integrated approaches to testing and assessment, based on the AOP, are summarised. The impact of the AOP on regulatory policy and on the Three Rs are discussed. An overview of the next generation of the skin sensitisation AOP module in the OECD QSAR Toolbox, based on more-recent work at the Laboratory of Mathematical Chemistry, is also presented. 2016 FRAME.

Migration in Deltas: An Integrated Analysis

NASA Astrophysics Data System (ADS)

Nicholls, Robert J.; Hutton, Craig W.; Lazar, Attila; Adger, W. Neil; Allan, Andrew; Arto, Inaki; Vincent, Katharine; Rahman, Munsur; Salehin, Mashfiqus; Sugata, Hazra; Ghosh, Tuhin; Codjoe, Sam; Appeaning-Addo, Kwasi

2017-04-01

Deltas and low-lying coastal regions have long been perceived as vulnerable to global sea-level rise, with the potential for mass displacement of exposed populations. The assumption of mass displacement of populations in deltas requires a comprehensive reassessment in the light of present and future migration in deltas, including the potential role of adaptation to influence these decisions. At present, deltas are subject to multiple drivers of environmental change and often have high population densities as they are accessible and productive ecosystems. Climate change, catchment management, subsidence and land cover change drive environmental change across all deltas. Populations in deltas are also highly mobile, with significant urbanization trends and the growth of large cities and mega-cities within or adjacent to deltas across Asia and Africa. Such migration is driven primarily by economic opportunity, yet environmental change in general, and climate change in particular, are likely to play an increasing direct and indirect role in future migration trends. The policy challenges centre on the role of migration within regional adaptation strategies to climate change; the protection of vulnerable populations; and the future of urban settlements within deltas. This paper reviews current knowledge on migration and adaptation to environmental change to discern specific issues pertinent to delta regions. It develops a new integrated methodology to assess present and future migration in deltas using the Volta delta in Ghana, Mahanadi delta in India and Ganges-Brahmaputra-Meghna delta across India and Bangladesh. The integrated method focuses on: biophysical changes and spatial distribution of vulnerability; demographic changes and migration decision-making using multiple methods and data; macro-economic trends and scenarios in the deltas; and the policies and governance structures that constrain and enable adaptation. The analysis is facilitated by a range of consistent scenarios from global to delta scales, developed in consultation with major stakeholders. Initial results suggest that migration decision-making strongly interacts with diverse measures for adaptation of land, water and agricultural management. A key normative challenge is to identify the parameters of successful migration and adaptation across delta regions, to inform policy analysis and formulation. Key words: Deltas, sea-level rise, migration and adaptation Acknowledgement: DECCMA (Deltas, Vulnerability & Climate Change: Migration & Adaptation) project is part of the Collaborative ADAPTATION Research Initiative in Africa and Asia (CARIAA), with financial support from the UK Government's Department for International Development (DFID) and the International Development Research Centre (IDRC), Canada.

Regional accents. The RCN policy unit compares NHS plans across the UK.

PubMed

2003-09-01

All three NHS plans that form the modernization agenda can be characterised by three themes: Centralization Partnership Culture change. Despite the absence of a Northern Ireland plan, the issues and themes that emerge in the other three plans are prevalent in Northern Ireland too. CENTRALISATION: The tendency to centralize has led to a greater involvement of health ministers, rather than civil servants, in the day-to-day running of the health services, but ministers are preparing to hand over operational control of new policies. PARTNERSHIP: Partnership underpins many of the new structural arrangements, with an emphasis on increased inter-professional working and education, but merged health and social care structures create funding tensions. CULTURE CHANGE: Culture change focuses on creating patient-centred care and dismantling the power of the health professions, while the curbing of professional autonomy is central to enhancing and improving patients' overall experience of the NHS. The cumulative effect of these developments is likely to lead to increasing debate about the future funding, provision and accountability of the NHS as regional and country differences continue to develop.

The contradictory logic of global ecosystem services markets.

PubMed

McAfee, Kathleen

2012-01-01

Commodification and transnational trading of ecosystem services is the most ambitious iteration yet of the strategy of ‘selling nature to save it’. The World Bank and UN agencies contend that global carbon markets can slow climate change while generating resources for development. Consonant with ‘inclusionary’ versions of neoliberal development policy, advocates assert that international payment for ecosystem services (PES) projects, financed by carbon-offset sales and biodiversity banking, can benefit the poor. However, the World Bank also warns that a focus on poverty reduction can undermine efficiency in conservation spending. The experience of ten years of PES illustrates how, in practice, market-efficiency criteria clash directly with poverty-reduction priorities. Nevertheless, the premises of market-based PES are being extrapolated as a model for global REDD programmes financed by carbon-offset trading. This article argues that the contradiction between development and conservation observed in PES is inevitable in projects framed by the asocial logic of neoclassical economics. Application in international conservation policy of the market model, in which profit incentives depend upon differential opportunity costs, will entail a net upward redistribution of wealth from poorer to wealthier classes and from rural regions to distant centres of capital accumulation, mainly in the global North.

Fostering inclusive, sustainable economic growth and "green" skills development in learning cities through partnerships

NASA Astrophysics Data System (ADS)

Pavlova, Margarita

2018-05-01

One of the requirements of building a learning city is working to ensure its sustainable development. In 2014, UNESCO developed a framework of the key features of learning cities, at the centre of which there are six pillars or "building blocks" which support sustainable development. This article focuses on the third of these pillars, "effective learning for and in the workplace". The author analyses a number of conditions to address this aspect in the context of "green restructuring" which is geared towards facilitating the sustainable development of learning cities. She argues that, at the conceptual level, an understanding of the nature of "green skills" (what they are) and the reasons for "green skills gaps" (why they exist) are essential for the processes of effective learning and strategy planning in sustainable city development. The specific focus of this article is at the policy level: the conceptualisation of partnerships between technical and vocational education and training (TVET) providers, industry, government and other stakeholders with the aim of fostering the production, dissemination and usage of knowledge for the purpose of sustainable economic development and the "greening" of skills. The author proposes a new model, based on the quintuple helix approach to innovation combined with a policy goals orientation framework to theorise the ways in which learning cities can foster sustainable economic growth through green skills development.

Protocol: a realist review of user fee exemption policies for health services in Africa.

PubMed

Robert, Emilie; Ridde, Valéry; Marchal, Bruno; Fournier, Pierre

2012-01-01

Background Four years prior to the Millenium Development Goals (MDGs) deadline, low- and middle-income countries and international stakeholders are looking for evidence-based policies to improve access to healthcare for the most vulnerable populations. User fee exemption policies are one of the potential solutions. However, the evidence is disparate, and systematic reviews have failed to provide valuable lessons. The authors propose to produce an innovative synthesis of the available evidence on user fee exemption policies in Africa to feed the policy-making process. Methods The authors will carry out a realist review to answer the following research question: what are the outcomes of user fee exemption policies implemented in Africa? why do they produce such outcomes? and what contextual elements come into play? This type of review aims to understand how contextual elements influence the production of outcomes through the activation of specific mechanisms, in the form of context-mechanism-outcome configurations. The review will be conducted in five steps: (1) identifying with key stakeholders the mechanisms underlying user fee exemption policies to develop the analytical framework, (2) searching for and selecting primary data, (3) assessing the quality of evidence using the Mixed-Method Appraisal Tool, (4) extracting the data using the analytical framework and (5) synthesising the data in the form of context-mechanism-outcomes configurations. The output will be a middle-range theory specifying how user fee exemption policies work, for what populations and under what circumstances. Ethics and dissemination The two main target audiences are researchers who are looking for examples to implement a realist review, and policy-makers and international stakeholders looking for lessons learnt on user fee exemption. For the latter, a knowledge-sharing strategy involving local scientific and policy networks will be implemented. The study has been approved by the ethics committee of the CHUM Research Centre (CR-CHUM). It received funding from the Canadian Institutes of Health Research. The funders will not have any role in study design; collection, management, analysis, and interpretation of data; writing of the report and the decision to submit the report for publication, including who will have ultimate authority over each of these activities.

Improving the nutrition and screen time environment through self-assessment in family childcare homes in Nebraska.

PubMed

Dev, Dipti A; Williams, Natalie; Iruka, Iheoma; Garcia, Aileen S; Guo, Yage; Patwardhan, Irina; Cummings, Katrina; Rida, Zainab; Hulse, Emily; Sedani, Ami

2018-06-01

To determine if family childcare homes (FCCH) in Nebraska meet best practices for nutrition and screen time, and if focusing on nutrition and screen time policies and practices improves the FCCH environment. A pre-post evaluation was conducted using the Go Nutrition and Physical Activity Self-Assessment for Childcare (Go NAP SACC). FCCH in Nebraska, USA. FCCH enrolled in the Child and Adult Care Food Program (CACFP; n 208) participated in a pre-post evaluation using Go NAP SACC. At baseline, all FCCH met the minimum childcare standards for fifty-four of fifty-six practices in nutrition and screen time. After the intervention, FCCH demonstrated significant improvement in fourteen of the forty-four Child Nutrition items and eleven of the twelve Screen Time items. However, FCCH providers did not meet best practices at post-intervention. Lowest scores were found in serving meals family-style, promoting visible support for healthy eating, planned nutrition education and written policy on child nutrition. For screen time, lowest scores were reported on the availability of television, offering families education on screen time and having a written policy on screen time. FCCH in Nebraska were able to strengthen their policies and practices after utilizing Go NAP SACC. Continued professional development and participation in targeted interventions may assist programmes in sustaining improved practices and policies. Considering the varying standards and policies surrounding FCCH, future studies comparing the current findings with childcare centres and non-CACFP programmes are warranted.

Genetic counseling services and development of training programs in Malaysia.

PubMed

Lee, Juliana Mei-Har; Thong, Meow-Keong

2013-12-01

Genetic counseling service is urgently required in developing countries. In Malaysia, the first medical genetic service was introduced in 1994 at one of the main teaching hospitals in Kuala Lumpur. Two decades later, the medical genetic services have improved with the availability of genetic counseling, genetic testing and diagnosis, for both paediatric conditions and adult-onset inherited conditions, at four main centers of medical genetic services in Malaysia. Prenatal diagnosis services and assisted reproductive technologies are available at tertiary centres and private medical facilities. Positive developments include governmental recognition of Clinical Genetics as a subspecialty, increased funding for genetics services, development of medical ethics guidelines, and establishment of support groups. However, the country lacked qualified genetic counselors. Proposals were presented to policy-makers to develop genetic counseling courses. Challenges encountered included limited resources and public awareness, ethical dilemmas such as religious and social issues and inadequate genetic health professionals especially genetic counselors.

Ending child poverty in the good times and the bad.

PubMed

Dornan, Paul

2009-01-01

It is now 10 years since the present Government pledged to eradicate child poverty by the year 2020. Some progress has been made, for example through increases in child benefit and the tax credit system, increased parental employment rates, and children's centres. However, the charity Child Poverty Action Group (CPAG) argues that progress has been disappointingly slow and that some aspects of policy development have undermined this progress. This article discusses the implications of the current economic recession on child poverty and includes the key points from the CPAG's manifesto, published in 2009 to mark the 10th anniversary of the pledge to end child poverty.

[Experience feed back committee in radiotherapy (CREx): a compulsory tool for security management evaluation at two years].

PubMed

Lartigau, E; Coche-Dequeant, B; Dumortier, V; Giscard, S; Lacornerie, T; Lasue, A; Cheval, V; Martel, V; Malfait, B; Fuchs, A; Pestel, M; Damman, M; Forrest, M

2008-11-01

After working on treatment organisation in radiotherapy (bonne pratiques organisationnelles en radiothérapie - action pilote MEAH 2003), the development of a security policy has become crucial. With the help of Air France Consulting and the MEAH, three cancer centers in Angers, Lille and Villejuif worked together on the implantation of experience feed back committees (CREx) dedicated to the registration, analysis and correction of precursor events. After two years, we report the centre Oscar-Lambret experience in Lille and try to get the recommendations for generalisation of the process. This seems now to be compulsory for security management in oncology.

Paediatric type 1 diabetes in Ireland--results of the first national audit.

PubMed

Hawkes, C P; Murphy, N P

2014-04-01

The aim of this study was to describe the services provided for children with type 1 diabetes in the Republic of Ireland, and to identify a baseline from which services and outcomes might be improved. Lead clinicians in 17 of the 19 centres providing paediatric type 1 diabetes care responded to requests for information from 2012 regarding demographics, patient numbers, diagnostics, outpatient management, multidisciplinary team resources, comorbidity screening, transition policy, clinical guidelines, and use of insulin pumps. The total number of patients attending these centres was 2518. Eight centres initiate insulin pump therapy. Insulin pump usage ranged from 0 to 42% of patients attending each centre. Self reported clinic mean haemoglobin A1c ranged from 8.2 to 9.4% (66.1 to 79.2 mmol/mol). Variation existed in guideline availability, frequency of clinic appointments, age of transition and insulin types used. We recommend a national approach to standardising and improving care for these patients.

Patient engagement and patient-centred care in the management of advanced chronic kidney disease and chronic kidney failure.

PubMed

Bear, Robert Allan; Stockie, Suzanne

2014-01-01

The purpose of this article is to review the current status of patient-centred care (PCC) and patient engagement (PE) in the management of patients with advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD), to identify some of the barriers that exist to the achievement of PCC and PE, and to describe how these barriers can be overcome. The review is based on the professional experience of one of the authors (RB) as a Nephrologist and health care consultant, on the MBA thesis of one of the authors (SS) and on a review of pertinent internet-based information and published literature. Evidence exists that, currently, the care of patients with advanced CKD and ESRD is not fully patient-centred or fully supportive of PE. A number of barriers exist, including: conflict with other priorities; lack of training and fear of change; the unequal balance of power between patients and providers; physician culture and behaviour; the fee-for-service model of physician compensation; slow implementation of electronic health records; and, fear of accountability. These barriers can be overcome by committed leadership and the development of an information-based implementation plan. Established Renal Agencies in Canada appear interested in facilitating this work by collaborating in the development of a toolkit of recommended educational resources and preferred implementation practices for use by ESRD Programs. A limitation of this review is the absence of a substantial pre-existing literature on this topic. Receiving care that is patient-centred and that promotes PE benefits patients with serious chronic diseases such as advanced CKD and ESRD. Considerable work is required by ESRD Programs to ensure that such care is provided. Canadian Renal Agencies can play an important role by ensuring that ESRD Programs have access to essential educational material and proven implementation approaches and that implementation successes are celebrated. In this area, enabling policies are required, as are clinical research studies focusing on the measurement of outcomes.

Political rhetoric from Canada can inform healthy public policy argumentation.

PubMed

Patterson, Patrick B; McIntyre, Lynn; Anderson, Laura C; Mah, Catherine L

2017-10-01

Household food insecurity (HFI), insufficient income to obtain adequate food, is a growing problem in Canada and other Organisation of economic cooperation and development (OECD) countries. Government political orientations impact health policies and outcomes. We critically examined Canadian political rhetoric around HFI from 1995 to 2012 as a means to support effective healthy public policy argumentation. We analysed a data set comprised of Hansard extracts on HFI from the legislative debates of the Canadian federal and three provincial governments, using thematic coding guided by interpretivist theories of policy. Extracts were examined for content, jurisdiction, the political affiliation of the legislator speaking and governing status. Members of non-governing, or 'opposition' parties, dominated the rhetoric. A central hunger-as-poverty theme was used by legislators across the political spectrum, both in government and in opposition. Legislators differed in terms of policy approach around how income should flow to citizens facing HFI: income intervention on the left, pragmatism in the centre, reliance on markets on the right. This analysis is a case-example from Canada and caution must be exercised in terms of the generalizability of findings across jurisdictions. Despite this limitation, our findings can help healthy public policy advocates in designing and communicating HFI policy interventions in OECD countries with a similar left-right spectrum. First, even with a divisive health policy issue such as actions to address HFI, core themes around poverty are widely understood. Secondly, the non-polarizing centrist, pragmatist, approach may be strategically valuable. Thirdly, it is important to treat the rhetoric of opposition members differently from that of government members. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Knowledge and perceptions of physicians from private medical centres towards generic medicines: a nationwide survey from Malaysia.

PubMed

Kumar, Rohit; Hassali, Mohamed Azmi; Saleem, Fahad; Alrasheedy, Alian A; Kaur, Navneet; Wong, Zhi Yen; Kader, Muhamad Ali Sk Abdul

2015-01-01

Generic medicine prescribing has become a common practice in public hospitals. However, the trend in private medical centres seems to be different. The objective of this study was to investigate knowledge, perceptions and behavior of physicians from private medical centres in Malaysia regarding generic medicines. This study was a cross-sectional nationwide survey targeting physicians from private medical centres in Malaysia. The survey was conducted using questionnaire having (i) background and demographic data of the physicians, volume of prescription in a day, stock of generic medicines in their hospital pharmacy etc. (ii) their knowledge about bioequivalence (iii) prescribing behavior (iv) physicians' knowledge of quality, safety and efficacy of generic medicines, and their cost (v) perceptions of physicians towards issues pertaining to generic medicines utilization. A total of 263 questionnaires out of 735 were received, giving a response rate of 35.8%. Of the respondents, 214 (81.4%) were male and 49 (18.6%) were females. The majority of the participants were in the age range of 41-50 years and comprised 49.0% of the respondents. Only 2.3% of physicians were aware of the regulatory limits of bioequivalence standards in Malaysia. Of the respondents, 23.2% agreed that they 'always' write their prescriptions using originator product name whereas 50.2% do it 'usually'. A number of significant associations were found between their knowledge, perceptions about generic medicines and their demographic characteristics. The majority of the physicians from private medical centres in Malaysia had negative perceptions about safety, quality and the efficacy of generic medicines. These negative perceptions could be the cause of the limited use of generic medicines in the private medical centres. Therefore, in order to facilitate their use, it is recommended that the physicians need to be reassured and educated about the drug regulatory authority approval system of generic medicines with regard to their bioequivalence, quality, efficacy and safety. Apart from the policy on generic substitution, it would also be recommended to have a national medicine pricing policy, which controls drug prices, in both the public and private sector. These efforts are worthwhile to reduce the drug expenditure and improve the medicine affordability in Malaysia.

User fee exemptions and excessive household spending for normal delivery in Burkina Faso: the need for careful implementation.

PubMed

Ben Ameur, Amal; Ridde, Valéry; Bado, Aristide R; Ingabire, Marie-Gloriose; Queuille, Ludovic

2012-11-21

In 2006, the Parliament of Burkina Faso passed a policy to reduce the direct costs of obstetric services and neonatal care in the country's health centres, aiming to lower the country's high national maternal mortality and morbidity rates. Implementation was via a "partial exemption" covering 80% of the costs. In 2008 the German NGO HELP launched a pilot project in two health districts to eliminate the remaining 20% of user fees. Regardless of any exemptions, women giving birth in Burkina Faso's health centres face additional expenses that often represent an additional barrier to accessing health services. We compared the total cost of giving birth in health centres offering partial exemption versus those with full exemption to assess the impact on additional out-of-pocket fees. A case-control study was performed to compare medical expenses. Case subjects were women who gave birth in 12 health centres located in the Dori and Sebba districts, where HELP provided full fee exemption for obstetric services and neonatal care. Controls were from six health centres in the neighbouring Djibo district where a partial fee exemption was in place. A random sample of approximately 50 women per health centre was selected for a total of 870 women. There was an implementation gap regarding the full exemption for obstetric services and neonatal care. Only 1.1% of the sample from Sebba but 17.5% of the group from Dori had excessive spending on birth related costs, indicating that women who delivered in Sebba were much less exposed to excessive medical expenses than women from Dori. Additional out-of-pocket fees in the full exemption health districts took into account household ability to pay, with poorer women generally paying less. We found that the elimination of fees for facility-based births benefits especially the poorest households. The existence of excessive spending related to direct costs of giving birth is of concern, making it urgent for the government to remove all direct fees for obstetric and neonatal care. However, the policy of completely abolishing user fees is insufficient; the implementation process must have a thorough monitoring system to reduce implementation gaps.

Applying knowledge translation tools to inform policy: the case of mental health in Lebanon.

PubMed

Yehia, Farah; El Jardali, Fadi

2015-06-06

Many reform efforts in health systems fall short because the use of research evidence to inform policy remains scarce. In Lebanon, one in four adults suffers from a mental illness, yet access to mental healthcare services in primary healthcare (PHC) settings is limited. Using an "integrated" knowledge framework to link research to action, this study examines the process of influencing the mental health agenda in Lebanon through the application of Knowledge Translation (KT) tools and the use of a KT Platform (KTP) as an intermediary between researchers and policymakers. This study employed the following KT tools: 1) development of a policy brief to address the lack of access to mental health services in PHC centres, 2) semi-structured interviews with 10 policymakers and key informants, 3) convening of a national policy dialogue, 4) evaluation of the policy brief and dialogue, and 5) a post-dialogue survey. Findings from the key informant interviews and a comprehensive synthesis of evidence were used to develop a policy brief which defined the problem and presented three elements of a policy approach to address it. This policy brief was circulated to 24 participants prior to the dialogue to inform the discussion. The policy dialogue validated the evidence synthesized in the brief, whereby integrating mental health into PHC services was the element most supported by evidence as well as participants. The post-dialogue survey showed that, in the following 6 months, several implementation steps were taken by stakeholders, including establishing national taskforce, training PHC staff, and updating the national essential drug list to include psychiatric medications. Relationships among policymakers, researchers, and stakeholders were strengthened as they conducted their own workshops and meetings after the dialogue to further discuss implementation, and their awareness about and demand for KT tools increased. This case study showed that the use of KT tools in Lebanon to help generate evidence-informed programs is promising. This experience provided insights into the most helpful features of the tools. The role of the KTP in engaging stakeholders, particularly policymakers, prior to the dialogue and linking them with researchers was vital in securing their support for the KT process and uptake of the research evidence.

A journey towards inclusive education; a case study from a ‘township’ in South Africa

PubMed Central

Luger, Rosemary; Prudhomme, Debbie; Bullen, Ann; Pitt, Catherine

2012-01-01

The purpose of this case study was to relate part of the journey to appropriate education for two young children with physical disabilities in a low socio-economic peri-urban informal settlement – or ‘township’ – in South Africa. The part of the on-going journey described here spanned four-and-a-half years and included the two children, their families, their teachers, their community and a small team of rehabilitation professionals working for a non-profit organisation in the area. The rehabilitation professionals’ goals were to provide support for the children, their families, their current special care centre and the school(s) they would attend in the future. The steps from the special care centre, to a mainstream early childhood development (ECD) centre for both of them, and then on to (a) a school for learners with special educational needs (LSEN) for one child and (b) a mainstream primary school for the other, are described. Challenges encountered on the way included parental fears, community attitudes and physical accessibility. Practical outcomes included different placements for the two children with implications and recommendations for prioritised parent involvement, individual approaches, interdisciplinary and community-based collaborations. Recommendations are given for clinical contexts, curricula and policy matters; for research and for scaling up such a programme through community workers. PMID:28729975

Challenging nurse student selection policy: Using a lifeworld approach to explore the link between care experience and student values.

PubMed

Scammell, Janet; Tait, Desiree; White, Sara; Tait, Michael

2017-10-01

This study uses a lifeworld perspective to explore beginning students' values about nursing. Internationally, increasing care demand, a focus on targets and evidence of dehumanized care cultures have resulted in scrutiny of practitioner values. In England, selection policy dictates that prospective nursing students demonstrate person-centred values and care work experience. However, there is limited recent evidence exploring values at programme commencement or the effect of care experience on values. Mixed method study. A total of 161 undergraduate nursing students were recruited in 2013 from one English university. Thematic content analysis and frequency distribution to reveal descriptive statistics were used. Statistical analysis indicated that most of the values identified in student responses were not significantly affected by paid care experience. Five themes were identified: How I want care to be; Making a difference; The value of learning; Perceived characteristics of a nurse; and Respecting our humanity. Students readily drew on their experience of living to identify person-centred values about nursing.

A guide to reading and using systematic reviews of qualitative research.

PubMed

Tong, Allison; Palmer, Suetonia; Craig, Jonathan C; Strippoli, Giovanni F M

2016-06-01

There is an increasingly widespread policy momentum to increase patient-centred care and to improve quality of life outcomes within health services. Qualitative research methods are used to elicit in-depth and detailed insights into people's attitudes, beliefs, emotions and experiences-much of which may remain unspoken during clinical encounters. Questions about patients' beliefs and preferences for treatment can be addressed by qualitative research and inform evidence-based strategies for delivering patient-centred care. Systematic reviews of multiple primary qualitative studies bring together findings from different studies to offer new and more comprehensive understandings of social phenomena across various healthcare contexts and populations and are an emerging methodology in the literature including for care in chronic kidney disease. This article will provide a framework for the systematic review of qualitative research so readers can make sense of these study types and use them in clinical care and policy. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Professionals' views on the development process of a structural collaboration between child and adolescent psychiatry and child welfare: an exploration through the lens of the life cycle model.

PubMed

Van den Steene, Helena; van West, Dirk; Peeraer, Griet; Glazemakers, Inge

2018-03-23

This study, as a part of a participatory action research project, reports the development process of an innovative collaboration between child and adolescent psychiatry and child welfare, for adolescent girls with multiple and complex needs. The findings emerge from a qualitative descriptive analysis of four focus groups with 30 professionals closely involved in this project, and describe the evolution of the collaborative efforts and outcomes through time. Participants describe large investments and negative consequences of rapid organizational change in the beginning of the collaboration project, while benefits of the intensive collaboration only appeared later. A shared person-centred vision and enhanced professionals' confidence were pointed out as important contributors in the evolution of the collaboration. Findings were compared to the literature and showed significant analogy with the life cycle model for shared service centres that describe the maturation of collaborations from a management perspective. These findings enrich the knowledge about the development process of collaboration in health and social care. In increasingly collaborative services, child and adolescent psychiatrists and policy makers should be aware that gains from a collaboration will possibly only be achieved in the longer term, and benefit from knowing which factors have an influence on the evolution of a collaboration project.

Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): a pragmatic, open-label, cluster randomised feasibility trial.

PubMed

Jairath, Vipul; Kahan, Brennan C; Gray, Alasdair; Doré, Caroline J; Mora, Ana; James, Martin W; Stanley, Adrian J; Everett, Simon M; Bailey, Adam A; Dallal, Helen; Greenaway, John; Le Jeune, Ivan; Darwent, Melanie; Church, Nicholas; Reckless, Ian; Hodge, Renate; Dyer, Claire; Meredith, Sarah; Llewelyn, Charlotte; Palmer, Kelvin R; Logan, Richard F; Travis, Simon P; Walsh, Timothy S; Murphy, Michael F

2015-07-11

Transfusion thresholds for acute upper gastrointestinal bleeding are controversial. So far, only three small, underpowered studies and one single-centre trial have been done. Findings from the single-centre trial showed reduced mortality with restrictive red blood cell (RBC) transfusion. We aimed to assess whether a multicentre, cluster randomised trial is a feasible method to substantiate or refute this finding. In this pragmatic, open-label, cluster randomised feasibility trial, done in six university hospitals in the UK, we enrolled all patients aged 18 years or older with new presentations of acute upper gastrointestinal bleeding, irrespective of comorbidity, except for exsanguinating haemorrhage. We randomly assigned hospitals (1:1) with a computer-generated randomisation sequence (random permuted block size of 6, without stratification or matching) to either a restrictive (transfusion when haemoglobin concentration fell below 80 g/L) or liberal (transfusion when haemoglobin concentration fell below 100 g/L) RBC transfusion policy. Neither patients nor investigators were masked to treatment allocation. Feasibility outcomes were recruitment rate, protocol adherence, haemoglobin concentration, RBC exposure, selection bias, and information to guide design and economic evaluation of the phase 3 trial. Main exploratory clinical outcomes were further bleeding and mortality at day 28. We did analyses on all enrolled patients for whom an outcome was available. This trial is registered, ISRCTN85757829 and NCT02105532. Between Sept 3, 2012, and March 1, 2013, we enrolled 936 patients across six hospitals (403 patients in three hospitals with a restrictive policy and 533 patients in three hospitals with a liberal policy). Recruitment rate was significantly higher for the liberal than for the restrictive policy (62% vs 55%; p=0·04). Despite some baseline imbalances, Rockall and Blatchford risk scores were identical between policies. Protocol adherence was 96% (SD 10) in the restrictive policy vs 83% (25) in the liberal policy (difference 14%; 95% CI 7-21; p=0·005). Mean last recorded haemoglobin concentration was 116 (SD 24) g/L for patients on the restrictive policy and 118 (20) g/L for those on the liberal policy (difference -2·0 [95% CI -12·0 to 7·0]; p=0·50). Fewer patients received RBCs on the restrictive policy than on the liberal policy (restrictive policy 133 [33%] vs liberal policy 247 [46%]; difference -12% [95% CI -35 to 11]; p=0·23), with fewer RBC units transfused (mean 1·2 [SD 2·1] vs 1·9 [2·8]; difference -0·7 [-1·6 to 0·3]; p=0·12), although these differences were not significant. We noted no significant difference in clinical outcomes. A cluster randomised design led to rapid recruitment, high protocol adherence, separation in degree of anaemia between groups, and non-significant reduction in RBC transfusion in the restrictive policy. A large cluster randomised trial to assess the effectiveness of transfusion strategies for acute upper gastrointestinal bleeding is both feasible and essential before clinical practice guidelines change to recommend restrictive transfusion for all patients with acute upper gastrointestinal bleeding. NHS Blood and Transplant Research and Development. Copyright © 2015 Elsevier Ltd. All rights reserved.

Guidelines for developing effective health education service in a national health agency.

PubMed

Ochor, J O

1983-01-01

The constraints facing health education include: the fragmentation and dispersal of health-educational services among different agencies and personnel; lack of policy guidelines; ineffectively organized and inefficiently managed health education systems; poor hierarchical status and inadequacy of resources. To resolve these constraints, national health education systems in health agencies should be developed on the basis of stipulated guidelines that could ensure their viability, efficiency and effectiveness. A study at the African Regional Health Education Centre, Ibadan, Nigeria, has yielded thirty synthesized guidelines. The "guidelines" were empirically tested as an evaluation tool by assessing the operational and organizational status of Oyo State Health Education Unit, Ibadan, Nigeria. These guidelines are adaptable to local conditions to enhance the re-organization, re-orientation and consolidation of health education in national health agencies.

Canadian Educational Development Centre Websites: More Ebb than Flow?

ERIC Educational Resources Information Center

Simmons, Nicola

2010-01-01

This paper examines information portrayed on Canadian educational development (ED) centre websites and, in particular, whether information that corresponds to questions compiled from a literature search of ED centre practices is readily available from centre websites. This study phase is part of a larger national study of Canadian educational…

Reshaping policy to deliver holistic care for adolescents with Crohn's disease.

PubMed

Smith, Claudia; Gettings, Sheryl

2016-12-08

The number of adolescents with Crohn's disease (CD) is rising, with one third of cases diagnosed before turning 21 years old. Evidence shows that long-term medical intervention, school absence and the physical toll of CD on the growing adolescent also have a psychological effect on patients. In addition, poorly defined transition pathways are extending these problems into adulthood. The National Institute for Health and Care Excellence (NICE) guidelines are important in shaping service delivery and distribution. However, analysis of the full 2012 NICE CD management guidelines indicates they fall short of providing adequate recommendations for holistic management of the disease in young populations. An update in 2016 added a new clinical recommendation to the guidelines, but no further exploration of the psychosocial aspects of the impact of the disease. The authors of this article used a critical review of literature and concluded that service provision for adolescents with CD could be made better by improving CD support networks, involving young people in the development of policy centred on their care, as well as incorporating other (non-NICE) well-researched CD guidelines in national policy. These changes would improve quality of life for this vulnerable population.

From the coliseum to the convention centre: a reflection on the current state of medical education conferences and conference-goers.

PubMed

Blanchard, Rebecca D; Engle, Deborah L; Howley, Lisa D; Whicker, Shari A; Nagler, Alisa

2016-12-01

The advancement of knowledge and development of policy in the field of medical education require critical academic discourse among the most intelligent medical educators; and critical academic discourse requires coffee. In this essay, we reflect on the state of professional development conferences in the field of medical education and the rituals that surround their success. Having begun in ancient Greece, symposia were ripe with debauchery. Today, sedated by the light brown walls of hotel conference centres, symposia are more serious endeavours, engaging men and women in the sometimes turbulent waters of epistemological debate. The abstract submission process (summed up by: 'Yay! It was accepted for presentation' [Deep breath] 'Oh no…it was accepted for presentation'), the 'juggling act' of parent attendees, the acting prowess of abstract presenters and the unapologetic approach to buffet eating are all by-products of the collision of true intellects among medical education scholars. We hold these rituals in high regard and argue that they are required to advance the field of medical education. These rituals bind the walls supporting true progressive thought and innovative research, all fuelled by the glass of wine purchased with that one coveted drink ticket. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

An e-consent-based shared EHR system architecture for integrated healthcare networks.

PubMed

Bergmann, Joachim; Bott, Oliver J; Pretschner, Dietrich P; Haux, Reinhold

2007-01-01

Virtual integration of distributed patient data promises advantages over a consolidated health record, but raises questions mainly about practicability and authorization concepts. Our work aims on specification and development of a virtual shared health record architecture using a patient-centred integration and authorization model. A literature survey summarizes considerations of current architectural approaches. Complemented by a methodical analysis in two regional settings, a formal architecture model was specified and implemented. Results presented in this paper are a survey of architectural approaches for shared health records and an architecture model for a virtual shared EHR, which combines a patient-centred integration policy with provider-oriented document management. An electronic consent system assures, that access to the shared record remains under control of the patient. A corresponding system prototype has been developed and is currently being introduced and evaluated in a regional setting. The proposed architecture is capable of partly replacing message-based communications. Operating highly available provider repositories for the virtual shared EHR requires advanced technology and probably means additional costs for care providers. Acceptance of the proposed architecture depends on transparently embedding document validation and digital signature into the work processes. The paradigm shift from paper-based messaging to a "pull model" needs further evaluation.

Delivering smart city system through experimental smart building concept. Design case of Nordhavn Community Centre, Denmark

NASA Astrophysics Data System (ADS)

Septiandiani, F.; Raharjo, W.

2018-05-01

It is an undisputed fact that the development of a city requires more energy to accommodate the needs of the city’s population. Greater energy consumption due to growing cities is a concern for scholars as well as governments all over the world. In the European Union, Denmark’s renewable energy policy provides tax exemptions for passive air conditioning and renewable energy sources to foster public participation. To meet its energy provision objectives under this condition, cities need instruments to reduce energy consumption. The building of a community centre in Nordhavn (Denmark) was chosen as such an instrument due to its flexibility and possible exposure to solar radiation as an endless source of energy. An experimental design for the building envelope was developed to test its thermal performance when including a thermal storage wall. Design research was conducted using 3D modelling. Testing was done on a simulation of the building made with the Ecotect software application to provide comparable results for thermal performance supported by qualitative-descriptive methods. It was concluded that including a thermal storage wall in the building model corresponds well with the objectives of the design. Based on the result of the test, in the context of, the thermal storage wall is capable of contributing to passive air conditioning.

Community health professionals' dementia knowledge, attitudes and care approach: a cross-sectional survey in Changsha, China.

PubMed

Wang, Yao; Xiao, Lily Dongxia; Luo, Yang; Xiao, Shui-Yuan; Whitehead, Craig; Davies, Owen

2018-05-25

Community health professionals play a significant role in dementia care. However, little is known about community health professionals' capacity in dementia care, especially in low and middle-income countries. The aim of the present study was to assess community health professionals' dementia knowledge, attitudes and care approach in China, a country with the largest population of people with dementia in the world and where community based dementia care services are much needed. A cross-sectional survey was conducted. 450 health professionals were recruited into the study using random sampling from community health service centres in Changsha, China. Their knowledge, attitudes and care approach were assessed utilising the Chinese version of the Alzheimer's Disease Knowledge Scale, Dementia Care Attitude Scale and Approach to Advanced Dementia Care Questionnaire respectively. A total of 390 participants returned the questionnaire (response rate 87%). Age, education, professional group and care experience were associated with knowledge scores, and overall dementia knowledge was poor. Attitudes were generally positive and influenced by age, professional group, gender and care experience. The experience of caring for people with dementia was positively associated with a person-centred care approach, although the participants tended not to use a person-centred care approach. A statistically significant association was found between knowledge and attitudes (r = 0.379, P < 0.001), and between attitudes and care approach (r = 0.143, P < 0.001). However, dementia knowledge has no relationship with a person-centred approach. Community health professionals showed generally positive attitudes towards people with dementia. However, they demonstrated poor dementia knowledge and tended not to use a person-centred care approach. The results suggest that a multifaceted approach consisting of educational interventions for community health professionals, and policy and resource development to meet the demand for community dementia care services, is urgently needed in China.

Breathing clean air is Są’áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centred approach to understanding commercial smoke-free policy among the Diné (Navajo People)

PubMed Central

Chief, Carmenlita; Sabo, Samantha; Clark, Hershel; Nez Henderson, Patricia; Yazzie, Alfred; Nahee, Jacqueline; Leischow, Scott J

2016-01-01

Introduction Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. Objective We describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Methods Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Results Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Conclusions Indigenous-centred approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people. PMID:27697944

100% of the World Ocean Floor Mapped by 2030 - Contribution of the South and West Pacific Regional Data Assembly and Coordination Centre to the Seabed 2030 Initiative

NASA Astrophysics Data System (ADS)

Lamarche, G.; Neil, H.; Stagpoole, V. M.; Greenland, A.; Mackay, K.; Black, J.; Griffin, E.

2017-12-01

The Seabed 2030 SaWPac Centre (South and West Pacific Ocean Regional Data Assembly and Coordination Centre) has been formed to generate new high resolution ocean floor maps of the western and southern Pacific Ocean. The centre is part of the joint Nippon Foundation and the General Bathymetric Chart of the Oceans (GEBCO) initiative to produce a definitive map of the World Ocean floor by 2030, empowering the world to make policy decisions, use the ocean sustainability and undertake scientific research based on detailed bathymetric information of the Earth's seabed. The SaWPac Centre is based at NIWA Wellington (New Zealand) and includes a collaborative partnership with GNS Science and Land Information New Zealand. It is responsible for the region from South America to Australia, north of latitude 50°S to 10° north of the Equator and the western part of the Northern Pacific Ocean to Russia. The region includes the world's deepest trenches and also covers some of the remotest oceans where bathymetric data form existing ship tracks is spaced up to 100 km apart. The challenge for the SaWPac Centre is to collate and combine all the available bathymetric data from the numerous nations that have surveyed in the region. The centre will also promote efforts to collect new data and contribute to map products generated by the Seabed 2030 global mapping project.

Adult education and the challenges of regional development: Policy and sustainability in North Denmark

NASA Astrophysics Data System (ADS)

Rasmussen, Palle; Staugaard, Hans Jørgen

2016-10-01

Adult education is governed at many levels - internationally, nationally and locally. The authors of this paper look at the challenges, structures and practices of adult education policy at the local level, more specifically in North Denmark (Northern Jutland), one of the five administrative regions of the Danish nation-state. In many ways, the current educational challenges in this remote region of Europe are similar to what can be observed worldwide and especially in countries which are generally considered welfare states. The authors see the growing social and educational divide between the region's peripheral areas and its largest city centre as a major challenge - for society as a whole and for adult education in particular. It is from this perspective that the authors describe the present structures of adult education in the region and the strategies employed by local authorities and educational institutions. This is followed by an evaluation of both structures and efforts in terms of their ability to cope with the challenges.

Regional inequalities in premature mortality in Great Britain

PubMed Central

Laroze, Denise; Neumayer, Eric

2018-01-01

Premature mortality exhibits strong spatial patterns in Great Britain. Local authorities that are located further North and West, that are more distant from its political centre London and that are more urban tend to have a higher premature mortality rate. Premature mortality also tends to cluster among geographically contiguous and proximate local authorities. We develop a novel analytical research design that relies on spatial pattern recognition to demonstrate that an empirical model that contains only socio-economic variables can eliminate these spatial patterns almost entirely. We demonstrate that socioeconomic factors across local authority districts explain 81 percent of variation in female and 86 percent of variation in male premature mortality in 2012–14. As our findings suggest, policy-makers cannot hope that health policies alone suffice to significantly reduce inequalities in health. Rather, it requires strong efforts to reduce the inequalities in socio-economic factors, or living conditions for short, in order to overcome the spatial disparities in health, of which premature mortality is a clear indication. PMID:29489918

The Japanese Preschool System in Transition

ERIC Educational Resources Information Center

Imoto, Yuki

2007-01-01

This article is an anthropological analysis of the recent policy reforms of the Japanese preschool system. It takes the introduction of the "nintei-kodomoen" ("accredited children's centre") as a point of entry to discuss the historical, social and political debates concerning early childhood education and care. The "dual…

Postgraduate Research Training: Some Issues

ERIC Educational Resources Information Center

Calma, Angelito

2011-01-01

This three-year study of research training policy and practice involved government and university executives, and university academics from the Philippines. A total of 53 participants were involved: two officials from the Commission on Higher Education, six directors of research centres, 28 university executives and 17 academic staff. Seven public…

Nutrition and dementia care: developing an evidence-based model for nutritional care in nursing homes.

PubMed

Murphy, Jane L; Holmes, Joanne; Brooks, Cindy

2017-02-14

There is a growing volume of research to offer improvements in nutritional care for people with dementia living in nursing homes. Whilst a number of interventions have been identified to support food and drink intake, there has been no systematic research to understand the factors for improving nutritional care from the perspectives of all those delivering care in nursing homes. The aim of this study was to develop a research informed model for understanding the complex nutritional problems associated with eating and drinking for people with dementia. We conducted nine focus groups and five semi-structured interviews with those involved or who have a level of responsibility for providing food and drink and nutritional care in nursing homes (nurses, care workers, catering assistants, dietitians, speech and language therapists) and family carers. The resulting conceptual model was developed by eliciting care-related processes, thus supporting credibility from the perspective of the end-users. The seven identified domain areas were person-centred nutritional care (the overarching theme); availability of food and drink; tools, resources and environment; relationship to others when eating and drinking; participation in activities; consistency of care and provision of information. This collaboratively developed, person-centred model can support the design of new education and training tools and be readily translated into existing programmes. Further research is needed to evaluate whether these evidence-informed approaches have been implemented successfully and adopted into practice and policy contexts and can demonstrate effectiveness for people living with dementia.

Transport for abciximab facilitated primary angioplasty versus on-site thrombolysis with a liberal rescue policy: the randomised Holland Infarction Study (HIS).

PubMed

Dieker, Hendrik-Jan; van Horssen, Elvira V; Hersbach, Ferry M R J; Brouwer, Marc A; van Boven, Ad J; van 't Hof, Arnoud W J; Aengevaeren, Wim R M; Verheugt, Freek W A; Bär, Frits W H M

2006-08-01

As of to date, the only large transportation trial comparing on-site fibrin-specific thrombolysis with transfer for primary angioplasty in patients presenting in a referral centre is the DANAMI-2 trial, with only 3% rescue angioplasty. The Holland Infarction Study (HIS) compared abciximab facilitated primary angioplasty (FP) with on-site fibrin-specific thrombolytic therapy (TT) with a liberal protocol-driven rescue angioplasty (transport to intervention centre in case < 50% ST resolution at 60 min). Patients in a referral centre without shock and < 4.5 h of chest pain presenting with ST-elevation having > or = 12 mm ST-segment shift were randomised to either strategy. Of the originally planned 900 patients only 48 were included due to suspension of financial funding. Death, recurrent MI and stroke at one year was 8% for the FP-group and 22% for the TT-group (p = 0.2). Two hours after randomisation the rates of complete ST-segment resolution (> or =70%) were 52% and 35%, respectively (p = 0.2). This prematurely discontinued randomised transportation trial shows favorable trends with respect to long-term clinical outcome and early ST-resolution for abciximab facilitated primary angioplasty. In view of the real world delays associated with interhospital transport for primary angioplasty, treatment strategies focusing on early fibrin-specific lysis with a liberal selective rescue policy are warranted.

Towards a shared service centre for telemedicine: Telemedicine in Denmark, and a possible way forward

PubMed Central

Larsen, Simon Bo; Sørensen, Nanna Skovgaard; Petersen, Matilde Grøndahl; Kjeldsen, Gitte Friis

2015-01-01

Although evidence of the effectiveness of telemedicine is accumulating, knowledge of how to make best use of telemedicine is limited. This article presents results from a multi-stakeholder project that developed a new concept, a ‘shared service centre’ for telemedicine that is envisioned as working across different telemedical initiatives to support the implementation and wider adoption of telemedicine. One year of participatory design and analysis of the shared service centre concept involved stakeholders, such as clinicians, patients, technicians, policy makers, lawyers, economists and information technology architects. More than 100 people contributed to the findings. Most of the ideas generated for potential centre support for telemedicine could be categorised under four service categories. The need for such support services was verified in the cases investigated, and by agreement among stakeholders from regional health authorities, municipalities, and general practice. Therefore, it is probable that a shared service centre could help enable the wider deployment of telemedicine. Definitions In this article, we use ‘telemedicine’ as an umbrella term for all the ‘tele-’ labels that are sometimes used rather indiscriminately to denote the use of information and technology to support healthcare services, including ‘telehealth’, ‘telemonitoring’, ‘telehomecare’, ‘e-health’, and so on. As per our definition, telemedicine may be synchronous and/or asynchronous, and may apply to any information and technology-based means of connecting healthcare actors and the patient, such as video communication, e-mail, electronic monitoring equipment, and Internet portals. Furthermore, the term ‘telemedical initiative’ covers projects in which telemedicine is conducted by a temporary project organisation, as well as self-contained telemedicine services used in daily, clinical practice in existing organisations. PMID:26261216

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: A case study

PubMed Central

2011-01-01

Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations. PMID:21575159

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: a case study.

PubMed

Pieper, Hans-Olaf; Clerkin, Pauline; MacFarlane, Anne

2011-05-15

Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol.

PubMed

Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Sagap, Ismail; Zakaria, Jasiah; Blazeby, Jane M; Law, Chee Wei

2012-09-03

Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil), then administered, scored and analyzed following the developers' guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments at the end of the study.

Reading the National Disability and Rehabilitation Policy in the light of Foucault’s technologies of power

PubMed Central

2013-01-01

In the area of disability studies, models have been at the centre of debates, influencing social policies, practices and legal frameworks. The former Ministry of Health and Social Welfare in the Kingdom of Lesotho was not an exception. In its efforts to tackle issues of disability, it produced The National Disability and Rehabilitation Policy: Mainstreaming persons with disabilities into society in 2011. This policy document is rooted in the social model and seeks to address long-standing problems and challenges of people with disabilities in the Kingdom. Using ideas from Foucault, particularly the technologies and regimes of power, which work through language and practice, this article examined ways in which people with disabilities are constituted through state knowledge and government policies, and concluded that these constructions form the basis for alienation and marginalisation in society. PMID:28729987

Politicize or perish! the importance of policy for Australian psychiatric-mental health nurses.

PubMed

Sgro, Silvana; Happell, Brenda

2006-05-01

As the largest professional group within the Australian mental health nursing workforce, psychiatric-mental health nurses are well positioned to influence mental health policy. However, the dominance of nursing by the medical profession has limited the extent to which this potential has been realized, with nurses remaining relatively unheard within the political arena. In recognition of this situation, the Centre for Psychiatric Nursing Research and Practice implemented a position for a policy analyst. Three primary aims were identified for this position: networking and relationship building, building profile, and providing a voice for psychiatric-mental health nursing. This article provides an overview of these three aims and the achievements to date. It is concluded that the policy analyst position has made a significant contribution to increasing the profile of psychiatric-mental health nursing and, therefore, to its capacity to influence policy.

Return of separated children: the impact of Dutch policies.

PubMed

Kromhout, Mariska

2011-01-01

In many European countries, both the voluntary and the forced return of rejected asylum seekers are problematic. In the case of separated children, the difficulties seem to be even greater. In the Netherlands, many of these children disappear from the reception centres for unknown destinations, instead of returning to their home country. The new, stricter return policies adopted by the Dutch government in recent years have not (yet) changed this situation.In an explorative study of separated children aged between 15 and 18, the implementation and results of these policies were studied. The impact of the activities designed to promote voluntary return appeared to be very limited. Most separated young people did not want to consider return and did not take any action in this regard. Forced return rarely constituted a viable alternative. These findings may be explained by several factors. Among other things, considerations pertaining to personal security, family circumstances, and structural conditions in the countries of origin influence both the attitudes and behaviours of separated children, and host government policies. Moreover, many children were not willing to discuss their return with the youth care workers who were supposed to discuss and promote a voluntary return with them. The fact that most of the young people were allowed to stay in the reception centres until their eighteenth birthday enabled them to postpone making a final decision. A forced return was hindered by such obstacles as the absence of documents and the lack of appropriate care in the country of origin. More insight into the backgrounds of separated children and the (im)possibilities regarding their return seems necessary to be able to design more effective return policies.

The Thai-Australian Health Alliance: developing health management capacity and sustainability for primary health care services.

PubMed

Briggs, D S; Tejativaddhana, P; Cruickshank, M; Fraser, J; Campbell, S

2010-11-01

There have been recent calls for a renewed worldwide focus on primary health care. The Thai-Australian Health Alliance addresses this call by developing health care management capability in primary health care professionals in rural Thailand. This paper describes the history and current activities of the Thai-Australian Health Alliance and its approaches to developing health care management capacity for primary care services through international collaborations in research, education and training over a sustained time period. The Alliance's approach is described herein as a distributed network of practices with access to shared knowledge through collaboration. Its research and education approaches involve action research, multi-methods projects, and evaluative studies in the context of workshops and field studies. WHO principles underpin this approach, with countries sharing practical experiences and outcomes, encouraging leadership and management resource networks, creating clearing houses/knowledge centres, and harmonising and aligning partners with their country's health systems. Various evaluations of the Alliance's activities have demonstrated that a capacity building approach that aligns researchers, educators and health practitioners in comparative and reflective activities can be effective in transferring knowledge and skills among a collaboration's partners. Project participants, including primary health care practitioners, health policy makers and academics embraced the need to acquire management skills to sustain primary care units. Participants believe that the approaches described herein were crucial to developing the management skills needed of health care professionals for rural and remote primary health care. The implementation of this initiative was challenged by pre-existing low opinions of the importance of the management role in health care, but with time the Alliance's activities highlighted for all the importance of health care management. Acceptance of its activities and goals are evidenced by the establishment of a Centre of Leadership Expertise in Health Management and the endorsement of the Phitsanulok Declaration by more than 470 primary health care practitioners, academics and policy makers. Problems with the primary health care delivery system in rural Thailand continue, but the Alliance has successfully implemented a cross cultural strategic collaboration through a continuity of activities to augment practice management capacities in primary care practices.

Environmental and social footprints of international trade

NASA Astrophysics Data System (ADS)

Wiedmann, Thomas; Lenzen, Manfred

2018-05-01

Globalization has led to an increasing geospatial separation of production and consumption, and, as a consequence, to an unprecedented displacement of environmental and social impacts through international trade. A large proportion of total global impacts can be associated with trade, and the trend is rising. Advances in global multi-region input-output models have allowed researchers to draw detailed, international supply-chain connections between harmful production in social and environmental hotspots and affluent consumption in global centres of wealth. The general direction of impact displacement is from developed to developing countries—an increase of health impacts in China from air pollution linked to export production for the United States being one prominent example. The relocation of production across countries counteracts national mitigation policies and may negate ostensible achievements in decoupling impacts from economic growth. A comprehensive implementation of the United Nations Sustainable Development Goals therefore requires the inclusion of footprint indicators to avoid loopholes in national sustainability assessments.

The Microbial Resource Research Infrastructure MIRRI: Strength through Coordination

PubMed Central

Stackebrandt, Erko; Schüngel, Manuela; Martin, Dunja; Smith, David

2015-01-01

Microbial resources have been recognized as essential raw materials for the advancement of health and later for biotechnology, agriculture, food technology and for research in the life sciences, as their enormous abundance and diversity offer an unparalleled source of unexplored solutions. Microbial domain biological resource centres (mBRC) provide live cultures and associated data to foster and support the development of basic and applied science in countries worldwide and especially in Europe, where the density of highly advanced mBRCs is high. The not-for-profit and distributed project MIRRI (Microbial Resource Research Infrastructure) aims to coordinate access to hitherto individually managed resources by developing a pan-European platform which takes the interoperability and accessibility of resources and data to a higher level. Providing a wealth of additional information and linking to datasets such as literature, environmental data, sequences and chemistry will enable researchers to select organisms suitable for their research and enable innovative solutions to be developed. The current independent policies and managed processes will be adapted by partner mBRCs to harmonize holdings, services, training, and accession policy and to share expertise. The infrastructure will improve access to enhanced quality microorganisms in an appropriate legal framework and to resource-associated data in a more interoperable way. PMID:27682123

The Microbial Resource Research Infrastructure MIRRI: Strength through Coordination.

PubMed

Stackebrandt, Erko; Schüngel, Manuela; Martin, Dunja; Smith, David

2015-11-18

Microbial resources have been recognized as essential raw materials for the advancement of health and later for biotechnology, agriculture, food technology and for research in the life sciences, as their enormous abundance and diversity offer an unparalleled source of unexplored solutions. Microbial domain biological resource centres (mBRC) provide live cultures and associated data to foster and support the development of basic and applied science in countries worldwide and especially in Europe, where the density of highly advanced mBRCs is high. The not-for-profit and distributed project MIRRI (Microbial Resource Research Infrastructure) aims to coordinate access to hitherto individually managed resources by developing a pan-European platform which takes the interoperability and accessibility of resources and data to a higher level. Providing a wealth of additional information and linking to datasets such as literature, environmental data, sequences and chemistry will enable researchers to select organisms suitable for their research and enable innovative solutions to be developed. The current independent policies and managed processes will be adapted by partner mBRCs to harmonize holdings, services, training, and accession policy and to share expertise. The infrastructure will improve access to enhanced quality microorganisms in an appropriate legal framework and to resource-associated data in a more interoperable way.

Rating maternal and neonatal health services in developing countries.

PubMed Central

Bulatao, Rodolfo A.; Ross, John A.

2002-01-01

OBJECTIVE: To assess maternal and neonatal health services in 49 developing countries. METHODS: The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these services for both rural and urban women, the likelihood that women would receive particular forms of antenatal and delivery care, and supporting elements of programmes such as policy, resources, monitoring, health promotion and training. FINDINGS: The average rating was only 56, but countries varied widely, especially in access to services in rural areas. Comparatively good ratings were reported for immunization services, aspects of antenatal care and counselling on breast feeding. Ratings were particularly weak for emergency obstetric care in rural areas, safe abortion and HIV counselling. CONCLUSION: Maternal health programme effort in developing countries is seriously deficient, particularly in rural areas. Rural women are disadvantaged in many respects, but especially regarding the treatment of emergency obstetric conditions. Both rural and urban women receive inadequate HIV counselling and testing and have quite limited access to safe abortion. Improving services requires moving beyond policy reform to strengthening implementation of services and to better staff training and health promotion. Increased financing is only part of the solution. PMID:12378290

Language Choice in Multilingual Encounters in Transnational Workplaces

ERIC Educational Resources Information Center

Kingsley, Leilarna

2013-01-01

This paper is based on research conducted in banks in the international banking centre of Luxembourg. Operating in the globalised context of international banking and multilingual Luxembourg, financial institutions are an ideal focal point for investigating policy and practices in complex multilingual and transnational work spaces. Two theoretical…

Working Towards Educational Transformation through Action Research with Botswana's Music Teachers

ERIC Educational Resources Information Center

Chadwick, Sheelagh

2015-01-01

Contrary to government policy, schooling in Botswana remains largely teacher-centred, with music teaching being no exception. However, other possibilities for classroom dynamics arise under the pressure of practical examinations and when some students have better instrumental facility than their teachers. This article describes initial…

Disabilities and Inclusive Practices within Toronto Preschools

ERIC Educational Resources Information Center

Killoran, Isabel; Tymon, Dorothy; Frempong, George

2007-01-01

A current objective in Canada is a provision of childcare services for all children. This objective has not been achieved as many children, especially those with disabilities, are often denied services from publicly funded daycare centres. The authors argue that policy discussions framed from an inclusive perspective provide a better understanding…

Social Value and Adult Learning

ERIC Educational Resources Information Center

Lamb, Penny

2011-01-01

An examination of the current government policy discourse on social value and the capturing of social impact leads immediately into the centre of the fast-moving and transforming public-sector reform agenda. The thinking around social value takes an individual to the heart of contracting, localism, the relationship between the public sector and…

New Public Management in Educational Reform in Norway

ERIC Educational Resources Information Center

Solhaug, Trond

2011-01-01

The article focuses on the similarities and differences in using new public management (NPM) administrative arrangements in educational policy as they have been presented in the educational reform process carried out this millennium by two governments in Norway: the Centre-Conservative government and the current Red-Green coalition government.…

Improving Participation and Success in VET for Disadvantaged Learners. Research Report

ERIC Educational Resources Information Center

Lamb, Stephen; Maire, Quentin; Walstab, Anne; Newman, Graeme; Doecke, Esther; Davies, Merryn

2018-01-01

Improving the educational outcomes of the various disadvantaged groups, such as Indigenous Australians, people with a disability, learners with low prior educational attainment and individuals from non-English speaking backgrounds, is a focus of many government policy initiatives centred on social inclusion. This research takes a regional approach…

How a "Top-Performing" Asian School System Formulates and Implements Policy: The Case of Singapore

ERIC Educational Resources Information Center

Tan, Cheng Yong; Dimmock, Clive

2014-01-01

This article analyses the paradox inherent in the "top-performing" yet tightly controlled Singapore education system. As government controls have increased in complexity, existing policymaking conceptual heuristics in accounting for centre-periphery relationships appear inadequate. It argues that more direct government control is being…

The Philippine Department of Education: Challenges of Policy Implementation amidst Corruption

ERIC Educational Resources Information Center

Reyes, Vicente Chua

2010-01-01

This inquiry interrogates the experiences of local implementation actors of the Philippine Department of Education as they navigate through reform efforts within systemic corruption. Departing from dominant analytical paradigms centred on patron-client frameworks, the article introduces the typology of complex linkages where local actors play…

Accountability and the Public Trust: Restoring the Balance. An Annotated Bibliography

ERIC Educational Resources Information Center

Beaulieu, Paul

2006-01-01

This bibliography was compiled for the 2006 Summer Institute at The Centre for Literacy-"Accountability and Public Trust: Restoring the Balance." The selections include lectures, research studies, policy papers, and government documents that describe and analyze recent concepts of accountability in the context of government funding in…

Medical education today: globalising with quality.

PubMed

Shahabudin, S H

2005-08-01

With globalization education has become a tradable service governed by the rules and regulations of GATS and worth trillions of dollars. International standards are rapidly being developed to facilitate cross border supply of services. In medical education, the WFME has produced International Guidelines on Quality in Medical Education which has a regional equivalent in the WHO Western Pacific Region, and the IIME has defined the minimum essential requirements of standards in medical education in seven core competences. Malaysia, having an explicit policy of making education a sector for revenue generation, has put in place regulatory frameworks and incentives to make the country a centre of educational excellence. Within the ambit of this national aspiration, medical education has grown phenomenally in the last decade. Standards and procedures for accreditation of medical schools in line with the world standards have been developed and implemented and policies are enforced to facilitate compliance to the standards. The ultimate goal is for medical schools to be self-accredited. In striving towards self-accreditation medical schools should be innovative in making changes in the three requirements of medical education. These are the intellectual and social imperatives and strategies for effective implementation.

Analysis Of The Health Care System Of Pakistan: Lessons Learnt And Way Forward.

PubMed

Kurji, Zohra; Premani, Zahra Shaheen; Mithani, Yasmin

2016-01-01

Pakistani health care system is in progress and since last year, Pakistan has tried to make much improvement in its health care delivery system and has brought out many reforms. A systematic search of national and international literature was looked from peerreviewed databases form MEDLINE, CINAHL, and PubMed. There is little strength in health care delivery system in Pakistan like making health policies, participating in Millennium Development Goals program, initiating vertical programs and introducing Public Private Partnership, improving human resource development and infrastructure by making Basic Health Unit and Rural Health Centres. However, these all programs are very limited in its scope and that is the reason that Pakistan's healthcare system is still not very efficient. There are numerous weaknesses like poor governance, lack of access and unequal resources, poor quality of Health Information Management System, corruption in health system, lack of monitoring in health policy and health planning and lack of trained staff. Pakistan is improving very slowly in the health sector for the last five decades as is evident by its health indicators and above mentioned strengths and weaknesses. Therefore, the Government needs to take strong initiatives to change the current health care system.

Canadian community health centres and the Internet: exploring the challenges and solutions.

PubMed

Jamieson, R

1997-01-01

Community Health Centres (CHCs) across Canada are providing essential health and social services to many communities, and this function is becoming more vital as provinces concentrate on cutting costs and developing more economic and efficient solutions to the current healthcare system. More than 300 of these community-based organizations currently serve upwards to 13% of the Canadian population, providing a wide range of services in an attempt to promote total wellness in their communities. Over one half of all CHCs are located in rural or remote areas. However, despite the apparent need for, and success of, CHCs, they are among the most underserved health provision groups in the country. Many CHCs lack critical funding and resources, particularly in the area of technology. In this Information Age, the health sector is realizing the importance of using information technologies to increase efficiency, improve services, and maintain viability. Community Health Centres, however, often do not have money for even the most basic technologies such as fax machines, let alone computers and Internet access. Community Health Centres in Canada need to be given the tools they need in order to continue providing quality health care to their communities. This article provides an overview of the current situation of CHCs in Canada vis(-)à-vis the Internet and other information technologies. Some of the practical and organizational challenges facing CHCs in this area will be discussed, as well as potential solutions that could and are being developed to overcome these barriers. It is an objective of this article to facilitate information and resource-sharing and the creation of links between CHCs across Canada. Community Health Centres may benefit from better understanding of the implications of these new technologies, discovering ways in which their peers are using the Internet, and communicating with one another in order to begin basic planning and needs assessments. As part of this overview, a brief update on the status of the HealthNet Community Access Pilot will be provided. The HealthNet Community Access Pilot is a collaborative project aimed at educating and providing CHCs across Canada with the tools to help them begin implementing Internet systems and policies within their own context. Part of this grassroots effort involves developing appropriate technical solutions, software, training materials, and support resources to help demystify and simplify the technology. Some of these tools and recommendations will be available at ITCH '96 for use by other CHCs.

An evaluation of the behaviour-change techniques used on Canadian cancer centre Web sites to support physical activity behaviour for breast cancer survivors

PubMed Central

Sylvester, B.D.; Zammit, K.; Fong, A.J.; Sabiston, C.M.

2017-01-01

Background Cancer centre Web sites can be a useful tool for distributing information about the benefits of physical activity for breast cancer (bca) survivors, and they hold potential for supporting health behaviour change. However, the extent to which cancer centre Web sites use evidence-based behaviour change techniques to foster physical activity behaviour among bca survivors is currently unknown. The aim of our study was to evaluate the presentation of behaviour-change techniques on Canadian cancer centre Web sites to promote physical activity behaviour for bca survivors. Methods All Canadian cancer centre Web sites (n = 39) were evaluated by two raters using the Coventry, Aberdeen, and London–Refined (calo-re) taxonomy of behaviour change techniques and the eEurope 2002 Quality Criteria for Health Related Websites. Descriptive statistics were calculated. Results The most common behaviour change techniques used on Web sites were providing information about consequences in general (80%), suggesting goal-setting behaviour (56%), and planning social support or social change (46%). Overall, Canadian cancer centre Web sites presented an average of M = 6.31 behaviour change techniques (of 40 that were coded) to help bca survivors increase their physical activity behaviour. Evidence of quality factors ranged from 90% (sites that provided evidence of readability) to 0% (sites that provided an editorial policy). Conclusions Our results provide preliminary evidence that, of 40 behaviour-change techniques that were coded, fewer than 20% were used to promote physical activity behaviour to bca survivors on cancer centre Web sites, and that the most effective techniques were inconsistently used. On cancer centre Web sites, health promotion specialists could focus on emphasizing knowledge mobilization efforts using available research into behaviour-change techniques to help bca survivors increase their physical activity. PMID:29270056

An evaluation of the behaviour-change techniques used on Canadian cancer centre Web sites to support physical activity behaviour for breast cancer survivors.

PubMed

Sylvester, B D; Zammit, K; Fong, A J; Sabiston, C M

2017-12-01

Cancer centre Web sites can be a useful tool for distributing information about the benefits of physical activity for breast cancer (bca) survivors, and they hold potential for supporting health behaviour change. However, the extent to which cancer centre Web sites use evidence-based behaviour change techniques to foster physical activity behaviour among bca survivors is currently unknown. The aim of our study was to evaluate the presentation of behaviour-change techniques on Canadian cancer centre Web sites to promote physical activity behaviour for bca survivors. All Canadian cancer centre Web sites ( n = 39) were evaluated by two raters using the Coventry, Aberdeen, and London-Refined (calo-re) taxonomy of behaviour change techniques and the eEurope 2002 Quality Criteria for Health Related Websites. Descriptive statistics were calculated. The most common behaviour change techniques used on Web sites were providing information about consequences in general (80%), suggesting goal-setting behaviour (56%), and planning social support or social change (46%). Overall, Canadian cancer centre Web sites presented an average of M = 6.31 behaviour change techniques (of 40 that were coded) to help bca survivors increase their physical activity behaviour. Evidence of quality factors ranged from 90% (sites that provided evidence of readability) to 0% (sites that provided an editorial policy). Our results provide preliminary evidence that, of 40 behaviour-change techniques that were coded, fewer than 20% were used to promote physical activity behaviour to bca survivors on cancer centre Web sites, and that the most effective techniques were inconsistently used. On cancer centre Web sites, health promotion specialists could focus on emphasizing knowledge mobilization efforts using available research into behaviour-change techniques to help bca survivors increase their physical activity.

Choosing an out-of-hospital birth centre: Exploring women's decision-making experiences.

PubMed

Wood, Rebecca J; Mignone, Javier; Heaman, Maureen I; Robinson, Kristine J; Roger, Kerstin Stieber

2016-08-01

the primary objective for this study was to explore women's experiences of choosing to plan a birth at an out-of-hospital birth centre. We sought to understand how women make the choice to plan for an out-of-hospital birth and the meaning that women ascribe to this decision-making process. a qualitative phenomenological study was conducted in Winnipeg, Canada with a sample of seventeen post partum women who represent the socio-demographic characteristics of the actual users of the Birth Centre in Winnipeg. The women participated in semistructured interviews. Through a feminist perspective and using interpretative phenomenological analysis (IPA), each participant's experience of birthplace decision-making was explored. six themes emerged through the analysis: (1) Making the decision in the context of relationships; (2) Exercising personal agency; (3) An expression of one's ideology; (4) Really thinking it through; (5) Fitting into the eligibility criteria; and (6) The psychology of the space. The findings suggested that a woman's sense of safety was related to each of these themes. the birth centre decision-making experience has many similarities to the homebirth decision-making process. The visceral impact of the physical design of the facility plays an important role and differentiates the birth centre decision from other birth setting options. The concept of relational autonomy was emphasised in this study, in that women make the decision in the context of their relationships with their midwives and partners. The study has implications for midwifery practice and health-care policy related to: client education on birth settings, design of birth environments, validation of the birth centre concept, and upholding the women-centred midwifery model of care. The study highlighted the importance of increasing access to out-of-hospital birth centres. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparing the nutrition environment and practices of home- and centre-based child-care facilities.

PubMed

Martyniuk, Olivia J M; Vanderloo, Leigh M; Irwin, Jennifer D; Burke, Shauna M; Tucker, Patricia

2016-03-01

To assess and compare the nutrition environment and practices (as they relate to pre-schoolers) of centre- and home-based child-care facilities. Using a cross-sectional study design, nineteen child-care facilities (ten centre-based, nine home-based) were assessed for one full day using the Environment and Policy Assessment and Observation (EPAO) tool (consisting of a day-long observation/review of the nutrition environment, practices and related documents). Specifically, eight nutrition-related subscales were considered. Child-care facilities in London, Ontario, Canada. Child-care facilities were recruited through directors at centre-based programmes and the providers of home-based programmes. The mean total nutrition environment EPAO scores for centre- and home-based facilities were 12·3 (sd 1·94) and 10·8 (sd 0·78) out of 20 (where a higher score indicates a more supportive environment with regard to nutrition), respectively. The difference between the total nutrition environment EPAO score for centre- and home-based facilities was approaching significance (P=0·055). For both types of facilities, the highest nutrition subscale score (out of 20) was achieved in the staff behaviours domain (centre mean=17·4; home mean=17·0) and the lowest was in the nutrition training and education domain (centre mean=3·6; home mean=2·0). Additional research is needed to confirm these findings. In order to better support child-care staff and enhance the overall nutrition environment in child care, modifications to food practices could be adopted. Specifically, the nutritional quality of foods/beverages provided to pre-schoolers could be improved, nutrition-related training for child-care staff could be provided, and a nutrition curriculum could be created to educate pre-schoolers about healthy food choices.

An enquiry of 'Every3Days' a drama-based workshop developing professional collaboration for women experiencing domestic violence during pregnancy in the South East of England.

PubMed

Baird, Kathleen; Salmon, Debra

2012-12-01

this exploratory work examined and assessed the experiences of participants (n=90) using an interactive drama workshop to facilitate the planning and understanding of multiagency working around domestic violence during pregnancy. a descriptive research design was utilised to collect data from field observations, participant reflective feedback sheets and semi-structured telephone interviews. participants invited to the workshop originated from a wide range of backgrounds including health and social care, criminal justice and the third sector. All participants were invited to complete the reflective feedback evaluation form. To enhance the comprehensiveness of the enquiry, semi-structured interviews were also conducted with 10 of the participants. shared themes emerging from the data analysis included improved awareness of the consequences of domestic violence; greater understanding of multiple professional roles including the policy context and enhanced skill development. However, participants questioned the extent to which this approach impacted upon longer term practice and policy development. by centring attention on the emic perspective of women themselves, the drama approach developed professional's awareness, relationships, understanding and skills. Nevertheless, drama can be an expensive education tool. It is therefore essential that further research explores the longer term impacts on practice and outcomes for women that include cost-benefit analysis. Copyright © 2011 Elsevier Ltd. All rights reserved.

Leading an Effective Improvement and Development Programme for Children's Centres

ERIC Educational Resources Information Center

Weston, Gill; Tyler, Mary

2015-01-01

This article reviews the process and achievements of leadership of an improvement and development programme for children's centres in the context of public value and Ofsted inspection. It analyses how the capacity has been developed of children's centre managers to work more strategically and collectively. Distributed leadership theory is applied…

An exploratory qualitative assessment of self-reported treatment outcomes and satisfaction among patients accessing an innovative voluntary drug treatment centre in Malaysia.

PubMed

Ghani, Mansur A; Brown, Shan-Estelle; Khan, Farrah; Wickersham, Jeffrey A; Lim, Sin How; Dhaliwal, Sangeeth K; Kamarulzaman, Adeeba; Altice, Frederick L

2015-02-01

In Malaysia, compulsory drug detention centres (CDDCs) hold suspected drug users for two years without adjudication. Acute detoxification without healthcare access has been documented. CDDCs are criticized globally due to ineffectiveness in treating addiction and human rights violations. In response, the Malaysian government began transitioning these facilities into voluntary drug treatment centres known as "Cure and Care" (C&C) centres that embrace a holistic treatment-based approach to drug addiction rehabilitation. An explorative qualitative study was undertaken to explore patient perspectives and satisfaction regarding treatment and services at the new Cure and Care centre in Kota Bharu, Malaysia. A convenience sample of 20 patients was recruited to participate in semi-structured in-depth interviews. Content analysis was used to identify the salient themes. Patients identified methadone treatment, psychosocial programs, religious instruction, and recreational activities as important factors contributing to treatment success for addressing both health and addiction needs. Though many had previously been in a CDDC, adherence to treatment in the C&C centre was perceived to be facilitated by the degree of social support, the voluntary nature and the array of new programs available for selection. C&Cs represents a dramatic shift in the Malaysian government's approach to drug addiction. Our findings demonstrate positive patient experiences associated with the holistic treatment-based approach of these centres. This exploratory study provides additional evidence to document this ongoing policy transition and may guide continued expansion of new holistic drug treatment programs across the country. Copyright © 2014 Elsevier B.V. All rights reserved.

An Exploratory Qualitative Assessment of Self-Reported Treatment Outcomes and Satisfaction Among Patients Accessing an Innovative Voluntary Drug Treatment Centre in Malaysia

PubMed Central

Ghani, Mansur A.; Brown, Shan-Estelle; Khan, Farrah; Wickersham, Jeffrey A.; Lim, Sin How; Dhaliwal, Sangeeth K.; Kamarulzaman, Adeeba; Altice, Frederick L.

2014-01-01

Background In Malaysia, compulsory drug detention centres (CDDCs) hold suspected drug users for two years without adjudication. Acute detoxification without healthcare access has been documented. CDDCs are criticized globally due to ineffectiveness in treating addiction and human rights violations. In response, the Malaysian government began transitioning these facilities into voluntary drug treatment centres known as “Cure and Care” (C&C) centres that embrace a holistic treatment-based approach to drug addiction rehabilitation. Methods An explorative qualitative study was undertaken to explore patient perspectives and satisfaction regarding treatment and services at the new Cure and Care centre in Kota Bharu, Malaysia. A convenience sample of 20 patients was recruited to participate in semi-structured in-depth interviews. Content analysis approach was used to identify the salient themes. Results Patients identified methadone treatment, psychosocial programs, religious instruction, and recreational activities as important factors contributing to treatment success for addressing both health and addiction needs. Though many had previously been in a CDDC, adherence to treatment in the C&C centre was perceived to be facilitated by the degree of social support, the voluntary nature and the array of new programs available for selection. Conclusion C&Cs represents a dramatic shift in the Malaysian government’s approach to drug addiction. Our findings demonstrate positive patient experiences associated with the holistic treatment-based approach of these centres. This exploratory study provides additional evidence to document this ongoing policy transition and may guide continued expansion of new holistic drug treatment programs across the country. PMID:25577322

Improving the effectiveness of service delivery in the public healthcare sector: the case of ophthalmology services in Malaysia.

PubMed

Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin

2015-08-28

Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy makers and service managers to intuitively visualise the overall performance of resource use in an otherwise difficult to assess scenario. The considerable potential output gain estimated indicates that effort should be invested to understand what drove the performance variation and optimise them. Similar performance assessment should be undertaken for other healthcare services in the country in order to work towards a sustainable health system.

Protocol for a qualitative study on promoting dietary change and positive food choices for poor people with low income who experience cardiovascular disease in Pakistan

PubMed Central

Barolia, Rubina Iqbal; Clark, Alexander M; Higginbottom, Gina M A

2013-01-01

Introduction There is a misconception that cardiovascular disease (CVD) is the burden of wealthy nations, but, in fact, it is the leading cause of death and disability-adjusted life worldwide. Healthy diets are an essential factor in the prevention of CVD. However, promoting healthy diet is challenging, particularly for people with low-socioeconomic status (SES), because poverty is linked with many risk behaviours such as smoking, unhealthy eating and obesity. Multiple factors, cultural values and beliefs interact and make healthy eating very challenging. The effects of these factors in the context of low-SES populations with CVD are largely unknown. To address this gap, this study will examine the factors that affect decisions about consuming healthy diet in Pakistanis with low SES who suffer from CVD. Methods and analysis A qualitative method of interpretive description will be used. 25 participants will be selected from two cardiac rehabilitation (CR) centres in Karachi, Pakistan. Face-to-face interviews using a critical realist framework will be used to understand individual and contextual factors in the food choices of people with low SES and CVD. ATLAS.ti qualitative data analysis software will be used to identify themes and patterns in the interview data. Ethics and discussion Ethical approvals were received from the Ethics Review board of University of Alberta, Canada and Aga Khan University, Karachi Pakistan. The findings will generate new knowledge about which and how factors influence the food choices of Pakistanis with CVD and low SES to provide an insight into the development of an operational framework for designing interventions for prevention of CVD. For knowledge-translation purposes, we will publish the findings in highly accessed, peer-reviewed scientific and health policy journals at the national and international level. This research protocol received IRDC (International Development Research Centre) doctoral award from International Development Research Centre, Ottawa, Canada. PMID:24309173

Breathing clean air is Są'áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centred approach to understanding commercial smoke-free policy among the Diné (Navajo People).

PubMed

Chief, Carmenlita; Sabo, Samantha; Clark, Hershel; Nez Henderson, Patricia; Yazzie, Alfred; Nahee, Jacqueline; Leischow, Scott J

2016-10-01

Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. We describe the process for applying the Diné (Navajo) paradigm of Są'áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Indigenous-centred approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people. 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/.

"Fast and Violent Integration": School Desegregation in a Hungarian Town

ERIC Educational Resources Information Center

Neumann, Eszter

2017-01-01

Joint European and national initiatives aiming at Roma inclusion in Central-Eastern European (CEE) education systems have repeatedly been assessed by policymakers, lobby groups and researchers as failing their original targets. My article centres on the in-depth analysis of the evolution of the education policy discourse and practice in a…

Private Agricultural Extension System in Kenya: Practice and Policy Lessons

ERIC Educational Resources Information Center

Muyanga, Milu; Jayne, T. S.

2008-01-01

Private extension system has been at the centre of a debate triggered by inefficient public agricultural extension. The debate is anchored on the premise that the private sector is more efficient in extension service delivery. This study evaluates the private extension system in Kenya. It employs qualitative and quantitative methods. The results…

Trends Shaping Education 2013. Centre for Educational Research and Innovation

ERIC Educational Resources Information Center

OECD Publishing (NJ3), 2013

2013-01-01

What does it mean for education that our societies are increasingly diverse? How is global economic power shifting towards new countries? In what ways are the skills required in the world of work changing? "Trends Shaping Education 2013" brings together international evidence to give policy makers, researchers, educational leaders, administrators…

Outsourcing, Globalizing Economics, and Shifting Language Policies: Issues in Managing Indian Call Centres

ERIC Educational Resources Information Center

Morgan, Brian; Ramanathan, Vaidehi

2009-01-01

This paper offers a dialogic discussion about several issues concerning call centers, including globalizing surges, modernity tropes and educational practices. Based on a critical discourse analysis of a document offering to train west-based entrepreneurs to assume managerial positions in call centers in India, the paper explores ways in which…

Professional Conversations: A Collaborative Approach to Support Policy Implementation, Professional Learning and Practice Change in ECEC

ERIC Educational Resources Information Center

Irvine, Susan; Price, Julie

2014-01-01

In 2012, Australia introduced a new "National Quality Framework" (NQF), comprising enhanced quality expectations for early childhood education and care services, two national learning frameworks and a new assessment and rating system spanning childcare centres, kindergartens and preschools, family day care and outside school hours care.…

Personal Learning Environments and University Teacher Roles Explored Using Delphi

ERIC Educational Resources Information Center

Shaikh, Zaffar Ahmed; Khoja, Shakeel Ahmed

2014-01-01

This paper presents the results of research using an online Delphi method, which aimed to explore university teacher roles and readiness for learner-centred pedagogy, driven by personal learning environments (PLEs). Using a modified Policy Delphi technique, a group of researchers worked with 34 international experts who are university teachers by…

Free Primary Education Policy and Pupil School Mobility in Urban Kenya

ERIC Educational Resources Information Center

Oketch, Moses; Mutisya, Maurice; Ngware, Moses; Ezeh, Alex C.; Epari, Charles

2010-01-01

This paper examines pupil school mobility in urban Kenya using African Population and Health Research Centre (APHRC) household survey data which contain information on pupil transfers between schools. The aim is to identify which school characteristics attract the greatest demand for incoming transfers. The analysis reveals that there are frequent…

The Education Policies of International Organizations: Specific Differences and Convergences

ERIC Educational Resources Information Center

Akkari, Abdeljalil; Lauwerier, Thibaut

2015-01-01

This article analyzes the role that international organizations play in orienting education reforms and changes, based on an examination of key texts these organizations produced in the 1990s. The analysis shows that some specific trends persist: UNESCO and UNICEF centre their philosophy on a humanistic and child-centered vision of education,…

Day Service Provision for People with Intellectual Disabilities: A Case Study Mapping 15-Year Trends in Ireland

ERIC Educational Resources Information Center

Fleming, Padraic; McGilloway, Sinead; Barry, Sarah

2017-01-01

Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual…

Lunch Time at the Child Care Centre: Neoliberal Assemblages in Early Childhood Education

ERIC Educational Resources Information Center

Nxumalo, Fikile; Pacini-Ketchabaw, Veronica; Rowan, Mary Caroline

2011-01-01

In this article we interrogate neoliberal assemblages within the context of eating and feeding practices in early childhood education. We consider how neoliberal assemblages are enacted and created through multiple linkages between micro and macro regulations and policies, and everyday food routines. We attend to the embodied intensities, desires…

Reinventing "Inclusion": New Labour and the Cultural Politics of Special Education

ERIC Educational Resources Information Center

Armstrong, Derrick

2005-01-01

New Labour has placed inclusion at the centre of its educational agenda. Its policies have been characterised by an attempt to include disabled children, together with others identified as having "special educational needs", within the ordinary school system and the shifting of responsibility for meeting their needs to teachers in the…

Sustainable development of a GCP-compliant clinical trials platform in Africa: the malaria clinical trials alliance perspective.

PubMed

Ogutu, Bernhards R; Baiden, Rita; Diallo, Diadier; Smith, Peter G; Binka, Fred N

2010-04-20

The Malaria Clinical Trials Alliance (MCTA), a programme of INDEPTH network of demographic surveillance centres, was launched in 2006 with two broad objectives: to facilitate the timely development of a network of centres in Africa with the capacity to conduct clinical trials of malaria vaccines and drugs under conditions of good clinical practice (GCP); and to support, strengthen and mentor the centres in the network to facilitate their progression towards self-sustaining clinical research centres. Sixteen research centres in 10 African malaria-endemic countries were selected that were already working with the Malaria Vaccine Initiative (MVI) or the Medicines for Malaria Venture (MMV). All centres were visited to assess their requirements for research capacity development through infrastructure strengthening and training. Support provided by MCTA included: laboratory and facility refurbishment; workshops on GCP, malaria diagnosis, strategic management and media training; and training to support staff to undertake accreditation examinations of the Association of Clinical Research Professionals (ACRP). Short attachments to other network centres were also supported to facilitate sharing practices within the Alliance. MCTA also played a key role in the creation of the African Media & Malaria Research Network (AMMREN), which aims to promote interaction between researchers and the media for appropriate publicity and media reporting of research and developments on malaria, including drug and vaccine trials. In three years, MCTA strengthened 13 centres to perform GCP-compliant drug and vaccine trials, including 11 centres that form the backbone of a large phase III malaria vaccine trial. MCTA activities have demonstrated that centres can be brought up to GCP compliance on this time scale, but the costs are substantial and there is a need for further support of other centres to meet the growing demand for clinical trial capacity. The MCTA experience also indicates that capacity development in clinical trials is best carried out in the context of preparation for specific trials. In this regard MCTA centres involved in the phase III malaria vaccine trial were, on average, more successful at consolidating the training and infrastructure support than those centres focussing only on drug trials.

Sustainable development of a GCP-compliant clinical trials platform in Africa: the Malaria Clinical Trials Alliance perspective

PubMed Central

2010-01-01

Background The Malaria Clinical Trials Alliance (MCTA), a programme of INDEPTH network of demographic surveillance centres, was launched in 2006 with two broad objectives: to facilitate the timely development of a network of centres in Africa with the capacity to conduct clinical trials of malaria vaccines and drugs under conditions of good clinical practice (GCP); and to support, strengthen and mentor the centres in the network to facilitate their progression towards self-sustaining clinical research centres. Case description Sixteen research centres in 10 African malaria-endemic countries were selected that were already working with the Malaria Vaccine Initiative (MVI) or the Medicines for Malaria Venture (MMV). All centres were visited to assess their requirements for research capacity development through infrastructure strengthening and training. Support provided by MCTA included: laboratory and facility refurbishment; workshops on GCP, malaria diagnosis, strategic management and media training; and training to support staff to undertake accreditation examinations of the Association of Clinical Research Professionals (ACRP). Short attachments to other network centres were also supported to facilitate sharing practices within the Alliance. MCTA also played a key role in the creation of the African Media & Malaria Research Network (AMMREN), which aims to promote interaction between researchers and the media for appropriate publicity and media reporting of research and developments on malaria, including drug and vaccine trials. Conclusion In three years, MCTA strengthened 13 centres to perform GCP-compliant drug and vaccine trials, including 11 centres that form the backbone of a large phase III malaria vaccine trial. MCTA activities have demonstrated that centres can be brought up to GCP compliance on this time scale, but the costs are substantial and there is a need for further support of other centres to meet the growing demand for clinical trial capacity. The MCTA experience also indicates that capacity development in clinical trials is best carried out in the context of preparation for specific trials. In this regard MCTA centres involved in the phase III malaria vaccine trial were, on average, more successful at consolidating the training and infrastructure support than those centres focussing only on drug trials. PMID:20406478

Human embryonic stem cell science and policy: The case of Iran☆

PubMed Central

Saniei, Mansooreh

2013-01-01

The paper is based on a large qualitative study of ethics, policy and regulation of human embryonic stem cell (hESC) science in Iran. This case study in five academic research centres used semi-structured interviews to examine in depth the views of stem cell scientists, embryologists and ethics committee members on hESC research policy in this Shia Muslim country. Although Iran's policy approach has been considered 'intermediate', what is described here seems to be a 'more flexible' policy on hESC science. This article describes three arguments to explain why Iran has shaped such a policy. These are: (1) a flexibility of the Shia tradition has allowed for hESC science; (2) permissive policy related to other fields of biomedicine, such as new assisted reproductive technologies, facilitated approval of hESC research; and (3) a lack of public debate of bioscience in Iran influences how its hESC research policy is perceived. Based on the empirical data, this paper then expands and refines the conceptual bioethical basis for the co-production of science, policy, and society in Iran. The notion of co-production implies that scientists, policy-makers, and sometimes other societal actors cooperate in the exchange, production, and application of knowledge to make science policy. PMID:24230960

Human embryonic stem cell science and policy: the case of Iran.

PubMed

Saniei, Mansooreh

2013-12-01

The paper is based on a large qualitative study of ethics, policy and regulation of human embryonic stem cell (hESC) science in Iran. This case study in five academic research centres used semi-structured interviews to examine in depth the views of stem cell scientists, embryologists and ethics committee members on hESC research policy in this Shia Muslim country. Although Iran's policy approach has been considered 'intermediate', what is described here seems to be a 'more flexible' policy on hESC science. This article describes three arguments to explain why Iran has shaped such a policy. These are: (1) a flexibility of the Shia tradition has allowed for hESC science; (2) permissive policy related to other fields of biomedicine, such as new assisted reproductive technologies, facilitated approval of hESC research; and (3) a lack of public debate of bioscience in Iran influences how its hESC research policy is perceived. Based on the empirical data, this paper then expands and refines the conceptual bioethical basis for the co-production of science, policy, and society in Iran. The notion of co-production implies that scientists, policy-makers, and sometimes other societal actors cooperate in the exchange, production, and application of knowledge to make science policy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Genetics education for health professionals: strategies and outcomes from a national initiative in the United Kingdom.

PubMed

Farndon, Peter A; Bennett, Catherine

2008-04-01

The National Health Service (NHS) National Genetics Education and Development Centre was established by the Department of Health in 2004 to help drive and co-ordinate genetics education for health professionals working outside specialist genetic services. This paper reviews the experiences and lessons learned to date. At the outset, it was clear that understanding the learning ethos, preferred delivery methods and attitudes towards genetics of different NHS healthcare groups was vital. We collected evidence by undertaking needs assessments with educators, practitioners and patients. We have determined the genetics knowledge, skills and attitudes which they said were needed and translated these into learning outcomes and workforce competences in a continuum of education. Beginning with core concepts introduced (and examined) pre-registration, the continuum continues with development of concepts post-registration as appropriate for role, leading to practical application and assessment of competences in the workplace. These are supported by a portfolio of resources which draw heavily on patient based scenarios to demonstrate to staff that genetics is relevant to their work, and to convince educators and policy makers that genetic education is likely to result in real clinical benefit. A long term educational policy, inclusive of learners, educationalists and their institutions must be evidence based, flexible and responsive to changes in workforce structure, provision of clinical services and conceptual and financial commitments to education. The engagement of national policy, regulatory and professional bodies is vital (www.geneticseducation.nhs.uk).

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

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.

User-payment, decentralization and health service utilization in Zambia.

PubMed

Blas, E; Limbambala, M

2001-12-01

The study was undertaken to assess the impact of health sector reform from 1993 to 1997 in Zambia in respect of health care service utilization and the shift of caseload from hospitals to health centres. Four key indicators were chosen: general attendance, measles vaccinations, general admissions, and deliveries. Complete sets of district data were analyzed, covering 4.5 million people out of the total population in 1997 of 9.7 million. The results show, on the one hand, a dramatic decrease of about one-third in general attendance for both hospitals and health centres over a 2-year period, followed by a period with a continued but slower decrease. On the other hand, the results also show increases at health centres in measles vaccinations (up 40%), in admissions (up 25%) and in deliveries (up 60%). The study further documents a shift of caseload from hospitals to health centres for some key services. The health centre share increased from 72.2% to 79.8% for measles vaccinations, from 23.9% to 31.0% for general admissions, and from 22.9% to 32.4% for deliveries. However, the intended overall shift in outpatient caseload from hospitals to health centres did not materialize. The main lessons are: utilization patterns can be influenced by policies such as user-payment and decentralization; user payment in poor populations leads to dramatic declines in utilization of services; and decentralization with local control of resources could be an alternative to the traditional vertical disease programme approach for priority interventions.

Health research in the developing world: a gastroenterological view from Bangladesh.

PubMed

Hamilton, J R

1997-01-01

Ill health is a serious impediment to progress in most poor countries, yet health is not a high priority on foreign aid agendas. Health research, which provides the essential base for sustainable progressive health programs, is barely visible in developing countries. For example, in Bangladesh, one finds unacceptably high morbidity and mortality rates among infants and children, health programs that are struggling and a rudimentary health research establishment; for the huge foreign donor community in that country, health programs and research do not appear to warrant major investments. Diarrheal diseases are at the top of the list of killers in many poor nations including Bangladesh. Recent advances in our understanding of diarrhea suggest that when prevention may not be possible soon, improved active treatment can evolve from an aggressive research effort centered in a developing country and linked to appropriate international partners. Global agencies such as the World Health Organization have demonstrated a declining interest in health research, as reflected in the policies of their Diarrhoeal Disease Control Programme. Major donors to the developing world, the Canadian International Development Agency for example, have had a relatively minor involvement in health and little commitment to health research. University links with the west, private enterprises and specially targeted programs are involved in developing world health research but they have not been able to foster and leave behind sustainable, high quality research programs. The problem should be attacked directly by supporting focused, relevant health research centres in regions of the world where the burden of disease continues to impede progress and where the environment is conducive to high quality research that is well integrated with care delivery programs. An instructive model of this approach is the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh.

A call for action to establish a research agenda for building a future health workforce in Europe.

PubMed

Kuhlmann, Ellen; Batenburg, Ronald; Wismar, Matthias; Dussault, Gilles; Maier, Claudia B; Glinos, Irene A; Azzopardi-Muscat, Natasha; Bond, Christine; Burau, Viola; Correia, Tiago; Groenewegen, Peter P; Hansen, Johan; Hunter, David J; Khan, Usman; Kluge, Hans H; Kroezen, Marieke; Leone, Claudia; Santric-Milicevic, Milena; Sermeus, Walter; Ungureanu, Marius

2018-06-20

The importance of a sustainable health workforce is increasingly recognised. However, the building of a future health workforce that is responsive to diverse population needs and demographic and economic change remains insufficiently understood. There is a compelling argument to be made for a comprehensive research agenda to address the questions. With a focus on Europe and taking a health systems approach, we introduce an agenda linked to the 'Health Workforce Research' section of the European Public Health Association. Six major objectives for health workforce policy were identified: (1) to develop frameworks that align health systems/governance and health workforce policy/planning, (2) to explore the effects of changing skill mixes and competencies across sectors and occupational groups, (3) to map how education and health workforce governance can be better integrated, (4) to analyse the impact of health workforce mobility on health systems, (5) to optimise the use of international/EU, national and regional health workforce data and monitoring and (6) to build capacity for policy implementation. This article highlights critical knowledge gaps that currently hamper the opportunities of effectively responding to these challenges and advising policy-makers in different health systems. Closing these knowledge gaps is therefore an important step towards future health workforce governance and policy implementation. There is an urgent need for building health workforce research as an independent, interdisciplinary and multi-professional field. This requires dedicated research funding, new academic education programmes, comparative methodology and knowledge transfer and leadership that can help countries to build a people-centred health workforce.

Woman-centred care during pregnancy and birth in Ireland: thematic analysis of women's and clinicians' experiences.

PubMed

Hunter, Andrew; Devane, Declan; Houghton, Catherine; Grealish, Annmarie; Tully, Agnes; Smith, Valerie

2017-09-25

Recent policy and service provision recommends a woman-centred approach to maternity care. Midwife-led models of care are seen as one important strategy for enhancing women's choice; a core element of woman-centred care. In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians. This study considers women's and clinicians' views, experiences and perspectives of woman-centred maternity care in Ireland. A descriptive qualitative design. Participants (n = 31) were purposively sampled from two geographically distinct maternity units. Interviews were face-to-face or over the telephone, one-to-one or focus groups. A thematic analysis of the interview data was performed. Five major themes representing women's and clinicians' views, experiences and perspectives of women-centred care emerged from the data. These were Protecting Normality, Education and Decision Making, Continuity, Empowerment for Women-Centred Care and Building Capacity for Women-Centred Care. Within these major themes, sub-themes emerged that reflect key elements of women-centred care. These were respect, partnership in decision making, information sharing, educational impact, continuity of service, staff continuity and availability, genuine choice, promoting women's autonomy, individualized care, staff competency and practice organization. Women centred-care, as perceived by participants in this study, is not routinely provided in Ireland and women subscribe to the dominant culture that views safety as paramount. Women-centred care can best be facilitated through continuity of carer and in particular through midwife led models of care; however, there is potential to provide women-centred care within existing labour wards in terms of consistency of care, education of women, common approaches to care across professions and women's choice. To achieve this, however, future research is required to better understand the role of midwife-led care within existing labour ward settings. While a positive view of women-centred care was found; there is still a difference in approach and imbalance of power between the professions. More research is required to consider how these differences impact care provision and how they might be overcome.

The effect of the National Essential Medicines Policy on health expenditures and service delivery in Chinese township health centres: evidence from a longitudinal study

PubMed Central

Zhang, Xin; Wu, Qunhong; Liu, Guoxiang; Li, Ye; Gao, Lijun; Guo, Bin; Fu, Wenqi; Hao, Yanhua; Cui, Yu; Huang, Weidong; Coyte, Peter C

2014-01-01

Objectives The government of China has introduced a National Essential Medicines Policy (NEMP) in the new round of health system reform. The objective of this paper is to analyse whether the NEMP can play a role in curbing the rise of medical expenditures without disrupting the availability of healthcare services at township hospitals in China. Design This study adopted a pre–post treatment-control study design. A difference-in-differences method and fixed-effects model for panel data were employed to estimate the effect of the NEMP. Setting Chongqing, Jiangsu and Henan Province, in China, in 2009 and 2010. Participants 296 township health centres. Outcome measures Outcomes for health expenditures were average outpatient drug expenses per visit, average inpatient drug expenses per discharged patient, average outpatient expenses per visit and average inpatient expenses per discharged patient. Outcomes for care delivery were the numbers of visits per certified doctor per day and the numbers of hospitalised patients per certified doctor per day. Results The township health centres that were enrolled in the NEMP reported 26% (p<0.01) lower drug expenditures for inpatient care. An 11% (p<0.05) decrease in average inpatient expenditures per discharged patient was found following the implementation of the NEMP. The impacts of the NEMP on average outpatient expenditures and outpatient drug expenditures were not statistically significant at the 5% level. No statistically significant associations were found between the NEMP and reduction in quantity of health service delivery. Conclusions The NEMP was significant in its effect in reducing inpatient medication and health service expenditures. This study shows no evidence that the quantity of healthcare service declined significantly after introduction of the NEMP over the study period, which suggests that if appropriate matching policies are introduced, the side effects of the NEMP can be counteracted to some degree. Further research including a long-term follow-up study is needed. PMID:25534214

Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands.

PubMed

Dobrowolski, Linn C; van Huis, Maike; van der Lee, Johanna H; Peters Sengers, Hessel; Liliën, Marc R; Cransberg, Karlien; Cornelissen, Marlies; Bouts, Antonia H; de Fijter, Johan W; Berger, Stefan P; van Zuilen, Arjan; Nurmohamed, Shaikh A; Betjes, Michiel H G; Hilbrands, Luuk; Hoitsma, Andries J; Bemelman, Frederike J; Krediet, C T Paul; Groothoff, Jaap W

2016-11-01

Hypertension in kidney transplant recipients (KTRs) is a risk factor for cardiovascular mortality and graft loss. Data on the prevalence of hypertension and uncontrolled hypertension (uHT) in paediatric and young adult KTRs are scarce. Also, it is unknown whether 'transition' (the transfer from paediatric to adult care) influences control of hypertension. We assessed the prevalence of hypertension and uHT among Dutch paediatric and young adult KTRs and analysed the effects of transition. Additionally, we made an inventory of variations in treatment policies in Dutch transplant centres. Cross-sectional and longitudinal national data from living KTRs ≤30 years of age (≥1-year post-transplant, eGFR >20 mL/min) were extracted from the 'RICH Q' database, which comprises information about all Dutch KTRs <19 years of age, and the Netherlands Organ Transplant Registry database for adult KTRs (≥18-30 years of age). We used both upper-limit blood pressure (BP) thresholds for treatment according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. uHT was defined as a BP above the threshold. A questionnaire on treatment policies was sent to paediatric and adult nephrologists at eight Dutch transplant centres. Hypertension and uHT were more prevalent in young adult KTRs (86.4 and 75.8%) than in paediatric KTRs (62.7 and 38.3%) according to the KDIGO definition. Time after transplantation was comparable between these groups. Longitudinal analysis showed no evidence of effect of transition on systolic BP or prevalence of uHT. Policies vary considerably between and within centres on the definition of hypertension, BP measurement and antihypertensive treatment. Average BP in KTRs increases continuously with age between 6 and 30 years. Young adult KTRs have significantly more uHT than paediatric KTRs according to KDIGO guidelines. Transition does not influence the prevalence of uHT. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

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.

Public computing options for individuals with cognitive impairments: survey outcomes.

PubMed

Fox, Lynn Elizabeth; Sohlberg, McKay Moore; Fickas, Stephen; Lemoncello, Rik; Prideaux, Jason

2009-09-01

To examine availability and accessibility of public computing for individuals with cognitive impairment (CI) who reside in the USA. A telephone survey was administered as a semi-structured interview to 145 informants representing seven types of public facilities across three geographically distinct regions using a snowball sampling technique. An Internet search of wireless (Wi-Fi) hotspots supplemented the survey. Survey results showed the availability of public computer terminals and Internet hotspots was greatest in the urban sample, followed by the mid-sized and rural cities. Across seven facility types surveyed, libraries had the highest percentage of access barriers, including complex queue procedures, login and password requirements, and limited technical support. University assistive technology centres and facilities with a restricted user policy, such as brain injury centres, had the lowest incidence of access barriers. Findings suggest optimal outcomes for people with CI will result from a careful match of technology and the user that takes into account potential barriers and opportunities to computing in an individual's preferred public environments. Trends in public computing, including the emergence of widespread Wi-Fi and limited access to terminals that permit auto-launch applications, should guide development of technology designed for use in public computing environments.

Estimating costs of quality improvement for outpatient healthcare organisations: a practical methodology.

PubMed

Brown, Sydney E S; Chin, Marshall H; Huang, Elbert S

2007-08-01

Outpatient healthcare organisations worldwide participate in quality improvement (QI) programmes. Despite the importance of understanding the financial impact of such programmes, there are no established standard methods for empirically assessing QI programme costs and their consequences for small outpatient healthcare organisations. The costs and cost consequences were evaluated for a diabetes QI programme implemented throughout the USA in federally qualified community health centres. For five case study centres, survey instruments and methods for data analysis were developed. Two types of cost/revenue were evaluated. Direct costs/revenues, such as personnel time, items purchased and grants received, were evaluated using self-administered surveys. Cost/revenue consequences, which were cost/revenue changes that may have occurred due to changes in patient utilisation or physician behaviour, were evaluated using electronic billing data. Other methods for evaluating cost/revenue consequences if electronic billing data are not available are also discussed. This paper describes a practical taxonomy and method for assessing the costs and revenues of QI programmes for outpatient organisations. Results of such analyses will be useful for healthcare organisations implementing QI programmes and also for policy makers designing incentives for QI participation.

Chief medical officer actions on information security in an Italian rehabilitation centre.

PubMed

Reni, Gianluigi; Molteni, Massimo; Arlotti, Stefano; Pinciroli, Francesco

2004-03-31

In a multi-speciality rehabilitation centre, where child neuropsychiatrists, neurologists, physical rehabilitators, psychologists, nurses, therapists and other health care professionals actively care for patients, the moment will arrive when information security takes high priority on the chief medical officer (CMO) agenda. This has happened at the La Nostra Famiglia Institution. Local push to high priority arose from several concurrent forces, like privacy both on the patient and on the doctor side, legal and ethical aspects. Recommendations on the protection of medical data require appropriate technical and organisational measures to be taken to protect personal data against unauthorised access, alterations or any other form of inappropriate processing. In the same time quick and easy access to patient information should be granted to authorised personnel to ensure proper and in time treatment of patients. A long lasting sequence of co-operative negotiation meetings between the CMO and the chief information officer (CIO) led to appropriate outline of policies. We developed a suitable and modular architecture for designing systems that can simultaneously manage an increasing number of healthcare actors, objects and related access levels taking into account temporal conditions. Actions for keeping the prototype in use on an everyday basis are directly taken by the CMO.

Implementing efficient and sustainable collaboration between National Immunization Technical Advisory Groups: Report on the 3rd International Technical Meeting, Paris, France, 8-9 December 2014.

PubMed

Perronne, Christian; Adjagba, Alex; Duclos, Philippe; Floret, Daniel; Houweling, Hans; Le Goaster, Corinne; Lévy-Brühl, Daniel; Meyer, François; Senouci, Kamel; Wichmann, Ole

2016-03-08

Many experts on vaccination are convinced that efforts should be made to encourage increased collaboration between National Immunization Technical Advisory Groups on immunization (NITAGs) worldwide. International meetings were held in Berlin, Germany, in 2010 and 2011, to discuss improvement of the methodologies for the development of evidence-based vaccination recommendations, recognizing the need for collaboration and/or sharing of resources in this effort. A third meeting was held in Paris, France, in December 2014, to consider the design of specific practical activities and an organizational structure to enable effective and sustained collaboration. The following conclusions were reached: (i) The proposed collaboration needs a core functional structure and the establishment or strengthening of an international network of NITAGs. (ii) Priority subjects for collaborative work are background information for recommendations, systematic reviews, mathematical models, health economic evaluations and establishment of common frameworks and methodologies for reviewing and grading the evidence. (iii) The programme of collaborative work should begin with participation of a limited number of NITAGs which already have a high level of expertise. The amount of joint work could be increased progressively through practical activities and pragmatic examples. Due to similar priorities and already existing structures, this should be organized at regional or subregional level. For example, in the European Union a project is funded by the European Centre for Disease Prevention and Control (ECDC) with the aim to set up a network for improving data, methodology and resource sharing and thereby supporting NITAGs. Such regional networking activities should be carried out in collaboration with the World Health Organization (WHO). (iv) A global steering committee should be set up to promote international exchange between regional networks and to increase the involvement of less experienced NITAGs. NITAGs already collaborate at the global level via the NITAG Resource Centre, a web-based platform developed by the Health Policy and Institutional Development Unit (WHO Collaborating Centre) of the Agence de Médecine Préventive (AMP-HPID). It would be appropriate to continue facilitating the coordination of this global network through the AMP-HPID NITAG Resource Centre. (v) While sharing work products and experiences, each NITAG would retain responsibility for its own decision-making and country-specific recommendations. Copyright © 2016. Published by Elsevier Ltd.. All rights reserved.

Educational Development Websites: What Do They Tell Us about How Canadian Centres Support the Scholarship of Teaching and Learning?

ERIC Educational Resources Information Center

Woodhouse, Ros A.; Force, Kristin A.

2010-01-01

The study investigates how university educational development centres in Canada currently support faculty in developing the skills and knowledge to engage in the scholarship of teaching and learning. Content analysis of centre websites was used to identify strategies used to support SoTL. The main strategies identified were providing information…

[Medical policies, state and religious missions in Rwanda (1920-1940). An authoritative design of colonial medicine?].

PubMed

Cornet, Anne

2009-01-01

The Belgian health policy set up in mandated Rwanda after the First World War was mainly centred on some campaigns taking specifically yaws as a target. The struggle against this endemic disease (not fatal, but most disabling) was organized in a very systematic and authoritarian way. This article looks into two of those yaws campaigns, questions their runnings and alterations, and finally brings to light the intra-colonial tensions between the health services and the administration on the one hand, between the colonizers and the African populations on the other hand.

Using practice development methodology to develop children's centre teams: ideas for the future.

PubMed

Hemingway, Ann; Cowdell, Fiona

2009-09-01

The Children's Centre Programme is a recent development in the UK and brings together multi-agency teams to work with disadvantaged families. Practice development methods enable teams to work together in new ways. Although the term practice development remains relatively poorly defined, its key properties suggest that it embraces engagement, empowerment, evaluation and evolution. This paper introduces the Children's Centre Programme and practice development methods and aims to discuss the relevance of using this method to develop teams in children's centres through considering the findings from an evaluation of a two-year project to develop inter-agency public health teams. The evaluation showed that practice development methods can enable successful team development and showed that through effective facilitation, teams can change their practice to focus on areas of local need. The team came up with their own process to develop a strategy for their locality.

Non- medical prescribing in Australasia and the UK: the case of podiatry.

PubMed

Borthwick, Alan M; Short, Anthony J; Nancarrow, Susan A; Boyce, Rosalie

2010-01-05

The last decade has witnessed a rapid transformation in the role boundaries of the allied health professions, enabled through the creation of new roles and the expansion of existing, traditional roles. A strategy of health care 'modernisation' has encompassed calls for the redrawing of professional boundaries and identities, linked with demands for greater workforce flexibility. Several tasks and roles previously within the exclusive domain of medicine have been delegated to, or assumed by, allied health professionals, as the workforce is reshaped to meet the challenges posed by changing demographic, social and political contexts. The prescribing of medicines by non-medically qualified healthcare professionals, and in particular the podiatry profession, reflects these changes. Using a range of key primary documentary sources derived from published material in the public domain and unpublished material in private possession, this paper traces the development of contemporary UK and Australasian podiatric prescribing, access, supply and administration of medicines. Documentary sources include material from legislative, health policy, regulatory and professional bodies (including both State and Federal sources in Australia). Tracing a chronological, comparative, socio-historical account of the emergence and development of 'prescribing' in podiatry in both Australasia and the UK enables an analysis of the impact of health policy reforms on the use of, and access to, medicines by podiatrists. The advent of neo-liberal healthcare policies, coupled with demands for workforce flexibility and role transfer within a climate of demographic, economic and social change has enabled allied health professionals to undertake an expanding number of tasks involving the sale, supply, administration and prescription of medicines. As a challenge to medical dominance, these changes, although driven by wider healthcare policy, have met with resistance. As anticipated in the theory of medical dominance, inter-professional jurisdictional disputes centred on the right to access, administer, supply and prescribe medicines act as obstacles to workforce change. Nevertheless, the broader policy agenda continues to ensure workforce redesign in which podiatry has assumed wider roles and responsibilities in prescribing.

The experiences of patients and carers living.

PubMed

Leeder, Stephen R; Jowsey, Tanisha; McNab, Justin W

2018-01-01

Non-communicable diseases (NCDs) are increasing in prevalence and straining health systems globally. This creates a so-called 'burden of disease', which can be traced in terms of fiscal health system matters and in terms of quality of life and lived experiences of people with NCDs. The United Nations has called for a global agenda to manage NCDs and reduce their burden. The purpose of this article is to summarise key findings from the Serious and Continuing Illness Policy and Practice Study concerning patients’ and carers’ experiences of multimorbid NCDs in Australia. We focus on the relevance of findings for policy and general practitioners in Australia. We suggest that a complex multimorbidity policy is needed to contextualise and guide single-illness NCD policies. Our research suggests that specialist NCD nurses and allied health professionals could have important roles in improving care coordination between general practices and community health centres.

The International Hydrological Programme of UNESCO

NASA Astrophysics Data System (ADS)

Tejada-Guibert, J.

2007-12-01

UNESCO's International Hydrological Programme (IHP) is the only intergovernmental scientific program of the UN system on freshwater having a global scope. Since its inception in 1975, IHP has been at the forefront of international cooperation on water research and management, bringing together scientists, engineers, policy- makers, managers, and stakeholders. Currently there are over 160 National Committees for the IHP, including the US. During six successive phases, IHP has evolved into a transdisciplinary, action-oriented and policy- relevant program with a strong scientific core responding to the needs of the Member States. This presentation will address the concepts underpinning the strategic plan of the seventh phase of IHP (2008-2013) and the proposed lines of action. Adaptation to the impacts of global changes on river basins and aquifer systems is a theme central to this phase. Global changes associated with climate, demographic factors and modifications in land use, among other factors, can have significant impacts on the hydrological cycle and on water resources. Due to the global character of such changes, its potential interaction with the hydrological cycle, and the transboundary nature of many river basins and aquifers, international cooperation is essential to improve our understanding and to efficiently address the challenges posed to water resources. During IHP-VII, particularly stressed and/or vulnerable areas (i.e. arid and semi-arid regions, the Polar regions, glaciated mountainous, urban areas and coastal regions) will be assessed, with the aim of supporting the development of mitigation and adaptation strategies by Member States and policies based on institutional synergies to diminish stresses on water resources. Strengthening water governance for sustainability is another thematic concentration, emphasizing the need of society to be able to respond adequately to the critical freshwater challenges. Lessons learned from the cross-cutting projects FRIEND (Flow Regimes from International Experimental and Network Data Programme) and HELP (Hydrology for the Environment, Life and Policy Programme) and the supporting efforts from the network of water-related centers under the auspices of UNESCO, such as the International Groundwater Resources Assessment Centre (IGRAC) based in The Netherlands and the International Centre for Water and Hazard Risk Management (ICHARM) based in Japan will contribute key elements to the studies. Opportunities for collaboration with the American scientific community will be highlighted.

Regional implementation of a national cancer policy: taking forward multiprofessional, collaborative cancer care.

PubMed

Ferguson, A; Makin, W; Walker, B; Dublon, G

1998-09-01

The vision of the Calman-Hine paper is of patient-centred care, delivered by co-ordinated services which have genuine partnerships with each other. There is integration of other providers of support, to meet psychological and non-clinical needs. There is access to palliative care when required, from diagnosis onwards, and not just in the terminal stage. Effective communications and networks are the keys to making this vision a reality. Our recommendations are based upon in-depth discussions with purchasers, doctors and nurses, and others involved with cancer services within hospitals or the community across the region. They reflect the priorities placed on the development of good practice. Purchasers and providers should work together to implement these guidelines.

Epidemiology and pattern of paediatric and adolescent trauma deaths in a level 1 trauma centre in Benin city, Nigeria.

PubMed

Osifo, Osarumwense David; Iribhogbe, Pius Ehiawaguan; Ugiagbe, Ezekiel Enoghama

2012-11-01

Trauma is a common cause of death amongst children/adolescents, and data on its epidemiology and pattern are crucial for policy formulation. The aim of this study was to determine the epidemiology and pattern of paediatric/adolescent trauma death in a Nigerian referral trauma centre. The clinical and autopsy data of all paediatric/adolescent trauma death at the University of Benin Teaching Hospital between 1999 and 2010 were analysed in a retrospective study. Of 905 trauma-related deaths, 78 (9%) involved children/adolescents who comprised 49 males and 29 females, with a male/female ratio 1.7:1 and a mean age of 9.2 ± 5 years (range <1-18 years). The Injury-Arrival time varied from 1h to 4 days (mean 18 h). Thirteen (17%) cases were dead on arrival (DOA), and majority of the deaths occurred within the first week on admission. Road traffic accident (RTA), accounting for 61 (78%) cases, was the leading cause of trauma death. Other causes included burns, eight (10%); gunshot injury, five (6%); and stab and sport injuries, two (3%) cases each. Head injury which occurred in 44 (56%) cases was the commonest cause of death, followed by haemorrhagic shock in 25 (32%), hypovolaemic shock in five (6%), septic shock in three (4%) and spinal cord injury in one (1%). Head injury following RTA was the major cause of paediatric/adolescent trauma deaths. Increased road safety campaign, appropriate injury control policies, legislations, enforcement, development of high-quality trauma system, and emergency medical services are advocated. Copyright © 2011 Elsevier Ltd. All rights reserved.

Mapping ethical and social aspects of cancer biomarkers.

PubMed

Blanchard, Anne

2016-12-25

Cancer biomarkers represent a revolutionary advance toward personalised cancer treatment, promising therapies that are tailored to subgroups of patients sharing similar generic traits. Notwithstanding the optimism driving this development, biomarkers also present an array of social and ethical questions, as witnessed in sporadic debates across different literatures. This review article seeks to consolidate these debates in a mapping of the complex terrain of ethical and social aspects of cancer biomarker research. This mapping was undertaken from the vantage point offered by a working cancer biomarker research centre called the Centre for Cancer Biomarkers (CCBIO) in Norway, according to a dialectic move between the literature and discussions with researchers and practitioners in the laboratory. Starting in the lab, we found that, with the exception of some classical bioethical dilemmas, researchers regarded many issues relative to the ethos of the biomarker community; how the complexity and uncertainty characterising biomarker research influence their scientific norms of quality. Such challenges to the ethos of cancer research remain largely implicit, outside the scope of formal bioethical enquiry, yet form the basis for other social and ethical issues. Indeed, looking out from the lab we see how questions of complexity, uncertainty and quality contribute to debates around social and global justice; undermining policies for the prioritisation of care, framing the stratification of those patients worthy of treatment, and limiting global access to this highly sophisticated research. We go on to discuss biomarker research within the culturally-constructed 'war on cancer' and highlight an important tension between the expectations of 'magic bullets' and the complexity and uncertainty faced in the lab. We conclude by arguing, with researchers in the CCBIO, for greater reflexivity and humility in cancer biomarker research and policy. Copyright © 2016 The Author. Published by Elsevier B.V. All rights reserved.

The International Development Research Centre: A Guide for the Canadian University Research Community = Le Centre de recherches pour le developpement international: guide a l'intention des scientifiques des universites Canadiennes.

ERIC Educational Resources Information Center

Tillman, George; Wasilewski, Ania, Ed.

Written in both English and French this is a manual for the Canadian research community. It describes the International Development Research Centre (IDRC) and its operations. The main objective of the IDRC is to assist scientists in developing countries to identify and conduct research into long term practical solutions to development problems.…

Necessary organizational changes according to Burke-Litwin model in the head nurses system of management in healthcare and social welfare institutions - the Slovenia experience.

PubMed

Filej, Bojana; Skela-Savic, Brigita; Vicic, Visnja H; Hudorovic, Narcis

2009-05-01

To discover which changes should be implemented in the system of head nursing management in Slovenian healthcare institutions and social welfare institutions. The questionnaire was distributed to 155 head nurses of Slovenian hospitals, primary healthcare centres and social welfare institutions. The Burke-Litwin organizational change model has been used to look at which changes have to be implemented in the management system of head nurses. In hospitals head nurses have greater independent competence for planning professional training of nursing employees (p<.022) and are also more independent when it comes to selecting employees when it comes to new job openings (M=4.20, S.D.=.83, p<.004). According to the Burke-Litwin organizational change model, the elements to which changes should be introduced include "external environment" for primary healthcare centres and social welfare institutions, and "system (policies and procedures)" for primary healthcare centres. According to results of our study, changes are needed in leadership and management of nursing in primary healthcare centres. In social welfare institutions changes are only required in leadership. Organizational changes are not necessary for any element of the Burke-Litwin model for hospitals.

Education of staff--a key factor for a safe environment in day care.

PubMed

Sellström, E; Bremberg, S

2000-05-01

In order to create a safe environment in day-care settings, an understanding of factors within the organization of day care, factors which influence safety, is essential. Day-care directors in 83 daycare centres completed a mail-in survey that contained questions about professional experience, the day-care centre's organization of child safety measures and a battery of questions designed to evaluate the directors' perceptions and beliefs about child safety. The day-care directors also carried out a safety inspection at their centre. The results were analysed using the multivariate logistic regression technique. The existence of a continuing plan for continued staff education in child safety was shown to be the strongest predictor of few safety hazards in day-care centres. The day-care directors' perceptions and beliefs about injury prevention were of less importance. This study indicates that in order to promote safety in day-care settings, an on-going plan for continued staff education in child safety should be a matter of routine. The introduction of such a plan should be the concern of the individual day-care directors, policy-makers and managers at the local and national level, and health professionals working in this field.

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

PubMed

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

2015-11-01

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

RTEMS Centre - Support and Maintenance Centre to RTEMS Operating System

NASA Astrophysics Data System (ADS)

Silva, H.; Constantino, A.; Freitas, D.; Coutinho, M.; Faustino, S.; Mota, M.; Colaço, P.; Sousa, J.; Dias, L.; Damjanovic, B.; Zulianello, M.; Rufino, J.

2009-05-01

RTEMS CENTRE - Support and Maintenance Centre to RTEMS Operating System is a joint ESA/Portuguese Task Force initiative to develop a support and maintenance centre to the Real-Time Executive for Multiprocessor Systems (RTEMS). This paper gives a high level visibility of the progress, the results obtained and the future work in the RTEMS CENTRE [6] and in the RTEMS Improvement [7] projects. RTEMS CENTRE started officially in November 2006, with the RTEMS 4.6.99.2 version. A full analysis of RTEMS operating system was produced. The architecture was analysed in terms of conceptual, organizational and operational concepts. The original objectives [1] of the centre were primarily to create and maintain technical expertise and competences in this RTOS, to develop a website to provide the European Space Community an entry point for obtaining support (http://rtemscentre.edisoft.pt), to design, develop, maintain and integrate some RTEMS support tools (Timeline Tool, Configuration and Management Tools), to maintain flight libraries and Board Support Packages, to develop a strong relationship with the World RTEMS Community and finally to produce some considerations in ARINC-653, DO-178B and ECSS E-40 standards. RTEMS Improvement is the continuation of the RTEMS CENTRE. Currently the RTEMS, version 4.8.0, is being facilitated for a future qualification. In this work, the validation material is being produced following the Galileo Software Standards Development Assurance Level B [5]. RTEMS is being completely tested, errors analysed, dead and deactivated code removed and tests produced to achieve 100% statement and decision coverage of source code [2]. The SW to exploit the LEON Memory Management Unit (MMU) hardware will be also added. A brief description of the expected implementations will be given.

Airline policy for passengers requiring supplemental in-flight oxygen.

PubMed

Walker, Jacqueline; Kelly, Paul T; Beckert, Lutz

2009-05-01

The aim of this study was to investigate the current Australian/New Zealand airline policy on supplemental in-flight oxygen for passengers with lung disease. Fifty-four commercial airlines servicing international routes were surveyed. Information was gathered from airline call centres and web sites. The survey documented individual airline policy on in-flight oxygen delivery, approval schemes, equipment and cost. Of the 54 airlines contacted, 43 (81%) were able to support passengers requiring in-flight oxygen. The majority (88%) of airlines provided a cylinder for passengers to use. Airline policy for calculating the cost of in-flight oxygen differed considerably between carriers. Six (14%) airlines supplied oxygen to passengers free of charge; however, three of these airlines charged for an extra seat. Fifteen airlines (35%) charged on the basis of oxygen supplied, that is, per cylinder. Fourteen airlines (33%) had a flat rate charge per sector. This study confirmed that most airlines can accommodate passengers requiring supplemental oxygen. However, the findings highlight inconsistencies in airline policies and substantial cost differences for supplemental in-flight oxygen. We advocate an industry standardization of policy and cost of in-flight oxygen.

Lost in Space: Designing for Learning

ERIC Educational Resources Information Center

La Marca, Susan

2010-01-01

The design of a learning space, and the many factors that come together to create that space, impact on how we feel and behave in that space and ultimately how we learn. This paper will discuss the importance of mission statements, policy and planning in light of how we create spaces that are learning-driven, human-centred and flexible. Of…

Influencing Health Policy in the Antenatal and Postnatal Periods: The UK Experience

ERIC Educational Resources Information Center

Hawthorne, Joanna

2015-01-01

Since 1997, the Brazelton Centre UK has offered courses to a wide range of professionals working with newborn infants and their families. In 2009, the Neonatal Behavioral Assessment Scale was recommended in the Healthy Child Programme by the Department of Health. Both the Neonatal Behavioral Assessment Scale and the Newborn Behavioral Observations…

Representing New Math: Genre Chains and Controversy in the Saskatchewan Media

ERIC Educational Resources Information Center

LeBlanc, Robert J.

2012-01-01

The media's response to the release of "Math Instruction that Makes Sense" (2011), a research report by the Frontier Centre for Public Policy (FCPP), helped spark a public controversy and spur the Saskatchewan government to reexamine the Ministry of Education's math curriculum. The purpose of this article is to examine the CBC's…

Mentoring and Individual Learning Plans: Issues of Practice in a Period of Transition

ERIC Educational Resources Information Center

Lawy, Robert; Tedder, Michael

2011-01-01

This article draws upon research undertaken with 28 teacher education mentors, managers and trainee teachers within the SW Centre for Excellence in Teacher Training (CETT) in 2008, following the introduction of the new revised Lifelong Learning UK (LLUK) standards. The first part of the article locates and contextualises the policy context in…

Sexually Inappropriate or Abusive Behaviour among Pupils in Special Schools

ERIC Educational Resources Information Center

Fyson, Rachel

2009-01-01

In this article, Rachel Fyson of the Centre for Social Work in the School of Sociology and Social Policy at the University of Nottingham reports the findings of a study into sexually inappropriate or abusive behaviour occurring between pupils in special schools in four local authorities in England. The behaviours identified ranged from relatively…

Family-Centred Applied Behaviour Analysis Verbal Behaviour Intervention for Young Taiwanese Children with Disabilities

ERIC Educational Resources Information Center

Chu, Szu-Yin

2016-01-01

Current educational policy promotes the use of evidence-based practices to maximize children's learning outcomes. With the goal of enhancing a child's ability to learn functional language, the purpose of this study was to focus on involving families through the utilization of evidence-based intervention based upon the Applied Behaviour Analysis…

Families and Parenting: Conference Report. Proceedings of a Conference (London, England United Kingdom, September 26, 1995).

ERIC Educational Resources Information Center

Utting, David, Ed.

These proceedings contain papers presented at a conference sponsored by the Family Policy Studies Centre in London, September, 1995, which brought together professionals to describe their parenting support or education projects which were part of the Department of Health's Parenting Initiative. Conference papers discussed the role of government in…

The Flipped Classroom, Disruptive Pedagogies, Enabling Technologies and Wicked Problems: Responding to "The Bomb in the Basement"

ERIC Educational Resources Information Center

Hutchings, Maggie; Quinney, Anne

2015-01-01

The adoption of enabling technologies by universities provides unprecedented opportunities for flipping the classroom to achieve student-centred learning. While higher education policies focus on placing students at the heart of the education process, the propensity for student identities to shift from partners in learning to consumers of…

Every Which Way We Can: A Literacy and Social Inclusion Position Paper

ERIC Educational Resources Information Center

Bird, Viv; Akerman, Rodie

2005-01-01

According to a recent study by the Centre for Analysis of Social Exclusion (CASE) at the London School of Economics, poverty and social exclusion have been taken very seriously by this Government, resulting in high-profile targets, new policies and funding streams. Social exclusion was recognised to consist of multi-faceted and interlinked…

Australian Teacher Education: Inside-Out, Outside-In, Backwards and Forwards?

ERIC Educational Resources Information Center

Ling, Lorraine M.

2017-01-01

Teacher Education in Australia seems to be in a dynamic and constant cycle of review and change. Policy governing teacher education has also been eminently changeable and dynamic. To some extent this stems from three year terms for governments where a short term and expedient political view is taken. There has also been ongoing centre-periphery…

Secondary Analysis of Large-Scale Assessment Data: An Alternative to Variable-Centred Analysis

ERIC Educational Resources Information Center

Chow, Kui Foon; Kennedy, Kerry John

2014-01-01

International large-scale assessments are now part of the educational landscape in many countries and often feed into major policy decisions. Yet, such assessments also provide data sets for secondary analysis that can address key issues of concern to educators and policymakers alike. Traditionally, such secondary analyses have been based on a…

Vietnam: The Political Economy of Education in a "Socialist" Periphery

ERIC Educational Resources Information Center

London, Jonathan D.

2006-01-01

In this article I examine historic changes in the goals, conduct and outcomes of education policies in Vietnam from the 1940s to the present, under the Communist Party of Vietnam. Recent studies of Vietnam's education system centre on econometric and demographic analysis of education data dating back to the early 1990s, when Vietnam began an…

Travels in Extreme Social Mobility: How First-in-Family Students Find Their Way into and through Medical Education

ERIC Educational Resources Information Center

Southgate, Erica; Brosnan, Caragh; Lempp, Heidi; Kelly, Brian; Wright, Sarah; Outram, Sue; Bennett, Anna

2017-01-01

Higher education is understood as essential to enabling social mobility. Research and policy have centred on access to university, but recently attention has turned to the journey of social mobility itself--and its costs. Long-distance or "extreme" social mobility journeys particularly require analysis. This paper examines journeys of…

Relationships Matter: The Views of College Entrants to an Ancient Scottish University

ERIC Educational Resources Information Center

Cree, Viviene E.; Christie, Hazel; Tett, Lyn

2016-01-01

It is widely acknowledged that higher education in the UK is under pressure. As successive government's policies have reinforced the idea that higher education is a market like any other, with students as consumers of packages of education, so the pedagogical relationships upon which education have been centred are stretched to breaking-point. But…

"In and against the Museum": The Contested Spaces of Museum Education for Adults

ERIC Educational Resources Information Center

Grek, Sotiria

2009-01-01

This paper focuses on museum and gallery education for adults in Dundee, Scotland. Dundee has recently experienced a shift from being mainly working class to an educational, cultural and tourist centre. Hence, an interesting field for the examination of the educational policies and practices of the city museums/galleries and the different fashions…

Cognitive Tools and the Acquisition of Literacy. Working Paper No. 5

ERIC Educational Resources Information Center

Egan, Kieran

2001-01-01

This is the fifth paper published by The Centre for Literacy in its Working Papers on Literacy series, which presents new perspectives on literacy-related topics relevant to researchers, practitioners, and policy-makers. This paper was adapted from a longer manuscript submitted by Kieran Egan in 1999 for the UNESCO Award for Research in Adult…

Recruiting for Fitness: Qualifications and the Challenges of an Employer-Led System

ERIC Educational Resources Information Center

Lloyd, Caroline

2008-01-01

Current UK skills policy is centred on the need to drive up qualification obtainment and make the system more employer-led with Sector Skills Councils (SSCs) being given the role of articulating the "voice" of employers. Through a study of recruitment and selection processes in the fitness industry, this paper explores employers'…

"New Education" for the Congo? The Indigenist Approach, New Education and Prescriptive Pedagogy

ERIC Educational Resources Information Center

Depaepe, Marc; Simon, Frank; Vinck, Honoré

2015-01-01

This article responds to a question put forward approximately a decade ago by the history of education research group at the Katholieke Universiteit Leuven: Did the child-centred ideas of New Education, as promoted by Ovide Decroly, influence the education policy in the former Belgian colony of Congo? Naturally, ideas were circulating that could…

Globalisation and science education: the case of Sustainability by the Bay

NASA Astrophysics Data System (ADS)

Carter, Lyn; Dediwalage, Ranjith

2010-06-01

It is impossible to consider contemporary science education in isolation from globalisation as the dominant logic, rethinking and reconfiguring social and cultural life in which it is located. Carter (J Res Sci Teach 42, 561-580, 2005) calls for a close reading of policy documents, curriculum projects, research studies and a range of other science education texts using key concepts from globalisation theory to elucidate the ways in which globalisation shapes and is expressed within science education. In this paper, we consider an example from our own practice of a school-based curriculum project, Sustainable Living by the Bay, as one such instance. The first section reviews neoliberalism and neoconservativism necessary to understand how globalisation penetrates education, while the second outlines aspects of the curriculum project itself. As there were many different facets to the development and implementation of a project like Sustainable Living by the Bay, there is space only to elaborate two examples of the globalisation discourse. The first example concerns the government policy initiative that funded the project while the second example focuses on learner- centred pedagogies as globalisation's pedagogies of choice.

WHO multicentre study for the development of growth standards from fetal life to childhood: the fetal component.

PubMed

Merialdi, Mario; Widmer, Mariana; Gülmezoglu, Ahmet Metin; Abdel-Aleem, Hany; Bega, George; Benachi, Alexandra; Carroli, Guillermo; Cecatti, Jose Guilherme; Diemert, Anke; Gonzalez, Rogelio; Hecher, Kurt; Jensen, Lisa N; Johnsen, Synnøve L; Kiserud, Torvid; Kriplani, Alka; Lumbiganon, Pisake; Tabor, Ann; Talegawkar, Sameera A; Tshefu, Antoinette; Wojdyla, Daniel; Platt, Lawrence

2014-05-02

In 2006 WHO presented the infant and child growth charts suggested for universal application. However, major determinants for perinatal outcomes and postnatal growth are laid down during antenatal development. Accordingly, monitoring fetal growth in utero by ultrasonography is important both for clinical and scientific reasons. The currently used fetal growth references are derived mainly from North American and European population and may be inappropriate for international use, given possible variances in the growth rates of fetuses from different ethnic population groups. WHO has, therefore, made it a high priority to establish charts of optimal fetal growth that can be recommended worldwide. This is a multi-national study for the development of fetal growth standards for international application by assessing fetal growth in populations of different ethnic and geographic backgrounds. The study will select pregnant women of high-middle socioeconomic status with no obvious environmental constraints on growth (adequate nutritional status, non-smoking), and normal pregnancy history with no complications likely to affect fetal growth. The study will be conducted in centres from ten developing and industrialized countries: Argentina, Brazil, Democratic Republic of Congo, Denmark, Egypt, France, Germany, India, Norway, and Thailand. At each centre, 140 pregnant women will be recruited between 8 + 0 and 12 + 6 weeks of gestation. Subsequently, visits for fetal biometry will be scheduled at 14, 18, 24, 28, 32, 36, and 40 weeks (+/- 1 week) to be performed by trained ultrasonographers.The main outcome of the proposed study will be the development of fetal growth standards (either global or population specific) for international applications. The data from this study will be incorporated into obstetric practice and national health policies at country level in coordination with the activities presently conducted by WHO to implement the use of the Child Growth Standards.

Improving the safety and quality of nursing care through standardized operating procedures in Bosnia and Herzegovina.

PubMed

Ausserhofer, Dietmar; Rakic, Severin; Novo, Ahmed; Dropic, Emira; Fisekovic, Eldin; Sredic, Ana; Van Malderen, Greet

2016-06-01

We explored how selected 'positive deviant' healthcare facilities in Bosnia and Herzegovina approach the continuous development, adaptation, implementation, monitoring and evaluation of nursing-related standard operating procedures. Standardized nursing care is internationally recognized as a critical element of safe, high-quality health care; yet very little research has examined one of its key instruments: nursing-related standard operating procedures. Despite variability in Bosnia and Herzegovina's healthcare and nursing care quality, we assumed that some healthcare facilities would have developed effective strategies to elevate nursing quality and safety through the use of standard operating procedures. Guided by the 'positive deviance' approach, we used a multiple-case study design to examine a criterion sample of four facilities (two primary healthcare centres and two hospitals), collecting data via focus groups and individual interviews. In each studied facility, certification/accreditation processes were crucial to the initiation of continuous development, adaptation, implementation, monitoring and evaluation of nursing-related SOPs. In one hospital and one primary healthcare centre, nurses working in advanced roles (i.e. quality coordinators) were responsible for developing and implementing nursing-related standard operating procedures. Across the four studied institutions, we identified a consistent approach to standard operating procedures-related processes. The certification/accreditation process is enabling necessary changes in institutions' organizational cultures, empowering nurses to take on advanced roles in improving the safety and quality of nursing care. Standardizing nursing procedures is key to improve the safety and quality of nursing care. Nursing and Health Policy are needed in Bosnia and Herzegovina to establish a functioning institutional framework, including regulatory bodies, educational systems for developing nurses' capacities or the inclusion of nursing-related standard operating procedures in certification/accreditation standards. © 2016 International Council of Nurses.

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

PubMed

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

2016-03-05

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

Occupational voice demands and their impact on the call-centre industry.

PubMed

Hazlett, D E; Duffy, O M; Moorhead, S A

2009-04-20

Within the last decade there has been a growth in the call-centre industry in the UK, with a growing awareness of the voice as an important tool for successful communication. Occupational voice problems such as occupational dysphonia, in a business which relies on healthy, effective voice as the primary professional communication tool, may threaten working ability and occupational health and safety of workers. While previous studies of telephone call-agents have reported a range of voice symptoms and functional vocal health problems, there have been no studies investigating the use and impact of vocal performance in the communication industry within the UK. This study aims to address a significant gap in the evidence-base of occupational health and safety research. The objectives of the study are: 1. to investigate the work context and vocal communication demands for call-agents; 2. to evaluate call-agents' vocal health, awareness and performance; and 3. to identify key risks and training needs for employees and employers within call-centres. This is an occupational epidemiological study, which plans to recruit call-centres throughout the UK and Ireland. Data collection will consist of three components: 1. interviews with managers from each participating call-centre to assess their communication and training needs; 2. an online biopsychosocial questionnaire will be administered to investigate the work environment and vocal demands of call-agents; and 3. voice acoustic measurements of a random sample of participants using the Multi-dimensional Voice Program (MDVP). Qualitative content analysis from the interviews will identify underlying themes and issues. A multivariate analysis approach will be adopted using Structural Equation Modelling (SEM), to develop voice measurement models in determining the construct validity of potential factors contributing to occupational dysphonia. Quantitative data will be analysed using SPSS version 15. Ethical approval is granted for this study from the School of Communication, University of Ulster. The results from this study will provide the missing element of voice-based evidence, by appraising the interactional dimensions of vocal health and communicative performance. This information will be used to inform training for call-agents and to contribute to health policies within the workplace, in order to enhance vocal health.

Safety in Numbers: Mathematics Support Centres and Their Derivatives as Social Learning Spaces

ERIC Educational Resources Information Center

Solomon, Yvette; Croft, Tony; Lawson, Duncan

2010-01-01

This article reports on data gathered from second and third year mathematics undergraduates at two British universities which have developed Mathematics Support Centres, primarily with a view to supporting skills development for engineering students. However, an unforeseen consequence of the support centres was the mathematics students'…

Waste management outlook for mountain regions: Sources and solutions.

PubMed

Semernya, Larisa; Ramola, Aditi; Alfthan, Björn; Giacovelli, Claudia

2017-09-01

Following the release of the global waste management outlook in 2015, the United Nations Environment Programme (UN Environment), through its International Environmental Technology Centre, is elaborating a series of region-specific and thematic waste management outlooks that provide policy recommendations and solutions based on current practices in developing and developed countries. The Waste Management Outlook for Mountain Regions is the first report in this series. Mountain regions present unique challenges to waste management; while remoteness is often associated with costly and difficult transport of waste, the potential impact of waste pollutants is higher owing to the steep terrain and rivers transporting waste downstream. The Outlook shows that waste management in mountain regions is a cross-sectoral issue of global concern that deserves immediate attention. Noting that there is no 'one solution fits all', there is a need for a more landscape-type specific and regional research on waste management, the enhancement of policy and regulatory frameworks, and increased stakeholder engagement and awareness to achieve sustainable waste management in mountain areas. This short communication provides an overview of the key findings of the Outlook and highlights aspects that need further research. These are grouped per source of waste: Mountain communities, tourism, and mining. Issues such as waste crime, plastic pollution, and the linkages between exposure to natural disasters and waste are also presented.

Development of an analytical method for quantitative comparison of the e-waste management systems in Thailand, Laos, and China.

PubMed

Liang, Li; Sharp, Alice

2016-11-01

This study employed a set of quantitative criteria to analyse the three parameters; namely policy, process, and practice; of the respective e-waste management systems adopted in Thailand, Laos, and China. Questionnaire surveys were conducted to determine the current status of the three parameters in relation to mobile phones. A total of five, three, and six variables under Policy (P 1 ), Process (P 2 ), and Practice (P 3 ), respectively, were analysed and their weighted averages were calculated. The results showed that among the three countries surveyed, significant differences at p<0.01 were observed in all the P 1 , P 2 , and P 3 variables, except P 305 (sending e-waste to recovery centres) and P 306 (treating e-waste by retailers themselves). Based on the quantitative method developed in this study, Laos' e-waste management system received the highest scores in both P 1 average (0.130) and P 3 average (0.129). However, in the combined P total , China scored the highest (0.141), followed by Laos (0.132) and Thailand (0.121). This method could be used to assist decision makers in performing quantitative analysis of complex issues associating with e-waste management in a country. © The Author(s) 2016.

Review of atmospheric ammonia data in the context of developing technologies, changing climate, and future policy evidence needs

NASA Astrophysics Data System (ADS)

Braban, Christine; Tang, Sim; Bealey, Bill; Roberts, Elin; Stephens, Amy; Galloway, Megan; Greenwood, Sarah; Sutton, Mark; Nemitz, Eiko; Leaver, David

2017-04-01

Ambient ammonia measurements have been undertaken both in the atmosphere to understand sources, concentrations at background and vulnerable ecosystems and for long term monitoring of concentrations. As a pollutant which is projected to increase concentration in the coming decades with significant policy challenges to implementing mitigation strategies it is useful to assess what has been measured, where and why. In this study a review of the literature, has shown that ammonia measurements are frequently not publically reported and in general not reposited in the open data centres, available for research. The specific sectors where measurements have been undertaken are: agricultural point source assessments, agricultural surface exchange measurements, sensitive ecosystem monitoring, landscape/regional studies and governmental long term monitoring. Less frequently ammonia is measured as part of an intensive atmospheric chemistry field campaign. Technology is developing which means a shift from chemical denuder methods to spectroscopic techniques may be possible, however chemical denuding techniques with off-line laboratory analysis will likely be an economical approach for some time to come. This paper reviews existing datasets from the different sectors of research and integrates them for a global picture to allow both a long term understanding and facilitate comparison with future measurements.

Integrated primary health care in Australia.

PubMed

Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

2009-10-14

To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Neuroscience and Values: A Case Study Illustrating Developments in Policy, Training and Research in the UK and Internationally**

PubMed Central

Fulford, K. W. M

2011-01-01

In the current climate of dramatic advances in the neurosciences, it has been widely assumed that the diagnosis of mental disorder is a matter exclusively for value-free science. Starting from a detailed case history, this paper describes how, to the contrary, values come into the diagnosis of mental disorders, directly through the criteria at the heart of psychiatry’s most scientifically grounded classification, the American Psychiatric Association’s DSM (Diagnostic and Statistical Manual). Various possible interpretations of the prominence of values in psychiatric diagnosis are outlined. Drawing on work in the Oxford analytic tradition of philosophy, it is shown that, properly understood, the prominence of psychiatric diagnostic values reflects the necessary engagement of psychiatry with the diversity of individual human values. This interpretation opens up psychiatric diagnostic assessment to the resources of a new skills-based approach to working with complex and conflicting values (also derived from analytic philosophy) called ‘values-based practice.’ Developments in values-based practice in training, policy and research in mental health are briefly outlined. The paper concludes with an indication of how the integration of values-based with evidence-based approaches provides the basis for psychiatric practice in the twenty-first century that is both science-based and person-centred. PMID:21694963

Evidence-based health policy-making, hospital funding and health insurance.

PubMed

Palmer, G R

2000-02-07

An important goal of health services research is to improve the efficiency and effectiveness of health services through a quantitative and evidence-based approach. There are many limitations to the use of evidence in health policy-making, such as differences in what counts as evidence between the various disciplines involved, and a heavy reliance on theory in social science disciplines. Community and interest group values, ideological positions and political assessments inevitably intrude into government health policy-making. The importance of these factors is accentuated by the current absence of evidence on the impact of policy options for improving the health status of the community, and ensuring that efficiency and equity objectives for health services are also met. Analysis of recent hospital funding and private health insurance initiatives shows the limited role of evidence in the making of these decisions. Decision-making about health policy might be improved in the future by initiatives such as greater exposure of health professionals to educational inputs with a policy focus; increased contribution of doctors to health services research via special postgraduate programs; and establishing a national, multidisciplinary centre for health policy research and evaluation.

Subjective experience or objective process: understanding the gap between values and practice for involving patients in designing patient-centred care.

PubMed

Lord, Laura; Gale, Nicola

2014-01-01

Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve "patient-centred" care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK. Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method. While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organizational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system. Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice. The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

Determining the political influence of nurses who work in the field of hepatitis C: a Delphi survey.

PubMed

McKeown, Clare; Gibson, Faith

2007-07-01

The principle aim of this study was to determine the political influence and the professional profile of nurses who work in the field of hepatitis C. Hepatitis C has emerged as a major public health problem. Its growing impact on health services has led to the development and expansion of a range of specialist nursing roles in hepatitis C. The professional group has never been profiled in the current political and social context, although many nurses traverse patient, organizational and strategic levels of practice and service development. A multi-centre survey design using the Delphi technique was undertaken to gain consensus. A total of 160 nurses who work in the field of hepatitis C, were invited to participate. The target population was located from 90 sites across the United Kingdom. Data collection comprised two questionnaire rounds. Final sample included 40 participants in round 1 and 34 in round 2. The results showed strong consensus on the necessity of structural and policy changes at national and regional levels and nurses' inclusion within that process. Of note was the need for policy group representation and engagement in the commissioning agenda. Overall, the findings demonstrate that most nurses have advanced contextual understanding of the issues. There is evidence of political activities and nursing influence at local and regional levels. This is less evident at national level, where there is only a core of active members. These findings reveal nurses to be operating and thinking strategically without referencing their activities as political. Nurses should be more focused in translating strategic thinking into political activities. This should be coordinated and supported through the Hepatitis Nurse Specialist Forum to ensure nurses become increasingly visible in driving services forward at policy level. Successive governments have failed to address the serious structural problems in resource allocation, lack of public awareness and policy direction. This is where patient, organizational and strategy levels interface in hepatitis C because policy affects patients and organizations, patient level care affects policy direction and nurses can influence all three.

Artisticc: An Art and Science Integration Project to Enquire into Community Level Adaptation to Climate Change

NASA Astrophysics Data System (ADS)

Vanderlinden, J. P.; Baztan, J.

2014-12-01

The prupose of this paper is to present the "Adaptation Research a Transdisciplinary community and policy centered appoach" (ARTisticc) project. ARTisticc's goal is to apply innovative standardized transdisciplinary art and science integrative approaches to foster robust, socially, culturally and scientifically, community centred adaptation to climate change. The approach used in the project is based on the strong understanding that adaptation is: (a) still "a concept of uncertain form"; (b) a concept dealing with uncertainty; (c) a concept that calls for an analysis that goes beyond the traditional disciplinary organization of science, and; (d) an unconventional process in the realm of science and policy integration. The project is centered on case studies in France, Greenland, Russia, India, Canada, Alaska, and Senegal. In every site we jointly develop artwork while we analyzing how natural science, essentially geosciences can be used in order to better adapt in the future, how society adapt to current changes and how memories of past adaptations frames current and future processes. Artforms are mobilized in order to share scientific results with local communities and policy makers, this in a way that respects cultural specificities while empowering stakeholders, ARTISTICC translates these "real life experiments" into stories and artwork that are meaningful to those affected by climate change. The scientific results and the culturally mediated productions will thereafter be used in order to co-construct, with NGOs and policy makers, policy briefs, i.e. robust and scientifically legitimate policy recommendations regarding coastal adaptation. This co-construction process will be in itself analysed with the goal of increasing arts and science's performative functions in the universe of evidence-based policy making. The project involves scientists from natural sciences, the social sciences and the humanities, as well as artitis from the performing arts (playwriters, film directors) as well as the visual arts (photographs, designers, sculptor) working in France, Senegal, India, Russia, Greenland, Alaska, and Canada

A feasibility study with process evaluation of a preschool intervention to improve child and family lifestyle behaviours.

PubMed

McSweeney, Lorraine; Araújo-Soares, Vera; Rapley, Tim; Adamson, Ashley

2017-03-11

Around a fifth of children starting school in England are now overweight/obese. There is a paucity of interventions with the aim of obesity prevention in preschool-age children in the UK. Previous research has demonstrated some positive results in changing specific health behaviours, however, positive trends in overall obesity rates are lacking. Preschool settings may provide valuable opportunities to access children and their families not only for promoting healthy lifestyles, but also to develop and evaluate behaviour-change interventions. This paper presents a cluster randomised feasibility study of a theory based behaviour-change preschool practitioner-led intervention tested in four preschool centres in the North East of England. The primary outcome measures were to test the acceptability and feasibility of the data collection measures and intervention. Secondary measures were collected and reported for extra information. At baseline and post intervention, children's anthropometric, dietary and physical activity measures as well as family 'active' time data were collected. The preschool practitioner-led intervention included family intervention tasks such as 'family goal-setting activities' and 'cooking challenges'. Preschool activities included increasing physical activity and providing activities with the potential to change behaviour with increased knowledge of and acceptance of healthy eating. The process evaluation was an on-going monthly process and was collected in multiple forms such as questionnaires, photographs and verbal feedback. 'Gatekeeper' permission and lower-hierarchal adherence were initially a problem for recruitment and methods acceptance. However, at intervention end the preschool teachers and parents stated they found most intervention methods and activities acceptable, and some positive changes in family health behaviours were reported. However, the preschool centres appeared to have difficulties with enforcing everyday school healthy eating policies. The findings from the current study may have implications for nursery practitioners, nursery settings, Local Educational Authorities and policy makers, and contributes to the body of literature. However, further work with preschool practitioners is required to determine how personal attitudes and school policy application can be supported to implement successfully such an intervention. ISRCTN12345678 (16/02/17) retrospectively registered.

ESCAP/POPIN Working Group on Development of Population Information Centres and Network: report on the meeting held from 20 to 23 June 1984.

PubMed

1984-12-01

The Expert Working Group on the Development of Population Information Centers and Networks met in June 1984 to consider the organizational and technical aspects of the development of national population information centers in the countries in the Bangkok region, as well as national, regional and global networking. Representatives from China, India, Indonesia, Malaysia, the philippines, the Republic of Korea, Sri Lanka, Thailand and Viet Nam participated in the meeting. POPIN was represented by its coordinator. Among the major issues considered by the Working Group were the role and functions of population information centers with special reference to the positioning of centers in national population programs user-oriented products to facilitate the utilization of research findings for policy formulation and program implementation, and the possible approaches to be developed by population centers in facilitating in-country networking to extend population information services beyond capital cities to the local level. The mandate and responsibilities of national population information centers should be explicitly stated by the highest authority. Centers should contribute to the national population programs by collecting, processing and disseminating population information effectively. Greater flexibility in performing activities should be given to centers. Training of staff should be expanded; external funding should be continued; and research and evaluation techniques should be developed. Surveys of users and their needs should be periodically undertaken to determine needs. Systematic user education programs should be provided and policy makers should be informed of current research findings and policy implications. Automation of bibliographic information should be undertaken. The Asia-Pacific POPIN Newsletter produced by ESCAP should be institutionalized as a channel of information centers in the region. ESCAP should take the initiative in establishing a South Asian network along the lines of ASEAN-POPIN to facilitate exchange of ideas and information. Efforts should be directed at linking the WHO Health Literature Library and Information Serivces (HELLIS) and POPIN in the Asian and Pacific region.

Developing and testing the patient-centred innovation questionnaire for hospital nurses.

PubMed

Huang, Ching-Yuan; Weng, Rhay-Hung; Wu, Tsung-Chin; Lin, Tzu-En; Hsu, Ching-Tai; Hung, Chiu-Hsia; Tsai, Yu-Chen

2018-03-01

Develop the patient-centred innovation questionnaire for hospital nurses and establish its validity and reliability. Patient-centred care has been adopted by health care managers in their efforts to improve health care quality. It is regarded as a core concept for developing innovation. A cross-sectional study was employed to collect data from hospital nurses in Taiwan. This study was divided into two stages: pilot study and main study. In the main study, 596 valid responses were collected. This study adopted reliability analysis, exploratory factor analysis, confirmatory factor analysis and selected nurse innovation scale as a criterion to test criterion-related validity. Five-dimension patient-centred innovation questionnaire was proposed: access and practicability, co-ordination and communication, sharing power and responsibility, care continuity, family and person focus. Each dimension demonstrated a reliability of 0.89-0.98. All dimensions had acceptable convergent and discriminate validity. The patient-centred innovation questionnaire and nurse innovation scale exhibited a significantly positive correlation. Patient-centred innovation questionnaire not only had a good theoretical basis but also had sufficient reliability and construct validity, and criterion-related validity. Patient-centred innovation questionnaire could give a measure for evaluating the implementation of patient-centred care and could be used as a management tool during the process of nurse innovation. © 2017 John Wiley & Sons Ltd.

Community participation in natural resources management: reality or rhetoric? Lessons learnt from the Kasanka Game Management Area (GMA) communities, Serenje District, Zambia.

PubMed

Mutamba, Emmanuel

2004-12-01

In the developing world, the term 'participation' has in recent years become a household word in the same way that 'democracy' or 'gender' have. Development agencies are demanding increased participation in their programmes. The use of the word or its application has become a centre of debate. Due to the difficulties involved in measuring 'participation' or indeed determining levels at which participation should take place, who participates and when, many 'doubting Thomases' have questioned its effectiveness. It has, however been acknowledged in many areas that popular participation changes policies and enhances management and governance. In complex issues of natural resources management, participatory techniques have helped communities develop collective responsibilities towards management of their resources and projects. This paper discusses the complexities of community participation in natural resources management, ranging from interrelations among stakeholders to resource ownership based on the experiences in the Kasanka Game Management Area (KGMA).

Small Steps towards Student-Centred Learning

ERIC Educational Resources Information Center

Jacobs, George M.; Toh-Heng, Hwee Leng

2013-01-01

Student centred learning classroom practices are contrasted with those in teacher centred learning classrooms. The discussion focuses on the theoretical underpinnings of the former, and provides nine steps and tips on how to implement student centred learning strategies, with the aim of developing the 21st century skills of self-directed and…

What's Your Story?

ERIC Educational Resources Information Center

Stanistreet, Paul

2008-01-01

The Brighton Unemployed Centre Families Project, a community centre run by the unemployed for the unemployed, unwaged and low-waged, has run periodic creative writing classes for 15 years. The centre's creative writing scheme, Salt and Vinegar, gives centre users an opportunity to write about their lives and to develop their writing skills. The…

Sustaining the Leaders of Children's Centres: The Role of Leadership Mentoring

ERIC Educational Resources Information Center

John, Karen

2008-01-01

Leadership mentoring is a central component of the National Professional Qualification in Integrated Centre Leadership (NPQICL), which is designed to develop robust, creative and courageous children's centre leaders. Mentoring provides a safe, supportive and confidential space in which leaders can discuss the challenges of leading their centres.…

Teaching clinical skills in developing countries: are clinical skills centres the answer?

PubMed

Stark, Patsy; Fortune, F

2003-11-01

There is growing international interest in teaching clinical skills in a variety of contexts, one of which is Clinical Skills Centres. The drivers for change making Skills Centres an important adjunct to ward and ambulatory teaching come both from within and outside medical education. Educationally, self-directed learning is becoming the accepted norm, encouraging students to seek and maximize learning opportunities. There are global changes in health care practice, increased consumerism and increasing student numbers. In some countries, professional recommendations influence what is taught. Increasingly, core skills curricula and outcome objectives are being defined. This explicit definition encourages assessment of the core skills. In turn, all students require equal opportunities to learn how to practise the skills safely and competently. The moves towards interprofessional education make joint learning in a"neutral" setting, like a Clinical Skills Centre, appear particularly attractive. To discuss the potential role of Clinical Skills Centres in skills training in developing countries and to consider alternative options. Many developing countries seek to establish Clinical Skills Centres to ensure effective and reliable skills teaching. However, the model may not be appropriate,because fully equipped Clinical Skills Centres are expensive to set up, staff; and run. They are not the only way to achieve high quality clinical teaching. Suggested options are based on the philosophy and teaching methods successfully developed in Clinical Skills Centres that may fulfil the local needs to achieve low cost and high quality clinical teaching which is reflective of the local health needs and cultural expectations.

Improved nurse-parent communication in neonatal intensive care unit: evaluation and adjustment of an implementation strategy.

PubMed

Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

2014-12-01

To evaluate and adjust systematic implementation of guided family-centred care in a neonatal intensive care unit. Family-centred care is valued in neonatal intensive care units internationally, but innovative strategies are needed to realise the principles. Guided family-centred care was developed to facilitate person-centred communication by bridging the gap between theory and practice in family-centred care. Main mechanisms of guided family-centred care are structured dialogue, reflection and person-centred communication. Qualitative and quantitative data were used to monitor participatory implementation of a systematic approach to training and certification of nurses delivering guided family-centred care. Systematic implementation of guided family-centred care included workshops, supervised delivery and certification. Evaluation and adjustment of nurse adherence to guided family-centred care was conducted by monitoring (1) knowledge, (2) delivery, (3) practice uptake and (4) certification. Implementation was improved by the development of a strategic framework and by adjusting the framework according to the real-life context of a busy neonatal care unit. Promoting practice uptake was initially underestimated, but nurse guided family-centred care training was improved by increasing the visibility of the study in the unit, demonstrating intervention progress to the nurses and assuring a sense of ownership among nurse leaders and nonguided-family-centred-care-trained nurses. An adjusted framework for guided family-centred care implementation was successful in overcoming barriers and promoting facilitators. Insights gained from our pioneering work might help nurses in a similar context to reach their goals of improving family-centred care. © 2014 John Wiley & Sons Ltd.

Exploring the role of physical activity for people diagnosed with serious mental illness in Ireland.

PubMed

Cullen, C; McCann, E

2015-02-01

The aim of the study was to elicit the views and opinions of people diagnosed with serious mental illness in relation to physical activity. Ten people who were attending a community mental health centre participated in semi-structured interviews. The main results showed that participants found physical activity beneficial in terms of psychological and social well-being and perceived clear gains in relation to recovery and quality of life. Physical activity should be routinely included in plans of care and mental health policy guidelines globally should contain physical activity as a key component. Mental health policy guidelines globally should contain physical activity as a key component. The aim of the current study was to explore the subjective experiences of people diagnosed with serious mental illness (SMI) in relation to physical activity. The study was conducted using a qualitative exploratory descriptive approach. The participants (n = 10), who were outpatients attending a day centre, were interviewed to elicit their views and opinions about physical activity. The data were thematically analysed using a recognized framework. The main themes that emerged included physical activity as a meaningful activity, physical activity as a mental activity, quality of life and recovery, and perceived challenges to physical activity. The unique perspectives of service users provides fresh insights on the topic and the findings support the justification for the inclusion of physical activity in plans of care and to be contained in global mental health policy directives. © 2014 John Wiley & Sons Ltd.

Mental health policy in Kenya -an integrated approach to scaling up equitable care for poor populations.

PubMed

Kiima, David; Jenkins, Rachel

2010-06-28

Although most donor and development agency attention is focussed on communicable diseases in Kenya, the importance of non-communicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Mental illness is common but the specialist service is extremely sparse and primary care is struggling to cope with major health demands. Non health sectors e.g. education, prisons, police, community development, gender and children, regional administration and local government have significant concerns about mental health, but general health programmes have been surprisingly slow to appreciate the significance of mental health for physical health targets. Despite a people centred post colonial health delivery system, poverty and global social changes have seriously undermined equity. This project sought to meet these challenges, aiming to introduce sustainable mental health policy and implementation across the country, within the context of extremely scarce resources. A multi-faceted and comprehensive programme which combined situation appraisal to inform planning, sustained intersectoral policy dialogue at national and regional level; establishment of a health sector system for coordination, supervision and training of at each level (national, regional, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at national, regional, district and local levels; public education; and integration of mental health into health management systems. The programme has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, annual operational plans, mental health policy guidelines to accompany the general health policy, tobacco legislation, adaptation of the WHO primary care guidelines for Kenya, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, some strengthening of intersectoral liaison with police, prisons and schools, and public education about mental health. The project has demonstrated the importance of using a multi-faceted and comprehensive programme to promote sustainable system change, key elements of which include a focus on the use of rapid appropriate assessment and treatment at primary care level, strengthening the referral system, interministerial and intersectoral liaison, rehabilitation, social inclusion, promotion and advocacy to mobilize community engagement.

Nigerian resident doctors on strike: insights from and policy implications of job satisfaction among resident doctors in a Nigerian teaching hospital.

PubMed

Akinyemi, Oluwaseun; Atilola, Olayinka

2013-01-01

The Nigerian health system has been engulfed in a crisis occasioned by a deluge of strike actions by resident doctors in recent times. Dissatisfaction with conditions of service has been cited as the bone of contention. Job satisfaction studies among doctors have provided insights into the contributory factors to recurrent industrial disputes in other climes. This study aims to determine the predictors of job satisfaction among resident doctors in a tertiary healthcare centre in Nigeria. This is with a view to gain some insights into the possible contributory factors to industrial disputes and to discuss the policy implications of such findings. A semi-structured questionnaire was used to obtain socio-demographic characteristics and job-related determinants of job satisfaction among resident doctors. Logistic regression analysis was carried out to determine predictors of job satisfaction. A total of 163 resident doctors completed the study. Overall, 90 (55.2%) of the resident doctors were satisfied with their jobs. Lower age, career advancement opportunities, autonomy of practice, alignment of job with core personal and professional values, and working environment predicted job satisfaction. To restore satisfaction and possibly stem industrial disputes by resident doctors, government of Nigeria needs to sustain current wages while introducing non-financial benefits. There is a need to adopt policies geared towards increasing government spending on health especially in the area of human capacity and infrastructural development, so as to afford resident doctors opportunities for skill acquisition and career development. Copyright © 2012 John Wiley & Sons, Ltd.

[Fewer breech deliveries after implementation of a modified cephalic version protocol].

PubMed

Kuppens, Simone M I; Francois, Anne M H; Hasaart, Tom H M; van der Donk, Maria W P; Pop, Victor J M

2010-01-01

To investigate the effect of implementation of a number of process policy guidelines (protocol), on the success rate of external cephalic version (ECV) for breech presentation. Prospective study. During a 3-year period (2004-2006) a standardized protocol for an ECV consultation was developed, evaluated and adapted. After implementing this modified protocol as 'process policy guidelines', the effect on the rate of successful ECV was prospectively evaluated during the period 1 January 2007-31 July 2008. Success was defined as cephalic presentation (ultrasound) immediately after ECV. A secondary outcome measure was the elective caesarean section rate for breech presentation. The rate of successful ECV increased significantly from 47% (110/236 pregnant women) in the period January 2004-December 2006 to 61% (85/139, p = 0.006) in the period January 2007-July 2008. Patient characteristics were similar in both groups, with the exception of 2 subgroups of term of version. The increase was preferentially found in nulliparous and multiparous women with frank breech. Nulliparity, frank breech, anterior placenta and low birth weight were associated with a lower success rate of ECV. The term of pregnancy at which ECV was performed did not seem to affect the success rate. Implementing the process policy guidelines increased the number of cephalic presentations at delivery and decreased the rate of elective caesarean sections for breech presentation from 39% to 27% (p = 0.03). The number needed to treat to prevent 1 elective caesarean section by ECV according to the process policy guidelines was 8. After implementation of the process policy guidelines, the success rate of ECV increased considerably. The rate of elective caesarean section for breech presentation declined. These findings are in favour of establishing specialized ECV centres in the Netherlands.

Public-Private Policy Change and Its Influence on the Linkage of Agricultural Research, Extension and Farmers in Iran

ERIC Educational Resources Information Center

Karamidehkordi, Esmail

2013-01-01

Purpose: This article aims to show the linkage of Iranian agricultural research centres with extension and farmers, using three case studies in 1999, 2005 and 2010. Design/methodology/approach: The data were collected through document analyses, structured and semi-structured interviews and observations. Findings: The 1999 and 2005 cases were…

Power, Ideology, Politics: "The Elephant in the Room" in the Relationship between Assessment and Learning

ERIC Educational Resources Information Center

Flórez Petour, María Teresa

2017-01-01

María Teresa Flórez Petour is an assistant professor and head of research in the Pedagogical Studies Department of the University of Chile. She also coordinates the Department's Assessment Study Group, and is a research associate at the Oxford University Centre for Educational Assessment. Her research interests are related to assessment policy in…

Behaviour and Beliefs of Volunteer Literacy Tutors. Working Paper No. 3

ERIC Educational Resources Information Center

Hambly, Catherine

2011-01-01

This is the third paper published by The Centre for Literacy in its Working Papers in Literacy series, which presents fresh perspectives on literacy-related issues. The topics are relevant both to other researchers, to practitioners in the field, and to policy-makers. This paper examines the behaviours and beliefs of a group of volunteer tutors to…

Measuring and Maximising Research Impact in Applied Social Science Research Settings. Good Practice Guide

ERIC Educational Resources Information Center

Stanwick, John; Hargreaves, Jo

2012-01-01

This guide describes the National Centre for Vocational Education Research (NCVER) approach to measuring impact using examples from its own case studies, as well as showing how to maximise the impact of applied social science research. Applied social science research needs to demonstrate that it is relevant and useful both to public policy and…

Culture Clash: Mentoring Student Literacy Educators in a Marketised and Instrumentalist Further Education Policyscape

ERIC Educational Resources Information Center

Garbett, Georgina; Orrock, Deborah; Smith, Rob

2013-01-01

At the centre of the study on which this article is based, there is a sense of cultural collision. While from a global perspective, Literacy education has an exciting and radical pedigree, the teaching of Literacy in England has been harnessed to an explicitly instrumentalist policy agenda since the introduction of the Adult Literacy Core…

Language Use, and Language Policy and Planning in Hong Kong

ERIC Educational Resources Information Center

Poon, Anita Y. K.

2010-01-01

This monograph provides an overview of the language situation in Hong Kong from a historical perspective. Hong Kong has evolved in the past 167 years from a small fishing port to an international financial centre which forms part of a financial network hailed by "Time Magazine" as Ny.Lon.Kong (i.e. New York-London-Hong Kong). Hong Kong…

Leaving Education Early: Putting Vocational Education and Training Centre Stage. Volume II: Evaluating Policy Impact. Cedefop Research Paper. No 58

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2016

2016-01-01

This Cedefop study focuses on the contribution that vocational education and training (VET) can make to reducing early leaving from education and training (ELET). Published in two volumes, the first is dedicated to understanding better the learning pathways of young students, providing measurements of early leaving in VET, and understanding the…

Voices of Divergence: Resistance, Contestation and the Shaping of Namibia's Teacher Education, 1990-2010

ERIC Educational Resources Information Center

Nyambe, John; Wilmot, Di

2015-01-01

This paper reports on an aspect of a broader study that investigated teacher educators' uptake of learner-centred pedagogy in post-apartheid Namibia. The paper shares part of the study that illuminated the path traversed by Namibian teacher education policy from 1990 to 2010, two decades into the country's post-apartheid self-rule. It argues that,…